The bumpiness of the playing field...

There’s something I’ve been wondering for a while, and it to do with the way we talk about caesareans.

I know I’m not the only person who wonders it, because I’ve heard other people say similar things, but I’ve not yet heard a good answer to it.

What I’m wondering is this:

In what state does a baby need to be born by caesarean in order for us to say, “Oh, maybe we shouldn’t have done that caesarean. Perhaps that baby should have been born physiologically”?

Because when a baby is born in less-than-optimal condition by caesarean section, people say, “Wow, it was a good job we did a caesarean … that baby really needed us to get it out”.

And when a baby is born looking really healthy, happy and alert by caesarean section, people say, “Wow, it was a good job we did a caesarean … we managed to get that baby out while it was still in good condition”.

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Both of these sentiments are common in maternity care settings.

But the lack of a comparable comment about physiological birth raises an important point about the bumpiness of the playing field.

About our culture’s attitude to the different approaches to birth.

And perhaps about our dislike of accepting that some decisions might not, in retrospect, have been the only or best options.

Although caesarean operations can be lifesaving, we know a couple of things.

One, that they are overused and two, that they carry greater risks and side effects and far fewer advantages than physiological birth.

It is for these reasons that so many countries, agencies and organisations are looking for ways to reduce the caesarean section rate.

I’d like to humbly suggest that deeper thinking about the way we think and speak about birth might help us take a step towards this goal.