oh those pesky moms

Most of you know I had a c-section when Guthrie was born. I'm pretty vocal about it. I've come to the conclusion it was necessary and unnecessary. Necessary because after a 48 hour induction my uterus resembled a limp rag and my cervix 1/2 the size it needed to be. Unnecessary because no one was in distress. Necessary because protocol of borderline pre-eclampsia dictates you must get the baby out immediately regardless of the symptomatic or asymptomatic mother. Unnecessary because my body wasn't allowed to do what it was made to do.
It was such a, well, we've reached the bottom of our bag of tricks, guess we'll cut ya open now, kind of deal.

The two years since then have included a lot of reading. I am always interested in what the media has to say about the 30% c-section rate of the US. (It should be around 10%-15% according to WHO.)
Did anyone else catch the ABC Nightly News special a few weeks ago? They reported on a huge research report came out stating that c-sections done before 39 weeks are more detrimental to the baby. I know- what a shock! Kind of like when we take the turkey out of the oven a few hours early. Makes Thanksgiving so much more exciting! The report was interesting. I was impressed that it seemed pretty fair and balanced until the end -- when they so slyly stated that all these c-sections are 1. usually 'elective', and 2. requested by the mom.
Really? Really??

I know your asking, dude, why are you so indignant? Everyone knows it's those women who have schedules. They're the ones that have these crazy early c-sections. Women in New York where people have babies because it's cool. Don't get all uptight.

Guess what? Not them. There are maybe a couple thousand of those women. Maybe. So where are all these other elective women-blamed c-sections coming from?
Say down the road I get pregnant again. Say I go into my doctor and she says, well, we'll see how it goes. If you stay low risk you can have a 'trial of labor'.
Oh.
Wait.
First we must assume my doctor has delivery privileges at a hospital that allows vbacs. So, say I get to 35 weeks. The baby still isn't head down or my blood pressure is up or the baby is measuring big or, or, or almost anything. She says, well, if this keeps up I'm not comfortable with you trying for a vbac, let's just schedule a c-section and then we've got it as backup. I say ok because I trust my doctor. I trust that ACOG has these guidelines set for a reason. I just became one of those women; elective and scheduled. See how easy that was? See how I just got blamed for the c-section epidemic in this country? Hence my indignation.

Jennifer Block wrote a great book called Pushed: The Painful Truth About Childbirth and Modern Maternity Care. You should check it out. She has a blog too that I subscribe to. She wrote this great article on Reality Check about the treatment of this report. She talks about the vernacular of the c-section. Words like elective, medically indicated, and informed consent. It's worth perusing if you or someone you know is pregnant. Or if you're just concerned that 1/3 of the women who had babies last year needed the help of a scalpel and it's being blamed on the women themselves.

But, bottom line, what's a girl to do? With so much miseducation about vbac's out there, what are we supposed to think when our caregiver says, I think this is the right thing to do?

I once had a woman tell me that she was having a repeat cesarean, it was schedule by her second trimester, because her uterus could rip open during labor. She was terrified. When you hear the statistics of disastrous complications with a vbac you rarely get them next to all the disastrous possibilities that can happen in any childbirth, c-section or vaginal. Trust me, they look a lot different in that light.

Thanks for listening to my soap box. It's not all chopsticks and Hello, poop's here. I hate that women are going through unnecessary pain. The risks of vbac don't outweigh the risk of repeat cesareans. I hope by the time we are back on this road the landscape has changed. I hope we get to have a home birth. I hope it's at least a possibility.

Oh, that woman I was telling you about? Even though they scheduled her c-section for 38 weeks she went into spontaneous labor and 4 hours later she had a beautiful son. Her doctor didn't even have time to get there. Because she'd never gone into labor before she didn't know she was in labor. By the time she got to the hospital she was fully dilated. She was glowing when she described her natural birth. Even though she didn't really want to have one she was still proud of herself and her body. Maybe we should all be given that chance.