Out With The Old

Six C-Section Myths & Misconceptions

People tend to have a lot of thoughts on Cesarean birth, whether or not they’ve actually experienced it.

When it comes to labor and delivery, there are lots of loaded terms, and none perhaps more so than “C-section.” People tend to have a lot of thoughts on Cesarean birth, whether or not they’ve actually experienced it. And yet despite the fact that about one-third of American babies are delivered this way, misconceptions about C-sections dominate much of the discourse.

Like many people, I believed a lot of the C-section myths before my first delivery, an emergency C-section after 18.5 hours of labor. But experience has since taught me why they’re so detrimental to a vulnerable new mother. (And yes, if you just sucked in air or made an “ooooh” noise at 18.5 hours of stalled labor, that is the correct response.)

“It’s so much easier...”

C-sections are routine and very safe, but they’re also abdominal surgery, which is nothing to sneeze at. (Incidentally, if you have to sneeze, cough, or laugh after a C-section, grab a pillow to hug, because it’s going to hurt for a while.) Your doctor cuts through layers and layers of muscle and fat to get to the uterus (which, spoilers, is also cut into), and all those layers need to heal afterward. Do you know how often you engage your core muscles to do literally anything? You are never more aware of this very high number than after you’ve had abdominal surgery. And in spite of all that, you’ll have an infant to care for.

“The recovery is so much harder...”

Of course the flip side of this misconception also pops up with alarming frequency: That a C-section is so horrific you won’t be able to move afterward and your body will never be the same again. The truth — as is often the case — is somewhere in the middle.

“C-sections can be avoided if you just know better.”

New parents are increasingly drawn to the idea of proactively planning for their deliveries. Researching birth outcome trends, hiring a doula, making a birth plan — these are all great things to do if they help you feel supported and empowered, but it’s also naive to think that you can simply research your way out of needing a C-section.

Not only is that not how C-sections or human bodies work, but it’s more than a bit insulting to those who have had C-sections to suggest that if only we had read another birthing book or taken another yoga class, our baby wouldn’t, for instance, be breech. Certainly there are things one can do to put yourself on track for a vaginal birth, but making those choices isn’t the same thing as controlling the outcome.

“Once a C-section, always a C-section”

There’s a reason people believe that once you’ve had a C-section all subsequent births had to be Cesarean deliveries as well: because it used to be true. Back in the day, all C-sections were performed using a vertical incision, which would run from just below the belly button to the top of the pubic bone. (It is still used sometimes in cases of emergency.) This long scar makes labor and delivery dangerous since it increases the likelihood of uterine rupture. But nowadays, C-sections are generally performed using a low, transverse (horizontal) incision, and considering a fully-formed baby comes out of there, that cut is tiny. Not only does this mean you can usually hide your C-section scar while wearing a bikini (or, in some cases, if it’s low enough, just not shaving your “intimate area”), it minimizes the risk of uterine rupture.

It is worth mentioning that a scarred uterus has a significantly higher chance of rupturing than an unscarred one. In fact, it’s 91 times more likely to rupture! That information is scary until you learn the infinitesimal odds of an unscarred uterus rupturing: fewer than 1 in 10,000 births, or 0.007%. So the chance of uterine rupture during a VBAC, on average, is still below 1%. The risks and benefits are definitely something to discuss with your doctor when or if the time comes.

“You won’t bond with your baby.”

While it can sometimes be the case that you won’t hold your newborn baby immediately after a Cesarean delivery or that surgery can delay milk production, neither of those outcomes are foregone conclusions.

In many cases, skin-to-skin contact can start within 20 minutes of a C-section (or even right away — putting the baby directly onto the mother’s chest is becoming more common in low-risk C-sections). Some moms may not skip a beat when it comes to lactation. Others (like yours truly), will run into challenges with early breastfeeding as a result of their delivery, but “challenge” doesn’t mean “unsurmountable obstacle.”

Even in an outlier scenario in which you can’t initiate skin-to-skin for hours (or days, in some rare cases), you’re not doomed. Even if breastfeeding doesn’t ultimately work out, you’re still going to bond with your baby. Those first minutes, hours, and days are important, but they don’t represent your one and only chance to connect with this new little person. After all, you get to take them home with you and you get the rest of your life to bond with them, in all sorts of ways.

“All that matters is that everyone is healthy.”

This is a platitude you hear before and after a C-section delivery, and it has the unfortunate side effect of making a new mom who had a negative experience think her feelings don’t matter, to say nothing of the parents whose babies aren’t healthy. Sure, everyone making it through birth alive and well might be the most important thing, practically speaking, but it’s not the only important thing: Remember that “health” includes mental health.

C-section parents can talk about their birth and their feelings about it, good and bad; those feelings are worthy of discussion, exploration, and empathy, whether she wants to talk about traumatic birth or, maybe, how much she really loved her experience.

Instead of listening to what we presume to be true about C-sections, let’s take the time to listen to the people who’ve actually been there. We might just learn something.