‘At Least I Have a Healthy Baby’ and The Birth Experience

by Asheya on August 19, 2010

Many women reassure themselves after a cesarean section that even though they did not have the vaginal birth experience they had envisioned, at least they have a healthy baby. The process leading to the decision to do a c-section is often frightening, as mothers fear for the lives of their babies. The medical model of care seems to generally support this view, that the health of the baby is the reason cesarean sections are performed, and that the baby was saved through the surgery.

The fact is that at least 11% of cesarean sections in Canada are done unnecessarily, either because the medical model of care with high interventions stressed the mom and therefore the baby to the point where the baby was in distress, or because the use of such things as continuous electronic fetal monitoring leads to false conclusions about the baby being in distress, or because of denial of vaginal birth since it is considered too risky or there is no skilled care provider (i.e. breech, vaginal birth after cesarean section).

It can seem that the natural birth movement has a different value, which emphasizes the mother’s experiences during birth as the factor of primary importance, with a cesarean section as an extremely last resort. Some care providers and mothers feel that this perspective leaves women feeling guilty, angry, and traumatized when their birth didn’t go as planned and the result is a cesarean section. Care providers may also worry that this perspective will prevent the mother from seeking or accepting medical help when she actually needs it, as the pursuit of the birth experience is perceived as a primary goal.

We know that creating environments and supports for mothers and babies in labour that do not disturb or intervene in birth does result in less cesarean sections, greater satisfaction, and better health outcomes. We also know that having medical help available and the ability to perform cesarean sections can be life-saving.

What if we started framing these ideas in different ways? Could we approach this from a different angle, that would result in safer and healthier birth and a better experience for both mom and baby?

What if we asked:

What about the baby’s experience?

and

What about a healthy mom?

After a cesarean section you cannot say, “At least you have a healthy mom.” The c-section itself is considered to be a morbidity (an injury) to the mother.

Mental health is also an important consideration in what kind of care is provided to the mother during labour and birth, as postpartum depression affects both mother and baby.

If we were really thinking about the baby’s experience of labour and birth, there are a lot of things we might refrain from doing, either because we know it stresses the baby or because we don’t know what affect it has on the baby, which means it could be having a negative effect.

For instance, induction. We know that induction causes stronger, longer contractions that are harder for the baby to handle. Birth is a challenging journey for the mom; there is no reason to assume it’s not challenging for the baby as well. Being squeezed and pushed between pelvic bones is probably not an extremely pleasant experience. Why make this experience harder for the baby?

What about an epidural? We know to some degree how this changes the mom’s experience; it usually takes the pain away. But how does this change the baby’s experience? Does it make the baby’s experience less painful or more? Does it make birth harder or easier for the baby?

Now let’s look at these two things from a ‘healthy mom’ perspective. We know that labours that are induced have a much higher chance of ending in cesarean section than those that aren’t. Induction interferes with the natural hormones and endorphins in labour, and while in the short term there do not seem to be any ill health effects from this, we have no idea what kind of long term health effects this is creating, for the mom or the baby.

The use of epidurals also seems to lead to higher c-section rates, and again interferes with the natural labour hormones.

A cesarean section also detracts from a baby’s health and experience; there are labour hormones in effect during pushing that help to create natural highs and encourage bonding between mom and baby, and decrease feelings of pain. Babies born by c-section miss out on important bacteria that they acquire in the birth canal, which provides them with the right bacteria for their digestive system. They also tend to have more respiratory problems, both short and long term.

The point is, it’s not just about the mom’s experience, whether she wants a pain-free experience or a totally drug-free birth, and it’s not just about having a healthy baby: it’s about the whole picture.

It’s about having a healthy baby and a healthy mom.
It’s about both the mom and the baby having the best birth experience possible.

What might happen if we, as in society as a whole, start thinking about these things for each birth, and encouraging each mother to think not only about her baby’s health but her own health, and not only her own experience of birth but her baby’s experience of birth?

What might happen if we, you and me and moms who are receiving maternity care, started presenting these ideas to maternity care providers? How might that change the system? Is the experience of the baby really being considered the way maternity care is practiced right now? Is the short and long-term health of the mom a primary concern, so that optimal supports and environments are being provided for the physical and psychological well-being of the birthing mom?

I think that if mothers, maternity care providers, and everyone else surrounding the pregnant and new mom started placing emphasis on both the health of the baby and the mom, and the experience of the mom and the baby, that we would see an improvement in both birth outcomes, like cesarean section rates, and in how mothers feel about their birth experience. Perhaps these ideas can contribute to creating pregnancy and birth environments in Canada that support truly healthy, truly optimal birth for both baby and mom.

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