Natural Breech Birth Deserves Our Support!

A friend posted a link to the Coalition for Breech Birth on her gmail status. I’m so thankful to know about this resource now.  The following quote applies to all low-risk mothers (regardless of fetal presentation or previous cesarean):

“However, caesarean surgery, while it presents many advantages for the surgeon, has lifelong ramifications for the birthing woman and her family, including issues with subsequent pregnancies, secondary infertility, vbac availability, and depression, not to mention a risk of death in childbirth increased threefold over vaginal birth. Women should not be obliged to accept these serious risks as ‘standard of care’. . .”

Please have a look at this site which provides links to the original report that caused breech birth to fall off the natural birth map and the subsequent research that DISPROVED the report authored in 2000 that continues to govern obstetrics & midwifery access and practice to this day.

Recent Interesting Reads

Not that I’m voting Republican, but I am curious to know anything about Sarah Palin.  Who is this woman and how did she secure the VP slot on the Republican ticket?  Here are my guesses: (1) She’s such a nobody that when McCain loses, no Republican with a political future would be sacrificed and (2) Should McCain/Palin pull out a win, they have Alaskan Oil in their pockets.  But I digress – read this post at Jezebel about Sarah Palin’s brand of feminism.  I don’t mean to be polemic, and well, when you hear it enough times, it ceases to be polemic and looks more like the down-low on shadiness.

Researchers from the University of Connecticut released a study which looked at the relationship between cesarean rates and malpractice rates.

“When I compared the malpractice rates to cesarean delivery rates prior to 1999, both were declining at a similar rate,” says Spencer. From 1999 to 2005, however, both were increasing. “I can’t say one led to the other or visa versa,” he says, but he speculates that rising medical malpractice rates are driving up cesarean delivery rates.  “With our data, we cannot prove a causation but only suggest an association.”

An insightful read from the UK, especially:

“Since the 1970s, the medicalisation of childbirth has been a hot topic for obstetricians, midwives and feminists. There exists in maternity services a clear division between the interventionists, typically headed by the obstetricians, and those, such as midwives, who favour a low-intervention approach. Caught in the middle are the women giving birth. Those who opt for high-tech hospital births are condemned for giving in to unnatural patriarchal models of healthcare and betraying the sisterhood. Those who eschew medical and technological assistance are deemed irresponsible and reckless. They can’t win.”

No, we can’t seem to win, especially those of us who have already been cut once.  To put our babies through a “trial of labor” is considered irresponsible and reckless at best by a growing majority of care providers and the general public.

And finally, I’ve never liked Dr. Phil.  I’ve watched enough of him on TV at various times in his career to know that he has nothing new to add to my knowledge base.  I find him to be a subversive character – wish I could remember the exact moment I decided that, but it was many years back and had something to do with him blaming a wife (in front of her husband) for their marital distress.  I don’t know who was at fault, but Phil pinned the whole thing on the wife and was using this icky patronizing tone.  Ick.

I digress.

Over at Inspired Mama I came across this post – Dr. Phil is asking for homebirth disaster stories.  <sigh>  I’m reproducing it below so you don’t HAVE to click on the link unless you want to go to the horse’s ass, I mean, mouth.  (Keep in mind that when you click active links it raises their “rating” in search engines.  Click at your own risk.)

DO YOU REGRET HAVING A HOMEBIRTH?
Did you have a child at your home?

Did you want to have a soothing experience where you were in control and could bond with your child?

Did it not go the way you planned?

Do you regret having a home birth?

Do you regret using a midwife instead of going to a hospital?

Did you have your second child the traditional way in a hospital?

If you or someone you know regrets having a home birth please tell us your story below.

Be sure to be specific and include details!

Here’s an idea – instead I recommend flooding the Dr. Phil show with letters about how wonderful homebirth can be, how difficult VBACs can be to achieve within a hospital environment, and how the current maternity system ruins natural childbirth.

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Hospital Waterbirth VBAC

I was catching up over at the True Face of Birth and was immediately drawn to a link about a successful hospital VBAC.  The story posted at Bellies and Babies is awesome and inspiring, and how wonderful to read the woman’s narrative and that of her doula!

I was tremendously impressed with the two obstetricians mentioned in the story.  The first OB ultimately told the woman that he wouldn’t allow her to VBAC.  (At 36 weeks this was BAD FORM.)  She found a provider who was supportive of her choice to have a vaginal birth, and it “sounds” like this OB really knew how to stay out of the way and let the mom do the work.  He also was educating his nurse about the whole process – how normal it is to be in water during the late stages of labor, how normal it can be to birth a baby in water, how normal it is to push at will (as opposed to pushing in 10 count blocks), how normal it is to birth the placenta when it is ready to release from the womb.  I am also impressed with the first OB – the one who told her “no.”  He evidently did some research after she left his practice and changed his mind about VBACs.  It takes guts and humility to be able to change your ways and be open to new practices (as if vaginal birth or even VBAC is a new practice).

Anyway, I hope you will enjoy reading these stories as much as I did.

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Two Cents: Modern Obstetrics and Gynecology

I happened upon an interesting self-ascribed feminist post about “medical rape” and the “medicalization of childbirth.”  I’m certain that I have written about being an empowered patient, since that is one of my goals as a childbirth activist – to help empower women to participate in their health care, ask questions, get second opinions, etc.

I’m not sure the original author has much knowledge of the socio-political dynamic in part responsible for the current state of modern medicine.  However, she makes some good points.  For instance:

But other interests come into play in a corporate system of medicine, and the patients’ best interests are unfortunately not at the forefront (for more reading, check out Paul Starr’s The Social Transformation of American Medicine). There are systematic and institutionalized incentives for the American Medical Association to promote hospital births and to keep childbirth squarely in the realm of a self-regulating medical profession. And there is a long history of a predominantly male medical establishment ignoring women’s concerns and knowledge about their own bodies.

The male medical establishment – even with female practitioners – tend to subvert women and suppress their decision-making ability, especially in the reproductive health sector.  Why?  Well, it is easiest to exert power over a woman when she is on her back with her feet in stirrups, her butt hanging over the edge of a paper-clad table, and a speculum shoved into her private parts.  Who hasn’t felt vulnerable and less powerful in that position?

I’m not suggesting that all obstetricians are bad or that men make sucky gynecologists, not any more than I’d suggest that cesareans are completely unnecessary, or that the safest place to have a baby is at home.  Then again, statistically about half of the cesareans performed in this country are not necessary (and don’t improve our infant mortality rate), and actually staying home is the best way to ensure that unnecessary interventions aren’t performed on you when you’re only 2cm dilated at the hospital.  Unfortunately, a growing number of women are dissatisfied with the services their obstetricians provide, are disgusted by medico-legal decision-making when it comes to women’s (and babies’) physical and psychological well-being during the childbearing year, and suffer poor childbirth outcomes.

Something has to give.

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Caution: You may not need a myomectomy

I just talked with my regular OB.  He was under the impress that I had a Mullerian Anomaly (such as a septate uterus) and a major contributor to my recurrent pregnancy loss.  I’ve seen a Reproductive Endocrinologist recently who came up with his own recommendation.  He suggested that my 1-1/2 inch fibroid was distorting my uterine cavity and causing the recurrent pregnancy loss.  He said that he would be “very concerned” about that fibroid.

I double-checked my obstetric records from my 2004 pregnancy.  The fibroid was discovered during a 10-11 week ultrasound (a first-time mom, I was nervous that the midwife didn’t find my baby’s heartbeat).  The fibroid was roughly 4.5 cm then and is therefore about the same size now.  However, I don’t believe it to be a cause of my recurrent losses.  Rather, it is a symptom.  It is a symptom of imbalanced hormones, usually too much estrogen.

Anyway, my OB’s nurse called me today to say that he (my OB) would NOT recommend a myomectomy for a non-symptomatic small fibroid.  I don’t bleed without stopping; I don’t have unmanageable pain.  Since I already have a cesarean scar, he sees no reason to add to that.  Phew!

So, if anyone tells you that you definitely need a myomectomy, please do seek other opinions.  Your uterus may just say “thank you.”  In my case, it should be thankful that I’m saving it from at least two more uterine surgeries.

When doctors don’t support women’s choices

As you can tell, I am back to reading my google alerts.  I came across a post titled “Cesarean vs. VBAC – Birthing Story” and decided to read it.  It seems to me that this is the very type of woman who needs the support and resources that ICAN, CIMS, Childbirth Connection, Conscious Woman, and the like provide.  Women are understandable very protective of their birth stories, so I didn’t post a comment.  However, she may come across my post if she tracks her pings.

I’d like to address specific details of her story.

  1. “I was instructed to read through the risks of VBAC and give in my consent in writing…. this during my first visit to the doctor.” She wisely decided to wait to “consent” to the mode of delivery.  Understandably she had concerns and questions due to the manner in which the information was presented to her in her first visit.  Furthermore, she states that her doctor never seemed to discuss the benefits of normal birth.
  2. “No mommy would want to carry a healthy baby for 9 months only to risk the baby’s health during delivery.”  Absolutely!  And natural birth advocates believe that every woman deserves the right to weigh the risks and benefits of cesarean versus normal birth for herself.  OBs are not upfront about the risks to both baby and mother from cesarean delivery much less the harm that occurs once mom and baby are home.  Doctors suggest procedures and tests that have not been proven to aid the birth process yet may have a negative impact on normal birth.  These include continual fetal monitoring, artificial rupture of membranes, induction, vaginal exams, IV, episiotomy, and the list continues.  These interventions usually only benefit the doctors and nurses.  And did you know that amniocentesis carries a substantial risk for pregnancy loss?
  3. “My mid-wife advised me to wait till the 35th week before I made any decision. But the doctor would not wait till such time. Even before I gave my written consent on my preference I got a call from doctor’s office about scheduling my C-section for the 13th May. (my due date was 26th May).  This irritated me to great levels. While one of the major benefits I was going to get by opting for C-section was a date of my choice, the doctor had deprived me of the same by just giving me one option.”  OBs suggest that it is safer to perform a cesarean before Mom goes into labor.  However, scheduling a cesarean 2 weeks before a due date is risky.  It is sad that this OB was intent on taking this woman’s last “choice” away from her.
  4. “Besides, I knew that I was making good progress and could go in for VBAC.”  Women should trust their instincts about birth and surround themselves with people who support their needs and desires.
  5. “During my 40th week appointment, the doctor examined me and said that I had made no progress at all since 37th week. The baby’s position and the cervix measured the same. She also scared me that the baby was big and it could be a very hard delivery for me.”  The next day at the hospital she began labor on her own. 
  6. “The nurses who were monitoring me repeatedly started asking me if I really wanted to go in for C-section which was scheduled at 11:30am.”  Hooray for her nurses!!  It seems like they wanted to encourage her to have a normal birth!
  7. “I got a call from the doctor immediately … I must say it almost sounded like a threatening call. She said if I didn’t go for C-sec at the decided time, she was not going to be available for the entire week and that some random doctor from the hospital.”  Yes, that was a scare tactic.
  8. Her “big” baby weighed just over 7 pounds.

The reason I’ve quoted and listed these points from her story is that this story is all too common.  When are we going to stop this abuse, this subversion, this last form of modern sexism?