A Word from K, Our Senior Adjunct Section Correspondent
Wednesday, September 28, 2011 at 7:20AM
Guest Post by “K”, Senior Adjunct Section Correspondent (SAS-C)
Guest contributor’s note: Fans of The Unnecesarean have expressed dismay that a “pro-cesarean” post would ever appear on this site. Let it be stated, for the record, that my contributions here have never been intended as “pro-cesarean” — but rather, pro-individual choice. I support the choice of each individual woman to birth how she chooses, and yes, (gasp) to view her birth experience as warm and wonderful if that’s how she sees it — be it in a birth center, at home in a tub, or on an operating table. I’ve been invited to provide guest posts here before, because Jill and I met in person at a birth conference (OH GOD, REALLY?! Yes.) and she deemed me somewhat intelligent enough to have a sharable opinion. Bless her heart.
And now, on to the post:
NPR: I Had A C-Section And I Loved It
The picture with the post says everything that needs to be said. A wonderful birth experience has just happened. And I’m glad that NPR decided to include as a follow-up to their Baby Project.
I, too, had a planned and medically-indicated c-section earlier this year. But before it happened, I shared my story here on The Unnecesarean. That post generated a lot of support as well as consternation, as well as a few people who threw up their virtual hands and “left” the Unnecesarean community. And it added a lot of stress and tension to the final months of my pregnancy - which was the only reason I regretted posting it.
Fast forward to the day we met our son. As I held him in my arms and reflected on the significance of that post, wondering if I would write a follow-up, I thought to myself, “Good grief. That’s so in the past, and now he’s here. Moving on….” As Barrie so perfectly summarized, I was ready for the baby experience. And I’ve never looked back.
It’s worth considering that we all have the right to frame our experiences as we see them, as we’re the only ones with the perspective to do so.
Reader Comments (26)
K, you're so SAS-C. Thank you for picking that marvelous title.
The problem I had with that post was not that the author wanted and got a C-section, it just seemed she made a decision based completely on a fear of birth and without seemingly any research into the pros/cons or risks of the surgery. It all ended well for her, she apparently bounced right back and without any pain and her baby was able to breastfeed with no issues. From what I have seen with friends & family, this is absolutely not the norm. It also felt like, though she said homebirthers and elective C-section moms have more in common than we realize, that she was reinforcing the stereotype that natural child birth advocates care more about the birth than the baby.
This is a tricky one. Yes, it's critical that women choose the birth environment and method that is most appropriate for them. No doubt. And there is no room (or need) for guilt in any of this--none of this is ideological (although some try to make it so). If a woman is pleased with her birth experience, she is entitled to feel pleased, and her reaction/emotions are no one else's damned business. No such thing as false consciousness when it comes to birth. What concerns me, however, about choosing unindicated surgery is a) it contributes to a context that undermines our collective faith in women's bodies and women's ability to give birth without intervention, and is connected with beliefs and policies that malign women's abilities and the integrity of our bodies (and this undermining/maligning context hurts real women, every single day, all over the world); and b) in a system like Canada's, where our medical care is publicly funded, it costs a lot of extra tax dollars to do c/s than to attend vaginal births. Call me petty if you will, but I'd like to still have a public medical system a decade from now, and at the rate we're going--not just because of unindicated c/s, but because of burdens on the system from a variety of angles, mostly to do with people living longer and with more chronic disease--the whole thing is going to implode if we don't make some changes. Women choosing c/s aren't the only ones to blame for this of course, but every dollar saved is a good one, and if we can both save money and encourage birth choices that are as low-risk to the woman and baby as possible (a c/s without medical indication introduces risks that just aren't present in a non-surgical birth), then from a health systems perspective, that is a good thing.
But I do still feel twisted up about how all of this maps on to the rhetoric of individual choice. It's tricky. And, of course, I have biases as I absolutely detested every second of my c/s and "recovery" and am now an ICAN leader...
I would argue that a blessed c-section that a woman feels happy about and ready for can be as research based and fantastically well-informed as a lovely homebirth with a midwife. Anxiety and stress from being in a situation you don't want is definitely enough of a factor that women MUST be able to choose their birthing situation and be given support in their choices. Triumphant necesareans of any variety can be so joyful. Focusing on positive necessary c-sections is just as important in getting the c-section rate down as bringing the unnecesarean epidemic to light. If we must have c-sections, which of course we must for a variety of reasons, we need positive examples from which to draw. Everyone deserves their best birth.
I also think that it may not be the norm, but, I think, preparation, education, and empowerment are the key factors in any woman's success during and after her chosen birth experience. I'm not really a fan of the title of the article as it encourages elective C-section with no background information. Some women look for an anthem more than they look to be educated, and although the message about being happy with your personal choices is a good one, it would have been great to see something more thoughtful, even if less marketable. I think it is degrading to a good article to just go for the controversial punch-line title.
I am a Doula and Childbirth Educator, and nothing makes me happier than to see a woman have a wonderful, natural, non-interventive birth experience and an easy slide into post-natal life-with-baby. Unfortunately, it is an ideal and under-supported by our current health care system. Equally as important as a healthy birth experience, is a confident mother's entrance into motherhood. Despite circumstances where we feel WE would have made other decisions regarding our birth experience, we should support each other as mothers and watch out for each other. In our lifetime experience as moms, we make plenty of our own regrets and guilty burdens. There is no need to start life with our little ones feeling that we are already being judged for our mothering decisions. Kudos to K for her healthy experience and feeling confident about her choices. Moving on to Motherhood...
Alisa, your comment shows that you've thought about the potential health implications (positive and negative)of having major surgery without medical indication critically and are well aware of how your biases/experiences impact your opinion. That is a starting point for any respectful discussion on the matter.
Elita, I agree that the implication is that "vaginal birth" is synonymous with "experience" and all of the inferences within, yet choosing a cesarean is choosing the experience of having a cesarean. It's a red herring to try to pin wanting a specific experience on a specific group of people. Even providers choose the cesarean experience when performing one for medical indications or to avoid being sued. Whether averse to experiencing vaginal birth (patient) or averse to experiencing a lawsuit (doctor), it's important to keep in mind that one experience has simply been swapped for another. With wanted pregnancies, everyone typically shares the end result of wanting a healthy mother and healthy baby. To try to frame that for someone else isn't possible because, as K wrote, "we’re the only ones with the perspective to do so."
Another way to put that is that vaginal birth is viewed as process and outcome, whereas cesarean birth is mistakenly perceived as cutting straight to the outcome. There is still quite a process involved. Some (patients and providers) value that process, others are neutral, still others hate it. The same could be said about vaginal birth.
I had a c-section for my son and had a great experience!
I made the choice that was best for me at the time.
I will be trying for a vbac this time but will not be hugely disappointed if I cant have one. My doc is willing to let me try.
Debbie, that's very cool that the option is on the table and that you can make the decision. Congrats. :)
Brilliant comment on the Facebook page: "I hope we never cut health care enough that women are forced to birth a certain way to "save money." Remember folks, it goes *both ways* once you start making a woman's birth a political statement."
I absolutely 100% agree with Elita. I think every woman should make an educated decision for herself - if her choice is to have a cesarean, then so be it. It's the fact that she attributed her cesarean to a fear of vaginal birth that got me. It's this fear that is perpetuated by the media, by women who don't know any better, etc. that is the biggest problem. It's the same reason that many women opt for an epidural early in labor - it's not that they can't handle or cope with it - it's the expectation that it will get worse and the fear of that. If birth was more normalized, then these educated decisions might be based more on factors that are really important to the family than on a fear of what could have happened. I'm very glad this woman had a great cesarean experience - it's not true for everyone, as the readers of this blog know.
Ive just finished reading this post and the one that started it all. I had 2 terribly traumatic cser births with both my children. Both caused from medical intervention. With my first i was admitted to hospital for 6 weeks post-birth as i had near fatal wound infections, numerous subsequent surgerys to try and rectify these. I had no help from nurses afterwards. I was constantly found passed out on the floor after ringing the nurses to help me pick up my baby (when he was screaming), having no nurse come so trying to get out of bed myself. However i managed to breastfeed and be an amazing mum to my now almost 4year old. My second baby was prem, i was FORCED into an extremley unwanted cser by doctors who knew i was in a vanureble position, as all women are whilst in labor or even pregnant. They know just what to say, how to scare us and how to manipulate us into having an "elective" cser. Im pretty sure they use that word to make us feel better about it. My little angel was born to early, was in NICU for 2 weeks, the nurses stuffed up my pain meds for days, i had no help getting from my ward to the NICU to see or feed my baby. A student nurse had to help my start expressing and i thank god she was there! She is now 16months old and sue to being in NICU at birth suffers from severe RSV+ bronch reoccurences aswell as asthma and constantly being on steriods because of her lungs. I myself have and still are suffering from post-natal depression and post-traumatic stress disorder. I have nightmares, night terrors, flashbacks and weepy days due to these. My next birth WILL be a vaginal birth, i guarantee that!! I guess at the end of the day the main thing is that mum and baby are ok, but what happens when that isnt the case and either end up scarred and broken....Thats how i now consider myself, broken!
Im all about choice but was extremely disappointed with the npr article. I dont feel it sends a positive message twards pregnant woman who may stumble apon that article and its not very different because that type of feeling in pregnancy and adittude twards birth is the norm in western culture. Were supposed to be steering away from medicalized births and empowering woman who can birth naturally to do so. Im disappointed to hear she felt judged by "the hippie moms" and they obv. didnt go about it the right way. A breech positioned baby can be delivered naturally and I am too biased, I guess, because I see what the hippie moms were getting at. I seen what repeat cesereans do to mothers and to children of those mothers who have to wrap their little minds around the fact that mommy could die when she goes to see the doc. next time she gives birth. I was one of those children my mother had four cesereans and I was scarred as a child visiting my mother seeing her white as a ghost being pumped with new blood over something that didnt have to happen in the first place if she was supported and empowered.
Jill,
You left no room to comment on your post requesting contributions to get to the Home Birth Consensus Summit.
I hereby offer to pay for your entire plane ticket, hotel room and meals IF you get me into the Summit as one of the participants.
I'm not holding my breath, of course, since the "consensus" has been agreed upon in advance and participants have been extensively vetted to make sure that no one who might dare disagree is allowed across the threshold.
Dude - I will NOT be able to front the cost of your plane ticket, et al. as above, but I will totally promise to improve the quality of my biscuits. From now on, all ingredients will be USDA-approved as fit for human consumption. o_0
Monkey Biscuit, I am salivating and I don't know why. I read your comment and I can't stop drooling.
Amy, I got my invitation on the later end, I think. I might have only been second or third tier (after cancellations)-- don't overestimate my clout. I don't know that I can sneak you in in my jacket, either.
That's a seriously generous offer. Thank you so much. Have you already e-mailed Saraswathi or Holly so see if they'll include you? Let me know here or by e-mail what you've already done to try to get an invitation if you'd like and I can always send an email.
I'm not sure if you realize it, Jill, but only those vetted for agreement with the predetermined outcome of the Summit are allowed to attend.
"The invitation selection process has been an iterative process with many rounds of vetting, internally and externally. Many individuals were nominated ... Short lists were created by multidisciplinary subcommittees chaired by the Vision Team members who were most familiar with representatives of certain stakeholder groups. Each subcommittee went through a detailed vetting and weighing process and considered the balance of perspectives, ethnicities, gender, age, geography and other factors... We also prioritized those who were likely to respect the process by fully engaging in open-minded dialogue."
So the only participants can be those who were invited and you can only be invited if the "Vision Team" knows you, knows what you are going to say and and knows that you won't bring up any issues that the team would prefer to hide.
It's pretty clever when you think about it. The "Vision Team" wants to hold a meeting about homebirth without mentioning the safety of homebirth ("The point is not to debate the "rightness or wrongness" of homebirth. "). Since safety is the single most important issue, that is quite a challenge. The only way to make sure that it provides the predetermined "consensus" is to have only invited participants who are undergo "many rounds of vetting" to be absolutely, positively sure that they won't provide any information isn't pre approved, any perspective that isn't pre approved, and above all else, any of that pesky data that homebirth advocates don't want women to see.
I really, really would foot the bill for you to attend if I could attend, too, but we both know that Holly and Saraswathi would never allow that to happen. That's the difference between scientific conferences and homebirth conferences. At real scientific conferences, everyone is allowed to attend and no one is "vetted" in advance to be sure that they won't say anything awkward. The opposite is true for this summit, which means, unfortunately, that it is a farce even before it begins.
Dr. Amy have you looked at the most recent list of delegates who have accepted their invite?
(from the HBCS website)
Home Birth Consumers (mothers and fathers from a variety of perspectives)
Consumer Advocates (including doulas, childbirth educators, childbirth and women's health care activists)
Home Birth Midwives (CPM, CNM, LM, Amish, traditional, etc.)
Maternal-Child Health Collaborating Providers (including paediatrics, labor and delivery nursing, neonatal providers, CNMs who facilitate access for hospital admission or consultation)
Obstetricians and OB Family Practice Doctors
Health Care Models, Systems, and Administrators
Health and Liability Insurers and Payors
Health Policy, Legislators, Regulators, and Ethicists
Public Health, Research, and Education
I don't think this is going to be the home birth hug fest you think it is.
I think it is important to consider a number of aspects when choosing a birth method or place. Many advocate of natural birth think that the mother's psychological well-being is important, yes (although I will not say that "the experience is everything")? In this case, K's psychological well-being was one of the reasons for her elective C-section; I don't see how we can fault her for thinking seriously about this and making her decision the way she did. In addition, she also had a medical indication for a C-section, in a breech baby. Yes, I agree absolutely that breech babies can be born safely. However, many providers are not trained in breech birth now, and it can be much safer to go for a C-section in that case, than a breech with a provider unfamiliar with breeches. I think that providers need to be trained in breech, yes, if only because sometimes there are surprises and one needs to be prepared for that, but it is not always the case that a vaginal breech is safe. I am happy that K was able to read, think, and research, and make the decision best for her (and her family) and that she is still happy and comfortable with it. I wish so much for other women as well.
As for the Home Birth Summit (omg thread hijacking), I'm not sure that all of the delegates are so well known to those in charge, and I remain hopeful - for a number of reasons - that there's not a pre-decided consensus.