Around 5% of the emergency c-sections carried out in hospitals are real emergencies in which this surgery is medically necessary, and saves lives. The average cesarean section rate for the US in 2006 was 31.1%. This varies greatly between hospitals and physician’s and can go higher than 50%. Cesarean’s are carried out by Obstetricians are concerned with their time management, schedule, liability insurance and litigation pressures, and their income (they are paid more for c-sections and can ‘deliver’ more babies faster this way). In the Netherlands where midwives attend most births, and obstetricians are only called in for a real emergency, they have a c-section rate around 10%. I am using 10% as a baseline for necessary and healthy use of surgery in birthing. Most obstetricians have never even seen a normal birth, and the US is the only country in which surgeons are present at birth. A Cesarean Section is major abdominal surgery.

Here in the US we have shocking levels of unnecessary c-section’s. High levels of medical interventions in birthing are happening routinely in all U.S. hospitals. Jennifer Block (see below) interviewed a number of OB/GYN’s about this issue in her book and it is clear from their responses that c-sections are done for financial and liability reasons, and not because they are actually needed. E.g. if they think a baby is going to have shoulder dystocia during birth they will do a c-section rather than risk a malpractice suit from the parents. This is very shocking and is having a devastating effect on mom’s and babies, and therefore on families and on our culture as a whole. The medical profession has no idea about the psychological, emotional and spiritual effects of these bizarre, highly technologized birthing practices. They have yet to begin to understand both the immediate traumatic effects, and the long-term effects. Those of us, like myself, working in the Prenatal and Perinatal Psychology & Health field know a lot about how these practices are affecting birthing mom’s, their baby’s, bonding, and family dynamics.

A new category of c-section has been created by doctor’s called ‘failure to progress’ (FTP). There is a grey zone between ‘emergency’ and FTP c-sections, and these make up a large part

of c-sections. So what does FTP mean? It means that mom has come into the hospital when her labor began, or she has come in to have her labor induced (see Induction article - this is becoming more common and is putting c-section rates up even higher). When birthing in the hospital you are going to be on their clock, obstetricians and labor wards do not understand or operate on ‘baby-time’, they are mostly wanting to speed everything up, get you in and out as fast as possible, and they certainly don’t want to wait for birth to happen naturally in its own time. The earlier you go into hospital in your labor the more medical interventions you are likely to receive. You will receive your epidural, be strapped into a fetal monitor, put on an intravenous drip for fluids because you are not allowed to drink (in case of surgery), and then monitored from afar on a screen at the nurses’ desk.

Already you are taken over by medical interventions, even though you are just at the beginning of your labor and everything is progressing normally. You are in a strange environment with nurses you have never met coming in and out - checking your dilation and giving you vaginal exams. Birthing women need to be free to move around, and to drink, and eat! Moving and changing positions is such an integral part of normal, healthy birthing. Laying on your back is the worse position you can be in to give birth, it impedes the babies descent down the birth canal making it harder both to get your baby out, and for your baby to get out. This position is more convenient for the nurses, and doctor and that is the only reason that they do it.

Mom’s and baby’s needs are less important than the doctor’s. This is very dis-empowering for the birthing family. Mom is not at the center of her birthing in the sense that she is not supported to have an empowering, ecstatic birthing experience, nor to have her baby naturally. Obstetricians and nurses are not supporting her innate knowing that she can do it, and birthing is not seen as a natural and normal life experience. Women are restricted, induced, drugged, and often undermined. These interventions inhibit the extraordinarily deep letting go and opening up that is required to give birth, so it frequently does not progress. For this miracle to happen a woman and baby must be deeply supported and totally empowered in a completely safe environment, with the support of loved ones around her. Some people do manage to have a natural birth in hospital with the help of doula’s and extremely supportive and protective spouses, if they have a very strong desire to have their own birth the way they want it. This takes a lot of work and forethought. Many women never get to experience the incredible power, ecstacy and rite of passage of natural birthing.

Anesthesia has a big affect on baby, the drugs will slow baby down and can impede their impulse to get born, this is why anesthesia can lead to FTP, then a c-section. Outside influences involved in FTP births are the doctor’s schedule and income, the doctor’s schedule and income and the doctor’s schedule and income, and oh yes - malpractice fears. In general you are lucky if you are ‘given’ 12 hours to get your baby out from induction or arrival at hospital. If it is not out you become an FTP, especially if it looks like you are going to go on laboring into the wee hours of the night, or after the time that your surgeon wants to get home for his/her dinner.

In a study on the effectiveness of doula’s, a woman was put in the room with a birthing mom, and she simply sat there, inactive, the whole way through the birth. They concluded that this significantly reduced c-section rates and other medical interventions significantly. Why? Because women need women to be present in a supportive way in the birthing room, the same woman throughout, even if they are not ‘doing’ anything, birthing is much more about ‘being’ and letting go into the baby time zone.

There are some differences between the effects on baby from an elective (see article) and an emergency c-section. To briefly summarize the elective c-section article - baby is the one who begins labor, and it is from this impulse that a chemical is released that starts the contractions. When you have been born with no labor, you lack the ability to feel your own internal impulse - a very important part of the sequencing that affects how we get through our daily life and relationships. A normal sequence is: preparation, impulse to action, our energy/potency builds, begin movement, move through the middle, the end, and to completion, then integration. Most of the things we do involve this sequence. Read the elective c-section article for more detail on this crucial sequencing that comes naturally in a normal, uninterrupted birth and labor.

In the emergency c-sect there has often been some labor, and then something has ‘gone wrong’ causing an ‘emergency’. Sometimes the emergency may occur before labor has a chance to begin. When baby has been able to experience beginning the labor and progressing to a certain stage under her own steam, she will have the healthy and necessary imprinting up to that stage in the sequence. Then she will have the interruption imprint - the surgery. She will be missing parts of the sequence, that part she was unable to complete herself, because she was pulled out by a doctor. On top of that she will have the emergency surgery trauma imprint on top of the sequencing/interruption imprint. It can get complicated, but essentially these kids will have transition issues, may have tactile sensitivity, and have difficulty beginning, ending or completing a full sequence on a daily basis. Transitions can be very revved and emotional. It helps if your baby has had the chance to begin the labor because at least they will have a sense of their own impulse and potency up until the point of interruption. This is not so for elective c-section kids who don’t get to begin, or experience any labor. C-section kids need to get support and understanding with transitioning issues, and they often need to experience a simulated vaginal birth over and over again so that they can get the imprint in their body and nervous system, and complete their birth sequence.

Often in emergency c-section baby will need to be pulled out of the birth canal backwards, sometimes quite forcefully. A physician can also push baby backwards up the birth canal from the top of their head. How they are lifted out, pushed or pulled will be part of their birth imprint. These maneuvers can be quite forceful and fast. There is always a need to speedily and manually clear out baby’s lungs immediately after she has been taken out because there is a risk of respiratory problems. In a normal birth the physical action of going through the birth canal squeezes the fluids out of her lungs so that she can take her first breath when she arrives on the outside. C-section babies come out with their lungs still full of fluids so they can’t breathe on the outside without medical intervention. This procedure - called intubation which means putting a tube down their throat - can be quite traumatic for baby and often causes feeding problems.

Both mom and baby suffer the grief and loss of their birthing dreams in an emergency or FTP c-section, and their deep instinctual needs to both birth and be born have been thwarted. After surgery mom has to go to the recovery room, and baby is not allowed to go with her. The medical profession does not understand the health benefits of keeping mom and baby totally connected to each other, e.g. they will put baby in an electric warmer instead of next to mom’s skin. This separation interrupts bonding, and can cause post-partum depression in the mom, and therefore in baby. If mom is depressed, so is baby. It is becoming more acceptable for dad’s to go off with baby to the nursery after a c-section, and whilst it is an improvement on baby being taken there by a stranger, it has its own problems. The first hour after birth is when the oxytocin is highest and this is for a good reason! Nature is perfect. When baby goes off with dad, she is going to bond with dad, not mom. Later, when mom and baby are reunited it can be very difficult for mom and baby to bond, because baby has already bonded with dad. Dad’s job in this situation is to support mom and baby to bond. Bonding interruptions can affect breastfeeding outcomes.

High intervention medical birthing is not a mom and baby centered process, as I believe birth most certainly should be, and birth is not treated as normal in hospitals, but as an impending medical emergency.

I have sat with many people and witnessed their rage when re-visiting their birth because they were interrupted and not allowed to do it themselves. They felt so strongly that they had it in them to do their own birth. Many feel their birth was taken away from them in this way. We all have this blueprint in us that knows how to do it, moms and babies both get cheated out of that empowering and grounding experience of doing it together and being successful. Birth is very bonding for mom and baby when it happens the way nature intended, and depressing and disempowering when it doesn’t, or if it is interrupted continually.

We are holistic beings with multi-level needs, and many moms are unable to open their bodies to the arrival of their baby because they are not being treated as a whole person who can birth their babies themselves. Doctor’s have made the mistake of believing that they are the ones delivering the baby, this is entirely wrong - moms and babies birth together! We need to get back to supporting mom’s in their own innate ability to do this wonderful, empowering, ecstatic birthing themselves with the right support and environment. Hospitals are for sick people, and birth is normal, it should not be happening in a hospital, nor attended by surgeons.

Read Pushed: The Painful truth About Childbirth and Modern Maternity Care by Jennifer Block for more insight into this bizarre and frightening phenomenon.

Watch The Business of Being Born by Ricki Lake and Abby Epstein - a dvd