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Tuesday, March 30, 2010

A Journey to Homebirth: Part 1

My friend R and I recently reconnected on FaceBook after a long hiatus. I read her status one day about being a homebirther and my eyeballs nearly fell out of my head, I was so excited. Who would have thought a decade and then some ago, that our paths would again converge in such a way? 

R has two children, and has written both of her wonderful birth stories for me to share with you here. I have decided to make them into two separate posts. Both are some of the most empowering birth stories I have ever read, and I hope you feel the same. 

A Hospital Birth



The Deranged Housewife asked me to share my story... forgive me if I ramble. I will get to the point eventually.

Long before marriage and babies, I had often said that if I had kids, to “give me the drugs!!!!” Why should I go through the “unnecessary” pain of labor?

Years later, after marrying the fantastic man that God gave me for a husband, we were expecting our first child. After doing a little research, I learned that those aforementioned drugs most often came in the form of a needle and catheter placed directly in the spinal column, an epidural. The thought of that scared me so much more than the thought of having a baby. Women had been having babies for thousands of years with no needles in their spines; if they could do it, so could I. But, how? 

I had no idea how to birth a baby, so I took classes in The Bradley Method® of Natural Childbirth. During those classes I not only learned about the potential negative effects of the drugs on me, but also on my baby. Did you know that traces of drugs given in labor and delivery can sometimes be found in the baby's system up to two weeks after birth!?! We are so careful to avoid drugs, fish, caffeine, etc. when we are pregnant, yet, freely and willingly inundate our bodies and our baby's body with drugs and chemicals right before birth. Also, because of those classes I became so confident in my body's ability to birth my baby, I was feeling like “bring on the labor!!  I can do this!” After all, God created me and he designed my body to have babies. I needed to trust that natural process. I also had an awesome Certified Nurses Midwife attending my birth. She was a homebirther herself, so I knew that she was in full support of natural, unmedicated, intervention-free birth. I was thankful for my childbirth classes when I went to do my hospital tour and the nurse said “you WILL have an IV; you WILL have an epidural.”  Because of my education I knew that, contrary to the way it was phrased, these were options, not absolutes. This nurse also looked at me like I had two heads when I asked about a birthing ball and a squatting bar.

Finally the day came. I woke up at 4:00 AM in labor. I will spare you all the glorious details of my labor (mucous plugs, etc.), but I did go back to sleep and was able to sleep for several hours. I woke up at 7:00 AM to eat breakfast and prepare for a long day. After eating, I had settled on the living room floor in the contour chair position to labor. Around noon my midwife stopped by and checked me (she just happened to be in the area... she wasn't supposed to do house checks!). I spent the next few hours laboring comfortably while sitting on the floor. At some point I walked around the freshly mowed  backyard and I also took a shower. Walking and the warm water both felt good.

Around 4:00 PM, I started transition. I was walking back from the bathroom when I started crying for no reason. My contractions were hard and very close together. My husband knew it was time to go. We arrived at the hospital around 4:45 PM. My contractions were coming fast and hard and the car ride had made me very uncomfortable. It took a few minutes to get to the labor and delivery room; my husband was wheeling me down the hallway in a wheelchair. The upright position was so painful that I asked him to stop during a contraction so that I could wriggle around to a more comfortable position. The nurse on duty (yes, the same one from my hospital tour), snidely said to my husband, “that thing has wheels!”   He politely told her that I had asked him to stop. She then turned to me and told me nastily that I am probably about “ready to push” (I knew I wasn't), and that I  “didn't want to have the baby in the hallway, did I?” and to “get up and walk!” I was in no mood or position to be walking during a contraction. 

My midwife had called the hospital so that they would know we were coming. Of course, the room was not ready when we got there. (We live in a small community and we were the only patients in the Labor and Delivery ward.). As soon as I had changed into my gown, I threw up (and peed) all over the floor of the LDR  room. As I said, they weren't prepared for me... my mom and husband were left scrambling to find a trash can for me to vomit in. One of the nurses called it the “seven centimeter pukes.” Nurse Crusty was not too pleased with the mess on the floor. She then ordered me on the bed to get checked. I refused to lay on my back, but told them that I was more comfortable on my hands and knees and if they wanted to check me they could do it that way. The other nurse did my exam. When I was checked, I was 7 cm. My husband eventually got fed up with Nurse Crusty and told her to leave and not come back.  The other nurse was great. She had had her babies naturally, so she knew what we were desiring. It was also her first day working at our hospital, so it took her a little while to find things.

I labored on a birthing ball for a while. I was able to relax deeply and fell asleep between contractions. I nearly fell off the ball and onto the floor and decided it was time to get into the bed.

Later, when noticed that I started involuntarily grunting with each contraction and I knew that pushing time was coming. My midwife checked me and I was complete. I never got the overwhelming urge to push, but I knew the grunting was my body's way to pushing on its own. At 9:00 PM, when I started pushing it felt good. It was so nice to be doing something after so many hours of concentrating on relaxing. After I started pushing, the feeling was overwhelming; I couldn't stop. At first I wasn't a very efficient pusher; I kept letting my air leak out through my mouth. Once I got the hang of it, things progressed much better.

The nurse would check my baby's heartbeat periodically with the Doppler. At one point she kept saying that she couldn't hear his heart beat any more. I started pushing with all my might. I was determined to get the baby out as soon as I could. In the back of my  mind I did notice that my midwife was calm and laid back. This helped keep me from panicking. She later told me that she knew everything was OK because she could see the top of Baby's head and it was nice and pink. The nurse wasn't able to hear his heart beat at that time because my pubic bone was in the way.

At some point during my pushing, my mom, my husband and my midwife were laughing because the bottom of my feet were grass-stained from walking barefoot in the backyard. It's odd the things that stand out in your mind during labor.

Our son was born at 10:34 PM. He had some molding off to the side of his head. My midwife said that he was probably wedged in my pelvis for a while.

He weighed 7 pounds 1.9 ounces and was 20 inches long. I nursed him before the placenta was born and before the cord was cut.

Even though I really wanted to go home right away, we decided to stay the night at the hospital to get some rest. Ha ha ha!! Every few hours a nurse came in the wake me up to check my temperature, blood pressure, etc. In the morning, my midwife released me to go home at 10:00 AM. We weren't able to leave the hospital until after 6:00 PM because the doctor we had chosen as a pediatrician did not come to check our baby until 5:00 that evening, even though he was notified the night before AND again that morning. Then, on top of that, he kept asking the nurses if he was doing the newborn exam correctly. He did not exactly exude confidence!  (He was promptly fired as our pediatrician.) 

When we were checking out of the hospital, Nurse Crusty said to me, “See, next time won't you want to schedule an induction so that you can have it all planned?  Think of how convenient that would be.”

Click here for Part 2. 

Saturday, March 27, 2010

Defiance

I admit it - I often defy authority (bats eyelashes). If someone tells me I can't, or shouldn't, do something, that often only makes me want to do it even more. So when I again submit myself to routine punishment on pregnancy and birth forums like the one on BabyCenter, I probably come off as quite pushy and bitchy, I'm sure. 

Ahh...BabyCenter. About as bad as Yahoo! Answers. It's often like the internet version of The Learning Channel's "A Baby Story," often very one-sided and equally frustrating. 

I was engaged in "conversation" on a VBAC thread there a few weeks ago (before I dropped off the blogosphere for awhile due to the Sinus Infection from Hell) after a mom had posted awhile back on whether or not to have a RCS or attempt a VBAC. The post was old, she'd already had her baby, but I commented anyway, thinking that other women in the same situation could possibly benefit from it. 

To them, it opened a can of worms. The original poster jokingly said "I wish this thread would just die!" The board owner said (half-jokingly) that she wanted to ban VBAC threads because they created such controversy. I kind of blinked at the screen like, "Wha....?!" There were some good stories on there from women who have VBACed, those who needed support and were thinking about it, and then the one that pissed me off royally: "No VBAC for me! I love my baby!" The original poster felt that "c-sections were more mundane," and therefore more predictable, a sign that they were 'safer,' I'm sure. 

The kicker, though, is that there is a doctor who apparently devotes his time to answering questions about certain topics. Dr. So and So weighed in and offered his opinions, most of which presented uterine rupture at its highest estimate and made it sound like insurance companies were the ones solely to blame for the lack of VBAC options available. I respectfully questioned him, only because I thought his estimate was high, and was able to back it up with evidence (which he, and the other posters, ignored). This didn't go very well, either. Apparently, if you're not a doctor, you can't possibly know anything about birth, apparently.

The board owner then responded by saying 'women' (me) come on here and try to be teachers, etc. to other women, and her bet was 'with the doctor' because "he's a doctor." Apparently by questioning him (which is against board rules, by the way) I was somehow out of line, even though Dr. So and So said he invited healthy debate, which I think this was. By posting another differing statistic, suddenly it was perceived that I thought I knew more than he did. 

I wanted to ask Ms. Board Owner, "Do you go along with everything your doctor says? How about your kids' pediatrician? Hasn't there ever been something you've respectfully questioned, even though you're just the patient?" Give me a freakin' break, lady. 

Yes, it's great that Dr. So and So devotes time and energy to a lowly pregnancy message board full of hormonal women. But these are our bodies, too. Our babies. And that should mean something. 

The latest post on the Talk Birth blog tells women how they can be  better educated birth consumers by learning all they can. The question is, how can we help others to be better birth consumers? Certainly not by cramming it down their throats. But I find it troubling that so many of them don't want to be, it seems. And by their behavior, they are effectively encouraging other women not to be, either. Or harshly criticizing those who are, and who do encourage other women to be as well. 

Some of these women were basing their decision solely on the opinions of one doctor, who, actually seemed somewhat fair, but of course was protecting his best interests as a physician as well. I pointed out that he was just one opinion, and not the be-all end-all supreme authority on VBACs. (Well, you can imagine how that went over.) 

I guess in the meantime I'll just have to keep crashing message boards, one at a time....(respectfully, of course) :P

Wednesday, March 17, 2010

Does your c-section make you feel like less of a mother?

It's become a legendary topic of debate, right up there with formula vs. breast, co-sleeping vs. crib. I stumbled across this blog post from repeat c-section mom, Amy Hatch, who laments why certain people make her feel like she's less of a mom because of her choice to have a cesarean . She also was riled at how a doctor at the recent NIH VBAC conference referred to a vaginal birth as 'normal,' making her feel like her births were 'abnormal.'

I won't go so far as some people did and say "get over it." I can't put myself in her shoes, and honestly, on one hand I can see how it would be easier emotionally if we didn't find it as important as we do. But on the other hand, as one person interviewed for The Business of Being Born put it (God help me, I can't remember her name, but it was familiar) to some a c-section is as routine as clipping your fingernails. I couldn't agree more.

I would never willingly make someone feel inadequate because of her choices on birth. But it's such a fine line. I guess in my passionate "birth Nazism" (how I hate that term) I only think women should make those decisions not based on one five-minute, one-sided conversation with their doctors, but some dedicated research to the topic. But I can't force someone to read books about it, nor can I force them to care as much as I do about it.

Hatch goes on to say that:
it's even A-OK with me if you want to pop a squat in the forest and have your kid while someone braids your hair and sings "Kumbaya." 
*Sigh*. There it is again: the perception that moms who insist or are passionate about vaginal birth are hippies, somehow freakish in nature. Someone else in the comments section also made a reference to this, too.

Since I can't keep my big mouth shut, I had to chime in. (I've decided that I don't really need coffee in the morning, because reading some of these birth forums would get the job done just as easily.)  I offered this:
Now see, you're insulted by the 'you're less of a woman if you had a c-section' vibe that you get from certain people. Most of us who are very passionate about vaginal birth are equally annoyed with the "squatting in the woods while singing kumbaya and having your hair braided" references. Why is it that women who feel a vaginal birth is important, not to mention without an epidural, are treated as freaks?
....
I think by and large that a lot of OBs practice "fear-based obstetrics" not only to save their own butts, but to discourage us from making them go out of their way to "allow" us to birth in the manner of our choosing. Sometimes yes, squatting is effective in order to better position the baby, but many doctors see it as offensive to get down on our level to help us deliver. And what did your doctor tell you about the risks of c-section when you were planning your second? Did he discuss VBAC? Like mine, probably for two seconds, if only to make it sound like the most dangerous thing I'd ever do and only carried risks. Which is crap. And then, we as women who like to talk to our friends about "girl stuff" like pregnancy and birth, perpetuate the myth that our bodies are broken, deficient and incapable of giving birth. That women who don't want interventions or drugs during labor are stupid, crazy or 'think they're getting a medal.' 
One woman said that "VBACs carry risks." As if to say that c-sections do not? Are you kidding? And on another forum, I actually heard this: "No VBAC for me! I love my baby!" As if to imply that those of us who choose a VBAC don't love our children? WTH?!

I think perhaps the debate stems from people realizing that maybe things didn't have to be the way they were? I don't know. I continually realize that it has to be a kick to the gut to suddenly be told "you should have known better," or "could have made better decisions if only you had known the facts." That's great, thanks for telling me now. I know my VBAC could have been "better" (no amniotomy, for instance, or insisting on changing positions, no Nubain, etc) but it was my VBAC, and I own that experience. There is no going back and changing what happened, but, if you're lucky, you can try to prevent it from happening again, should you have more children. And even then, there are no guarantees. In the meantime, I have chosen to be an advocate for women who are having more children, even if I myself never have another one.

Ironically, I have never met a woman who made me feel inadequate or questioned me for having two sections. I pray that I don't make others feel that way, either.

Saturday, March 13, 2010

Americans - even President Obama - getting "too much" care

Experts are suggesting that perhaps Americans are getting over-treated : "too much cancer screening, too many heart tests, too many cesarean sections." Recently a study found that angiograms are being overused, and even the President has gone through a battery of tests lately that some feel are unnecessary and extensive for no real reason.

I was excited, if for a brief shining moment, that the article mentioned "too many c-sections," and in one article I read the recent NIH conference on VBAC managed to register a blip on their radar screen. It gave me hope. But none of this is "news" to countless pregnant women who feel they've been tampered with, prodded and poked endlessly, often for no good reason.

Some tests, like cancer screenings, I'm all for, though, especially when you consider that Americans generally have a better prognosis and survival rate for certain cancers like prostate - because we generally treat it more aggressively than some of our European counterparts. Of course, I can't find the article I read several years ago in the Wall Street Journal, but it basically suggested that in some countries more males were dying of prostate cancer - a generally slow-spreading disease - than they were in the US, because of their less-aggressive approach to treating the illness.

Maybe this latest revelation is good news for pregnant women, but maybe not. It might bring to light that medicine in general is overwrought with waste and needless intervention across the board, and no where does it seem to be the case than in maternity care. If it can somehow change opinions that "it's best for the baby" when, in fact, it might not be, then we might be getting somewhere in educating others of our plight.

The most recent push for a national healthcare plan has had me wondering how all this is going to sort itself out for some Americans, or if it will make it worse. What does it mean for the pregnant woman? Generally speaking, we know that a more low-tech approach to prenatal care and labor can, in the low-risk woman, have better results, both in the short and long run. Fewer interventions means mom's labor can actually be shorter, less painful, and that she'll likely have a better recovery.

But how do you re-train doctors to this way of thinking? Will they revert to unsafe practices to avoid being punished by a government-run healthcare scheme for wasting too much money? I've often thought that some private insurance carriers should investigate OB's with a high rate of induction, episiotomy and c-section, as these are all procedures that cost the insurance company more money because it means more drugs and more care. When I compare the insurance bill I received after my VBAC delivery with no epidural and the one I received from just the anesthesiologist after my third was born, I realized the spinal block for my section alone cost almost as much as my entire vaginal birth.

If I were a pregnant woman using national healthcare, I'm not sure how I would feel being seen as a means to save the government money. But neither do I appreciate being seen as a cash cow by an OB. And if it means I could have a healthy, low-tech birth without you sticking your fingers in my vagina every 10 minutes, then I guess I'm all for it.

I wonder if, in a way to save money, the government would encourage OBs to avoid c-sections unless absolutely necessary. Would they again start teaching OBs how to deliver breech babies? Restrict the use and administration of Pitocin (which, according to manufacturer guidelines, they should be doing already)? Or does it mean doctors will continue to induce, but go back to using the less expensive Cytotec instead? Would the government condone its use because it's cheaper, ignoring the risks that Searle has outlined and put women at even more risk? From what I've read some OBs disagree with Searle's warning and are using it anyway, or are pissed off and think it's bunk.

My biggest fear is that OB's would be forced to return to a care model that they are, by and large, out of touch with. Does it mean that doctor who's been in practice for 30 years, in the last 15 of which he's never delivered a breech baby vaginally, is now suddenly being asked to deliver that baby? Maybe more women would choose midwives, who are usually more equipped to handle low-tech births, and then there would be even more midwife backlash from OBs than there is already. Maybe OBs would feel that their hands were tied, and as a result, just recommend to a government payor that cesareans are the safest way for every mother.

We know that some countries with national healthcare, like The Netherlands and Great Britain, have great success with low-tech, low intervention births. As a way to save the government money, they encourage home births and VBACs. But if you take a physician who does not practice this model of care, hasn't in years, and doesn't plan to in the future, what outcome can we expect for pregnant women?

Tuesday, March 9, 2010

Welcome to the NICU! Enjoy your stay!

Every once in a while I read something that really boggles my mind. I just don't know how to process such things sometimes, they're so bad.


This forum post involves a woman 35 weeks pregnant, with a history of preterm labor, asking how to induce herself with castor oil. She said she was about 1 cm dilated and 65 percent effaced. Many of us who answered were like, "Why would you want to do that?! You're not even full term yet!" Castor oil in and of itself is sketchy - for some, they say it works; others get only a massive case of diarrhea from using it. I've heard reputable midwives recommend it, so let's just say for the sake of argument that it works.


Apparently she was in the hospital earlier in the month and the baby was given steroids to mature its lungs. Okay, fine. So why are you inducing labor then? If nothing is happening, consider this a blessing, that your baby will hopefully be born at full term with fewer complications. But no! This mom replied, "I do not want a 9 pound baby. I took the oil and now im dilated to 2. I didnt experiece ANY side effects from the oil. no diarrhea, no vomiting, no cramps. just alot of contractions. My baby is fully developed now that he has had the steroids." It doesn't help that the answer she picked was from a woman for whom it worked, and she was only 38 weeks pregnant. 


Dear God, help this woman. I only hope the castor oil doesn't work and her baby won't truly be evicted before it's even fully done yet. While helpful, there is nothing guaranteeing the antenatal steroids will actually be 100 percent effective, and her baby could still have problems. 


I wonder, how can she be so misguided? Did the hospital not tell her while she was there the dangers and risks of a baby being born so early? I pray she doesn't have to find out the hard way.

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 theunnecessarean.com 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 theunnecessarean.com, 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.

Saturday, March 6, 2010

"Are you done having kids yet?"

Since I've had my third child, so many people have asked me that. It's like I have an invisible sign on my forehead that says, "Ask me if I'm done having children!" Friends, strangers, you name it. (Thankfully, the only person who hasn't asked me that is my OB, surprisingly.) And I've always wanted three children, but now that I have them, I think to myself, "I don't know. Am I done yet??"

My son isn't quite a year old yet, so it's a little soon for me anyways. My body is, needless to say, not quite ready either, but then again, I'm not sure if that will ever happen. My husband isn't ready either, and probably would be perfectly fine stopping at three, but somehow yields to my bizarre desires to grow our family further. Like me, though, he wishes I would exercise more and possibly lose a little weight if only for health reasons, especially since I had borderline pre-eclampsia with my last two pregnancies. I echo his concerns, but not loudly enough to get myself back on the treadmill, I guess.

I've been reading birth books again and obviously blogging a lot, and it's carried over into my dreams. I have nightmares about pregnancy, bleeding out, doctors, cold, sterile hospitals, and of just-born babies covered with vernix held to my breast. It's bizarre, and I know it's influenced by my mind over-thinking everything. In reality, I think about the possibility of pregnancy again and I just don't know if I can do it - if I want to put myself through it again. And it's not even the pregnancy part that bothers me; it's the final weeks leading up to the birth that give me anxiety, knowing that it would be near-impossible to find a doctor in my area who would support me with my complicated history, which already includes two cesarean deliveries.

I wonder, isn't one VBAC enough for me? What, if anything, am I trying to prove? It's been on my mind since my youngest was literally about 24 hours old, when I was recovering from my c-section. I thought I must have been crazy and surely it was the hormones talking, but it's been very difficult to not think too much about the birth and feel cheated, ripped off somehow, even a year later. I distinctly remember lying on that table and not feeling much joy about it, even when he announced the sex of the baby, except the thought "I can't believe I ended up back here again" playing over and over in my head like a broken record. The hours and moments leading up to the birth, I was fine with: while crazy, perhaps risky, showing up at the hospital 10 cm dilated with a double footling breech baby didn't bother me. Ending up back on the table did, somehow. Even though I knew it was the best decision: I wouldn't trust anyone to deliver my baby breech when he hadn't done it in 20 years.

The biggest hesitation I have about pregnancy is "What if the baby is breech again? What if I have another c-section?" I don't know at what point the idea of multiple surgical births really bothered me, but I know it's been a long journey from my first birth until now, and my ideas and opinions on the subject have changed radically. I have gone from a close-minded midwife-distrusting mother-to-be to a woman who would gladly have birthed at home with the local fire squad, if only I knew the exact position of my baby. And I still wouldn't change that part.

I started watching Ricki Lake's "The Business of Being Born" last night and wondered if it would make me really want another baby. I'm not done watching yet, but so far it's made me very sad, and very angry. Angry for all those women who are taken advantage of, coerced or gladly accept their fate without so much as a second thought. The hospital images in the movie made me tense and anxious just looking at them, remembering how something so innocuous as the smell of hospital hand soap can remind me of bittersweet memories surrounding the births of my children. Even the idea of scheduling a yearly regular exam with my OB makes me nervous and I'm anxious about going, having rescheduled twice. Normally I have no problem with it, but this time I detest the thought of even having one at all.

I suppose the best thing for me to do right now would be wait until my children are farther spaced apart and then weigh my options. One of the things I wish I had done last time was interview doctors even before I got pregnant, even though really it wouldn't have changed my outcome. I'm starting to think that one of the reasons women have so few children anymore is probably because their birth experience was so terrible, and even though it had a "good outcome" (the all-important healthy baby), they can't quite put their finger on what they feel except a deep sense of dissatisfaction. Perhaps they shrug their shoulders and acknowledge that, "without doctors and hospitals, my baby could have died," which might or might not even be true.

I don't know why I essentially want a "do over," like I'm getting closer each time to my version of an ideal birth. I don't know if I can "fight the good fight" anymore, because it seems like a battle that's been going on for so long.

Wednesday, March 3, 2010

Where to go for important VBAC information

I have to remember that not everyone visiting my site is a seasoned "VBACer" and might be just starting out in their search for good, basic information, even on birth in general.

I was visiting the ICAN (International Cesarean Awareness Network) website yesterday in search of VBAC-friendly providers . In a nutshell, we are considering moving out of state, and I'm not sure I'm done having children yet. On the site you can find very useful information on VBAC-friendly hospitals as well as those who ban it outright, and those who have a 'de facto ban,' which basically means the hospital has no formal ban policy in place, but there are no doctors who would support your decision.

Also included in the search criteria is what the hospital's stance is on it should you show up ready to push at a VBAC-banned hospital. If you click on the hospital's name, it shows a date for when the information was obtained, and what their policy is on VBACs. Many that don't allow them stated up front that you would be transferred to a larger hospital more equipped to handle your delivery (many base this on how far your labor had progressed when you arrived) and some say that should you show up and labor is imminent, they will let you deliver the baby vaginally.

I am not a doctor and therefore not willing to dispense crazy medical advice, but I have heard of many brave women laboring outside the hospital or in the lobby, and then show up at L&D when the baby was crowning. (But you didn't hear this from me.) While this might sound like an insane idea, it only drives the point home that in places where VBACs are "banned," it could possibly drive women to take chances that care providers might consider risky, and could create even more potentially dangerous situations should women feel threatened by care providers who won't let them attempt a VBAC.

Since I don't know any of the women who read my site, I am a bit concerned that my post on a VBAC gone wrong has been coming up in search criteria and I wanted to make sure no one was basing their decision on reading that post alone. Granted, if you want to do a VBAC that is just one facet in the entire bigger picture, but again, since I'm not sure where some women are in their "birth journey," so to speak, I didn't want them to possibly get scared away from even considering one.

No one is, or should be, making you feel like less of a woman because you decided not to attempt a vaginal birth. The information is out there, but many care providers will discourage you from even thinking about it by giving negative stories, skewed statistics and misinformation that does nothing but cloud your judgment, sway you towards your doctor's opinion, and make you think that VBAC produces nothing but bad outcomes. In fact, the opposite is usually true, but many women don't realize this or even consider the possible dangers of having a repeat c-section.

If you have a supportive care giver who is willing to accurately tell you both sides of the story, then you probably need to look no further. But please understand that many, many physicians and midwives will initially support you in your decision, only to turn around at the last minute and change their minds, which can be a crushing blow to many women who have their hearts set on a vaginal birth.

It's unfortunate that you have to go searching for your own information simply because your doctor isn't telling you everything. Again, I am not a medical professional, but have experienced first-hand some of the negativity and bias of physicians, I have had a VBAC, and have done a lot of my own research through invaluable sites like ICAN and others. I only offer information to women with the knowledge that they can do with it what they choose, but at least want them to know that they do have a choice. No one is dispensing "badges of honor" for having a vaginal birth, but just information that can possibly help you to make the most informed choice possible.

Other websites to check out, that can help both with a VBAC and a vaginal birth in general, can be found here: VBACfacts.com , vbac.com , and Giving Birth Naturally .