Poles apart: two perspectives on caesarean birth | |
Cesarean Section. Understanding and celebrating your baby’s birth. Michele Moore, Caroline de Costa. Baltimore: Johns Hopkins Press, 2003 (vi + 149 pp). ISBN 0 8018 7336 3. |
Hooray for guilt-free caesarean! As a consumer reviewer, my first reaction to this book was — at last! This is a book for anyone about to have a baby; a book which not only addresses the imbalance in childbirth information, an imbalance that generally favours non-caesarean sections, but also speaks to the difficult issue of guilt. Guilt seems to pervade conversations among women talking about delivering their babies by caesarean. Should this be how women feel? Through clear, respectful, everyday language this book explains the history of C-section surgery. This makes a significant contribution to understanding the reasons why childbirth has become politicised, and why a process of social and medical review might leave women feeling inadequate if they delivered by caesarean. It explains the anatomy of C-section surgery, the possible risks and the reasons why. The book always keeps you close to the fact that the decision to have a caesarean delivery, if unplanned, is a medical decision, and it remains honest about the emotional issues connected to the decision for the parents. It seems to me that the goals of the authors — to reassure women through the provision of information and to highlight the perspective that “a caesarean section is simply another way to give birth” — have clearly been met. Both authors seem highly qualified to have written this text. As doctors and mothers they are in a key position to give a valid account of the medical and personal sides of the experience of childbirth. Furthermore, at $33.95, it represents good value for money. I cheered as I read the end of the introduction: “The most satisfying, empowering and rewarding part of birth is not pushing a baby through your vagina, but holding your healthy infant in your arms and knowing you are responsible for his or her life.” Surely that’s what it’s all about! Fiona Robertson
The knife is not normal No one, no matter the mode of birth, can be guaranteed a problem-free pregnancy, labour, birth, postpartum course or a perfect child, but to trivialise the extent to which caesarean section may impact on all of these areas is undesirable. Australia already has one of the highest annual caesarean rates in the world, and in recent years there has been a concerted effort to undertake clinical research trials and practice audit that will hopefully result in a reduction in caesarean section rates. The authors offer their own opinions with regard to the “benefits” of caesarean birth, particularly as a repeat event. “In our view the movement to avoid repeat caesarean sections has gone too far, and some women feel they cannot choose a planned and well-controlled repeat C-section because it is not socially acceptable” (page 7). I would have thought that caesarean section, whether repeat or not, is an option that would be discussed with their respective healthcare providers to ascertain the best and safest option available to a woman with all her individual health information at hand. I do not believe that this book is suitable for the Australian market. Some of the language is inappropriate and would have a different meaning for an Australian reader (eg, “Baby lies fanny first”). References to care providers may be relevant to the American healthcare system, but not to Australian maternity care services, and this could serve to confuse rather than clarify. While some of the “lay” descriptions would be of general interest to women, I do not feel that overall this book is a responsible approach to this important topic. Susan J McDonald
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