June 23rd, 2010
Independent Women Will Be Cut
Without trying to sound ageist or condescending, every time I see a 20-something year old on Jezebel bragging about the cesarean she’d sign up for if she were ever pregnant, I want to butt in and say “Don’t you see?!?! That’s what they WANT you to do!!!” Toward the end of this post I’ll explain what They want, and why we shouldn’t give it to them, but first, let’s talk about the language of “choice” in relation to birth.
So many young women today think that drugged-up births and cesareans are the “feminist” choice, and that labor pains are oppressive or patriarchal in nature. I understand… I really do. I once was that girl. I thought anything that could disconnect me from my biology meant freedom, and even joked about wanting a hysterectomy before I ever had kids.* I didn’t necessarily want a cesarean (I’m scared of surgery) but when I became pregnant, I had blind faith that the obstetrician I hired could easily and painlessly remove the parasite I was growing in my womb with a nice epidural cocktail and some forceps. Simple, right?
Of course I had no education whatsoever about epidurals or forceps or cesareans, and how much damage they could do to a woman’s body. I just assumed that if the technology existed, then they must have perfected it, and if it could keep me from feeling a contraction then by golly, I had to get me some of that.
We all know how that worked out for me. I learned the hard way that attempting to circumvent nature had a miserable outcome for me, and once that happened, I started to wonder why I’d had so little faith in (or love for) my body’s amazing abilities to begin with. And then I started to discover that my mistrust and contempt for my biological functions came from years of programming by The Establishment.
See, if I stay home to have my baby, the local hospital, OB, and pharmaceutical company doesn’t make a penny, and exercises no control over my body. However, if I go get me one of those cesareans, well… a whole lot of people are making money; obstetricians, anesthesiologists, drug companies, makers of surgical supplies, hospital administration, etc, etc. And me? I’m left with a scarred uterus for the rest of my life, which will greatly limit my choices in the next pregnancy, and further compromise my health.** Thanks Doc!
So, what if you decide to take control over your birth? Ah, well, The Establishment doesn’t like that. In this brilliant 2008 expose, Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First
In his book, Dr. Wagner (an obstetrician and former Director of Women and Children’s Health for the World Health Organization) explains,
“This table heaps contempt on women whose ideas and preferences for giving birth inconvenience the doctor. Many obstetricians find the table hilariously funny. Isn’t it frightening that the ultimate weapon obstetricians use to punish overly “independent” women is to cut into their bodies, using a surgical procedure (cesarean section) only obstetricians can perform, which completely deprives the women of control over their own bodies?”
Yes, Dr. Wagner – it IS frightening. Even more frightening is the fact that so many young women frivolously joke about electing a procedure that you describe as nothing short of violence against women. All the while, women and babies are dying at a higher rate in the U.S. than in most other developed countries. In a fact sheet offered by The Safe Motherhood Quilt Project, it is noted that,
“The maternal mortality rate for cesarean section is four times higher than for vaginal birth and is still twice as high when it is a routine repeat cesarean section without any emergency.”
In fact, our U.S. maternal mortality rates are so high, earlier this year Amnesty International released a report titled “Deadly Delivery: The Maternal Health Crisis in the US”, calling for the United States to make dozens of changes to women’s health care, including “establishing clear national guidelines… for the appropriate use of medical interventions and procedures such as c-sections.”
How did we get here, and how can we turn this around? Well, so many brilliant authors and film makers have already shown us the many ways that handing over the keys to our biological castle has backfired for women. All we have ever wanted to do is be treated as equals, yet instead we discover that The Establishment has found ways to capitalize on our desire for independence, and ultimately, punish us for it – during the most vulnerable and transformative period of our entire lives, no less.
All of this sounds very Debbie Downer, and my intention isn’t to scare women, or inject fear into a woman’s birth experience. Contrarily, books like Marsden Wagner’s are focused on exposing the problems, and proposing solutions to the mess we’re in. Independent women need to be aware of the real price of trying to buy the “perfect, painless” birth experience from surgeons, and think about ways to change the system for the betterment of all women and babies.
Last year I gave a 10-minute talk in an advanced public speaking course on this very topic. When I finished, one young woman raised her hand and said,
“Wow, I never knew any of this. I always figured I’d sign up for a c-section the minute I got pregnant, but you’ve really got me thinking.”
And that’s all I hope for. I want more young feminists to ask “Are we taking control over our own bodies, or are we really just unwittingly giving all the control away and labeling that a choice?” and “When I enter my birth environment, am I sure I’ll be treated with respect, or are the residents joking that my desires for an autonomous birth just bought me a ticket to the OR?” If it’s the latter, then it’s time to demand better, and to keep demanding it, until our maternal and infant mortality rates reflect the amount of money women are paying into our maternity care system.
I won’t put up with a doctor joking about cutting me just because I hyphenated my last name or wrote a Birth Plan, and neither should you.
Now… what’s your gut reaction to seeing the table above?
UPDATE: For those who were even one bit skeptical about whether or not I could possibly be right about physicians opposing autonomy, this week Kingsdale Gynecologic Associates in Columbus Ohio sent a letter to their patients banning doulas and birth plans. Here’s their letter: http://birthingbeautifulideas.com/?p=1922
There you have it. RUN LIKE HELL LADIES!!!!!!!!!
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*In a display of pure irony, the period I wrote about in that post ended up being my Last Menstrual Period (LMP) before I got unexpectedly pregnant with my first son. Sometimes the Universe has a way of forcing us to deal with things.
**No matter how many times I insist that SOME cesareans sections are 100% necessary and life-saving, people always complain that I don’t leave that disclaimer enough, so here it is again. SOME cesareans are 100% necessary and are worth the risks involved. However, The World Health Organization estimates that a national cesarean rate of 15% is “a threshold not to be exceeded,” yet our current national rate is 32%. In some hospitals, it’s twice that. This says a lot.
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Now I’m thinking it’s a *miracle* that I didn’t wind up with a c-section for my hospital birth. Three-page birth plan, *both* parents attorneys, obviously more than four years college, insurance, etc. Not to mention over 48 hours of labor, 24 at the hospital.
The Mommy Blawger´s last blog ..Midwifery Legal/Legislative Updates
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I totally agree with your thoughts on c-section = giving up control. I had no control over my body after, not being able to get up and tend to my new baby didn’t feel very “in-control” …that is so backwards.
Kimberly´s last blog ..Fathers’ Day 2010
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I read Jezebel a lot, and I always always try to comment when women talk about signing up for a cesarean. Like you said, it’s often someone younger, without children, who hasn’t done any research on the subject. And maybe they never will, but I feel like it’s my duty to say SOMETHING to them.
Also, that table needs to include something about a due date falling on a holiday. I have two friends who were needlessly induced at exactly 40 weeks because their doctors didnt’ want to be delivering babies on Thanksgiving and Christmas. Both of them ended in cesareans within a matter of hours. The doctors got to be with their families for the holidays — but one friend ended up back in the hospital at Christmas because her incision got infected. (I guess we see who got the real benefit there… and it wasn’t the mom.)
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Husband has a hyphenated name? Wow, you were screwed from the start.
Jen @ Two Embrys´s last blog ..New Web Address
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Tell me about it!!!! I think I scored about 200 on that damn table. It’s SHOCKING I got my VBAC.
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Honestly, when I first read it, I thought it was something you made up to prove your point because it seemed geared right at you. I’m still shocked something like that could even exist outside failblog.
Jen @ Two Embrys´s last blog ..Bye-Bye School
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Keeping control over your body is the most feminist thing you can do–rather than yielding it to the patriarchy!
Charlotte´s last blog ..Zit on the behind
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This post was just what I needed after reading another blog post in my Google reader: http://skepchick.org/blog/2010/06/reader-rants-doulas-vs-doctors-vs-dolphins-lexicakes/
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I’m skeert… I dunno if I wanna click on that link. I think I can only handle so much feminist fury for one day.
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Oh my. I just read this and it makes me very sad. She is really misleading women who want facts. They need to read “A Thinking Woman’s Guide” by Henci Goer. It is true that if you don’t deal well w/ pain on a daily basis then you probably won’t deal well in labor. That being said, just b/c you don’t deal well with pain doesn’t mean you need to end up with a section. If you were well informed you would know there are ways to at least still end up with a vaginal birth even if you don’t want a natural birth.
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Who said cesareans are pain free? MINE SURE WASN’T!!! WTF? Gah. I think Bethany is right: Henci Goer is the antidote!!!
Melissa Vose´s last blog ..Update on crochet adventures
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Actually, I don’t believe it’s true that if you don’t deal well with pain on a regular basis then you can’t deal with labor. I am regularly told that I have a low pain threshhold, but I did give birth without drugs. I actually now use the pain management techniques I learned in childbirth class to manage regular pain. Not to mention that I learned in class that labor pain has a purpose and is temporary. Other pains also have a purpose and it’s to tell us something is wrong.
Fun Mama – Deanna´s last blog ..Strawberries
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Oh, that is one giant HULK SMASH/HEAD DESK. So. Many. Cuss. Words. I. Want. To. Type.
Jill @BabyRabies´s last blog ..The Power of Poop
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I really liked that post and the comments too! Probably not your intent, but thanks anyway.
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I read it, thanks for sharing…I too was a little aprehensive reading it but felt i needed to. I believe in being skeptical. It seemed odd to me (being that she is a skeptic), the poster hadn’t considered the data and statistics because that’s what they normally do. When maternal mortality rates in the US are among the highest in the world, and there can be places like Ina May’s “The Farm” where birth is treated as “naturally” as possible and her rates are quite low how is that not clear. I will post this on that site as well and see what they say.
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“So, when the time came, I went to the hospital and had my totally unnatural, medicalized birth experience, complete with an unnecesarean. I didn’t mourn the loss of my “natural” perfect birth experience. I didn’t get any Super Awesome Mom Perfect Woman Badge of Honor, but the consolation prize was much better: a healthy baby boy.”
umm……so she was into natural childbirth, decided that NCB advocates were liars, experienced the truth in the hospital, but still thinks they are liars?! I don’t understand that at all. At least most people are just plain ignorant. But she learned about the whole thing, and still chose an unnecesarean just so she could get a “healthy baby”?! Bet she could have had that without the scar if she had paid attention to what she had learned…
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Wow, I read the link because I can’t help following rabbit trails and I am shocked. I did a lot of research when I was pregnant with my son, (because that is who I am on everything 
) and that research led me to natural child birth. I do think she has a point about the judgments that women can put on each other but when there are those in the medical community that are pushing their wants at the expense of mothers and babies that is the problem. There are too many stakeholders in birth. Dr’s, insurance companies, hospitals and who knows who else all seem to have a say in how a woman gives birth. If more hospitals allowed women to make their own choices and then only used interventions when they were truly needed we wouldn’t be in this mess. Anyway, sorry for the rant but I have a hard time when someone presents their rant against natural child birth as the reasoned choice when you can make an argument either way. Grr.
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When I first told my doctor I had a doula, she (yes, she) asked if that meant we would all have to get “naked and dance around” in the delivery room.
With so many points on this scale, and without family present and it being my first child, I’m thankful to have had a strong and capable woman as my doula to make my voice and choices heard in the delivery room.
Rebecca´s last blog ..Something’s Got to Give…
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wow! have you submitted that to ‘my ob said what?’… it’s times like that I would find i difficult to refrain from punching my doctor.
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Your doctor may not always know what’s best for you. I had a doctor tell me “You might as well take this Depo Prevera shot, you’re going to bleed anyway.” Depo is a three month birth control shot. She told me this AFTER I had anesthesia and a D&C, which she did with NO monitoring of blood pressure, heart rate, or anything else. And I said yes to a shot that isn’t right for me because I was too doped up to know what she was talking about.
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Whenever I talk to other women about how elective inductions (including inductions for no other reason than the due date has recently passed) and C-sections are dangerous, I always get the response, “I trust my doctor, and he/she would not recommend something that wasn’t in my best interest.” Then my jaw hits the floor, since while an excellent doctor will definitely keep the patient’s best interest in mind while simultaneously respecting her wishes regarding her own body, people who follow the medical literature and government/medical association discussions of maternal and fetal mortality and the national Cesarean rate know that obstetrics is not always practiced in an evidence-based manner.
Incidentally, I noticed that the NIH gave an even worse risk of maternal death from repeat C-section vs. TOL/VBAC than did The Safe Motherhood Quilt. NIH quoted a 4-fold increase in risk of maternal death with RCS vs. TOL/VBAC, and it was 5-fold higher at term. Yet, mothers are almost never given that statistic. All they hear is that they are going to rupture and die and have their babies die, even though the data do not support that warning.
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My response when someone asks is ‘But do you KNOW the risks of a VBAC?’ has now unanimously become ‘Yes, do you KNOW the risks of a c-section? Cause I know those too.’… it either opens a door for discussion or shuts them the h*ll up… either way I’m happy
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I have heard that so many times! “But they wouldn’t make a decision for me that was against my best interests!” Who is making the decisions about YOUR body? Why isn’t it you? Why aren’t you educating yourself? What part of feminism tells me I have to relinquish control to someone who does not care about me?!
Excellent post, Gina.
Dionna @ Code Name: Mama´s last blog ..Allowing Toddlers to Choose Compassion
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If it helps, you’re getting props from some of us on Jezebel!
http://jezebel.com/comment/24960870/
Beating down the ‘women choose caesareans yayyy!’ strawman takes some beating, but I try…
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As a 20-year-old aspiring homebirth/birth center midwife (and current women’s studies major at a formerly all-female liberal arts college), I spend a significant amount of time informing my peers about this issue. It’s scary the lack of information that’s out there for young women, unless they actively seek it out. The assumption that somehow handing over complete control of your body to someone else is empowering baffles me. Thanks for another great post!
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While completely infuriating, it is also not surprising. Obstetrics was created by men in a patriarchal system. Why wouldn’t this system want to punish women who are independent? In patriarchy independent women seems to mean “threat to power” and thus in need of “squashing.” And I know there are female obstetricians, but they are still being trained in a system that is built on this traditional patriarchal model. As women, we have been duped that this system works in our favor (i.e., “it is in your and your baby’s best interest”.)
Another good book that touches on this is Robbie Davis-Floyd book, Birth as an American Rite of Passage. Through anthropological research, she examines how many of the routine procedures hospitals/doctors have for laboring women are in the interest of the doctor/hospital and often used to subjugate women. She also found that many women succumbed to procedures and interventions because they trusted the doctor whom they believed knew better than themselves and had their best interest in mind. Its very very sad.
We need more women like you TFB spreading the word!!
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LOVE that book and I have her other one too (Birth in Four Cultures? It’s on my shelf at work).
Dee
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This is the type of fear women need. We tell our children to not go into the street so as not to be killed by a car. We tell them not to consume things like bleach. We will react strongly if there is a plastic bag over their heads. A little fear is necessary in life. Young women NEED to have some of this fear. This is not a manipulation, as medical fear mongering is, it is wise guidance to connect back to the powers of their unbelievably powerful female bodies. How much more feminist can you get?
Super important post. I hope thousands of young women look at it and discover an important wake up call. I applaud you for using your experience to bring illumination.
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How wonderful that you were able to change at least *one* mind about it with your ten-minute speech. Had I known then what I know now, I would have gone full throttle with my college speech communications class. LOL Excellent!
The Deranged Housewife´s last blog ..Parenting and body image – a weighty issue
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I heart your blog SO much! Thank you for this. I loved Marsden Wagner’s book, I loved Jennifer Block’s Pushed, and I loved Tina Cassidy’s Birth. All wonderful books.
On an almost daily basis, I find myself trying to inform women that doctors aren’t perfect, that you can’t blindly trust them, and that we as women need to be informed! Elective c/s and elective inductions are NOT without risk and are NOT the ultimate in feminist birth. As another poster said, having control of your own body and making informed, educated choices for yourself–now THAT sounds more like the ultimate in feminist birth.
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I think I scored like a million on this! I was 25 when I got pregnant with my son and while I had a very naturally minded OB, it took a LOOOONG time to get any respect from his staff. They assumed that because I am in my mid 20s (and I look like I should be on 16 and Pregnant) that I obviously didn’t know anything about anything. One nurse told me that she thought it was “cute” that I wanted a natural birth. Another told my doctor that I was being “irrational and difficult” after she told me my due date was a week before it actually was (she was looking at my old due date, not the adjusted one after my ultrasound) and after I refused a vaginal exam she huffed and puffed and literally ripped the blood pressure cuff off of me and slammed the door. Luckily, my OB had my back through everything and made her apologize. I feel your feminist fury, Gina!
Kelli Paulus´s last blog ..Post-baby Body Blues
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I feel exactly the same way you do. I remember taking a Sociology of Women’s Health class in college and learning about this. In fact the lightbulb went on in a huge way when I realized that this whole “birth control pill is so feminist” is not quite the truth and women weren’t being told the truth about the long time effects on their bodies. In many ways the medical establishment has played our feminist selves. I actually don’t think anyone did it on purpose, but rather it was just the outcome of a lot of circumstances on both sides (the medical community and the women’s movement). But NOW we know. In many circles it may seem daunting, but it doesn’t matter–the truth is out there and it’s unraveling more and more every day. In many ways it feels exciting–the next frontier of the women’s rights movement and we’re right in the thick of it.
Somehow I was lucky enough to read Robbie Davis-Floyd as a 20 year old undergrad and said over my dead body would I go and let a doctor stand over me (literally and figuratively). I did a presentation on her findings in a college class and the feed back was brutal. The other women in the class said things like, “Why wouldn’t I want to be lying down in a comfy bed, in a loose gown with a doctor near by?”
Why not? Well, now we know.
I just learned about a New York STate hospital with a C rate of 51%!!!!!!!!!!!!!!!
Ahhhhhhh!!!!!!!!!!!!
hillary´s last blog ..hillaryboucher: @jilliansdrawers where are you taking swim lessons?
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As recently as the 19th century, birth was women-centric and, more specifically, body-centric. Doctors were only ever there for back-up. It’s shocking to me how far away from that model we’ve come. We’re basically laughing in the face of evolution.
Clearly, the way we’ve always done it works, or else no one would be here… yes, it’s scary, yes, it fucking hurts, but it’s also the way it’s supposed to be. (And I also believe in medically necessary c-sections, too.)
I dunno – it is really scary to think of the message we pass on to girls about their bodies and birth (and everything else, for that matter). But handing over their sacred bodies to an establishment based on control is a losing judgment, in my opinion.
I’ve read that Wagner piece. Is that the same book with the accidental study of the hospital in CA where the L&D ward had been run by doctors, then due to cut-backs, the administration brought in midwives and the maternal and infant mortality rates dropped drastically?
Anyhoo – great post.
Jessica – This is Worthwhile´s last blog ..Social media interactions: How not to be an asshole
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yes…birth and mothering has been stolen from women. Having been through a nasty hospital birth expereince I feel that birth needs to be reclaimed as women’s business. Now that fathers are expected and encouraged to be in the birth space, performing a role that they are ill-equipped to handle, women are left even more vulnerable.
Women may find that their husbands – the most trusted person in the world – cannot be counted on to understand and support them fully at their most vulnerable. no matter how well intentioned they start out, men are still men and will never ‘get it’, they will quickly be swayed to the ‘safe’ seeming medical paradigm, and their need to feel ‘in charge’ can lead men to demand their ‘right’ to a role that naturally isn’t theirs, and where their ‘participation’ renders vulnerable women even more powerless!
This subtle domination of women happens outside the birth space too…I’ve read advice (from men, duh) suggesting mothers express milk just so that fathers can have the ‘experience’ of feeding their baby. What about the baby’s right to a real breast? the mother’s right to rest and not spend every spare waking moment expressing so her husband can play mummy?
All this is couched in the guise of being a ‘sensitive father’. So what right have we to complain? It’s crap.
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People tell a lot of horror stories about c-sections, but that was not my experience. I liked my c-section. I labored for 48 hours, pushed for 4 hours, and my hospital stuck to my birth plan like glue, never mentioning a c-section because that was in my birth plan. In the end it was my decision and I still think it was exactly the right choice. We do too many c-sections in the US, I’ll give you that, but I don’t at all see that as some kind of feminism gone awry. I really think you are way off there and wonder what it is that would make you attribute it to that. I think it is more likely a product of our litigious society than an anti-woman conspiracy. It was never about the perfect painless birth for me or for anyone else I know who had a c-section or an epidural or any other kind of medical birth intervention. I’m happy to have given birth in a hospital attended by doctors and nurses. I felt and feel that a hospital birthing center is the safest place to give birth because if anything goes wrong with the baby, you want intervention in the first few minutes after birth. I gave birth in a hospital so I could be close to the NICU. While it is true that women have been giving birth for millenia, it is also true that it has always been dangerous. Just walk through an old graveyard and you will see it. Lots of woman died young and lots of babies died at birth. And still do all over the world. For my next kid, should I be so lucky as to conceive again, I will consider a VBAC, but mostly because I don’t believe in binding yourself too closely to any one kind of birth experience. More likely I’ll happily have a scheduled c. My c-section was easy. I breastfed within 10 minutes of birth. My daughter roomed in with me. My recovery was easy, I was home 30 hours after giving birth and I am healthy and so is she, baruch hashem.
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Also, re that chart – since it refers to a “Walkman” and New age “tapes”, how old is that? It looks like a slightly tasteless joke a bunch of doctors were making in the 1980′s rather than evidence of how the entire medical profession hates and infantalizes all women.
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I tend to agree with this (tasteless joke as opposed to most doctors hating educated women).
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Tasteless joke it totally how I took it too – AND I HATE THOSE KINDS OF JOKES! People with power over other people (bottom line – that is what physicians have) should wield their power with dignity and respect – and they should ALWAYS conduct themselves in that manner in relation to their “subjects”. I have ZERO tolerance for doctors who make jokes and their patients’ expense.
I’m glad you had a good experience with your cesarean. You should know, however, that making it out of one cesarean does not mean being out of the woods for complications. A cesarean scar puts every future pregnancy at risk for serious complications. The Coalition for Improving Maternity Services put together a fact sheet on this which says:
Compared with prior vaginal birth, prior cesarean puts women at increased risk of:
*Uterine scar rupture. Planning repeat cesarean reduces the excess risk, but it is not completely protective
*Infertility
*Cesarean scar ectopic pregnancy (implantation within the cesarean scar), a condition that is lifethreatening to the mother and always fatal for the embryo.
*Placenta previa (placenta covers the cervix, the opening to the womb), placental abruption (placenta detaches partially or completely before the birth), and placenta accreta, (placenta grows into the uterine muscle and sometimes through the uterus, invading other organs), all of which increase the risk for severe hemorrhage and are potentially life-threatening complications for mother and baby
*Emergency hysterectomy
*Preterm birth and low birth weight
*A baby with congenital malformation or central nervous system injury due to a poorly functioning placenta.
Stillbirth
Those may seem like long shots, but a mom in my area recently died during her second pregnancy because of placenta acreta. Sure, her first cesarean went well, but it ultimately killed HER and HER baby. Her other child is motherless now, and her husband a widower. It happens — much more than anyone will talk about.
It is a complete myth and total historical inaccuracy that birth has always been “dangerous.” That is something we have all been led to believe. Those women dying of childbed fever in the 1900′s were killed by doctors who refused to wash their hands, believing for an entire CENTURY after researchers knew better, that germs were a superstition, and that doctors were not capable of transmitting disease. All you need to do is pick up ANY of the books I listed above (or that others have listed in the comments) and you’ll see how wrong your statement is.
Women have a responsibility to stop spreading patently false information, and saying that childbirth is “dangerous” is false. Childbirth is more dangerous when smothered by unnecessary interventions than when it is left the hell alone. Our DISMAL maternal mortality rates conclude this. The data is there… the research is there… we just have to open our eyes and deal with the truth. Don’t take my word for it. Research it yourself.
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I don’t see how it is possible to attribute a maternal mortality rate in the 1900s to any cause. There just isn’t any real way of knowing why a particular set of circumstances in the past occurred. Since it is impossible to know, any speculation will necessarily be revisionist and agenda-based.
That list of scary things that can happen as a result of c-section are all real concerns. The best person to evaluate my chances of any of those things is my doctor. She’s very smart, and easy to talk to. I chose her for those qualities and because of where she went to medical school and did her residency. She is an expert at obstetric and gynecology. She went to school for a long time and studied for many years to gain this information. It’s important to select a doctor you trust and then it is important to take the advice of the expert you have hired to oversee your health. I am not a doctor and so I need expert advice to make decisions about my care. She’s seen me through ovarian cancer, 2 abdominal surgeries, 5 years of infertility and one healthy pregnancy and hospital birth with a c-section. She has never given me bad advice.
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Well, good luck with that. I hope your doctor (or any doctor that might be on call) didn’t go to school where these doctors went: http://birthingbeautifulideas.com/?p=1922
Most women who died in childbirth historically developed infections or massive hemorrhage (placenta previa/abruptio) or labored with transverse babies and ruptured, etc. These are the women who would be (and usually are) saved today with medically necessary Cesareans and/or blood transfusions and antibiotics. Most experts say that roughly 10% of all deliveries should be C-sections in order to preserve maternal and fetal health. That leaves a heck of a lot of unnecesareans. A lot of them are set up by failed labor inductions.
Like TFB Gina mentioned, there are risks to repeat C-sections as well, and women are not often informed objectively about them. Ten years ago, a woman I knew died while having her second C-section, an elective repeat, from a problem with the spinal block that was done by the head of anesthesiology at the hospital. It resulted in an almost 7 million dollar award to her family. I lurk on a Cesarean support board, and there are women with severe placenta percreta whose health and babies’ lives are in danger from having had multiple C-sections.
It’s great that your C-section went smoothly. One of my two previous deliveries was a C-section, and it also went as smoothly as possible. The staff couldn’t have been nicer and more respectful of bonding with my son, and I had no problem at all breastfeeding. If I had another C-section, I would want it to be handled just like that. However, I still wouldn’t risk another one unless it was a true medical necessity, which is why my VBAC is planned for August.
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I’m sorry to hear that you know someone who died in a repeat c-section. I’m sure that has influenced the choices you’ve made in that regard. My own choices have also been influenced by the death of a family friend during a home birth some 12 or so years ago. She bled to death in front of her entire family including her 4 kids.
You and I are not in charge of why women get c-sections. It’s a highly personal choice a woman makes with her doctor. Like all issues of choice we can only assume that a woman is an adult capable of making educated necessary choices for herself and her family.
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“You and I are not in charge of why women get c-sections. It’s a highly personal choice a woman makes with her doctor. Like all issues of choice we can only assume that a woman is an adult capable of making educated necessary choices for herself and her family.”
I believe that women will choose the best reproductive route for themselves when they have all of the information at hand, but I do not believe that they are truly giving informed consent when it comes to deciding on labor induction vs. continuing to wait or when it comes to VBAC vs. RCS. Many, many medical experts are out there saying that inductions and RCS are far overused in the USA and are causing harm to women, and then when women go to their doctors for advice, the doctors often tell them the merits of inductions and RCS. There is a real disconnect between the actual scientific data and what is told to women by doctors that they fully trust. I have no problem with a woman being totally informed about the benefits and risks of VBAC and RCS and given an honest opportunity to pursue either one with full support of her doctor, but it is rarely the case. There has been so much information about this exact issue that has come out this year, and it is overwhelmingly stating that the pendulum has swung too far in favor of inductions and Cesareans and that we are doing more harm than good. It isn’t just from “feel good” birth blogs, but from doctors and public health experts speaking out.
These stories are encouraging to hear, but I can’t help but ask you what we should do about the other kind of C. The one where the woman was spoken to disrespectfully like she wasn’t in the room, her labor support wasn’t allowed in after dad left with baby, she didn’t see her baby for hours and then finds out that quite possibly her surgery wasn’t even necessary.
The reality is that this *is* an issue for many, many women and these discussions are so important as we find out way towards more medically needed C’s and outcomes that sound more like yours.
(Also, a lot of our ideas of “so many women used to die in childbirth” come from an era where women were corseted, or malnourished or told to stay indoors away from exercise and sunlight.)
hillary´s last blog ..hillaryboucher: @jilliansdrawers where are you taking swim lessons?
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I agree with you, Pocket.
I had a doula, my birthplan, I chose a very “hippy’(hehehe) hospital, I went through my home and then in class hypnobirthing course, I laboured at home for 11 hours….ended up in labour for 32 hours with a raging fever (I also have a ventrical septal defect)…no epidural, 3 hours of pushing and he was still at a -3…and I was the one that brought up the C after all that time. I was up and about 12 hours later, my recovery was easier than most I’ve seen b/c I got up and walked everywhere (I think)…and I was taking fewer pain meds after than my vaginal birth counterparts. Regardless of the cesarian, my little guy is exclusively breastfed and we had an easier time of it than most of the gals I know, which wasn’t what I was made to believe about having a cesarean.
I realize that this is not the norm for most cesarian candidates but it worked out.
I hope one day that we can choose our birth and choose to breastfeed (or formula feed for that matter) without criticism from other women.
When are we going to stop being critical and just be supportive?
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Birth and breastfeeding are considered public health issues by every medical organization in the world, and women need to think critically about all issues that effect their long-term health. This isn’t just another silly Mommy War. It’s a matter of disasterous maternal and infant mortality rates in this country.
I certainly am not calling this a “silly Mommy War”…I am only wishing that we could be more compassionate and by treating these issues with more empathy we could make a greater impact…more bees with honey.
Kathryn´s last blog ..Bass Ackwards
This: (Also, a lot of our ideas of “so many women used to die in childbirth” come from an era where women were corseted, or malnourished or told to stay indoors away from exercise and sunlight.)
You have no idea whether or not this is true because there is no possible way to know. Women did historically die in childbirth. Many many women did. In fact, Mary Wollstonecraft died in childbirth which is pretty interesting in terms of a feminist angle.
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Actually, you DO have a way of knowing, because it was documented and studied. All you have to do is read Birth as an American Right of Passage for heaps of anthropological research on childbirth and death in childbirth. The information IS there. You just have to choose to get educated on it.
Not to mention “Birth: The Surprising History of How We Are Born” by Tina Cassidy, “The American Way of Birth” by Jessica Mitford, the brand new book “Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank” – the list goes on and on. TONS of information out there if you’re actually interested in it.
Dou-la-la´s last blog ..Fire & Rescue
I think I said as a 20 something that I wouldn’t have kids til they could beam the baby out of me with lasers, but I don’t think I ever considered a c-section as a realistic rosy alternative.
I seriously never understood that sentiment (which I heard while pregnant all the time) that I didn’t have to suffer or put up with pain, or prove something. To me it was sexist to imply that I somehow couldn’t handle it. I knew I could and I did.
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Lynne,
Exactly how I felt about labor “pain”, well at least by the 3rd try I actually did handle it. I am a total wimp about pain but I always believed that childbirth was something I definitely could and would do. It definitely is a mindset and I am one who also thinks its sexist to think women can’t handle it.
Grrr, I feel your fury Gina!!!
Jen´s last blog ..To those little lost souls
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I think too that we often think of labour pain as just something to get through, whether bravely or not, without asking ourselves about the PURPOSE of labour pain. If we believe we can trust our bodies, then it makes sense there would be a reason for the a pain. Check out http://www.mothersofchange.com/2010/06/purpose-of-pain-in-labour.html for a look at the purpose of pain in labour.
Asheya´s last blog ..Birth
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I am not good with words like you are, but that chart is infuriating. THanks so much for a great post. Hillary brought up a great point about BCP’s as well, why is it women are responsible for that when they are only fertile a few days a month, and men are fertile all the time, yet there is not birth control pill for men. Maybe I’m silly for saying it but what’s up with that?! 
Megan´s last blog ..oh so frustrated
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Good point Megan – there should be a pill for guys until they are ready to be fathers.
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This is really infuriating. You know what my gut reaction is? To really get my ass in gear and look into that birth center on our insurance plan and get over my fear about leaving with a 5-8 hour old newborn who is due on a Friday which also happens to be CHRISTMAS EVE, hopefully born med-free, through my vagina in a pool, following my birth plan, leaving with it’s parents who have 10 years of college education between the 2 of them. Mother F-er, this pisses me off.
Jill @BabyRabies´s last blog ..The Power of Poop
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Aaah haa, Jill. You literally made me laugh out loud. In Starbucks. Everyone is staring at me now. “Go back to drinking your skinny Chais, people!!!” *shaking fist*
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I don’t know you, but you can do it!!
foxy.kate´s last blog ..Three bitches in a bathtub
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I only THOUGHT I was informed prior to my unnecessary c/s in March of 2009. THOUGHT. Had I known then what I know now, I have no doubts in my mind that my labor would’ve ended with a vaginal delivery (albeit a medicated one, which, in the end, I would’ve been okay with).
I consider myself a pretty well educated individual, what with two degrees, a successful teaching career, and a thirst for knowledge. But there were so many things I just didn’t know.
I’m glad to have found your blog, and groups like ICAN so that I know I have a better chance of a VBAC the second time around (whenever that time may be).
Miranda´s last blog ..Why didn’t my Staycation (and my child) come with a snooze button?
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Whew, I scored a 0.
Is that chart in the book? Is it attributed to someone? Did i ask you this on facebook? (I am getting old.)
My SIL who is a nurse and spent some time in L&D said that when women would come in with their birth plan there’d always be a lot of eyebrows raised & someone would invariably make the joke to start prepping the OR.
I did my clinical at that hospital this past semester – it has a 40+% C/S rate and it plays this little lullaby thingy over the loudspeaker through the hospital whenever a baby is born. (twice for twins, 3x for triplets, etc.) My classmates were AMAZED at how often it played…and I was like, “because they’re slicing everyone! We’re here btw 9 and 5! How many times do you think it gets played overnight?” and just…nobody got it. NOBODY.
foxy.kate´s last blog ..Three bitches in a bathtub
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Yes, it’s a scan directly from the book, and the original source is listed on the table (look at the bottom.)
Marsden Wagner might argue that your fellow nurses got the joke, they were just showing loyalty to, what he calls, Tribal Obstetrics. This book is an amazing, eye-opening read. Highly recommend it.
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Dude, I replied to this like 4 times last night and each time the internet ether ate my words. BUT I WILL PREVAIL, ETHER.
I will def. check out the book. I have to admit that it freaks me out a little bit that Wagner chose an outdated, fictional table from “The Science Humor” magazine and presented it as evidence of a large, medical machine (which I totally believe in, yes) and cited that “many OBs” find it hilarious. I feel like a) there are probably women who *don’t* know that it was written tongue-in-cheek and think that it was some sort of internal memo or perhaps a Tuteur Original and b) there’s SO MUCH MORE out there from which to choose to make that same point.
Part of me had this epiphany this past year (maybe the moment I was withdrawing from nursing school?) that in order to do the work that I *want* to do in the realm of birth I need to go back to medical school and become an OB. And part of me is terrified of that idea, and the idea of having to live inside that culture and witness what I’d have to witness in order to do the work I want to do.
foxy.kate´s last blog ..Three bitches in a bathtub
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In the surrounding text of the book, Wagner talks about how he has seen physicians print this table out and hang it on their wall. The table may have been created in 1991, but the physicians’ attitude toward women is the same today. I’m sure he’s seen many other examples of this type of behavior, but if physicians still have this table hanging on their wall (or came up in the ranks seeing it on their bosses wall) then I think it’s a good illustration of where the attitudes came from.
Ah… good post. A newly married friend of a friend came over to me and DH at the pool and asked who our OB was. We just had our third babv at home. While I know this is not for everyone, we live in a very bad for birth county and I was encouraging her to seek care closer to Baltimore or Washington where there are more choices. She asked me if our midwife made us get a whole bunch of tests… I said NO and that made her happy that everyone does not HAVE to do everything. She is young and doing her research and i’m happy that –for once– the conversation did not disolve into “I’m getting my epidural ASAP” and “I worship my Doctor, I’ll do what ever he says is best”. For once!!!!
Naomi´s last blog ..I’m Totally Obsessed with the Sociological Images Site
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I hate patronizing. The worst thing you can do to me is patronize me. And that table is the height of patronizing. It also makes me very glad for awesome midwives.
Amber´s last blog ..An Ode to Elastic Waistbands
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Could not have said it better myself – and I’ve tried. Well done – I’m sharing on FB, as you will know
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Thank you so much for writing this post. I used to be a big reader at Feministing, but I found it difficult that while everyone went on and on about the exhaustive nature of what it really means to be pro-choice about abortion, if a story came up about natural birth/homebirth or midwives, many (not all) but many comments bashed midwives and natural birth/homebirth advocacy. (Along with the “well, when I get pregnant, I’m going to ask for a c-section!” type comments.) It was a real disconnect. And it pissed me off because I see both issues on the same spectrum of real, educated choices for women and their bodies, health and families.
And yeah, that table is a pretty sick misogynistic joke.
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This is one of the main reasons I can’t hang around the “mainstream” feminist sites. Too much birth-bashing.
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Oh I love that book. I want to give it to every pregnant friend (and I do if they express the slightest interest, but feel uncomfortable about ‘forcing’ it on people for some reason).
I sometimes wonder that if every woman was empowered in her childbirth experience, if every woman experienced birth the way I did (though of course everyone’s experience is uniquely their own) then women would surely rule the world.
I was a different and stronger person after giving birth.
We are amazing. We must be a bit terrifying.
You are brilliant for pushing awareness. It just takes one woman telling another who knows and trusts her that birth can be an incredible and wonderful experience to set her on the path to a great birth. That’s what happened t me and I’ve passed it on. You are doing that 100 fold. Keep up the great work!
geekymummy´s last blog ..jellies
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I always thought I was extremely weird for believing cesarean surgeries can be a type of violence against women that is rampant and systematized to the point of being propagated by the very women who are its victims…it reminds me of Memoirs of a Geisha. Thanks for expressing that surgery can be a form of violence towards women. That idea is embedded very deep in my psyche.
Is it okay if I link this post to our birth advocacy website?
Melissa Vose´s last blog ..Update on crochet adventures
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p.s. that website is mothersofchange.com [not my personal blog, which is the one listed in my last comment!!!]
Melissa Vose´s last blog ..Update on crochet adventures
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Thank you for this. I live in the Netherlands and the medicalization of birth is nowhere near what it is in the US or England (primary care givers are almost always midwives, unless there’s a medical need for an OBGYN; home birth is always the option offered first, you have to pay 400 euros extra for a non-indicated hospital birth; etc.). But, it is becoming more medicalized. And although I am all for women having a choice, something has been bothering me: every time I tell someone I’m having a home birth – especially [young] women who haven’t had kids yet – they go “oh, I would so go to the hospital”. And I am left speechless – wanting to say more about the woman’s body, about natural birth, about all these things but nothing comes out.
This post really hit home why those comments bother me so: it is as if they want to distance themselves completely from the female side of things, as if they’re saying “I’ll let the men take care of that, i want nothing to do with it!” Of course, I would hope that when they do become pregnant, they’ll become more informed than they are now. I know I used to yell all the time that I’d be getting an epidural, and that making women give birth the natural way was old-fashioned and related to the Bible passage about Eve’s punishment for offering Adam the apple
Ruby´s last blog ..Day 5 – 37 week belly pic & pet pics & Happiest baby on the block review
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It is darn miracle I did not have a section!
I added up my score for ONE of my children. It was 55. Thankfully I had a very supportive OB (seriously a doc, who supported my choices) I suppose it helped that his wife was pregnant too.
My first birth was highly managed and very traumatic. Each subsequent birth was less managed and better…
Elizabeth Handler´s last blog ..June Giveaway!!
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Wow…just…wow. You hear about doctors and nurses purposely trying to sabotage someones birth plan but to actually see that table… I know there are some good OB’s out there, but this condescending, “I know what’s best for you and your baby” attitude seems to be so widespread. :/ I could just never be comfortable with an OB. It’s like, if you don’t sit down, shut up and quietly submit to whatever is easiest for the doctor, it’s a personal insult to them somehow.
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Formula use is also patriarchal: “There, there dear, its hard to breastfeed, just let us men take over for you and sell you this wonderful snake oil”
Empowered women surrounded by empowered women breastfeed. They aren’t carrying around coolers of formula and worrying about it going bad, nor are they hiding in the house afraid to nurse in public.
Breastfeeding should be easy, empowering, and actually often takes less time than formula feeding if you prepare formula properly.
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I think the best part of your post (which I agree with completely) is that your 10 min speech opened someones eyes to their power. We just all need to keep giving “10 min speeches” whether online or in person hopefully over time more women will be empowered regarding birth.
Sheridan´s last blog ..Cesareans Create Bad Bacteria on Babies!
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I was lucky enough to give birth at a great hospital that was part of the ‘Baby Friendly USA’ initiative – the Family Birth Center at CHOMP (Community Hospital of the Monterey Peninsula), and I STILL had an OB (not MY OB – my OB was ‘off’ that weekend) that strolled in just in time to watch my placenta come out and then stitch me up. The nurses there were amazing, and stayed with me the whole time AND delivered my baby despite the OB trying to tell me (via phone, of course) to hold off on pushing. The good news was that I got to hold my daughter and nurse her right away AND a lactation consultant checked in on us WITHIN AN HOUR of me giving birth – at 1:40AM.
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I have to completely agree with you on this one! What could be more feminist than pushing out a baby unmedicated, at home, with other women, then putting that baby to your breast! Honestly, what man can do that?
Take another look at modern medical maternity care, created by men. it has only been in the last few decades that we haven’t been drugged out of our minds, literally(!), our vaginas cut and our babies pulled from our bodies via forceps, which, incidentally, were invented by a man. It is time for women to remember that our strength and our power come from our Blood Mysteries, from menarche, to birth, to menopause, no man can do that, all they can do is try to control it by pushing patriarchal ideals that menstruation is dirty, that women are weaker, dumber, that vaginas and breasts are here for mens pleasure, that women can’t birth their babies without medical intervention, that menopause needs to be managed with synthetic hormones.
Now don’t get me wrong, modern medicine is a wonder and it saves lives. There are those out there that do absolutely need to see a doctor for their pregnancies and by all means should birth in a hospital! Fortunately those that really and truly do are actually few and far between. A majority of the complications that lead to c-sections in healthy women are caused by the very interventions that are supposed to save lives in the first place. Instead of OBs being with women and supporting them through labor and birth, a majority of them see it as just a job and a woman going into labor in the middle of the night is an inconvenience. Why else would we see the majority of c-sections and inductions done during normal business hours?
Thanks for giving a voice to this!
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first off. I LOVE this post. Thank you for it. I will be sending the link off to several friends so they can enjoy it as well.
My gut reaction to that table was an exasperated eye roll. At what exactly? Not sure. Partly anyone who would come up with something so condescending. Partly at people who do all of those things (I’m somewhat brainwashed too, obviously) partly at myself for falling for it, for being embarassed to bring my birth plan to my dr. and my L&D nurse.
Thank you for pointing out that avoiding the pains of childbirth is NOT necessarily the feminist choice. Labor is not actually our punishment for some indiscretion in the garden of eden. I have never felt MORE powerful or more alive than after bringing my baby into this world and feeling every moment of it.
I don’t feel that this post is critizing women who make these choices so much as criticizing those of us who know better and do not help others find their power.
Jen´s last blog ..Babies Babies Everywhere but not a One to Hold
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So I admit, I busted out crying when I read this. I feel the same way and it sounded similar to the passionate rants my husband listens to when I reach the peak of my frustration and need to just yell it out. Thankfully he is a wonderful listener It can just be so overwhelming and disheartening to know that not only is this type of *stuff* occurring, but that young women are being fed into it with a smile. I can’t say that I am too surprised when I hear information like this, instead I just pack it into my tool belt on my quest to change the system from within. We were just discussing a lot of this in my Women’s studies class recently and it was both encouraging and eye opening. Some people really have no idea what it out there that they subject their bodies to with blind faith in their practitioner. I feel comfortable saying all of this since I was on the receiving end of the unwanted scalpel. Keep on spreading the good word
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For those who were even one bit skeptical about whether or not I could possibly be right about physicians opposing autonomy, this week Kingsdale Obstetrics in Columbus Ohio sent a letter to their patients banning doulas and birth plans. Here’s there letter: http://birthingbeautifulideas.com/?p=1922
There you have it. RUN LIKE HELL LADIES!!!!!!!!!
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This is a local practice in my area, and a pretty big one (although I am obviously not a client!). One of my closest friends got a “big baby” induction there recently. Luckily, not a Cesarean. I agree that I would run like hell if I got a letter like that from my OB/Gyn!
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My husband told me that one of his coworker’s wives worked at the hospital and they don’t like women with birth plans…as if that was going to change my mind about having one.
I told him I really didn’t care if they liked it or not,or if they rolled their eyes, etc, but they had better read it and stick to our wishes.
I think that most of the families in my town would meet half of the criteria on that chart, but we still have tons of c-sections! I know I met several them…
Every time I think about my (albeit very fast) hospital birth I think…”next time I will do this and that..” and then I realize that next time I will just do it at home!
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As dated as that chart may seem, I don’t think the sentiment behind it has changed. I’ve taught pre-med students who would talk openly about how much they looked forward to putting women in their place when they got to do OB rounds before going on to lucrative careers curing cancer. At least in their sophomore/junior years of college, medicine was as much about power as healing or helping, and that attitude sealed my decision to deliver only at a hospital that is not a teaching hospital.
That said, this whole thing makes me very glad I was able to find a hospital with a fabulous midwives group to have our baby. They didn’t even ask why my husband has a hyphenated name and I don’t, but they did ask about our education, and they welcomed our desire for a birth plan and the multiple birthing playlists on an ipod. They didn’t ask what we drive, but it is the only place I interviewed where I believed that our score of 130 on this chart wouldn’t automatically get us treated like being feminist hippies is a bad thing!
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And yet, giving birth to my son in one of the biggest hospitals of a big city was one of the best experiences of my life. They were ready for a c-section if I needed it, but my OB worked with me for HOURS to let me have the vaginal birth that I desperately wanted.
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Wow, going off of what Krista said, just above…
I needed to process/post this in a place where it would be welcomed and I could finally put it down (It’s been swirling around my brain too long in a head-will-explode-soon kind of way). Here is a recent exchange I had, on Facebook, typos included, with two former high school classmates (one who is now pregnant and one who is a labor & delivery nurse, heaven help us):
pregnant one’s status: ” making dinner, and starting to formulate my “birth plan”…baaahahaha”
unrelated person: “how exciting! I wanted to give birth in water, but they didn’t have that option. 
”
L&D nurse: “DO NOT make a birth plan!! The nurses will hate you! We pretty much make fun of people who do that. Plus most people who do end up having disasterous things happen, I’m just sayin…..”
preggo: “well dont worry, im not getting over anal or anything…just things to think about i guess and ideas..ya know.”
nurse: “ok good, you dont want to jinx yourself!!!”
That was back in May, so yesterday I couldn’t take it anymore and posted this as a comment:
me: “[One who's a nurse], the comments you made here have troubled me ever since I read them. How sad and disempowering, for you and other hospital workers to “pretty much make fun of people who” want to have a safe, informed birth. I kept telling myself, “Just let it go, it’s none of your business,” but it is on Facebook after all.
Please read this article: http://thefeministbreeder.com/independent-women-will-be-cut/
Specifically:
“This table [shown in the article] heaps contempt on women whose ideas and preferences for giving birth inconvenience the doctor. Many obstetricians find the table hilariously funny. Isn’t it frightening that the ultimate weapon obstetricians use to punish overly “independent” women is to cut into their bodies, using a surgical procedure (cesarean section) only obstetricians can perform, which completely deprives the women of control over their own bodies?”
It’s not the birth plans that “jinx” women (??), it is a systemic oppression, described powerfully here:
http://mamabirth.blogspot.com/2010/06/misogyny-paternalism-and-dice-em-up.html
The “disastrous things” you mentioned are way too often set up (with noble intentions) by the medical establishment.”
An unrelated person said “Wow.” and then the nurse replied:
“Well first of all I work in laobr and delivery and see these “birth plans” often. Most of the time its very undecuated women trying to make health care chocies for the saftey of theirself and their baby. What we dont understand is if you dont want any healthcare worker to touch you or help you and do the things they need to, then DONT COME TO THE… See More HOSPITAL!!! Have a home birth or go to a birthing center. My job is to make sure that we have a healthy baby and a healty mom and most women who have a birth plan seem to refuse to let us make sure of that. I think you would be surpirsed at how many tragic things can happen in labor and delivery and how many moms or babies I have lost in my carrer, its not a simple processes for everyone and if you have seen any of the horrific things that I have maybe you would change your mind. Not to mention my nursing liecense is on the line with all these women who are making poor deciosns. And another thing most of these women end up with a c/s because they are trying to control every aspect of the situation that they never relax enough to let their cervix to open”
Another person said “Wowza is right” after that. I wanted desperately for that to mean, “Wow, what a ridiculous system that women are put through unnecessarily, so many times” and not, “Wow, who is this chick ‘bashing’ our friend?” Alas, I have a feeling it was the latter. So I followed up with the nurse by posting this:
Me: “For what it’s worth, I’m going to put this out there: http://www.huffingtonpost.com/melissa-bartick/ipeaceful-revolutioni-mot_b_536659.html
It is fascinating and doesn’t blame mothers for any of the problems that have more to do with money and systems… Please consider reading it.”
And the “Wow” person said, and I quote:
“To each his own, and until you are personally in a situation like that, then you can only go by what others say….and in saying today I saw a unicorn swimming in the ocean.”
Finally, the nurse: “I would def have to agree with [the person who made the unicorn comment]! And yes I did read the atricle which only strenghtens my argument, the “birth in the US” is not even close to comparing to what a REAL delivery is like. So like I said UNEDUCATED women making decisions! If people want to make good choices they should perhaps know a little bit about what they are talking about… See More, considering their own life and their newborn babies are on the line, and reading articles online IS NOT sufficient which is why med school and nursing school was invented. Woman can have a voice, yes, but to be calling all the shots NO. I mean would you tell a heart surgeon how to operate on you simply because you read an article about it on-line? Dont think so…..”
So….yeah, I would to know what others think of this exchange.
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Oops, I just noticed there are a couple places in what I posted that still have the “See More…” thing left over from extending a too-long Facebook post; please disregard those!
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Nurse makes a classic but inappropriate comparison when she likens childbirth to heart surgery. Childbirth is a normal process that when left alone almost always has a good outcome, especially when medical reasons that preclude vaginal delivery have already excluded that SMALL percentage of women from even attempting a vaginal delivery, and someone medically trained is reasonably available to intervene if there is a complication. In normal childbirth, less is almost always more, and interfering with a labor that is puttering along on its own generally worsens the outcome.
Patients wouldn’t interfere with heart surgery or create a “surgery plan” because the procedure is totally out of their realm of expertise and is meant to correct a serious problem rather than manipulate a normal physiologic process. Pushing out a baby is exactly within a woman’s area of expertise. It isn’t a medical issue at all except in rare cases. So why can’t the birth attendant, whether that person is an OB or midwife, hang back and let the mother do what she is designed to do, only to step in if there is an emergency? Does the fact that a few births are emergencies mean that every woman must be treated as if she is about to have an emergency, and why not intervene only if an emergency is arising? No woman is going to refuse emergency intervention or get pissed off that her birth plan is not being followed in an emergency.
I think Nurse would also have trouble explaining why outcomes for mothers and babies are actually better for women delivering under a low intervention midwifery model rather than a high intervention obstetrics model, even when the known high-risk patients are excluded from the groups.
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Reading this reminded me of what my doctor’s attitude was like during the birth of my daughter. The nurses were great but the doctor… My contractions never regulated, and in between pushes, my doctor looked BORED. I understand she had just come from a c-section to assist me, but she ended up ordering pitocin, which I agreed with, which worked so fast and hard that I ended up tearing and ultimately having an episiotomy because the baby came so fast (from beginning to push to birth, it was less than an hour). I look back now and wonder if a) I wouldn’t have torn if we just went with what my body was ready to do and b) I wouldn’t have torn if the doctor didn’t look so impatient.
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Thank you for this post (and for your blog, which I discovered last week). I always wonder why healthy women with low-risk pregnancies go to OBs for their primary care. And then I remember that I was very nearly a healthy woman with a low-risk pregnancy going to an OB for my primary care. It was when a friend said that her doctor didn’t believe that she was in labor because she wasn’t screaming in pain that I started to research care providers (I wasn’t pregnant yet, but trying to be). I didn’t even know that OBs are surgeons. I didn’t know that hospital practice is too often not in line with current research. I could go on and on about everything I didn’t know.
As for Leah’s comment above … I’m very curious why the L&D nurse characterizes the women who have birth plans as usually “uneducated.”
Rachael´s last blog ..A Vow
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[As for Leah’s comment above … I’m very curious why the L&D nurse characterizes the women who have birth plans as usually “uneducated.”]
I agree! I think women who really think through the process of labor and delivery and explore options and pros and cons of various interventions are PARTICULARLY educated. We aren’t talking about women rejecting life-saving measures here. We are talking about women doing everything in their power to have safe and normal births that do the least amount of harm to their bodies and babies.
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I cannot relate to this really, I live in the UK and health care is, for now, free…
Never been a fan of unnecessary surgery. But for as long as I can remember, I’ve never said whether I wanted to have kids or not, saying you don’t want to have kids when you are, like, 17, is naive because you don’t know how you will feel when you have fully matured. Same applies to saying you will want to have kids. It’s like how young girls are brought up to think about their wedding day before they’ve even discovered what their sexuality is or even had a sexual relatonship.
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Excellent post. With my first pregnancy, they induced, gave an epidural, and laid me flat on my back… none of which had been remotely discussed before I arrived… and when I was getting too close to 5pm on a Friday without delivering (despite the twenty students in the room, observing), they threatened me with a C-section. Luckily for me, an unlucky college friend had just gone through the process and had shared how miserable an experience it was. The greedy gleam in the eyes of the med students was the motivation I needed, I guess, because by 5pm my delivery was complete.
Don’t stop talking about this! It’s something every woman needs to hear, regardless of whether she’s even contemplating motherhood.
(Nod to The Hathor Legacy; I’m subscribing to your blog.)
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I have to admit when I saw the birth movies, the scheduled c-section looked so clean and pleasant I was drawn to it. However my lovely OB-GYN violently disagreed. It was her opinion that C-sections were only to be done in extreme circumstances when life or health were in serious danger.
Another Suburban Mom´s last blog ..HNT Gorge-ous Edition
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Great post! After sharing with a few friends and talking about this subject, I came up with this simple question:
Why would anyone anticipate a hospital situation by saying that they want the MOST invasive procedure with the longest healing time?
I thought I was doing my part by allowing my husband’s 18 year old niece to witness my non-induced, non-medicated, birth in the hospital. Unfortunately, she said not long after delivery that she still wanted to be medicated when she had kids. Granted, she comes from a family that makes fun of breastfeeding, so I shouldn’t have expected much…
Molly´s last blog ..The milk works
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Two questions: 1. Who checks their own cervix at home? Didn’t know that was possible… and 2. What’s wrong with bringing my own Walkman??? =)
Seriously though, I’m about to attempt a VBAC (any day now) and I’ve learned a lot from your posts. Thanks for making it an issue, I’ll be thinking about TFB at some point I’m sure while in labor!
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Answer to question #1: lots of people, actually! I did, and when I told my sOB that, he laughed at me. Now I know why. But seriously lots of women (and husbands) do this. You can too! Love your cervix. She’s your friend.
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Boy, some of these comments are really wild. Especially the lady who thinks her baby spending a week in NICU after an induction plus C-Section was a ‘positive’ outcome! Wow! If I were her I would be looking at all the statistics on atrogenic prematurity and wondering if my doc was one of those clowns.
The really frustrating thing though is this constant refrain of it being all about self-indulgent mothers who want a ‘birth experience.’ Where does this even come from? For me, and for most other pro-natural birthers I know it’s about the science: I wanted to give my son the best possible change to grow up healthy and strong — and with a mother to take care of him. And if that’s your goal, then there’s only one answer: don’t get a C-Section unless you damn well need one.
I had to fight through obnoxious, dishonest, condescending doctors in order to not have a C-Section. It became clear to me early in pregnancy that the real reason the OBs were pushing for a C-Section was: IVF baby with two lawyer parents. It probably also didn’t help that I have a strong science background and asked them for large scale population studies assessing risks of various treatments … I had no idea what a red button word that was until much later when I read Henci Goer. The poor doctors must have practically fainted when I walked in the door. I was their worst nightmare!
Long story short, after getting totally frustrated with the irrational, malpractice-haunted OBGYNs I found a great family doc who actually made decisions based on my real medical needs rather than his malpractice coverage. Great birth, healthy alert baby who crawled up my tummy and latched on within a few minutes of coming out … and nursed like gangbusters from that moment forward. Whenever I talk to a woman who says her C-Section went ‘great’ and then starts bemoaning the fact that even though she wanted to much to nurse her baby she just couldn’t make milk, or he just never figured out how to latch on or whatever … I have to bite my tongue to not tell her about all the studies on breastfeeding problems after C-Sections. Not to mention the higher asthma rates and everything else the OBGYNs never ever tell you about.
I actually think that a lot of my good birth experience was attributable to having family doc instead of an OBGYN. I firmly believe that if OBGYNs had to do the pediatrics for the babies they deliver we’d soon see fewer C-Sections. Or not. Maybe the cynics are right, after all when they say it’s all about the bottom line. And the evidence is starting to accumulate the C-Section babies keep on making money for doctors for years after their deliveries.
Sad epilogue to my story, however: this great family doc has been pushed out of the local hospital by a larger, aggressively interventionist OBGYN group, which is now the only birth care provider in the county. So with baby number two I’m having to make some hard choices.
So frustrating! It seems like a downward spiral: OBGYNs’ non-evidence based practices create medical complications, which makes birth look more and more scary to most women, who don’t know enough to ask for healthier birth options, which means that the elective C-Section guys make more and more money and their profit margins become the baseline, which means that hospitals deem natural birth a money-losing proposition, so even fewer options are available …. and so on and so on.
And then I read the Amnesty International Report on maternal mortality in the States and it’s so depressing. Case after case of very young very poor mothers who were automatically slotted into (probably unnecessary) C-Sections and then ignored in post-op while they bled to death or died of infections. It’s sickening.
So how do we CHANGE it? How do we make birth safer not just for the Volvo driving feminists — but also for the poor young mothers who are the most tragic victims here? Nothing we say seems to make any dent — except to provoke idiots like these into mocking us as ‘birth experience’ fanatics. Which is just SO not the issue. For me the C-Section mess in the states is about one thing and one thing only: thousands of kids growing without mothers for no damn reason at all. But that message just never seems to get any air time….
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I scored a 45 the first time around…no wonder I ended up where I did!
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Yikes on that chart!
I had been planning a homebirth, but wound up needing a cesarean (after 34 hours at home I stalled at 8 and it turns out that my baby was presenting brow first, which has a 50% c-section rate on The Farm), and my birth was the most empowering experience of my life. After 33 hours of labor I realized that something was not right at all. I decided to go to the hospital to get some help (which they refused, apparently they don’t staff doctors overnight), and by the time the doctor offered a c-section I knew I needed it and agreed willingly. The c-section went so well that I was home 32 hours later.
Now, I don’t want another c-section ever again, but the fact that I labored so long naturally, and that I knew something was wrong and made my own decisions are incredible gifts. Yes, I had surgery, but it was on my terms, and that’s all I can ask for.
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What’s weird is that when I had my daughter three years ago at 18 (I know, I know) I really did ask if I could have a c section. However, I had just started providing my own insurance that year and under the policy I had, you had to have had the policy for 12 months for them to cover prenatal care.
So basically the doctors did EVERYTHING in their power to not let me get a c section. I’m guessing because they figured they would never get the money out of me. So I guess being broke (but not broke enough for wellfare) actually helped me out huh?
I did have ab induced (pitocin) birth and an episiotomy that they didn’t even mention as well as an epidural. They really didn’t even want to give me that. The one thing I did want to do was breastfeed though, but they took my daughter away without even letting me hold her and gave her formula. Then 4 hours later they tried to bring her in for me to breastfeed. Obviously that didn’t work. But, lesson learned, next time I will know.
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I love this post! If I had read it before my first Cesarean, I wouldn’t have had one. Alas, it took me 6 years and two Cesareans to figure it out how to take back my birth rights. Now, when I see a first-time pregnant woman, I make it a point to tell her what a beautiful experience giving birth is. More often than not, this startles her; she had been expecting yet another horror story.
Roanna Rosewood´s last blog ..Secret to Opening the Cervix
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