It was alarming to read reports that the actor Kate Winslet was "so completely traumatised" by the fact that she "hadn't given birth" to her first child that she lied about it. This week G2 carried a lengthy piece by Lucy Atkins that identified with Winslet's sense of failure.
Next month the French birth "expert" Michel Odent publishes his book, The Caesarean, which rails against the rise in caesarean births and claims, on what seem totally unscientific grounds, that caesareans may incapacitate a child's ability to love in later life - and thus they may spell the end of civilisation as we know it. His mission is to condemn the caesarean to "the history books", as if it were an unnecessary evil rather than a remarkable medical advance. Presumably his sequel will be an examination of maternal and neo-natal mortality rates in the 19th century. No wonder some women feel that caesareans equal failure.
I might even buy a copy of Odent's book to keep me amused in hospital when, in 10 weeks, I head into the operating theatre to take delivery of child number three. Submitting to major abdominal surgery for the third time in seven years is not something I would choose to do, but the subversive part of me enjoys the look of distaste and disbelief when I tell people I am "too posh to push": a statement so at odds with reality that it is laughable.
The debate about caesarean birth has taken on a dimension that would be unthinkable in any other area of medical progress. People who conceive via IVF are delighted to have children and don't think of their child as any less precious or their birth as any less "real" because of high levels of medical intervention early in the process. Nobody would suggest that, given an ageing population, the fitting of pacemakers should cease as not all of them may be "necessary".
Yet for some reason, an increasingly common method of birth is regarded as being inherently bad, although medical statistics clearly demonstrate that in terms of neo-natal mortality and maternal morbidity, it is literally a lifesaver. The fact that Winslet and Atkins can be made to feel "failures" is shocking. Birth, if nothing else, should be all about results - not transitory experiences. Seeing your child for the first time is magical, whether you have pushed it out in a field of daisies, were awake on the operating table, under general anaesthetic, or adopting. Like all magic it can be also be unsettling and weird. You do not have to be in mortal danger and great pain to experience that thrill and you do not have to be traumatised by a caesarean to find bonding with your newborn difficult.
There is a new imperative to lower caesarean rates - which are now one in five, or one in four in London - that is not simply to do with health. Caesareans are relatively expensive, they mean that women "bed-block" for days rather than hours, and they require doctors as well as midwives and nurses. There is a legitimate debate about "overuse", but it should be about balancing risk with resource and should stay away from the emotional minefield of putting a qualitative measure on the experience of birth.
Men like Odent, and the tabloid editors who coined the offensively judgmental "too posh" phrase, may have our best interests at heart, but they potentially do great damage. What is particularly noxious about the current debate is that it detracts from providing balanced information to mothers-to-be. A natural birth, if you can manage one, is better for you. According to surveys, a caesarean could make you less likely to have another child, it could lead to more infection and it could make subsequent pregnancies more perilous.
But where there is risk to the baby, it can sometimes be minimised by a caesarean, and this should be wholeheartedly celebrated. The fact that the neo-natal mortality rate is now about five per thousand births compared to nearer 20 per thousand in 1950, is significant progress. Likewise the incidence of maternal morbidity is now so low that it makes the papers rather than popular novels.
It is very possible that I would have graced a Victorian mortuary slab rather early in life if my experiences of one emergency c-section for a 10lb 3oz baby and one for a breech had been left to nature. I am happy to take my chances with a third caesarean, though mild anxieties about dying on the table are never far away. But if all goes well I will certainly feel that I have given birth, having the scars to prove it. And hopefully, I won't have to sit on a packet of frozen peas for a month. But most importantly there will be a baby.
We fetishise birth so much - antenatal classes, acres of literature about birth plans, and the malevolent statistics about delivery methods - that the sudden presence of a baby seems an inconvenience to the business of birth. The few hours we spend in labour or under the surgeon's knife can be many things, but ultimately - though to realise it is a shock - it is not about our own experience, but about what doctors might call "a good outcome". I would take a baby over a birth any day of the week.
