Last week I showed my students the documentary The Business of Being Born, an eye-opening and important film about birth in the United States. While I applaud the film in multiple ways, I always wonder whether its critique of the medicalization of birth, and its elevation of natural birth without intervention, might not inadvertently make some women feel shame. What about those women who “fail” in their quest for a natural birth?

Writer Solange Lopes reflects on her own struggle with ideals of natural birth in the essay below. A mother, writer, and editor of the blog, Solange last wrote for Global Mama in July. Originally from Senegal, she now lives in Rhode Island.

— Heather Hewett

Natural or C-section: Birth or Stigma?

Hello, my name is Solange, and I did not give birth naturally, twice over….

Sounds like the typical introduction line at your local AA meeting, yes? Maybe there’s a reason. I delivered my daughter via emergency Cesarean section three years ago, and had a repeat, scheduled intervention for my son’s birth eight months ago.

Now, understand, I am an African woman, born and raised in Senegal, West Africa. My maternal grandmother walked herself to the hospital to deliver each one of her 12 children, all of them barely a year apart from each other. Where I come from, women are admonished not to scream in the labor room, because giving birth—naturally that is—is a woman’s ultimate pride.

As I suffered through 18 hours of excruciating labor, my mother, sitting by my side alongside my husband, kept reminding me to breathe… and to forego the epidural. I didn’t need it, she said, I could just push my way through it. Well, it turns out that my body wasn’t exactly in a cooperative mood, and neither was my mind.

I can still taste the disappointment in my mother’s eyes, as salty as the tears rolling down my face, as I signed the medical release authorizing the drugged relief into my body. A lifetime of suffering and self-denial flashed through her eyes, as she shook her head and sat back down with the heaviness of forced resignation. Despite the relief offered me a few hours later, pain still stung my entire being, this time more mental, more acute.

Hour after hour of pushing and breathing and laboring, and… nothing! Then the doctor’s stern face announcing that the baby’s heart rate was declining and that surgery was needed. The first thought that coursed my mind was: “What will my mother think about it?” I had mentally foregone my unborn child’s well-being, as always seeking my mother’s approval. I was not a grown woman giving birth; I was back to being a fatherless little girl looking for her mother’s approval.

And again, I saw it. The disapproval in her eyes, the images of centuries of strong women before me who gave birth alone, laying on dirt floors, with little or no assistance at all… And I, incapable, unworthy, weak thing!

The remaining hours were a blur. Within a matter of minutes, I was a mother: a child, my child, removed from the depths of my womb, or so it seemed. I was neither deserving nor did I feel entitled to receive the customary congratulations. The title of mother felt usurped, stolen by this little woman, this sell-out whom I could only perceive from my ego’s eyes. This other woman, not me, who had not proved worthy, or up to the task at hand.

In both Senegalese and Cape-Verdean cultures, both cultures I was raised in, how you gave birth is more important than the extraordinary act itself. When my more Westernized guests would inquire about the height and weight of my small angel, some other guests would ask, crudely and without compromise: “So did you have her natural?”

As I would fumble, searching for the right enough words to summarize one of the most defining moments of my entire existence, I would meet, yet again, disapproving glance after shocked look.

Ay credu, you couldn’t push that baby out?”

Scheduling my son’s delivery via C-section was no easy feat either. Faced with the grim statistics of a repeat C-section delivery as opposed to a VBAC (vaginal delivery after C-section), I followed my doctor’s recommendation and opted for another intervention.

Another silent inner battle against deep-seated feelings of lacking self-worth and humiliation. Yet another excruciating series of questions from family members. Another opportunity at practicing my hard-earned skills at dodging inquisitive glances and words alike.

Yet in all this confusing brouhaha of egotistical mentalities, mine included, one cannot help but hear the deafening sound of sad world statistics around maternal mortality.

According to the World Health Organization’s May 2012 Fact Sheet, approximately 800 women die every day from preventable causes related to childbirth and pregnancy. Ninety-nine percent of these occur in developing countries like my native Senegal. The reported figures are staggeringly high: for each 100,000 births in developing countries, 240 result in maternal death. Compare this to a maternal mortality ratio of 16 per 100,000 in developed countries. As much as unnecessary surgeries should certainly be avoided, it is evident that adequate medical care before, during, and after childbirth is still lacking.

Having access to surgery saved my life and my babies’ lives, despite the cultural stigma I am trying hard to let go of. It will save the lives of many like me who are privileged enough to benefit from it.

But shouldn’t this privilege be available to all women?

Hello, my name is Solange, I am healthy, and so are my babies.