The Glamorization of C-Sections

Every Tuesday, I listen to the Just Trish podcast while water coloring. I fill in the lines and listen to the girlies until my creativity bucket overflows. On one Tuesday this past summer, I was unexpectedly captivated when I heard these fifteen seconds shared between host Trisha Paytas and guest Tana Mongeau:

Tana: I just don’t want to give birth. Yeah. So, [I would] adopt or [use] a surrogate, for sure.

Trish: Oh, so you do want kids?

Tana: Yeah, oh my god. I would love to be a parent. I just– I don’t– I’m scared to push anything out of this situation.

Trish: Well, I would say if you accidentally get pregn–

Tana: – C-section.

Trish: Yeah! It was so easy. Mine was so easy. And it was scheduled this time.

From there, Trish goes on to discuss her second birth experience, regularly highlighting the ease of the hospital process and the benefits of an epidural. The absence of pain and the joy of getting that baby out of there as quickly and efficiently as possible. She adds on how quickly she could eat after her C-section and her ability to return to cosplaying as Sabrina Carpenter on TikTok just two days after the scheduled surgery.

I recognize that these are two influencers chatting it up in a pink mansion in LA. I also recognize the reality of parasocial relationships; I do not know, nor will I make assumptions about, the circumstances of Trisha’s birth or any medical decisions Tana may make in the future. To me, we are on a first-name basis, but I am aware that I do not know these people.

I do, however, know a lot of people like them – albeit people with less money and less privilege. I think of the hundreds of thousands of listeners who will one day want their own family and are hearing these same words. People of all ages and gender identities who might make decisions about their care based on society’s most popular opinions. Tana and Trish aren’t the only influential figures depicting a version of pregnancy and birth that feels luxurious and simplified to a task checked off of The Person-With-Uterus To-Do List.

From attending a three-day doula certification last summer to the in-depth intake appointments I’ve had with potential overnight newborn clients, I’ve listened to the birth stories of many first-time moms and heard horror stories of every degree. New mothers have told me about doctors who downplayed the realities of cesarean recovery despite being encouraged to end the pain, get the baby out, and be on their merry way during labor. I’ve heard about physicians who recommended induction to speed up the labor process by using quippy phrases like, “Let’s get this show on the road,” without taking time to explain what natural, hormonal, and physical reactions are being disrupted with these medical interventions.

In many instances, it is the medical interventions (such as C-sections) that cause short and long-term health effects for the baby and/or mother. But, when the mother’s body can follow its natural hormone-release cycle during every stage of a low-risk labor, there are significantly fewer side effects for either the baby or the mother. It is a fact that vaginal birth is the safer and healthier option for first-time, low-risk pregnancies.

I’ll emphasize that last part: low-risk. I am not discrediting the importance of OB-GYNs and hospital physicians. The ability to judge the circumstances of ongoing changes within any pregnancy can involve a number of complications that may arise, and some will result in a surgery that is medically necessary and/or life-saving.

But it seems far too many women are having C-sections when they’re not medically necessary – and, some, without being fully informed that the medical interventions they’ve consented to during early labor may increase their chances of needing more interventions as the labor progresses. Supplemental hormones, like Pitocin and misoprostol, may expedite the birth process, but they also make it so the body can no longer hear when to release oxytocin, sometimes making the birth feel more painful. And when you are given an epidural for the pain, the body will no longer be able to feel when it should stop pushing, sometimes resulting in perineal tearing. With a medically induced vaginal delivery, the recovery time can be as little as two weeks, but this timeline triples if the birth ends in cesarean surgery.

And this isn’t a new phenomenon: Women my mother’s age, who gave birth over 30 years ago, have told me stories about facing the same obstacles as women who gave birth last year. They all deserved an advocate to hold their hand and monitor the individualized changes that dictate a labor’s progression from painful to insufferable. Some probably could have labored for a few more hours and had healthy deliveries. They could have changed positions regularly and responded to what aids in lowering the baby.

Let’s take, for example, a baby showing signs of breech. Some doctors would suggest cesarean surgery over repositioning techniques because allowing gravity to adjust the position of the descending baby would take more patience than the immediate satisfaction of surgical intervention.

So why do doctors push these unnecessary C-sections? In many cases, it’s because, for these hospitals, time truly is money. Practitioners are often compensated for performing interventions that escalate an otherwise low-risk birth, and when additional medical interventions are utilized, hospitals can charge insurance agencies for more than just the room and time spent in the hospital. The most common medical inductions and surgeries require, at minimum, an anesthesiologist, additional nursing staff, and more than 24 hours in the hospital. All of these unexpected interventions will then be billed in surplus after the family is discharged, in awe of the newborn baby they are now bringing home. To assume hospitals’ financial priorities do not influence (if not fully inform) patient care is ignorant. It’s worth considering: if there were monetary value in performing a cesarean on farm animals, like horses and cows, instead of allowing them to deliver on their own, would Americans capitalize on it?

When you study the origins of obstetrics, the rabbit hole gets dark very quickly, but scientifically, the female body forming and pushing a fully matured baby out of their vagina is as rudimentary as a horse birthing their foal. There are a few first-time moms who have emphasized regretting their choice to see the best neonatal surgeons and doctors for their low-risk, healthy pregnancy. While OB-GYNs are the correct choice for some women, at the first sign of trouble, these physicians are trained to find a solution -- quickly and safely, yes, but avoiding legal liability is included in their job description. Sometimes these solutions are simply hospital protocol, but it is vulnerable demographics (BIPOC and queer families) that are most often victimized by “hospital protocol.” Labor and delivery care are frequently left to the discretion of whichever practitioner is available at the time can lead to choices that differ from the patient’s best interest.

The truth is that surgeons are trained to cut, and doctors are trained to heal. High-risk pregnancies aside, there is nothing to be healed during the process of birth that the body has not already thought of. Physicians recommend epidurals and pain management medications over breathing and relaxation routines. Now, someone in hour 10 of active labor, completely unable to relax or breathe through the pain of contractions? Well, they should probably take the damn epidural. But, to schedule the pain away before it is felt, to limit the body before it has a chance to even try? It’s unfortunate to me that medical interventions and cesareans of this degree have become the Hollywood norm for bringing a child into the world.

To be fair, Tana and Trish clearly weren’t trying to tell their followers to induce or get a C-section in every birthing scenario, but they are sharing a very narrow experience that is not representative of the full reality of delivering a baby via C-section.

Before getting a cesarean, the potential progression from pain to suffering of the birthing person should be monitored, and they should have a choice and informed consent before escalating to surgery. The transition into becoming a parent should be a supported experience. Having a postpartum support system in place is not an option; it’s a necessity. Being aware of the vast possibilities of birth and the options available before labor occurs is not an option; it’s a necessity.

Giving birth must be empowering.