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Friday, July 31, 2009

Birth Day: A Televised VBAC

This morning I was watching tv at my inlaws - they have fancy cable with all the premium channels I don't get at home. While flipping through I spotted a half-hour show on Discovery Health about VBACs and froze in my remote-controlled tracks. What?! They're showing a VBAC on tv? Skeptically, I thought it was going to end in the obvious way: mom would be scared into giving up her hopes of delivering vaginally and would be wheeled into the OR, pronto. I was pleasantly surprised to hear that the laboring mom had already had a successful VBAC and was now having her third child. Of course, doctors gave her the familiar warnings that her uterus could rupture, baby could die, blah blah blah. Not discounting that those things can happen, I'm sure she's heard it before, seeing as how she's already done it once. Granted, it was a half-hour show, so they could really only go over the major points: who should have them, who might not be good candidates, etc. etc. Her reason for a prior c/s was fetal distress, which is definitely a legitimate reason, but sometimes can be misinterpreted by a particularly overzealous doctor who is ready and waiting to slice you open. Halfway through mom's labor, an OB resident became concerned that the uterus was rupturing, as the baby's heart rate was starting to show decelerations. The patient's doctor came in, examined her, and thankfully determined that she could proceed and that the baby was probably fine. The baby was successfully born via VBAC, but was very blue. The minute they showed his little head coming out, I thought, Oh my God, he's blue, and was lifeless and limp as they moved him over to the warming table to clean him up. They would have to pick this particular birth to show a VBAC, I thought, meaning that whoever seeing it that might actually be considering one is probably sufficiently scared off from ever attempting it now that they've seen this episode. But something else struck a familiar cord in me as I watched this child enter the world: his cord was wrapped around his neck, just as my son's was. I sobbed as I held my baby and watched this show, not only for this fellow VBAC "sister," but also for what could have been in my own situation: I knew my VBAC was unsuccessful for a reason. While this woman's baby ultimately was fine, a healthy pink color and breathing on his own, I wondered if perhaps it would have been different for us. I try not to dwell on it too much, because, after all, I look at my chubby, healthy son and praise the Lord that he arrived safely. There are some points I wished the program would have touched on, though.
  • Many doctors will give you the option, yet do everything in their power to dissaude you from choosing it, including the use of scare tactics and even harrassment.
  • Your chances of a successful subsequent VBAC increase with each prior VBAC you've had.
  • The overuse and even abuse of Pitocin (which has often been called "the devil's drug" in some medical circles) and how studies show that the chance of uterine rupture, although rare, was increased in those women who had Pitocin during their labors. The risks further increased with the use of prostaglandins such as Cervidil, which are used to ripen the cervix.*
This last point is the scariest, because it might actually (well, you would hope, anyway) force doctors to re-examine how they 'manage' labor. I found an article dating from 2001 that discussed how the increased risk of u/r might turn patients off from the idea of having a VBAC, but yet goes on to say how the risks increase because of the use of Pitocin and similar labor-inducing agents. Which begs the question: When are doctors going to admit they can't control all aspects of the birth process, and change their practices accordingly? (Even though the article is almost a decade old, the same ideas and mentality are still very much at work here.) Sadly, probably never. It's too much of an industry for some, which turns the birth process into little more than a baby-making assembly line where all laboring moms should fit the same model or want the same thing from their births; the idea that 'it doesn't matter how you got here, just as long as you did.' After awhile the "you" part of this equation starts to feel like you have very little involvement in the whole process and are just a vessel, prodded and poked and insulted like you're a piece of flesh that has no feelings whatsoever. The following phrase comes to mind: "Doctors will get down from their pedestals when patients get off of their knees." *It's important to note that some doctors, even against dire warnings to do so, will still induce labor with the synthetic prostaglandin Cytotec. Its off-label use for induction of labor can cause miscarriage, severe birth defects and uterine rupture even in women who have had no prior uterine scar. Doctors will sometimes use it because it's supposedly cheaper than Pitocin, and claim that it's just as safe to use. I'm not sure how many doctors are still using this drug, but if yours is one of them, please know the risks and then run the other way. Searle, the drug's manufacturer, has issued numerous warnings against its use in labor inductions, and personally I think doctors who ignore those warnings are throwing all common sense and caution out the window in favor of the all-mighty dollar.

Thursday, July 23, 2009

Big, Fat, Hairy Deal

The old saying from the Garfield comic strip comes to mind right now. I'm doing a load of laundry with like three things in it because my son has not had his Very Special Crocodile T-Shirt for Vacation Bible School for the last two days now. So, because I forgot to throw it in with the last load, and told him it would be okay to not wear it one or two days, he had his picture taken with the group - and was about the only one not wearing his Very Special Crocodile T-Shirt. Man, I felt terrible. 
My husband told me tonight how much our son wanted to wear his special shirt today. Of course, I forgot, and pretty much insisted that another green shirt would do. And tonight at dinner when my husband tried to give him a pink bowl instead of the dark green one he wanted, my son threw a mini-fit because, I'm sure, he thinks pink is only for girls. He eventually relented, but not without a fight. 
I told my husband that the picture taken at Vacation Bible School today made me realize something: that sometimes, yes, it IS a big, fat, hairy deal, especially when you're five. Sometimes we lose sight of those little important things that mean so much to our children, and need them, in their infinitely pure wisdom, to remind us once in a while. 
The Very Special Crocodile T-Shirt will be ready and waiting tomorrow morning, for sure. 

Wednesday, July 8, 2009

Home Delivery is for Pizzas

I was already in a bad mood yesterday. When I got to the grocery store, I happened to park next to a car with a bumper sticker that read, "Home delivery is for pizzas," with an image of a stork next to it. 
I wanted to blow a gasket. I searched female faces once I got in the store, wondering, "Was it her? Is it her car?", which is ridiculous, but still: I wanted to know who could possibly espouse such narrow-minded ideas. Surely, as a result of the great abortion debate, the mantra is, "Our bodies, our choice!", right? I guess only in certain situations. If you want to keep your baby, suddenly it's not your choice anymore what happens to your body or where and how you give birth. It's as if you've handed over all your rights to someone who suddenly knows your body better than you do. Lots of doctors (although not all, let's not lump everyone into that group, I suppose) use your baby as a weapon to coerce and pressure you.
While I've never had a homebirth, I was pretty darned close to the idea of one during my last pregnancy. I realize now it wouldn't have been the right choice for me (yay, two points for Dr. Congeniality and mom has to admit she is wrong!) but, had my child been in the birthing position, I was seriously considering going into labor on my own and having my friends at the local fire station attend their very first HVBAC. 
There are lots of reasons why someone might choose a homebirth: a terrible hospital experience, fear of being pushed into numerous unnecessary interventions, or wanting to birth in a natural place that was most comfortable to them. One look at the crazy ridiculous c-section rate in this country and I can totally understand, especially after having had two sections myself. I haven't met a doctor yet who doesn't see pregnancy and birth as a medical condition, a clinical process that has nothing to do with your mind and spirit as much as it has to do with your body being an amazing machine, really. They offer little support in the process and do more to tear you down than build you up. They could have witnessed thousands of successful births, but the minute you mention the words 'homebirth' or VBAC, they immediately start pulling out the horror stories to dissuade you from making a decision about your own body. Yes, it's important to know the risks - but more importantly, it's key to have support in your decision. 
I got online to read the statistics on the safety of homebirth, and once again was directed to the blog of Dr. Amy Tuteur, an OBGYN. While not discounting any of Dr. Tuteur's experiences, I couldn't believe the sheer arrogance expressed in her blog. She claims her site,, is for both supporters and opponents of homebirth. But it reads more like a bash session against homebirth and midwives than anything else, and supporters are probably few and far between. At one point, Dr. Tuteur actually says, in the comments section of her post "and they wonder why no one takes them seriously," that "midwives lack basic knowledge, and don't like what they find out when they do acquire basic knowledge." She goes on to say, "Midwives aren't knowledgeable, they don't like what knowledge shows them, and they place inordinate value on their own emotions."
Midwives aren't knowledgeable? What? Isn't that a bit of an overgeneralization? The certified nurse midwife who delivered my second child certainly seemed to know what she was doing. No woman, or midwife, should approach homebirth without a lack of knowledge. I also don't know many women who wake up at 39 weeks pregnant and say, "Oh, I think I'll have a homebirth!" Nor can I imagine a midwife who says, "Sure, let's do a homebirth! How hard can it possibly be?" You cannot approach a homebirth or VBAC without knowing the risks, and the facts - not the trumped up worries of a handful of people who think you're being selfish or dangerous. Tutuer is trying to separate the emotional from the clinical aspect of birth, and in my experience, you can't do it. You can't deny that birth is a very emotional, spiritual process, something that many cold, scientific doctors are unwilling to admit or lend credence to. If midwifery is not to be trusted, and midwives like Ina May Gaskin are so 'unknowledgeable,' then how do you explain her success rate
Whatever the case, yes, there are risks. But there are risks to doing everything: riding in your car, going for a walk outside, even having a fatal accident within the four walls of your own home. It's important to put this into perspective, rather than fall victim to scare tactics like the ones Dr. Tuteur has firmly seeded in the brains of women everywhere. The what if's that might never be suddenly take on a life of their own and completely overshadow everything else, and ultimately, there are risks involved that might be unavoidable, even in a controlled hospital setting. Because that's what it's ultimately all about: control, and how countless American obstetricians suffer from a God complex and are trying to control a process that is still not up to them. What she fails to mention is that women still do die during hospital births and after c-sections, even despite our wealth of knowledge and superior facilities. She also fails to mention that the intrusive and often unnecessary practices of her very cohorts are what drives many women to seek out a homebirth in the first place. 

Friday, July 3, 2009

Putting a price tag on human life

I just read the latest headlines coming from Great Britain: apparently police dogs were left in a hot car and died as a result. Not surprisingly, charges are expected to be filed against the handlers. 
But wait - back up a minute. Does anyone remember a few years ago when an Ohio mom forgot to drop her child off at daycare, only to accidentally leave the kid in the hot car all day long? You can imagine the result, which was probably no less than horrific for that mother. But I'm wondering if charges shouldn't be filed anyway - why in the case of the dogs, but not in the case of the mom - where an actual *human* life was lost?
And sadly, after the death of this little girl, it came to light that she had been left in the car before. What the heck?
And yet she still didn't face charges. 
Anymore, I think society tends to place more importance on the lives of animals over humans. I remember several years ago hearing about the raging wildfires in the west, and how brave men and women were placing their lives on the line to quell the flames. At one point, they needed to tap into a nearby lake for more water, but environmentalists wouldn't let them because it would endanger the local wildlife. As a result, some firefighters died that day. 
Who's more important - a fish or a person? This story falls along those same lines. I'm sure the handlers of those dogs will face extensive prosecution, yet the Ohio mom who repeatedly endangered and neglected her child walks free, if only to be shackled by lifelong guilt. 
But I wonder - after reading the story about the dogs, will anyone remember this child and draw the same conclusion? How her life seemingly means less than that of an animal? No job in the world should be more all-consuming than my kids, which is the point of being a mother in the first place.