The Right to Know – Cesarean Birth

I fell in love with childbirth the first time I witnessed it with my own eyes.  I had seen kittens and puppies be born before and thought it a glorious thing, but when I helped my sister bring my nephew into the world on that warm summer day in 2000, I knew I had witnessed a miracle.  I knew I had watched a rite of passage like none other possible in life, and while I didn’t think at that time I would be a mother, I was glad to be a woman.

When I prepared for my own daughter’s birth I did everything I thought I should do.  I did prenatal yoga and walked.  I ate a healthful diet and kept my weight gain to a minimum.  I took my vitamins.  I chose a practice with all women (7 of them) obstetricians and never missed an appointment.  I attended every session of the childbirth classes held at the hospital.  I wrote a birth plan that outlined the process that I hoped would be my natural vaginal birth and gave it to the doctors.  I did everything I knew to do to insure that I would experience birth in the most natural form.  The way I felt nature/God intended in most cases.

Then, on the day I turned 38 weeks I was given my 7th ultrasound in my pregnancy to check on the size of my baby.  They estimated her to be upwards of ten pounds.  The doctor I saw that day said that if I had any hope of giving birth vaginally I would need to go in that night to be induced.  I agreed because I wanted a vaginal birth.  I called my family and packed my bags.  We got to the hospital and as soon as the doctor on call (different from the doctor who recommended the induction) read my chart she ordered another ultrasound.  She then explained to us that she believed that my baby being upwards of ten pounds was too large to risk a vaginal birth.  She gave us a list of possible complications if we did indeed choose to attempt a vaginal birth – shoulder dystocia, cerebral palsy, brain damage, death.  The doctor left the room for us to make our decision.  I looked at my husband and sister in uncontrollable tears.  We all thought that there was only one thing to do.  I consented to have a surgical birth.

My daughter was born 8 pounds and 13 ounces 20.5 inches long.  I immediately felt like I had been played.  Then, as complications arose for the both of us from the surgery, including a five night hospital stay, I knew in my heart that I had made the wrong choice.  I now know that surgery was unnecessary and have had it most likely confirmed so by another obstetrician.  At this point, I became passionate about childbirth, and have since set out to educate myself and anyone that was looking for answers on the topic.

While cesarean section is a blessing for many mothers and babies, as it was in the case of my second birth, when it is necessary because of a medical complication, the practice in this country is obviously being abused putting in danger mothers and their babies.

In the United States the cesarean rate is 31.8%.  The World Health Organization (WHO) recommends that to remain within a healthy range no country should exceed 10-15%.  That means that the US has doubled that recommendation.  It has increased 48% since 1996.  Why?

There are many speculations as to why, however there are some things we can be sure of, the first being elective cesarean surgery.  With rumors of celebrities scheduling their surgical births, women wanting to plan ahead to avoid certain days and times to give birth, and others misinformed and afraid of a vaginal delivery, it has become possible for many women to just choose surgery.  I believe convenience for the obstetrician plays into this as well.  They don’t have to be on call or wait on a long labor.  Not only does this seem more convenient for some, but it is also more money in the pockets of the doctors and hospitals.

The other large reason is malpractice lawsuits and insurance companies.  Doctors fear being sued, which I think might play a part in many of the cases of recommended c-sections for a large baby.

Then, there is the cascade of medical interventions most often starting with an induction and leading to a c-section.  A labor brought on by chemical induction is much more intense than regular labor brought on by natural hormones released from both the mother and baby.  This often leads to an epidural and the mother growing tired sooner.  It is also more likely to cause a baby to go into distress.  A natural labor for a first time mother can easily last twelve hours or longer and be completely safe.  Induction brings on hard contractions much sooner.  It is not as gradual a process as natural labor.

Why do we consent to these things?  Some of you may even be wondering why I’m concerned at all with any of this.  It is because we are misinformed and left in the dark by the health care practitioners we are trusting to deliver us safely through our pregnancies and birthing experiences.  It is because for me ignorance was not bliss and has had lasting health complications for both myself and Deladis.  I wish I had known to know better.  I wish what I know now was common information and not something you have to search for.  I wish all women had the means to inform themselves and were respected by their practitioners.

So, you have the right to know this (whatever your choice is)…

1. A c-section is a major abdominal surgery.

2. C-section surgery poses risks to the mother including infection and hemorrhage among others that are 2 to 4 times more than a vaginal birth.

3. C-section surgery can delay mother and infant bonding due to post-op regulations in the hospital and the delay of natural bonding hormones.

4. Babies born via c-section are more likely to have allergies and have issues breathing at birth.  A c-section also runs the risk of babies being cut by a scalpel during surgery.

5. The “big baby” reason is a myth.  Ultrasounds are notoriously wrong the later you are in your pregnancy at determining the size of your baby.  Unless you have had the rickets or your pelvis is knowingly deformed in some way, there is no reason to think that your pelvis would not accommodate the size of your baby.

6. You have the right to refuse cesarean surgery or any other medical intervention you feel is unnecessary.  (Barring any medical emergency, this is your safest option).

7. You have the right to be fully informed of all the pros and cons of any medical intervention before making your decision.

8. You are more likely to experience a c-section if you have private insurance and private doctor.

9. If you become uncomfortable with you health care provider, you have the right to change.  (Check with your private insurance companies as to their date requirements, but in most cases arrangements can be made.)  You also have the right to a second opinion.

10. Homebirth with a midwife is available in most states and is the safest option of vaginal birth.  Midwives generally have better birth outcomes than obstetricians who are trained to look for an emergency not normal vaginal birth.

11. VBAC is safer than repeat c-section.

Please take the time to inform yourself.  Start by visiting some of the links provided in this article and watching this short film.  Then, I recommend you watch Ricki Lake’s, The Business of Being Born.  If you are then inspired to learn more, please feel free to email me and I can recommend more websites and books to help you avoid or prepare for your necessary c-section.  You have been given a glorious gift of pregnancy and the opportunity to give birth.  Take it into your hands.  Make it a peaceful place for you no matter than manner of delivery.

The Big Push for Midwives

I was a victim of an unnecessary c-section in August 2005 as was my first born little girl.  We have suffered the consequences of that event in both our physical and emotional health.  Since that time, I have been an advocate for pregnant and birthing mothers and their right to chose a practitioner and healthcare model that will provide them with the safest outcome.

For my second birth, I chose to birth at home.  In the state of Kentucky, as with many states in our country, it is illegal for any midwife certified or not to attend a homebirth.  It is not illegal for a mother to chose homebirth and/or deliver her baby at home.  Unfortunately, in order to serve women and provide them with the option of a safe birthing environment our midwives are often putting their own personal lives at risk of prosecution.  It is shameful that a trained professional cannot offer their services to a paying and educated client.  It is a shame that if needed doctors and hospitals are not supportive of these midwives.

Why do I feel this way?  The c-section rate in the United States stands at 31.8% of all births.  The state of Kentucky stands at 34.6%.  The World Health Organization recommends a rate of between 10-15% nationwide for the safety of both mothers and their babies, and believes that over half of all c-sections performed in the United States are unnecessary.  That means that doctors are performing surgeries on women for no other reason than speculations, convenience of both mother and doctor (they don’t have to wait on labor), and the spiraling out of control of labor inductions and augmentation.  What doctors often fail to tell women is that a c-section is considered a major abdominal surgery.  The mortality rate in the US for mothers is also alarming.

It is an outrage that in a country where we are supposedly medically advanced that obstetricians and the companies that insure them are ignoring the fact that a woman is more likely to have a successful vaginal birth and/or natural birth under the care of the midwifery model at a location where the mother feels safe.  It is upsetting that they ignore the fact that a vaginal birth after c-section is safer than a repeat surgery.  It is shameful that trained and educated midwives can’t provide their services to women without the risk of prosecution.

This needs to be changed!  As women we should insist that our births shouldn’t be looked at as dollar signs or illnesses but one of the biggest events of the lives of the baby and its family.  We deserve to be treated holistically and ethically.  Yes, hospitals are great, as are obstetricians, when a medical emergency arises, but when choosing doctors who are trained to respond to emergencies it makes us subject to them viewing our pregnancies as an illness to be treated rather than a fact of life to be supported.

What can we do?  Tomorrow May 21st there will be a DC birth briefing on Capital Hill.  Let your congress people know that you support midwives and a woman’s option to chose homebirth. Tell 10 friends to do the same.  Visit The Big Push for Midwives to find out more.  In the state of Kentucky, visit The Kentucky Midwifery Taskforce to find out how you can help.

My second birth was attended by a homebirth midwife who gave me the best healthcare I have ever received in my life.  Ultimately, she had to transfer me to the hospital where I eventually recieved another c-section.  A necessary one this time.  The doctor performing the c-section badmouthed midwives to me while he was removing my baby from my womb.  At no time were either myself or my baby in any danger under the care of my midwife.  That doctor was unprofessional and condescending at a time when I needed his expertise to have a healthy birth.  But, it was inconveniencing him.  How did my midwife respond to my needing a doctor’s services?  By recognizing within a healthy time frame that my birth was not proceeding normally and was one she needed a doctor’s assistance with, and trusting that that doctor would take good care of me.  She never left me alone.  She talked to me while I grieved the choice I was having to make and assured me that I was making the right decision for myself and my baby.  Now, tell me who is professional and offered the best healthcare.