Saturday, April 3, 2004

Choosing a Cesarean

Choosing a Cesarean
Rebecca Ryan Hunter

Today I learned that most likely, my baby will be born on the morning of May 20. My obstetrician and I got out a calendar on Friday and looked over Jewish holidays, my parents work schedules, and his brother’s wedding, and decided that May 20 would work. The baby’s birthday will be 5-20-4 which is perfect for me since I have developed an irrational fear of all prime numbers except 5 and 7. Also, 5 times 4 is 20. Numerically, it makes me happy.

Everyone I know, including myself, is surprised that I am planning a scheduled cesarean for this birth. When I was pregnant with my daughter, I planned for a natural childbirth. I worked with midwives and a doula, and did all the things you’re “supposed” to do in order to have a natural childbirth. My daughter did not agree and I had an emergency cesarean birth. Since becoming pregnant again, I have done an insane amount of thinking and research into what kind of birth is best for me, for my baby, and for my family. And it turns out, it is likely a scheduled one.

At this point, most people ask me what in the world I am thinking, choosing to go under the knife instead of delivering vaginally. The more righteous folks get angry with me and imply (or directly say) that it’s the wrong thing to do. Some folks will grant me acceptance of my choice, as long as I have enough “good” reasons.

I’ll happily supply the reasoning but not so I can get some pass on the imperfection of a cesarean birth. I don’t need anyone’s approval or understanding of my decision, I’d just like to debunk a myth that women who choose cesareans are self-centered, manicure-happy posh moms who can’t be bothered with waiting for their babies. Some of us actually come to this through a great deal of soul searching and thought, weighing factors such as personality, past experience, a family’s financial situation, and even the dreaded convenience factor.

So why? Why am I doing this?

First off, I'm a planner. I like to know things as much as possible. I like to be prepared and have plans. Much like some who may be afraid of hospitals, to some extent, I am afraid of uncertainty. Being able to make a plan makes me far less anxious and unhappy (in general) than the unknown. I think having me be less anxious in the months before and during delivery is a pretty good start to life. It helps my peace of mind to be able to go into this with a pretty clear idea of what will happen.

I never felt badly about Maggie’s birth. I do not feel sorry that I had a cesarean. Unlike many women who have cesareans, I had a very fast, easy, and uncomplicated recovery. In less than 2 weeks I was back to normal - at least in terms of physical functioning anyway. I’m pretty sure I will never be the same again since becoming a mother, but I’m pretty sure that has more to do with my newfound humming of Wiggles songs more than how the child was born. A new affection for singing dinosaurs aside, I had a better recovery from my surgery than many of my friends who had vaginal deliveries.

Then there’s the whole financial picture. Recognizing that I don’t live in a civilized country that prioritizes paid family leave for the arrival of a new child, I am stuck with my company’s existing policy, which is essentially the minimum legal requirement. I get 12 weeks unpaid family leave starting from whenever I choose to stop working and ending 12 weeks later. That is, if I stop working 4 weeks before the baby is born, I get 8 weeks afterward. We get 60% of my pay based on the physical act of giving birth – 6 weeks for a vaginal delivery, 8 for a cesarean.

I am the sole financial support of my family. We have to rely on the 60% of my income combined with a small amount of savings to pay basic living expenses for a family of 4 in New York City for 3 months. That extra 2 weeks provided for a cesarean recovery nearly covers a mortgage payment. It allows me to stay home the extra 4 weeks of unpaid leave without risking our financial situation, taking out loans, or charging our food on credit.

Equally importantly, I know when I will go on maternity leave. With my daughter, I was on bed rest for the last 3 weeks of my pregnancy. It is likely that this will happen again. If on May 1, I have high blood pressure and have to stop commuting, I can call our office and say “I need to finish the following 3 projects at home and will work through the 18th to do so.” I will be paid in full and I won’t have to shorten the time I can spend with an actual baby and with my daughter. It’s a known entity.

Between knowing when I will leave and getting those extra two weeks, I can stay at home with my new baby and with my daughter for the full 12 weeks. I can't guarantee that otherwise. The worst case financial scenario for me could be that I go on unpaid bed rest at 37 weeks, deliver at 42 weeks, and return to work 6 weeks later. 6 weeks or 12 with my family? There’s no question for me in that. I’m taking the guaranteed 12. I’ll even take the guaranteed 12 over a likely 10 any day.

One thing I have learned in the past 20 months is that for me, being a mother is about making the right decisions for my family. I think in some ways, were I to have a VBAC and choose to possibly eliminate 6 weeks of my time with my new child, I would be doing it for my own personal experience. Not for the child or for the family, but for me alone. In other circumstances, I wouldn’t necessarily make this choice. If I was a SAHM and was looking at a year or two or ten with my children, I may make a different decision. Maybe I will be sad that I missed the experience. I won't ever know. But I do know that I will get 12 weeks time with my children. 12 weeks that are worth more to me than a missed experience or a tough recovery.

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