THE CUT

The world first heard Rachel Somerstein’s story in a harrowing, brilliantly written essay on Longreads that chronicled her traumatic first birth via emergency c-section. The piece struck a major nerve—it was picked up by the Daily Mail and generated a slew of reader responses sharing similar experiences and words of gratitude and support.

In a way, such a strong response should come as no surprise: 1 in 3 babies are born via c-section; that’s over 1.1 million births in the US in 2019, a rate that has grown exponentially over the last 50 years. But at the same time, most people – even those who have had a c-section themselves – would never peg the number that high. In popular culture, mommy blogs, even standard medical advice and parenting books, c-sections are all-but-invisible, and when they do happen, while sub-optimal for those on the natural parenting train (the main train leaving the station these days), they’re portrayed as benign, even an “easy way out.”

Rachel’s experience left her reeling and desperate for answers. Completely unprepared for the operation itself and given little guidance on the recovery process, she was having difficulty nursing and bonding with her baby (common issues with c-section births, though no one advised her of that at the time) in addition to being unable to sit up or go to the bathroom unassisted. In fact, the surgery comes with many risks, both short- and long-term, from complicating future pregnancies to postpartum depression to nerve damage. The truth is that while in most cases it is “safe and routine,” it is also vastly overprescribed, according to the WHO, and contributes to America’s ignominious rank as the most dangerous industrialized country to give birth in. Its burdens fall disproportionately on Black people, people of color, and poor people, who are overrepresented in those numbers. In fact, when they become pregnant again, many people will go to extremes, including skirting medical regulations and crossing state lines, just to avoid having another.

As Rachel emerged from the pain of the early days, she tried to listen to the advice from those around her: you’re fine, the baby’s healthy, move on. But the experience dogged her, and, with her journalist’s eye and honed research skills as an academic, she set out to understand why, in a moment where women are breaking taboos left and right on issues around sex and reproductive health, the world’s most common operation remains so much in the shadows.

What she found reached far beyond the operation itself. Even the women she spoke to who had had uncomplicated c-sections often felt that they were missing something – that they hadn’t really given birth, as Leslie Jamison powerfully captured in her Times magazine piece on the subject. There is a strong expectation among low-risk, healthy parents, encouraged by health care providers, that if they do pregnancy “right,” their birth will follow the cultural script: a transcendent vaginal birth, in which the mother’s pain and effort is transformed—indeed, erased—by the bliss of union with her baby. When that pain persists, our instinct is to look away, to deny it, and to ascribe blame to the mother. In her research, Rachel found that again and again, fetishization of motherhood and the pregnant body as a sacred space were twinned with denigration and denial of pregnant people’s autonomy and even their safety – the idea that their pain was a sacrifice to be expected on behalf of their children, and that their body was disposable once it had served its purpose. She illuminates surprising connections between hospital policies on c-sections and legal restrictions on abortion, which both stem from these same dangerous ideals. The moment for this exploration could not be more timely, as women across the country are fighting back against Texas and other states’ growing stranglehold on reproductive rights. The way we look at (or away from) c-sections tells us so much about how feminism and health intersect; how pregnant people are treated in our healthcare system and in society more broadly; and about racial, economic, gender and sexuality-based discrimination in the health system. All of this underpins the question at the heart of the book: what do we want from birth, and how can we create change to make it an experience that is safe, equitable, and joyful for everyone?

Ranging from the surprising history of the operation (which may not have been practiced on Julius Caesar’s mother, but whose technique was refined on enslaved women) to modern-day ideals of pregnancy and birth, The Cut features perspectives from medical experts from hospital administrators to home-birth midwives alongside a diverse group of women who have had the operation to capture the full picture of the c-section experience. While c-sections typically feature as a chapter in popular pregnancy books, the information they provide is woefully inadequate to those who actually have the operation. This book will be the first to offer a personal narrative, practical guidance, and rigorously researched context, an ideal resource for those planning a pregnancy and those who have (or have loved ones who have) experienced the operation, as well as readers interested in how we give birth as a feminist issue. Most importantly, it will serve as a desperately needed point of communion to rally around in the project of breaking this persistent taboo.

Rachel Somerstein teaches journalism at SUNY New Paltz and holds an MFA in creative writing from NYU and a PhD in Mass Communications from Syracuse. Her work has appeared in n+1, the Washington Post, the Boston Globe, WIRED, Guernica, and the Rumpus, among others, and she’s been a guest on NPR’s “On the Media.”