Apparently April is not only National Poetry Month, but also Caesarean Awareness Month and blog posts (like this one) are popping up all over talking about why people believe in “non-intervention.” One thing I’ve noticed is that some of these posts refer to the idea that the World Health Organization (WHO) recommends a 15% c-section rate. The problem is, the World Health Organization doesn’t actually have any reason for that rate.
The introduction to this article in the WHO medical journal states:
There is no consensus on the “optimal” rate of caesarean delivery at the population level. Although values between 5% and 15% of live births have been suggested, the basis on which these thresholds have been proposed is not clear.
Earlier editions of this handbook set a minimum (5%) and a maximum (15%) acceptable level for caesarean section. Although WHO has recommended since 1985 that the rate not exceed 10–15% (125), there is no empirical evidence for an optimum percentage or range of percentages, despite a growing body of research that shows a negative effect of high rates (126-128). It should be noted that the proposed upper limit of 15% is not a target to be achieved but rather a threshold not to be exceeded. Nevertheless, the rates in most developed countries and in many urban areas of lesser-developed countries are above that threshold. Ultimately, what matters most is that all women who need caesarean sections actually receive them.
Of course bloggers and natural birth fanatics also say that they aren’t against necessary c-sections, only the unnecessary ones. But how do you tell if a c-section was really necessary? Do you wait until it is so late in the stage that the baby is one step from death and may have already started to suffer brain damage? A properly timed necessary c-section will result in a healthy baby and a mother who may well go home and think she had an “unnecessarian.”
The idea that a particular c-section was unnecessary will be reinforced by random bloggers and internet friends who are busy trying to convince themselves that natural births are totally safe. When people want to believe something they’ll find the bloggers and authors who support their ideas. There are plenty of “communities” online where phrases like “cascade of intervention,” “babies aren’t library books, they don’t have due dates” and “you can’t grow a baby too big” are floated around like cult mantras. Occasional comments about the science get rejected and newcomers assume the lack of a different opinion is because there really is a consensus about this type of thing, rather than because of heavy censoring. Stories of deaths of babies that could have been saved by a timely c-section will be removed or brushed aside as trying to scare people.
Being a parent is hard. It always has been and always will but I write this post about caesarean rates in the hope that it can help remind women that they aren’t responsible for trying to lower the c-section rate and they don’t have to believe the mothering communities that would tell them they should have somehow managed without it. C-sections are not something to be ashamed of. They are not a sign of failing. They are not because you did not “trust birth” enough. You are the envy of thousands of years worth of mothers who lost their babies due to what is inherently a dangerous process. You had access to medical assistance and accepted it.