In a blog titled "The Myth of The Unnecessary Cesarean" Dr. Nicholoas Fogelson argues that while many cesareans may be preventable, it is impossible to truly call any specific c-section "unnecessary" because we don't know what would have happened had the surgery not been performed. There's some excellent discussion in the comments (and I can't tell you how great it was to see the doctor coming back and responding!), I posted the topic for discussion on BabyCenter's VBAC board, and the discussion has continued on other blogs as well. As you might imagine, many who feel strongly about the cesarean epidemic are taking Dr. Fogelson to task, saying he's missing the point and sometimes suggesting he is no different from any other scalpel-happy OB.
I beg to differ.
Don't get me wrong. I understand the necessity of questioning the reasons behind an unwanted cesarean. I understand needing to look back and find failure in the system that put you in the OR rather than finding failure in your body. I spent literally years trying to pin down how I really felt about my own c-section, and after almost 8 years I still have not been able to finish writing my birth story because by the time I've read what I do have written I'm an emotional wreck and just can't face it. And yet... when I read the responses to Dr. Fogelson's article, what strikes me is the defensiveness, the aggressiveness, the instinct to attack over a single turn of phrase rather than consider that perhaps we are trying to acheive the same goal with different words.
Words are powerful, and the way we talk about birth is important. I've been taken to task for using the word "normal" in my blog title, we talk about how discouraging it can be when we're told we'll be "allowed" to have a "trial" of labor, and I've even seen heated debates about whether or not a cesarean should rightly be called a birth at all. While the perspective offered by this OB may raise our hackles, I think it can be helpful if we sometimes lower our defenses and agree to speak the same language when we're talking about birthing options and outcomes.