Monday, February 19, 2007

Four out of five

I have decided to remove the original post since it has hurt some people deeply...I am quite sorry.

I hope my readers will understand that my dislike of a high cesarean rate does not mean I dislike, or judge, or feel superior to women whose babies are born that way. Not at all! I understand that a cesarean section can be the best choice for some women. For others it isn't their first choice, but not overly traumatic either. But I am writing for those women who feel deeply wounded by their surgeries, who feel violated on a day that they wanted to be one of joy and empowerment.

Let me end with this thought: for women who want a cesarean section, it is reasonably easy to find a doctor to agree to it. But for women who do NOT want one--for example, those with a breech presentation or those who want a VBAC--it can be nearly impossible to find a care provider who will support them. By advocating for this last group of women, I am not at all trying to take away the options from the first group.

18 comments:

  1. Uh...wow. I think I'm speachless. That's horrible. Can you start some heavy-duty outreach/teaching during the women's groups??

    On another note, how many of those four are breastfeeding?

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  2. 3 of the 4 are exclusively breastfeeding. I am not sure about woman #1, but I think she formula feeds. Well I am nearly positive, since I saw her shaking up a bottle of formula during church once. I don't know if she also breastfeeds or not...I should ask her.

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  3. *sigh*, indeed.

    Nearly all the moms I know IRL had C-sections. Myself included It's so sad.

    -Jill

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  4. just a brief thought. Just as you wish for people to be considerate and thoughtful of your decision to birth your baby at home, unassisted, I would hope you would be considerate of other's decisions to have their child in the hospital with interventions. . .you can disagree with the system but judging people's decisions without knowing all of the facts is a bit dangerous!

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  5. I am in agreement with poster above. Why do you care how many people & for what reason had a c-section? You are not in their shoes & it is none of your business. There are more important things going on in this world!!! Get over yourself. And in my opinion unassisted birth is not only dangerous but selfish. What if something had gone wrong during your delivery? Would you ever forgive yourself if something had happened to your baby? There are many unforseeable complications that go along with labor & delivery....

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  6. to anonymouses:

    Two of the four women did not prefer a c-section, so it was not a matter of choice for them; to the extent that Rixa implies that they are unfortunate (b/c she is the fortunate 5th one) I agree. It is unfortunate to have major abdominal surgery you would rather avoid, do you not?

    The woman who had a non-emergency section (woman #1) Rixa says she does not know a reason and makes no further comment.

    The last woman had an in-labor (emergency) cesarean: she also did not freely choose her surgical birth, and no judgement can be or was passed by Rixa on her lack of choice.

    I simply see no judgemental attitudes here pertaining to the individual women, but I do see this little survey as a comment on the circumstances many pregnant women find themselves in, in general.

    Accompanying a friend to a vaginal breech at a hospital is a pretty convincing indication to me that Rixa is supportive of women's choices other than unassisted or home birth.

    As for the safety of unassisted birth, I only want to point out that unassisted is not unprepared or uneducated. Please see posts and comments elsewhere on this blog if you're interested in more!

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  7. Correction: 3 of the 4 would have preferred vaginal birth.

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  8. There are 4 women in my play group besides me. 3 of them had c-sections, one had an induced birth that was vaginal. Of the c-sections, one was done for premature labor despite no other indicated problems, one for the cord being around the neck, and another for breech with no other complications. And with my son I had a c-section because of a mountain of interventions that I not only did not want, but fought against and was ignored. Thankfully I had my second as a UC.

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  9. Anonymous, as complications are more likely in hospital, perhaps women who chose to have hospital deliveries should be the ones asking themselves the question "Would you ever forgive yourself if something happened to your baby?"

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  10. (very long, sorry!) After reading the other posts, I wanted to insert my two-cents worth... Speaking from my own experiences... My first pregnancy ended in a 'blighted ovum'. (I was never told that is what it is called. Instead, I was assured that there was NOT a baby, that there never HAD been a baby & they would scrape all the unnecessary tissue & gore out of me with a scheduled D&C. Oh, and that I was in 'good hands' and "Hey, at least you know you CAN get pregnant". I was eleven weeks along & crushed... I only know this term because of extensive reasearch, on my own, via internet, during my THIRD pregnancy.)(frowns) My overall experience was horrible & one I prayed I'd never have to repeat. (I'll share this story and any of my others, if anyone is interested.) With my second pregnancy, I thought I was well-read & well-informed. I read EVERYTHING my OB, or friends, gave me. I read every book I could find on pregnancy in the library. I was an active member of a popular, baby-centered website! However, despite all my preparations- I was NOT ready to be told that my son was frank breech & that the ONLY 'safe' way to deliver him was by scheduled c-section. I knew enough about the c-word to know that I didn't want it, but when you're faced with your OB (and everyone else you trust) telling you, "healthy mom, healthy baby" & "this is the ONLY way"- what are you going to do?? At the time, I thought things went relatively well. (for what it was) Little did I know that the interventions AFTER the surgery were kept to a minimum ONLY because my mom chose to be the 'bane' of the L&D floor nurses' existances...(grin) Hospital 'policy' was somewhat 'overlooked' because I was the ONLY mother on the entire floor- it was Easter weekend in 2002. I chose to exclusively breastfeed, and sucessfully did so for 20 months, despite the nurses reluctance to leave him with me & their continued attempts to feed him bottles. Fast-forward to my third pregancy... When we first found out our wonderful news, I was anxious to become even MORE informed that I already was. My desire was to do everyhing 'right' this time... I knew I wanted to at least be given the chance to attempt a VBAC. I was barely 6 weeks pregnant when I began my 'journey' of 'discovery'. (grins in rememberance of those first few weeks...) I have spent COUNTLESS hours researching my 'options' online & through the library. I've read dozens of birth stories. I've read 411 re: 'standard' prenatal/birth procedures- both 'pro' & 'con'. I've read every book in the library. I re-read every book I have at home. After coming to the realization that I was destined for another c-section, if I were to allow my pregnancy to be medically 'managed', I came to the conclussion that I'd rather birth at home. I was dismayed to learn that it is illegal in SC to have a licensed MW 'attend' an HBAC. (If you are under the care of a MW, & birth in a hospital or birthcenter, she's governed by 'hospital policy' AND the OBs on staff- which ISN'T VBAC-friendly. Furthermore, there is only ONE birth center in SC & although it's considered 'free-standing', they tend to err on the side of caution & will transfer to the nearby hospital at the first sign of a 'problem'.) If a SC MW is 'caught' attending an HBAC, regardless of the outcome, she risks losing her license. (sigh) When I realized that the only way to truly have the birth we invisioned for our family, one without unnecessary medical interventions, was to birth at home without the aid of a 'professional'- it was like a calm settled over me. Before then, I was terribly stressed because it was difficult to find any 411 supporting non-invasive pregnancy, labor & birth while under the care of a 'professional'. It just doesn't exist... not here anyway. I discussed this 'option' with my husband & he was extrememly supportive! After some tentative, intitial searches, I realized 'it' has a name- UC AKA 'unassisted childbirth'. (And, there is a wealth of 411 out there!! I'm willing to share what I've found!) I also discovered that having no prenatal care (AKA prenatal 'scare', in some circles) wasn't so strange after all... (At this point I was 15 weeks along & feeling ashamed because I hadn't seen anyone to 'confirm' my pregnancy & to begin 'routine' care...) I'm now 27 weeks along & couldn't be more at peace with our decision to birth at home. We are preparing ourselves mentally, emotionally, spiritually, & physically. IF there is a problem, we have a 'transfer' plan... Knowing that I won't have my focus divided between BOTH labor/birth AND 'fighting' for my right to my choice of birth is SO comforting!! UC, in whatever form it takes ISN'T for everyone, just as 'mainstream' hospital care isn't for everyone either. I think what makes us (UCers) SO very passionate about advotating a more 'natrual' birth, of ANY sort, is that SO very many women AREN'T well-informed/well-educated.(and they don't even realize it. In this case, ignorance is NOT bliss...)(Look at me! I truly TRIED to learn all that I could & didn't do nearly as well as I could've...) I'm not saying that homebirthers are better informed or that those that CHOSE a hospital aren't informed. It will vary from individual to individual... (However, I can't help but wonder why a woman would CHOOSE to do NOTHING, to hand over ALL responsibility for her pregnancy/labor/birth to her caregivers. What happens after baby arrives?) I try not to make any assumptions. However, based on my own experiences, & those of the women whose stories I've read, it would appear that we (in general) are either 'spoon-fed' what our doctors would like us to know- whether it's because of insurance CYA, convenience, or what-not is of less importance than the fact that it happens OR that our doctors are educating us to the extent of what THEY know. (In many cases, the reason an OB is reluctant to even 'try' a VBAC, or a relaxed, 'wait & see' approach to labor, is two-fold... hospital insurance won't 'allow' it AND they have no 'formal' training in that area...)(How many OBs have ever seen a truly non-invasive pregnancy, labor & birth??? Very few... What was once a 'normal' pregnancy/labor/birth is now 'managed' beyond recognition...) Regardless, I believe that we're being short-changed (information-wise, care-wise) as a whole. The internet has allowed us to better educate ourselves than EVER before! I would LOVE to share what I've learned with all the women I know. I'm reluctant to because it IS so different from what they've grown up 'knowing' & being taught... I'm not willing, at this point, to try & defend myself for my beliefs. I shouldn't have to! They're not 'wrong' or 'right', they're just 'mine'... If I had known then, what I know now, MY 'choices' would've been MUCH different. I would've refused my D&C & allowed my body to naturally complete my miscarriage. I would've refused the scheduled c-section & insisted my body be allowed to labor- w/o intervention- to see if my son could've been birthed (breech or not) naturally. I would've been more confident in myself, & my body, & relied less on my doctors. I trusted them to do what was best for me & my baby. I'm sure that they did exactly that- what THEY thought was 'best'. I know better now... I now know that no one knows me better than ME. Just my own thoughts & opinions.... Thanks for reading!

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  11. sc_mommie, thank you very much for your story. I am so excited that you feel at peace, finally, after discovering UC. You mentioned wanting to share about birth options--feel free to tell friends or acquaintances about my blog. They might enjoy hearing things from other people, and we have some really interesting conversations going on in some of the posts. Plus you wouldn't have to spend the emotional energy trying to explain your choices--leave that to me! LOL

    I know what you mean about not wanting to have to think about fighting for what you want, while laboring at the same time. That was a big factor for why I didn't birth in an institution, or invite a midwife into my home. I wanted absolutely no distractions, nothing to think about but opening up to my labor.

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  12. sc_mommie... I too thank you for your story...

    I wish you all of the best in your upcoming birth. My UC was one of the most amazing experiences of my life and it truly healed the birth trauma that I had in the past. I hope it does the same for you.

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  13. Dear Rixa,

    I enjoy your blog, but I'm wondering about this entry: in at least 2 of the cases you cite, you state that you don't know the full facts of the situation. So how can you claim that the C-sections were "arguably avoidable or unnecessary?" How can you be sure, for example, that none of these women had genital herpes or any other medical condition that might necessitate a C-section, or make it the safest option? (They might be extremely unilkely to share this information with you, or anyone.) I acknowledge the fact that you have a great deal of expertise in this field, and that there are indeed a vast number of unnecessary C-sections ordered by doctors who are "in a hurry" or otherwise ignorant. It seems to me that a large purpose of your blog is to inform women and empower them to make their own decisions regarding their birth experience. But it seems like this would also mean having respect for the choices these women do make, even if they didn't make the same ones you might have, or made them using a different line of reasoning than your own. I read your blog, and do quite a bit of my own research, and feel that a C-section is probably the best option for me (though believe me, I don't expect it'll be a picnic). It would be nice to feel that I had the support of like-minded women in the birthing community, rather than having to feel defensive and unfairly judged.

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  14. I know for a fact that some of the "information" you claim to have about these women is not accurate. Where do you get your information?

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  15. From talking with these women. I don't know how else I'd know these things...I tried to include what I knew (or didn't) about the situations. If I got something wrong I sincerely apologize.

    The point of my post isn't about the women per se, but the fact that so many surgeries have occurred lately. Why so many? What can we do about it, especially for those who didn't really want to have surgery?

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  16. hello anonymous from 8:22 pm!

    Thanks for reading first of all.

    This post wasn't about personally judging these women's surgeries. It arose out of my frustration from an obstetrical system that has failed women. Finding fault with a system that lands far too many women with surgeries is different than passing judgment on individual women.

    I also cannot say that any kind of birth is okay, that "all that matters is a healthy baby." I don't judge women for ending up with or choosing c-sections; I just wish that so many women didn't have to go through major surgery in order to have a baby!

    I don't want to play armchair obstetrics either. But any way you look at it, the number of cesareans among women I personally know is appalling.

    I want to support women in my own way--offering information, educating, encouraging them to explore their options and to question the status quo. Teaching them about their bodies' amazing abilities and about the importance of undisturbed birth. This is an ideal that can't always be a reality for everyone, such as my friend who had surgery for a breech presentation. She was devastated because she didn't feel it was necessary at all. But she wasn't comfortable enough with her only other option, which was to birth unassisted. In that case, I did everything I could to make it a better experience for her. I went with her to the hospital, helped her explore her options for the surgery and postpartum (single vs. double layer suturing, staples vs. sutures to close the external incision, how to waive baby procedures she didn't want, making sure the baby never left the room after he was born, etc.). I also spent hours upon hours talking with her before and after, and most of all, listening to what she felt without trying to tell her how she should feel. Everyone else in her life told her that she was crazy to desire a homebirth, that c-sections
    "weren't that bad," that she was selfish for not wanting surgery. That didn't help her at all, or make her feel any better about what was for her a very traumatic event.

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  17. By identifying the women as being from your church, to some extent, you have made their identity known. There are church members who read your blog. Did you ask their permission? I do know that at least one is very offended and hurt. Her husband is mad--and I don't blame him. You have attacked their very personal experience--an experience meant only for them and not for your blog.
    I admire how you have birthed your daughter. You blog can be very informing, but your words about others decisions are hurting those mothers.

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