Making Peace With a ‘Medicalized’ Birth in the Bay Area
“If I go by all that has been advocated by the natural birth community, I’ll fail as a mother before I’ve even given birth.”
“Does anyone know the age at which children are weaned in the developing world?” the instructor asked a room full of pregnant women in San Francisco. “Seven,” she said definitively, after a cursory glance around. “Children breastfeed until they’re 7 years old,” she said. If anyone besides me was skeptical, they didn’t show it.
She spent the next 20 minutes of “Introduction to Breastfeeding” extolling the virtues of breast milk. It’s a cure-all for everything — from diaper rash to eye infections. It’s an elixir made of magical hormones and superhero antibodies. It’s a fail-safe way to make your kid smarter. She recommended squirting breast milk up a baby’s nose to clear out boogers. She said it would heal minor scrapes. She even said that if everyone in the world was breastfed, the world would be a better place.
I went home that night and spent two hours double-checking every claim she’d made. No, despite the screaming newspaper headlines, there are serious questions about whether breast milk makes your child smarter. No, it’s not going to turn your child into a disease-destroying superhuman.
And no, children in the developing world don’t all breastfeed until the age of seven. Much like 1980s kids in the United States, I’d spent the first year of my life being fed a mix of breast milk and formula in Bombay, India. By six months, I had fully transitioned off my mother’s breast. By seven? I was eating roti, subzi, dal, and a whole lot of spice.
I didn’t start my pregnancy so skeptical of the natural birth and breastfeeding movements that have swept the Bay Area. I’d watched Ricki Lake’s documentary about the medicalization of America’s births; I’d extensively researched epidurals; I’d even already started thinking about my birth plan.
In the first few months of my pregnancy, it was clear to me that the medical community was intervening with the birth process much more than it needed to. The logic was seductive: Humans had reproduced for millennia without doctors; why did we suddenly need a phalanx of medical professionals controlling every step of the process?
When I traveled to India a few months later to visit family, I felt smugly validated. The medicalization of birth is rarely questioned in Indian society — even more so if you’re wealthy. Medical procedures and interventions are seen as the best way to ensure a safe birth. The poor receive only the most basic hospital care, so when a doctor at an expensive private hospital suggests a C-section after a woman has been laboring for 14 hours, the obvious conclusion is that it’s the best possible option for the baby. Episiotomies are routine and common in India, despite almost universal recommendations limiting their use. Caesarean sections are skyrocketing, especially at private hospitals.
I came back home and congratulated myself on my life choices. I obnoxiously told my mother that I was so lucky to live in San Francisco. I found a doula and signed up for a host of birth classes, including the aforementioned Intro to Breastfeeding.
A few days after the first class, my doctor began talking about a possible C-section. My baby is in breech position — meaning she’s bottom-first instead of head-first — and there’s a good chance that she’ll weigh 8 lbs or more at birth. At only 5-feet tall, I have a petite frame. Getting a biggish baby out would’ve been a challenge even without the added complication of a breech delivery.
I was disappointed, to say the least. I’d imagined a quiet labor at home, surrounded by tea lights, my favorite music, and meditation. Meeting my baby under the naked lights of an operating room did not fit with my plan.
Still, I accepted my obstetrician’s recommendation. Vaginal breech births are clearly risky, and my husband and I were going to err on the side of caution.
But around me in the Mission, a C-section meant that I had to be pitied. The class instructors gave me a long list of chiropractors and acupuncturists to visit. My doula told me that I’d take 12 weeks to recover, when research revealed that most women recover between 4 and 8 weeks. She then gave me a catalogue of exercises to do every night. Someone else suggested headstands in a swimming pool.
If I go by all that has been advocated by the natural birth community, a C-section means that my baby won’t get good bacteria from my birth canal, and her immune system will be compromised. She won’t get the benefits of delayed cord-clamping. I’m at risk of injury and even death. Somehow, I’ll fail as a mother before I’ve even given birth.
It all came together to set off a wave of anxiety. In addition to the C-section, I was worried about postpartum depression. The thought of being the primary source of the baby’s wellbeing and nutrition for at least the first year of her life left me feeling isolated. Working at Medium is a dream, but we’re also in the middle of some big projects, and I hate the idea of work taking a backseat. How would I find the time to pump all the way until the recommended one-year mark? When would I finally be able to introduce the bottle so that my husband could share some of the sleepless nights with me?
As I struggled with my swinging hormones and new-mother anxieties, the birth classes did little to make me feel better. I was told that not being able to breastfeed was only a sign that you weren’t doing it right. I listened to one of the instructors tell me that I needed to build a “cave” for myself and stay indoors for the first several weeks of the baby’s life — when all I imagined I’d want in the immediate aftermath of birth was some sense of normalcy and visits from my friends. Another told me that staving off postpartum depression was easy — I just had to sleep when the baby sleeps! I was silently judged for having taken Benadryl and Unisom through the pregnancy to help me sleep.
I’d often leave the sessions with the feeling that breastfeeding and motherhood were the most natural things in the world, and that my insecurities were my own failings.
Back in India, of course, my friends and family think I’m ridiculously lucky to be having a C-section. I can plan my baby’s birthday. I won’t have to experience labor. She won’t have a cone head. I’ll be wheeled into a room, and voila, we’ll have a baby 30 minutes later.
One day before I go into my C-section, here’s what I’ve made peace with: A C-section isn’t perhaps the ideal way for my baby to make her grand entrance into the world, but it’s also the safest option for my baby and me. And let’s put it into perspective. Birthing is only a minuscule portion of the larger parenting experience.
If there are a few mantras I’ll follow as I take my first tentative steps into the world of parenting, here they are: Judgment and unambiguous, black-or-white opinions have little use in this universe. Do your research. Don’t accept any advice, medical or otherwise, at face value. Natural isn’t always better, but neither is a notoriously overcautious, profit-oriented medical system.
And finally, a child’s life is the product of many, many variables. Breastfeeding, natural births, screen-time and any number of other seemingly high-stakes parenting issues pale in comparison to the importance of love, safety, empathy, and communication.
Illustration by Denise Nestor for The Development Set. // The Development Set is made possible by funding from the Bill & Melinda Gates Foundation. We retain editorial independence.
