ACOG Smartens Up While DONA Throws Baby Boys To The Wolves...

I know. Has the world gone mad?! You read the post title right. I woke up this morning to find a published position from ACOG that discourages elective inductions and cesareans overall, and especially discourages either for macrosomia (big baby). Whaa??

Here are a few highlighted quotes from ACOG's statement:

“Let nature take its course.” Over the years, I’ve found this saying particularly applies to the process of giving birth. My personal experience as an ob-gyn and reams of scientific research demonstrate that Mother Nature knows best when a child is ready to be born."  - James Breeden, President of ACOG

Wait. Did you read that too? He said to let nature take its course. Sadly, I fear that these words are going to fall on the deaf ears of women who will still believe, due to long-time conditioning by Obstetricians themselves, that as long as baby is "term" then baby is ready. The funny thing is, state medical boards are ALL OVER regulating Midwives, citing the safety of women and babies as the reason. Where has the regulation been with Obstetricians who are happy to perform elective inductions and cesareans, which put baby's life at higher risk than home birth does? Where is the outcry for public safety?

Okay, okay...I give ACOG serious credit for taking a stance on this again. Yep, ACOG has long since discouraged elective anything, in favor of labor starting naturally. But, it seems that Obstetricians have not been held responsible when they do otherwise. Here's another quote from an article on Improving Birth:

"For one, induction or surgery for “suspected big baby” (macrosomia) is not medically indicated. This is one myth we hear about all the time, even though ACOG has been talking about the “imprecise” nature of diagnosing macrosomia for at least ten years. Bottom line: induction for big babies is NOT medically indicated.

Elective inductions prior to 39 weeks gestation is, again, not recommended. Studies have shown that babies do better when they are able to remain in utero until 39 weeks. In the article above, ACOG sais, “Early-term infants have higher rates of respiratory distress, respiratory failure, pneumonia, and admission to neonatal intensive care units compared with infants born at 39 to 40 weeks gestation. Infants born at 37 to 38 weeks also have a higher mortality rate than those born later." - Dr. Capetenakis, OBGYN in Encinitas, CA

So again, I have to ask where the accountability is? I am very excited that ACOG has published this. However, I am skeptical that all of a sudden Obstetricians will start practicing evidence-based medicine when it is more profitable for them and the hospital in which they have privileges to keep doing what they've been doing. And going back to the factor of women in all of this - it's going to take a LOT of effort if there is ever going to be a hope of women waking up and realizing that being uncomfortable is better than putting their baby at risk.

I was recently told a story. A friend of a friend is a L&D nurse. She kept saying that she was not going to term. She got a stomach bug at 36 weeks, contracted from the vomiting, and went in to L&D. Even though it was not causing any cervical change, she decided it was just time to get baby out. Because she was 36.6 though, they waited until just before midnight to induce, because otherwise it was against hospital policy. But she went ahead with it, with an epidural in place before the induction was started. Kept saying that she KNEW she wasn't going to term. After the delivery, she told everyone about what a blessing it was that she was in the hospital (and not at home, like my crazy friend) because baby ended up having complications.

I will keep my comments to myself here, because they aren't nice. They even include much foul language. But THIS - THIS is the type of system that women are in. The one where it's perfectly acceptable to choose to rip your baby out of the womb, just because you don't feel like being pregnant anymore. The one where it's perfectly acceptable for Obstetricians to manipulate, coerce, and even FORCE women into intervention, procedures, and consent when they had previously denied consent. My heart is heavy in knowing that we have a loooong way to go.

I also woke up this morning to a find that DONA (Doula certification organization) has published an article in their magazine that is in favor of routine infant circumcision.

"A family's decision about circumcision should come from personal values. Religious and cultural reasons usually win out over all other arguments. Otherwise, you can make the case that circumcision is mainly a cosmetic procedure, with some potential medical benefits. It typically takes less than five minutes, and complications are very rare."

:scream:  Actually, the medical need for a circumcision later in life is less than the risk of DEATH from routine circumcision. Complications are not, "very rare". From Dr.Momma.org:

Out of 100 Circumcised boys:

75 will not readily breastfeed post-op

55 will have adverse reactions from the surgery

35 will have post-op hemorrhaging to one degree or another

31 will develop meatal ulcers

10 will need to have the circumcision surgery repeated to fix prior surgical problems/error
8 will suffer infection at the surgical site

3 will develop post-operative phimosis

2 will have a more serious complication (seizure, heart attack, stroke, loss of penis, death)

1 will require additional immediate surgery and sutures to stop hemorrhage

1 will develop fibrosis

1 will develop phimosis

1 will be treated with antibiotics for a UTI (urinary tract infection)

1 will be treated with antibiotics for surgical site infection

Of those who do receive pain medication for the surgery (about 4% of those boys undergoing circumcision in the U.S.) some will have adverse reactions to the pain medication injected

Out of 100 Intact boys: 

2 will be treated with antibiotics for a UTI (fewer if the foreskin is never forcibly retracted)

1 will be told to get cut later in life for one reason or another (fewer if the foreskin is never forcibly retracted)

Note: One reader of these statistics (a man cut against his will at birth with 4 intact sons today) critiqued (quite accurately) that it is actually 100 of 100 circumcised boys who experience negative consequences as a result of circumcision. Each and every one has lost an organ responsible for a great deal of his life-long normal health and functioning.

DONA is taking a defensive stance, saying that the article does not reflect the organization's belief as a whole. If that's the case, I wonder if they would allow a guest post about elective inductions and cesareans being a perfectly acceptable choice? Or, as Gloria Lemay put it to them, what about an article endorsing the cutting of females? They have now pissed off a whole lot of people. Personally, I'm not a fan of DONA. Or of any organization, really, that capitalizes on making labor-support a certified position. I've always found that to be completely and utterly ridiculous, especially when said organizations are clear in restricting many Doulas from attending women who choose to birth unassisted, and who have made it a thing of status and income in disproportionate ways. And, as I have heard Nancy Wainer speak about the atrocities that occur in hospitals every day, and the doulas who stand by and are essentially part of the rape and injuries that happen, by holding the woman's hand and telling her that "it's okay".

But this is really a low point for DONA. Another quote from the doctor who wrote the article:

"Often dads have strong feelings about circumcision, so fathers should definitely be included in the decision-making. If the parents care about their son looking different from other boys in the neighborhood, they may research the rate of circumcision in the area." 

Right. Forgot about teaching our children that they need to look like everyone else. Except for the fact that intact is, right now, the majority. Does this apply to girls in the neighborhood who have smaller or larger breasts than average? Should we encourage breast enhancements or reductions in order for our daughters to not be made fun of? Should we start young children on contact lenses so that they will not be made fun of for wearing glasses? What about those who need to wear braces? What about children with Autism and Downs Syndrome? Should they be hidden from the general public so that they never face teasing?

This is a really shitty reason to permanently alter an infant's body without his consent. Period.

Another gem:

"But once they decide, they should be encouraged not to drive themselves crazy with second guesses - in the long run, it will probably be fine either way." - Marjorie Greenfield, MD. 

Yes. We wouldn't want parents to consider the gut feeling that they may be doing the wrong thing. After all, that's lost money! Err, I mean a child who might be ridiculed by his peers! I'm sorry, am I the only one seeing dollar signs here?!? Am I the only one seeing, "Doulas, keep your mouths shut. Do not encourage in-depth research into circumcision."?

Shame on you, DONA. Shame on you for allowing an article of this type in your print. Shame on you for essentially agreeing with the idea that Doulas should NOT be encouraging parents to keep their sons whole. I'm not sure it's possible, but I'm less of a supporter now, than I was before. You just made a joke of your entire organization.

Strength Has Different Faces

Throughout the years I have been "given" (thrown into?) opportunities to show me that I am stronger than I ever thought I could be. Cutting through all of the lies after my very unnecessary and damaging cesarean in 2004, to have a triumphant and empowering home VBAC in 2005. Going through that labor in 2005 after weeks of exhausting prodromal labor, only to end up with a stubbornly posterior baby whose gift to me was 100% back labor on my injured back. But, I did it. I gave birth to my 10lb 10oz, posterior baby girl only 19 months after I was told that I could not safely birth my 8lb 8oz son safely because of his size. Oh, I wanted to give up. Several times. But due to the support of my husband (which was a surprise, because he had been VERY against the home birth), and my amazing Midwife - I did it. It was an amazing feeling.

I didn't think that I would go through anything as physically challenging as that labor and birth. Boy was I wrong.

One year ago, three days after my due date with baby #4, I was in early labor. I knew he was breech. I knew he was larger. And I was struggling with knowing that he wasn't in a good position for breech. I am trained in breech deliveries. I have caught breech babies. And due to this, I knew the position that he was in wasn't favorable. Added to that - my intuition, my heart, my gut told me that things weren't going to go as planned. However, I wasn't willing to change my plan of me birthing with my husband. I had no idea that early labor would continue tomorrow, then heavy (and very hard) active labor would go on for a full 48 hours before I met my son.

I actually began early labor on November 12, one day after my due date. It was definitely early labor, but it was spaced out enough so that I could get some rest and try to get things done. In the wee hours of November 15, labor developed into something harsh. Contractions were still decently spaced, but they were incredibly rough. I'd not experienced contractions like this until *much* further along in labor. The next day, November 16th, was my HBAC baby's 5th birthday. I tried as best I could to celebrate with her, in between contractions that were wreaking havoc on my body. Labor spaced out a little bit in timing, not intensity, in the middle of the day...but then came back with a vengeance that evening. Several times in the course of the week or so before meeting my son, I cried. And I sobbed. You see, in my heart I knew something was wrong and that I wouldn't meet him the way that I had planned. And this was nearly impossible for me to accept. In fact, I didn't accept it until after I decided to go into the hospital for a cesarean.

And yes - here's where the skepticism, the questioning, and the downright unbelief comes in. Women are told to trust their intuition in birth....except when it comes to accepting intervention. A home birth Midwife went into the hospital to ask for a cesarean. I've been told that things were said about me, everything from, "She went in and asked for a cesarean because she was scared of breech. She didn't labor or push as long as she said.", to, "Karma's a bitch." The latter is because of how outspoken I am about birth. I speak often about breech being a variation of normal, and long labors sometimes being necessary. I still stand by them. I have also, when asked, critiqued a birth story so that the mom can have a better understanding of what choices she can make differently in a future labor/birth, in order to have a better shot at a different outcome. There *were* times, I'm ashamed to admit, that I critiqued a birth without invitation, though not TO the mother, but with friends. Not that it justifies it, but these were almost always hospital birth stories where it came out that mom decided to allow intervention, or home birth stories that started with mom inducing "naturally" and allowing intervention. The only comfort that I have is that *I* know what I went through. *I* know that I did absolutely everything I could, and everything "right", and still ended up in the operating room. Also, I have the comfort of knowing that anyone who knows me well, knows at least that my story is likely true - though, I got questions from people who I thought knew me well enough to know that I would NEVER step foot in a hospital, never mind ask for a cesarean, if it weren't 100% necessary. :shrug: I'm not sure many people will ever understand the agony involved in this journey. The decision to go into the hospital was necessary, and I was actually at peace with it at THAT point. But the agony before that point is indescribable. And people have told me that I shouldn't care what people think, or want to believe, and I know I shouldn't.

Knowing that doesn't stop it from hurting.

I have received incredible validation from Gail Tully, of Spinning Babies. I met her at the ICAN conference in April. She was doing a lunch session on breech births. She pulled out a sketch of the exact breech position that Caleb had been in and said, "I wasn't going to draw this one for this session. But last night as I crawled into bed after reviewing my notes, I had this tugging feeling that someone here needs to see this.", and she went on to explain how this particular position more often leads to bad outcomes. That the way he was sitting can cause major complications when the baby rotates. I sat there in disbelief, and began crying. Whether anyone believes this to be intuition or fear - it was there. I had an increasingly unnerving feeling about head entrapment as my labor went on with Caleb. And I've never seen one. The breech births that I have attended have all gone beautifully. But it's what kept grabbing me. Now, I will never know for sure if that's what would have happened had he been able to descend. Some have told me that him not being able to descend is probably what saved him. I don't want to be that dramatic, because I don't know. I never will. Maybe he would have been born just fine had he been able to descend. Maybe he wouldn't have been. I can't keep thinking of "maybes", because it'll drive me nuts. But this validation from her is invaluable to me. In the past week I found a comment from her on my birth story, from last January. Three months before I even met her. I didn't see the comment before last week. She reassured me that I did absolutely everything I could, and that sometimes these breech babies are just not able to descend, and a cesarean is necessary. I know that mine was, but having the validation from a woman who has seen breech more times than I probably ever will, and who very much believes that it can be normal and totally fine ... it was amazing.

On the night of the 16th, once the kids were in bed, labor picked back up to an excruciating pace. I texted back and forth with a friend. I told her that I didn't think I could emotionally survive another cesarean, yet I knew unless some miracle happened in the middle of the night, that it's what I would end up with. Things were wrong. I sobbed, and I raged, and I sobbed some more in between contractions. I cried to my husband, who tried to reassure me that everything would be okay. He didn't get what I was saying, he thought it was from exhaustion and the intensity of labor, and how long the intensity had been going on without progressing further. I tried to lay down to get some sleep, and labor picked up to another level I didn't think possible. The pain was unbearable. I had never felt pain like this, not even in my posterior labor. But I had made an agreement that if things didn't change by morning, that I would go in for a consult to see what was going on. I was determined to keep going, trying to hold on to some last hope that things would totally change and he would be born into my hands in the water as planned.

At 3am my waters released. I was renewed with excitement, determination, and hope. Maybe that's all I needed. Maybe that's all HE needed, in order to come down. I woke Jeramy up and got in the water. My waterbirth tub was my comfort. I labored in there with candles lit and my playlist playing.

When pushing sensations started to take over my body at about 8, I was once again renewed. He would finally come! I had no idea that six more hours of unstoppable, excruciating pushing would be my labor.

48 hours of hard, active labor, and six hours of physiological (unstoppable) pushing later ... I saw that my son wasn't descending. He hadn't moved down even an inch. He was in the same exact spot, same exact height, as he had been in the last few weeks of pregnancy. His hard little head was still right underneath my left breast. Waters releasing, and pushing hadn't changed it. I knew this was the sign that it was time to ask for help. His heartrate was still strong, and I knew he was okay ... but I wasn't sure how much longer he and I could endure a labor like this. It took *forever* to get to the car, because contractions weren't only a mere 2 minutes apart, but they were well over a minute long, and double peaking. The car ride was excruciating. I've never felt so trapped, so immobile, and in so much pain.

Caleb Eliuddin Fiscer was delivered via cesarean section at 2:39pm on November 17th, 2010.

In the end, we were treated with respect. They honored our wishes. I was spoken to like a human being while on the operating table, which is a far cry from my first cesarean. I was awake. And I held and nursed my son - all 10lbs 6oz of him - within 20 minutes of his delivery. Caleb didn't have any drugs whatsoever - I refused any narcotics in my IV, much to the disagreement of the anesthesiologist who tried his best to convince me that I would be in horrible pain as soon as the spinal wore off. He didn't have any shots, vaccinations, eye drops. He was handed to daddy in the operating room. So very, very different than 2004.

I still cry. I still hate how this birth went. I still mourn the loss of my home and water birth. I mourn the loss of a peaceful, safe, and easily healed vaginal birth. My body is wrecked from this labor, in ways I won't go into detail about here.

But all in all, it showed me (much to my anger some days) that I am much stronger than I previously believed. I made it through the labor from hell, through 6 hours of incessant and excruciating pushing, and ultimately through surgery again. I didn't think I could make it through the latter. But I did. For a while I was angry because I didn't think I needed another birth "lesson", as to what can happen, and what we as women are capable of. I didn't think I needed to have another experience to be an example. All I wanted was a peaceful, beautiful birth. I didn't have a peaceful birth. To me, I didn't even have a beautiful birth. But it taught me some things that I will never forget.

I'm not sure how long it will take me to be able to think about this labor and delivery without crying, and mourning. Hopefully the sadness will continue to decrease in intensity.

Happy 6th Birthday to my HBAC Princess, who showed me just how amazing and empowering birth can be. And Happy First Birthday, my Caleb. My heart and joy, who showed me that I am capable of strength even in the face of heartbreakingly hard circumstances.

"You were not born in the way that I had intended.We did not meet in the way that I had hoped.You cried with confusion and hunger. I cried with confusion and pain.
We returned to our cocoon together. When we emerged – transformed. Beautiful and with delight. For we had fallen in love in the way I had dreamed." - Karyn Peabody

Brilliant Repeat Cesarean Patient Plan

Step 1:

Convince first time moms that pregnancy and childbirth is so dangerous and so scary that they need to hire a trained surgeon (OB) to care for them. Even though pregnancy and childbirth are physiologic events. After all, things can go wrong at ANY MINUTE, right?

Step 2:

Convince women that heavy monitoring and/or induction and/or epidural and/or cesarean is going to be necessary. Small pelvis. Past due date. Low fluid. Big baby. Small baby. One or two higher blood pressure readings. Water broke without labor.

Step 3:

If women refuse labor induction, find a reason to scare the shit out of them. Most often? "YOUR BABY WILL DIE IF YOU DON'T ACQUIESCE!" Your baby will be too big, and will get stuck in the birth canal. Your baby is in distress because we found meconium on the bio-physical profile at 41 weeks. Your baby has little to no fluid left, and can die. Your pelvis is just too narrow...we'll LET YOU TRY, but you will probably need a cesarean. If you attempt a vaginal birth with a breech baby, you will kill/harm/damage him. If you attempt a vaginal birth with twins, you will kill/harm/damage them.

Step 4:

Begin induction on a woman whose Bishops Score is unfavorable. Crank up the pitocin, even though the woman's cervix is not low, soft, or dilated. (Or barely so) Recommend an epidural so that the pain of the unnaturally strong (and unnaturally occurring) contractions can be taken away. Break her water artificially. Do internal exams every 2-4 hours.

Step 5:

As soon as the baby goes into distress as planned as you knew he would unexpectedly/mom gets a fever/placenta abrupts, explain to woman that she needs an emergency cesarean NOW, otherwise baby will die/be harmed. You DO WANT WHAT'S BEST FOR BABY, DON'T YOU?

Step 6:

Do not share with woman that according to evidence based research, it was a failed induction because her baby was not ready to be born. Or that inducing for "suspected macrosomia" is going against evidence based protocols. Or that inducing at 12/18/24 hours after water breaks is not evidence based. Or that inducing with a low Bishops Score is formula for cesarean. Or that inducing for low/no fluid is not evidence based.

Step 7:

Convince the woman that it was her body's fault, or baby's fault, that she had a cesarean. Your pelvis wasn't large enough. Your labor wasn't fast enough. Your body didn't create enough fluid at the end. Your baby didn't tolerate labor well. Your baby was too big. Your baby didn't come out when he was supposed to. Your baby wasn't in the right position.

End result?

Scenario 1:

A woman who is now even more scare of pregnancy, labor, and birth. A woman who believes that her body is broken, and that her body put her baby in danger. A woman who will be far too terrified to plan for a normal birth with the next baby. Who will plan her repeat cesarean for 39 weeks, since her body is too dangerous to try again.

Scenario 2:

A woman who will ask her "wonderful, natural friendly" OB (surgeon) if she can "try" for a VBAC, and will not do so because her OB (surgeon) reminds her that her body didn't do well the first time around, and it's safer to have repeat surgery.

Scenario 3:

A woman who will plan a VBAC, but will once again hire a trained surgeon (even though she's trying to AVOID surgery) and most likely will allow interventions in a normal pregnancy and/or labor (VBAC is still normal!) for the same reasons listed above.


Obstetrics, even though 2/3 of their protocols are NOT based on scientific evidence (according to the latest research), continues to claim 99% of women as "patients". Some people wonder why our cesarean rate is so high nationally, and our infant mortality rates are inexcusable. It's really pretty simple. Take healthy, low risk women with healthy, low-risk babies and convince them that they need Obstetric (surgical) care. Add this to the above formula, and you have almost guaranteed repeat cesarean clients. Higher revenue for doctors, insurance companies, and hospitals. (Let's not forget that with cesareans comes a higher rate of NICU admission - even more revenue)

Women - start thinking wisely. Research your options more carefully than you research the car seat, crib, diaper bag, or latest accessories. Childbirth is nothing to fear. Really.

Neonatal Outcomes Better With VBAC

This is from the June issue of *Obstetrics and Gynecology*!! All of the things WE'VE KNOWN, yet they have been against admitting. Maybe the evidence of harm in ERCS is increasing?

Women need to be educated. That's the first step. They need to stop being so darn scared of the pain of labor, and educate themselves of the dangers of things like inductions, augmentation, epidurals, labor narcotics, artificial rupture of membranes, and delivering in the hospital period.

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Neonatal Outcomes May Be Better With Vaginal Birth After Cesarean Delivery

Laurie Barclay, MD


June 3, 2009 — Neonates born after elective subsequent cesarean delivery have significantly higher rates of respiratory morbidity and neonatal intensive care unit (NICU) admission and longer length of hospital stay vs those with vaginal birth after cesarean (VBAC), according to the results of a retrospective cohort study reported in the June issue of *Obstetrics & Gynecology*.

"Controversy remains on whether a trial of labor or an elective repeat cesarean delivery is preferable for a woman with a history of cesarean delivery," write Beena D. Kamath, MD, MPH, from the University of Colorado
School of Medicine in Denver, and colleagues.

Wait? What?!?!?! Didn't the study prove that outcomes were better with VBAC?

"Historically, concerns regarding the increased risk of uterine rupture and perinatal asphyxia in trial of labor after cesarean compared with planned repeat cesarean have swayed obstetricians away from recommending a trial of labor after cesarean delivery; however, the absolute risk of perinatal asphyxia remains small."

Um - the risk of Uterine Rupture is approximately 0.3-0.7%. And that's not the risk of death with UR. The actual risk of death of baby after a Uterine Rupture is a FRACTION of this less than 1% risk. And the OBs are swayed against recommending it - why?? And historically? Really? Is that why the VBAC rates were HIGHER 10 years ago, and the cesarean rate lower?

The goals of this study were to compare the outcomes of neonates born by elective subsequent cesarean delivery vs VBAC in women with 1 previous cesarean delivery and to compare the cost differences between these
procedures. The study cohort consisted of 672 women with 1 previous cesarean
delivery and a singleton pregnancy at or after 37 weeks of gestation. Participants were categorized based on their intention to have an elective subsequent cesarean delivery or a VBAC, whether successful or failed. The main endpoints of the study were NICU admission and measures of respiratory morbidity.

Compared with the VBAC group, neonates born by cesarean delivery had higher
NICU admission rates (9.3% vs 4.9%; *P* = .025).

:Nods: I lived through the absolute HELL of this.


Rates of oxygen supplementation were also higher in the subsequent cesarean group for delivery room resuscitation (41.5% vs 23.2%; *P *< .01)

:Nods Again: Noah was on CPAP the first 2 days, intubated the following 2 days, and then on a nasal cannula for the remainder of his 9 day stay.

and after NICU admission (5.8% vs 2.4%; *P* < .028).

DOUBLE the risk of NICU stay - did you catch that?!?!

The rates of delivery room resuscitation with oxygen were lowest in neonates born by VBAC and highest in neonates delivered after failed VBAC.

Yep. I can see that. "Failed" VBAC = Another Cesarean Section. Cesareans are harmful for baby. Got it.

Although the costs of elective subsequent cesarean delivery were significantly higher vs VBAC,

And women really believe that their surgeon - Ooops! I mean OB - don't get paid more for elective surgeries? They can schedule it around their personal schedule, and they're in and out in about a total of 2 hours. Hmmmm ...


the highest costs for the total birth experience were for failed VBAC, considering both delivery and NICU use.

I would LOVE to see hospital VBAC success % vs Home VBAC success %. Those of us who know, know that VBACs are more likely to be successful at home, due to a NUMBER of different factors.

"In comparison with vaginal birth after cesarean, neonates born after elective repeat cesarean delivery have significantly higher rates of respiratory morbidity and NICU-admission and longer length of hospital stay," the study authors write.

And yet, women are still told that VBAC is too dangerous. Really?!

Limitations of this study include relatively short postpartum follow-up of the mothers to determine the additional costs of postsurgical complications and insufficient data to allow estimation of costs other than those for hospital care.


Even if you don't know a whole lot about Cesareans vs. Vaginal Birth, it is a pretty logical conclusion to believe that complications are higher after surgery, correct? This study didn't account for those women who had to go back into surgery because of an infected uterus or incision. It didn't account for those who were sent home with Home Health Care Nurses, because they had to pack their incision for several weeks.

"Given the increasing rates of primary cesarean delivery and the concomitant decrease in VBACs, once a woman has had a primary cesarean delivery, we must consider the risks that this places on her subsequent deliveries and subsequent neonates," the study authors conclude.


Hmm. Okay study authors, are you suggesting that cesarean sections not be recommended for the slightest thing, as they are now? That would require OBs not intervening in normal labor as much as they do. That would mean not breaking a woman's water, not restricting women to the bed, and not recommending inductions or augmentation. Start THERE!


"Indeed, this argues for greater selectivity in performing a cesarean delivery in the first place, and certainly a greater need for counseling before a primary elective cesarean delivery.

The ways that "elective cesarean delivery" are used though, is what needs to be examined as well. My cesarean was labeled "elective" in my surgical notes. Did I ultimately consent? Sure, after having the crap scared out of me by my OB. Do they account for coercion? Abuse of perceived authority?


As investigators continue to search for ways to make cesarean delivery safer,

Wait - WHAT?!?! There *AREN'T* any ways to make cesareans safer. It's MAJOR ABDOMINAL SURGERY! You are literally removing a baby from a woman's body - most of the time before the baby is ready to be born. And has anyone missed how rough a cesarean can be for a baby?

we may be better served by exploring other means for reducing overall cesarean delivery rates and recognizing our own preoccupation with the individual that will be our patient, whether it be mother or neonate."

Not very intelligent or witty, I know - but my only response to this is DUH!

*The study authors have disclosed no relevant financial relationships.*

*Obstet Gynecol*. 2009;113:1231-1238.

Cesarean Awareness

There are people who might look at this title, and think "What is there to be aware of?". So often now people view cesareans as just another way to have a baby. Rarely are the true risks of a cesarean told to expecting couples, and those are usually the immediate risks that are mentioned ( most often in passing ), nevermind the long-term risks that a cesarean can create.

I am involved in a new organization called BirthAction. The site is still in progress, but we very much hope for it to be a hub for pregnant women to come and receive well-rounded information on everything pregnancy. Kind of like What To Expect When You're Expecting, just with accurate information. ;) We'd like it to be a place where women can come and find information about routine pregnancy screenings ( like ultrasound, afp testing, gestational diabetes testing, Rh sensitization, gbs, etc ) and make informed decisions about their prenatal care. It also offers tips on how to avoid a primary cesarean, tips on how to optimize the chance of a successful VBAC, information on home birthing, unassisted birthing, water birth...and everything in between.

In our goal to create awareness about the risks of cesarean sections, I designed the poster that I am putting on this page. Women need to think long and hard before agreeing to a cesarean for reasons that are not life threatening, and to elective ( or coerced ) repeat cesareans.

I am five years out from my one and only cesarean, and I have what will probably be life-long side effects. For the first time in my menstrual history, I have irregular periods, endometriosis, and PCOS. This did not occur until *after* my cesarean. I have had hormonal problems, weight gain, and much pain as a result. It breaks my heart when I hear of women resigning to a cesarean for a "large" baby, for a breech baby, or for twins. It breaks my heart and makes me want to throttle doctors when I hear of elective inductions, inductions for "large baby", inductions because mom hits 40/41/42 weeks. It makes my stomach drop when I hear women count down to their due dates, because they obviously are unaware that a due date is simply an estimation, NOT a guaranteed date of arrival. It makes me cringe when women call themselves "overdue" when they are a few days past 40 weeks. They do not know that they are not a bit "overdue" until after 42 weeks. Technically, according to medical literature, not even until after 43 weeks. It's 42 *completed* weeks.

So many cesareans can be avoided. If women would come back to the knowledge that their bodies are strong. That they are capable. That pregnancy is not a condition or disease or pathology. That they do not need drugs to begin, or to get through their labor. That their baby is healthier when they allow labor to begin, and to occur naturally. I wish that women would stop believing that there is something wrong with their body, or that they are not strong enough to endure labor without the blasted epidural.

Women need to wake up and realize what is being done to their babies.

Bittersweet Anniversary

Some may think it completely odd that I get emotional and sentimental over the anniversary of Noah's delivery, and my cesarean. And some years are more difficult than others, for whatever reason. My husband even will tell me to knock it off, because I admit that it's a self-led walk down memory lane, remembering this day each year.

Five years ago today, at this very moment, I was in the hospital for pre-op stuff. I had been told to come in by my new OB, to have another ultrasound done to check for Noah's maturity. Apparently they were looking for the "practice breathing", and for vernix floating in the water. Knowing what I know now, I look back at myself and fully realize how naive and gullible I was. In the time that I was there, I also had an NST. It was during the NST that my OB noticed regular contractions. He checked me, and found me to be a stretchy 4cm. He announced that apparently my son was not waiting for the scheduled cesarean tomorrow, and that I would undergo surgery as soon as everything was prepped. I was so nervous.

It was supposed to be totally uneventful. A simple procedure to deliver the son that was too big to be safely birthed by me. He was supposed to be big and healthy. After the doctor announced that Noah was out, I waited for the cries. And waited. My husband explained that they were working on him on the warming table. I heard some gurgles, and then finally those cries. But they were different than what I remember Kaitlyn's being. The hardest part was, I was struggling to stay awake. The anesthesiologist gave me something in my IV to help with anxiety. Apparently some women don't care about seeing the instruments that were to be used on their body, or cry when they sit on the OR table for the first time.

They announced that he needed a bit more help, held him to me for a quick few seconds to kiss ( I have a picture of this - he was quite gray )...and then took him out. I went in and out of sleep as the OB sutured and closed me. The only thing that I remember from recovery is something that has haunted me for five years. The neonatologist that was taking care of Noah that day, came in and explained to me that he had had two seizures after delivery. They didn't know why. He wanted me to sign a consent form for them to do a spinal tap on my newborn son.

But that's not what haunted me. As drugged up as I was, I vividly remember signing it, thinking that it was no big deal. Thinking that they would handle everything, and that I would see Noah soon. I was too drugged up to be worried about my son. Most people think that this is very silly. But, in reality, the favorite passtime of a mom is to worry about her children. It's our job in life. We're supposed to make sure that they're safe, and when they're not, be worrying and praying and waiting on bated breath to hear word. I wasn't. I was too drugged. My son was laying in the NICU, with strangers rushing around him, bright lights, beeping machines, gloved hands, and his body under assault...and I was falling asleep. This has been one of the more guilt-induced memories of my cesarean. I didn't know any better when it came down to choosing a totally unnecessary c-section. I didn't know that it was unnecessary. I thought that I was doing the best I could for him. But *every* mom worries about a sick child. And I couldn't even do that.

My Noah is now mostly healthy ( he's the first one to get sick, and it lasts the longest for him...I truly believe this is residual from his problems at delivery and the 9 day NICU stay ), kind, happy, humorous, outgoing, and adventurous. Many people have said "At least he's healthy now!". Yes, I agree. I'm grateful that he is healthy now, and didn't suffer any permanent damage from my stupid choice that day five years ago. But it doesn't change what happened, and it doesn't change my feelings about it.

The situation with my c-section, and Noah ending up in the NICU, was a catalyst in my life. It caused me to research like crazy in my next pregnancy. Ultimately, it is what led me to my own home birth, and then to my path as a Midwife. I know that without Noah ending up in the NICU, I would have happily signed up for a repeat cesarean for Megan. Had everything been fine, I would have thought nothing of it. My cesarean recovery was as uneventful as a surgical recovery can be. At the point when I got pregnant with Megan, my lasting problems hadn't been as severe as they are now ( PCOS, adhesions, etc ). So this is why I firmly believe that everything happens for a reason. However, sometimes it sucks to go through that life-changing events. Not all catalysts are exciting and happy.

Each time I hear of a story where a woman undergoes an unnecessary c-section, my heart aches. Because I know that unless something even slightly dramatic happens with her or baby, she's likely to choose a repeat cesarean the next time around, rather than research, learn to do things differently than the first time, and *give birth* the way her body was designed for...and give her next baby a healthier birth.

Happy Birthday Noah. While words will never be able to fully express my sorrow over my choices that led to you being so sick, I want to thank you for being my son. Thank you for the change that you have caused in my life, and in turn, being able to help other women give their babies a healthier start in life.

Love you buddy.

When a Woman's Body Fails Her

Within the past month, I have heard more than a handful of stories where planned vaginal births ended up in "emergency" cesareans, and mom was given a diagnosis of either FTP or CPD. More horrifying, I keep hearing of *ELECTIVE* cesarean surgery, to avoid the pain or possible injury of a vaginal birth, because a woman is led to believe that a VBAC is just too risky, or because she "cannot" find a care provider to support her in one. I continue to be utterly baffled by the mentality in our society, surrounding cesarean sections, ie, major abdominal surgery. The risks are pasted all over the internet, warning women about choosing such a dangerous mode of delivery, and yet...we have the highest cesarean rate that we've ever had as a country. There's absolutely no excuse for a 31.1% ( and that was 2006, we don't know 2007's rates yet! ) cesarean rate. The WHO has recommended a national cesarean rate of NO MORE than 10-15%, which means that roughly 1/2-2/3 of *all* cesareans done are unnecessary!

I'll say it again. Roughly 1/2 - 2/3 of ALL cesareans done right now are unnecessary.

Does that not bother anyone? Ah, but I get the myriad stories of "My body wouldn't dilate", "My baby was too big", "My pelvis was too small", "I have already had a cesarean, and my OB ( SURGEON! ) wouldn't 'do' a VBAC".

I did a recent poll on a mommy-site, to see what reason women were given for their "emergency" c-section. 85% of them said that it was an induction ended in either FTP ( Failure to Progress ), or CPD ( CephaloPelvic Disproportion...pelvis too small, baby too big ). And they believed their diagnosis, because why would their doctor lie to them? They tried *everything*, and their baby just could not come out naturally.

Why is it that women are so ready to believe that their body failed them, rather than the SURGEON that they hired, screwed them over? Maybe not intentionally, no. I'm not saying that all Obstetricians are evil, and I'm also not saying that ONLY Obstetricians are the cause for unnecessary cesareans. Midwives can be just as bad, if not more damaging, IMO. But, let's face it. Women are hiring trained surgeons, but begging to avoid surgery. Why?

Let's go over a VERY common scenario:

First time mom, hires an OB because that's "just what's done". Plans a hospital birth. Really wants a natural birth, or as natural as she can "handle". Excitedly prints up her birth plan, that includes "No cesarean unless absolutely necessary", and has her doctor sign it, who is happy to do so, and says to patient "I ONLY do cesareans when necessary!". Patient gets to her due date. Doctor begins to check her cervix, that is yet "not doing anything". Cervix is high, thick, and closed. Doctor begins planting seeds about induction being necessary if patient is still pregnant by 41 weeks, because her body may need a jump start. And, baby might be a bit bigger since the baby has not dropped.

Mom may not necessarily want to be induced, but trusts that her doctor knows more about childbirth than she does, because she's never given birth before, and he's seen thousands of deliveries.

Does this sound familiar yet?

Patient gets to 41 weeks, cervix is still high, thick, and closed. Baby has not dropped. Doctor fails to inform patient of her Bishop's Score ( chart that can predict the likely success of an induction ), and says to head over to the hospital for an induction the next morning. Doctor also fails to tell patient that the labor hormones are more potent at night ( which is why women usually begin laboring at night ), because it's more convenient to schedule an induction during business hours.

Patient is excited, and nervous, and doesn't do any research, because she believes that she will go in, have baby, and leave hospital happy. She arrives at the hospital between 6 and 7 am, signs paperwork, is monitored, blood drawn, and cervadil is usually administered. For doctors who don't care about the risk of DEATH, cytotec might be administered instead. Patient must lie in bed for roughly an hour, and then is *allowed* to walk the halls if she wishes. But, needs to sport her IV pole and sexy hospital gown as well. Patient is checked a few hours later, and the cervadil has softened the cervix a bit, but hasn't done much dilation wise, so she is informed that the Pitocin is being ordered, and will be started shortly. With the pitocin comes constant monitoring, because of the risk of overstimulation to the uterus, though she isn't told this risk.

Sometimes, the doctor will also suggest breaking the bag of waters, to get things moving more. Patient is not told the risk of causing, or cementing, a malposition along with this procedure, nor of the risk of distress to baby by causing head to hit pelvis unnaturally. ( Meaning before it would have broken on its own ) So now, patient is in bed ( or in a chair if she's *allowed* to be out of bed ), dealing with the unnatural contractions that pitocin brings, and will shortly ask for the epidural that she didn't really want to resort to, just a few weeks ago.

She is given her epidural, and left to lie/sit in bed, while not being able to feel much from the hips down. She is likely not told of the risks ( both short and long term ) of the epidural anesthesia, to both her and baby. However, she signs a blanket consent form, without reading, and happily gets a very long needle inserted into her dural space. She is checked a few more times, and is told that she is making progress, but slowly. So, the doctor is ordering that the unit of pitocin is turned up a bit. Sometimes they will then insert an internal monitor for both contractions, and for the baby's heartrate. The one for baby is a monitor that *screws into the baby's scalp*. Patient is not told of the risk of infection to baby in doing so.

When she is checked again and found at the same dilation as the last two checks, the Obstetrician comes in and talks to her about CephaloPelvic Disproportion, or CPD. He explains to her that her pelvis is not large enough to allow the baby to drop, nevermind be born through it. He tells her how good of a job she has done in labor, and that she gave it her absolute best. He explains that if they continue, there is a risk of injury to the baby, since her pelvis is too small to allow him/her to pass through. He tells the patient and her partner, that he can do a cesarean section, and they can see their baby within 30 minutes. He has a team waiting in the OR.

Or, alternate outcome....patient is finally found to be 10cm, preparations for the birth begin. The bed is broken down, the stirrups are pulled out, and the doctor dons the facemask, surgical gown, gloves, and turns on a very bright light. Mom is told when to push, where and how to push, and for how long. The baby's descent is seen, but baby continues to go back up after mom pushes. After a few of these, the doctor explains that he is going to help mom out, by using a set of forceps, or a vacuum extractor. The "aid" is placed, and doctor pulls on baby, to try and assist in the delivery. After a few tries, the doctor tells the patient that her pelvis is not large enough to allow the baby to pass, and that is why the baby never descended, and that is why the baby was not able to be born, despite the aid of forceps or vacuum. Patient is rushed off to an "emergency" cesarean.


I'm sure anyone reading this has heard a story ( or several! ) that runs along these exact lines. Is it that there are now so MANY women who cannot deliver their own baby, or have screwed up bodies that fail them in the one thing that they were LITERALLY designed for? Or is it that Doctors and Midwives are failing women in not informing them of the risks of the things that they walk into willingly, and equally, the fault of the women for not doing research for the most important thing they will ever do?

It makes me so incredibly sad, and so incredibly angry that women would rather believe that their body is broken, rather than understand that they weren't given a fair shot, and that their choices ( in care provider, place of birth, interventions ) failed them instead. I will agree though that it is MUCH harder to take responsibility. I didn't want to believe that I could have avoided my cesarean, or that I could have avoided my son being in the NICU. That was one of the hardest things that I have ever done. To realize that my choices led to what happened to my body and my son, was heartbreaking.

I don't wish heartbreak on every woman out there who had an obviously unnecessary cesarean, but I do wish that women would become educated. I would rather heartbreak, than elective repeat cesareans. I would rather heartbreak than the belief that a woman's body just didn't work for them, and failed them in becoming a mother.

So above, what went wrong, and why?

* First time moms with a low Bishop Score, is up to 80% more likely to have a cesarean section due to the body not being ready for birth.

* Pitocin is known for causing distress in a baby, as it causes unnaturally strong contractions. If a baby wasn't ready to be born to begin with, the baby was not ready for *any* labor, nevermind unnaturally strong labor.

* Artificially Rupture Of Membranes ( AROM ) is known to sometimes cause a malposition in baby ( if baby is not low in pelvis ), or cement a bad position such as posterior, asynclitic, transverse. It can also cause distress, as the baby's head could have gone from outside the pelvis, to rammed *onto* the pelvis, with no cushion.

* Drugs or Epidural anesthesia are known for slowing or stalling labor progression. The medication also passes through the placenta, and into the baby's blood stream. This can lead to breathing depression, lethargy, problems nursing, and lower apgar scores in baby. Epidural anesthesia can also lead to a spike or drop in blood pressure for mom, fever ( which will be treated as possible infection ), headache ( that can last for weeks ), infection at the injection site ( that can lead to Staph ), nerve damage to the back, and in extreme cases...paralysis.

Epidurals also inhibit the pushing phase. Not only is mom unable to get up into varying positions to facilitate a larger pelvic opening ( lithotomy position causes the pelvis to be up to 20% smaller than in other positions for birth ), has a high risk of instrumental delivery, and perineal injury. Controversially, epidurals increase the risk for cesarean delivery because of these factors. When a woman has an epidural, she cannot efficiently feel when/where/how to push. She loses the ability to push effectively, therefore leading to the risk of higher rates of instrumental delivery.

* Vacuum delivery comes with a list of its own risks to baby. The most common is a hematoma, or a pocket of blood underneath fibrous covering of the skull bone. This can result in a "lump" the size of the vacuum cap. Also common are "superficial" markings to the scalp, or splits in the skin. Less commonly, these can be open to infection. Less common risks include neonatal jaundice, intracranial hemorrhage, and retinal hemorrhage.


But the most damaging risks, in my opinion, are the risks that come with a woman believing that she did everything she could, and that her body just didn't work right. Women anymore have so little belief in their body's ability, and don't look at the risks that come with each of the interventions that are allowed into a normal labor.

My desperate goal is to get women to make more careful choices in care provider, place of birth ( What is your doctor's cesarean rate? What is the hospital's cesarean rate? What is your doctor's track record with NATURAL - not just vaginal - births? What is your doctor's instrumental delivery rate? What's your doctor's episiotomy rate? ) Women need to make truly INFORMED decisions. Not just take the word of their care provider ( whether this be OB, Hospital Midwife, Birth Center Midwife, Home Birth Midwife ), friends, family members, and online pregnancy sites. Women need to understand the possible consequences of their decisions.

So many women believe that inductions are harmless, and therefore don't research the MANY possible risks. Many women believe that epidurals are harmless, and therefore don't research. Many women sign up for repeat cesarean sections, believing that it's safer than a VBAC ( Vaginal Birth After Cesarean ), without actually doing the research.

Women, we're smarter than this. And yet, we allow our instincts to be overridden by a care provider with a medical degree, or a mom who has had more children than we have. We allow our empowerment to be taken away by believing that the hospital is the safest place for ANY birth, and hand over our autonomy as soon as we check in.

I feel helpless so often, because it's constantly pointed out that I have no medical degree. It's true, I don't. But I have devoted the past 4 years to study pregnancy, childbirth, and ALL that goes along with it. Four years to this alone. Every aspect that comes with each. I have attended women in birth who had previously been duped into believing that their body didn't work, and watched as they labored beautifully, and then reached down to welcome their baby into their own hands. The incredible moment where they learned that their body worked just as it was designed to do. When they didn't have any separation from their baby. No nurse taking baby off to the nursery for "observation". No separation, but immediate bonding. Immediate smell, touch, love. Breastfeeding as soon as baby is ready, not when a nurse says it's okay.

I have the honor of attending women in birth, and watching as they unfold in childbirth, and regain their power.

Here is a video of women who were told that their body failed them...and went on to discover that it was their care provider, rather than their body, that failed them.




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Bishop Score and Risk of Cesarean Delivery after Induction of Labor in Nulliparous Women

http://www.ncbi.nlm.nih.gov/pubmed/15802392

Risks of Epidural Anesthesia

http://www.healing-arts.org/mehl-madrona/mmepidural.htm

http://www.breastfeeding.com/helpme/epidural_anesthesia.html

http://www.transitiontoparenthood.com/ttp/foreducators/ceinfo/Side%20Effects%202.htm


Risks of Vacuum - Assisted Deliveries:

http://www.fda.gov/cdrh/fetal598.html

http://childbirth---labour-delivery.suite101.com/article.cfm/the_truth_about_vacuum_deliveries

http://jama.ama-assn.org/cgi/content/full/289/1/46

http://content.nejm.org/cgi/content/extract/341/23/1758

Why Epidurals AREN'T "God's Gift to Women"

I hear this so many times...."Thank GOD for the Epidural!", or "The Epidural is God's gift to laboring women..."

There are so many reasons why an Epidural in labor is a BAD idea, nevermind that it is definitely NOT a gift from God.

Why?

1. God designed labor to work perfectly together. This includes *FEELING* your contractions, pelvic floor, and pushing sensations so that your body can respond accordingly. With an epidural, you *cannot* push as effectively as you would without one.

This OFTEN leads to longer labors, augmentation with pitocin ( because an epidural has a high risk of slowing labor down ), and a much longer pushing stage that is often accompanied with an instrumental delivery ( Vacuum, forceps ).

2. Epidurals can cause a fever in mom. In turn, the baby will likely be sent to the NICU for a complete sepsis work up, because they cannot assume that the fever is simply from the epidural, instead of a full infection in the uterus.

3. Epidurals can cause both temporary and permanent back and nerve damage. If it is not placed PERFECTLY, it can cause major damage.

4. Epidurals can cause major headaches that can last up to several weeks. Try recovering from childbirth, caring for a newborn ( which hopefully includes breastfeeding ), while dealing with a headache that won't go away.

5. Women who use epidurals during labor are statistically less likely to be breastfeeding at 6 months. And, since breastfeeding was designed by God to be a baby's perfect nutrition.....

6. Epidurals come with a higher risk of cesarean surgery. When a woman's labor slows, and pitocin can't pick it back up...it usually leads to a cesarean. When a woman cannot push effectively, and it's been longer than your Obstetrician ( Trained Surgeon ) is comfortable with...it usually leads to a cesarean. If you happen to get a fever from the epidural, and it increases and you are not near delivery...it usually leads to a cesarean.

7. Having an epidural disconnects you from the birthing process on an emotional level. You basically leave your baby to go through the physical aspects of labor, by him/herself, while you chit chat away, do your makeup, or get some shut-eye.

8. When you choose an epidural in labor, you screw up the flow of endorphins that was supposed to be released ( the HIGHEST amount your body will ever receive at once .... that God is a smart one! ) after natural childbirth. Now, you will not have that release. The release of endorphins after natural childbirth aids in the breastfeeding relationship, the immediate bonding, and lowers the rate of Post Partum Depression.

9. Epidurals confine you to bed, which can lead to a malpositioned baby. God designed our pelvis to be mobile, and this helps *tremendously* during labor. Through remaining mobile, we are able to help the baby rotate into optimal position for birth. In the absense of mobility, the pelvis can become stiff, and not respond to labor/pushing as it should. Epidurals also often come with the doctor artificially breaking the amniotic sac, which in turn helps to create or cement a malpositioned baby.

10. The final reason? Epidurals are selfish on the part of the mom. Epidurals have no benefit for the baby, it only adds risk. Epidurals allow the mom to have decreased to no pain during labor, once again, leaving the baby to experience the physical aspects of labor on his/her own.

Women, we are STRONG. Our bodies are CAPABLE of pushing a baby out without anesthesia. We were designed, by God, to birth babies without intervention. And sadly, it's the intervention that often leads to problems during labor and delivery, and leaves our babies susceptible to invasive intervention in the first hours of their lives...when they should be in mama's arms, and at mama's breast.

Labor Induction

I've ranted and raved about this subject more than a dozen times before...and it never gets old. There is always new material out and about for me to rant about, when it comes to the practice of women forcefully evicting their unborn babies, mostly out of either convenience or coercion.

Rarely anymore do I hear of an induction that is actually medically warranted. Usually, it's because mom is so sick and tired of being pregnant, that she just wants baby out. Or, due to the holiday season, the OB is leaving on vacation...and well, you wouldn't want another doctor to attend your birth, would you? :sigh:

What gets me is the continuing cycle of ignorance. Women really don't get, or care to understand, that inductions without medical reason do more harm than good to their baby. But why would you listen to a crazy ranting lady, instead of your WONDERFUL *coughTrainedSurgeoncough*...err, I mean OB? Is an extra couple of days, or an extra week or two REALLY worth putting your baby at risk? Is it worth putting your body at risk for so many things? Is it worth the greater risk of ending up with a c-section, and possibly a baby in the NICU? Really?

What kills me is that I recently read the birth story of a woman I used to know. She has NEVER been patient enough to allow her babies to come in their own time, and always made herself sound like an idiot with the "I'm not trying to be a hero", in regards to forgoing that precious epidural. So she has never gone into labor on her own, and she has never allowed herself to actually FEEL any of her babies be birthed. This last baby was no exception. And this time? This time she allowed them to use Cytotec to induce her...and her incredibly ignorant explanation was that Cytotec is a much more "gentle" way of inducing labor, in comparison to Pitocin.

Maybe she's never read the reports of women and babies *DYING* after Cytotec inductions, or the fact that the FDA pulled it off the "Accepted Drug" lists, along with issuing an extreme warning about its use. :shrug:



The sad part is, there are so many babies out there who are not allowed to be birthed gently, in their own time. They are forced out with harsh drugs, and then more drugs are poured into their tiny systems just so their mother doesn't have to "suffer" birth pains. So baby is left to go through a forced labor, on their own.


What are the risks of an induction?

Failure. Your body does what it's supposed to do, and protects the baby who is not yet ready to be born.

Fetal Distress. In forcefully trying to get baby out when baby is not ready, many respond to induction drugs by going into distress.

Hemorrhage. When your body has been forced to do something it's not ready to, the uterus can become over-stimulated, and exhausted, causing problems with it contracting after a birth, leading to hemorrhage.

Instrumental Delivery. Since women rarely withstand inductions without drugs or an epidural, inductions have a very high rate of instrumental ( forceps, vacuum ) delivery, which would also come with iatrogenic perineal injury.

Cesarean Section. The fact is, inducing labor comes with a high risk of a cesarean delivery. If you weren't in labor, your body and your baby weren't ready. Forcing it may work for some, but definitely not for all. You will likely spend the time recovering from major abdominal surgery ( and a harder time getting baby to breastfeed if baby spent any time in the NICU ), that you could have spent in the remainder of the pregnancy, and birthing a baby who was ready to be born.

When will women learn? When will women regain the patience that women USED to have, and rest in the knowledge that babies know when it's the best time to come?

And for those who love to argue for arguments' sake...I'm not speaking of medically necessary inductions. ( Eclampsia, true IUGR, etc ) I'm speaking of the women who get to 40,41,42 weeks and don't want to be pregnant anymore. I'm speaking of the women who have been "stuck" at 1,2,3,4cm "forever" and like to believe that they'll never go into labor on their own. I'm speaking of the women who allow their doctors to schedule induction because they're ready to go out of town, or have a Tee Time to make it to. Or for women who believe it's safest to induce at 39/40 weeks because their baby will be TOO HUGE to birth within a week or two....because we all know that baby's head and shoulders hit an INCREDIBLE growth spurt past then. ;)

And for the Prodromal Laboring women....Prodromal labor SUCKS, but it still doesn't mean you're in actual labor for weeks on end, or that your baby will never come out. It doesn't mean that baby is ready. It doesn't mean that induction is okay because you're tired, frustrated, or hurting. Have patience. Your baby will come, and often, there's a VERY good reason for prodromal labor, or intense Braxton Hicks contractions.

Women, slow down. Have patience, and allow your babies to come in the time that they're meant to, naturally.

Big Babies = Cesarean Sections

My stomach lurched when I read this in a news story today:

http://www.kdhnews.com/news/story.aspx?s=29508

So, when I got the call on Nov. 13 at 1:30 p.m., it was no surprise to hear my mother say Ben checked in at a whopping 9 pounds (don't worry gals, Ben came into the world by way of cesarean section at 12:37 p.m.).

Yes, don't worry gals!!! Don't become horrified over the idea that a **HUGE** 9 lb baby came out of a woman's va-jay-jay, hoo ha, pwerta....ah hem, VAGINA. Lord no!!! Who would want that?!?! There's no way! That's an appaling idea!

When did nine pound babies become monsters that required extraction through the abdominal wall? When did nine pound babies become un-birthable? When did it become a societal "joke" that women wouldn't be so stupid as to deliver a "large" baby in any other way than the on-demand birth way?

Last Sunday, November 16th, was my HBAC baby's birthday. She turned three. My baby turned three! She was 10.10lbs, 23" long, and was posterior. It infuriated me that everyone's FIRST reaction when her weight was told, was "You had a c-section, right?"

I got enormous satisfaction by telling them that she was born at home, onto the very bed she was created in. Also, that she was a VBAC baby. That my cesarean baby was pulled out of my body, because my bastard OB told me that he would be "too big" to deliver safely. He was only 8.8lbs...and spent 9 days in the NICU because of severe respiratory distress ( i.e., wasn't READY ). I didn't know any better.

So women...be offended. This article plays up the social stigma that women are INCAPABLE of delivering a large baby. We are, in fact, more than capable! We are WOMEN. We are made to birth. Whether the baby be 7lbs or 11lbs...we are made to birth.

And in honor of my baby's birthday, here is my MONSTER of a HUGE baby now :

Women Unaware of Adhesion Risks

Maybe that's because cesarean *surgery* has become so commonplace, that women don't realize that there are major risks associated with it? Maybe because women now are so conditioned to believe that a cesarean is simply another way to have a baby? It deeply, deeply saddens me that cesarean risks are so downplayed. And ahdesions may not seem like a huge deal - until you've experienced a particularly bad bout of adhesions breaking up...feeling like dozens of rubber bands snapping inside of your body. :(

And seriously? They're offering free copies of "Guide to preparing for gynecologic surgery"?!?!? How about a guide on how to PREVENT gynecologic surgery? Where's that free copy?

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Wednesday, October 1, 2008*
5:41:00 PM EDT New Survey Reveals Women Are Unaware of the Dangers of
Surgical Adhesions

*Red Bank, NJ* - Although more than half of the country's women will have
some type of pelvic surgery and are therefore at risk for surgical
adhesions, a survey released this month by the not-for-profit National
Women's Health Resource Center (NWHRC) finds that women are largely unaware
of the health risks associated with adhesions.

Surgical adhesions occur when tissue in the abdominal cavity adheres, or
gets stuck to other tissue. Adhesions commonly form following pelvic
surgeries, such as hysterectomy, tubal ligation, cesarean section, and cyst
removal. Left untreated, adhesions can cause infertility, abdominal pain,
and bowel obstruction.

The survey of 1,000 women showed respondents strongly believe women should
be informed about surgical adhesions prior to surgery (69%). Conversely, an
overwhelming majority of women (80%) who had pelvic surgery were not
informed about adhesions prior to their surgery. Of the women in the survey
who suffer from adhesions, seven out of ten (70%) say they would have taken
special precautions to protect themselves from getting adhesions if they had
been aware of possible adhesion-related complications.

Susan Jones*, a human resources director and mother of three from McLean,
Virginia, has experience with the long-term effects adhesions can have on a
person's health. All of Jones's children were delivered by cesarean section.
Due to adhesions caused by these three surgeries, she suffers from
reoccurring abdominal pain and has been advised not to have any more
children because of the increased difficulty of delivering a baby surrounded
by such a large amount of scar tissue.

"My first c-section only took about 10 minutes for the doctor to get the
baby out," said Jones. "My second c-section took nearly 45 minutes and my
final c-section took nearly an hour and a half. My doctor had such a hard
time maneuvering around the scar tissue to get to my baby."

"If I had known about adhesions," continued Jones, "I would have talked to
my doctor about what can be done to reduce my risk for getting them."

Like Ms. Jones, half (51%) of survey respondents were not aware that
preventative measures can be taken to lower your risk of adhesions and an
even higher proportion (68%) of women that had undergone surgery did not
know if their surgeon took specific steps to guard against adhesions.

"Preventive measures to reduce the incidence of adhesions are the mainstay
of limiting the complications related to adhesions," stated Dr. Glenn
Schattman, Associate Professor of Obstetrics and Gynecology at the Weill
Medical College of Cornell University. "These include using minimally
invasive surgical procedures, meticulous surgical technique, keeping tissues
moist, reducing bleeding and the use of adjuvant adhesions prevention
barriers to keep the tissues from sticking to each other."

"It's important to understand that once adhesions form, they are hard to get
rid of," continued Dr. Schattman. "Adhesions can cause blockages of the
intestines, fallopian tubes causing infertility and pain."

When faced with pelvic surgery, women said they were most concerned about
short-term surgical issues such as the general recovery process (60%),
immediate surgical results (59%) and post surgical pain (59%).

"Along with their immediate post-surgery concerns, women need to make
adhesions part of the pre-surgery dialogue with their health care provider,"
stated Elizabeth Battaglino Cahill, RN, executive vice president of the
NWHRC. "We hope that this adhesion awareness campaign can give women the
tools they need to understand the health risks of adhesions and how to
protect themselves from this life-long internal scarring."

To provide women the information they need about ways to minimize the risk
of surgical adhesions, the NWHRC has developed a one-page fast facts on
adhesions and an in-depth *Guide to Preparing for Gynecologic Surgery*. The
guide includes sections entitled:

- All About Adhesions
- Preparing for Surgery Checklist
- Choosing a Surgeon
- After Your Surgery

To download your complimentary online copy of the *Guide to Preparing for
Gynecologic Surgery*, "Fast Facts for Your Health: Pelvic Adhesions" or to
learn more about the adhesion survey, please visit NWHRC's award-winning Web
site, www.healthywomen.org. The survey and campaign materials were made
possible through support from Ethicon Women's Health & Urology, a division
of ETHICON, Inc.

Color me a feminist?

It's interesting to me how people are labeled - either according to beliefs, personality, opinions, or affiliations. I have been labeled so many things that it appears I am quite the hypocrite, depending on how you look at it. ;)

I've been labeled a feminist by some Christians, because I don't believe that the husband should be the governing authority when it comes to childbirth.

I've been labeled a right wing Christian for my staunch Pro-Life beliefs, and beliefs that the husband is the head of the household. We won't even get into the fact that I believe that women have no place, biblically, in political authority. Hehe.

I've been labeled as Anti-Cesarean as a whole...because yanno...ALL cesareans performed are necessary. A doctor would NEVER do something that isn't necessary.

I've been labeled as too militant when it comes to home birthing, unassisted birthing, etc. Silly me for believing that birth MATTERS. ;)

I've been labeled as too much of an advocate.

I've been labeled as not enough of an advocate.

I've been labeled incompetent by someone who portrays herself to be whatever the people in front of her are. Talk about a chameleon!

I've been labeled knowledgeable by those who have taken the time to inquire about me.

I've been labeled naive.

I've been labeled dangerous, for believing that a woman has the ability to birth safely without any sort of "professional" around.

I've been labeled a smart ass. I don't mind that one so much. ;)

I've been labeled as passionate.

And on rare occasions, I have been labeled as life changing. Sometimes, my beliefs and opinions and passion have been able to make a difference in someone's life. It's quite an honor to be told this!

Do I flip flop because I can often see a point to two sides? I don't think so. I think this makes me a contemplative individual. For example, as I already said, I am staunchly pro-life. I don't think that there are any good reasons for aborting a baby. And I've heard all of the arguments, so don't think that this is an open invitation for an abortion debate. It isn't. However, I am actually NOT for deeming the baby to be an individual with rights of it's own in the womb. Why, you may ask?

Laura Pemberton. She is a mother of 8 in Florida. In her last pregnancy, which was a VBAC, she had decided on a home birth. During labor she felt dehydrated and went into the hospital for an IV ( I'll leave comments about this to myself ), and once there was refused treatment unless she consented to a cesarean. She was told that if she didn't sign consent, that a court order would be started. So she fled out of the back of the hospital at 7cm, to go back home.

She resumed a labor pattern at home. Not long after returning, she had the local sheriff and state attorney in her bedroom. They had court orders for a cesarean. They forced her onto a stretcher, and into an ambulance. She pleaded and screamed. She was 9cm and was able to feel her baby's head when they cut her open.

Why did they do this? They deemed that she was acting in negligence, and that she was violating her baby's rights to a safe birth.

The government tells us that they deem it negligent to birth our children at home. They tell us that it is negligent to teach our children at home. They tell us that it is negligent to refuse vaccinations. They tell us that it is negligent and abusive to spank our children on the bottom when they misbehave. Most families don't stand for their homeschooling rights to be taken away. Most families don't stand for their disciplinary rights to be taken away. Why is this a lesser issue?

So for the first time in my staunchly pro-life life...I can agree with the pro-choice side. I am a VBAC mom. What if someone had gotten a hair up their butt, and had decided that I was being negligent with Megan, and had strapped me down and cut her out of my body? When is it up to the government to decide that it is their job to tell us what we can and cannot do with our families? And that's such a sticky statement, because I don't believe in true abuse being ignored. Birthing at home, homeschooling, spanking children on the butt....these are not abuses.

And in all of this...the once Republican me ( because of my parents ), really opposes McCain and Palin in the White House. I am dumbfounded over the information that keeps coming out about Palin. Most recently, the information that she cut funding on Rape Kits being available at no cost to rape victims, because it includes emergency contraceptive. And on the flip side of that, she hunts ( for sport, not survival, obviously ) wolves and bears from planes. So she can be pro-life when it comes to babies ... to the point where she will not fund help for rape victims ... but she can murder helpless animals from a plane. So incredibly noble. :-/

I don't know what I am politically. I'm really not keen on labels for this either. But boy I wish that Ron Paul had stayed in the race! LOL

So there ya go. Political and personal rants all in one blog. :phew:!

Novelty Births

Wouldn't it be horrifying if you heard of someone surgically removing the babies of animals on a certain day because it was considered a fun delivery date? No thought to the fact that the babies were probably not ready for life outside of the womb, no thought to the fact that at least half would probably end up needing extra medical care because of being pulled out early.

Imagine a baby, safe and warm inside of his mother. He hears her heartbeat, her breath sounds, her soft voice. He is safe, he is comfortable. He is growing and practicing breathing movements for the day that his body signals labor inside of his mother's body.

Now imagine that baby, warm and snuggly, all of a sudden has drugs coursing through his system. Lots of drugs. Drugs that make him sleepy and possibly jittery at the same time. Imagine this little baby, all of a sudden having a bright light shine through his warm cocoon as a surgeon cuts through the uterine wall. Imagine now, that without the hormones to prepare him for this change, his home is drained of the warm fluid that has surrounded him for the past 9 or so months. Now there is very cold air coming inside of his cocoon along with the bright light. Baby doesn't know what's going on - this isn't supposed to happen yet. There was nothing to prepare him for any of this. Someone grabs a hold of his head, very roughly. They're pulling on his head, extending his neck. A nurse is at the top of mom's fundus, practically sitting on her to apply enough pressure to push him out of his cocoon, since there were no contractions to do this job. Instead of a slow build up of contractions that wrap around the baby to further stimulate hormones, slowly squeeze fluid out of the lungs...it's all quick, forceful, and violent. As mom and dad anxiously await for their baby to cry, to see that little being, with a smile on their face...the baby has a shock to his system. No more warm cocoon, dim lights. Now it's a freezing cold operating room, very bright lights, strange hands and voices. Since his little lungs weren't squeezed out as in a vaginal birth, now he will have a tube sent down his nasal canal and his throat, causing him to gag, all to suction out this fluid that should have been naturally expelled. He is handled roughly, instead of the gentle way that every baby deserves. Instead of being on his mother's bare chest, once again hearing the familiar and comforting heartbeat and voice or having the benefit of feeling her regulated breathing - he is sent to the NICU in a plastic box. More strangers, more unfamiliar voices and sounds. Instead of being warmed by his mother's breasts and touch, he is put under heat lamps while strangers talk around him. He will not again see the woman who carried him, nourished him, loved him for *at least* an hour or more.

Mom and dad know nothing of what he will go through ...

... They just want him to have a cool birthday.

Seem like a ridiculous notion? Sadly, it's a reality. On the date of 8-8-08 this year, many babies were forced to go through the scenario above, all for the sake of mom wanting to have a cool delivery date. Some had this elective cesarean three or more weeks before their estimated due date. The average is roughly two weeks before the due date. Inductions were scheduled on this date, forcing the baby to endure violent contractions and drugs coursing through his system....

... All for a cool birthday.

This is a quote from a woman on a mothering site I am on:

Well its about 5 o'clock in the morning here and I am getting ready to go to the hospital! I am having a c-section today at 8! So our little boy will be born in less than 4 hours if all goes well! The cool thing is the doctor is going to aim for 8:08 am as the birth time! Wouldn't that be neat!!! 8-8-08 at 8:08 am! I'll be back on to add some photos when I can!! WISH ME LUCK!!!

There were elective c-sections talked about all over the world, for this "cool" birthdate.

Am I the only one that is horrified for these poor babies? Has the medical community and ignorant parents done THAT good of a job convincing people that elective cesareans are no big deal? Despite medical study after medical study that is released saying that the maternal and newborn mortality and morbidity rates are soaring high?

Is a "cool" birthday really worth possibly sacrificing your child's health - both short and long term? How very, very sad.

A Healthy Baby Isn't ALL That Matters

This was a post from March 26th, 2008. It is being published in one of the upcoming issues of Midwifery Today. :)



There are so many details of my cesarean that I have either left unwritten, or have written in fragments in various locations. A reply back to an online thread regarding the “safety” of a cesarean; or to a mom who is being told that her baby will be too big and she needs to have her baby surgically removed.

But you see, my story doesn’t just end when we brought our son home from the hospital on Palm Sunday in 2004. My journey began when I found out I was pregnant in 2003, and it continues every day. Some days I wish it would all just be over with. Be done with the deeply seated emotional pain, be done with the physical pain of ongoing adhesions and endometriosis from my cesarean – even 4 years later. The ongoing torture of the emotional pain could have been avoided, I suppose. However, in 2005 I made the decision to take the red pill. And for those of you who paid attention during the movie The Matrix, you’ll get my analogy here. The red pill enables us to see truths that we otherwise would have never believed. The red pill takes us out of the “habit” beliefs – simply believing what we are told or what we were raised to believe. On the other hand, the blue pill enables us to live in the “ignorance is bliss” state. Never digging deeper, simply being happy with the things we believe and never questioning the origin or the author. So, in 2005 I made the choice to swallow the red pill. The reality that had been mine in childbirth, was shattered as I learned more. And as I gained more knowledge, my guilt and anger grew over what I had done to my son; and also pain for the vast number of women who do the same to their children unknowingly.

Just before my son turned one, I found the ICAN support list. To this day I don’t remember exactly how I found it, but I did. I was still of the mindset and belief that some babies simply grow too big for mom to deliver safely, inductions are perfectly acceptable, and epidurals should be used by every woman. I joined the support list, totally oblivious to what I was walking into. Women who were totally angry over their cesareans, marriages compromised due to lack of support or differences in birth beliefs between a woman and her spouse. Women having their babies at home, after having undergone a cesarean with a prior pregnancy. Basically, a group of crazy women. Or so I thought at the time. I defiantly challenged their arguments that claimed it was intervention, not size, that caused my very difficult first birth and recovery. The harder I fought it, the more information and resources they flung my way. After a few days of this, I sent out a post calling them all crazy, and then unsubscribed. Six little words posted by a woman who is known for pulling out a wet fish when needed, haunted me and really made me think. “Damn. She took the blue pill.” The nerve! Crazy, fanatic, rude women! Who were they to tell me that my cesarean was unnecessary and avoidable? But it planted a seed…

I began to research all of the things that they had challenged me with. Little by little, that seed began to sprout. Three months later I returned to the list, apologized for calling them all crazy , and asked for help.

So why am I telling you about ICAN and my beginnings with it if I am not writing this about my VBAC? Well, because without ICAN I would have continued to believe that my babies were just too big for my body. I would have continued to believe that there is nothing wrong with cesareans. The day that I re-subscribed to the ICAN list, is the day that I chose the red pill. I no longer wanted to live in ignorance, because after all…ignorance is what led to my son spending 9 days in the NICU.

Ironically, it was my son’s 2nd birthday that hit me the hardest. On his 1st birthday, I was still learning, and not quite convinced yet that the cesarean wasn’t necessary. But by that 2nd birthday, not only did I know from research that it had been unnecessary, just five months earlier I had pushed out my VBAC baby onto my bed. She was 10.10lbs and posterior. By body had never been broken – I was only told that it was. As I began to really process through this, I realized just how alone and misunderstood I was outside of the ICAN list.

“He’s healthy now, that’s all that matters.”

From my friends, my mom, and even my husband. No one knew how damaging those words were, even though they were not meant to harm. I didn’t understand. How is him being relatively healthy now, negate all of the harm that was done to him in his first seconds, minutes, hours, and days of his life? When a woman is trying to heal from a rape trauma, do people essentially tell her to get over it…at least she’s safe now? But people are almost offended when the two are compared. Cesareans take place every single day and are accepted – even CHOSEN. So then, would it be different if many women didn’t mind their rape experience? What would happen as a society if we as women told rape survivors, that their experience was acceptable, because women are raped all the time? How damaging and belittling would this be? Cesareans are major abdominal surgeries. And so many women are lied to, coerced, and convinced to have one. Many occur because of a cascade of intervention during labor that never belonged there to begin with. As a society, we have strayed so far from what birth is – a normal, physiologic process. We’ve turned it into an ugly, scary, medical procedure. No wonder so many women are scared of it. All they hear are horror stories. You have to dig for the beautiful and unhindered birth stories that ARE out there. They are just not as common as the “You’ll be begging for the epidural…” stories. I’m afraid that until women take a stand for their babies, that our daughters are going to have to figure this out for themselves.

So, back to my cesarean.

The story is quite simple. I was young, I had delivered a larger-than-average baby vaginally 2 ½ years prior. The recovery from that birth was long and hard, and I had always been told that it was because she was 9.1lbs. Not the pitocin, AROM, stadol, or the forced pushing that ended up in a large episiotomy and vacuum extraction. I was terrified of another birth and recovery like this.

I met with a new OB late in pregnancy, because my former OB refused to induce me even though my son was showing to be over 8 ½ lbs already, and I did NOT want to go through the hell that I went through with my first. Yes, I warned you…I was completely ignorant. This new OB agreed with me about size, and went on to tell my husband and I stories of large babies and shoulder dystocia, nerve damage, and broken collar bones. He said our best plan of action was a cesarean, and soon, since my son was only putting on weight at this point. We agreed, even though my husband and I both discussed later how we had a slight uneasy feeling about all of this, but shrugged it off as uneasiness over the unknown. The very next morning I went in for an ultrasound and NST. During the NST it was discovered that I was contracting quite regularly. Upon a vaginal exam, I was told that I was 4cm dilated, and would be having the cesarean that afternoon, instead of the next morning. I was nervous, but the thought of finally meeting my son was what I kept focusing on.
A lab technician came in and drew several vials of blood. Then a nurse came in to start my IV, administer Terbutaline to stop my contractions, and to insert a catheter. My mind was in a whirl as I was being prepped for surgery, and trying to get a hold of my husband to get back to the hospital. He had dropped me off, thinking that I was just going in for routine pre-surgery stuff. He arrived, as did my grandmother in law and my mom. My husband was told that he could not go into the OR with me, until my spinal block was in place, and they were ready for the surgery. I was terrified, and I had to leave the one person that I trusted most in this world, behind. The one thing I asked before walking in was that they cover the instruments. I didn’t want to see what they were going to use on my body. They found this a bit strange, as they said that they have never had a patient request this before. Surely I couldn’t have been the only one afraid of being cut open, could I?

The nurse walked me into the OR. I remember how cold it was. It was like walking into a sterile vortex. Bright lights, blue paper sheets everywhere, trays, oxygen devices, and nurses in full face masks and scrubs. It was surreal. I sat down on the operating table, trying to brace for the spinal. I was absolutely terrified beyond my wits that the spinal would not work, and I would feel them cutting into my body. I began to cry as the anesthesiologist prepped my back for the insertion of the catheter, and a nurse stood in front of me in efforts to console me. She made eye contact and told me that everything would be okay. I just cried. I don’t remember a whole lot of the tiny details from here. I remember seeing my husband’s face come into view above me when he entered the room, and felt him touch my hand. I remember my Obstetrician “joking” about how we’d better get the show on the road if he was going to make it to his office in time for furniture to be delivered that evening. I remember slowly falling asleep from the drug cocktail that was placed in my IV, and desperately trying to stay awake. Then, it hit me. The smell of my flesh burning as my OB cauterized at each step. I tried hard to tell myself that it was the oxygen mask on my face. I was smelling the oxygen. I am only smelling the oxygen.

My OB announced that the baby would be here in just a few moments, and that I would feel lots of pressure as the nurses pushed on my fundus to get baby out. I said that it felt like she was sitting on my chest, and they joked and said she was. I heard a suctioning sound as they announced that his head was out. I felt the tugging sensation release when his full body was pulled from mine. I waited to hear him cry. Waiting, waiting…and nothing. I kept asking what was going on, and received no answers. I turned to the side to see people in blue working vigorously on him. I was falling asleep. Then, I finally heard him cry, and let go a little bit. They bundled him up, and put him to my face to kiss quickly, and while he was in front of me, he once again stopped breathing. I have pictures of us in this moment, and he was so very grey. As soon as I had kissed his cheek, they pulled him from me, placing him into an Isolette and whisking him off to the NICU. I fell asleep as I was being sewn back up, and wheeled to recovery.

Then, a moment in time that I will never forget. The neonatologist visited my husband and myself in the recovery room, and stated that my son had experienced two seizures. They needed to find out why. I was asked to sign a consent form for a spinal tap. You’re probably thinking that it’s unforgettable because I learned that he had experienced two seizures, right? Well, it’s unforgettable because I remember thinking that it was no big deal. I was so drugged up, so out of it, that it never even occurred to me to feel worry about my son. To even ask if he was okay. I signed the consent form, and fell back asleep. Later on that afternoon, as I was moved to my post partum room, I remember asking about him and not understanding that he needed to stay in the NICU. I was on the phone telling a friend that he had arrived, and then told her that he was in the NICU being checked out and would be in my room with me later that day. No one told me otherwise. No one told me much of anything, come to think of it. I continued falling asleep off and on throughout the day, sometimes even while my poor husband was mid-sentence. It wasn’t until he went home that night and I sobered up a bit, that I asked about my son. They said he was having some breathing difficulties and that I could see him in the morning. I was again confused, but again didn’t worry much because no one was seeming to make a big deal out of it. I requested a pump to help my milk come in, so that I would be ready the next day. I pumped every 3 hours that night.

The next morning my husband arrived, and I had already had my catheter removed and had the nurses help me up to the bathroom. We prepared to go to the NICU to see our son…for the first time since the surgery. No one did or could have prepared me for what I was going to walk in on. I was under the impression that he had mild breathing issues, and just needed observation. What I walked into was a mother’s worst fears. He was in his own little room, because he needed around the clock observation. When I entered the room, I couldn’t believe what I saw. He was in an open isolette, sedated, horribly swollen, and hooked to many lines and machines. He wasn’t moving. I began to cry as over and over in my head I kept repeating “This isn’t my son. This can’t be my son, they’ve made a mistake. This isn’t my son.” This fragile and broken baby couldn’t possibly be the one who was too big and healthy for me to deliver vaginally. He was swollen…he didn’t look like me or my husband! That couldn’t possibly be our son. I could not hold him, so I touched him and cried quietly. I stayed for a while until I couldn’t stand anymore. My belly was hurting, as was my back and the rest of my body. As my husband and I went back to my room alone, I just cried. He remained strong and just held me and told me that everything would be okay. I wasn’t so sure. After all, they had told me that my son would be big and healthy.
One of the hardest parts of the hospital stay was being the only mom on the floor who was without their baby in their room. I listened as babies cried in the next room, and then were promptly consoled by their mother’s touch. By nursing at the breast. By their mother’s soothing voice. My baby was in another place. He was in darkness induced by drugs. He was listening to the sound of the machine’s beeping, and by the sound of the nurse writing notes in his chart. My arms felt so empty, and I felt so helpless.

Two days after he was delivered, as my husband and I prepared to see him again, we were stopped by a NICU nurse. She explained that they were intubating Noah, and to please wait in the family waiting room for the neonatologist. I was confused, worried, frantic, and crushed. He had been doing just fine on the CPAP. I was so afraid that he wasn’t going to make it. The neonatologist came in after 15 minutes or so of agony, and explained that Noah had taken a turn that morning, and the CPAP was no longer as efficient as it needed to be. We asked questions, mainly why was this happening. He was the biggest baby in the NICU, by far, and was full term. He explained that this is a common side effect of babies delivered by cesarean. Why hadn’t our Obstetrician told us this while he was telling us all of the myriad risks of delivering a large baby vaginally? Why hadn’t we been told? He couldn’t answer those questions for us. We were allowed to go in and see our son a while later, and all I could do was cry. I couldn’t even talk to him, because it made things worse for me. I just stood and stared as I held his tiny little limp hand. There was no reaction, no ability to grasp my finger. Emptiness.

The very next day, we had been told that they took the intubation tubing out overnight. The neonatologist said that he had never heard an intubated newborn scream so loudly, and that Noah had tried pulling at it. They sedated him once again and pulled the tubes out. He was now on a nasal cannula. I still was not allowed to hold him, and it was killing my heart because I was scheduled to be discharged that afternoon. I had continued to pump around the clock to leave colostrum for them to administer through his g-tube. It was heartbreaking having to leave him there under the care of strangers, and head home with empty arms. Beginning at four days post surgery, I was driving myself back and forth to the hospital to visit Noah. Finally, on day four I was allowed to hold him for the very first time. I remember the gut wrenching feeling of placing him back in the isolette because my guts and back were hurting from the surgery. I had waited so long to hold him in my arms, and I then failed to be able to do it for long. I was told that the next day his g-tube would be removed if all was well, and he could begin feeding by mouth. I left explicit instructions for them not to feed him by bottle, that I would be there to breastfeed him. Thankfully, they respected my wishes, and I was able to breastfeed him for his first feeding. The poor baby was choked by my rush of breastmilk, as my milk had already come in. It was awkward to try and breastfeed when my belly was so tender, and he had tubes everywhere. I returned 3 times a day to feed him. I would often call the NICU in the middle of the night during pumping, just to see how he was doing.

It was finally on day 9, Palm Sunday, that we were able to take our son home. During his NICU stay, they had not figured out what had caused his seizures. They did a CT Scan, an ultrasound of his brain, X-rays, blood tests, the spinal tap, and an EEG. They found nothing abnormal. Once he was through with his round of antibiotics and did well on room air, he was cleared to come home. I was nervous, excited, anxious, and scared all at the same time. I had never cared for a sick newborn before. Yes, he was fine when we took him home…but I had images flashing in my mind of the baby that I walked in on the day after the surgery. These images still haunt me.

I know that I will carry guilt with me for the rest of my life. I have taken responsibility for my role in his delivery and his NICU stay, even though it was all done out of ignorance. I firmly believe if my son had been perfectly healthy after the cesarean, that I never would have learned my lesson. Sometimes we have to learn things the hard way, and sometimes God has a reason and a purpose for what He allows us to endure. Had I not found the ICAN support list, I’m sure I wouldn’t be who I am today, and be so passionate about birth today.

So you see, a healthy baby is not all that matters. A healthy mom matters too. A healthy birth matters. Just because a baby is healthy after a delivery, does not make everything that happened during the delivery any better or safer or healthier. And this doesn’t just apply to cesareans.

Oh…for those of you who are wondering…my son only weighed 8.8lbs.

This is my story. My journey. Today is the 4th anniversary of when I was told that my body was incapable of safely delivering my son. And tomorrow is the 4th anniversary of my c-section. Happy Birthday precious Noah. Even though this was written with tears, in a whole host of bittersweet emotions.