Offering surgery to people who aren't ill is a pretty kinky idea. So the idea that the NHS will start giving Caesarean sections to any woman who wants one, regardless of clinical need, and when maternity wards are crying out for more midwives, is perverse. Yet this extension of consumer choice is what the National Institute for Health and Clinical Excellence (NICE) will recommend in guidelines to be published next month, despite the procedure costing around £800 more than natural childbirth. It's a bit like saying, we know you're young and ruddy and fertile, but how do you fancy conceiving through IVF instead?
I should reveal that I am typing this with my right hand while holding a breastfeeding baby with my left, trying not to bash into my emergency C-section scar with either of them. She was born a month ago and my midriff still hurts, although the two weeks of agony of trying to get out of bed or pick up my newborn is over, and I no longer pee in a bucket at night as I can manage the stairs to the bathroom now.
It wasn't the birth I'd hoped for, but after two days of induced labour with a 10-pound baby who was 18 days overdue, trying to make her way through an unusually problematic cervix, facing the wrong way, with her placenta calcifying, it was the birth I got. I am forever indebted to the NHS for the surgery that may well have saved my baby's life. But the idea that you would go through such a major procedure when nothing is wrong is staggering.
I had wanted to leave the umbilical cord intact until it stopped pulsing with the transfer of blood to the child after birth. I had wanted her lungs to have the last liquid squeezed from them by the birth canal. As it is, she is still sneezing, as Caesarean babies are prone to do.
The NICE guidelines have apparently arisen because surgery has progressed and Caesareans are now rather safe operations. This may be true – but safe does not mean better for the baby. Safe is not the same as desirable – and the birth canal offers many advantages that coming through the sunroof, as my friend put it, does not.
Childbirth requires intimacy, privacy, an environment conducive to the stimulation of oxytocin, the hormone that propels labour, just as it propelled conception. Childbirth requires experienced, sensitive midwives who have the time and energy to care about the process. Childbirth requires love and encouragement, not plucking a butterfly from a chrysalis on a day that suits the diary. Pregnancy is not usually a problem that needs solving.
Yes, it's an unimaginably animalistic act to grow a baby in your womb and push it out between your legs, making wild grunting noises for hours on end. But it's what we animals do, it usually works, and sometimes it feels absolutely amazing. I live in hope that I will get to finish the job some day.
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