1. Their experience isn't open for judgement.
Doctors, hospitals and public health officials across the United States are working to help lower the national C-section rate, and for good reason. While the surgery can be necessary, there's also strong evidence that it's being overused. But that doesn't mean the personal birth stories of C-section moms are open for analysis, and postpartum women don't need friends and family speculating about whether things might have been different if only they'd delivered at a different hospital, or tried positions X, Y and Z ... or whatever.
"It's OK not to take other people's s**t," said Sharon Muza, a Seattle-based childbirth educator and doula who offers a childbirth class for C-section families. "It's OK to say, 'We don't owe you an explanation. We made the best decision for us.'"
Also, women who have C-sections aren't "lucky" to have missed out on the pain of labor, which according to Muza is something well-meaning friends and family will sometimes say. Many C-section moms spend a lot of time in labor, and it may have been long, hard and every bit as painful as labor that culminates in a vaginal delivery. Plus really, why compare?
2. They might be really disappointed.
Few women start out their pregnancies dreaming of a C-section, Muza said, and many will feel sad to have ended up with one -- especially if their experience was traumatic in any way. "All of the emotions are OK. Sometimes, very different emotions sit next to each other and don't necessarily want to play nice," she said.
"One minute you might feel, 'I’m mad. I’m angry,'" she continued, "but then that mingles with, 'My gosh, I’m so grateful to have a healthy baby, and an avenue that allowed me to have that baby. Shouldn’t I be grateful, why am I angry?'" That's particularly true for women who feel like they didn't have much of a voice or vote during their birth experience.
The key, Muza said, is for women to give themselves space to feel all of those different emotions, and for friends and family to keep an open mind, allowing moms to share whatever it is they're feeling. And some moms won't feel disappointed or conflicted at all.
3. They just had major surgery.
Reminder: Postpartum women need help.
"Whether they had a C-section or a vaginal delivery, women need time to heal," said Dr. Andrea Fernandez, section head of general obstetrics and gynecology, at Wake Forest Baptist Medical Center. "We say usually at least six weeks [after a C-section]," she explained. "With a vaginal birth, it can be less than that."
That's not to suggest that C-section moms are helpless; it's simply a reminder that they just had a serious operation. Most need around a week before they can drive, Fernandez said, and they shouldn't lift anything more than 15 pounds (like, a toddler) for at least six weeks. If friends and family can take over certain every day tasks, like caring for older children, cooking meals and doing loads laundry, "that's huge" she said, adding: "It can be very hard for women to remember that they can say, 'Yeah, I need help.'"
4. C-sections have improved.
"C-sections have changed for the better," said Fernandez -- and the C-sections of today are pretty different than C-sections of even a decade ago. Even the incision itself is generally smaller than it used to be, Fernandez explained, and many doctors and hospitals now allow for measures such as immediate skin-to-skin contact, to promote bonding and breastfeeding. Women can and should feel empowered to ask for having a few support people in the OR if that's what they want, echoed Muza, and can even bring in comforting items from home, like blankets. "There can be lots of choices for women having C-sections," she added.
And having one C-section doesn't necessarily mean a woman will have another one with any subsequent children, Fernandez said, because of the increased access to vaginal birth after c-section (VBAC). "The old expression was, 'Once a C-section, always a C-section, but that's not true anymore, even if women have had more than two," she said.
5. A C-section is still childbirth.
It seems incredibly obvious to say, but the 30 percent of women in this country who have C-sections don't somehow "miss out" on the experience of giving birth -- and that's true whether their C-sections are scheduled and they never experience a single contraction, or they end up in surgery after hours of laboring.
Yes, a surgeon physically removes the baby, but moms do everything else. Their bodies grow and nurture their little ones. They stay strong and calm during a major operation, and recover after. And with a little bit of help, they bring their babies safely into the world. No one should ever discount what an amazing accomplishment that is.