The panoply of risks associated with a C-section admittedly felt abstract. I was more frightened I might arrive at a place where my panic disorder felt inescapable—the maternal and fetal risks associated with having anxiety and panic during pregnancy felt much more immediate. Shouldn’t choosing to have a C-section be my prerogative?
I’m not alone in thinking that way. “Risks of surgery were not even a concern for me,” says Clare Frances, a mom in Palo Alto, California, who also asked her ob-gyn for an elective C-section when she was pregnant with her first baby. “Easing the anxiety and exercising control vastly outweighed any slight thought of possible medical risks—it was 100% based on what was the best emotional choice for me.”
The Hard Sell
Like my ob-gyn, most are “reluctant to grant requests for an elective cesarean section (ECS) due to childbirth fear,” according to a paper published in the journal BMC Pregnancy and Childbirth.
That may be changing, though. “In 20 years I have seen a trend in this direction with more emphasis on patient autonomy, awareness around consent, and discussion of process and choice,” says Suzanne Gilberg-Lenz, M.D. a board-certified ob-gyn and an adviser for Bodily. “Perhaps as women feel more partnership with their doctors and more empowered and less body shamed, they are asking more questions about the mode of delivery and feeling more able to voice their own expectations.” In her experience, women who request elective C-sections often have a history of trauma, a mood disorder, or anxiety—all things that can add potentially harmful stress to a pregnancy.
We’re told that wanting an elective C-section is potentially dangerous, but what about the risks of going through a pregnancy that seems at odds with your mental health? “A planned cesarean in a controlled environment, while still being an abdominal surgery and carrying risks, is actually quite safe in the hands of an experienced and skilled obstetrical surgeon,” says Dr. Gilberg-Lenz. “Surgeries should never be undertaken lightly, but this is what informed consent is all about.” She finds that when she as a doctor is open to elective C-sections, it helps her patients feel heard. “It's about creating safety and trust by listening to the patient, educating and supporting her through the process,” she says. “Most frequently, when I get requests for elective C-sections, they are abandoned later on because of the relationship that we have developed.”
Even with the support of a doctor, the stigma persists, whirring around in every phase of the pregnancy journey. “I felt very alone,” says Rachel Heston-Davis, a 36-year-old in Illinois. “My husband and I only told our parents and four very close friends about my choice. We told other people we’d had to schedule a C-section for medical reasons. I didn’t feel ashamed of my choice, but I knew I would get angry if people argued or made me defend this mental health decision, so it seemed easier not to poke the hornet’s nest.”
The Right to Choose
An obstetrician who’s willing to consider an ECS can change the experience for women with a fear of delivering vaginally. “As an anxiety sufferer, anything that overwhelms me physically and mentally can send me into a very dark place that is hard to recover from,” says Heston-Davis. “I was afraid to get pregnant until my ob-gyn reassured me that she would okay a C-section for me. The choice to elect for a C-section made a difference to literally every facet of my conception, pregnancy, and actual childbirth experience. If I’d spent my pregnancy anticipating vaginal delivery, I would have had frequent anxiety draining me on a daily basis. After that dark cloud of worry lifted, I became joyful about the thought of starting our family.”
