On Derrick’s first birthday, I watched my friend Alexandria put a single candle on his baked-from-scratch three-layer cake. Family and friends were gathered in the dining area, anxiously awaiting their chance to sing “Happy Birthday” to the smiling, babbling little boy for the first time in his life.

Tears were running down her face.

While Derrick’s birth was a celebration to everyone else, to Alexandria, it represented a day of failure, a day of exhaustion, a day of pain. A day when she lost complete control of her body, when doctors overrode her attempts to have a natural birth, and delivered her son via cesarean section, effectively saving her life.

Alexandria’s feelings of anguish were pushed even deeper, she confessed to me as I helped her gather herself together, because she felt she had no right to them. She was alive. She had a beautiful baby boy. She didn’t feel she had the right to feel this way.

Eventually, we walked out carrying the cake, and her reddened face smoothed over with contentment when her baby smeared his piece all over his tiny face.

Mourning how a little one was born is not the same as mourning a little one’s life. The two shouldn’t be put on the same scale, and yet they often are. One of the biggest issues is that women are being conditioned to believe that if they submit to surgery, they are failing as mothers.

Cesarean sections get a lot of attitude. They get a lot of snark. They’re looked down upon. Many women feel like they’ve failed their babies and themselves should they give in to the doctor’s suggestion of a section and, like my friend, many feel guilty their entire lives because they opted for one.

I admit it freely: I have two beautiful healthy twin girls because C-section was available to me.

At 34 weeks, Baby A broke my water. She was low, head to the cervix, ready to greet the world (or just tired of sharing such a small space with her sister). Baby B was hanging out right up near my rib cage, feet down, no plans to move.

When my doctor told me Baby B was breech, and she would prefer to do a section, I nodded and signed. I’m not saying everyone should do that. There are many women who are more secure and attached to their birth plan than I was. But I didn’t know the risks, I didn’t know the likely outcomes. I didn’t know every scientific study for or against the procedure. I knew my doctor thought the girls would fare better with a section, so I nodded and signed. She’s the doctor, after all. Not me.

Maybe Baby B could have flipped. Maybe she would have flipped. But I wasn’t willing to risk it. Breech babies delivered vaginally have a death rate 10 times that of babies born via C-section.

Still, there is this feeling that, as women, we should be able to do what we’re biologically intended to do. We think that C-sections are “cheating,” in a way. Women have been having babies for millions of years, we say, long before Cesarean section was an option.

We conveniently forget that those women were not just fine afterward. Eight hundred women die in childbirth every day, according to the World Health Organization, and 99 percent of those deaths occur in developing nations where many times C-section is not an option. Although our mortality rate is up slightly now due to the surgery, it’s not a blip on the map compared to those figures. And it’s only up when all C-sections are treated equally. The mortality rate of planned C-sections is lower than that of vaginal birth.

These numbers may reflect an increased number of emergency C-sections having to be performed after every avenue for natural birth has been exhausted. With limited time, limited resources, and a baby or mother already well on their way to injury or death, of course the surgery is more risky.

While my C-section was technically an emergency surgery, it actually wasn’t. They had time to prepare. They had time to assess. They could do the surgery calmly, with no one under any stress.

It wasn’t a walk in the park. I was strapped down, and unceremoniously injected with medication, with the tech saying, “don’t move now. This could paralyze you if it goes in wrong.” What a thing to say to a woman in labor.

I was wheeled into a sickly green room, with no power over what was to happen to me. Faceless eyes loomed above masks, and everyone was intent on their surgical implements. No one looked at me, or reassured me, save my husband.

I heard them sawing at me, felt them pulling my body apart, smelled my own burning skin, and when it was over, I heard them counting—not fingers and toes, but their equipment, to make sure they hadn’t left any inside of me. It was no joke.

But obstructed birth is no joke. Breech babies are no joke. Fetal distress is no joke. A cord around a neck is not a joke. These are serious conditions that Cesarean sections help to alleviate.

The fact of the matter is, our biology has yet to catch up to our lifestyle. We’re having bigger babies. We’re having multiples. We’re having children later in life.

Overlapping skull and all, some women’s birth canal simply cannot handle a 10-pound baby with a 34-cm circumference heard. Some women cannot carry to term and their children need special birthing care. Some carry too long, and evidence shows mortality is higher for babies born over 42 weeks gestation. C-sections help them have their children. Why make them feel bad about that?

Women who have to undergo sections require serious recovery time. Their children may face obesity, allergies, asthma, and diabetes. But their children may also have a better chance of being alive, or avoiding other serious health risks. That assessment is up to each individual woman and her doctor or midwife.

I’m not saying everyone should go out and have sections. The U.S. rate stands at 33 percent nationally, and the WHO says that’s too high. I’m not arguing with them. I’m not saying this surgery is better than natural childbirth by any means. I’m simply saying that if a woman chooses to have a Cesarean, perhaps there’s a good reason for it. After all, surgery is hard. But having healthy children, and being able to care for them as a healthy mother is important, at least to me.

My kids are six, now. Both happy and healthy, and most importantly, alive.

Darlena Cunha is a freelance writer. She blogs at Parentwin and can be reached on Twitter @parentwin.

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