Utter the phrase "natural childbirth" and the mind envisages a stoic and earnest woman, surrounded by murmuring midwives in a softly lit room, where ambient music plays and tea lights flicker. Upon the elapse of some decent, manageable labor, she pushes out her baby with honest grunts. While that may be true for some, for most women natural childbirth is one of the most violent physical traumas they will ever experience, bar a serious accident or grievous assault. The average length of labor for a first-time mother is anything from seven to 12 hours, but it can easily be 20 hours or more. During that time, she is wracked by contractions — a euphemism that doesn't even come close to conveying the violent spasms that take hold when the body reflexively tries to squeeze a baby through a narrow vaginal opening. The forces involved are such that when the baby's head emerges, it can do so with sufficient pressure to rip the mother's perineum and leave grind marks on pubic bone. In many ways, the act of giving birth resembles a medical emergency — in fact, if no medical intervention of any kind were made, up to 1 in 67 women would die in labor. Fear of birth pain is thus legitimate and it is no wonder that many women elect to have C-sections — especially when the procedure is over in about 40 minutes and feels no more uncomfortable, in the words of an anesthetist in one of Hong Kong's top maternity hospitals, "than someone rummaging around in your tummy." When cost is not an issue, women express even greater interest in cesareans. In Hong Kong, just over 45% of private-hospital births are surgical, compared to a territory-wide rate of 27%.
Good night, nurse! If you talk about it that way, well, I'd choose a cesarean too. But they don't talk about the c-section. They don't say how they take the woman into a hard, bright, cold room and remove her clothes. Depending on the surgeon, the woman's arms may be strapped out to the side. She will have been paralyzed from the waist down, although a good portion of women won't be adequately anesthetized and will feel everything that is to come. They don't talk about how the surgeon uses an extremely sharp scalpel to cut through your skin and fat. That he pokes his fingers between your abdominal wall muscles and tears them apart, holding them out of the way with cold, hard, metal retractors. A "blade" that resembles a garden hoe is shoved in between the uterus and the bladder to prevent accidental cuts to that organ. Then a forceps is jammed into the uterine muscle, a suction machine vacuums out all the water and the surgeon forces two fingers into the wound and rips it open side to side. He crams his whole hand in to grab the babies head and yank it free, pulling back and forth to release the shoulders and extrude the baby. He then scrapes the placenta off with his hand and pulls the uterus out of the mother's body. It's sewn up and then all the mother's internal parts are stuffed back in, the uterus forced back into it's place, the next layer sewn and then the mother's skin stapled back together. The forces used from this violence are sometimes enough to cause vomiting on the table for the poor woman who's hands may be strapped down in the crucifixion position.
After her baby is ripped from her womb, the woman will be able to hear but not see what is going on. Once the baby has been wrapped up in a bundle, with goo in it's eyes that prevents it from seeing mom, the mother will be given a few seconds to rub cheeks with her baby who will then leave the room with the mother's support person. This leaves the woman all alone on the table with doctors discussing their vacation plans and remarking what skilled surgeons they are for being able to complete this surgery so quickly. The mother may be given an amnesiac drug so she forgets everything, including her baby's first cry. She will wake up later in a room, alone, with a nurse sitting in the corner charting and her partner/support person and the baby in an totally different area of the hospital.
The woman may be unable to walk upright for better than a week, and is often on strong narcotic pain medication that can cause constipation, reduced milk supply, and drowsiness in her and her baby. Moms with cesareans often have difficulty breastfeeding their babies, have delayed milk production, experience postpartum depression, and have higher numbers of having to return to the hospital because of infection.
That's what it's like.