The Unnecesarean blog featured a post called “The Most Important Thing”, written by Courtroom Mama.  The post featured screen caps of comments from a recent post from a cesarean mother who was content with her surgical birth and didn’t understand the other commenters who grieve over their c-sections.  She is indeed entitled to her own feelings and her own opinions, and really, I’m happy for her that her cesarean scar doesn’t extend any further than the low transverse cut on her abdomen. I wish that could be true for all of us. Unfortunately, it is not. For many of us cesarean mothers, me included, the cesarean left a bigger scar on my heart than it did on my uterus and abdomen.  Though she may have meant no harm, and she even said  something along the lines of “not to disrespect”, her words were like salt on our wounds……it was the “just be happy you have a healthy baby” we’ve heard all over again.

To shake things up, the one and only “Dr.” Amy Teuter felt compelled to chime in the discussion. Here’s what she had to say:

There’s nothing inherently traumatic about having a C-section. It’s culturally determined. In the “natural” childbirth culture, a vaginal birth is an “achievement.” That’s why disappointment, trauma and “birth rape” are restricted to Western, white women who’ve been drinking the NCB kook-aid. .

It reminds me of my patients from certain ethnic groups who were disappointed and depressed about having a girl in a culture that deemed having a boy to be an “achievement.” It’s all about impressing others in the same culture.

At first I was speechless….what do you say to that?  Who SAYS something like that?! So cruel and heartless, and really just flat out untrue. And really, if there really was nothing traumatic about cesareans, why would women be desiring VBACs?

Any woman of any ethnicity, religion, or social status can experience a traumatic birth. Disappointment over the experience, traumatic memories, and “birth rape” don’t just happen to women who had their hearts set on natural child birth. Or as Amy puts it, women who have been “drinking NCB koolaid”.  It may be true that women who were planning an unmedicated birth might feel more disappointment at needing a cesarean or being coerced into a cesarean that they didn’t need. But a surgical birth can conjure up a huge range of emotions that even a mother who elected for a cesarean might experience.

Let’s examine Amy’s statement that “there is nothing inherently traumatic about having a c-section”, shall we?  In obstetrical managed hospital labors, their favorite position is the “stranded beetle” lithomy position where the laboring woman lays flat on her back with her feet in stirrups, or one leg being held by her partner and the other held by a stranger for the pushing phase.  Her epidural-numbed body can’t feel enough to push effectively or the baby starts showing signs of distress or both, off to the O.R. she’ll go.  She goes from the degrading enough stranded beetle position to the crucifix position to be sliced open and her baby surgically removed and quickly whisked away from her.  She spends her first days as a mother in pain and unable to perform even the simplest of her duties as a new mother with out help.  Maybe her hospital experience was worse than I described or maybe it wasn’t, but the cesarean isn’t what she expected or what she originally wanted.  She thought she would be the one to push the baby from her body, and instead he was cut out of her. She thought she’dbe the first to hold her baby, but instead he was handed off. Nobody can put the baby back inside her, or push the rewind button. The sense of accomplishment of “giving birth”, gone. The first few moments of the baby’s life, gone. Taken from her. Taken from her child.  Forever. 

It has nothing to do with whose Kool-aid she’s been drinking.  What was taken from her and her baby cannot be given back, and she does have the right to grieve what she has lost.  Every woman, pregnancy and birth is different.  Some women might be content about their cesareans- even if it was unnecessary. But others need to grieve. I cannot tell the happy cesarean mother to be sad about her cesarean because I’m sad about mine; and she cannot tell me to just be happy because she is. It doesn’t work that way.  No cesarean mother needs a guilt trip for their feelings, good or bad.

And I just gotta say, Obstetricians are not inherently better than Midwives……that is culturally determined by America’s mainstream medical culture!  People who believe so might be visiting Dr. Amy’s kool-aid stand!

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Home birthers are hippies. Pro-lifers are anti-choicers. Pro-choicers are pro-baby-killing. All conservatives want abstinence-only sex education. Girls have pillow fights in their underwear at slumber parties.

Can we ever get past these stereotypes?

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I recently signed a petition for ACOG to change its current guidelines for VBACs in hospitals to give more women access to a vaginal birth after a previous cesarean.  I believe that it is important that ACOG reassess many of their guidelines to improve maternity care and chip away at our unacceptably high cesarean rate.  However, even if they do change their rule that a physician and cesarean team be “immediately available” to perform an emergency cesarean on a failed VBAC attempt, I believe it is still only a baby step and we cannot expect any immediate or big improvements based on this guideline alone being changed.

As long as malpractice insurance rates remain high for care providers wanting to offer VBACs we may continue to have doctors deny women’s right to VBAC. I believe this is another factor needing big change as it is an enormous barrier to VBAC access along with ACOG’s silly non-evidence based guidelines.  What if instead of charging high rates for pro-VBAC docs, they based their rates on the doctor’s cesarean and induction rate?  Maybe, just maybe, that would motivate cut-happy OBs to think twice before performing surgeries that aren’t truly needed. Malpractice insurance is in need of reform just as much as all other aspects of health care.  They need to reassess their own guidelines. VBAC is not the risky problem, unnecessary cesareans are. Women would not be desiring to VBAC if they had not been cut for no good reason.

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It seems strange to me that we live in a nation that boasts of its freedom, and yet, we seem to not have total medical freedom or “birth freedom” when it comes to refusing a repeat cesarean- as implied by the panelists at the NIH VBAC consensus. 

By now there are already hundreds of blog posts on this matter, and like I said and many other bloggers have said, we are happy to hear that VBAC is being recognized as a safe option for most women.  However, it is disappointing that in the issue of a repeat cesarean, it could not be confirmed by the panel wheather women should make the decision after a fair and balanced evaluation of the risks and benefits of each of their options.

Let’s face it, our doctors are human. Sometimes humans act out of selfishness and unnecessary cesareans are sometimes an act of selfishness. Let’s just label her “failure to progress” because I’m sick of waiting around for this baby to come out. I’m not saying ALL doctors do this, or do it on a regular basis, but there is no doubt in my mind that cesareans are sometimes performed out of selfish motives.  Sometimes the doctor does it out of convenience or fear of litigation- but no matter what the reason, I can’t think of a situation in which a concious woman should not have the ultimate say on whether it is done.  The doctor does indeed have years of schooling behind him (or her), but it is the mother who posesses the God-given motherly instincts to do what is best for her child.

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Admittedly, I am a wee bit too tired to be blogging this late at night. So forgive me for the ramblings I’m going to unleash. I’ll probably edit it later and tweek it, but here it goes.

I am both happy and disappointed with the results of the NIH Consensus Conference on VBACs. I’m happy that the panel is urging ACOG to reevaluate its guidelines for VBAC trials of labor in hospital settings. As a VBAC mom myself, I found those current requirements to have a cesarean team on stand by and ready for the 0.5% chance that my uterus could rupture too much of an obstacle. Thankfully, in my state home birth is legal and I was able to take advantage of that freedom. Some mothers do not have the home birth option or don’t feel that home birth is right for them.

What was troubling to me was when the topic of informed consent was brought up, the NIH panelists left informed consent to be gray and shady- not black and white. Apparently we do not have consitutional rights when we become pregnant.  But in their defense, informed consent could be an entirely different issue for an entirely different conference. I hope that’s on their agenda.

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It’s been a few days since my last post. I have had a bit of writer’s block, but with the current events happening in the world lately, what can  I say…..things are crazy, to say the least.

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It has been a little over two years since my cesarean with my first daughter.  Words cannot express how deeply it effected me. My baby was frank-breech and some people have argued that my cesarean was necessary and maybe it was. I think it could have been avoided had my doctor listened to my concerns about my baby’s position and paid more attention to detail while palpitating my belly.  Or maybe I could have or should have been given a chance to birth her naturally- as breeches should be dealt with on a case by case basis rather than automatic cesareans. But what was done was done and I can’t go back to change it.

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This morning, after laying my babies down for their naps I settled my little nest on my couch with my Snuggie and Girl Scout Cookies, and flipped the channels until I arrived on DHC’s Deliver Me. I don’t know why I torture myself watching these shows. They always make my blood boil. But if anyone is unaware or skeptical of the fact that our maternity system is broken, watch these shows and you’ll see it. You’ll see mostly cesarean births, you see the lack of true informed consent. And of the vaginal births you might see, the women are almost always in the lithomy position and never squatting or on all fours for pushing. There are VBAC scare tactics galore and an over abundance of biased or even false information.

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Despite many articles of research conducted on the safety of home births proving that they are indeed a safe option, ACOG, many care providers, and others are skeptical.  It’s amazingly sad how we have been conditioned to believe that all medical technology and medical advancements are good, and should be used routinely instead of reserved for true emergency situations. 

It is as if some believe that a safe birth cannot happen if a woman is not in a hospital bed, with an IV in her arm, with continuous fetal monitoring, and a doctor only present in enough time to catch the baby.  Have we really forgotten that women have been giving birth longer than hospitals have existed and our trusty medical doctors have been trained?  One hundred years ago 95% of babies were born at home, and that was the norm.  Today, home births are frowned upon by many in the medical community.  Despite the numerous beautiful and inspiring home birth stories posted on the Net by home birthers like me (and others), the typical response is “Well, you’re lucky.”  Lucky?  What’s that supposed to mean?  Moms and babies can’t live without you, and those who managed to squeak by without serious harm or death are “lucky”?  The rather laughable insult to home birthers is that we are following a celebrity trend because there have been a few celebrities like Rikki Lake, Cindy Crawford and Demi Moore (just to name a few) who have given birth at home.  I didn’t choose to birth at home because these famous women did, and I highly doubt any other home birth mom chooses to do so because Rikki did it.  Though we are inspired by their stories, our choices have been carefully researched, the pros and cons weighed out, and our baby’s best interest at heart.  Did anyone  ever consider that non-medically necessary cesareans and inductions could be a trend for convenience and lack of patience?

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As I’ve mentioned before in my other posts, my first baby was born via cesarean for her frank-breech presentation. I had decided early on in my pregnancy that a natural birth was what was best for me and my baby.  I knew that with natural birth, I couldn’t pick the date or the hour at which my child would be born, or plan on how long my labor would last.  So I knew from the get-go that I wasn’t interested in scheduling an unnecessary induction for convenience reasons, and I studied heavily about coping methods for my natural labor. I thought that my plans for a natural labor and refusal of the IV and epidural during labor would “safe-guard” me from having a cesarean.  Well, it didn’t.  My OB, who had guessed my baby was in the vertex position throughout my pregnancy discovered that my baby was breech right before he was about to break my water.  I was devastated!  The options I was given were just going for the cesarean- or getting the IV and an epidural and attempting to manually flip the baby, which the doc said would likely be unsuccessful because I was already in labor. A vaginal breech birth was not listed as an option. I was given about five minutes to come to my decision, and with the choices I was given and being told that one would be unsuccessful, I of course went with the cesarean. 

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