Humanized Caesarean Birth: How do we help the 5-15% who will need a c-section? - Page 2 - Mothering Forums
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#31 of 111 Old 10-10-2010, 09:19 PM
 
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Um wow, this thread makes it sound like the woman who has a csection is doomed. Sure it can be dissapointing but dehumanized? Really? (Yeah I could tell from the OP you haven't had a c/s!!)

Personally my c/s done w/ the utmost respect and care as far as I could tell. My Dr's and MW did not dehumanize the experience for me or my babe in the least. No need to feel pity for us! I really pity those who feel they need to waste their energy onjudging someone else's experience!

Quite frankly this board all by it's lonesome made me feel like crap though about it all quite personally. Something I could have done without. All another part of the mommy wars though IMHO and who is doing what the "right" way..sigh.

I really truly am disgusted by threads like this.

Furthermore, I find the title of this thread really offensive and ridiculous. How about a halt on the judgement and pity that us c/s moms feel from those within the natural birth community? Support will go a lot farther in helping the poor c/s moms!

If you're REALLY worried about it why not trying to do something worthwhile like addressing malpractice insurance & hospital policies, etc. Stop victimizing the MOTHERS! It's not helpful!
Ok, I think this is a bit unfair to the OP. While I guess I'm not qualified to speak because I haven't had a c-section either, my interpretation of what she was saying is that in many instances that we hear about on this board and in other places, mamas are not treated well during and after c-sections. Not ALL the time, but enough that for many women it makes what is often a challenging situation worse. I know that personally (and I realized this very clearly while reading this thread), I am very fearful of having a c-section in large part because I am afraid of not being treated with respect because of the stories I have heard of, for example, docs making inappropriate remarks as if the woman is not in the room or awake, inappropriate music playing in the OR, doctors and nurses minimizing the experience or the woman's feelings about it, not being offered enough help with breastfeeding in the hospital, being separated from baby for hours unnecessarily, and on and on.

I do understand that there is a perception of abandonment of c/s moms by the NCB community and I think that there are definitely individuals out there whose words and actions have created that perception, and that needs to be worked on. But I think the OP's intentions here were pure.

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#32 of 111 Old 10-10-2010, 09:40 PM
 
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Sometimes it's just hard to hear moms who have not had a C/S discussing how to help us have a better experience, especially since many of here are very ok with how our C/S turned out and are not at all traumatized by the experience.
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#33 of 111 Old 10-10-2010, 09:51 PM
 
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My (emergency) c-section was a pretty good experience as these things go. I mean, it was surgery, I was pretty scared, the oxygen mask smelled awful, but the people taking care of me were respectful and communicative, and the surgery was the only way to make sure that DD and I both survived. We did what we had to do, we were well taken care of, we are all fine. This is good.

I find a lot of the suggestions for "family-centered" or "more natural" c-sections rather horrifying. Pushing the baby out with my hands? Good god in heavens no. My husband nearly passed out when I was given an epidural with my first baby. When I mentioned the possibility that we could look at my abdomen while it was cut open, he almost threw up. We did not want a natural c-section, we wanted extra sterile draping if it was available. And since, by the time my daughter was born, I was thoroughly traumatized by the sight of blood, I wanted her washed off first. So one of the things I think we need to keep in mind is that different people are going to want different things.

I agree that the armchair quarterbacking needs to stop.

One of the other things that needs to stop is the assumption that only a small proportion of those c-sections were necessary. Those WHO c-section guidelines have been quietly dropped - they aren't perfectly sure that 5-15% is an appropriate rate.
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#34 of 111 Old 10-10-2010, 09:55 PM
 
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Furthermore, I find the title of this thread really offensive and ridiculous. How about a halt on the judgement and pity that us c/s moms feel from those within the natural birth community? Support will go a lot farther in helping the poor c/s moms!

If you're REALLY worried about it why not trying to do something worthwhile like addressing malpractice insurance & hospital policies, etc. Stop victimizing the MOTHERS! It's not helpful!
Exactly!!!!
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#35 of 111 Old 10-10-2010, 10:07 PM
 
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"How do we help the 5-15% who will need a c-section?"

Get the rates down TO 5-15% so when someone hears "I had a c-section" the images of poor advice, over aggressive interventions, or, dare I say it, selfishness, do not play a part.

That was just my first thought when reading the title before I clicked on the thread. I think true support would be much easier if there were no unnecessary/completely preventable sections. On the part of those not directly involved (extended family, friends, "outsiders"), and on the part of the caregivers...meaning, if they weren't doing sections out the behind because so many were unnecessary, there would be more time to truly make it a positive experience for mum and baby.


Disclaimer: Yes, I said selfishness. NO I do not mean that all or even most women who have sections do it for selfish reasons, nor do I mean that all or most OBs do it for selfish reasons. BUT it is a factor that comes up on occasion ("too Posh to push" anyone? it's not the biggest reason by ANY means, but sometimes it IS a reason sometimes). I will admit, even if I turn heads in admitting this, that selfishness is sometimes on my list of assumptions when I hear someone has had a section. It's way, way down low, but it's there. I do not outwardly assume anything, but knowing the stats, I do automatically imagine many scenarios (most commonly, snowball interventions and impatient provider coupled with uninformed mum) because, fact is, half or more of cesareans aren't necessary and those are some of the reasons why.

Geez...I hope that made sense...and I really hope I don't get flamed...I shouldn't be allowed to post here when I'm THIS tired and pregnancy-brained.

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#36 of 111 Old 10-10-2010, 10:15 PM
 
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I also wanted to add, I felt abandoned by my natural birthing community after my section. My midwife didn't want anything to do with me post section, and when I walked in for my pp checkup, she seemed not to remember that I had even had a section. (asked how my vagina was healing?). She did not speak to my husband or I after the section, until the next day.
Heartbreaking. I've never had a section and I hope I never do and I am obviously a huge NCB advocate, but I feel a tremendous amount of love and respect for those who tried for a natural birth and ended up with a section. Those are the ones that often remind me that there ARE necessary sections that happen...and for a mum who wanted and prepared for and tried for the exact opposite outcome, it breaks my heart. If I were a midwife or doula or CBE, I can't imagine essentially "walking away" from my client at a time like that. That is a time when I would want to be with her even MORE, to remind her that she is still an amazing mother, and did an amazing job, and that she should be proud of herself.

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#37 of 111 Old 10-10-2010, 10:23 PM
 
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"How do we help the 5-15% who will need a c-section?"

Get the rates down TO 5-15% so when someone hears "I had a c-section" the images of poor advice, over aggressive interventions, or, dare I say it, selfishness, do not play a part.

That was just my first thought when reading the title before I clicked on the thread. I think true support would be much easier if there were no unnecessary/completely preventable sections. On the part of those not directly involved (extended family, friends, "outsiders"), and on the part of the caregivers...meaning, if they weren't doing sections out the behind because so many were unnecessary, there would be more time to truly make it a positive experience for mum and baby.


Disclaimer: Yes, I said selfishness. NO I do not mean that all or even most women who have sections do it for selfish reasons, nor do I mean that all or most OBs do it for selfish reasons. BUT it is a factor that comes up on occasion ("too Posh to push" anyone? it's not the biggest reason by ANY means, but sometimes it IS a reason sometimes). I will admit, even if I turn heads in admitting this, that selfishness is sometimes on my list of assumptions when I hear someone has had a section. It's way, way down low, but it's there. I do not outwardly assume anything, but knowing the stats, I do automatically imagine many scenarios (most commonly, snowball interventions and impatient provider coupled with uninformed mum) because, fact is, half or more of cesareans aren't necessary and those are some of the reasons why.

Geez...I hope that made sense...and I really hope I don't get flamed...I shouldn't be allowed to post here when I'm THIS tired and pregnancy-brained.
A study just came out this week saying that "too posh to push" is a myth.

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#38 of 111 Old 10-10-2010, 10:39 PM
 
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Heartbreaking. I've never had a section and I hope I never do and I am obviously a huge NCB advocate, but I feel a tremendous amount of love and respect for those who tried for a natural birth and ended up with a section. Those are the ones that often remind me that there ARE necessary sections that happen...and for a mum who wanted and prepared for and tried for the exact opposite outcome, it breaks my heart. If I were a midwife or doula or CBE, I can't imagine essentially "walking away" from my client at a time like that. That is a time when I would want to be with her even MORE, to remind her that she is still an amazing mother, and did an amazing job, and that she should be proud of herself.
The thing is, most women (at least who I know, and certainly most here on MDC) who ended up with c-sections did want and try for a natural birth. They didn't go into labor hoping for tons of interventions, yk? So, I guess, maybe it should just be assumed that all women who have had c-sections hoped not to. Then maybe that same compassion and understanding can be implied - and no, feeling sorry for us, generally, isn't a helpful form of empathy.

I sometimes wish there was a support thread for women who, while they didn't wish to be included in the c-section statistics, came out of it okay. We all aren't traumatized and left feeling unworthy. Yes, the HCP's and supporting staff at the hospital play a huge role in that outcome, but other people - namely other women - have a big part in the difference with how we deal with the aftermath and any ensuing emotions surrounding how our children were born.

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#39 of 111 Old 10-10-2010, 10:42 PM
 
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A study just came out this week saying that "too posh to push" is a myth.
Not to mention, it's really a subjective thing. If a woman is seriously so afraid of pushing a baby out that she'd rather have major abdominal surgery, is it really "selfish?" Obviously there's something going on there. And, of course, I have to point out that UC is often viewed as a "selfish" decision. So does that make it true?

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One of the other things that needs to stop is the assumption that only a small proportion of those c-sections were necessary. Those WHO c-section guidelines have been quietly dropped - they aren't perfectly sure that 5-15% is an appropriate rate.
Yes. AFAIK, there was no real basis for the 5-15% number. And again, the idea of "necessary" is subjective. The criteria for "necessary" generally laid out by the NCB community are pretty stringent and unforgiving. Even in cases where mom or baby (or both) were clearly in serious danger, I often see second guessing.

And, while I acknowledge and respect that there are women who have been traumatized by their experience with c/s, many women haven't and aren't interested in being "healed" because they just don't need it.

And Lord, yes, the whole "natural c/s" thing sounds horrifying to me! In theory it sounds fine if mom wants it, but I can't imagine that most women want to see themselves cut open or push their baby out through their incision. My birth plan has options for c/s and the closest I get to "natural c/s" is to have the drape lowered just enough so I can see the baby coming out (but not far enough to see myself sliced open!)
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#40 of 111 Old 10-10-2010, 10:57 PM
 
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And Lord, yes, the whole "natural c/s" thing sounds horrifying to me! In theory it sounds fine if mom wants it, but I can't imagine that most women want to see themselves cut open or push their baby out through their incision. My birth plan has options for c/s and the closest I get to "natural c/s" is to have the drape lowered just enough so I can see the baby coming out (but not far enough to see myself sliced open!)
I would not have been down with that (seeing it all clearly or helping pull the baby out some how). No, I don't want the drapes lowered to see what I look like cut open and bloody, no, I wouldn't want to feel anything more than the tugging and pressure on my chest I didn't enjoy, as is. It took me a while to look at the pics my mom took of my sections, and even then, I don't really want to see more than my babies heads being pulled out. I'm grateful I have them, and grateful that the anesthesiologist (it really is 'his' OR, so his decision), let my mommy be in there with DH there, too. But no, I don't know about wanting a more natural c-section - to me, that conjures up images of doing it drug-free (ha!) no, thanks!

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#41 of 111 Old 10-10-2010, 11:04 PM
 
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One of the reasons that the c-section rate is as high as it is in the U.S. is that we, as a society, are incredibly litigious. In the event that an infant is injured during a birth, the doctor and the hospital want to be able to tell the court that they did everything they could - and a c-section is really convincing in court.

So why are we such a litigious society, and what could we do to change that?

My theory is that we are so very lawsuit-happy because the social safety net in the U.S. is so very lacking. Were I to have a child permanently disabled by a birth injury, I do not know how I would support and care for that child with my current resources. But I could sue and probably get enough in a settlement to assure that I could leave my job, and arrange for my child to be cared for for life.

So here's suggestion number one: I think that universal, single-payer health care would help lower the litigation rate, and the c-section rate. I think that meaningful social services, better parental leaves, and more available part-time work would help. I think that until we, as a society, make a formal commitment to better care for all of our children, we are going to see undesirable obstetrical outcomes, like questionable use of surgical deliveries, and surgical deliveries that are pushed despite patient objections.

Overuse of c-sections is one symptom of an extremely large problem. This problem did not originate with any individual pregnant woman, and it cannot be solved in the delivery room.
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#42 of 111 Old 10-10-2010, 11:24 PM
 
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One of the reasons that the c-section rate is as high as it is in the U.S. is that we, as a society, are incredibly litigious. In the event that an infant is injured during a birth, the doctor and the hospital want to be able to tell the court that they did everything they could - and a c-section is really convincing in court.

So why are we such a litigious society, and what could we do to change that?

My theory is that we are so very lawsuit-happy because the social safety net in the U.S. is so very lacking. Were I to have a child permanently disabled by a birth injury, I do not know how I would support and care for that child with my current resources. But I could sue and probably get enough in a settlement to assure that I could leave my job, and arrange for my child to be cared for for life.

So here's suggestion number one: I think that universal, single-payer health care would help lower the litigation rate, and the c-section rate. I think that meaningful social services, better parental leaves, and more available part-time work would help. I think that until we, as a society, make a formal commitment to better care for all of our children, we are going to see undesirable obstetrical outcomes, like questionable use of surgical deliveries, and surgical deliveries that are pushed despite patient objections.

Overuse of c-sections is one symptom of an extremely large problem. This problem did not originate with any individual pregnant woman, and it cannot be solved in the delivery room.
It's not so much a theory as that you are absolutely right It is a major reason why we are so litigious.

When the powers that be talk about "tort reform," what they're usually actually talking about is restricting even further a potential safety net that people have if a large company does them wrong.

A perfect example is the infamous McDonald's coffee case. As much as people like to bring it up as an example of a superfluous lawsuit brought by a woman too dumb to know that coffee=hot, the reality is far more complicated. McDonald's had fielded hundreds upon hundreds of complaints about the heat of their coffee, and were well aware of the problem but thought it was cheaper to just pay out small settlements when things went wrong than it actually was to fix the problem by recalibrating their machines. The woman had no medical coverage, and suffered third degree burns to her inner thighs and labia, requiring extensive skin grafts and surgery. She attempted to settle out of court, and they offered her something like $2000. That would probably cover the asprin she received while in the hospital. So she sued, to recoup her medical expenses. It's actually the perfect example of tort law doing exactly what it was supposed to do.

I can pretty much guarantee that unless you are extremely wealthy, if your child's birth went wrong to the extent that they would need lifelong medical care because of the doctor's or the hospital's actions, you WOULD sue. (Not you specifically, MeepyCat. I mean the universal you: anyone reading this thread). No matter what you think of "frivolous lawsuits," even if you harbor no anger towards the hospital, even if you understand that accidents happen. Because that is how the system is set up. If your child will need 2 million dollars worth of care over her lifetime, and you don't happen to have that, then your only choice is to get the money from a source that you're legally entitled to seek restitution from. That's the system as it exists, and there isn't really any way around it.

Ensuring that every American has good health insurance would go a really long way towards this tort reform we always hear about.

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#43 of 111 Old 10-11-2010, 12:27 AM
 
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The only time I felt de-humanized was from her blatantly rude and insensitive comments, gimme a break, I had a baby, things didn't go as planned, don't go into how holier than thou you are. Let it go and let me be, and don't make me feel badly for the decisions I made for the safety of my baby and myself.
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#44 of 111 Old 10-11-2010, 12:39 AM
 
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Heartbreaking. I've never had a section and I hope I never do and I am obviously a huge NCB advocate, but I feel a tremendous amount of love and respect for those who tried for a natural birth and ended up with a section. Those are the ones that often remind me that there ARE necessary sections that happen...and for a mum who wanted and prepared for and tried for the exact opposite outcome, it breaks my heart. If I were a midwife or doula or CBE, I can't imagine essentially "walking away" from my client at a time like that. That is a time when I would want to be with her even MORE, to remind her that she is still an amazing mother, and did an amazing job, and that she should be proud of herself.
shockingly, it's more common than you think. I had a bradely instructor who didn't reply to my email about how much her class had helped us, even though we had a section (regarding bfing etc). I sometimes wish I had a doula, (someone to talk to besides my husband and mom who get teary talking about the birth, even a year later), but I remember interviewing a doula who said that she wouldn't stick around for the birth if I got an epidural, because what would there be for her to do?

I wonder if we had hired someone else, if they would have even been there for us. I think this attitude is really common-- "I love attending births, natural birth is so beautiful!" Yes, yes I'm sure it is, but mom's whose birth doesn't fit the ideal deserve to supported as well.

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#45 of 111 Old 10-11-2010, 01:11 AM
 
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I, too, have not had a c/s, but I know that if I were to have one, the biggest thing for me would be feeling like my voice was heard. So in supporting my friends who have had c/s, those who had vaginal births, and those who have had a major surgery, I ask the same questions: how do you feel about how things went? Anything you want to talk about? Anything I can do to help you? Letting moms talk honestly about their experience, without feeling like they are being judged, goes a long way.

As an individual, I think the best we can do is educate ourselves and our community about birth and postpartum care so that moms birth their babies in the best way possible. And we also need to realize that the best way is an individual thing, and includes NCB, epidurals, c-sections, vacuum assisted birth and more. While I might feel an intervention is not right for me, it might be best for your family, your body, and your baby.

Humanizing birth means realizing humans are involved, and therefore one size, one type of birth, and one way of doing things will never be right for everyone.

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#46 of 111 Old 10-11-2010, 01:25 AM
 
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Heartbreaking. I've never had a section and I hope I never do and I am obviously a huge NCB advocate, but I feel a tremendous amount of love and respect for those who tried for a natural birth and ended up with a section. Those are the ones that often remind me that there ARE necessary sections that happen...and for a mum who wanted and prepared for and tried for the exact opposite outcome, it breaks my heart. If I were a midwife or doula or CBE, I can't imagine essentially "walking away" from my client at a time like that. That is a time when I would want to be with her even MORE, to remind her that she is still an amazing mother, and did an amazing job, and that she should be proud of herself.
I can tell you from personal experience that the NCB is pretty quick to walk away from women who have neonatal losses due to birth complications too, even when the delivery was vaginal.

And after losing my first child to a cord accident I was pretty clear that I was going to err incredibly far on the side of the 'possibly unnecessary' c-section with my second, and I ended up with three doulas turning me down. A fourth would have but we were burnt out by that point. Incidentally I didn't have a c-section in the end.

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My theory is that we are so very lawsuit-happy because the social safety net in the U.S. is so very lacking. Were I to have a child permanently disabled by a birth injury, I do not know how I would support and care for that child with my current resources. But I could sue and probably get enough in a settlement to assure that I could leave my job, and arrange for my child to be cared for for life.
As someone who dropped a lawsuit about not having a c-section done and losing a baby, but in Canada, I can say that yes, if my child had been alive to be permanently disabled I would have pursued it fully despite the (incomplete) social safety net.

And I would have had no concern whatsoever about driving c-section rates up because my concern would have been for my child and tough. And I see that as entirely appropriate.

We can all agree that amputation isn't something that should be done lightly, but we can also agree that if an amputation that is clearly necessary isn't performed and the patient dies, that is an issue around standard of care.

So I'm a bit uncomfortable saying that it's a problem with parents whose children are genuinely disabled's faults (along with lack of safety net) for being litigious.

Because we were only suing for damages to us as parents we learned that the highest award ever in my province for an obstetrical screw up resulting in the actual death of a baby was $150,000 at that time ($75k per parent), and that's not missing a zero. Canada has been pretty hard-core about not upping punitive damages. And the insurance companies have been pretty hard-core about not settling easily and fighting them as hard and long as necessary.

So I think there's an argument to be made that allowing large punitive damages (as opposed to just working out how many millions it will take to fix a lifelong mistake) does impact inappropriately on decision making.

However our decision to drop the case wasn't because we weren't going to be millionaires. It was mostly because we didn't believe that $150k was going to be any incentive for the hospital to change its poor practices. So instead we pursued it in other ways and did, on paper anyway, get some changes. We also dropped it because I was pregnant and we didn't want to be in that adversarial situation at that point.

This particular hospital had an excellently low c-section rate, which is why we chose it - and although I have no proof I do kind of believe one reason my daughter died was that they had had a few c-sections that day and were trying to avoid driving their rates up.

This is one reason I don't believe medical decisions should be made solely or even mostly on statistical rates. I think if a hospital has a high c-section rate they should look at why, but there may be factors (like being a high-risk magnet) that make a higher than average rate completely appropriate.

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#47 of 111 Old 10-11-2010, 02:35 AM
 
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The question I'm having more and more on these threads is...what about the women who are traumatized by our c/s? It's starting to sound an awful lot like we should just shut up, because otherwise, we might add to that oh-so-bizarre NCB attitude that c-sections are traumatic. Someone right on this thread was being all "dehumanizing? Really?" as though the idea that a c-section could be dehumanizing is just over-the-top.

Yes. Dehumanizing. Really. If your c-section wasn't, good for you.

I just want to be clear. Are those of us who were traumatized by dehumanizing, disrespectful, and quite probably unnecessary c-sections supposed to just shut up and go sit in the corner? Because, I'm really starting to get that impression in a big way.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
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#48 of 111 Old 10-11-2010, 09:45 AM - Thread Starter
 
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I apologize for how my words may have been misconstrued. My intention is to try to work within my community to get protocols in place that would help women and families who have caesarean births, regardless of how needed or unnecessary that surgery is. If you personallly feel like your caesarean birth happened in a way that respected your rights as a woman and a mother, great! But I know that there are women who have felt depersonalized by the process of surgery, regardless how how necessary that surgery may have been, and no mother should have to deal with that.

I agree that care provider is probably the biggest factor here, but I still would like to do what I can to try to help there be more compassionate standard protocols in place. Right now there isn't much of a bottom in terms of how poorly a woman can be treated, and that is something I would like to see addressed. I don't mean to say that every woman should be pushing on incisions, etc. I'm not trying to write people's birth plans for them.

But I do want to look for ways to work on the institution level to guarantee certain minimums in particularly non-emergency situations, including maternal participation insofar as mom wants to do X, Y or Z and it is medically appropriate. Mainly at this point I'm thinking about logistical things like how maybe it would help to have target times to see how quickly a medically fine baby can get to mom or mom's support person after birth. Part of my concern is that Suzie Mainstream may not want a c-section, may still get one and not know what options she could be asking for with regards to surgery but which might make a difference for her in terms of how she experiences her c-section as more or less traumatic.

Thank you to all who have participated.

Catholic wife in love.gifwith my husband, mom to superhero.gifx5,  babygirl.gifx2, angel1.gifx6. Birther of babes, baker of bread, and connoisseur of human folly. WINNER OF THE SILVER BIRTH STOOL, APRIL 2010 DDC! Happily hospital birthing with my BFF, Epidural Man.
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#49 of 111 Old 10-11-2010, 10:03 AM
 
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I hardly believe 5-15% of c/s are dehumanizing. SO yes I asked the question REALLY? Because really? Are there that many victims? According to who? THose that want to feel sorry for c/s moms? I Have seen over and over moms become victims of the natural childbirth community attitudes though. Moms who were handling their experiences fine until they are repeatedly told they did the wrong thing or are continually pitied.

I think the trauma of having a c/s is slim and made out to be MUCH more than it is here. It's dehumanizing a whole lot of births and mamas though to keep up with the judgement displayed here right on this thread IMHO. There are many of us that don't want pity or to be discussed or to be told "What we should have done". Some of us are actually FINE with the choices we have made. That's just really disgusting and what is completely over the top. Not the small percentage of those that suffered trauma.

It's really like any hospital experience. They aren't all great. Some fantastic. Some awful. That is life. This thread is a perfect example of that. THe majority had ok experiences. Some didn't and that sucks but you don't need to lump together ALL c/s moms because of that.

No one said shut up and go sit in a corner and cry about your c/s, but in all honestly therapy may suit you much better and be more useful than arguing about it on a message board that is so quick to judge and where facts and experiences are highly skewed & experiences some have never even had clouded at times.


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Originally Posted by Storm Bride View Post
The question I'm having more and more on these threads is...what about the women who are traumatized by our c/s? It's starting to sound an awful lot like we should just shut up, because otherwise, we might add to that oh-so-bizarre NCB attitude that c-sections are traumatic. Someone right on this thread was being all "dehumanizing? Really?" as though the idea that a c-section could be dehumanizing is just over-the-top.

Yes. Dehumanizing. Really. If your c-section wasn't, good for you.

I just want to be clear. Are those of us who were traumatized by dehumanizing, disrespectful, and quite probably unnecessary c-sections supposed to just shut up and go sit in the corner? Because, I'm really starting to get that impression in a big way.

Blissful Mama to DD-(5), DS-(6) and someone new due in November!
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#50 of 111 Old 10-11-2010, 11:27 AM
 
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The question I'm having more and more on these threads is...what about the women who are traumatized by our c/s? It's starting to sound an awful lot like we should just shut up, because otherwise, we might add to that oh-so-bizarre NCB attitude that c-sections are traumatic. Someone right on this thread was being all "dehumanizing? Really?" as though the idea that a c-section could be dehumanizing is just over-the-top.

Yes. Dehumanizing. Really. If your c-section wasn't, good for you.

I just want to be clear. Are those of us who were traumatized by dehumanizing, disrespectful, and quite probably unnecessary c-sections supposed to just shut up and go sit in the corner? Because, I'm really starting to get that impression in a big way.
I think you're misinterpreting the objections posted in this thread. No one has said that all c-sections are not dehumanizing, and I certainly haven't seen anyone imply that a woman dealing with trauma from a c-section should just "shut up and go sit in the corner". I do think, however, that to frame a discussion as "humanizing cesarean birth" assumes de-humanizing experiences as the norm, which I think is inaccurate. It's not the idea of a traumatic experience itself that's over the top, it's the characterization of that trauma as the norm. Because then it's easy to fall into a depiction of c-section moms as victims, which, while sometimes true, is not true in a majority of cases.
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#51 of 111 Old 10-11-2010, 11:52 AM
 
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I hardly believe 5-15% of c/s are dehumanizing. SO yes I asked the question REALLY? Because really? Are there that many victims? According to who? THose that want to feel sorry for c/s moms? I Have seen over and over moms become victims of the natural childbirth community attitudes though. Moms who were handling their experiences fine until they are repeatedly told they did the wrong thing or are continually pitied.

I think the trauma of having a c/s is slim and made out to be MUCH more than it is here. It's dehumanizing a whole lot of births and mamas though to keep up with the judgement displayed here right on this thread IMHO. There are many of us that don't want pity or to be discussed or to be told "What we should have done". Some of us are actually FINE with the choices we have made. That's just really disgusting and what is completely over the top. Not the small percentage of those that suffered trauma.

It's really like any hospital experience. They aren't all great. Some fantastic. Some awful. That is life. This thread is a perfect example of that. THe majority had ok experiences. Some didn't and that sucks but you don't need to lump together ALL c/s moms because of that.

No one said shut up and go sit in a corner and cry about your c/s, but in all honestly therapy may suit you much better and be more useful than arguing about it on a message board that is so quick to judge and where facts and experiences are highly skewed & experiences some have never even had clouded at times.
to all of the above.

This conversation would not be happening and would not have garnered so much interest if the default attitude of the NBC weren't "if you had a C section, you did something wrong and/or are to be pitied." Saying that this attitude is not always appropriate is hardly telling someone to shut up and go sit in the corner.

I am sorry that you had a really traumatic experience, Storm Bride. Respectfully, I feel that traumatic experiences relating to C sections are more than represented in this community, and are assumed to be the default in the NCB community as a whole. And it's not something that I identify with, personally. And I, again personally, don't know anyone in real life who feels that way either. I do know several mothers who were severely traumatized by the very PROSPECT of a C section, because of all the things that they've heard about "dehumanization" and how it would all be their own fault and the risks related. I count myself among that group, actually. I don't see how this is a healthy mentality to saddle pregnant women with. And I think that suggesting that some of us aren't allowed to say "hey, you know, I would have preferred a vaginal birth, but life got in the way, and it wasn't actually so bad, and the only thing that matters to me is the healthy baby I got, and that's just the way the cookie crumbles" is, in a way, dehumanizing in and of itself.

Trying to live a simple life in a messy house in a complicated world with : DH, DD (b. 07/07), DS (b. 02/09), and DD (b. 10/10)
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#52 of 111 Old 10-11-2010, 12:00 PM
 
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The question I'm having more and more on these threads is...what about the women who are traumatized by our c/s? It's starting to sound an awful lot like we should just shut up, because otherwise, we might add to that oh-so-bizarre NCB attitude that c-sections are traumatic. Someone right on this thread was being all "dehumanizing? Really?" as though the idea that a c-section could be dehumanizing is just over-the-top.

Yes. Dehumanizing. Really. If your c-section wasn't, good for you.

I just want to be clear. Are those of us who were traumatized by dehumanizing, disrespectful, and quite probably unnecessary c-sections supposed to just shut up and go sit in the corner? Because, I'm really starting to get that impression in a big way.
Are all of us who had positive experiences with our c-sections supposed to just shut up and go sit in a corner? Because the exact same thing comes across pretty clearly when others can't imagine how I could be at peace with my c-sections and feel they were handled well. It must mean I don't have sympathy for someone else's plight. Or more often it must mean that I'm a mindless ninny who belies everything the medical community tells me. Or I'm delusional and clearly don't know how I felt about the process.

I had a wonderful c-section experience with my doctor communicating with us wonderfully (both doctors since my original family practice doctor had to turn my care over to the surgeon once a c-section became necessary). I had a surgical staff that completely rearranged the plan for surgical team placement in the operating room once they realized that one of the nurses was my college roommate (she was given the sole job of staying by my head and communicating with me and making sure I was okay).

I find it sad that other's experiences weren't as positive. But that doesn't mean that someone who had a bad experience is less credible or lacking if they didn't. Heck even if they would have had the exact same experience but perceived it differently that is okay too.

Basically, what I think many people on this thread are saying is that as much as you hate it when people devalue your c-section experience we hate it just as much.

In answer to the OP's question - the number one thing that I feel can make a c-section a positive experience is communication. Women want to know what's going on and why. If they have a choice in something they want to make that choice. If they don't have a choice they want the reason why clearly explained to them. Outside of communication I don't think their is any other thing that would universally fit every c-section mama.

I also think that reserving judgment from random friends and strangers about c-sections would go a long way as well.

Mom to DS 4/24/03 and DD 4/17/06
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#53 of 111 Old 10-11-2010, 12:36 PM
 
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I had one c-section I would consider fairly traumatic and one which was great. The traumatic one was due to being in a foreign country and unable to speak the native language. I thought I was going in to have the heart beat checked. There was a problem with the heart rate during mild contractions, then a failed induction and then a surprise c/s. I did luck out in getting a British anesthesiologist, but I couldn't understand the OB or nurse and they couldn't understand me. The anesthesiologist did his best to tell me what was going on, but I was still very uncomfortable and scared. A lot of it was my failure to be prepared for a c/s because I never even considered that I might not have the vaginal birth I was expecting.

The second one was in the US and much more comfortable. It was planned 2 days in advance and I had a lot of input into what happened.

things that made it better:

communication
someone paying a little attention to DH and letting him know what was going on - his uncertainty and fear in the first one didn't help to comfort me at all
DH and the baby staying with me
DH, baby and me in a private room for 3 days
everybody moved to my room for recovery the minute I was stitched up -the doctors and nurse sat at a little table in my room filling out their paperwork and asking me any questions they had while I got to hold and love on my new baby with my DH

During the procedure itself there were a few things that made a difference and all were due to the anesthesiologist portion of the procedure. The British one used an aerosol can to numb the injection site on my spine. In the US I had a nurse standing right next to me and looking over my shoulder during the spinal, but nothing to numb the site. She whispered in my ear everything that was happening and rubbed my knee while it was going on. I found that very comforting.

I'm always scared that they are going to start cutting and I'm going to feel it. I had two different techniques used to verify that the spinal was numbing high enough. The British guy took the aerosol can he had used to numb the injection site and started spraying my belly and working up to my breast. He told me to tell him when it felt cold. That was easy.

The US lady took a needle and started poking me with it on the belly and working her way up. She wanted me to tell her when it got painful. I had a really hard time telling the difference between just feeling it and feeling a little pain.

Another big difference was pain medication. I had only the spinal and had to beg for some pain meds when that started to wear off. They were pushing on my incision to get the blood clots out and it hurt so bad. I couldn't even enjoy my baby because of the pain. A nurse came in talking about the baby and I forgot for a minute that I had even had one an hour before.

In the US I had morphine directly in the spinal. I was in no pain for the first 24 hours and I got to enjoy that first day and night with my baby and husband.

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#54 of 111 Old 10-11-2010, 12:49 PM
 
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One of the reasons that the c-section rate is as high as it is in the U.S. is that we, as a society, are incredibly litigious. In the event that an infant is injured during a birth, the doctor and the hospital want to be able to tell the court that they did everything they could - and a c-section is really convincing in court.

So why are we such a litigious society, and what could we do to change that?

My theory is that we are so very lawsuit-happy because the social safety net in the U.S. is so very lacking. Were I to have a child permanently disabled by a birth injury, I do not know how I would support and care for that child with my current resources. But I could sue and probably get enough in a settlement to assure that I could leave my job, and arrange for my child to be cared for for life.

So here's suggestion number one: I think that universal, single-payer health care would help lower the litigation rate, and the c-section rate. I think that meaningful social services, better parental leaves, and more available part-time work would help. I think that until we, as a society, make a formal commitment to better care for all of our children, we are going to see undesirable obstetrical outcomes, like questionable use of surgical deliveries, and surgical deliveries that are pushed despite patient objections.

Overuse of c-sections is one symptom of an extremely large problem. This problem did not originate with any individual pregnant woman, and it cannot be solved in the delivery room.
Yup, this. In addition, universal single-payer healthcare would allow women to receive consistent prenatal care which does help to identify problems early and head them off at the pass, before they get to the point where it's only surgery that can ensure the safety of mom & baby.
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#55 of 111 Old 10-11-2010, 01:18 PM
 
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Thanks, OP, for starting this thread. I hope we can keep the conversation open.

I would love to get away from the dualistic thinking. There are not 2 kinds of births (vaginal & c-section). There are not 2 kinds of c-section (respectful/positive and traumatic/dehumanizing). There are many, many kinds of births. A birth isn't just one thing. It's a series of things, a whole bundle of things, some of which may be empowering and others not, some of which are easy to understand & others not. There isn't just one way to respond to a particular kind of birth. Some women have hard feelings about their birth, others don't, and many of us have a bunch of feelings that sometimes contradict each other. Trauma is in the eye of the beholder. So is happiness with a particular outcome.

What I appreciate on MDC is a safe space where we can share what we experienced and listen to what others experienced. That's how I define "support." My perspective is that the support gets harder to provide when we try to simplify things too much and determine how things "should" be. I'm an advocate of allowing the complexity & ambiguity of our experiences to stand for themselves and to not be too eager to moralize or distill things into a clear message. That may not be politically expedient, but I'm not here for the politics. I'm here for support and I get it by being reminded of the full range of human experience.

Back to the OPs original question....one thing that would have helped mitigate some of the more traumatic aspects of my c-section would have been post-partum care that took my whole person into account. I definitely felt that because my scar was healing and I was eating/pooping/peeing/walking, my care providers assumed that I was "doing well." No one seemed too interested in my emotions or my ability to be an effective parent to a newborn. But those were the things that were really NOT doing well.

I also wish that I had had the option of having a conversation with someone who was there about what happened during my labor leading up to the decision to do the c-section. Perhaps one of the nurses or the resident. I don't know, perhaps I was too tired & freaked out to have that conversation. And of course I was very focused on my baby. But later I wished that I'd at least had the opportunity to talk to someone from the hospital about what had happened and to get some perspective from someone who was there. It still feels weird to me that I went through one of the most difficult and painful episodes of my life with all these strangers.

There are lots of other things I can say, but for now I'll just add: thanks to everyone for having the courage to speak your truth.

Living in Wisconsin with my partner of 20+ years and our DDenergy.gif(Born 10/09/08 ribboncesarean.gif). Why CI Mama? Because I love contact improvisation!

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#56 of 111 Old 10-11-2010, 01:23 PM
 
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So I'm a bit uncomfortable saying that it's a problem with parents whose children are genuinely disabled's faults (along with lack of safety net) for being litigious.
I think it's important to note about my argument that I don't think that it's the fault of people who sue that the society is litigious. I really think that there are places where loving parents don't have better choices, where they are pursuing the ability to do right by their kids in a bad situation. I am always going to support parents in doing that. Litigiousness is not a problem with parents, litigiousness is the natural result of a large, systemic problem.
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#57 of 111 Old 10-11-2010, 02:18 PM
 
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Sometimes it's just hard to hear moms who have not had a C/S discussing how to help us have a better experience, especially since many of here are very ok with how our C/S turned out and are not at all traumatized by the experience.
I find here on MDC I am mum on my 2 C/S as because either one is painted as the victim or "uneducated" about the system and should've known better.

I mean no disrespect to the OP as I think the question is an interesting one. I do agree the choice of language is off-putting, but the intent I think is in the right place. I know as a doula, one of the points I am going to focus on with birth planning is to make sure each mom walks through all possible scenarios of what could happen and identify their needs so we can advocate for them appropriately.

For me - the best parts of my last section was:
  1. Communication with my MD, which then built respect and trust for my requests
  2. Knowing the players, having a plan and executing (ie. who to ask/ anesthesiologist for my doula to come in) with support from the hospital staff.

ETA: to add CI Mama's recommendation for post-partum care for C/S moms. Again this is an element overlooked I think by major CBE and Doula educational organizations i.e. specifically for C/S moms.

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#58 of 111 Old 10-11-2010, 03:03 PM
 
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I really do think that much of it does have to do with where you birth, and how your own attitude is towards birth in general. I mean for me I was in a wonderful hospital, part of my personality would have liked the comfort of a homebirth, but given where I live(45 minutes away from any hospital) I believed the safest place was in the hospital, I made the choice to be in our local "baby-friendly" hospital, which has both Dr and midwives practicing. It felt like the right decision.

My attitude from the beginning was things happen, sometimes even with the best preparations, life is unpredictable, birthing is unpredictable-sometimes women have easy births-some like me have unknown issues that don't come to the forefront until labor is well underway.

I think this honestly is VERY dependent on your own personality, I'm a go-with-the flow girl. I was prepared in my mind that if it came down to a C/S that I'd go with it and never look back. This is me, I don't expect anyone else to feel like I do. Some women do feel violated, have PTSD, have deep seeded anger toward the whole thing-those feelings are valid. My feelings of being thankful and joyful should be too. It's my baby's birthday, a new chapter in my life. For me my team was amazing, but I live in a small town with both C/S there were nurses I know personally, with DS I was friend's with our nurse. It was a family experience-and that is unique, most women don't get the kind of care I did. I mean there were only 2 women who had babies in my little hospital, so our care was impeccable.

Like I said before I never felt badly until our local MW said the ONLY reason was I was scared, it peeved me to no end(obviously it still does). She was not my care provider, nor there-so back off and keep your opinions to yourself.

Me Wife to T (14 years)Mama to Princess(4) and Monster Boy(my 1 year old ):
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#59 of 111 Old 10-11-2010, 04:02 PM
 
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I think a lot of the trauma of a c/s might be more related to surgery issues than to the actual c/s. A lot of my issues with c/s would be true of any surgery. Especially one I need to be awake for.

I've had 2 c/s. One that I believe was completely unnecessary (OB was pushing c/s 8 hrs into an induced labor!) and one that was necessary (ds started crashing between contractions).

The major difference between the two was that the second one was NOT coerced, the anesthesiologist was MUCH better (apparently I'm a lightweight and am too easily over-anesthesized), and they let my husband in pretty fast unlike the last time.

I do feel judged for having a c/s, but not just from the NCB community. Mainstream wise, I feel like there isn't enough acknowledgement that a c/s is MAJOR surgery. The lack of help right after my surgery was amazing. The nurses pretty much left me alone. I remember one night, ds was screaming in his bassinet and I paged a nurse, asking for help getting him out. NO ONE CAME. That is traumatizing.

Also, I think a lot of people, and it's not just limited to the NCB, see a woman who has had a c/s or more than one as inherently 'broken'. From judgments about how many c/s are ok (aka how many kids one can have), to asking 'why' one was needed, etc. All seem to put a lot of the blame on the woman herself. I am sure I could have birthed both of my babies. However, with my new one, I'm not sure if I would have been able to take him home. Of course, having lost a child before, there are the same judgments that somehow something must be wrong with *me*/my body. Because these things don't happen to those who do things right.

I think that better post-op treatment will also go a looooooong way to making a c/s more 'humanizing'. It's amazing how much more supportive nursing staff/family are with other major surgeries, yet somehow c/s don't count?

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I would love to get away from the dualistic thinking. There are not 2 kinds of births (vaginal & c-section). There are not 2 kinds of c-section (respectful/positive and traumatic/dehumanizing). There are many, many kinds of births. A birth isn't just one thing.

Back to the OPs original question....one thing that would have helped mitigate some of the more traumatic aspects of my c-section would have been post-partum care that took my whole person into account. I definitely felt that because my scar was healing and I was eating/pooping/peeing/walking, my care providers assumed that I was "doing well." No one seemed too interested in my emotions or my ability to be an effective parent to a newborn. But those were the things that were really NOT doing well.
Yes, and yes!

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Originally Posted by _ktg_ View Post
I know as a doula, one of the points I am going to focus on with birth planning is to make sure each mom walks through all possible scenarios of what could happen and identify their needs so we can advocate for them appropriately.

For me - the best parts of my last section was:
  1. Communication with my MD, which then built respect and trust for my requests
  2. Knowing the players, having a plan and executing (ie. who to ask/ anesthesiologist for my doula to come in) with support from the hospital staff.

ETA: to add CI Mama's recommendation for post-partum care for C/S moms. Again this is an element overlooked I think by major CBE and Doula educational organizations i.e. specifically for C/S moms.
Yes, especially to the bolded. Birth is UNPREDICTABLE. There's so much 'hokey' stuff around it, it's insane. So many people will believe that writing a c/s part for their birthplan is just 'asking' for it to occur. Ummm, no, it's not. No more than writing a will is asking to die.

For me, I find control soothing. My last c/s, I asked to not have my arms strapped down. Made a HUGE psychological difference. Why? Because not being strapped down meant I wasn't completely helpless. No one likes feeling out of control. Not even tiny babies.

Even though I was going for a VBAC, I made sure to put down several specific c/s requests, such as double suturing, stitches instead of staples, free hands, and my issues with certain anesthesias and pain meds used. All led to a MUCH better experience. I still have psychological issues linked to having to have another c/s, 'failing' in my VBAC, etc. However, the actual surgery itself wasn't so bad because I took back some of my power during it. I was NOT at the mercy of the doctors. I was a participant.

Ami

Wife to dh, Mommy to my heavenly angel, J (06), and my earthly angels, S (07) and E (10)

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#60 of 111 Old 10-11-2010, 04:27 PM
 
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Originally Posted by rainbowmoon View Post
Um wow, this thread makes it sound like the woman who has a csection is doomed. Sure it can be dissapointing but dehumanized? Really? (Yeah I could tell from the OP you haven't had a c/s!!)

Personally my c/s done w/ the utmost respect and care as far as I could tell. My Dr's and MW did not dehumanize the experience for me or my babe in the least. No need to feel pity for us! I really pity those who feel they need to waste their energy onjudging someone else's experience!

Quite frankly this board all by it's lonesome made me feel like crap though about it all quite personally. Something I could have done without. All another part of the mommy wars though IMHO and who is doing what the "right" way..sigh.

I really truly am disgusted by threads like this.

Furthermore, I find the title of this thread really offensive and ridiculous. How about a halt on the judgement and pity that us c/s moms feel from those within the natural birth community? Support will go a lot farther in helping the poor c/s moms!

If you're REALLY worried about it why not trying to do something worthwhile like addressing malpractice insurance & hospital policies, etc. Stop victimizing the MOTHERS! It's not helpful!
It may not be helpful to you, but it's helpful for those who work with birthing women, and plenty of women who have had c-sections are not offended and I thank them for their perspective and helpful information.

Christian SAHM & birth doula.
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