On natural childbirth.

[Red]

I have been reading a lot lately from mothers who want the perfect birth, who don't want this intervention or that. I just wanted to give you another perspective.

We lived in a very rural area, so when #3 was expected, we decided to use a birthcenter. (# 1 was before any of this was known to me, #2 was adopted)

As labor started I began to hemorage. I don't mean to scare anyone, but every birth isn't the perfect birth. WE rushed to the hospital, the midwife met us there with the doc. THe doc recommended a medication to mellow me, and maybe a c-sec. I was focused. I knew I wanted an unmedicated, natural birth.

Avoiding medication was a good decision, thoug we'll get back to that.

A c'sec would have saved my daughters lungs fromteh blood she inhaled, and from the lifel long learning disabilities she will fight. If I had jsut listened to that doc, instead of being so sure she was trying to give me unnecessary surgery, my daughters life would be immeassurably easier.

Since I did avoid surgery, it was good that I had no meds. The doc and midwives all agreed later that the meds may have been enough to tip the scales so that my daughter would not have recovered.

My point here is to let you all know there is no shame in choosing to listen to your doc and have a c-section. Have a doc you trust in the background, for emergencies. I had never met mine. Think objectively about your spouse. Are they capable of making decisions, or opposing you, under times of great stress? If not, find a relative, or very close friend you trust to come and help with decisions. Hire a doula who isn't opposed to surgery if necessary.

Err on the side of caution.

Let me say that again....

Err on the side of caution.

[Piglet68]

Well, I'll bite, seeing as I had a C/S (planned)...

The problem is that this situation can go both ways: you can have a woman who is so determined to have a natural birth, that she turns down surgery that might have improved the outcome...OR you can have a woman who wants a natural birth but does not arm herself with the correct information, support network, and emotional drive to succeed in an environment where the pressure to rob her of her planned birth experience is extremely high.

While I would obviously encourage ALL women to research when a C/S *might* be necessary, and mentally prepare for that possibility, it is my belief based on the statistics that the situation of women having unnecessary C/S just far, far outweighs the incidence of women not having them when they needed one.

This is not to diminish your own experience, but you do fall into a very small minority of cases. Sadly, most of the cases swing the other way. So while I understand your message, and wholeheartedly agree that mamas planning natural births should at least be aware of the possibility of a C/S and know when that is truly necessary, I don't think this message is quite as important as the message that you must be aware of when it is NOT necessary, and take steps to prevent that.

JMHO.

[Greaseball]

Doctors are to blame for this...they cry wolf so many times that "But your baby will die!" has come to mean nothing. No, I would not believe an obstetrician who told me my baby was going to die. Maybe if they had never once told anyone that unless their baby truly would have died, I'd find them easier to believe.

[stafl]

Here's what happened to me, and it's far more typical a story than that of the OP. And yes, I was educated, I knew I didn't want those interventions. Education by itself isn't enough to prevent avoidable cesareans, or the severe trauma that some of us feel for the rest of our lives as a result.



My water unexpectedly broke at 37 weeks. I was having no contractions or any other signs of labor (though I had been having lots of false labor the prior two months).
Called my doc, he wasn't on call, so paged his fill-in.
Doc called me back like an hour later, after I had paged him three more times. Said to get to hospital ASAP, to make sure baby is doing well. I was haing contractions about 6 minutes apart in the car, but they stopped when we got to the hospital. Lots more water comes out...only dilated 2cm or so. Lose mucous around the time doc finally shows up what seemed like ages later, but not blood-tinged, just clear and goopy.
(Here I must add that have an intense distrust and even hatred of doctors and hospitals, and having to deal with a doc I had never met before really made me quite anxious.)

Had I don't know how many more internal exams and two ultrasounds. Put in bed flat on my back, hooked up to monitors. (Gee, wonder why labor didn't progress) Couldn't even unplug the stupid monitor to go pee without nurses rushing in to check on me! Baby was moving and had great heartrate all night long. We were both just fine, except for the fact I was in a hospital and my water had broken. Some 12 hours later, doc starts talking about risk of infection since my water had already broken, yadda yadda yadda, says he wants to try to "ripen my cervix" and gives me what he simply told me was "an ulcer medicine like reglan." (I later read in my records that it was at this point that he artificially ruptured my membranes. Yeah, but wasn't the risk of infection only because of all the vaginal exams I'd had? Turns out it was Cytotec he gave me, and I was never told about any of the risks of taking it or that it is not approved for inducing labor.) Even lets me eat a big breakfast, because by that point I was starving to death, and he thinks it will be about 8 more hours before baby is born.

Okay, baby's heartrate starts decelerating (which is a known side effect from the Cytotec doc had given me). First couple times were scary, but it went right back up. They decide to do internal monitors, since my contractions weren't showing up on the external monitor. The internal monitors hurt like HELL, I was only dilated 3cm (records state 2cm) at that point, and they didn't show anything the external ones weren't showing. My contractions were upside down on the graph, so they removed the internal monitors (OUCH) and re-inserted them into my cervix which was only dilated to two or three centimeters (DOUBLE OUCH) - it made no difference in the readings, by the way. (hmmm...maybe I should have requested a different monitor? That one had been on continuously for like 14 hours.) At this point, I gave in and let them catheterize me. No more trips to the bathroom to escape the dreaded bed and monitors. Then, baby's heartrate starts dropping, and keeps dropping no matter what I do or what the nurses do. One gets on the intercom and yells "any available doctor to labor room four, STAT!" We had some six nurses and two doctors in there rushing around, not telling us what was going on. All I knew was they turned the volume on the monitor way up so everyone could hear it, and those beeps kept getting farther and farther apart. DD's heartrate went from 160 down to 10 beats per minute. Doc said he suspected prolapsed cord and that we need emergency c-section or my baby will die, or at the very least have very low apgar scores and need to be in NICU, where I wouldn't be allowed to stay with her.

Fifteen minutes later, I'm being rolled into OR, given a shot of morphine directly into my spine, and cut open. Jenny was born with PERFECT apgar scores! As I am leaving the OR, I hear doc say to nurse, "you know, contrary to popular belief, I do *sometimes* have vaginal births." I was paralyzed from my armpits down and kept in recovery for three hours before being moved into a room. It was at least one more hour after that before I ever got to see or hold my baby girl.

The entire four days I stayed at the hospital, nurses kept bullying me trying to get me to leave her in the nursery, telling me not to let her sleep in my bed with me, pushing me into a feeding schedule, etc etc etc Not to mention barging in no less often than every two hours, day and night.

Ok, nearly three years after the fact I get a copy of my records. In them I read nothing about what I was told about a fear of prolapsed cord. I read that somehow I had given my informed consent to a number of procedures and medications of which I was neither informed nor to which I gave my consent. I recall now that the day I was discharged, nurse Ratchet comes in with a stack of papers to sign, many of them "informed consent forms" three days after the fact! I was reading out loud, and mentioned that I had never been informed about spinal anasthesia, that they told me a little about epidural, but not spinal. Well, evil nurse tells me to just sign it anyway, that they are the same. She tells me that if I want to go home, and if I want baby to go home with me that I'll sign those papers, and even tells me to leave the date blank... at that point I had no fight left in me, so I did what she said.

(click on the link in my siggie to read all about my incredible VBAC that couldn't have been more different than the birth of my first!)

[pamamidwife]

I'm not sure what Red's ideal situation is. Cesarean for every woman? Is that what "err on the side of caution" means?

I guess I don't understand her intention. It's not about natural birth. It's about INFORMED birth. Birth, just like life, is not predictable or always falling within well-laid plans. However, if you're educated and know your choices, you feel stronger in your decisions. I've heard from many women who may have chosen to have a c-sec in her position and then later wondered, "what if? did I need it - really?" I don't think it's so black & white.

But, alas, I was so confused after reading her post, that I thought I shouldn't respond. I guess maybe I shouldn't. But, I did. I may regret it.

[2+twins]

Stacy, wow - you went through a LOT! I wish I believed that situations like yours weren't happening every day in this country but it sure sounds like they are. I think it's just horrible how the doc's play the dead-baby card with moms. They know they can get whatever they want by saying that, regardless of the damage (psychological or otherwise) they do in the process.

I'm very sorry that the OP's dd has life-long side effects from her labor. I think she makes a reasonable point (women *should* be educated on the possibility and necessity of an emergency c-section), however lke Greaseball said OB's just aren't a source we, as laboring moms, can trust.

[oceanbaby]

You said the doctor said "maybe" a c-section? What does that mean exactly? If even the doc doesn't know if you should have a c-section, then how are you supposed to make the choice?

I purposely chose a doctor I felt I could trust mainly because if I was told I needed a c-section, then I wanted to know that it was really necessary.

I don't think many women fight against being told they need a c-section once they have been rushed to the hospital when hemorraging. I think most women here are interested in educating and empowering themselves to avoid situations/interventions that put them in the category of "needing" a c-section to begin with.

[QueeTheBean]

Stacy: all I can say is

1. :Puke

and

2.




Off to read your other story now!

[pumpkinhead]

I'm not trying to be deliberately obtuse here, but, Red, could you clarify this for me?

Since I did avoid surgery, it was good that I had no meds. The doc and midwives all agreed later that the meds may have been enough to tip the scales so that my daughter would not have recovered

Wouldn't the C/S have involved meds?

[Kiki Runs]

Originally Posted by pamamidwife

I'm not sure what Red's ideal situation is. Cesarean for every woman? Is that what "err on the side of caution" means?

I guess I don't understand her intention. It's not about natural birth. It's about INFORMED birth. Birth, just like life, is not predictable or always falling within well-laid plans. However, if you're educated and know your choices, you feel stronger in your decisions. I've heard from many women who may have chosen to have a c-sec in her position and then later wondered, "what if? did I need it - really?" I don't think it's so black & white.

But, alas, I was so confused after reading her post, that I thought I shouldn't respond. I guess maybe I shouldn't. But, I did. I may regret it.

ITA with your ENTIRE post, Pam. I didn't respond either. I think I'm PMSing, b/c the post just struck some sort of chord in me and made me see red. (pun not intended, really)

I ended up w/a c/s, and now to read "err on the side of caution" makes me . For me to err on the side of caution I should have stayed as far away from that hospital as I could. And now, b/c the doc supposedly "erred on the side of caution", I'm SCREWED as I look down the road. ONE doc's choice (yes, I went along w/it, but not willingly, and I hugely regret it, whereas I would bet everything I have that the doc thinks he made the right choice AND will do the exact same thing if an identical situation presents itself) will echo in my life w/every child I have. I can VBAC (assuming I can find a care provider who will accept me AND that VBACs are still "allowed"), yes, but I will always have some doubt in my ability to birth vaginally. And that COULD interfere w/a VBAC.

So, yeah, I'm not sure what the point of the OP was, but it sure fired me up, huh?

Kinsey

[rochellep3]

Informed birth

Hi,

I've never had a c/s and hope to never have one. But I have had shoulder dystocia and had dr's that I couldn't trust and didn't believe play the "dead baby card" on me. The result of this experience was for me to find dr's that I CAN trust, and then see them as rarely as possible (once a year, to maintain a contact.)

With my second birth I interviewed a number of midwives. There was one that I didn't really care for, and one I did, and the combination of what they had to say had a profound effect on me. The first midwife (who had a client lose a baby to shoulder dystocia) spent an hour trying to reinforce in me the necessity of MY taking responsibility for my birth. This is a very important concept that I hadn't thought about in that light before. She made it clear that birth is a life or death situation, and that truly informed births can only happen when we accept that.

The second midwife (who I chose to attend me) agreed, (though she attributed the other midwife's attitude to a temporary fear brought on by some bad outcomes) but was also very interested in maintaining faith throughout the process. And I am talking about religious faith here, which she and I share, but I think faith in the birthing process also applies.

With the baby that I am carrying now I really feel deep down inside that I have reached a point where I can do both. I can take responsibility for what happens to me and my baby, and I can do it with faith, in God and the birthing process. It is a very empowering process and feeling.

I hope I was able to express what I've been feeling. Unfortunately, we've all heard of people who die, or lose children, or suffer devastating injuries. And even worse, one day we may be one of those people, but that only strengthens the miracle that come with choosing to bear children.

Rochelle
Mommy to Meg 5/00, Peter 6/02, #3 due 8/04

[pamamidwife]

Rochelle, that was so beautiful, eloquent and true. Thank you.

[spatulagirl]

Maybe it is just me...

...but I find it almost insulting for someone to imply that because most women here are planning/searching/hoping/having a natural intervention-free childbirth that they aren't erring on the side of caution.

To me, even though I am having a hospital birth, planning a natural intervention-free chinldbirth IS erring on the side of caution. I trust my doctor to a certain extent, but I trust myself even more.

[pumpkinhead]

I wanted to say this before but wasn't sure if I should post it, but I guess I'm gunna .

Not one of us is guarenteed a healthy child. Not of us is assured of having a safe positive birthing experience or even of both mother and child surviving it. Not one of us can look into the future or look back into the past and say: If I hadn't done *this*, *that* wouldn't have happened. We can't do that! We can make educated guesses, but we just don't know! Miracles can happen just as surely as tragedy.

Red, I am sorry for your experience and I am sorry for your child's troubles, but there is really no way you can *know* that the outcome of a C/S would have been more desirable. On this same line, you cannot blame yourself for your daughter's troubles!! s

[Red]

First of all, I didn't mean anyone here wasn't 'erring on the side of caution' (I wish I could take that sentence back!) by having natural birth experiences. Or for wanting them! I certainly wanted one.

I had been reading here and on another site I frequent about some mothers who either a) felt that they'd had c-secs that might not have been necessary or b) were detirmined not to let ANY doc talk them into one.

I was, I thought, well educated on all the possibilities. My water had broken days before and I had refused the internal exams, and even baked my TP to sterilize it (a tip I read in Mothering !) THere was no sign of infection when I delivered 3 days later.

My point? Just to tell people that even if you had a c-sec and weren't sure if it was truly needed, if your child is here and safe, maybe thinking of the other possibilities would bring some consolation to them.

I do believe in each of us accepting respopnsiblity for our own birth experiences. And I have. I am to blame. I did not listen carefully enough, though of course I was not capable of doing my best under those circumstances, to what I was paying this individual to tell me. And I did not take the time to carefully pick an OB I could trust, I didn't plan on needing one.

The reason the c-sec meds wouldn't have hurt the babe as much, is because of the length of time involved. (I think, this was years ago) I believe the c-sec would have been done quickly, but pain meds would have been given over a number of hours. Also, the worst of the trouble came in the last hour or so. The c-sec was recommmended hours before that, while the babe was in better shape.

Sorry, I didn't mean to hit a chord, just to give my view. I don't think many women should have c-secs, but I do think you should be prepared to save your baby. Maybe it isn't life or death, but the difference between an easy life and fighting for every bit of education.

BTW, her Apgar was a 2 at birth. They didn't have her life-flighted because they were administering emergency procedures and didn't think she'd make the trip. SHe had a transfusion, oxygen, and was in my arms being snuggled about 3 hours later. The longest three hours of my life.

I held my c-sec twins just an hour after!

[pumpkinhead]

Red, this was *NOT* your negligence! The negligence came on the part of your OB. No, you weren't in a position to make descisions and OBs and Midwives are supposed to KNOW this! If that Doctor felt a C/S was completely necessary, he should have been more foreceful and completely explained the situation and the risks that could have arose. Did he do either of these things? Please don't blame yourself! s

[kama'aina mama]

This is one of the reasons I was glad I took Bradley. My husband knew a lot about birth... what was safe and normal and what was significant in terms of danger signs. I honestly believe that if anything like this had arisen during my labor he would have done a pretty good job of hearing what the docs were telling him and helping me understand and make a good decision.

[Greaseball]

I don't think many women should have c-secs, but I do think you should be prepared to save your baby.

Who is saying we aren't prepared? I don't know anyone who would not have a c/s that was truly life-saving. I wouldn't let anyone "talk me into" a c/s either; I'd do it only if there were some medical reason to do so. If there were such a reason, no one would have to talk me into it. I'd be all over it.

The fact is, most of the time when someone says a c/s was necessary, it wasn't. Even doctors admit that the 26% rate is not all for medical reasons.

If I wanted a second opinion, I'd talk to a midwife instead of a doctor. They have nothing to gain from a woman having surgery.

[Red]

Greaseball, I'm not saying YOU aren't prepared. I have no idea whether or not you are. Some people, like me, may not be. You say you don't know anyone who would refuse a life-saving c-sec? I do. I nearly did. Another few minutes and my baby would be a statistic. I'm just saying that in the heat of the moment SOME OF US (I'm sure I'm not the only one) may NEED a c-sec, and think we don't. THink it's unneccessary. I'm tring to point out that if you know your DH might not cope well in an emergency, you may want to have another person there.

My dh took classes, but he just freezes in any medical situation.

I had a midwife. One I really liked, who supported my decision 100%. I think there was some tension between her and the doc (both women, BTW). Everyone, midwife, doc, mother, father has an agenda. We alll have some idea of what we want. The midwife agreed with me. Both doc and midwife apologized afterwards.

Poor dh, I'd told him NOT to let them make me have a c-sec. Then I cried because I didn't.

[georgia]

Red,

Thank you for sharing your experience. What I take away from your post is the idea which reinforces my belief that every birth is normal until proven otherwise. I believe you wanted your post to help educate others. So, what I learned from your post is hemorraghing (sp??) would not seem to indicate everything's ok. No matter how much mellowing out drugs they'd want to give me, I can't assume things are going well if I'm bleeding out.

I am so sorry to hear about your feelings of blame---I believe that you were desperately doing everything you could to ensure her safe arrival. That's what mothers do! It seems like many of us internalize the message that NOT doing everything we're told is somehow not doing everything we can to keep our babies (and ourselves "safe"). Sadly, in obstetric care, the "things" that can be so lifesaving are also the most detrimental when used inappropriately. It's a scary line mothers are walking every minute of the day.

I wish there was a do-over on horrible birth experiences---I know I could use one!