Do you cease being a woman after a caesarean birth?

A lot of mothers have had their babies through Caesarean section aka C-section and came out strong. Many more mothers will still have their babies through C-sections and still come out strong. No woman should be stigmatised or called lazy for birthing through C-sections. Shout out to the belly birth mamas; the warrior women who lay their lives on the operating table for their little ones. You are brave. You are bold. You are beautiful.

This is a message I shared on some of my social media platforms like WhatsApp and Facebook. Hardly did I know that this would catch the attention of most of the people in the community including medics and men. 

On one of the platforms, a lady said, “society has done a lot to stigmatize women who deliver by C-section”. Another one said “I remember after delivering my 1^st born via C-section, my friend paid a visit and assured me how I was such a lazy friend and wondered how I could fail to push my baby”.

On another platform, it turned out into a heated argument where one of the men said, “we encourage women to push their babies and it’s true most lazy women opt for C-section”. On most of the medical platforms, the comments were a mix with some saying we are having an increasing number of C-sections and that this procedure has been monetized especially in the private setting while others agreed that in our setting, C-section mothers are stigmatized. Another member said, “lack of knowledge, cultural and religious beliefs bring on the judgement and many women have perished during birth due to such”.

On the other hand, some members said that giving birth is a do-or-die and if C-section is what it takes to save a life, why not.  On another platform, one or two members even concluded that such a message promotes C-section, yet according to them, every woman should strive to push. 

As a Nurse-Midwife and Women’s’ Health Specialist, I have witnessed some women lose their babies or even their own lives due to such negative perceptions and traditional beliefs, even when all the medical reasons for need to perform a C-section have been explained to them.

Common indications of C-section include; obstructed labour, previous scar, antepartum haemorrhage, cervical dystocia, multiple pregnancies, malpresentation, malposition, inadequate pelvis and more.

 C-section is a life-saving intervention when vaginal birth represents a risk to the health of the woman or baby. Globally, rates of C-sections are increasing; and in the last 15 years, global rates of C-section have doubled to 21% of all births, and it is estimated that it will increase to 28.5% by 2030.

Although C- section is a life-saving intervention when medically indicated, it is not without risks for both women and babies, including higher risk for women of mortality, haemorrhage, infection, urinary and intestinal injuries, as well as long-term risks of abnormal placentation, ectopic pregnancy, stillbirth, and uterine rupture which increase after each subsequent C- section.

Some research studies have shown that babies born by C-section can be altered by the difference in exposure to hormones and bacteria compared to those born vaginally with evidence suggesting a link with higher risk of allergies, atopies, asthma, and childhood obesity, and decreased gut microbiome diversity. 

The community is therefore advised to embrace all women who have undergone C-section to bring a life on earth and stop the habit of stigmatizing them. All health workers need to ensure that any birth, whether vaginal or C-section, is free of stigma and judgment.

Lilian Nuwabaine Luyima is a BSc-Nurse & MSN-Midwife & Women’s’ Health Specialist & Heroes in Health Award Winner-Midwife of the year 2021