“Please talk about your feelings and ask for help when you feel bad.”

– Words of encouragement from our TUJU midwife Kerstin Lüking

Why is the number of C-sections in Germany so high? How can we get past negative feelings and thoughts after a Caesarean? Who can help us now? And how can you bolster all the C-section mums out there? Here is where you get even more tips from our midwife Kerstin on dealing with a C-section.

How many women give birth via a C-section? And why? Why is this number so high?

According to the German Federal Statistical Office, the rate of C-sections in Germany is currently just under 30%. Leading the list is the German state of Saarland (37%), and closing it off is Saxony (24%). Compared to the EU, Germany is, unfortunately, in the upper third, and the rate has nearly doubled since the start of the 1990s.

For me as a midwife, this is a very sad development. Because it means that every third birth in Germany ends in a C-section. The reasons for this often lie in giving parents the ability to plan better, in the fears of mothers and, of course, in the reduction of risks. Clinics and medical personnel are very worried about the complications that can arise from a spontaneous birth, which can make them liable.

An operation also comes with risks.

Unfortunately, things don’t always go as planned – after all, every operation comes with risks such as blood clotting or infections for the mother. Naturally the consequences for the children have also been researched. It has been shown that the risk of suffering from asthma increases. What’s more, the tendency to become extremely overweight has also been discussed.

I always ask that mothers or parents think about whether a desired C-section is actually really necessary. Frequently, the expecting mums can be convinced to rethink their decision over the course of many informative talks. We can minimize any fears and highlight the advantages of a spontaneous birth in an often persuasive way. Of course, a spontaneous birth is painful, but a C-section is not any less painful – the pain simply arises after the operation in this case.

Many women forget that they are very limited in their actions in the days following a C-section. This fact alone can be very stressful, which, in turn, can lead to problems with breastfeeding. The circle is unfortunately very large, and the mother requires lots of support to help her get better.

“It doesn’t hurt to know which processes take place in the body when giving birth.”

What tip do you have for women who are to give birth: should we basically be prepared for the fact that a C-section will be needed? If yes, how can we do this?

I basically advocate that we at least inform ourselves about the “basics” of birthing assistance. It doesn’t hurt to know which processes take place in the body when giving birth. For me, this includes a small basic understanding of anatomy and an overview of the interplay between the hormones. I’ve experienced that, in most of the cases, this information provides reassurance rather than fuels fears. Women simply know their bodies better and can better place signals such as pain.

In my antenatal classes , I never leave out the topic of having a C-section, as unexpected situations can always pop up that make an operation necessary. To ensure you don’t fall in panic and fear in such a moment, parents should at least have an overview of how this works.

Unplanned C-sections: “Many women feel overwhelmed and poorly informed.”

Please take us along in your world of feelings after giving birth via C-section. How do women feel after having an unplanned Caesarean? And how do you as a midwife help women who were having difficulty coping?

I have seldomly seen women simply take a C-section as it comes without any difficulties. There are lots of tears, and the expectant mothers don’t understand why a C-section is necessary. Many women feel overwhelmed and poorly informed. Of course, there is also the feeling that they haven’t been able to “manage” it and have thus failed as a mother.

We midwives are an important pillar of support for mothers in this situation. We can take on a lot, explain and supporting the healing process. I would like to emphasize that midwives are essential members of our society. Particularly in the first days and weeks after giving birth, a mother needs moral support so that she can grow into her new role. This takes a lot of time and can often not be provided by a doctor. I’ve had the experience that it is often very helpful for women to “simply” be heard at first. Sometimes it takes a bit longer until the new mum can express herself. I frequently just sit with the woman and hold her hand. It’s important that she takes her time. At some point, the woman will be able to communicate with words what is afflicting her. And then I can begin to explain.

Follow-up after a C-section: the clinic papers can be helpful!

To do this, we sometimes also need the papers from the clinic. They can be very helpful for the woman, because we then have a timeline that shows why the invasive procedure was plausible. I can explain, for instance: “Look, at 4 o’clock, your baby’s heartbeat wasn’t very good. The midwife documented green amniotic fluid, which is why a micro blood test was performed shortly afterwards,” etc. This enables us to unfold the process bit by bit, so that the woman can have peace of mind. The new mother then also feels mentally better when she feels physically better.

Yet, there are cases when additional specialists, psychologists and doctors have to be consulted, as the woman cannot come out of her deep spot. In such a case, we midwives are normally well networked and can organize help relatively quickly.

“I believe the causes of this feeling of being a ‘loser’ go extremely deep in our being as a woman.”

I, Doro, have also felt like a “loser” … what are your tips: how can we dispel the feeling and thoughts that lead us to believe that we are not good mothers because of a C-section?

It’s always a question of why we feel like losers. Is it perhaps the circumstance that we didn’t “try hard enough”? Because our body doesn’t work as it actually should? Do we feel “wrong” if we don’t perform as we should? I believe the causes of this feeling of being a “loser” go extremely deep in our being as a woman. Someone put this hat of the ideal woman and mother on us at some time and thus determined how we should fill it.

It’s nonsense. We have no expectations to fulfil, as sometimes simply circumstances arise that we have no influence on. As a mother, I don’t have any influence on green amniotic fluid and bad heartbeats. I can’t do anything about a pelvic or uterus anomaly. It’s not by fault if I have weak contractions.

We continually have to say this to ourselves:

“It’s not my fault! I can’t change anything. I have to accept it now and will get better with help and support. I will pay closer attention to bonding with my child and focus on myself and my baby. I will do everything I can to make sure I feel well and am at peace. One C-section does not mean I will have another. I’m not a bad mother. A C-section is also a way of giving birth.”

A C-section birth is also a great chance!

I think we are doing something wonderful by finally taking this “coat of guilt” off of women, which they unfortunately put on much too often. Luckily, there is the chance today to support women in a different way who’ve had a C-section. Unfortunately, the methods of a C-section birth have not made their way into all clinics, but the good news is that the methods are gaining acceptance. We’ll share more about this during part two of our talk!

Do you have more boosting words for all those C-section mums out there?

Please keep my words in mind! It’s not your fault, you are not bad and have not failed. Please talk about your feelings and ask for help if you’re not feeling well. Give your body and your soul time. It often takes several weeks until you feel well again. And it’s completely okay if you cannot take care of many other things during this time.