The most common thing I heard from everyone, doctors, nurses, midwives, friends and relatives, when I told them my awful c/section story, was, “Well, next time you can have a VBAC!”
Well, no actually. I’m not planning to have another child, and that probably won’t change.
And even if it did, what does it do to a woman to say this to her? It tells her “OK, well, you failed, but you can try again!”
And there are so many things wrong with that attitude I hardly know where to start. Here, let’s make a list:
Erasing the grief
A woman who has had a traumatic birth, c/section or no, is in grief. The more she tried for a good birth, the more she cared, the more she believes in healthy empowered birth, the more she is going to grieve. The more she feels her rights were not honored, the more she feels she was assaulted, the more she feels she was treated as less than a full person, the more she will grieve.
And she needs to grieve. And she needs her grief to be honored. Birth is a transformative event to many women, and the Story of How You Were Born is something mothers are supposed to be able to give their children.
But if that story is full of pain and trauma, she will not be able to tell all of it to her child. There is a lot she will have to leave out, to keep in silence, at least until the child is grown enough not to be traumatized by it; most women won’t tell even then.
All of that is a loss, and that loss cannot be erased by anything, because there is nothing that will make it Not Have Happened. It happened. It exists in her history, it is part of her memories, and most painfully, it is tied up in otherwise wonderful memories that she treasures of her child’s arrival. Unless she wants to forget the first few days of her child’s life, she does not have the luxury of forgetting her trauma either.
Implicating the woman
A woman who has had a traumatic birth has not failed, but she has been failed, either by her own body, or by the system. Both are painful. A woman failed by her body may feel broken, incomplete, less than a full woman, even feel shame, even as she knows it’s not her fault. A woman who was coerced and pressured into a c/section, on the other hand, may feel stupid, weak, foolish, and ashamed that she let it happen to her, even if she knows it is not her fault. Much like any accident survivor or assault victim will often have periods of blaming themselves.
So when others place all the focus on having a VBAC, what they may not realize they are also doing is agreeing with these viewpoints—agreeing that yes, she just needs to do things differently next time and hopefully, that birth will be a “good” one. Because this one so clearly wasn’t.
Making it about the listener
Look, I know that telling my story is hard on other people; it’s hard on me. I don’t enjoy it and I don’t tell it without cause. But if I am telling it, especially if the listener asked to hear it, I expect the listener to do me the courtesy of dealing with their own discomfort. In other words, sure, it does make the listener feel better to tell me I could have a VBAC, because then, they can move on from thinking about my bad experience to thinking about an imaginary good experience I might have in the future. I understand that, but it’s disrespectful to me and to other women telling their stories. We need listeners who will not rush to gloss things over or urge us to think happy thoughts, but who will endure, as we endure, thinking about the sheer awfulness of what happened to us, at least for a little while.
Ignoring negative possibilities
What if a woman does try for a VBAC, but doesn’t get one, for whatever reason? Is she supposed to keep trying till her uterus can’t take any more? And how will she deal with the newer pain and disappointment she feels after a CBAC? Or what if she can’t try for a VBAC for infertility, or other, reasons? Will her friends and supporters just feel uncomfortable and drop the subject now that there’s no chance for the happy ending? Or will they be with her in her pain, be angry with her, believe in her, accept her as she is, non-triumphant?
Making the political merely personal
This one is the biggest concern. Because the response to an injustice should not be “here are ways you can do happy related things to make you forget the injustice” but “let’s change this system of injustice so it doesn’t keep happening.” I was coerced for no medical indication whatsoever, into an induction that led to a c/section, one that increased my risks of mortality and was traumatic in itself in the way it was performed, and in subsequent complications. Other women have stories much worse than mine, indicating clear instances of abuse and bad practice, sometimes bad outcomes as well.
We have a multitude of evidence indicating that unnecessary c/sections are both common and rising to epidemic proportions, with troubling implications for maternal and fetal mortality in this country. We have a member of the obstetric community on record as stating they were not convinced that a woman in labor was a full person with the right to determine her own medical treatments, an attitude tantamount to declaring women less than human, at least while they are pregnant.
These are injustices that need addressing, not by achieving happy VBACs, but by demanding institutional reform. You cannot reduce domestic violence simply by giving women relationship advice or access to a divorce lawyer, good as those things are. You also have to enforce the laws against it. You also have to educate children in a way that makes it less likely for them to become abusers. You also have to change public attitudes away from being accepting of abuse.
Injustices in how women are treated during birth are no different. You have to assert and defend women’s rights to determine their own care, and to refuse it, even when pregnant. You have to educate doctors and medical staff about those rights, and about the proper way to treat laboring women in their care respectfully. You have to change public attitudes about birth, away from a painful and dangerous experience always requiring medical experts to a natural event that is, most of the time, achievable and safe for most women if they are treated respectfully and given a minimum amount of assistance.
The medical mistreatment of women highlighted by the skyrocketing c/section rate is not just a string of isolated personal tragedies; it is, to put things crudely, a big fucking deal. If you want to provide support to women you know who are dealing with a traumatic or coerced c/section, the best thing you can do is to recognize and understand what they were up against.