More Business of Being Born VBAC Segment

I was so excited to watch this. I thought that I would enjoy lending it to clients of mine, and had even prematurely asked if my Professor friend over at the college would help me set up another campus screening with a followup Q&A about VBAC.

Boy was I wrong. So, so wrong.

The VBAC segment was not only mostly one-sided, the risks were over inflated and misrepresented. The title of the segment is a load of crap, because it really DOESN'T talk much about what a woman's options are. It shows the incredible amount of unbalanced information that is out there, especially from OBs.  A sound resembling a dying cat escaped my throat every time I heard the words, "attempt a VBAC", "try to have a VBAC", and "trial of labor". Yes, this is OB lingo. And while I will agree that in the hospital it really IS "attempting" a VBAC, because hospital VBAC "attempts" are rarely successful...and even less so if we look at the big picture and include women that start out interested in having a VBAC, and then are dissuaded by the OB...it is hurtful language. I believe in the power of words. What if we told each mom who wanted a natural birth that she was, "attempting a natural birth", or that she could, "try for a natural birth"? What does this imply? This, to me (and many other women) implies great room for FAILURE. Never mind that most natural birth "attempts" are hindered by the hospital staff, or by lack of support, or by lack of knowledge.

What if I told my clients that I would be happy to help them "attempt" a home birth? Holy cow, that would be scary! That would leave their minds open to the idea that they are likely to end up in the hospital, and not with the home birth that they planned for.

One thing that they did portray accurately - though I'm sure wasn't the intention - is the fact that the Obstetric system is NOT set up to support VBACs. The doctors interviewed spoke openly about issues with hospital protocol, and mainly, liability insurance. And that's what it comes down to. Not risk. Not a woman's ability to have a VBAC. Politics.

One of the most common things I have heard from women and OBs is that a VBAC isn't allowed at a certain hospital because they are not equipped to handle emergency surgery. Let's think about this for a moment. A uterine rupture is HARDLY the only emergency that can come up during childbirth, necessitating immediate surgical delivery. Cord prolapse, placental abruption (both of which occur more often with intervention, for the record) both would fall in this category. If a hospital isn't equipped to handle a VBAC, it isn't equipped to handle ANY birth. Period.

I screamed outright at the screen when a woman was interviewed who had found a supportive OB, and planned for a VBAC. She labored at home before going in. Once in the hospital, her OB discussed the need for her to progress consistently and timely (?!?!?!?!) in order for her to have her VBAC. He discussed breaking her water to speed things up if need be. (!?!?!?!?!?!?!)  She was a good girl and progressed from 7cm to 8cm in an hour. Then an on-call OB came in 2 hours later and checked her AGAIN, and found her to "still" be at 8cm. Started talking cesarean immediately. She mentioned breaking her water (!!!!!!) and asking for her OB to be called in. The doctor was upset that she was refusing medical advice. Her baby was fine. She was fine. But she had not progressed in 2 hours - or so the new OB said. Her OB was called back in, and in this Mama's words was, "So gracious to allow me more time". OMG! So gracious to ALLOW you and your perfectly healthy baby more time in labor?!?! Let's give her OB of the year award, shall we? The OB said she MUST progress to 10cm quickly, and baby must be descending.

She got to 10cm. But baby was not descending. What did she do?

She said that she had already put her OB in a difficult situation, and she knew it wouldn't BE FAIR to her OB to expect more. She agreed to a cesarean.

SHE AGREED TO A CESAREAN AT 10CM, BOTH HER AND BABY WERE FINE. ALL SO THAT HER OB WASN'T MADE TO BE UNCOMFORTABLE?!?!?!?!?!?!?!?!?

This is what happens to a HUGE chunk of women who think they are going to have a hospital VBAC. They get HUGELY manipulated into thinking that they should be FAIR to the person they *hired*. At the expense of their body, and their baby. They agree to surgery that is NOT medically warranted...because they love their doctor.

One OB who was interviewed said that the risks of VBAC may *seem* low, but that those low risks can come with catastrophic results. Hmmm...so can induction of labor. How many women has he ordered induction for, in his years as a doctor? How many amniocentesis has he performed? An amnio comes with a higher risk of death to the baby than a VBAC does. (1 in 200-400 vs 1 in 2000)Yet, many women wouldn't blink an eye at having an amnio done if their doctor said it was best.

I recently read a study that said that women are more likely to go along with whatever their doctor says is the right course of action, regarding a VBAC or a ERCS. Regardless of empirical research that shows that a cesarean comes with a 2-4x greater risk of death for both mom and baby, if a doctor says it's best to do - most moms will go with it.

The study was a survey provided to women upon admission for their elective repeat cesarean section (ERCS) or trial of labor after cesarean section (TOLAC).  I am really shocked at the level of knowledge most of the women had. 73% of the women admitted for a ERCS did not know the chances of a successful VBAC and 64% did not know the risk of uterine rupture.  54% of women choosing a TOLAC did not know the chances of a successful VBAC and 45% did not know the risk of rupture.

So then I question - are WOMEN really making the choice if they are presented with inaccurate information? If they are willing to agree to major abdominal surgery on the suggestion of their OB? This is NOT informed consent. This is manipulation in the most base of forms. Women need to do their research. I've said it before - women research the type of car seat to buy, crib, diaper bag, more than they research their options in birth and weigh the risks/benefits of each. In our culture, however, we are pretty much brainwashed to view our doctor as our authority figure and not question. I have seen this with friends. Their OB lied to them or misrepresented risk, and they ended up with a cesarean. They go BACK to the same OB and talk to him/her about a VBAC. One of two things occurs most often:

1) OB says, "Well, you could TRY, but with your history of __________, the chance of needing an emergency cesarean - which is more dangerous for baby - is high. It's up to you though."  (yeah RIGHT)

2) OB says, "Sure, you can TRY for a VBAC. It doesn't LOOK like your issue should repeat." and then finds a reason at the end of pregnancy as to why a VBAC isn't going to happen. OB seems supportive, and then lovingly (HA!) finds a gentle way of telling mom that it doesn't look like a good idea after all.

Do you think she's going to switch care providers? For most women, no. It's this sick dependency thing we have going on, along with a very twisted romancing of complications and emergencies in birth and "needing" to be saved. Apparently this ranks higher than empowerment and an innate knowing that we are MADE to birth.

Anyway, back to the film. A doctor who was interviewed was asked to touch on the subject of HBAC - Home Birth After Cesarean. He inflated the risks. He talked about needing an OR available immediately - which is NOT GUARANTEED in the hospital!!! Nor is it evidence based. Studies show that you have 20-30 minutes to get to baby after a uterine rupture is suspected. Guess what? They can't have the OR prepped and ready in less than that in the hospital. But then he followed with, "Of course, a woman has to make this decision for herself."  HA! How many women do you think would choose this, or even do her own research if she was told that her baby is likely to die if she ruptures at home? (Let's go back to the fact that uterine rupture occurs in only 0.3-0.7% of VBACs, and those include the most common, asymptomatic uterine dehisciences, and that the risk of catastrophic rupture is a fraction of the 0.3-0.7%!)

Even Dr. Moritz admitted that in the hospital a VBAC has to go PERFECTLY. He called it a "Cinderella Birth." Which is realistic, how?? He also admitted that if there are ANY fluctuations in baby's heartrate, that it would be an immediate cesarean, without waiting any time at all to see if things were fine. Never mind that external consistent monitoring is highly inaccurate.

If I had been a mom watching the film for information on VBAC, I wouldn't be compelled to do my own research. I would walk away from the film with the idea that I should talk to my OB, and should act on his/her recommendation. I wouldn't look into my options, I would acquiesce to my doctor's advice and not think twice about it.

Ricky Lake and Abby Epstein had the opportunity to REALLY explore the problem with our current cesarean rates, and the extremely low rate of VBAC in our country - and they failed miserably. The only SLIGHTLY redeeming factor of this film is the birth story at the very end. Mom refused to bow to scare-based protocols of her local hospital, and planned a HBAC instead. Even in the face of the OB who refused her a "TOL" (trial of labor) calling her at 34 weeks to say that he would ALLOW her to TRY after all, she continued with her plan. It showed the very emotionally damaging effect that cervical exams can have, especially in a VBAC, when she was checked to be "only" 1cm, and wanted to give up and go in for a cesarean. Instead, her husband rallied by her side and helped her pick back up her resolve. She had a beautiful HBAC in the water - where she caught her baby herself.

But really, More Business of Being Born?? ONE positive, empowering story in all of an hour?? ONE? And the ONE woman you had talking about the risks of repeat cesareans - which are MANY - was not a "professional", but a mom. How does that look to people? The "professionals" are reiterating the risks and limitations of hospital VBAC, and a non-formally educated woman is citing the risks of surgery. Totally biased in presentation of risk/benefit. The risks of repeat cesareans were skimmed over, and the HUGE problem of care provider manipulation, hospital protocol, and misrepresentation of VBAC risks were barely touched on in the right way.

A study done on the morbidity rates of repeat cesareans:

METHODS:
Prospective observational cohort of 30,132 women who had cesarean delivery without labor in 19 academic centers over 4 years (1999-2002).
RESULTS:
There were 6,201 first (primary), 15,808 second, 6,324 third, 1,452 fourth, 258 fifth, and 89 sixth or more cesarean deliveries. The risks of placenta accreta, cystotomy, bowel injury, ureteral injury, and ileus, the need for postoperative ventilation, intensive care unit admission, hysterectomy, and blood transfusion requiring 4 or more units, and the duration of operative time and hospital stay significantly increased with increasing number of cesarean deliveries. Placenta accreta was present in 15 (0.24%), 49 (0.31%), 36 (0.57%), 31 (2.13%), 6 (2.33%), and 6 (6.74%) women undergoing their first, second, third, fourth, fifth, and sixth or more cesarean deliveries, respectively. Hysterectomy was required in 40 (0.65%) first, 67 (0.42%) second, 57 (0.90%) third, 35 (2.41%) fourth, 9 (3.49%) fifth, and 8 (8.99%) sixth or more cesarean deliveries. In the 723 women with previa, the risk for placenta accreta was 3%, 11%, 40%, 61%, and 67% for first, second, third, fourth, and fifth or more repeat cesarean deliveries, respectively.
CONCLUSION:
Because serious maternal morbidity increases progressively with increasing number of cesarean deliveries, the number of intended pregnancies should be considered during counseling regarding elective repeat cesarean operation versus a trial of labor and when debating the merits of elective primary cesarean delivery.

And these are JUST the risks associated with repeat cesarean for MOM. This also doesn't take into account the rates of infection, the increased risk of DEATH, nor does it take into account the difficulty of healing from major abdominal surgery while having multiple children (and a newborn) to care for.

Once a woman has had a successful VBAC, her risks actually DECREASE for future pregnancies.

RESULTS:
Among 13,532 women meeting eligibility criteria, VBAC success increased with increasing number of prior VBACs: 63.3%, 87.6%, 90.9%, 90.6%, and 91.6% for those with 0, 1, 2, 3, and 4 or more prior VBACs, respectively (P<.001). The rate of uterine rupture decreased after the first successful VBAC and did not increase thereafter: 0.87%, 0.45%, 0.38%, 0.54%, 0.52% (P=.03). The risk of uterine dehiscence and other peripartum complications also declined statistically after the first successful VBAC. No increase in neonatal morbidities was seen with increasing VBAC number thereafter.
CONCLUSION:
Women with prior successful VBAC attempts are at low risk for maternal and neonatal complications during subsequent VBAC attempts. An increasing number of prior VBACs is associated with a greater probability of VBAC success, as well as a lower risk of uterine rupture and perinatal complications in the current pregnancy.

The problem is that when women are given the MISREPRESENTED information about VBAC, very few who are initially interested end up having one. So they end up in the category above - at higher risk for serious complications with each subsequent pregnancy. We have a HUGE issue on our hands here, and most days I feel hopeless for change. With women refusing to do research on their own, because it might mean choosing a different OB (or - :gasp: - a Midwife, increasing her chance of a successful VBAC!), or standing firm and choosing a VBAC against the advice of her care provider....we are going to continue to see a very high rate of uninformed women choosing repeat cesarean. We will also see higher rates of complications in pregnancy, and eventually, higher infant mortality.

And the root of the problem lies in the lack of ethics and evidence based protocols in Obstetrics, where it is commonplace to manipulate, scare, and even bully a woman into intervention that increases her risk of that primary cesarean. Women NEED to become better informed of what empirical evidence says about the common issues that arise in pregnancy, labor, and birth. Until women make a stand and demand better care, these risks will only continue to increase.

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?

~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*

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.

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.