The Cesarean Section: How Expectant Mothers Experience It

The state of mind with which one thinks about a cesarean during pregnancy is very different from facing one without warning, because of some unforeseen event that makes a physiological birth impossible, or too risky. In these cases, it's inevitable that the cesarean is experienced with great anxiety, concerning above all the baby's health. The mother, often exhausted and in pain after hours of unproductive labor, awaits it as the solution to her fatigue and suffering: she has no time (and often not even the strength) to try to oppose something that is by now inevitable, even if it isn't the birth she had imagined.

Depending on her own psychic makeup and unconscious fantasies, every woman has expectations about how she would like her birth to unfold, and experiences differently the possibility of having to undergo a cesarean, which is either demonized or desired to the point of being preferred over a natural birth that frightens her more than the surgical procedure.

But what lies behind these preferences? Is it only a negative experience, personally lived through or heard about, that leads a woman to take sides for a particular kind of birth?

While the desire for a natural, physiological, minimally medicalized birth applies to most expectant mothers, two categories of women stand out who, from the moment they become pregnant, insist on choosing how they will give birth, placing their own demand ahead of the objective assessment that only the gynecologist following them through pregnancy and/or at the time of birth is able to make.

Some want a natural birth «at any cost», so as not to interfere with the natural course of the event: they therefore ask to avoid induction even when there might be reasons to induce, want to give birth naturally even if the baby is poorly positioned, refuse the epidural even though it could ease the pain, and so on.

This stance, which must inevitably be abandoned wherever medical intervention becomes essential, is driven by the feeling that being the protagonist of one's own birth is fundamental to establishing a bond with the child. What these mothers forget, though, is that if this bond was formed during the nine long months of pregnancy, it isn't the «brief» moment of birth that will change it, even if the mother isn't awake and alert to feel the baby coming out of her. It almost seems as if these mothers need to actively take part in the baby's birth in order to become aware of the separation it entails. And yet, while it's inevitable to acknowledge the separation on a physical level, it's far harder to accept it on a psychological one. How many women, even though they gave birth exactly as they wished, go on experiencing their child as if still part of themselves, without trying to see them as a separate being, with characteristics and desires that may differ from their own!

At the opposite end are women who reject the idea of natural birth and, from the very start of pregnancy, ask to schedule a cesarean.

The reasons can vary: an inability to bear living with the uncertainty of the birth date, fear of physical pain, or wanting to hand over such an important task to a medical team.

It's as if the desire to control, and/or skip, the moment of childbirth, going straight from being pregnant to holding the baby in their arms, were so strong that it obscures the fact that a cesarean is an operation carrying greater risks and requiring a longer recovery than a physiological birth: for this reason, it should only be performed when there is a real need for it.

It would therefore be worthwhile to give oneself the chance to explore what lies behind such rigid «demands», poorly suited to situations that instead call for great flexibility, since they can unfold in rather unpredictable ways.