Don't Know Nothin Bout Birthin No Babies

As little as a month ago, I hadn't considered the possibility that we'd deliver our baby by cesarean section. Our baby-in-waiting had long been sitting head down inside Momma, nosing towards the exit, as it were. Everything was on track, everyone was happy until, without warning, a visit to the obstetrics lab revealed that our Baby Bean had flipped into a complete breech position, at which point things got a little uncomfortable for all concerned.

The sono-doc immediately, if subtly, started counseling us as though something were wrong. A c-section would be needed, and soon (foregoing the clichéd "stat," thankfully). He would call our regular OB, who would certainly get back to us that day to move things forward. At 38 weeks, every all-star check-up and test suddenly got flushed by a late-term sonogram.

Apparently we are not alone in getting pushed down a surgical path. Almost a third of all births in the United States occurred through cesarean delivery in 2005, up 46 percent over the last decade. Clearly, breeched babies and birth complications are not skyrocketing in our advanced society, and yet American women are getting cut open faster than Whitechapel courtesans rather than squeeze a kid through the old-fashioned potato shoot.

When it comes to birthing babies, cesarean sections are the quintessential American procedure. From La-Z-Boys to Escalades, nobody expends more effort making things effortless. So it's no surprise that our default approach to birth is usually, "why feel it if you don't have to?" Pain avoidance is not the worst mantra in the world, but it's disturbing to me how quickly it seems to shut out all other options.

The perversity is that, once pain is removed from the equation, invasive surgery becomes inherently preferred to a natural birth. C-sections are the Tivo of childbirth, allowing everyone to skip the boring parts and deliver the baby on our schedule rather than the baby's. What on-the-go Mom wouldn't love typing "11:30. Have baby" into her Treo? And what doctor wouldn't prefer to avoid a late-night delivery? Fewer and fewer, apparently.

We absolutely adore our OB and count our blessings to have such a proficient and emotionally-connected doctor guiding us through pregnancy. Yet even he is subject to the demands of the Medical Industrial Complex. Our doctor isn't pushing a c-section so that he can ensure a Saturday tee time or an uninterrupted dinner, but he is regulated by an insurance industry that prefers a complex, controlled birth to a natural and unregulated one. He conducts his services within a hospital industry that prefers short and expensive procedures and penalizes doctors who don't do enough of them. And he is informed by an obstetrics industry that is largely ignorant of breech birthing techniques. All this, despite substantial health and financial concerns about elective c-sections.

So, the fact that our OB allowed us time to get Bean flipped came as something of a surprise. The fact that he told us we had a 1% chance of success was not. That may well be the rate among people who do not try, or the rate reported to obstetricians who warn parents against it. The medical industry is continuously poking and prodding its way to identifying every flaw and problem in our bodies, but is strangely ignorant of how bodies actually work.

In the 70's, that meant a mother might just get knocked out and deliver while unconscious. Today's epidural applications mean that moms can get slit open with the same detached numbness as a regular birth. Invasive surgery isn't a cozy cuddle by the fire, but removing pain without losing consciousness makes it a pretty compelling option.

And doctors don't just want to regulate their schedule, they'd prefer to avoid lawsuits too. For a country that pokes and prods its way to identify every flaw and problem, there aren't a lot of doctors that know what to do about them. The human genome, we've got that mapped, but don't even try to find a practitioner who can deliver a baby ass-first. The few who've attempted such barbarity have had a chunk of their gray matter removed by the insurance companies (solely for liability reasons, of course).

There are always other options. If we’d really wanted to push Bean out of the airlock, plenty of doulas could assist a natural childbirth regardless of which appendage made the first appearance. On the downside, that would mean birthing at home, being away from our trusted OB, and incurring a lot more risk (or “uncertainty,” in less loaded terms).

But would it have created more risk, or just different risks? As it was, we opted for the c-section. The birth, while glorious and miraculous in its own right, also yanked our baby from her mother’s gaping stomach well in arrears of her anticipated development. Medical science, which had made her delivery painless and possible, had also missed the boat on her prenatal advancement by about a pound and two weeks. Had we allowed nature to run its course, would our baby have struggled to breath at birth, or sleep through her first two weeks of development? Or could the complications from breech have created a more damaging environment for our daughter? Only Dr. Spock knows for sure, although it seems reasonable to say that the cesarean jump-started a process that the child was as yet unwilling to commit to.

Since we tallied another birth for the cesarean crowd, this also means that our next child will likely contribute towards this trend (Doctors are loathe to deliver a “v-back” once their procedures have weakened the uterus). One day, vaginal births may fall into the same atavistic category as ass-slapped newborns and cigar-chomping dads, and that’s not a wholly terrible thing if it means striking the word “episiotomy” from the Big Book of Post-Partum Recovery Fun. But there’s much to be said for the wisdom of the womb, and I would hope that it always takes precedence over the presumptuous convenience of the knife.