Fire & Rescue

Here's what we're talking about.

You're on the second floor of a burning building. Fire completely blocks the door of the room you're in. Your only chance of surviving is by jumping out the window, despite risk of some injury. Of course you're going to jump. This is absolutely a lifesaving action.

Bruises or a sprain are a probability, a broken bone is quite possible. Other major injuries are a lower risk, but still real. Once in a great while you could even be killed by jumping out the window, but the chances are very low, and it's absolutely worth the odds and the healing time to recover from the fall. After all, staying inside the house means facing certain death. THANK GOD we have the option to jump.

Now take the fire out of the picture. The house is perfectly fine.

Is jumping out the window still an equal choice to going down the stairs and walking out the front door?

It happens almost every time the cesarean epidemic is discussed these days. The most recent skirmish that I know of, which motivated this post, was, relatively speaking, a very minor one (a site rating blogs was discussing our mighty friend The Feminist Breeder). Sometimes the conversations go on for days, comments numbering into the hundreds. No matter the specific conversation, whether it's a story on how significantly the risks increase with multiple c-sections, or the possibility of increased likelihood of various lifelong problems for children born surgically, or simply talking about ways to avoid it, someone - and often multiple someones - posts defensively about their own cesarean experience, pointing out how it saved their life, their baby's life, or the live of a loved one or a loved one's baby. In many cases this is clearly coming from an emotional place, often quite a raw one, and very understandably so.

I would never argue the validity of someone's else's birth, and there is NO doubt that cesareans are lifesaving miracles when they are necessary. No doubt whatsoever. And I believe I can safely say that I speak for the vast majority of birth advocate types on this. I am so thankful that cesareans exist - they truly are a wonder of modern medicine, and we are lucky to live in an age where they are available. Sometimes it gets tiresome to have to preface any discussion of cesareans with this lengthy disclaimer, though, as genuinely as I mean it (and I do really mean it).

Once and for all (maybe): It is the unnecessary ones we are talking about. We know that houses do sometimes catch fire. And we know that sometimes it happens even when the house had been at low risk of catching fire, even when precautions are taken. It is when the house is NOT on fire, and a combination of factors pushes women - and their babies - to jump out the window anyway.

I realize that this analogy is a simplification (as all analogies do eventually break down). A house being on fire is a pretty absolute, concrete situation, whereas the reasons for cesarean are definitely a judgment call much of the time. But there is a core truth there, as well as other ways to stretch the metaphor.

A la: A toaster catching fire CAN, in fact, lead to the house catching on fire, which could then lead to jumping out the window. But does it then follow that as soon as we smell smoking bread, we should jump out the window? I would submit that we try to put out the toaster fire itself first, and further point out ways to avoid the toaster catching on fire in the first place. And we should also give thanks that modern technology has made jumping out the window safer than ever, if the fire department has assembled and is holding a good quality safety net*.

I could go on like this for way too long -but you catch my drift. So once again, when we ("we" being rather broadly defined here) discuss our myriad concerns about the growing cesarean epidemic, we are not denying the truly life-threatening situations that have indeed saved many lives, or criticizing the mothers in those life-threatening situations, or suggesting that she would be a better mother/woman/human if she had refused the lifesaving cesarean. We just don't want other mothers to be pushed out the window for no good reason.


* Thoroughly off-topic aside: one of my best friends was a firefighter and paramedic, working for a time on a campus-based volunteer service. Once year the batch of new trainees was learning how to hold a safety net, and was having some trouble organizing their group to do so effectively. One rookie piped up, "Well, can't we just lay it on the ground?"