Monday, October 4, 2010

Defining "Unnecessary"

Many women feel that their cesarean section was "unnecessary". They felt that, given a different set of criteria and birth setting, they should have been allowed to have a vaginal birth. Recently a obstetrician wrote this piece titled "The Myth of the Unnecessary Cesarean". In this article he explains how he finds the term tiring and incorrect. But for many women, his arguments fall flat.

He argues that one could not conclusively say the cesarean was necessary or unnecessary since you cannot guarantee birth outcome either way. Sure, "hindsight is 20/20" plays a big role in the term "unnecessary", but that does not mean it cannot be a legitimate term. If the cesarean, that was medically indicated at the time of incision, was precipitated by a series of interventions that were NOT indicated, would this not be deemed unnecessary? No one is saying that definitively the woman would have gone onto a vaginal birth. They are just saying given the terms of their OWN birth, they felt it was not necessary to have been coerced/rushed into the cesarean.

And as to elective cesareans, it could be said that many of them are "unnecessary" as well. It could be possible that a woman who is having an "elective" cesarean was not given true informed consent (realities of risk for this pregnancy, future pregnancies and a realistic expectation of recovery) or was expected/forced to have a repeat procedure due to lack of support for VBAC (vaginal birth after cesarean).

Birthing Beautiful Ideas also has an eloquent post devoted to this topic. I think this blogger also understands the sentiment of women who have had cesarean birth and the emotional/physiological/psychological impact of an "unnecessary" one.