Caesarean sections can be life-saving procedures for mothers who find them to be safer alternatives as compared to vaginal births. A Caesarean section, or C-section can be defined as a medical procedure to remove a child through various incisions in a mother's body and uterus. A C-section differs from a vaginal birth because during a C-section, the mother is numbed, so no pain is present, and the child does not pass through the vagina. A variety of factors can play into a mother's decision about how to bring her child into the world so that it is safe for both her and her baby. Anything from severe anxiety of giving birth to extreme medical complications can take the safety of vaginal birth out of one's hands. Making a decision about how a mother's child enters the world should not be criticized nor punishable. I personally believe that if a woman thoroughly understands the complications and consequences of both vaginal birth and Caesarean sections, she should initially be able to choose how to deliver her baby.

Katie Hurley, the author of The Happy Kid Handbook, does not regret her elective C-section. Hurley wrote an article in 2013 about how her elective C-section essentially saved her life. Before she gave birth in 2006, she experienced several miscarriages. When she did find out she was pregnant the latest time, she started to panic. After seeing blood on a trip to the bathroom, she visited the emergency room and was put on bed rest for the next three months. At that time, she told her physician about her decision to have an elective C-section. Her severe distrust with her body was the key instinct that pushed her to choose a C-section over vaginal birth. Differing from the opinions and advice from her physicians and family, Katie believed the C-section would provide a better outcome for her baby and for herself. She states that "They didn't know what it was like to have a body that doesn't follow the rules." (Hurley, n.p.) They didn't understand that "Women need maternity groups and therapists specialized in treating this very specific type of anxiety." (Hurley, n.p.).  By anxiety, Hurley is referring to tocophobia. This is the extreme fear of giving birth. Despite all of the disapproval and indecisiveness from her family members, Hurley gave birth to a healthy girl in December of 2006 via her elective C-section.

Just like Hurley, several other women who wish for C-sections possess instincts and intuition about birth that doctors may not necessarily detect on medical x-rays or scans. These emotions and feelings are all too real, however. Tocophobia actually affects six to ten percent of women. Just because these feelings are not necessarily visible to physicians, shouldn't they still be legitimate reasons for a mother to choose a C-section over a traditional birth? Rebecca Eckler had plenty of trouble finding a physician who would fulfill her request of an elective C-section. Being from Canada, where C-sections are very rare, Eckler made it her mission to find a doctor in the United States who would grand her her wish. She explains in her article that "In Canada, both doctors and mothers frown upon elective C-sections." (Eckler, n.p.) Doctors who spoke with Eckler told her to fly to several different places, like Brazil, if she wanted to find someone to fulfill her bizarre request. Eventually, Eckler found a physician in Canada willing to help her. The reason she wanted a C-section instead of traditional birth was because she "was scared shitless to go through labor." (Eckler, n.p.) She was so terrified, that the thought of labor pains sent her into panic attacks. Eckler argues that "In this day and age, where it's finally okay to admit that you suffer from mental illnesses like depression or bipolar (like Catherine Zeta Jones), why can't the medical community comprehend that there are just some women who can't deal with the thought of labor and consider it a real medical problem?" (Eckler, n.p.) Eckler sets a perfect case to display that fear should be considered a valid reason for not wanting a vaginal birth. Mom Natasha Baillie also speaks of her personal experience with having a C-section in Singapore. Like most mothers from my research, Baillie had trouble staying pregnant. For that reason, she elected to have a C-section when she finally held for 20 weeks because she wanted as much control over the process as possible. Because she wanted an elective C-section, she could have a say in what date the baby would be born (around possible due dates of course), better pain management due to anesthesia, and even better organ control after the procedure. One example is better bladder control as compared to post vaginal birth, where incontinence, or lack of bladder control, is very common. As Baillie speaks of her newborn, she states that "as soon as they're out, you don't even think about how they got here." ("Natasha Baillie - My Elective C-Section Birth Story") Although the process of birth is complex and may take a lot of patience, Baillie is trying to express that regardless of which method of birth a mother chooses, the important part is that giving birth will still bring a child into the world.

Very similar to Hurley, Eckler, and Baillie's experiences above, urologist Dr. Jennifer Berman writes about her first-hand experience not only having an elective C-section, but viewing the birthing processes of other women. During her fellowship as a urologist, Dr. Berman saw exclusively how birth can affect a woman and her body. These women experienced incontinence and prolapse quite frequently. One of the risk factors of uterine prolapse is indeed childbirth, and it results in the uterus completely falling out of position and down into, or completely out of the vagina. These conditions are particularly parallel with vaginal birth. Not only did Dr. Berman use this as a factor to choose an elective C-section, but she also had a difficult time delivering her first child. She was given an epidural too early which extended the birth process and added more time to her delivery. The baby also had complications while passing through the birth canal; his head and shoulders were stuck. Because of these issues, Dr. Berman opted for an elective C-section for her next child. Her OB/GYN, OB for obstetrics, and GYN for gynecology, also wrote in the article about the events that happened on the day Dr. Berman went in for her C-section. She goes into detail about the many risks associated with C-sections, but regardless of the numerous possible risk factors, Dr. Berman delivered a healthy girl in February of 2003. 

Intuition is not the only factor when considering an elective C-section. Cost is also relative. "It has been claimed that caesarean section has a higher cost compared to vaginal birth." (Druzin and El-Sayed, 2006). Although cost might not weigh into this particular decision quite as much as personal preference on one procedure over another, it is still visible. Some suggest that C-sections should not even be offered when a safe alternative is already an option. Not only because of the increased risk factors, but because having a C-section is more expensive than having a traditional birth. C-sections are considered unnecessary because one safe method of birth is already available. Having vaginal birth as the number one procedure will supposedly save the mother time and stress in the long run. Health professionals may also have a say in the mother's choice. Medical doctors do have experience and expert advice regarding the fields they may work in, but there is no surpassing the opinion and automatic feelings of the mother. The doctor will never know how she feels. The doctor will never understand the fear or anxiety that may take over the thought of birth. The doctor will never believe the mother has an issue unless it shows up on a scan. For that reason, they should not have the right to force a mother to do anything to her body that she is uncomfortable with. Given, there are medical professionals that gladly accept women who want elective C-sections, but every doctor in this field of practice should have the same outlook. 

There is clear opposition to elective C-sections; this is what makes it controversial. Those who are against elective C-sections believe that women should follow through with the traditional method of birth unless a serious medical complication arises, which a C-section could take care of. Rosenberg, for the New York Times, claims that "In the last 15 years, the rate of C-section has gone up by 50 percent in the United States." (Rosenberg, n.p.) She writes that many of those can be filed as completely unnecessary. The method of C-section can pose risks for both the baby and the mother such as post-partum depression, or depression after birth, infection, and hemorrhage. It has also been stated that "mortality is 2 to 4 times higher in mothers undergoing C-section than those with vaginal delivery (Petitti et al. 1982), with the most common causes of mortality being pulmonary embolus, sepsis, anesthetic complications, and hemorrhage." (Petitti 1985; Lehmann et al. 1987) Cari Nierenberg states that "Having a C-section also increases a woman's risk for more physical complaints following delivery, such as pain at the site of the incision and longer-lasting soreness." (Nierenberg, n.p.) Increased risks that can occur both during and after surgery will not always be relevant for every mother. However, if a mother does understand these possible risks and is still willing to follow through with a Caesarean section, she should have the ability to do so without judgment. There is also belief that "a caesarean section may bring about an emotional disconnect from labor, and that allowing CSMR (Caesarean section by maternal request) does a woman a disservice and constitutes a lack of responsibility." (Amu et al, 1998) The mother may not be as emotionally attached to her child if she has a C-section versus having a vaginal birth. The absence of a "push" and true feelings of birthing pains may have an impact on how emotional the experience may be. I believe this to be untrue. The amount of time a mother spends with her child prior to birth is so much more important in this sense. Regardless of how the child is delivered, the mother should and will always have a strong and emotional connection with her child. Proposing this, the birthing decision should not be focused on how strong of a bond, or how much pain will be endured while or after the child is born. 

In an article written by Mary Murry, she discusses the nature of Caesarean sections. She believes that the decision to have an elective C-section should not be made based on the fear of giving birth. She says "If fear is your major motivation, a frank discussion of what to expect might help  --  as can a childbirth education class." (Murry, n.p.) I disagree with this. I do not simply believe any mother who has her mind set on a C-section will simply be talked out of fear and anxiety over such an important procedure. Just as Katie Hurley stated a few paragraphs prior, people with tocophobia and birth anxiety need maternal groups and therapy specific to their problems. The decision to have a C-section, and obviously the severe anxiety that may come with the thought of vaginal birth should not be taken lightly, and I feel that this article has made it clear that it can be taken lightly. For some, a simple talk with a medical professional may do the job, but following my research, no problem as severe as tocophobia can simply be cured by small talk with a doctor. Fear can absolutely be a deciding factor for some women. It should be acceptable for a woman to choose a procedure that she feels more comfortable with than to be pushed into a procedure that she doesn't feel comfortable with. 

There is tangible change happening when it comes to the value of a mother's request. According to BBC, Britain's, National Institute for Clinical Excellence is now proposing new guidelines saying that "for all women requesting a Caesarean section, if after discussion and offer of support, a vaginal birth is still not an acceptable option, offer a planned Caesarean section." (North, n.p.) This is excellent progress from the current standards that state "maternal request is not on its own an indication for Caesarean section." (North, n.p.) They also currently state that "An individual clinician has the right to decline a request for Caesarean section in the absence of an identifiable reason." (North, n.p.) It is clear that this issue is evolving. It is becoming very relevant in today's society because of a current trending backlash to traditional standards. The author of an article published on Jezebel says that "All things being equal, women deserve to make their own decisions about the birthing process." (North, n.p.) She is absolutely right. Not only women, but everyone should have the right to make decisions about his/her body. 

The topic of C-sections is one that can easily fit as a subcategory of women's rights. The process of vaginal birth, in my opinion, has been traditionalized. Just like any other expectation from women, they are expected to give birth the traditional way, regardless of how the mother truly wants to deliver. I personally believe that if a woman thoroughly understands the complications and consequences of both vaginal birth and Caesarian sections, she should initially be able to choose how to bring her child into the world. Every woman should have the exclusive right to her body. The value of ownership and control over one's own body is so precious, and should not be bothered. When loved ones and medical professionals intervene with a woman's right, it may result in consequences and regret. There may positively be intuition that pregnant women feel that medical doctors cannot detect through exams and scans. For these reasons, I believe women should have the option to choose how they deliver their babies.

