Set Up.

Okay, so maybe I was jumping the gun a little, but I was curious.  First, let me say that I am NOT pregnant at this time. 

I booked an appointment with New Dawn, the main midwifery in town, just to see what our options were in the case that we were to get pregnant again.  (We aren't trying, but we also aren't preventing.  Nursing is a form of birth control in itself, called the lactational amnorrheic method if you are interested in more info.) 

The appointment was yesterday, and I was really looking forward to chatting with someone in the field about my birth experience and my future possibilities.  The midwife I met, Alicia, (I think I am remembering her name correctly), was really nice.  She was compassionate as I related my story to her, and understanding when a couple of tears made their way down my cheeks. 

She informed me of some shocking statistics, such as, when a woman is induced for her first labor, her chances of emergency C-section are 60%.  60%?!  She also told me that Mission Hospital’s rate is more like 80%.  WHAT??!  (Also, the national average of C-section births, as I have mentioned before, as about 33%; Mission’s is more like 40%.*)  

Can you imagine how angered I was by this??  I felt absolutely set up.  Surely my OB knows these rates.  I feel almost deceived.  Like a lie of omission.  I was very, very clear on my wishes for a natural birth and as little intervention as possible.  I feel like, knowing these outrageous numbers, she should have informed me of them. 

My hearing that I’d need an emergency delivery after 23 long hours of labor wouldn’t have come as such a shock.  Who knows, I may have opted not to be induced at all.  I can’t tell you what I would have done, but I can tell you that I am super upset.  Should I confront her?  I almost feel like switching doctors.  The thing is, though, that I really like her and I don’t think she intentionally deceived me.  I just feel like this is the kind of information every pregnant mother should know. 

Also, I believe I had said in a previous blog that the delivering OB had told me that my pelvis was too narrow and I wasn’t a candidate for VBAC for our next child…  The midwife looked at me in a way that told me she couldn’t believe what she had just heard.  She said that unless there is an extreme case, like disease or a pelvis that has been broken and wired shut, any woman’s pelvis will open and relax enough to vaginally deliver her baby. 

She also told me that it is best to wait at least 6 months, preferably a year, to try to conceive after having a C-section.  There may be placental attachment issues if enough time has not been given to the incision to heal, and the chances of uterine rupture go way up as well.  She said that their policy is that if a woman becomes pregnant before enough time has elapsed, the baby will automatically be delivered via Cesarean Section, that they don’t risk the “trial of labor”, as a VBAC is referred to in the medical field. 

Huh.  That gives me a lot to think about.  I hope it gives you something to chew on, too.  My next question is: what do we do to inform expectant mothers of this appalling information?  How can we become advocates for those that wish to deliver naturally?  I’m really fired up about this and want to reach out to others.  Any ideas? 

*A bit of good news, though: Mission’s VBAC success rate is somewhere between 60-80%, and New Dawn’s is around 90%.

Thoughts on Cesarean Section

So the question I want to pose is: why are there so many Cesarean Sections performed in the US now?  The rate for C-sections in the US is now at 33%!  One in three!  According to The Womanly Art of Breastfeeding, the World Health Organization sees 10-15% an acceptable rate.  So why?

Well, I am beginning to come to the conclusion that doctors are afraid of malpractice suits.  They see all the possible risks and things that could go wrong, instead of relying on the woman’s body (that knows what to do and has since Eve had her first baby).   Now, I understand that things have gone wrong in the past and can happen at any time, with any woman and with any baby.  But these things do not happen every day, nor with every woman or baby.  So why does it seem like all pregnant women who choose to use an OB instead of a midwife are treated like this?  Not every delivery is going to be life-threatening or cause serious debilitation.   

I had originally wanted to utilize the services of a midwife to deliver Lydia, but I got really comfortable with my doctor, who is a Christian, and who I felt would do everything in her power to keep me from having any form of intervention, let alone a C-section.  (Not that I blame my doctor, I blame myself really, for allowing myself to get anxious about getting the baby out of me.)   At 36 weeks I was measuring like I should have been.  Then at 37 weeks, I was measuring like I was at 35 weeks.  Worried, the doctor scheduled an ultrasound for 39 weeks and determined at that time that my placenta was on the decline.  She decided that she was not comfortable letting me carry too much past 40 weeks, if I did, and so we scheduled an induction for 40 weeks and 5 days, just in case.  And of course, you know the rest if you’ve read my previous entries. 

What would someone have done before the time when they had ultrasound?  Would they have induced me back in Bible times or even a hundred years ago?  I think not.  I know that medicine has come a long way since then, but, as my husband says, “they call it the PRACTICE of medicine for a reason”. 

So I am going to try for a VBAC (Vaginal Birth After Cesarean) for my next baby.  I am going to consult with a couple of the midwiferies in town and discuss my options.  (On a side note, the lady that was my parent’s Lamaze coach and also the person who delivered me at the time of my birth, Beth Korb, is in practice at MAHEC, a branch of our hospital here!  I’m going to try to meet her.)  I hold nothing against my doctor, but I believe it was said best by Ricki Lake and Abby Epstein in their documentary “The Business of Being Born”, that obstetricians are surgeons.  They have no business delivering babies.   (By the way, I recommend that any of you ladies thinking of having a baby watch this movie.  It is highly informative and will get you thinking.  Plus, you get to see some babies make their way into this world!)

I have been researching some about VBAC, and WebMD actually recommends that women at least try to have their baby vaginally after having had a C-section, because even a little bit of labor is good for the mother and the baby.  They call it a “trial of labor”, and up to 60% of women have successful VBACs.  Of course there are certain risk factors that make your chances of success go up or down, but that's true with any major medical or bodily occurance.

Something else that I am curious about is that the delivering doctor, who was not my OB, (I had been in labor so long that my doc's 24-hour on-call shift had ended) told me that my pelvis is too narrow and that VBAC would not be a good idea.  Where did this come from all of a sudden?  She was not the doc who examined me weekly and don’t you think that my doctor would have noticed something like a too-narrow pelvis before we started trying to deliver vaginally?  I have my annual on Monday, and I plan on discussing this at length with my doctor. 

Another thing that disappoints me about having the C-section with Lydia is that now I am no longer a candidate for home birth.  This is something that interests me b/c it seems so natural.  Where were babies born before there were hospitals?  Home.  Some people may think that home deliveries are insane, but successful ones happen every day.  It just seems the perfect place to start life out, don’t you think?  At home, where mama is comfortable and surrounded by familiarity.  At home, where you have everything you may need for your newborn.  At home, where you (hopefully) aren't surrounded by bright lights and unfamiliar faces barging in on you at all hours.

Though I am saddened by all this, I won’t let it get the best of me.  I am still capable of bringing babies into this world, and I do plan to.  The Lord has been very good to me and James, and we have been truly blessed with our wonderful daughter.  We are looking forward to the day when we get to bring her siblings into the world, no matter how they come.    

Us with Lydia, who is 3 days old in this photo.