April is Cesarean Awareness Month.
A lot of this month is dedicated to educating women on - you guessed it - Cesarean birth, including what the global, national, and local rates are; what to expect during and after birth; information about the risks and benefits of both VBAC (vaginal birth after Cesarean) and repeat C-section; and how to lower your chances of needing a Cesarean. These are all excellent resources, and a lot of heart and soul goes into this month in making sure women and families have access to all the information they want and need to make the best decision for themselves concerning this topic.
The World Health Organization states that at population level, Cesarean section rates that exceed 10% are not associated with reductions in maternal and newborn mortality rates… so we know that our nation’s current rate of 1-in-3 women is much too high. While we recognize the efforts to minimize this number are absolutely well-intentioned and and the information shared is hugely beneficial to countless of birthing families, we also realize that the language and ideas around Cesarean birth are not always very positive - and that this can be very alienating and place shame on the millions of women who already have or will give birth via Cesarean.
So in honor of these women, here are 5 things NOT to say to a Cesarean Mom (and what to say instead):
1. Did you try acupressure/chiropractics/inversion/different positions/finding another doctor/hospital...etc.etc.
What to say instead: You’re such a great mom! How are you feeling?
If you find yourself wanting to ask the first [“no-no”] question (with whatever potential preventative of a Cesarean that comes to mind), be aware that it makes the assumption that there was something the mother could/should have done differently and that you believe she didn’t try hard enough to avoid the outcome she had (AND that the outcome was all bad and no good).
Additionally, this question doesn’t help a mother who may be grieving the loss of the vaginal birth she envisioned; instead it invites shame and guilt. And as for the mother who chose a Cesarean - whether it was for a breech baby, twins, instead of a VBAC, or for any other reason that may not always be considered “high risk” or labeled an “automatic c-section” - this question belittles her choice and presumes that is was the “wrong” one. Whether a mother’s Cesarean was completely unplanned or a premeditated choice, listen to what she has to say about her experience, validate her feelings, and leave your assumptions at the door.
2. Are you sure your C-section was really necessary?
What to say instead: It sounds like there was a lot to sort out to make this decision. Would you like to talk about it more?
This question is typically reserved for mothers who didn’t plan a Cesarean. It’s important to remember that most doctors really do want the very best for their patients and when it’s time to start discussing Cesarean section, the conversation is usually held with respect and compassion. So be aware that assuming that a woman was bullied into the OR is not only unfair to her physician, but it can also cause distrust between a woman and her care provider when distrust may be unwarranted. Until you are the one responsible for the life of a woman and her child, be careful with making medical judgments that don’t involve you.
Furthermore, the question only assumes, again, that the mother made the wrong choice in the end. A better response is to support her as she works through her unexpected experience and open yourself up to be a safe person to process with.
3. Just be happy that you and your baby are ok.
(and “at least…” statements)
What to say instead: I’m here for you. How can I help?
This is another one you’ll be more likely to hear when a mother wasn’t expecting a Cesarean. When a woman tells her birth story and expresses emotions of sadness, confusion, anger, or disappointment surrounding her unplanned or unwanted Cesarean, many people tend to want to shy away from the “negativity” and offer a silver lining. It’s usually well-intentioned, but it’s important to realize that ignoring a woman’s “negative” feelings and telling her how to feel instead can invalidate her emotions and dismiss her experience of the birth.
Saying “I’m sorry” can be so healing and affirming to a mother who is grieving her Cesarean (but be careful not to say this to someone solely based on the fact that they had a Cesarean; it can be highly offensive to someone who not only chose to birth their baby this way, but to those who had a very positive experience doing so).
4. You took the easy way out / You’re selfish / You failed.
What to say instead: You are so strong! You are amazing.
Whether a woman went through hours of labor first or went in for her Cesarean before ever having a contraction, let’s get one thing straight: Cesarean birth is not the "easy way out". Both the surgery and recovery period can require a lot of strength and courage, and a mother who sacrifices her own body to bring her baby into the world is anything BUT a failure. Tell her what a great mom she is!
5. You didn’t really give birth.
What to say instead: Congratulations!
This one stumps me. Birth is defined as the emergence of a baby from the body of its mother. Notice that birth is not exclusive to any “kind” of birth. What are you supposed to say to celebrate a child who was born via Cesarean section, “Happy Extraction Day!”? Just because her baby wasn’t pushed through her vagina doesn’t mean a woman isn’t a real mom or that she didn’t really give birth. Did you grow a baby and have it come out of your body? Congratulations! You gave birth! You’re baby is beautiful and you’re total a rockstar.
Did you have a Cesarean birth? What would you add to the list of things not to say to Cesarean moms? What was the most encouraging thing someone said to you after your Cesarean?