Wednesday, March 4, 2009

Oh, Spare Me! (A VBAC post)


I’ve always prided myself on being a bit of a skeptic.  It’s not that I don’t believe in the supernatural, for instance. It’s just that I don’t think ghosts or aliens have much personal interaction with the inhabitants of planet earth.  I approach social causes in a similar frame of mind.  It seems to me that the greatest interest of most charities happens to be the kind accumulating in my bank account and how to get me to proffer it up for their “good causes.”  Before I sound, completely selfish and curmudgeonly, it’s not that I don’t support social causes and charities; it’s just that I want to know that my money is actually being used for good and is not just contributing to some administrator’s BMW fund.

Of course, I’m not anti-woman or anti-minority, but I do feel as if worthy causes get exploited to pull at the heartstrings of a sympathetic, gullible public.  The inverse is also true; sometimes causes I feel most strongly about seem to slip by with very little notice. 

I also submit that nothing stirs the ethical pot like reproductive issues.  For instance, consider the years of controversy over abortion, and, more recently, the hotly-debated topics of stem-cell research and cloning.  Why else the fascination with Octomom: hubbub over a woman with a lot of kids, and the public eager to stand as ethical judge? (Not that I support or sympathize, it’s just that there are bigger fish to fry.)

What reproductive issue, you may ask, could be more  important than a mother who has voluntarily sentenced herself to raising 8+ teenagers all at the same time ? My answer: VBAC's.  Ha!  Chances are you haven’t heard of them even as they are increasingly endangered and drawing close to extinction.  VBAC is the acronym for “Vaginal Birth after Caesarean.” (I know, bleck!  That’s why we call them VBAC’s.)

Currently, nearly one third of babies are delivered in the U.S. via Caesarean even though, according to the World Health Organization no more than 15% of babies should ever have to be delivered c-section.  The results of the overuse of this operation: increase of pre-term infants, increase in infant and maternal mortality rate, much longer maternal recovery time, baby is born drugged and groggy, mom is drugged and groggy and thus unable to give baby optimal care directly after delivery, and (my personal major gripe) c-sections often screw up the first, crucial moments when breastfeeding needs to be established.

On a more personal level, many hospitals forever sentence mothers to c-section:  my local hospital maintains the policy of once a c-section, always a c-section.  So as to avoid unnecessary abdominal surgery, I have had to resort to delivering my babies out of town in hospitals that are more willing to work with VBAC moms and now, even those hospitals are raising a wary eyebrow at my request.

So, why are healthcare professionals unwilling to let some mothers walk into their clinics and simply give birth?  They always claim the risk of placental accreta otherwise known as placental hemorrhaging.  VBAC deliveries, as all with all deliveries, present a certain risk that the placenta will rupture.  The increased risk of placental hemorrhage during a VBAC delivery: .5%.

The truth is that doctors and patients alike are attracted to the seeming ease of the c-section.  They love the idea of being able to schedule a delivery, but overlook the amount of risk involved by interfering with birth in its natural course.

Due to the increasing scarcity of VBAC friendly hospitals, with this delivery (which will be my third successful VBAC), I have been told that if I want to avoid the knife, I may have to schedule my surgery, stand-up the surgical team, allow myself to go into voluntary labor and get far enough along before I reach the hospital that the doctors will have no choice but to let me deliver the baby.

Am I intrepid enough to take on the hospital?  My pleasure!  Some causes are worth fighting for and I believe in a woman’s right to forgo unnecessary major surgery.  Of course, my definition of hell is a place where I am tied down and slashed open against my will; and where toddlers forever smear apple sauce across the kitchen floor that I am doomed to mop eternally (but that’s a different post.)


What can actually be done:

*For anyone who may read this and is interested in fighting the beast, the best approach is 

1-  Avoid ever getting a c-section.  How?  Pregnant moms should not let their obstetricians induce labor unless absolutely necessary (i.e. major risk is posed to mother or neonate.)  

2- If you are in the same boat as I am in and have already had a c-section and want to VBAC, I recommend the following:

a) Do not let your doctor discourage you or tell you that you are unable to VBAC without proving it first or presenting you with a darn good reason why you can't.

b) Link up with ICAN (International Caesarean Awareness Network).  They are a wonderful support and have a bevy of good information and studies that support VBAC's.

c) Try to find a doctor or birthing facility that will support your plan to VBAC.  This is often easier said than done.

d) Have a plan before you actually go into labor.  (Especially if you are VBACing for the first time.)

e) Talk to mothers who have VBACed.  It really does help.

  


11 comments:

Crista said...

Down where I live,we have a small hospital called "Mesa View" and it is know for having ceasareans sections as a method of birth than a actual vaginal birth.

I am scared that I will have a c-section and I am hoping that I won't because there isn't any reason that I should. I wanna be able to deliver my baby naturally the way that our bodies were intended to deliver them.

Marie said...

Avoid getting induce, if possible. Doctors induce for a variety of reasons and most of them are unnecessary. That is the main reason c-section is so prevalent.

Best of luck!

Carroll said...

When I think of this subject I think of Hilary, (find her birth story)http://littlesumpthin.blogspot.com/2008/12/introducing-jude-taylor-barlow-welcomed.html
and you as well. What a candidate for a C section in the eyes of the medical world. I am proud of the two of you! With grit and determination you both have enjoyed wonderful natural child births. Sorry it took so much grit and determination to do what is natural.

Persnickety Ticker said...

Marie,
Since you asked, I plan on actually writing a blog post about what is wrong with me. I actually just recently got a complete copy of my medical file and I am learning all kinds of things. Things I guess the doctors thought I was too dimwitted to comprehend so they never told me.

The simple answer to your question, and since I don't know where to email you this info, is that I was born with an Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery. ALCAPA or Bland-White-Garland syndrome. Google it. It's an interesting read if you are into that kind of thing.

I will be posting soon on it, with of course, my usual snarky bent.

Oh, and I hated having a C-section. I felt the whole thing since my epidural didn't work. Something I wouldn't wish on my worst enemy.

Marie said...

Persnickety,

I guess I don't have an e-mail address available anywhere. Sorry about that.

Wow, what a rare and interesting condition. At least it sounds poetic. (Well, not the Bland part, but the White-Garland.) I'll look forward to reading your new blog.

mim said...

Dude! you are positively inspirational! Thanks!

Lindy said...

I'm VERY interested in your post, as I'm having a VBAC in a month. I had a prolapsed cord, and thus absolutely HAD to have an emergency cesarean, and I was very grateful that the doctor that came in was so wonderful. My midwifes have never suggested having anything but a VBAC and are very optimistic that nothing at all will go wrong, of course I've had a natural birth with my first, so that helps. I do have to strapped to machines this time because of the hospital regulations, but my midwives are pulling for me to see if I can take a bath and just use a dopler machine. I guess if someone wants a VBAC they should find the right caregiver...midwives are the best!

mim said...

The ad on your blog about C-section recovery gear is scary enough to make me never, ever want to get one.

Anonymous said...

You don't know me but I came across your blog from my friend April's and was drawn to your bi-line. So I had to read. I couldn't agree with you more.
After 2 vaginal births and one c-section due to placenta previa I found myself up against a wall. With the medical community. Surprise. "You want to do what?!" "But you know that X Yand Z has a 1% chance of happening if you "attempt" a VBAC"- medical community.
Me-Well actually it is .04% and I know that the risks of a planned repeat C-Section are much higher than the risk of X Y and Z ever happening. Yeah.
So I did what I do and I started reading and reading and reading and here I am now, five months into planning and preparing for a VBAC homebirth. With a certified midwife who specializes in homebirth AND who has me continue to do all my pre-natal ultra sounds, paps, blood work, ect. and anything else I have to do ensure I continue to stay low risk to have a homebirth. I AM LOW RISK. Even after having a previous c-section. That is something to think about.
"IS IT SAFE?! VBAC or homebirth? The only way I can even think to reply to that question/accusation is- Hey, do your research, get the facts and numbers and answer that yourself. Is a C-section "safe"? Get the facts and numbers and answer that yourself too. It's all out there.
One of The BEST books to read (if you don't mind me passing this along) and which I personally think our OB's should be passing out as readily as the standard "What to Expect When You Are Expecting" is "The Thinking Woman's Guide To a Better Birth" by "Henci Goer and Rhonda Wheeler". If you want scientific facts, numbers and statistics, in this book you will get it. It's pretty much referenced like medical journal.
I'm a thinker, what can I say, that's how I operate. And yes I do want to be safe which is why I started doing all this in the first place. Well, mostly I didn't want another miserable c-section if I really didn't have to. I wasn't going to be talked or scared into one, that's for sure. I don't want opinions or scare tactics. I want accurate information that I know I won't be getting from my OB, plain and simple. So I went out and found it. I'm not pushing homebirth by the way. I agree with you that we need to understand more about VBACS. We are not getting accurate information from our doctors!
We need to learn the facts and learn to say NO. Because we are allowed that right. We are absolutely allowed that.
We should also know the risks of standard interventions that can lead up to that unnecessary C-section (there is such a thing) that will make that VBAC you want later on down the road so difficult to accomplish. When it IS necessary, as it was in my case learn about the risks of "repeats" compared to a VBAC. Most doctors AND most midwives will NOT give you that info.
When people say to me "Oh you're THAT kind of woman.." I don't know what to make of that. If that means a woman who educates herself and is choosing to take control over my body and choices than I guess I am. But frankly I find I am getting so much support from women, more than I think I would have in the past because I think we are starting to get a little suspicious and wary of what is really going on in the labor and delivery floor. Which is a good thing.
Sorry to post this long rant. You saved me from doing a similar post I have been brewing in my head recently. So sorry but thanks! I will just direct my friends over to this awesome post and I will take a nap:) Thanks for the unknowing support you sent my way. Good luck.

Marie said...

Anonymous,
Thank you for your post. I think you make a very important point and that is that the medical community is taking away (or at least making it more difficult) for a woman to exercise her right to have a natural delivery. I'm so glad you have found a member of the medical community who supports you in your decision. I know how negative doctors can be about VBACs. Thank you for your post. It made my day. Best of luck with a great VBAC! Sounds like we'll be birthing at about the same time=).

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