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Dr. Lauren Messinger and her husband after her second cesarean birth. Photos courtesy of Dr. Messinger.

In my years of practice as an ob-gyn, I’ve heard many patients say they want to avoid a cesarean birth. This is a goal I share and support. But cesareans are often necessary—even lifesaving. And lately, I’ve heard more and more patients express shame and fear about this way of giving birth.

Some patients tell me vaginal birth is the only “natural” way to deliver a child. Others think it’s their fault they need a cesarean, or that having one makes them a failure. There’s now so much pressure to give birth the “right” way, that it’s hard for anyone to escape these feelings.

Dr. Messinger and her two sons in 2021.

I feel this stigma around cesareans on two levels: as a doctor who cares for pregnant patients, and as a mom who has had two cesarean births myself.

I reassure myself that my births were right for me in the same way I reassure my patients. Bringing a baby into the world is “natural,” no matter how the birth happened. For some women, a cesarean birth can be the only safe way to have a baby. It all comes down to the circumstances of your body, your pregnancy, and your baby. It’s not your “fault”—or a failure—if you need one.

But I understand that if childbirth doesn’t go as planned, feelings of sadness can be hard to shake. So now I try to talk with all my patients about the possibility of a cesarean birth ahead of time. We discuss why a cesarean may be needed, and sometimes I share my own birth stories. Here is what I say.

Prepare for either scenario.

If you have a low-risk pregnancy and an uncomplicated labor, chances are you will have a vaginal birth. There are risks and benefits of both types of births, but cesarean birth is a little riskier when compared to vaginal birth. (Read Cesarean Birth for details.) The recovery process after a cesarean delivery is also slightly longer, but very manageable.

Sometimes a cesarean birth needs to happen unexpectedly, and sometimes it needs to happen without much warning. That’s why we discuss the possibility well before the due date. We talk about what to expect if an emergency cesarean is needed for any reason. I want my patients to feel heard, supported, and prepared, no matter how they have their baby when the time comes.

If you have an emergency cesarean, it’s important to talk with your doctor afterward about what happened. Feelings of trauma can be common after an emergency cesarean, especially if there’s not open communication. (More on this below.)

Many factors can lead to a cesarean.

You may know ahead of time that you need a cesarean—if, for example, your placenta is in a position that makes vaginal birth risky. In other cases, we decide on a cesarean birth once labor is already underway. A cesarean is major surgery, but it can also be lifesaving for you, your baby, or both.

“What did I do wrong?” patients sometimes ask me after the fact. The answer: nothing. You can’t change the location of your placenta, the shape of your pelvis, or your cervix’s ability to dilate. If you labored through contractions and it didn’t work, you did all you could. If trying for a vaginal birth would have put your health or your pregnancy at risk, that’s not your fault.

I’ll add that occasionally a pregnant patient asks to have a cesarean birth, even though vaginal birth is an option for her. In that case, we’ll have an honest discussion about the procedure, its risks, and what the recovery is like. If that patient decides a cesarean is right for her, I’ll be there to help her achieve it.

Your health care team is trained to keep you safe.

The idea of surgery is scary for many, me included. I was nervous when I was a patient myself. Know that ob-gyns are trained surgeons. Each cesarean delivery is informed by years of experience and data. The way the surgery is done—from how anesthesia is given to how incisions are made—has evolved over time to be as safe as possible.

There is joy in cesarean births. I’ve had two myself.

In my case, my first son was breech—that is, feet down or bottom down, a position that would be unsafe for a vaginal birth. My ob-gyn and I decided against trying to turn him manually, and we scheduled a cesarean birth.

Three years later, I was due with my second child. Although he was head down, I chose a repeat cesarean over trying for a vaginal birth after cesarean (VBAC). A VBAC can have many benefits, especially if you are planning to have more children in the future. But I knew this would be my last pregnancy, and after talking with my ob-gyn, I decided a second cesarean was the right choice for me.

Dr. Messinger in a hospital bed holding her newborn son.
Dr. Messinger after the birth of her first son.

I felt a little scared before each birth—nervous to have surgery and to become a mother. But each time, those nerves were soon replaced by the joy I felt when I heard my baby’s first cry.

Although I could not see the baby in those first seconds, I felt happiness and love. My husband and I laughed, cried, and talked with our doctor, sharing for the first time the names we had chosen. As the doctors finished the surgery, I lay there watching my husband hold our son with pure wonder.

I still look back at the photos of me in the recovery bed, holding my new baby, surrounded by my health care team in a room full of warmth.

Support is available to help process emotions.

I know not everyone has experiences like mine, as much as I wish they did. When my patients express regret after a cesarean, I listen closely to what they say. I reassure them that we chose the best course for a safe birth, and I encourage them to keep talking with me or other health care professionals about their feelings.

I wish no one felt ashamed, inferior, or “less than” because of a cesarean birth. But as I’ve realized, these feelings are common, especially after an emergency cesarean. Any birth experience that doesn’t go as planned can be distressing or traumatic. And long-lasting feelings of guilt about a cesarean birth can put you at risk for postpartum depression or anxiety.

If you’re struggling with painful emotions after a cesarean, please consider mental health counseling. Reach out to your ob-gyn, who can suggest a therapist near you. There are also support groups and resources for women with difficult birth experiences.

As a society, we need to be better about supporting women no matter how their babies are born. Whether you have a vaginal delivery or a cesarean, you deserve to come away satisfied with your birth experience—and feel proud of how you had your baby.

Published: September 2022

Last reviewed: September 2022

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This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

About the Author
Dr. Lauren Messinger.
Dr. Lauren Messinger

Dr. Messinger is an obstetrician–gynecologist in Washington, DC. Her professional interests include obstetrics, adolescent gynecology, and infertility. She is an ACOG Fellow.