As you might expect I have a bit of an issue with today’s news story about caesareans affecting human evolution mainly because I just feel like it’s a huge dollop of negativity.
Women are already pretty fearful of giving birth, doubting their body’s abilities and trying to get their head around their midwife appointments, the many conflicting messages about birth, about where to have their baby, about inductions and pain relief. Birth is seen to be dangerous, where medical interventions are king and instinct and waiting are questioned. Of course interventions are bloody brilliant and they do save lives but, thankfully, birth is not the big dangerous creature it is built up to be. I am more of a fan of medical observation and waiting, with an abundance of positive support and encouragement while the interventions wait in the wings unless needed or chosen by the birthing woman.
Very rarely will there be a serious disparity between the dimensions of a baby’s head and a woman’s pelvis. What can make a huge difference is positioning and gravity – if a baby is back to back during labour, descent through the pelvis is harder. Gravity can help babies get into a better position. Induction, speeding up labour and epidurals can all contribute to babies needing some assistance because they are not lined up to fit through the pelvis if they are back to back and women are often expected to be on their back for induction and epidurals – that’s why I spout on about being upright and using as much gravity as possible to give a baby the space he needs to get into a better position.
The research that hit the news this morning is not based on any evidence – IT IS PURELY THEORETICAL but this could be seen as just another negative message about birth. There are many reasons for an unplanned caesarean and that is what your midwife is there for – to monitor both you and your baby during pregnancy and during labour, to keep you both healthy and to look for signs that an intervention may be needed.
I passionately believe that every labouring woman should be supported, encouraged and informed with good, positive information and skills, to know how to breathe to stay calm and how to use positions whether they are in a pool, walking around or on a bed with an epidural because it all matters. I also passionately believe in supporting women to make choices about the right birth for them – caesareans can be a fantastic experience.
While Dr Mitteröcker, who published the research, says the idea is something to consider in discussions about the “right” level of C-sections I think it is also important not to let this increase fear about birth and undermine the belief in our body’s ability to birth. Some babies will need help but many won’t. We need more positivity about birth as well as more realistic expectations of how we can manage and of what we can achieve. I would really like to see more discussion about birth options, for more labouring women to be treated as an individual and for more investment in midwives, good birth preparation and in supportive birth environments and homebirths. This could all lead to fewer caesareans and less trauma for labouring women and their partners. Changes are happening with some brilliant birth centres popping up around the country, with excellent midwives and birth professionals and more women are active in labour now but the message is still centred on birth being hazardous.
Birth can be amazing. Birth can also be a long, hard slog when women can need to dig deep to stay positive, to keep going, to work with contractions and maybe to make decisions – and they need to be better supported to be able to do this. I also think that Caesareans should be celebrated because they do save lives, they do provide options and it’s no less of a birth.