Scars remind us where we've been. They don't have to dictate where we're going

Monday, April 4, 2011

What does it mean to "elect" a cesarean?

The comments on yesterday's post really got me thinking about what it means to have an elective cesarean. Of course, there are times--prolapsed, cord, complete placenta previa, transverse lie, etc--when a cesarean is absolutely indicated.  Then there are times when, on a doctor's advice or for her own personal reasons, a woman may choose a cesarean when one of these absolute indicators is absent.

I have to admit, I never really knew what the exact medical reason behind A's cesarean was.  At one prenatal during E's pregnancy, I asked my midwives and they showed me in my medical records that A's delivery was recorded as an elective primary cesarean. WHAT?!?!  That is not what I remember from his birth.  What I remember is my doctor telling me that my pelvis was absolutely too narrow, my induction didn't work and it probably wouldn't, that we could try again but the baby would probably get stuck and I would require an emergency cesarean. Sure, knowing what I know now, I absolutely would not have consented to the cesarean.  But with the information I had then, and being told that I basically would be endangering my baby's life, I consented to the cesarean.  And it was elective.

E's cesarean was medically indicated, and even though I consented to the cesarean, I absolutely do not consider it elective.  I want to be sure that I am completely clear with everyone reading this blog.  I really would love for T to be born vaginally.  However, if at any point during my pregnancy or labor it becomes clear that a cesarean is the safer route for me or baby, I will 100% without hesitation march myself into that OR, climb on the table and have a cesarean.  And K and B will attend my HBA3C.  My primary goal in all of my pregnancies and births is to have a safe, empowering pregnancy and delivery--a vaginal birth would be wonderful, amazing, beautiful, every positive word I can think of.  But so would a cesarean under the same kinds of circumstances as E's birth.  The reason I am even considering a HBAMC is because based on the research I've done, it is safer for me to attempt a vaginal delivery than to consent to an ERC for no other reason than I have been sectioned before.  If another reason does arise during my pregnancy or labor that would make a cesarean a safer method of delivery for myself or T, then that is what I will consent to. And it won't be elective.

I hope I am also clear in that, while I really do encourage women to explore all their options with regards to the delivery of their children including home birth, VBAC/HBAC, etc, I am completely supportive of whatever decision a woman makes regarding the delivery of her children.  Her birth is not my birth and vice versa--I only care that she has all the information she needs to make what she feels is the best decision for herself and her baby.  I feel like I am being a little redundant in saying this, but I also want to make sure there is no misunderstanding my position.  I believe a woman is empowered when she feels respected, heard and validated throughout the birthing process--and that is what matters to me.


  1. "I believe a woman is empowered when she feels respected, heard and validated throughout the birthing process--and that is what matters to me." That's exactly it. Even outside of birth, isn't that all we want? Thanks for such an eloquent, compassionate post.

  2. Thank you so much, sage :) And yes, exactly, even outside birth