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Monday, March 8, 2010

Have you been lied to today?

A few years ago a friend's daughter was pregnant with her second child. She'd already had a primary section, and was weighing her options as far as having a VBAC. I was trying my best to politely let her know she had a choice, but it was hard because I'm better friends with the mother than her daughter (if that makes sense) and didn't want to sound like a nut or come on too strong. I think I sent her an email but didn't expect much of a response, and her mother told me, basically, that her daughter would have to go to Babytown for her delivery three hours away, because no one in her home town of Babyville would do the birth.

I left it alone. I felt badly, because it sounded unreasonable, but I figured, well, that's that. I wasn't going to get in her face or persist because it's her decision how much she wants to fight for it.

Recently I got on ICAN's website and looked it up for myself. I found that only could she have had a VBAC in her town, but there were two hospitals that allowed them, and they were both less than 15 minutes away from her house. So, true to form, her doctor had basically lied to her.

The worst part is that she, like so many of us (I say us, because I, too have been many times in this category - please don't think I haven't!) fell for it. Which makes me so sad and angry. Yet, even with all the information we have, women aren't using it. And the worst part of all is that even when they do use it, sometimes it still doesn't matter.

Over on we had the discussion about "getting educated" and the Blame the Mother Game. I hate to use the word "blame," but really, we can't expect our doctors to inform us anymore truthfully, honestly and with our best interests at heart, instead of their own. But where do you draw the line? Doctors are misinforming their patients, and those patients go out into their circles of friends, sisters and daughters and misinform them, who, in turn, misinform their circle of friends and family. And no one bothers to question any of it, or even wonder if it's really true, often until it's way too late. And thus, the cycle continues. Because we can't put that trust in our doctors, it seems, (and from a historical perspective, could we ever?) it seems that the impetus is on us to learn the truth.

I admit, I thought I knew a lot about birth after I had my first child. Yeah, whatever. It took a rather persistent, sometimes unapologetic, passionate Fellow Birth Nerd to convince me what little I knew about what my body could do, and what doctors could do to my body that wasn't necessary, or even right. I hate to sound bitchy, or have an "I told you so!" attitude, but man - I just wish women realized that many of these things don't have to happen to them. That their own unwillingness to open their minds about it perhaps is what inadvertently led them down that road.

There I go, sounding like it's all the woman's fault. Which I don't think it is. But neither should we totally be let off the hook, either, for this reason: I was thinking how many people will do more research when buying a major appliance, car or computer than they will about childbirth choices. Those sentiments were echoed by a midwife interviewed for The Business of Being Born. Why is this? We are adamant about getting the best deal of a new refrigerator, and know how many colors it comes in, the range of features it has, and how much it costs. But we have no idea the range of "colors" (options) that our births can come in, the features that our bodies have to mitigate pain without the use of drugs, to enable a baby to be born without the need for excess tubes, wires and other superfluous crap. And many of us seem to take little stock in the cost: both financially, and physically, emotionally and psychologically.

A "doctor's birth plan" was posted awhile back on, which has been circulating the internet for awhile. It echoes the plaque on the wall at the birthing center, that someone took a picture of and posted, that basically says the laboring mother will do things according to what the doctor wants, and that's that. No Bradley Method, no doulas, no support, basically. And while many people thought that the doctor's birth plan sucked, at least he was up front with it and gave the patient all that much more impetus to leave the practice in search of something better. If only they all did that, rather than purposely wait to disclose their lack of support until they know it's too late for you to find another OB, thus trapping you into doing things "their way."

As I'm sure it did everyone, the thing that bothered me most about the "doctor's birth plan" was not that he was such an ass about it, but that he outright lied several times.
Labor positions that hinder my ability to continuously monitor your baby’s heart rate are not allowed....Your legs will be positioned in the standard delivery stirrups. This is the most comfortable position for you. (That's BS.) It also provides maximum space in your pelvis, minimizing the risk of trauma to you and your baby during delivery (That's also BS.)...I will clamp the umbilical cord shortly after I deliver your baby. Delaying this procedure is not beneficial and can potentially be harmful to your baby (More BS.)....Contrary to many outdated beliefs, inducing labor, when done appropriately and at the right time, is safe, and does not increase the amount of pain or the risk of complications or the need for a c-section. (OK, this is really BS!)
That last one was like having a nail driven through my thumb. It's a boldfaced lie, and there's lot of info out there to prove it .

I don't know what the answer is; I really don't. I can't speak for those women who know the risks and benefits, "got educated" and still got railroaded by overbearing doctors and nursing staff. I can't speak for those women who want desperately to have a natural birth and yet live hours away from a hospital, any hospital, which probably wouldn't support them anyway. I just know, from listening to others and from my own experiences, that hearing the lies and misinformation doesn't help. And ultimately we end up distrusting not the doctors, but ourselves. What bliss it would be if we could do both.


AtYourCervix said...

Just because a hospital (or website) touts that they can do VBACs, doesn't mean that it will be offered as an option. NOR does it mean that your desire for one will be followed. You will come across people who will bully you into a repeat c/s, or will outright LIE to get you to have a repeat c/s.

**I'm just saying**

The Deranged Housewife said...

Well, this is true. But I consider the ICAN website to be one of the more reputable sources of info. That said, you're right - you can easily get there and find they don't honor their statement. I realize your point - that's what I'm saying, that people will strongarm you into doing what they want, rather than what's really best. I suppose that's where the research comes in - do they have figures to back up how many VBACs a year they do? It's pathetic that you practically have to play detective to get answers. Which points to a greater problem ...

AtYourCervix said...

I'll give you an example of our monthly stats. And we're "VBAC-friendly", though not advertised.

One month: 1 successful VBAC. 0 unsuccessful. 39 repeat c/sections. How many were offered versus told that they could VBAC or have a repeat c/s? Who knows.

Glancing at another random one month time period: 4 successful VBACs. 1 unsuccessful. 56 repeat c/sections.

AtYourCervix said...

I was curious.....about our purported epidural rate of 58%. I did some basic math of my own with our stats. Year end for 2008: 72.4% epidural rate for labor for vaginal births. NOT 58%. Hmm. Interesting.

The Deranged Housewife said...

I'm curious, then how hard, theoretically, it would be for me to find support in a hospital after having had two sections. Even OSU Medical Center, where a lot of pro-VBAC research has been done, says they will only let you do one after one c/s.

So .. obviously your hospital is underreporting their use of epidurals ... right? I see your point. I knew one lady whose daughter had an OB who just 'didn't do epidurals' and told her she could do it without ... LOL which she did. I'm guessing he had a very low c/s rate.

AtYourCervix said...

Hard. It will be very, very hard. They (nurses and physicians) will look at you as if you were a ticking bomb.

Sad, but true.

The Deranged Housewife said...

I figured as much. The only thing left to do would be to consent to another c/s but do it under my terms - NO separation of mother and infant, seeing the baby be born, delayed clamping of the cord. With both of my sections, they never even asked if I wanted to watch or see my sons be born, and I wasn't even able to touch them for hours after the birth. There's something so robotic or rote about the whole thing - they have little if any consideration for how the mother feels about the whole thing, sadly.

AtYourCervix said...

One other option: homebirth with a midwife.