Trust ME Twitter Friend, You Don't Need That Cesarean

I think many of us walk a fine line between wanting to know what’s going on in the world, and being sorry we ever asked.  Thanks to the power of Twitter, I have been able to cyber-witness mothers everyday in hospitals all over this country being rolled off to the OR for their cesareans – all Tweeted live by the expectant father.  It’s not hard to tell by a quick glance at the blinkies on the side of my blog that I am no fan of cesarean deliveries, and I’m not one to hide my feelings on the matter either. Science and evidence are on my side, and I know it.  I realize this means I’m putting myself in a challenging position by exposing myself to certain Tweets in Twitterland.

Oh, they just make it too easy.  If you have a nifty application like TweetDeck or Seesmic, you can perform a quick search on any word, and it will open a column that is continuously populated with tweets that contain that searched word.  Right now I have a column open for the term “BFing” (or breastfeeding) and one for the term “cesarean.”

Almost every day I see a tweet or two come in from a dad in a delivery room somewhere in America’s heartland, saying something to the effect of “labor’s a bust, we’re going with the cesarean.”  And of course, being who I am, my heart drops just a little.  I can’t not say something (more on this later).  So here is the transcript from yesterday’s encounter:

TheDad: Thank god for the epidural. She's in labor getting close! Exciting!
TheDad: Doing cesarean in bout half an hour after no progress from baby with 2 hours of pushing

(Here's where I come in)

Me: Get rid of the epidural, and she probably won't need the cesarean (they r bad news). Seriously. That's what worked for me.

TheDad: it's only bad whentoo strong to feel anything. Babies head toobig nothing to do with epidural

Me: it's bad when she can't move to reposition the baby. If she was able to move, baby's head is likely to fit. Avoid cesarean.
Me: and btw, "big baby" and "big head" are good excuses for docs to cut, and 90% of the time they are wrong about size.

TheDad: of course she can move to reposition the baby. Epi doesn't mean handicapped. It's not rocket science. Some heads are too

TheDad: big and some hip bones are too small and don't move.

Me: i'm a small woman who birthed a 10 lb baby after the doctors said I never could. Doctors love cesareans. Very sad.

TheDad: great for you. Unfortunatelynot all womens bones cooperate

Me: we always blame the woman's body. Our bodies are not a lemon. Good luck with baby, I wish Mom a speedy recovery. Ican-online.org

Now, I realize that it seems completely ludicrous that I would expect some stranger to take my advice over Twitter.  I am under no delusion that this man is going to turn to his wife whilst she’s being prepped for the OR and say “Honey, unplug the spinal, this woman on Twitter says you shouldn’t have a cesarean.”  And I’d surely die of shock if she actually turned to him and said “Really?  A stranger on Twitter said so? Okay, unhook me Doc! I’m delivering this baby through my vagina instead.”

No, no, it’s not like I really think that’s going to happen. So why do I bother?  Why do I upset myself, and undoubtedly upset this expecting dad on the most important day of his whole life?  I promise this is not nearly as selfish as it sounds.  Or at least I hope not. 

Yes, I understand that I don’t know any of the details about this couple’s unique situation.  Maybe there was a really, really good reason why she needed a surgical delivery.  The issue is, though, this situation is hardly “unique.”  If people only knew how their cesareans played out like scripted screenplays, they might feel cheated and lied to.  The Business of Being Born did an excellent job of creating a cartoon out of this all-too-common situation.    Everyone thinks their cesarean was “necessary” and an “emergency” when in reality so few of them really are.  I want people to know this. I want to help them avoid this.  I want them to avoid the pain and trauma my cesarean caused me. 

My intentions are pure – but you know what they say about Intentions and that Paved Road to Hell…  The truth is, I can’t help it.  I have always felt some unshakeable urge to convince others of my argument, especially that which I am passionate about, even if it may not be the appropriate time or place for such an exchange.

Ten years ago I wrote and recorded a song called “The Joke’s On You” in which I announced to a (then) unrequited* love that:

I have two things
A big mouth, and bad timing
But I have something
You can’t admit that you need
Oh, oh, oh, the joke’s on you.

It seems not a lot has changed in the last ten years.  I’m a different person, arguing about different things, but my need to be right, and/or save people from certain doom (whether that be a major surgery, or the sin of not loving me back) hasn’t shifted much.  And now that I think about it, I may have been like this since I was a child.

I once held a sleepover in 7th grade.  You know, the kind that you invite all the popular girls to in an effort to improve your social status.  For some reason these sleepovers always consisted of a crying session, in which girls would sit in a circle and take turns telling some tear-jerking tale. We would all sob and hug each other – the general purpose being that all this emotion-sharing would bond us, like, 4-ever.

I remember at this particular party, one girl, let’s call her “Lydia”, used her turn to tell the story of her uncle who was dying from cancer.  Very sad indeed.  Everybody loaded onto the Sympathy Train and listened intently to Lydia’s sad story.  She came to a point where she told us all that she visited her uncle in the hospital, and he had lost all his hair.  Lydia informed us that the cancer had made him bald.

I looked at Lydia with the typical level of care and concern that an 11 yr old girl is capable of, and proceeded to correct her.  “No Lydia,” I said, “the cancer itself didn’t make your uncle lose his hair, it was the chemotherapy – the treatment for the cancer that did that.”  Big Mouth.  Bad Timing.  Even at 11 yrs old.

Lydia screws up her face and shouts back at me “No! It was the cancer! He said so!” and wails a little harder.  All the other girls rush in to hug her, glancing over their shoulders at me with daggers in their eyes, like I’m the biggest dickhead in the whole world.  They think to themselves, “Ughgh, there goes Gina again, being an argumentative ass. It’s no wonder none of us really likes her.  We only came to this sleepover because she promised that there was an old liter of vodka stashed in the back of her grandparents cupboard.” 

What?  I was right about the Chemo.  But I guess that’s no excuse for saying so.

I don’t know.  Perhaps I am a dickhead.  Perhaps my habitual urge to explain the truth to others indicates that I harbor some clinical form of narcissism that could benefit from a little old-fashioned shock therapy.

I prefer to believe that I am a Defender of The Truth.  I think this is what will make me a great lawyer.  If I wasn’t willing to take one for the team, how could I ever help anybody?  I suppose it is my destiny in life to be a little bit hated by some, but appreciated by those souls I can actually get through to.  I may not have saved that woman from her cesarean, but maybe I planted a seed?  I hope, very very hard, that’s what happened.

Though most days I think I ought to delete the columns from Tweetdeck, and surgically remove the part of my soul that aches from these un-truths. 

It is just so much simpler not to care.

~TFB

_______________________________________________

*We went on to date for two years, and are still very good friends.  That relationship remains one of the most important relationships either one of us has had to date. See?  I was right.

Comments

[Naomi Dwyer]

Wow, I wish I could of had a slumber party with you! That twittering thing must be annoying at times, can you do other list too? Poor 'Lydia' ha ha.
Stupid dad, how could he possibly even entertain the idea that he and the docotor was wrong at that point. That would mean *gasp* he was fuctioning in a crappy alternative cut happy universe that just did major surgery for day to day activities....oh wait...it's real life!!!!!

[Dou-la-la]

I can totally relate to this feeling, in life in general as well as online, as a regular member of both MDC and a mainstream board. The comments on this post at Stand and Deliver (http://rixarixa.blogspot.com/2009/04/not-staying-true-to-my-wordwhatever.html) go into the matter of how hard it is sometimes to not become so invested in others' births. It's a fine line, isn't it? We want to advocate for change, and sometimes that can get personal.

Thought-provoking as always.

[TheFeministBreeder]

Wait... which part of the slumber party sounds fun?  The crying?  Or
the old bottle of vodka?  ;)

[Jennifer]

See? You've just convinced me again of why I really don't want to go the Twitter route. I wouldn't be able to get away from it. It would suck up my very existence.

My question is this: WHY do so many people go into the labor room not knowing that lithotomy position compresses the pelvis so the baby's head often won't fit? Why do so few people know that epidurals stall labor? Why did Dad hear this for the first time from a stranger on Twitter? Why didn't Mom know? That's just wrong. It's like talking only to the used car salesman on the lot you're buying a car from, and saying you did "research." Of course he's going to tell you what he wants you to hear. And it's not like they didn't have nine months to get ready for this.

The friend of mine who was most vocal in telling me I was an idiot for wanting to birth without drugs was the same one who, with her first baby, had had an OB slap misoprostal onto her cervix, went into violently fast labor and of course DID need the epi, and 10 minutes after birth started hemorrhaging and almost died. And she's telling ME I'm crazy for trusting my body instead of the hospital/docs/etc. She's not a stupid woman. But she's completely hoodwinked. I don't get it.

Sigh.

(And go you, by the way.)

[TheFeministBreeder]

"Hoodwinked" - oh, I LOVE that word, especially to describe this
situation.  If I ever write a book about this, maybe I'll steal that
word from you for the title. ;)

[Laurie/MobileMommy]

I totally understand. Sometimes I feel like I am banging my head against a wall when I tell people about cesareans, epidurals, staying mobile in labour, blah, blah, blah. They just don't want to hear it because 2) they want the epidural (heck, so did I) and b) their doctor is great and would never steer them wrong (and now I vomit)

I'm active in my local VBAC group and it's so sad how often we hear that the mother just "couldn't" vaginally deliver - and later she does exactly that. And I am a chronic arguer and want to help people see the light - just think though - every women who thinks, even for a minute, that there might be a better way, we're helping. And down the line (usually their next birth) they will remember what you said. Keep on doing what you do and know that it is worth it!

[Emily Jones]

"Big mouth, bad timing...I suppose it is my destiny in life to be a little bit hated by some, but appreciated by those souls I can actually get through to."

Wow, I could have written that exactly. When I first started doing research into nuchal cords, and realized they weren't any big deal, I was shocked at how many women were saying they had a baby die from a nuchal cord, or they were going in for an elective c-section to prevent a nuchal cord. So I thought I'd do the humanitarian thing and go onto one of these message boards and enlighten them that whatever may have killed their babies, it wasn't nuchal cord. I was not well-received.

I really have a hard time getting it through my skull that some people have a personal investment in their own version of the truth. See, I don't. To me, facts are neither good nor bad - they just are. But clearly not everyone thinks this way! Part of my growing up has a lot to do with learning how to share what I know in a more tactful fashion, and praying that when the right opportunity comes up, I'll know what to say and how to say it. That's also one thing I love about having a blog. I can say what I want in my own environment without worrying about to whom or when I'm saying it.

[Carina]

I have the same problem with breastfeeding:

Just one bottle
Supplement until my milk comes in
Top off with formula
I don't have enough milk
Baby weaned

It's ALWAYS THE SAME ALWAYS THE SAME ALWAYS THE SAME.

I'm sorry, do I sound upset?

Welcome to the wall-banging club.

(And my story was telling the popular girls who were going to perform a can-can in the 7th grade that the REAL reason original can-can dancers were popular in the 19th century was that they didn't actually wear underwear. Also went over like a lead balloon.)

@jet_set

[TheFeministBreeder]

HAAAAA ahaah haa haha ... or as my proudly hillbilly boss would say
"went over like a fart in church." 

And yes... same thing with breastfeeding. "I HAD to supplement" turns
into "My milk never came in."  Yeah... because you told it not to by
supplementing.  *headdesk*

[MdMommy2Two]

Maybe she did know that epidurals can stall labor and maybe she didn't care. I read all the info about epidurals before I had my first child and I still asked for one as soon as I got to the hospital. At that point, I had been in labor all day long at home and was so exhausted and in so much pain that I just wanted relief. For me, it was a Godsend, because I was able to get a few hours of sleep and when I woke up, it was time to push.

Or maybe she did know that position has everything to do with how easily the baby comes out, but her doctor wouldn't let her move. That was the case with my second. She came fast, no time for an epidural, but when the contractions started shooting terrible pains through my pelvis and down my leg and I was in agony and I begged to get up and try a different position, he wouldn't let me and I couldn't move without help because of the pain. I gave birth at Johns Hopkins, which was just voted as the country's top hospital, but it's also an enormous place and "your" doctor won't neccesarily be there. You get whomever happens to be working when you go into labor.

I do believe that there is a time to bite your tongue, even when you're right, because sometimes other people's feelings are more important.

[mothergreenest]

I was DETERMINED to have a natural childbirth. The direct-entry midwives in my community wouldn't take me on as a client, so my only option was a UC at home, or my CNM or an OB at the single hospital in our town. I chose to go with the CNM rather than an OB/Gyn. I had read Birthing from Within multiple times. I'd read Ina May's books. I owned TBOBB. I had practiced Hypno Birthing. I was in really good physical shape at term, and I was certain that I'd be able to deliver my baby normally. I had a birth plan, and I was going to use it. I had a doula. I was empowered, and excited about the event. I wasn't going to become another Unnecesarean. My husband was almost as informed as I was, and was prepared to be my advocate at the hospital.

And yet, I ended up with a section.

The short story is this: I labored for more than 36 hours, including more than 8 hours in transition, only to stall at 9.5 centimeters. I moved around. I walked. I climbed stairs. I used the birthing tub. I used the birthing ball. But my baby's head never engaged. It was still ballotable when he started having late decels after hours at 9.5, which my MW noticed after monitoring me through a contraction. We waited another few hours, but his head never got lower than a -4 station. When he started to tank (I could tell it was serious because the nurses were, well, frantic) I very, very, very reluctantly agreed to allow a c-section.

I am heartbroken about it.

Now for the excuses: He did have a big head - it was terribly bruised from being battered against my pelvis for more than a day. He was a relatively large baby (8lb 11oz). I'm a fairly small woman. Was some combination of those factors why he didn't ever engage? I'll probably never know.

I guess that what I wanted to say is that sometimes, being informed about the evidence isn't enough. And while I love your blog, and I really do believe that (almost) every woman can birth her child without medical or surgical interventions... this post made me feel guilty for failing to give birth vaginally. It sounds a lot like you're blaming women for their births, and that isn't always fair. The truth is that I tried. I really did. I know that you were trying to educate other women, and reduce the incidence of C-sections, but I think you ought to know that it hurt, and continues to hurt, to hear myself called a failure. Truth hurts, I suppose.

That said, thank you for raising the issue. It needs to be discussed with candor if we hope to avoid the fear mongering that goes on in OB offices. I hope that I'll be able to attempt a VBAC if we decide to have another child, but I've already been told that it's unlikely, with what happened during my labor, that anyone will take me on as a VBAC patient. *sigh* We've got a long ways to go, don't we?

[Laura]

a c-section saved mine and my baby's lives!
my first total natural pregnancy, ended in a midwife-attended home birth.
my second pregnancy ended up being highly medicated (with steroids) when a pregnancy-induced return of childhood asthma almost killed me and my baby. they ended delivering my 9lb 1oz baby by c-section at 36 weeks and it was beautiful. that's right. a 9lb 1oz preemie!

i totally agree that there are FAR too many c-sections. however, you CAN NOT argue that they can save lives.

[TheFeministBreeder]

I ask that you point me to the paragraph in this post where I called anyone a "failure". I never even implied it. I think that I made it abundantly clear that the situations in which a person is not informed are the ones I try to help. I know how hard it can be to feel depressed and traumatized by a cesarean, but recognize that that those are your feelings, and I cannot induce guilt on anyone, especially with a post directed at an entirely different subset of people that does not include you. You hated your cesarean, I know, but that's not my fault, and I can't make it go away by shutting up about them.

[Amber]

The thing about Twitter that gets me is how many OTHER people are reading. It's true that you're not going to change that couple's mind. But it's really hard to just stand by when you think about the 327 followers who now believe that many women just can't birth babies. That's my dilemma.

I usually end up biting my tongue and ranting to my husband. But I'm not totally comfortable with not saying anything. Sure, I'm not barging in where I'm not wanted, but I'm not doing anything to help anyone either.

I just don't think there's a good answer. But I do admire you for trying. I think the world needs more people who are willing to step out on a limb and state their convictions.

[TheFeministBreeder]

I think that's just it Amber. You hit the nail on the head. It really is my fear that other people will see those Tweets and take them as fact. Birth has such a bad name already. I'm just trying to stick up for it.

[Naomi Dwyer]

The "you making snarky comments" part!

[Naomi Dwyer]

I don't think anyone is saying that they are never needed, just that not --all-- of them are or the over-active management of labor makes them more likely (and labor more dangerous then it is-- see the stuff on pit to distress) http://www.ican-online.org/pregnancy/cesarean-fact-sheet

[Traci]

No one's said that they don't save lives. In fact, the WHO recommendations of a 10 - 15% c-section rate are an acknowledgement that it is a life saving surgery when used properly. Below the rate of 10 - 15% the benefits of having a c-section outweigh its risks. Above 15 % however, the risks outweigh the benefits. What a lot of people are missing is that although when used properly c-sections can save lives, when overused, they kill people. A c-section isn't having a few stitches under topical anaesthesia in your local clinic. It's major surgery. Babies have more complications, mothers have more complications. Any doctor who ignores these basic facts is trying to relieve his or her own anxieties about the uncontrollable nature of birth. They think because they're weilding the scapel, that they can manage or even prevent unwanted events. They can't. But they'd rather accept those risks along with the illusion of control, than accept the risks of natural birth which are completely out of their hands. I've had two c-sections. My first was because I was uninformed and my doctor was an unethical, chauvanistic ass (Dr. Stephen Trillet, M.D. Kalamazoo, MI, in case anyone cares). The second time, I was informed, planned a homebirth, and had a section anyway because I labored for over 24 hours and made no progress. The first time, I healed quickly with very little physical pain. The second time, I got a drug resistant infection, my wound came open and I was on antibiotics for over a month. I nearly died. And I nearly died from a surgery that a lot of people schedule for their convenience just so the in-laws can buy their plane tickets cheaper. That's why a lot of people are very passionate and outspoken about this issue.

[TheFeministBreeder]

Thank you Traci. I really could not have said it any better than that. 
Your situation (the infection/near death) is the one people never think
about.  They never think about the cesareans that cost lives.

[Natural Mom Loves Prada]

Gina, I can totally relate, the sleep over is so my memory...my life.
When I learn something new or get new information it doesn't even occur to me that others would not want it and like me start applying it immediately. I've never lost friends but there have been many tense moments.
This also happens a lot when I somehow get involved in some convo with an attachment parent (which I do consider myself on the AP spectrum, although I wear camo so as not to be seen)...ugh, don't even get me started...

In the last few months I have tried to find a balance of offering information and if the person does not seem interested than I accept that they have to make their own decisions and live with the consequences.
We do need to be vigilant at encouraging parents to become educated not just informed and nothing will change if no one ever says "it's really too bad you are having or had a c-section, you might want to read Ina May's Guide to Childbirth before your next baby is born"...

I'm glad we're on the same team - who knows what tweets I would get from you!! LMHO

[Laura]

i just thought i'd bring another perspective in :)

i think people on the more crunchy end of the spectrum get so focused on how *bad* c-sections are that they can't focus on the good they do too.

[TheFeministBreeder]

That's true Laura, they can be good, and I appreciate your perspective.
But the truth needs to get out there before we start suppressing it,
and the fact is that most women who've had a cesarean believe it was
necessary, when in reality most aren't.

[Laura]

very true. if all the cesareans that happen today were truly "life or death" (like a lot of people believe they are... because that's what their doctors tell them :-/) the human race would never have survived!

[Cate]

For a second there, when I read the blog title, I was worried that you were describing a Twitter DM fight that I had today. Because I wrote a C-section blog and someone else wrote a completely different, no-words-alike blog on the same video clip (Dick Morris on The O'Reilly Factor spouting that if we socialize medicine, we'll be FORCED to give birth naturally). I was told I should credit them, and while I believe in credit where credit's due, I didn't even read their stuff 'til later in the day after I'd written mine! I love linking. But I won't link because someone made me. I almost turned to you on Twitter for some bloggy/tact lessons, actually, but I just sat up straight and took care of the matter.

Anyhow, that's totally off topic. I mean, besides the speaking your mind part.
Every. Single. Time. I write a blog about the States' phenomenal C-section rate, I almost feel I should give a disclaimer, "Two of my nephews were born by C-section. I don't hate the method when it's needed." Because afterward, I get flooded with wonderful, inspiring stories about how lives were saved and how hard women tried.
We should try! But often we are not given the chance, and that's sad.
But there must be enough of us to say: "Birth is natural. Our bodies can do this."
Because how many times during your pregnancy are you confronted with horror stories that say otherwise? Much, much too much. And I'm living proof that there is another way. So are my boys. ;)

[Cate]

Awww, for fuck's sakes. (and no, I don't know the proper grammar on that term, thank you.)
Right after I got done reading this blog and writing my comment, I click on Facebook, and some new dad has THIS as his status:
"7lb 6 onces. 20 inches. Not as heavy as we hoped. We and the Dr.'s are going to be watching this. At least he is growing and is in good health."

Both my boys were in the 7lb range, and I'd be damned if I'd have anyone fretting about that!

[TheFeministBreeder]

I know what you mean.  I'm tired of giving the disclaimer.  I think my
entire blog is enough of a disclaimer.  If someone wants to read my
full flushed out feelings on cesareans, they can make with the
clicky-click on the "Cesarean Awareness" link prominently displayed at
the top of my blog, which will display every post I've ever written on
the subject (which is more than most people care to sit through.)

[TheFeministBreeder]

I have a friend who's 5' 9" - gained over 100 lbs with each of her
pregnancies, and birthed 5 lb babies each time.  There was nothing in
the world wrong with them, they were totally healthy, she just grows
small babies.  (I should note that bitch lost all that weight about ten
seconds after delivery and has a body like a former super model.)

It's always something - they're either too big or too small or too cute
or too hairy.... always some excuse for it to be an emergency.

[Natural Mom Loves Prada]

LOL - yup - 5 kids later and the biggest was 6lbs 15oz...so just 7lbs. Smallest 5lbs and all did exactly the same - great!!!!
Drama, drama, drama...

@FB - interesting... I'm 5'9, all my babies were in the 5lbs range, phew - I didn't gain 100lbs... ;) but I have had to dodge more and more daggers with each child and count down to "oh my gosh you...SHE has had 5 children!"

[angelagraceziegler@gmail.com]

Re: the whole "it's so much easier not to care" thing...

FUCK. YEAH.

The energy I expend caring could power a small city. Sometimes I wish I didn't have it in me to care so much.

[angelagraceziegler@gmail.com]

EXACTLY.

I'm am so sick and tired of women not taking personal responsibility for their feelings (and births as well, most times). The statement "you made me feel xyz" is fundamentally false because we actually choose to feel our feelings, and though sometimes it might feel like someone has "made" us to feel a certain way, really it is simply a knee jerk reaction. I am having this exact conversation on my local ICAN list because of a mommy blog that was discussing how Dooce has "made" her feel guilty for getting an epidural.

Own up to your feelings people! They are caused only by ourselves!

[Crystal]

Thanks for sharing your story!

I think it's often the most heartbreaking when you do everything by-the-book to get that natural childbirth experience, and still fall short for whatever reason. I also read ALL the books (Ina May's, Hypnobirthing, Bradley) and watched "Business of Being Born", and I hired a Doula which cost $700 out of my own pocket, and hired CNM at an independent birth center (wanted a Home Birth but insurance wouldn't cover, and couldn't afford to pay out-of-pocket). I knew all about the "cascade of interventions" and desparately wanted to avoid a C-section...yet despite the Birth Plan stating NO C-SECTION UNDER ANY AND ALL CIRCUMSTANCES, that is how my pregnancy ended!

My labor was easy and fast, w/in 7hrs I'd dilated all the way to 10 (impressive for a 1st time mom), water broke and was all clear, but then as soon as I started the pushing phase Midwife started to pick up disturbing heartrate decelerations. This was with a handheld doppler, and after administering me oxygen and me doing position changes etc., she decided we needed to get to a hospital and so 911 was called. At the hospital in the ER they couldn't pick up a heartrate, and so an Internal Monitoriing device was screwed into babies head (he was still high up) and rates were in the 50s/60s, roughly half what it should have been. We delayed to think things over, but ultimately I feared a brain-damaged mentally challenged child and so I decided to have a C-section. I really don't know if this was a "medically necessary surgery", perhaps baby could have been 100% okay with another 2hrs of me pushing, but we do know the heart rate was very depressed for whatever reason, and my Midwife had no financial incentive to do a transfer and so I believed her when she said this was serious.

I wish someone could point me to more (ANY) studies about how the FHR affects the outcome, because I know that electronic fetal monitors are useless and that "fetal distress" is tyically caused by epidural/pitocin/etc., but I was on NOTHING and the heart rate still ended up being an issue. In the past nobody ever tracked the fetal heart rate, and so I'd be curious to know what would happen if doctors & midwives simply stopped tracking fetal heart rate during labor! Would more infants be stillborn, or brain-damaged and mentally-challenged as toddlers and adults? Of course no one is going to do that study, but I would definitely be curious to know what role fetal heart rate plays into negative outcomes.

[TheFeministBreeder]

Actually Crystal (just to answer that last part) the ACOG just amended
their own policy on electronic fetal monitoring, and have decided that
it has not done a single thing to improve outcomes.  They have now
changed their position on it and the new policy is that intermittent
monitoring is a safe option for most mothers.

http://www.acog.org/from_home/publications/press_releases/nr06-22-09-2.cfm

from the ACOG release: "Although EFM is the most common
obstetric procedure today, unfortunately it hasn't reduced perinatal
mortality or the risk of cerebral palsy. In fact, the rate of cerebral
palsy has essentially remained the same since World War II despite
fetal monitoring and all of our advancements in treatments and
interventions."

Draw your own conclusions.

[Jennifer (Conversion Diary)]

I think it's great that you're getting that info out there. Also, I don't think you're crossing a line by offering your perspective. After all, the nature of blogging/Twitter is to get feedback on what you write. They don't have to publicly write about their births if they don't want feedback. :)

I thought what you said about the "had to" phenomenon is interesting. I've noticed that too, in a lot of areas of life. I think that sometimes there's some willful ignorance going on -- it's just seems too complicated and difficult to challenge the status quo, and the idea that you "had to" have a c-section for medical reasons seems to make it all go away. (Though I'm not saying that there's never a legit reason to have one, of course.)

Anyway, great thoughts, as always. I follow very few blogs these days but yours is one of them. I love how intellectually honest and thoughtful you are. Keep up the good work!

[TheFeministBreeder]

Well thank you so much for the kind compliments.  That always makes my
day. ;)

[michele]

UGH!!!!! Maybe that's why I just cannot get into Twitter. Hearing those things make me literally shake with anxiety. Good for you for "talking" to that man. Maybe you made him think...if even just a little.

It really is just a damn shame though. In stories like this, where a woman gets cut open to deliver her baby though most likely could have done so vaginally, I get incredibly anxious because that was ME. That was many of us. I wanted someone there when I was in labor with my son to say "NO!" for me. To snap me out of that 'my doctor is a god' trance I was under (that many are under).

So what if you piss people off. If you make people think and it's a reality they don't want to accept-you are trampling on they're perfect little bubble world. Of course they will be pissed off. Let them, and hope they will learn something.

[Crystal]

Yes, I read that recent statement too, and I knew all about the controversy surrounding EFM which I why I did not have this done to me while laboring (actually, the Midwife didn't even have an EFM machine present).

The statement still doesn't clarify if even intermittent monitoring by handheld doppler is useful. Most Midwives use a doppler to monitor at least at some point. I wish the ACOG had gone further to state whether or not ANY monitoring is effective. In any case, the reversal of standards of care was too late for me, but if I'd read this statement a year ago I would have told my Midwife not to monitor at all, even with a doppler.

[TheFeministBreeder]

So Crystal, the way that I interpreted that was that the ACOG realized
that FHR is no indicator of outcome, so whether it's electronic or not,
things like cerebral palsy cannot be determined based on heart rate
patterns.  There have been a few studies outside this press release
(that resulted in this conclusion) that FHR cannot be relied upon to
determine brain injury necessarily.  It's all a little frightening if
you ask me - it seems impossible that we are no further along in
predicting outcomes than we were 60 years ago (since WWII the article
says), but that seems to be the general consensus.

[Family Nature]

I've had 4 c-sections. Yes the were necessary (no, really) and yes I'm happy to have healthy babies, blah, blah, blah -- that is besides the point.

I am proof positive of how c-sections can mess with you, not only physically, but mentally too. I agree completely with angelagraceziegler and you Gina: any negative or guilty feelings I have about my c-sections are all mine. I don't blame anyone for them. My c-sections made me feel bad, not other people.

I love blog posts about cesarean awareness/prevention (like this one). But what really gets my goat is how offended and hurt people get because someone spoke the truth about c-sections. Why are facts so offensive?

It has taken me many years to accept the way my kids were born and it has not been easy. I continue to heal but the scars remain, as do the frequent reminders of 4 major abdominal surgeries (like the fact that I can't have any more kids -- which we wanted to do).

I guess the point to my rambling comment here is this: lets focus less on being offended and hurt about the facts. Let's work on spreading the word about: cesarean prevention; support for those who who've had c-sections; support for those planning a VBAC; and support for those who wanted a VBAC so desperately but in the end had another c-section.

Thanks for the post Gina, keep spreading the word.

[joie]

I have two similar stories: Hypnobirths, labored in water, on the ball, on my hands and knees. The first was a disappointment, but it was the "failed" VBAC that really broke my heart. I tried SO hard. I have analyzed them both to death and now I don't want to anymore. Knowing why won't change what happened. I am in full support of movements to educate and empower women to let their bodies do what they were designed for. But, why do I feel so alienated, like I was just kicked out of the sorority? There has to be a way to get this message out there in a way that embraces and nurtures all mothers who are just doing their own personal best with what they have to deal with.