Feeling Overwhelmed . . . hmm

I’m feeling overwhelmed this week.  Icky.

A couple of things have thrown me off my center, perhaps.  Like my good friend’s threatened labor now at 30w gestation.  Like my sister-in-law’s straight-forward CBAC yesterday – don’t get me wrong, I’m thankful, but it’s still affecting me.  Like having to go back to work in less than two weeks – survival mode.  Like all of the projects that I haven’t accomplished this winter break.  Like my birthday coming tomorrow – gross late-30s number!  Like CBA2C vs. VBA2C vs. CBA2C vs. VBA2C and on and on.

Ack.

What do you do when you’re feeling overwhelmed and ineffective?  Any suggestions?  It’s really causing me to stagnate and procrastinate.

It’s not like I’m doing absolutely NOTHING.  It’s just that I feel like I’m hiding in my birth research and stressing about a lot of different things and not actually accomplishing things in a timely fashion.  I just need to break the cycle.  I probably need a to do list – maybe a reward chart?!  Haha!

Thinking Through Birth

You may be surprised to discover that I’m pregnant again!  I’m due in late June or early July 2011, and this means that I’ll have three babies under the age of 2.  I’m excited and terrified, let me tell you.

I’ve been back on the ICAN yahoo list, the ICAN forums, and Mothering’s forums getting back into the swing of things.  This has forced me to really look at my birth experiences, my fears, and my hopes for this future baby’s entrance into the world.  It’s quite uncomfortable.  I’m a huge fence sitter.  Which means that I do poorly on multiple choice tests.  Which means that I can see both sides of political situations and most conflicts.  Which means that I am afraid to let go of the medical birth model that I claim to so strongly resist.

Why wouldn’t I be afraid.  My first birth ended with medical interventions and a cesarean.  I suffered three consecutive losses that couldn’t really be explained until I saw a specialist.  I naturally conceived twins and had to have early pregnancy supplemented with hormones which led to other interventions.  I was risked out of homebirth.  My OB was in love with his ultrasound machine which means that I had a ton of baby pictures.  I didn’t really have a viable choice for homebirth care.

Even this pregnancy has been medically supervised and supplemented beyond the norm.  First trimester progesterone supplementation and already two ultrasounds to check viability and growth.  How am I going to sever this link?  Even though I am planning a home birth, I am now so used to medical intervention, that I’m having a hard time ripping off the bandaid, so to speak.

Here is the link  to the twins’ birth story for anyone interested in reading it.  It’s not terribly thorough, but I guess that’s because what can I say about it really?  I had double footling breech twins which was a no go for vaginal birth at the hospital.  (Twins and breech are not in the scope of practice for homebirth midwives in MT.)  So, I got cut.  It sucked.  Recovery was long.

What I’m noticing this time around is how many women are UCing their twins, even breech twins.  I was not brave enough for that even though I talked as thought I could be.  Honestly, I didn’t see how I could be prepared to UBAC twins, and I didn’t want to put that kind of pressure on myself or my husband.  I think it’s a real failure of the “system” that I couldn’t be attended by a capable midwife at home.

These stories are great to read and make me feel so much better about my own plans to HBA2C, but they also make me sad.  It’s another slice of the knife reading that other women successfully birth breech twins in the comfort of their own homes.  My good ICAN friend, L, rightly challenged me on my belief that I had no choice.  These stories are proof of this.

But then I think back on the fear mongering . . . the claim that my lower uterine segment is too thin at the end of pregnancy to VBAC safely.  And I think of the statistically significant higher rupture rate with VBAmC – why wouldn’t it be higher for VBAmC than it is for VBA1C?  Considering how many bizarre statistics have applied to me during my childbearing years, the fear flag is raised regarding my potential to rupture.

And then I remember that the risks of repeat cesarean and the risks of serious complications with a VBA2C are about even.  And I realize that it’d be hard for me to have a successful VBAC at the hospital even if there was a provider who would attend me, which there isn’t.  And I think about my recent conversation with my family practice doctor who reminded me that my midwife will transfer me to the hospital if anything goes wrong, and that emotionally/mentally it would be hard for me to be successful to birth normally in a hospital setting.

So this is the snapshot of where I am right now with it all.  And in case you’re curious, here’s my current reading list:

And I’ve placed holds on a couple of Ina May Gaskin books to read during my winter break.  I’ll also review Simkin’s The Birth Partner.

Monkeying in the VBAC BS

These sorts of stories are so common and so infuriating . . .

A fellow ICAN lister posted a recent conversation with a midwife regarding VBA2C (VBAC after 2 cesareans).  The midwife didn’t really even know VBAC rates and quoted this woman a rupture rate of “um, I think like 6-8%” for VBA2C.  Where did she get that statistic?  I’m thinking it came from her . . . “um”.

The midwife called her back shortly thereafter to give her the ACOG act:  Rupture rate for VBAC after one cesarean is 1-3% and after two cesareans the risk is (supposedly) 5 times greater, somewhere in the amorphous neighborhood of 5-17%.  Was this woman given any references?  Well, no of course not.  You have to ask them, and then watch them squirm, and then of course they don’t have that information readily available.  Give us a primary author for chrissake!  Can’t you at least remember an author?  Or is your “author” ACOG?  ACOG the trade union.  ACOG is NOT a research-based college.  The fact that “college” is in their name makes me sick.

Luckily for women across the country and all over the world, there exist numerous evidence-based transparent resources for women who would otherwise get cut.  I talk about them here like a broken record, but it’s necessary.  Again, here’s where I recommend you start:

If your care providers aren’t aware of these organizations (ICAN, CIMS, Childbirth Connections), please refer them to these sites.  And here is one recent study that they should have read already:

Landon, MB et al.  “Risk of uterine rupture with a trial of labor in women with multiple and single prior cesarean delivery.”  Obstetrics and Gynecology.  July 2006;108(1):12-20.