Originally Posted by PlayaMama
i think that what has caused the most harm is the after-the-fact questioning and doubting and suspicion.
i believe that education to reduce c-sections is a necessary component of encouraging women to think critically about their own care. i think that posters can educate women about natural birth choices while still praising medical intervention that saves lives. i don't feel that they are mutually exclusive.
there have been suggestions on ways to do this effectively by quite a few posters in this thread. i'm actually going to start a new thread following up with some of these suggestions as ways that we can communicate on this topic. i'll post the link as soon as i get it going, toddler pulling on my leg for attention
I agree that thoughtless or judgmental "backseat driving" individual c-sections as that is what most people seem to be reacting to in this thread. I do think that we ignoring the elephant in the room, though - that in some cases, there were other options. Let's posit that every person on MDC had an absolutely necessary c-section and that I am not at all asking or questioning any person here (b/c I'm not.)
Let's use the very common hypothetical of the woman whose HCP orders an U/S at 38 weeks, pronounces that her baby is "huge, about 9 lbs - we need to schedule you for a c-section first thing Monday morning." So she has a c-section and the baby is 9'1" and now she tells people "I had to have a c-section b/c my baby was huge - 9 lbs." As a NCB advocate, this VERY common scenario is a huge stumbling block to lowering the c-section rate. These birth stories are repeated and believed and the idea that 9 lb babies can be delivered vaginally becomes suspect. No particular labor is repeatable or falsifiable, so we really don't know what might have happened in any other situation.
-Her baby might have been able to born vaginally with no problems. That was a potential outcome of her birth.
-Her baby could have had a prolapsed cord while she was at home and died before birth. Another potential outcome of childbirth.
-Her baby might have died during a vaginal birth. Another potential outcome.
-Another potential outcome was that she had the c-section and had an embolism b/c of the surgery and died.
-Another potential outcome was that she was induced to "get him born before he got even bigger" and the induction caused him stress b/c he was not yet due and he did not tolerate the pitocin and so she had to have an emergency c-section.
And so on. Each birth only ends one way, so there is no way to say for sure what might have happened in an "alternate universe." We can't go back and repeat the birth and try it a different way.
But that's where statistics comes in. We can look across a big slice of births and see that c-sections performed before labor has begun have a greater risk of a baby with difficulty breathing and/or who needs to be in the NICU. We can look across that big group of births and see that inductions performed before the mother's body shows signs of readiness have a greater risk of ending in a c-section. And so on - these are statistics that we all can know if we are willing to read. The nice thing about statistics is that it never guarantees you a certain result - it just gives you a guide as to what is more likely - you can then make your own decisions. But you will never get a guarantee.
So back to my hypothetical woman above - if we hear her story in conversation (maybe she is a friend of a friend and we are hearing it third-hand and she is not present), then what should a NCB advocate say? Does she just nod and smile, knowing that there is a chance that she actually did not need a c-section? What if there is a teenage girl there listening. If I do not say that having a 9 lb baby does not rule out vaginal birth, and that choosing a c-section in this scenario comes with risks, then I am harming this young girl. I am tacitly allowing this girl to absorb the idea that all babies over 8 lbs must be born surgically. As a member of the NCB community, I do not find this acceptable. I am seriously and genuinely asking, what would be acceptable in this situation? How could the NCB advocate deal with this?
Now what if this hypothetical woman is a poster here on MDC and she says, "I had to have a c-section b/c my baby was 9 lbs." Then what is okay to say? Now we have a statement that will live on the internet and be read by thousands of women, rather than just vanish into the air. This statement definitely has the potential to harm. What does the MDC member and NCB advocate say or do in this situation? Again, I am genuinely asking for solutions and advice from people on this thread.
If the answer to both these questions is that we say nothing in either situation, then I have to wonder if some people here would rather nothing be said in order to protect any mother from potential bad feelings. How is the NCB ever supposed to advocate for NCB, or at least, how we can do it without c-section mamas becoming angry, if we cannot address the risks and benefits of any given practice before and during birth?
Do we make a flyer about choices and risks in childbirth and post it on bathroom walls? Do we teach it in health class? Would these be acceptable ways to educate?
The fact remains that most knowledge is transmitted socially, from one person to another, in the form of stories. Humans are social animals and telling stories about ourselves and others is how we communicate our norms and values. The transmission of labor stories has a direct effect on how women are treated in childbirth and what choices we have. 50 years ago, you heard a lot more stories of 9-11 lb babies being born normally, b/c c-sections simply were not done just b/c the baby might be large. Today, you hear many more stories about c-sections being done b/c of a baby being large. It normalizes it and contributes to the rising rate, despite the fact that our hypothetical woman's c-section came with very real risks and may not have been necessary.
I think that "both sides" in this debate (and I know that at least on this thread, "my side" is small) have a responsibility to give a little something. If we are to work together to help women, we are going to have to come to a middle ground. The one overwhelming point that most people seem to agree on in this thread is that questioning any specific birth, whether to the person's face or third-hand without any identifying details, is off-limits b/c some find it hurtful. If I agree to concede this (despite the fact that it will seriously hamper our ability to lower the c-section and unnecessary intervention rate), then I ask that when people are discussing ways to educate women and/or bring down the c-section/intervention rate, that women who have had a c-section refrain from derailing the discussion with defensive statements like "But my baby really was too big to be born vaginally! Stop hurting my feelings!" If the NCB makes a huge effort to never ever make any categorical statements and instead is careful to qualify them with things like, "Elective induction increases the risks of potentially harmful outcomes like x, y, z..." then it is not necessary to see such statements as a personal attack and/or claim that no such education be done.
Perhaps MDC needs a space for c-sections that is support only, and not classified as traumatic. Then the women who need that type of support can get it without fear of being attacked, and the conversations outside that forum about NCB do not have to become wells of hurt mamas reacting defensively to statements that were never meant to hurt.