What Defines a birth? Cesarean birth and language choice | Ruth Castillo, Salty Mama Doula & Family Services

What defines a “birth”?

A closeup photograph of a dictionary entry for the word, "birth". | Ruth Castillo, Salty Mama Doula & Family Services

Birth: a : the emergence of a new individual from the body of its parent
b : the act or process of bringing forth young from the womb. 
Birth.” Merriam-Webster.com. Merriam-Webster, n.d. Web. 5 Apr. 2017.

Who decides what counts as a birth or not?

“Vaginal” and “natural” are often used synonymously to describe birth; instead of considering that “cesarean” would be the antonym, some people would rather use language that detaches “cesarean” completely from “birth”.  There are those who reject phrasing such as “cesarean birth” because it would normalize cesareans as a part of the birth landscape – as if 1 in 3 American births was not by cesarean.  Some people feel that since a surgeon intervened in delivering baby, that it was not “giving birth”.  Toxic thinking like this leaves some parents feeling detached from the experience of their child’s birth.

But cesareans are births.  The body still must open, and baby must come out.

So who decides what counts as a birth?

You do.

Ultimately, you define birth when you do it.  For you birth, may be a very active, all-hands-on-deck birth at home with two doulas, a photographer, a midwife and her assistants, and your family.  Birth might be a quiet affair with just you and your partner in a hospital.  Birth might even be a cesarean.

I most often use “cesarean birth” when I work with clients or speak of my own experience, but I also say cesarean, cesarean section, section, C-section, and surgical birth. Why? When I work with clients as their doula or childbirth educator, I use reflective language. Mirroring the phrasing and language my clients use gives them the power to define their experience. I want to validate that some of my clients give birth via cesarean, and that their journey and decisions are just as valid and valued.

Birth workers like myself, will always work towards encouraging healthy pregnancy and birth practices — practices that increase the overall health of all parents and infants.  When we work on a one-on-one level, we step back from philosophy and support each individual where they are.

I help people as they navigate pregnancy and birth, however that happens. I will always help them find the best practices to use for their health – physical and mental.  If my use of the phrase “cesarean birth” helps them to frame their experience of their child’s birth, then that is precisely what I plan to do.  Because language matters.

What does a doula look like? Blog header Ruth Castillo Salty Mama Doula San Antonio Texas

What Does a Doula Look Like?

What does a doula look like?

I honestly could not tell you.

Sorry. There is no one type of person who pursues doula work. Doulas provide support in many different situations and different people find themselves doing this work, so there’s no one doula “uniform”.

I can tell you what you can expect to see in your doula:

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The Grief of Cesareans

April is Cesarean Awareness Month.  People all over the internet are recognizing this month, reminding us that one in three first-time mothers in the United States will deliver via cesarean.

I had a cesarean birth with my daughter in 2011. It was not the birth I planned. I struggled to heal physically from that birth – extra swelling from the fluids, increased pain in my core, an infection at my incision. I still struggle sometimes with healing emotionally – grieving the loss of the birth experience I had planned, the impact on my obstetric future, the hurt of the days of separation between me and my newborn necessitated by the circumstances that led to that cesarean.

My story – my grief and triumph – is unique to me;  I will not pretend to speak for every other mother.  But I am able to speak as a supporter of people who have had cesareans – a daughter, a friend, a relative, a doula.  For those who are not sure about how to support their friend, family member or partner who had a cesarean, I want to offer you a two things to consider:

Firstly: Let them grieve. You should also let them celebrate and let them feel neutral. A person is entitled to their own feelings and perspectives. They also do not need your “permission” to feel certain ways. Telling another how to feel is not conducive to any sort of growth or momentum.

You may find that different, maybe even opposing, emotions come up for you when you are with others who are grieving a birth experience.  You can feel your own emotions… without imposing them on others.  This can be tough for some, but to be an effective supporter of people, one must learn to focus outside of their own experience and to be careful with how they direct their passions. You can advocate for reduction in cesareans, or the option of Vaginal Birth after Cesarean (VBAC) as a public health issue without negating the personal experience and perspective of a parent who did have a cesarean.

Secondly: If they are grieving their birth, you do not have to “fix” it. It can be incredibly uncomfortable to see someone grieve. It does not matter our relation to the person – some of us just have natures that drive us to want to make them happy. We want to “do something.”  But often the best “something” we can do is to just be present with our friends in pain. Be with that person, there in that moment. “Puddle sit”, if you will. You do not have to find the silver lining in the situation – “well, at least you didn’t tear up your yoni!” You do not have to educate them on what you think went wrong – “it was that cascade of interventions,” or, “your doctor was quick to cut you.” You don’t have to find anything nice to say – “Your scar is very tidy,” or, “at least you have a healthy baby.” All you have to do is be there and listen.

For some, having a cesarean birth is not something they need to grieve – they may even celebrate it.  That is okay.  For those that need to grieve the birth or an aspect of that process, that is just as valid.  Be there for them by giving them the space to grieve and lending them your ear.

Playing Birth

A couple of weeks ago, I ran into a Buzzfeed article (groan) about an odd game called “Anna Giving Birth”.  In this unlicensed app, the player assists Anna, the naïve younger sister from Disney’s Frozen, as she gives birth (duh) to Kristoff‘s child — don’t worry!  It’s okay, because they’ve known each other for more than a day now and they’re married now and he’s probably a knight or duke or something (though there’s no proof that they invited the “love experts” to the wedding *sad trombone*).

This game is not a stand-alone product.  The app stores are flush with games with titles like “Mother give a birth [sic],” “Little Newborn Baby Birth,” “My Aunt Gives Birth,” and “Pregnant Princess Mama Gives Birth Baby Girl Baby Boy So Kawaii Lots of Love…”  Okay, I made the last one up…


My issue is not with the existence of such games.

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Mary’s Christmas

Mary totally breastfed the infant Jesus. Merry Christmas from your favorite Salty Mama
Well, the story of the nativity *is* a birth story. (“Virgin of the Green Cushion,” Andrea Solari)

Does a woman born without sin get to complain about cankles?  Did she get excited when she felt those first contractions?  How did she feel when she realized she was going to labor next to livestock?  Did a sweet local woman or relation hold her hand and guide her through transition?  Did she hold that sweet infant to her chest and exclaim, “my baby, my baby!” in postpartum ecstasy?

I can’t help but ponder the details of how Mary birthed and breastfed the infant Jesus.  I think it’s part of being a doula.  Birth is a universal experience, yet it seems we always seek out more details on what made each experience unique.  (Edit: My friend and fellow doula, Nikki, has a GREAT post on Mary’s birth story as told in the Qu’ran, and the wisdom it holds for modern mothers.)

I bet the first time the Holy Mother latched her infant son on to her breast, she looked down and there were tears in her eyes, because as it is for all mothers the first time they gaze upon their child, he was perfect and the moment was magic.

I wish everyone a merry Christmas!  My thoughts are especially on new and expecting parents today – may the trials and joys of parenthood leave you a stronger person, and may your love for your children grow without bounds.