The first time I ever fainted was at school watching an educational video on childbirth. I remember the pink, the placenta and the moans, I closed my mind and my eyes and tipped backwards off my stool, where I remained unnoticed until the end of class. From that point on, I reached for the remote whenever a pregnant woman on TV let out a gasp, and used to pass pregnant women on the street and think only, 'How can you bear the thought of delivery day?'
Though I reached the stage of wanting to be a mother, I still didn't feel comfortable about the birth. By then, friends and friends of friends had started having children and some had ended up agonised, incontinent and so deeply traumatised by their natural deliveries that they likened them to a car crash. For me, then, the caesarean section seemed straight from heaven. Controlled, relatively painless, no writhing or ripping, no mess, no moaning.
Thankfully, my children were born in a sympathetic London teaching hospital. When I became pregnant five years ago, I asked for a caesarean and was treated very well. My obstetrician reeled off the risks, which included infection, blood clots and bladder injuries, but assured me that, because of my age, weight and general health, none of these was likely to happen. She also conceded that no form of delivery was risk-free. When I remained adamant, I was given a date for an elective caesarean at 39 weeks. Simple as that. I sighed huge relief and loved the rest of the pregnancy.
As I went into labour a couple of days before D-day, I was asked again if I wanted to change my mind, as my body had already started the process naturally. I toyed with the idea for all of 20 seconds before a massive contraction coincided with the chilling groans of the woman next door ('Just get it out,' she begged. 'I want a caesarean'). I quickly reverted to Plan A. As I was wheeled into surgery, I clearly remember my husband asking if I was scared and truthfully telling him I wasn't, not a bit. There was a team of experts around me, an epidural to block the pain, I was only excited.
Our daughter, Ruby, was gently lifted out, round and robust, 15 minutes later. She breastfed as soon as she was given to me and continued to do so for the next 18 months. Less than two years later, her sister Tara was born in a planned caesarean at 39 weeks. She also breastfed instantly and despite the predictions of some we all bonded just fine. Both are cuddly, kissable and very affectionate.
(This is contrary to natural childbirth pioneer Michel Odent's recent suggestion that children born by caesarean may be 'less able to love'. He cites the high crime rate in São Paulo, caesarean city, though I'd argue socio-economic factors probably play a larger part.)
This is a piece in praise of the caesarean, but let's make it clear that most women aren't like me. The rise and rise of the C-section (now accounting for one in four pregnancies) is not because pregnant women everywhere are crossing their legs, wishing to schedule the deliveries around their business meetings (if you wanted to be up on your feet and back at work the following day, you'd choose a natural delivery rather than surgery).
Cases like mine, where a woman asks for a caesarean, make up only 7 per cent of the total number carried out. The vast majority are given because of fears for the baby's well-being, failure of a labour to progress and breech births. Perhaps doctors are quicker to wheel women off to surgery these days because it can be a safer, cleaner, quicker option than a protracted labour.
It can also be cheaper. Though caesareans are more expensive than straightforward deliveries, the high price of lawsuits when babies are starved of oxygen at birth makes it hard to know what costs the most. Just one day before the National Institute for Clinical Excellence (Nice) report calling for a reduction in caesareans, the parents of Emma Hubery, who suffered severe cerebral palsy during her birth, were awarded £3.5 million compensation. Medical experts admitted that Emma's condition would have been prevented if she had been delivered 90 minutes earlier. Eight more cases like this a year equals the entire annual cost of caesarean sections.
(Oh, and one more word about cost. Without wishing to go all middle England on you, I pay my taxes, don't smoke, drink, drive fast, jump out of aeroplanes, climb mountains or dangle from pieces of elastic. I've never been to hospital before or since, and I feel it was my right to have my children in a way I felt safe.)
Isn't it ironic that, instead of placing the emphasis on avoiding caesareans in the cases when women really don't want them (something which would require more midwives and more midwife-led units in order to be safe), the Nice report is targeting the tiny handful of women who do ? At the same time, rather bizarrely, Health Minister Yvette Cooper has promised a new emphasis on 'choice' in maternity units - including greater opportunity to choose a home birth.
In other words, if you are the kind of woman who is frightened of hospitals, white coats and medical intervention, and who likes the idea of deep breathing and delivering at home on the carpet, you'll be given every assistance. If , like me, however, you really would rather have a section - then you'll be told to pull yourself together and get pushing.
Is there anything, apart from simple economics, that makes home births 'good' and caesareans 'bad'? Both carry their risks. And, of course, caesareans aren't for everyone. Witness Kate Winslet, finally admitting she had lied to the world about the birth of her first child. Though Mia was delivered safely by emergency section, Kate felt so 'completely traumatised' and 'unable to enter the powerful women's club', she chose to tell the press it was a natural delivery. In fact, she only came clean having redeemed herself by pushing out her next baby all on her own.
If Kate's 'trauma' proves anything, it is just how far removed we've become from what's important. There is so much judgment, too much politics and far too many headlines around childbirth - gas and air 'brave', epidural 'bad', forceps 'dodgy', caesarean 'disastrous' - that thousands of women embarking on motherhood must feel like failures from day one. (I wonder what that does to their ability to 'bond', to breastfeed and to love?)
The Nice report has not only whipped away a woman's genuine right to choose, but also fuelled the notion that caesareans are a kind of failure.
To state the obvious, the aim of childbirth is to deliver a baby safely - end of story. It has nothing to do with your skills as a mother.
Ruby and Tara don't care how they were born. They care about how they're raised - how much time I spend with them, how much patience I have, how I talk to them, whether I'm listening, what's for tea, who gets to drink from the pink straw. That's what matters, and what I'll be judged on - not the way my children were born.
