April is cesarean awareness month.  I know, I know – there’s a month, a week, a day, a color, a ribbon, a something for every disease, disorder, condition, syndrome, event, etc. you can imagine.  So why in the world would we need a month, A WHOLE MONTH, for cesarean awareness?  Well, in my mind there are two important reasons to bring additional attention to the method of birth almost 1/3 of mothers in the US experience.

First and foremost, the fact that nearly 1/3 of mothers in the US experience a cesarean delivery – in 2014 32.2% of births were via cesarean section – while the World Health Organization (WHO) recommends an optimal cesarean rate of no more than 15%.  It is true that the rate in the US is beginning to decline, ever so slightly.  We went from an all time high of 32.9% in 2009, to the 32.2% rate in 2014.  But we are still more than twice the recommended WHO rate, so the US has a long way to go for our mothers – and awareness that we may be using this method for delivery to the extreme is an important tool to help continue that downward trend.

Second, again the fact the nearly 1/3 or mothers in the US experience a cesarean delivery is important – and remembering that even in an ideal world approximately 10-15% of women will still give birth by cesarean section is important.   We will never see a day when no mother has this type of birth.  It is extremely important to remember all of this as we talk about childbirth in our country because language matters.

It is extremely heartening to see a trend in our country towards empowered women having empowered birth experiences.  Women are starting to realize they have options for their birth experiences.  We are educating ourselves.  We are taking control and ownership of our bodies and our births.  This is FANTASTIC!  However, there seems to be an unfortunate side effect.  In the effort to discuss and distinguish the experience of a woman who achieves an intervention free, un-medicated, vaginal birth, the phrase “natural birth” has sprung up.

I do believe this phrase was born out of the best of intentions. It is supposed to champion the idea that childbirth is a normal and natural experience for a woman’s body.  It is supposed to be empowering for a woman fighting a health care system that tends to over medicalize childbirth.  Unfortunately, though, it also has the effect of dividing women and mothers who should be supporting each other.

If you ever read internet mommy chat boards or groups, you have very likely seen that sadly, some women have taken to using the phrase “natural birth” as a sort of badge of superiority.  It can be thrown out into the internet ether as a way to imply that a woman who had an un-medicated vaginal birth is somehow better, more of a mother or woman, than all of those mothers who experienced a cesarean delivery or who used/accepted some form of intervention or medication.  This, my fellow mothers and women, is a sad state of affairs.

If you did not have a cesarean, and especially if you were able to avoid all interventions and medications, imagine being a mother who did experience a cesarean; now imagine a mother telling you that in contrast to your experience, she had a “natural” birth.  How would you feel?  Would you feel like something about your child’s birth was wrong?

Using the phrase “natural” birth as a means to distinguish an un-medicated vaginal birth from all other methods of birth inherently implies that those other methods of birth are unnatural.  It implies that something is wrong with those other methods of birth, and for a mother who experiences a different method of birth it can imply that something is wrong or unnatural about her.  Her body grew her baby didn’t it?  Her body helped bring her baby into this world by creating a placenta, and an umbilical cord, and amniotic sack didn’t it?  Her baby entered this world and separated from her body didn’t it?  Ok, so her baby was born, and the act of being born is natural – even if the method to achieve that birth is different.

Yes, we as women and mothers should be advocating for a reduction in unnecessary interventions and cesareans.  We should be advocating for the health care system to remember that birth is not inherently risky or complex and that outcomes improve when it isn’t over managed.  We should be advocating and fighting for our rights to have the best birth possible.  But, we have to remember, even in the best and most ideal circumstances approximately 15% of mothers will experience some complication that will require intervention and/0r cesarean birth.  These women are not less for this.  The birth of their children is not unnatural or abnormal.  Instead their birth experiences are simply different from the women who experience an un-medicated vaginal birth.  I know, that phrase “un-medicated vaginal birth” doesn’t have the same ring as “natural birth,” but language does matter.  To properly advocate for our rights and to empower ourselves with more choices we have to be united as women and mothers.  An this phrase “natural birth” only serves to divide and create a sense of failure or shame for women who don’t fit the current definition of a “natural birth.”  In fact, if we really want to reiterate the concept that birth itself is a natural and normal process, then we should be referring to all childbirth as natural with a subset of methods to achieve the desired outcome.

To wrap up, I’ll just ask that as you talk to others about your birth experiences, be aware of the language you use to describe it.  For you mammas who had an un-medicated vaginal birth – woo hoo!  Congratulations, your body did something awesome.  Thank you for sharing your story and your help in spreading the word and knowledge that it is possible to experience this type of childbirth.  For you mammas who had a cesarean or an induction or used medication for your birth – woo hoo!  Congratulations, your body did something awesome!  It might have been different from your friend, sister, or neighbor, but guess what, you all have beautiful babies to love!  If you had wanted a different birth experience, I’m sorry.  I hope you have better a experience next time, if there is a next time. Remember you have options to explore and discuss with your providers; and if you still have a different birth experience, it’s ok, your body still grew and gave birth (however that looks) to a little person.

Women’s bodies are awesome and amazing things.  WE GROW PEOPLE!  And those people are born, in a variety of ways, all of which are natural because birth is natural.