Why women like me are choosing caesarean when they give birth | Elspeth Hussey

When Elspeth Hussey tells people she’s choosing another caesarean, the eye-rolls begin. Today, the SAWeekend columnist asks why women’s birth choices remain so controversial.

Baby number two is on the way and I’m in full planning mode. Shortlist of names. Tick. Second car seat and cot. Tick, tick. Caesarean booked. Tick.

Who knew deciding how to give birth could stir up more debate than co-sleeping or screen time?

I was one of approximately 112,000 Australian women who gave birth via C-section last year. Just under half of those were elective. I chose it because I wanted it – and feel lucky to live in a world where I can choose what works for me. And it did.

Much focus is put on the “birth experience”. People will fiercely argue that natural births are a superior experience. Of my “experience” what I remember above all else, is the sound of my baby’s first cry and the first hold on my chest that changed my life forever.

This is a notoriously sensitive topic.

Seven News presenter and SAWeekend columnist Elspeth Hussey with baby son Monty. Picture: Supplied

A woman’s reasons for choosing a caesarean – anxiety, age, past birth trauma – are often dismissed with eye-rolls or the old line: “too posh to push”.

Instead of recognising caesareans as a medical breakthrough that’s helped bring babies safely into the world, some still dwell on the “experience” – and what it says about the woman.

When a mother from my playgroup shared her plans for a C-section with her family, her brother-in-law declared he “didn’t believe in caesareans” – speaking from his extensive experience with vaginal births, of course.

People might not always say it outright, but the message is clear enough: “Shouldn’t you at least try to do it naturally?” or “You know it’s major surgery?”. I’ve found it’s the silent disapproval that lingers the longest. Second time around though, it’s water off a duck’s back.

“Just smile and laugh,” my obstetrician told me. “You’re not in the minority. It’s the new normal.”

The pattern in Australia is clear: the number of women having caesareans is rising – and rapidly.

Elspeth Hussey and Alastair Dillon moments after the C-section birth of first child Monty.

The latest available data from SA Health shows 38 per cent of South Australian births were via
C-section in 2021. In 2005, it was 25 per cent.

Updated statistics are expected within weeks – and experts believe the current figure could nudge closer to 50 per cent.

At Ashford Hospital last May, 70 per cent of babies born were via caesarean. Many of those were planned. In some Adelaide practices, obstetricians now deliver exclusively via C-section – meaning women wanting a vaginal birth may need to look elsewhere.

For many women, it’s about the certainty and control that comes with booking in for a C-section. For others, it’s the fear of long-term pelvic floor issues – or something going awry during labour.

One in three Australian women will experience a traumatic birth, according to a world-first inquiry in New South Wales.

That’s not to suggest a caesarean would prevent their distress – in fact, many women who gave submissions said enduring an unplanned caesarean was the cause of their trauma. But advocates have used the findings to call for changes to the Australian system, including moving away from a “one size fits all approach”.

Elspeth Hussey and husband Alastair Dillon with baby Monty.

Some hospitals now offer so-called “gentle caesareans” that incorporate aspects of a labour and delivery experience, such as letting the mother watch the birth and hold her newborn right away.

Of course, caesareans come with risks – just as natural births do. We all carry our own hopes, fears and reasons into the delivery room – but we’re all working toward the same goal.

If there’s anything that should bring women together, it’s childbirth. Alas, the baby bible What to Expect When You Are Expecting reminds us that we’ve long pitted “ … homebirth mums against hospital mums, unmedicated-birth mums against mums who opt for an epidural, VBAC (Vaginal Birth After Caesarean) mums against those who sign up for a second section.”

If only it ended there.

After that you can look forward to breast or bottle, stay-at-home or back-to-work and baby-wearing versus prams.

My sister-in-law calls it the “baby Olympics”. Gold for who had the hardest, drug-free labour. The best breastfeeding bosoms. The baby who crawled, walked or spoke first. A battle for “best” mother – that stretches well beyond the birth.