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Cesarean birth support circle #8 - Page 2

post #21 of 159
Quote:
Originally posted by quiltinglance
My great OB and one other friend feels I need to be more mentally committed to the VBAC or it won't be a success, I think I'm at the point where I just want a healthy happy baby and what I've learned is not to judge other women (or their doctors) for those "scheduled" c/b.
This is the main reason I abandoned my vbac at 39 weeks and planned Bryce's c/b And I don't regret it at all!!!
post #22 of 159
Quote:
Originally posted by quiltinglance
My great OB and one other friend feels I need to be more mentally committed to the VBAC or it won't be a success, I think I'm at the point where I just want a healthy happy baby and what I've learned is not to judge other women (or their doctors) for those "scheduled" c/b.
I totally agree with the part about not judging others -- however, I very much disagree that your VBAC won't be a success if you're not "mentally committed" to it. Before my VBAC, I read all the books and articles and so many of them say that if you're not in the proper frame of mind, you can't have a successful VBAC. I know where they're coming from, but I think this can actually have the effect of sabotaging a VBAC attempt in a mother who is feeling unsure of herself or nervous -- which is normal, of course you're unsure and nervous! Those feelings are totally natural when you're trying to plan a birth and your previous one wound up in Cesarean for some reason.

Anyway, I decided to go ahead and give VBAC a try even though I didn't feel fully committed to it, and had lots of feelings of doubt and nervousness. And what do you know, I had a successful VBAC after all. (Even with an epidural... in a hospital... with an obstetrician... and maternal diabetes!) So, it can be done. But I would never fault someone for deciding it's all a bit too much and just going with the repeat scheduled section, either.
post #23 of 159
Hey Quiltinglance, have you looked at The VBAC Companion? (I forget the author, but it's a great book, and very gentle.) I found her thoughts on our emotions as we approach a VBAC to be very helpful... The doubts are totally normal. I realized that different people probably need to be in different places with all of it... I feel pretty committed to a VBAC, but I also feel very strongly that I should be prepared for a C, too. I think you know yourself best, and you should do what *you* need to do to prepare for this.

The more I work on preparing for this birth (no matter how it turns out), the more I realize that there are so many layers to my feelings about my cesarean, and they affect how I feel about this birth and how I'm preparing for it...
post #24 of 159
Thank you Megan, JanB and KKMama....

First, I think I just realized (due to your posts) that what I am feeling is anxiety about the unknown. Not much different than when I was pregnant with my first and you REALLY DON'T KNOW what to expect. So, now I need to focus on the fact that I did get to 8cm last time, my body does know what to do.

Thank you for your honesty about going into your birth (vbac) "not totally committed", it makes me realize I'm not the only one out there. I just feel like I'm on an emotioinal roller-coaster sometimes. Hormones!!!: I too am going from my ideal environment, birthing center to the hospital/ob/place of intervention!!

I have read the VBAC Companion but think I need to re-read those areas on emotions. Hopefully it will help settle my brain a bit.

Kim, mama to Lance 2yrs, EDD 3/25
post #25 of 159
Oh, I totally identify with feelings of anxiety about the unknown WRT labor and vaginal birth. *I* never went into labor with ds (although I did have 6 days of BH contrax ~10 min apart). I really feel like I'll be going where I've never been before.... Honestly, when I go into labor this time, I'm going to be really happy just for *that*...

I've also tried to get my dh to read the "key chapters" of The VBAC Companion so I'd be able to talk to him about my feelings (and to try to get a sense of his). He tries, though I'm not sure how much he really understands (same with pg... he's a wonderful guy, but men just don't experience this stuff the same way).

Kim, how supportive is your dr of a VBAC? There are 2 "supportive" and 2 "unsupportive" (though 1 of these is leaving before my due date) drs. at my practice. I'm learning that I just have to limit what I say to the unsupportive dr. (and fortunately, I will only have 1 more appt with her before "the end").

Yeah, it is an emotional roller-coaster. (*Pregnancy* for me is a roller-coaster at times, too! ) I'm trying to do what I can to get in the right mental "zone" and stay there. Going and visiting the hospital and talking with a L & D nurse has helped a lot (helps me feel like it's going to be a safe place for me, helps me visualize a positive birth setting). Talking to my doula has helped, too.

I don't think there's only one route to "success" in VBAC... we all have had such different experiences in childbirth and in our Cs. We have different kinds of drs. and hospitals, with different rules.

I'll be thinking of you as your edd draws near. Keep us informed!

Oh yeah, other Kim (OnTheFence), thanks for posting your birth plan! We're talking with our doula next week about birth plans, and then I'm probably going to discuss it with the dr. the following week.

And now for something totally off the topic of VBAC and C/B... I've been feeling unusually tired the last couple of days. Ug. I'm thinking of doubling my iron (I was at 34 the last time they checked... still low, but up from 32 the time before). I think the baby is starting to make big demands for iron and calcium...
post #26 of 159

No Caesarean leads to murder charge

I am posting this here. Saw this on the news last night. Comments?

http://www.cnn.com/2004/US/West/03/1...er.charged.ap/
post #27 of 159
I love everyone on this thread and I don't want to offend anyone as I am very sure that many are on the opposing side of the abortion issue, but I am anti-abortion, and therefore, it is easy for me to say what this woman did is wrong IMO. However in a country where abortion on demand is legal- I see no reason why this woman should be tried for murder, makes no sense to me legally- although morally, I find her actions reprehensible.

ETA-
I am glad to see your still posting with us OTF!
post #28 of 159
Thread Starter 
I respect your beliefs and that was well-put, jess7396.

I'm for a woman having the right to birth in whatever way she chooses-whether that be unassisted at-home, cesarean or medicated at hospital. Although I would never have put myself in this woman's position I think she does have the right to refuse surgery & shouldn't be tried for murder. Tragic outcome.
post #29 of 159
Ug, I saw the story, too, and it makes me really sad. From what I was able to glean from whereever it was I read it, I think she *should* have had the C. Cs are no fun, but I'd gladly undergo one myself if I were in the circumstances she was in to try to save the life of my baby (no movement, slowing heartrates). I wondered based on the few details they give about it whether she really properly understood the risks and was unnecessarily afraid of Cs? (Like I said, they're no fun, but I would think a stillborn baby would be *so* much worse.)

Morally, legally, I feel really confused. The baby was term, but it wasn't born yet, so still technically a fetus. I feel pretty uncomfortable with laws which grant fetuses equal rights as human beings, especially when they start infringing on the rights of (pregnant) women. I totally understand wanting to be able to say no to surgery--that's what my whole beef about VBAC disappearing is about. But I think this woman acted irresponsibly... perhaps the end result is that she'll reduce the rights available for the rest of us??
post #30 of 159
I have mixed feelings about this and I am pro-choice. Morally I definitely feel she was wrong. Legally -- I am not sure. I think with a full term, otherwise healthy fetus that what she did was neglect and at the very least man slaughter. I would like to know more background on why she refused the surgical birth.Sim ply to avoid a scar? Then that makes me sick and I think she should be strung up. This is a really hard subject for me, beause my middle child has fetal alcohol effects, something that could have been prevented had his birthmother not been boozing up while pregnant.

I wonder how that woman feels now that her baby is dead. I would much rather have a scar, pain, etc than a dead baby.
post #31 of 159
KKMama, when are you due? We sound so close on the emotional roller-coaster.

My OB is very supportative....she has her own practice but shares call with 4 other doctors, I've never met. She tells me they are just as supportative. Again, more "unknown" to add to the anxiety. I would prefer to birth with one of the midwives in the group but they are not "allowed" to birth a VBAC. Geez the things you find out the further along you get.

What is your doula or Dr. saying about you going into labor? Have you considered acupuncture? It's amazing, if for nothing more than the calming effect. Was your c/b due to post-dates without labor?

My hsb is very supportative, my labor was emotionally hard on him too, all that "helplessness".

I'm still processing, still unsure of the path but I look forward to checking email and seeing all the comments/threads. Thanks. Kim
post #32 of 159
Re: OnTheFence, "I would like to know more background as to why she refused the surgical birth"

I think that is key in the article! I'm going to guess that she was never properly informed on the actual c/b procedure, low incision, minimal scaring, etc. The only way to determine if she was educated would be to look at her medical records. Sometimes we just need to get so basic with information. Birth, regardless of method, is scary and decisions seem so much bigger and harder to make. Imagine making them with very little understanding and/or educational background.

I need more information.

Kim, Mama to Lance, Edd 3/25
post #33 of 159
The woman in question has a history of mental illness, and was born to a mentally handicapped mother. The surviving twin had traces of cocaine (and I believe alchohol) in her bloodstream. I'm not sure education or informed consent is the issue here. I think it's tragic how the initial media reports (the one everyone will remember) painted this.
post #34 of 159
Thanks for the info, NHF. I knew the initial stories couldn't be telling everything.... the whole situation just seems very sad. But I *do* wonder if the result will be reduced rights for the rest of us (despite the extenuating circumstances)...

Kim (QL), I'm about 6 weeks behind you (EDD 5/7). I get nutty early. I'm really glad I've had appts with the other drs., even though I'm not overly thrilled with one of them. Yeah, I hate the little "surprises" too. I didn't know that they rotated call until I was ~3-4 mos along. I also feel like I have to brace myself for the less supportive dr. to not be supportive of a VBAC at the end (I only have 1 more appt with *her*, but unfortunately, it's at 39 wks). If she tries to pull that, I'm prepared to go to the more senior drs (who are a lot more supportive of the VBAC).

My doula is being so great, so positive. I know she's trying to help me stay in a positive frame of mind, and I'm glad (hey--that's what she's there for! ). I did acupuncture at the end with ds, and it helped, but circumstances were ultimately not such that I was going to have a vaginal birth. I'm going to ask my doula for names of acupuncturists next week...

Ds' birth... I went 2 1/2 wks late. He was transverse at the end. I did everything under the sun to try to get him engaged/get labor going (sex, EPO, lots of walking, castor oil, pelvic tilts, hours of gardening on my hands and knees, yoga, acupuncture, Chinese herbs, may have left something out... you get the idea). Nothing worked. I *did* have 6 days of mild BH contrax 10 min apart (which was a little annoying). On the last day, I had a prenatal appt in the morning. Ds was fine (and was fine in my several NSTs). We decided to schedule an induction for that night (despite the fact that I was about a zero on Bishop's induction scale). I got to the hospital, and the fetal monitoring said ds was in 2nd degree distress. We had an immediate cesarean. He was tangled in the cord (2x around his neck)... he couldn't engage, and I seriously doubt that he would have made it through an induction.

The best things about my C are that I didn't have to labor beforehand and I didn't know about it beforehand (I would have worried way more than it was worth).

I'm definitely concerned that I'll go late again, although this baby "feels" better positioned already, which I think will help. I'm concerned that I may "run out of time" (esp. with the one dr., who thinks that I should have a repeat scheduled for 40 wks if I haven't had the baby... the others will give me 42 wks).
post #35 of 159
Quote:
Originally posted by quiltinglance
Re: OnTheFence, "I would like to know more background as to why she refused the surgical birth"

I think that is key in the article! I'm going to guess that she was never properly informed on the actual c/b procedure, low incision, minimal scaring, etc. The only way to determine if she was educated would be to look at her medical records. Sometimes we just need to get so basic with information. Birth, regardless of method, is scary and decisions seem so much bigger and harder to make. Imagine making them with very little understanding and/or educational background.

I need more information.

Kim, Mama to Lance, Edd 3/25
Turns out she was using coke. Has mental illness. The works. I am getting bashed on the Talk Among Yourself board and have got some interesting and threatening IMs. I should have not delurked over there. I get sucked in everytime!
post #36 of 159

read this this morning

I've been doing research on something and came across this this morning. I've been reading about elective csections and emergency csections and their risks. What is the difference? Ect. Just so you know why I was checking this out.

"Dr. Robert DeMott's comments about the dangers of cesarean delivery reflect the scare-mongering that has kept American women in the dark over the true risks and benefits of cesarean section and vaginal birth ("Elective C-Sections Stir Up Controversy," Oct. 1, 2000, p. 1).

In 1965, the C-section rate was 6.5% and the maternal mortality rate was 32 per 100,000. Since the so-called epidemic of cesareans peaked in 1985, the C-section rate had reached 24% (a fourfold increase) while maternal mortality is 8 per 100,000 (a fourfold decrease).

Recent statistics suggest that elective cesarean delivery is no more dangerous than attempted vaginal birth. Emergency cesarean C-sections are the salvage pathway for vaginal births that have gone wrong. All obstetricians know that it is in this scenario that most maternal mortality occurs.

If a woman dies as the result of a cesarean which is performed after labor has failed to bring about a vaginal birth, these complications should be added to the vaginal delivery statistics, not used to frighten young women about cesarean delivery.

Cesarean birth continues to be the only area of medicine where the patient is not presented a balanced discussion of the risks and benefits of the alternative therapies. Instead, the advantages of vaginal birth are always exaggerated and the risks are never discussed,

David C. Walters, M.D."

I was wondering of those of you here, because all of you are thought provoking educated mommas, if you believe that last statement. That their is not a balanced discussion.
post #37 of 159
I am thinking that the idea that c-sections are needed after attempted vaginal birth going wrong is only partly true- I think that so many people are induced, etc. which leads to the vaginal birth "going wrong" necessitating a c-section. I think there would be less necessary c-sections if labor weren't "helped along" so much. I have heard a lot of stories on our threads of simply necessary c-sections, as well as sections which ended up needing to be done- b/c of prior interventions- which led to the c-section being necessary- as in- if labor had come on and progressed without intervention- the c-section *may* not have been necessary. Am I making sense?

Granted I do think more c-sections are *necessary* than the natural birth advocates say, but I still venture to guess that 24% is too high.

I think the truth of the last statement is dependent on who you are talking to, IMO some natural birth activists do downplay what the risks for some women are to have natural birth (ie- 2nd or 3rd time c-section patients, footling breech, etc), but many OBs downplay the risks of c-birth (I never was talked to about the future risk of rupture when I had my first c-birth scheduled).

Interesting stats that you quoted though about the maternal mortality rates, I wonder about the fetal mortality rates- I would think those stats would be even higher in 1965 and lower (bigger difference) in 1985, am I right on that?
post #38 of 159
Interesting things to ponder.
What I am looking into is, which is safer: choosing an elective csection or having a csection after a failed VBAC. So far, it appears that choosing a repeat is actually safer, than if you have to have a csection after a failed VBAC.

I also feel that down risks are played on all sides. Also from what I have read repeatedly here and forums like here is that the maternal mortality rate had actually not changed from say 30-40 years ago. Maybe I misunderstood. I will try to find out about infant mortality rates.

I don't want to work or do anythign today, can you tell? :LOL
post #39 of 159
I remember now something that I wanted to respond to I think in the last CBSC thread (but I kept losing my post)... someone asked about the figure that is cited for success rate for VBAC (~75%)... No, that figure doesn't apply to *everyone* who's had a C (because not everyone who's had a C can go on to have a V/B)... it applies to everyone who gets to the point of having a *trial of labor*. If you don't have a TOL, you're not in this number. I've read the figure in several reputable sources (no, not just ICAN), so I believe it.

I would agree that probably not everyone is talking about the relative risks of vaginal births, cesarean births (scheduled, elective, repeat, emergency, whatever), VBAC, etc. in an adequate way. And different sources have different kinds of biases. To be honest, I think OBs downplay the risks of *all* C/B, because they feel like they are in control in a C/B (whereas they aren't, really, in a V/B), even though they may not have total control over a woman's blood pressure, her response to anaesthesia and other drugs, whether the baby squirms and gets cut while the uterus is being cut, etc.

Correlation does not equal causation. The rise in C/B and the drop in maternal mortality may be causally linked, but I'd like to see the evidence first. I think improved nutrition, less smoking, and better access to prenatal care may have *more* to do with the drop in mortality (but I don't know).

I also have to say that there are definitely different flavors of emergency cesarean. There's the crash surgery with general anaesthesia and a vertical incision, and then there's situations like mine where it was definitely urgent, but I wasn't tired out from labor (because I never went into labor!) and there was time for a good spinal and careful cutting. Part of the reason that I want to have my VBAC in a hospital with fetal monitoring is that if there *is* a problem, I'm hoping that we will be aware of it sooner and "take steps" sooner (so that if I have a repeat C, it isn't a "crash"). Some might say that I'm taking the risk of having more interventions by being in a hospital (but hey--they can't induce or augment labor), but I see it as a trade-off I'm willing to make.

One thing I keep saying over and over again is that when we weigh repeat Cs and VBAC and their relative risks, we need to include long-term stuff... quite frankly, I don't like what I know about what having the scar (and repeated cuts)... like increased complications in future pg (like placenta acreta), more adhesions, higher rates of infertility, endometriosis, need for hysterectomies, etc. I also think if you're going for a VBAC, you have to try to figure out your own odds of success and your own risks... eg, if you have a vertical incision, looks bad, if you had a prior breech, you have the highest odds for success, etc.

I think the entire atmosphere surrounding pregnancy, labor, and childbirth (V and C) should be about keeping the mama and the baby as healthy and intact as possible. Surgery is sometimes necessary, but there are things we can do in prenatal care and education and in "labor management" to minimize it. 25% is way too high a number... I think it could be safely halved without increasing maternal or newborn mortality.

I totally agree that when someone is having a V/B, she should be left alone as much as possible. I think, to be honest, that everyone would be better off if we had birthing models more like the Netherlands (where if I understand correctly CNMs deliver most of the babies and there are fewer interventions). I wish all women had access to *really good* childbirth education and natural pain coping/alleviating techniques (including water, massage, TENS/acupuncture, visualization, whatever).

I also have to say that I think that most OBs probably don't have a good understanding of natural childbirth or any of the "crunchy" stuff which just might help some women in labor and childbirth. And to be honest, I just don't understand why *so many* women are induced and augmented, and so early (I didn't really believe that it was happening, and then I checked out some mainstream boards, and I was shocked at the percentage who were doing it, and so early!). I just don't see the medical benefit to mother or child, and it costs more, and there's a higher risk that you'll end up with an unplanned cesarean.

I hope no one perceives this as being negative (especially Kim). I'm just frustrated by the current state of affairs. My scientific background leads me to really question statistics and their interpretation and the line of reasoning people use to come to their conclusions. I also am one who likes to really *see* the evidence and be able to weigh the facts so I can come to my own conclusions.
post #40 of 159
Quote:
Originally posted by KKmama



One thing I keep saying over and over again is that when we weigh repeat Cs and VBAC and their relative risks, we need to include long-term stuff... quite frankly, I don't like what I know about what having the scar (and repeated cuts)... like increased complications in future pg (like placenta acreta), more adhesions, higher rates of infertility, endometriosis, need for hysterectomies, etc. I also think if you're going for a VBAC, you have to try to figure out your own odds of success and your own risks... eg, if you have a vertical incision, looks bad, if you had a prior breech, you have the highest odds for success, etc.

I agree with all you said, but thought this part was particularly important. If it weren't for the size of my pelvis- I still would've had c-birth #1-(shoulder presentation breech), but wouldn't have had number 2 or 3 (or likely wouldn't have), and thus, would probably be able to have more children safely- which is not the case for me now. B/C I do have the pelvis issue- #2 and 3 were easy repeat decisions for me, but I might've been "talked into" them either way had labor not progressed "fast enough", etc., and then I would be angry now at the shape of my body. You hear all about women who can have multiple c-births, and I expected to be one of them (I'm pretty healthy and take good care of my body). I'm not sure I'm making sense- what I am trying to say is that for women who would like a large family VBAC might be more important (although, I agree, in a hospital in case of rupture).

And hey- my OB's never warned me about the risk of cutting the baby- maybe that is common sense, but it seriously never dawned on me as a risk. I do think both OBs and midwives downplay risks to work toward what they are comfortable with, and each have their own predjudices about birthing processes. I've never had an OB that was "induction happy"(you like that term ), but all of mine have been "pain relief happy" in that they encourage epidurals as safe, etc.
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