Cesarean Sections and SUVs

There’s been a bit of controversy over one of my earlier posts (Four out of Five) and I wanted to write a more lengthy response to some of the recent comments. I unknowingly offended someone and decided to remove the original post with the brief descriptions of the different women’s circumstances. (For new readers, it was a short post about a recent string of cesarean sections among women I know IRL. Of the last 5 to give birth, four had cesareans. I was the "fortunate fifth.")

The intent of the original post was not to pass judgment on the individual women. I included a few brief sentences about the circumstances of their births to give some context to the post. I tried to keep my language neutral because it was not meant as a critique of the women themselves. Judgmental or attacking comments would have read along these lines:

“I can’t believe that X made Y decision. What was she thinking?”
“X was wrong for doing Y.”

In my follow-up responses, I emphasized that I have a problem with our maternity care system in general, because too many women end up with surgeries for their births. I find fault with any birth, vaginal or cesarean, that leaves women traumatized.

Brooke Shields, for example, had such a nightmarish experience with her first child (induction that ended in a cesarean section, followed by postpartum depression) that she chose an elective cesarean for her next child. I feel sad and angry that she had such a traumatic experience in the first place. To choose medically unnecessary major abdominal surgery for her second birth speaks volumes about how traumatic her first birth was. Women deserve better!

I think that some of my readers are equating my condemnation of a general circumstance (our high cesarean rate) with a condemnation of the women who undergo these surgeries. Disapproval of a general situation does not at all translate into judging women who find themselves in that circumstance, for whatever reason. I think Judit summed it up well with her comment: “I simply see no judgmental attitudes here pertaining to the individual women, but I do see this little survey as a comment on the circumstances many pregnant women find themselves in, in general.”

Let me use an analogy to illustrate my point:

I don’t like SUVs or other large, gas-guzzling vehicles. I have made the choice to drive a small, fuel-efficient vehicle (diesel VW Golf) that gets 50 mpg. I also invested a lot of time and money into converting my Golf to run on used vegetable oil. I am concerned about our country’s level of fossil fuel consumption, especially its role in exacerbating global warming.

Let’s say I wrote a post about the number of SUVs and large trucks in our church parking lot (or grocery store, or wherever), and I expressed the sentiment that many of those vehicles were wasteful or unnecessary. I mean, you don’t really *need* an SUV to drive on paved, plowed, and salted roads!

Okay, so I write the post disapproving of a general circumstance (high numbers of fuel-inefficient vehicles). That does NOT mean at all that I dislike or judge the people who own them! It just means that I disagree with a particular practice. I also acknowledge that SUV ownership is a lot more than simply a matter of consumer choice. For example, most passenger sedans will fit only two children in the back seat, because you have to use car seats or booster seats until children are 8 years old. So after two children, you are essentially forced to buy a larger vehicle, and SUVs or minivans are usually the only choices in the States. Consumers don’t have a lot of fuel-efficient options for larger vehicles. This is partly the fault of auto manufacturers: in France, for example, there are loads of small minivan and mini-SUV type cars that get 40-50 mpg. It’s also partly the fault of our government for not establishing stricter fuel economy standards. And it’s partly the fault of American consumers for not demanding more efficient choices.

Let me tell a story about how appearances don’t tell the whole tale: a dear friend of mine drives an SUV. Waving hi, since you probably are reading this post! Turns out, her parents gave it to her and would be incredibly offended if she didn’t drive it. Does she like driving a gas guzzler? Nope. Would she prefer a fuel-efficient compact car? Yep. But she has to balance her environmental principles with her family relationships.

To wrap things up:
I don’t like cesareans; in particular, I don’t like our national cesarean rate of 30%. Am I glad they exist though? Yes. As Judit remarked in response to another post: “If I felt like I had no access to an emergency c-section in the event of a real emergency, I would be a lot more apprehensive of birthing anywhere.” Do I hope I never need one? Yep. Do I condemn our maternity care system that leaves the majority of birthing women with some sort of scar (episiotomy or C/S)? Most definitely. Do I condemn those who have cesarean sections? Nope.

My defense rests.