January 29th, 2011

Meet the HCACBAC

***Please note the heavy sarcasm before jumping in… this is a funny post, not a serious one!***

Bet I can’t make you can’t say HCACBAC 5 times fast… hell I bet you don’t even know what it is short for. Before you get all out of shape trying to figure out our new cryptic birth code I will break it down for you…

Home
Cesarean
After
Cesarean
Birth
After
Cesarean

I know… you have heard it all now right?  I mean, one of the growing VBAC trends these days is the HBAC, or Home Birth After Cesarean, so why can’t I have a home cesarean after a cesarean right?

We take all the OR equipment, and we can set it up in my living room, fully equipped with an OR staff, fishy pool in the case we need it, and all the other perks home birth comes with. Maybe I can even hire someone to play the drums and do some sort of a spiritual chant in the background right…  I mean that is what all home births come with… right?

I can’t help but laugh hysterically at the whole thing, while trying to poke fun at all the anti-home birth advocates out there. But in reality, I have to thank some of my favorite birth advocates for helping with this whole idea in general. It was actually born on my private facebook page yesterday after posting an update about my kidney stone saga.

Yes, I brought up the scissor cesarean in my bathroom… If you have ever had a c-section, or a kidney stone, or even both, you can and will know why I can say I would rather do my own HCACBAC rather than have a kidney stone. Kidneystonesarethedevilduringpregnancy.

But just when you thought the conversation had made a peak in amusing comments, it got better.

I want to thank Brooke, one of my fellow ICAN ladies for coining the term HCACBAC during this discussion. She is truly is an innovator, and advocate for all women.  But I have to say, much of my chipper mood came from the poking fun of Dr. Amy… I am sure you know who she is, especially after my post about her exploiting dying American women.

As sad as it sounds, I could picture her in a straight jacket, plucking away at keys with her nose just to write something about those dangerous home cesarean advocates and their agenda… maybe that is slightly evil of me?

I may take Michael’s dad up on his dremel, and if that doesn’t work, it will be Ben’s tool set for the home kidney stone ectomy. Because at this point I will take anything.

But mark my words, I will be a huge advocate for the HCACBAC community… just wait and see!

October 19th, 2010

No, I am NOT a Hypocrite…

I found out we were expecting our third child almost two full months ago. During this time I have put an insane amount of thought into our options for birth. I searched high and low for a provider who would even accept me as a patient for a VBA2C… I dug through surgical reports, research, had awesome ladies like Amy Romano, and Kristen from Birthing Beautiful Ideas help me write letters to the backup OB/GYN’s of the midwives I love so much.

It has been stressful, and I have had up after down, after down, and then up again. I have been confused, worried about judgment, felt attacked and unsupported, and loved all at the same time. I took my thoughts about having a VBA2C vs. a repeat cesarean out of the public spotlight and started to discuss it with two people that I trust the most.

1. My husband
2. My midwife who attended my VBAC attempt in May 2009.

The two people I knew would ….

1. Not pull any punches with me
2. Tell me like it is
3. Support me in my choice.

They did when I was in labor with Benjamin, they did during the surgery, and they did in my postpartum period.

After looking at surgical reports, taking my last labor and birth into consideration, and all the factors in between, I have made the very educated and hard decision to opt for a scheduled cesarean this time around. I think one of the biggest statements, and ideas that has remained in my head through all of this was my midwifes speculation on my pelvis. And the more I think about Camden, and Ben’s births, the more I think that there very well may be a malformation that doesn’t allow my babies to get down into the pelvis. Neither ever made it, and there is little hope this one would either.

With the damage done by the two surgeries, one NICU stay, two emotional recoveries, and serious lack of support after my first son, I know that I can make things different this time around. Do I want to have another cesarean?  No. Not at all, I never wanted to have one, or even two… it was just the cards that I was dealt. Do I want to plan to have a scheduled delivery after bitching about other people doing it for years?  No. But the difference at this point is… and this is also where the title of this post comes from… the vast majority of scheduled cesareans in this country taking place have no medical reason.  This situation I am facing has a number of medical reasons.  And if I felt like there wasn’t going to be hundreds of people picking the reasons apart, I would certainly share them more openly. Unfortunately in recent weeks, it seems like internet harassment over medical choices that peaked, and it is something I am not going to deal with.

Especially over a choice that hurts me to come to terms with myself.

I have opted to go to the backup OB/GYN’s that my personal midwives I used last time around have. And my midwife from Benjamin has signed on to be with me for my surgery, and postpartum time in the hospital as my doula, which means the world to me since I lost Karen (My doula) a year ago unexpectedly.  It makes me know my experience will be more comfortable, and I will have not only my husband, but her with me, two people I trust very much to help my experience.

I will be writing a positive cesarean birth plan over the next couple months in a real attempt to make this not only a Family Centered Cesarean, but a positive experience for all of us.

Am I dreading the recovery?  Yes, I am scared to death.

After my first c-section, I had a newborn I was able to lay and rest with all day. Breastfeed in my bed, and change his diaper right there also.

With my second c-section, my husband was home and able to help me through my recovery. I laid in bed for weeks, not only in pain, but an emotional wreck from a failed VBAC.

This time around, I will have a 3 year old, a 2 year old, and a newborn to take care of after the surgery with little help. It is scary!

October 18th, 2010

History of C-Sections

I want to thank my awesome guest poster for this today!

The Birth of the Cesarean

Mandi Hardy

According to records, the first successful cesarean delivery took place at a Boston hospital in 1894. Undoubtedly, for the time period it was a very exciting obstetrical advance. Prior to the cesarean delivery if labor was obstructed, and forceps were not able to free the infant from the birth canal, the infant may have been killed to save the mother, or both mother and baby may have died. Now, keep in mind that the rates of this happening (obstructed labor) during this time, much like today, were low. Although the “invent” of the cesarean certainly had many benefits, and unquestionably has saved many lives, this is not the part of the story that I find most interesting. There are two social and historical aspects of the cesarean, which I find worthy of further thought and reflection: (a) how the procedure was perfected and (b) how issues surrounding the procedure have changed over the past 100+ years (or not).

Before going further there are also a few other key social, historical, and cultural understandings that need to be established. At the time of the first cesarean, most births (95%+) were still taking place at home and maternity hospitals were free-standing charity hospitals. Although the establishment of maternity hospitals seems like an altruistic endeavor, in reality they were more likely obstetrical experimental laboratories. New instruments and/or procedures needed to be tested, perfected, and improved upon. Therefore, clinical (observable and treatable) subjects needed to be readily available – the maternity (charity) hospital provided this steady flow of women subjects. It also seems worthy to note that from a cultural perspective unwed and/or poor women who were pregnant were generally believed to be of lesser moral character and therefore of lower social standing. These were the very women in need of the services the maternity hospitals were alleged to provide. What this means is that the way in which the charity patients were treated experimented on, was considered acceptable because it was to the benefit (allegedly) of more worthy and proper women patients. In summary, the women laboring in maternity hospitals were likely often not viewed as such (women), but rather as research and experimental subjects – in the name of medical advancement.

By 1913, the director of the Sloane Hospital in New York had preformed 112 successful cesarean deliveries. One can only speculate how many failed and unnecessary cesareans were preformed in order to accomplish this – to hone his performance skills. What is most interesting to note, is that this director is the doctor cited with stating “once a cesarean always a cesarean.” Words spoken nearly 100 years ago still heeded today as hallowed fact.

Even during the early days of the cesarean heated debates over the necessity and indications for the use of the procedure were frequent. Interestingly, a common justification for such invasive procedures, and the increased apparent necessity for other types of instrumental deliveries, was frequently attributed to the woman’s moral character. A review of a Boston maternity hospital in the 1890s cited “patients as too lazy or too stupid to deliver by themselves, ¹” hence requiring the use of various interventions. Several social childbirth historians have noted that the use of instrumentation and other interventions were often employed as an, “expressions of impatience” on the part of the doctors. Of course, there were many occasions when interventions were, in fact, humanitarian and necessary. However, it appears that it was as difficult then as it is today to determine what indications are appropriate to warrant the use of intervention.

Certainly, few would question that the success and safety of this particular procedure has certainly improved since this time, specifically following the invention of antibiotics; however, many raise concern over the justification for its use in the first place. Many have argued that as the procedure became safer it also became an easier intervention – the ultimate intervention – to rely on. In the U.S. the cesarean rate in the 1960s was approximately 3% of all births, in 1970 it was 5.5%, 24% in 1988 and in 2007 the rate was the highest ever reported 32% (a 53% increase from 1996).^{2, 3} It leads one to questions if women’s bodies are evolving (or de-evolving) in their ability to birth or if there are other factors influencing these rates. I happen to believe it is not the women’s bodies, which are to “blame,” but rather a complex web of other explanatory factors interactions.

Sources:

1. Wertz, R., & Wertz, D. (1989). Lying-In: A History of childbirth in America. New Haven: Yale University.

1. Menacker, F., & Hamilton, B.E. (2010) Recent trends in cesarean delivery in the United States.

NCHS data brief, no 35. Hyattsville, MD: National Center for Health Statistics.

1. Tew, M. (1998). Safer childbirth? A critical history of maternity care (3^rd Ed.). New York: Free Association.

Mandi Hardy has a master’s degree in psychological counseling and worked as a mental health professional for a number of years before returning to school to seek a doctoral degree in human development and family studies.  She is currently a doctoral candidate at Iowa State University working her dissertation research, which will be a feminist study on childbirth experiences in the American maternity care system.  Mandi is a certified doula through DONA International and currently working on her ICEA childbirth education certification.  Married for over 4 years with one child.

August 3rd, 2010

New VBAC Guidelines

After being so involved in the National Institute of Health’s VBAC consensus earlier in the year, I, as well as so many others were really anticipating the new ACOG VBAC Guidelines. The decline in VBAC began when they changed their guidelines suggesting only certain women, and certain hospitals were candidates for a Trial of Labor after a previous Cesarean delivery.  We saw a peak in the VBAC numbers in 1996, then a drop consistently there after.

ACOG included in their release something new that previously had been unthinkable in the medical community as a valid option for most women, and that is a trail of labor after two previous cesarean sections. Studies show that it is a safe and valid option for women who wish to attempt a VBA2C, which I have been saying all along.  But maybe now because a huge medical organization with MD after their names says it, people will understand it truly is a safe choice for mothers to make.

Also included in these guidelines are women pregnant with twins, with a prior cesarean delivery, and an unknown uterine scar, which in the past have meant automatic repeat cesarean deliveries.

Just some numbers to include into this also.

In 1970, the cesarean delivery rate was 5%, in 2007 it increased to over 31% of all deliveries with very little improvement to maternal and neonatal outcomes. VBAC was at about 5% which increased all the way up to 28% in 1996. Then the decline started, in 2006 the VBAC rate dropped down to a little over 8%.  Which is horrible for our women here in the U.S.

While I stand by women being informed on making their own choices regarding their care, as a mother who has had two cesarean deliveries, researched, learned the numbers, the risks, and everything involved in VBAC vs. ERCD (Elective Repeat Cesarean Delivery) the risks for a repeat c-section are much higher than a trial of labor after a previous cesarean. You are more likely to have long term complications, be re-hospitalized, need a type of blood product, and all the risks that go along with major surgery when opting for a cesarean over a trial of labor.

The risk for a uterine rupture is between 0.6-0.8% with one previous cesarean delivery, and the most recent studies and numbers has not shown a neonatal death from uterine rupture. I am not sure the amount of years it has been, but per the information from the NIH VBAC consensus, it has been at least 10 years since they have documented a case.

Maternal mortality rates are higher with elective repeat cesarean deliveries over VBAC also. When comparing ERCD to VBAC, per 100,000 births, there are 9 less maternal deaths with VBAC than elective repeat cesarean delivery. Hence showing that VBAC is safer, despite all the discussion of risks.  Those are 9 mothers, sisters, daughters that can and should be saved!

I think that these new VBAC guidelines are certainly a step in the right direction, while the change may not take place overnight, we are seeing that it is something now being addressed on a large public forum as the backlash of high cesarean rates are starting to take their toll on our women and babies.

May 17th, 2010

Happy First Birthday Benjamin!

Well, this time a year ago, I was getting set up for an epidural. I had been awake for 30 hours, my labor wasn’t progressing, and we were all really at a loss. I needed sleep, and everyone, except for my husband really agreed the epidural may be most helpful. I think Will disagreed with it so much because I had told him and basically drilled it into his head for 9 months that I would not be having one this time around, but none of us anticipated a back labor that would span over 26 hours either.

Complication after complication started when I woke up a little before noon. My cervix was starting to swell, and Ben just wouldn’t come down past -1 station. We tried everything to get him to budge, and he wouldn’t move.  At this point I think the giant elephant in the room became more and more apparent to everyone. It took me about an hour to come to terms that the only way Benjamin was safely coming into this would was by a second cesarean section, which I worked so hard through my entire pregnancy to avoid.

Benjamin Emil Elwood was born at 1:59 pm via cesarean section weighing in at 7 pounds, and 3 ounces. Smaller than my oldest, even though I was diagnosed with gestational diabetes with my pregnancy. The moment I saw him, right after they removed him from the incision in my abdomen, I could see a giant bruise on his forehead. It took the on call OB, and the Resident on staff for the day to get him out. He was JAMMED in there.  No way he would have descended anymore than he had.  I think that made me feel slightly better than I originally felt with the decision to consent to the second cesarean.

I know looking back at all that happened with his birth, there is nothing that I could have done differently to change the outcome of my birth experience. I think that is what has helped me be more accepting of his birth than my first. Had I not consented and continued to labor, I not only could have hurt myself, but I could have hurt myself.  I desperately wanted a VBAC, but I am not a martyr, and I would not do it at the expense of anyone’s safety.  Contrary to what some seem to think.

Looking back, there is nothing that I would have changed. Not getting pregnant when Camden was only 8 months old, not choosing the midwives I did, nothing. I loved every moment of my pregnancy with Benjamin, while I may not feel the same about his delivery, I was blessed with such a unique, bright, and beautiful little boy who was always meant to be part of our family.

I certainly do not feel that our family is complete, but for the time being, it certainly is. I think after Ben’s birth, both my husband and I are certainly scared to have anymore children any time soon. The two cesareans have been emotionally trying on both of us, and certainly physically trying on me. It took me nearly 3 weeks to actually feel human after Ben was born, and to remove myself from my dark bedroom and join the rest of the world.

There is so much my little Jo Jo (one of Ben’s many nicknames) has taught me. One being that no matter what we do as parents, sometimes our children have other plans for us.  Ben was exclusively breastfed for the first 5 weeks of his life, during that time, we couldn’t figure out why he was so colicy but in reality, it was a reaction to my milk. We tried everything from dietary changed, to a variety of formulas before we finally found something that would work for him. It was the longest 8 weeks of my life. Cap that off with 3 surgeries (for me) starting when Ben was only 5 weeks old… I think that seriously aided to the stress in the house.

He is the light of all of our lives, including his big brother Camden. I thought there would be some jealousy issues in the house between the two children, but I couldn’t have been more wrong. Camden has been the most attentive big brother. Loving, teaching, and overall infatuated with his little brother. I really could not have asked for a better big brother.

The process of transitioning from a mother of one, to a mother of two would have made me insane if I didn’t have the help of my husband. The day we brought Ben home from the hospital, our oldest got his first flu of his life. Such timing!

There are some days I am sure I am going to lose my mind before my husband gets home from work, but I somehow manage to keep it together till he walks through the door and the kids clamor to him like they haven’t seen him in a year.

Wow!  I just can’t believe that it has been a year already!  Where does the time go?  It feels like yesterday he was born and I was cradling him in my arms in my hospital bed waiting for one of the nurses to come in and yell at me for co-sleeping!

Benjamin Emil, you have changed my life in so many ways. Given me and understanding of difficult parenting, and children. Taught me the feelings and emotions that go with a medically necessary cesarean section, which has enabled to me help mothers on a whole new level.  You are the light of my life and Mommy loves you so much!

Happy first birthday Ben!

April 22nd, 2010

Post Cesarean Feelings Survey – Question #6

Continuing to unveil the results of the World Wide Post Cesarean Feelings Survey that I recently worked on with Theresa from Health Baby Network, I wanted to move on to question number 6 which was “Did you feel like you were in control or your care and respected through out the process?”

Like every other question on this survey, we saw complete extremes on each side of the question, and very few moderate or middle of  the road answers. 312 women left a comment with their answer for this question, which left me with 14 pages of information, experiences, and comments that could be a trigger for anyone with any sort of a birth trauma. So I truly caution those same people from reading further.

Our of the 851 women who answered this question :
37.4% or 318 women felt like they were in control of their experience, and respected.
35.3% or 300 women felt like they were somewhat in control of their experience, and/or respected.
31.4% or 267 women felt like they were not in control of their experience, and were not respected.

When I discussed some of the comments these women left, Theresa said to me “Man, some nasty treatment” which is horribly sad for any woman who has been subjected to such treatment. It took me nearly 2 weeks to get through these comments and write this post because of the extreme nature of some of it.

So on to the comments.

“They treated me like a number. Like a ticking clock. They seemed to be prepping the OR behind my back, and every request, from ice to squat bar was ignored and almost sneered at.”

“No one treated me harshly at any time, my requests were carried out without protest, good lactation help”

“No respect, no compassion. At the mention of a c-section I started sobbing and the OB just stared at me stone-faced.”

“Dr. came into the room only a couple times the entire day, told me what was going to be done (never asked) she even laughed when she saw me sitting on the birth ball”

“Doctors are experts. I was OK with them being in control.”

“I am disappointed that no one ever explained the risks of c/s to me, especially to subsequent pregnancies, but I do feel like my OB would have respected my choices/opinions had I known better and refused c/s”

“The doctors were very respectful, explaining every step & making sure I understood why & what was going on.”

“I was constantly told what I needed in an effort to wear me down so that I would agree to their demands. I was forced to have my legs open in front of many strangers. I cried and nobody batted an eyelid. I wasn’t important. Childbirth is supposed to be a sensual, sexual, and most significant event in a woman’s and her child’s life which is certainly not acknowledged by the hospital system. I would say that I was sexually abused while in the hospital bed – another doctor (this time male) came and put his fingers into my vagina and the hospital midwife looked on with a smirk on her face that said ” You’re lucky to have such a good looking doctor like that up you”

“my membranes were ruptured without my consent, the OB did an episiotomy without my consent, the midwife was rude and confrontational, students were invited into the delivery room for the birth without my consent, i was left to hemorrhage until i came close to death, and so many more instances of poor care.”

“I felt in control of everything and I was able to explain my desires/wants”

“My first c-section – No. I felt like scare tactics were used to get me to induce w/o medical reason (“every day past your due date your baby has a higher chance of dying”), and then after 13 hours of labor, progressing nicely, I was told I had to have a c-section because my baby’s heart rate was very concerning. Yet, it took nearly 1.5 hours from decision to incision. Doesn’t seem very emergent to me.
Later, when I requested my records, I found that it listed my c-section as ELECTIVE. I still think I was coerced into a c-section because the doctor felt my labor was taking too long, it was the night before Thanksgiving, and she wanted to go home. After the surgery, they told me I couldn’t be with my baby and she HAD to go to the nursery. I didn’t see her for two hours and no one would call the nursery to find out if she was okay. I laid in a hospital bed, unable to move, terrified for my baby who was FINE (the nursery was understaffed). No one seemed to care how I felt or how upset I was. My second c-section was much better supported – however, I firmly believe that was because I demanded it of my caregivers. I knew everything I could know about VBACs and repeat c-sections
and refused to let myself be treated as poorly as I was the first time.”

I feel as though some of these comments are very telling as to the way maternity care works today, and the way that women view their providers, especially the comment above that a woman was happy her Doctor was in control because they are the professionals show us how much faith and trust women are putting into their providers. Good, bad or middle of the road outcome way too much faith and trust is being placed blindly in providers today.

Women need to build relationships with their provider, and build trust, it is not something that we should just automatically be giving because we picked Dr. X to deliver our baby, or provide us with prenatal care.

April 7th, 2010

Post Cesarean Feelings Survey Comments : Positive Experiences

While the comments regarding positive experiences were greatly overpowered by the negative experiences in this survey, as we also have seen in the numbers we got and the results. It would not be fair to only include the negative comments or experiences.
So today I wanted to share the comments on positives experiences from mothers who took part in the survey.

While we cannot include all of the comments, we will surely include as many as we can. Again, I read through over 20 pages of comments on question #5 alone. Question #5 was  :

Would you describe your experience as :
Wonderful – 27.7%  – 227  Mothers
Empowering – 7.4%  – 61 Mothers
Frustrating – 26.7%  – 219 Mothers
Traumatic – 46.8%  – 384 Mothers
Disappointing – 45.5%  – 373 Mothers
41 Mothers Skipped this question
479 left a comment with their answer

WARNING!  : Some of these comments may be hurtful for cesarean mothers who have had a traumatic birth, or birth trauma.

“I don’t view giving birth as a contest or a right and wrong way to do things. As long as baby and mom end up healthy it was a good experience.” – Nancy

“My OB was wonderful. C-section was a very easy thing and not really very scary.”

“I loved every minute of it and was utterly euphoric – I didn’t care how the baby came out. All I cared about was having my baby.”

“It was great! the staff was caring. My family was supportive. The procedure went well. Baby nursed like a champ.”  – Tomi

“The first emergency cesarean was traumatic to say the least. But my second cesarean, which I was prepared for, was wonderful. In the ensuing years, I’ve come to realize that the first was traumatic for a multitude of reasons, not the least of which were my feelings of failure brought about by the multitude of mothers and ‘experts’ who seem to feel that giving birth by cesarean is somehow cheating. It took me quite some time to accept that I had not done anything wrong, and that contrary to the hype, sometimes a cesarean IS the best choice for both mother and babies.”

“I cannot deny that I was in the hands of some of the best hospital staff ever. I was made fully aware of the procedure and the after effects. I had good care following the surgery. But the differences in my life and the way I handled the Cesarean birth compared to my firstborn (who was a natural homebirth) was incredibly hard. I am still healing from all of it 17 months later, and I still have pain in my incision site on a regular basis. I will always be in fear of birthing another child for fear I won’t be able to control the birth process and will have to have a repeat C/S.”  – Jill

“Anytime you bring a child into the world is a wonderful experience. A cesarean is still a birth and a woman should not feel any less for this.”

“My section was not at all tramatic like my vaginal delivery was. Birth was quick and recovery was better all around.”

“I was in control of my medical decisions, the staff/my physician were helpful and non confrontational, some of the hospital practices were unhelpful and unnecessary during my labor. I think surgery was the best option in my particular case.” – Holt

“How my babies are delivered doesn’t define me as a woman. They are all healthy & happy and arrived in the safest way possible.” – C

“I felt at total peace because I went in feeling secure in my choice”

“I would describe my first vaginal birth as traumatic, my c-sections were calm & stress free”

“I can think of nothing but good things with my c sections. I healed well. The c section produced 4 very healthy babies.”

“Quick delivery, fast healing time, healthy mom, and healthy babies”

“It was fast, easy, pain free, I knew the exact day that I was going to have my babies, I adored both of my c-sections.”

“My experiences were great. No trauma, no feelings of missing anything, totally rewarding birth experiences.”

“We are still talking about a c-section birth, right? My vaginal delivery was horrible, frustrating, traumatic, disappointing, we both almost died because the baby was stuck due to the position of my pelvis. My c-section delivery was absolutley wonderful! Sure there was some fear before and during and pain after, but it was 100 times better experience. With my vag. delivery, it was stressful and the hospital staff were stressed too. For the c-section, everyone was calm and friendly and helpful.”

“The staff did a wonderful job of making it a pleasant experience for me and my husband, despite the fact that I didn’t want c-sections”

I am sure there are many out there that do not agree with, or upset with the comments above. I know myself, some of them upset me on a personal level because of my experiences. But unfortunately I need to remain professional as well as unbiased on reporting the results of this survey.

Please keep the comments free of vulgarity, and no direct insults.

For more information on having a positive cesarean birth experiences, please take the time to read Family Centered Cesarean from ICAN.

April 5th, 2010

Post Cesarean Feelings Comments : Negative Experiences

Because of the overwhelming amount of comments that we received on question #5 on the Post Cesarean Feelings Survey, I felt the need to split up not only the results, but the comments into two categories because they were clearly so powerful, moving, and telling of the current maternity care system as well as the trauma some women are facing during their birth experiences.

Just as a refresher question #5 was :

Would you describe your experience as :
Wonderful – 27.7%  – 227  Mothers
Empowering – 7.4%  – 61 Mothers
Frustrating – 26.7%  – 219 Mothers
Traumatic – 46.8%  – 384 Mothers
Disappointing – 45.5%  – 373 Mothers
41 Mothers Skipped this question
479 left a comment with their answer

479 comments = 20 pages of comments I took nearly two days to read through, and decide which comments would be more appropriate for including in our blog posts on the survey itself.
If you are sensitive, some of these comments may be a trigger for you, or shocking, please read carefully, and exit if they become too much.

“The admitting hospital staff was awful, and I had mentally prepared for a natural birth, having drugs pushed on me and to end up having a C/S was upsetting.”  – Wanda

“My first birth was pre-term after hospital mismanagement, leading into probably the worst three months of my life as I had three babies in NICU and I KNEW the hospital was to blame for it.”

“OB spent the last 15 minutes of labor convincing my husband how dangerous it was to continue pushing despite the fact that I had refused the section 3x and I had known of the risks but was comfortable with continued pushing despite HR accelerations. I had been at this for 26 hrs and didn’t want to give in at the last 15 mins. Hubby had been completely supportive up until the OB keep hounding him and refused to participate in my pushing efforts unless I could get the baby to crowning in 1 more push.”

“Multiple infections, complications, loss of control, hospital staff didn’t listen or support, PTSD afterwards, negative effects on baby and bonding” -  Kayte

“Had no idea baby was over 9 lbs. Dr. policy not to vaginally deliver over 9.”

“I was frustrated with my doctor that she wasn’t paying attention to the fact that my first daughter was breech until it was too late to get her to turn. My 2nd was traumatic because of the uterine rupture and losing my baby’s heartbeat for a time right before delivery. My 3rd c-section was my best because I had the best care and doctors.”  – Corrina

“Felt disjointed, like my daughter was not my own because I didn’t birth her” – Mellissa

“I suffered from Post Traumatic Stress Disorder because I was coerced into an unwanted, unnecessary cesarean”  – Kristen

“Treated like crap at the hospital, had no say in anything, I was uninformed and scared, they rushed me and pumped me with Pitocin and eventually cut me” – Erin

“The operation was horrific and my baby died.” – Diana”

“Felt as if control over my body was taken from me and I was powerless and weak.”

“I enjoyed labor to the point of my caregivers deciding I was no longer progressing, at which point they took over and I felt like a failure, and that I hadn’t been given the opportunity to do what I felt I needed to do. There was no emergency, just impatience on their part.”  – Hannah

“I knew I wanted natural but got talked into every intervention with “do you want your baby to die” as the reason. Of course my answer was no but with no education I assumed the Doctors knew more.”

“I wish I had been better informed about the risks of c/s delivery.”

“I cannot deny that I was in the hands of some of the best hospital staff ever. I was made fully aware of the procedure and the after effects. I had good care following the surgery. But the differences in my life and the way I handled the Cesarean birth compared to my firstborn (who was a natural homebirth) was incredibly hard. I am still healing from all of it 17 months later, and I still have pain in my incision site on a regular basis. I will always be in fear of birthing another child for fear I won’t be able to control the birth process and will have to have a repeat C/S.” – Jill

“It was induction at 39 weeks for no reason, artificial water breaking, pitocin, laying in bed, epidural and very little progress after 17 hours. I was uneducated and thought the OB and hospital knew what they were doing. I was wrong.” – Lisa

“It has ruined me”

“Labour was a battle ground with no communication between OBs and Hospital Staff. Non-evidence based care where my labour was pushed to a point where my baby’s heartrate became critical.”

“There was no emergency – I was fully conscious and felt wonderful – I just timed out. I had drugs forced upon me that I didn’t need, an epidural was forced upon me as well with”You’re getting tired” and I WAS NOT TIRED. The epidural has left nerve damage in my vagina that continues 11 years after the cesarean. For a normal physiological process to be taken out of my hands, and “needing to be
controlled” is utterly ludicrous and a complete blow to my womanhood.”

“I never imagined I would end up with a cesarean, I never even read the chapter in the pregnancy books.”

“Being coerced into a cesarean because the OB had somewhere to be has made me lose all faith in the medical profession. It was traumatic, degrading and unnecessary.” – Mari

“Insensitive medical team (made rude remarks), not fully aware of options during operation and suffered with reaction to epidural, inadequate support post operative for breastfeeding.”

“I was scared into having a c-s because my OB said I was going to be having a “big baby.” I had a c-s at 39 weeks and my daughter was a very normal 7 lbs 13 oz. I never even got a chance to have a trial of labor.”

“I was disrespected and no one cared about my needs or wants. It was more about the hospital’s experience then mine.”

“I felt dehumanized as all the hospital staff poked and prodded my naked body around me without acknowledging my humanity. I lost all dignity in that moment. It was scary and horrific.”

“Currently suffer from P.T.S.D. from birth, rude Ob who took over, no communication during surgery and newborn exam, thought baby was near death turned out a medical student was practicing weighing and measuring newborn, before I’d even seen him.”

“Felt ignored, belittled. OB’s ignored me during surgery, no one told me what was going on. Was separated from my son for 3 hours after the c/s.”

“I did not want a CS, epidural. Was asked if I wanted my baby to die.”

“Started with well informed, educated, empowered couple trying to birth, wound up with Failure to Wait doctor and staff wielding scapels, seemingly unknowing what this would do to me forever.”

“The hospital staff & doctor were assuring me that a c-sectoon was the right thing or else my baby and I would die because he would get stuck coming out the “other” way and there was no way they could get him out then. During the surgery they talked about Ikea furniture and their wedding rings ignoring me when I told them I needed to throw up as a result I threw up on the floor & someones shoes which they were quick to pony out were brand new.”

“My babies were kept from me even though they were healthy. Didn’t get to nurse them until 4 days old. Felt physically and emotionally incapable to care for both of them and myself post surgery.”

“I felt like an utter failure, felt like I was dying”

“What birth Experience? I had a c-section”

“Once I gave in to the 1st section, I was run through the mill as if I was only a slab of meat. No one paid human attention to me, talked to me, etc. except for one sweet nurse intern who took pity on my pleas & came held my hand.”

“I didn’t get to hold my baby right away, I heard the doctors say whoops! we can fix that!, and my DH got so scared and sick he wasn’t able to be in the room with me   “

“I have always felt that my birth was a traumatic experience bc of the complete lack of control I felt throughout the process and the repeated dismissal of my feelings by attending OB along with other inappropriate statements made during the delivery by OB.”

“Bad recovery, devastating unnecessary cesarean due to ridiculous hospital protocols”

“HATED the feeling of being vivisected and paralyzed. Felt clinical, not maternal.”

“Based on my doc’s history of high cesearan rates I couldn’t trust that he did all possible before demanding a cesarean”

“I was lied to, manipulated, and rushed into surgery. There was no emergency, they just wanted me cut open before my doula could get there to remind me that I still had options.”

Most of these comments really speak for themselves.
No woman should be made to feel like so many of these women felt, and were treated, no matter what kind of birth they are having.

Remember, these were the most extreme out of almost 500 comments.

I can say I look forward to writing up the positive experiences as I need some kind of relief of the negative comments that were left on the survey.

April 1st, 2010

April is Cesarean Awareness Month!

Many do not know this unless you are heavily involved in the childbirth community, but the month of April is recognized as Cesarean Awareness Month. When I first started my ICAN Chapter in 2008 here in Connecticut, we submitted a request to our governors office to have Cesarean Awareness Month recognized in Connecticut.  To my surprise it was denied.
That is when my project began. I created a petition which in the end collected over 300 signatures and come 2009, we submitted our request for our Proclamation, with the petition. I guess they realized we weren’t going to go away huh?

In 2009 we got our first CAM (short for Cesarean Awareness Month) proclamation, and this year in 2010 we continued our tradition and again it was granted.

But why is this important?

With the growing cesarean birth rate nationwide it is so important that we take some time and realize that the 32% numbers we are seeing are not healthy, nor are they improving maternal or neonatal outcomes. In the past month we have seen several reports in large national news sources about this, and while bringing attention to this is great, it is not going to make the change that we need.

Cesarean Awareness is important to me because of the births of my two children, so different, but much alike.

My Birth Journeys from Danielle Elwood on Vimeo.

So how can you get involved?

• Are you involved with your local ICAN Chapter? Is there no ICAN Chapter in your area? START ONE!
• Does your local hospital have a VBAC Ban in place?  Contact them and encourage them to practice evidence based medicine, and consider the new statement from the NIH VBAC Consensus.
• Protest!  Make some signs, and stand out in front of those hospitals with high c-section rates, or VBAC Bans and have your voice heard!
• Write a letter to the editor!  Your voice is powerful and important!
• Check out the ICAN Blog and read the birth stories of some amazing women.

Some of the recent news stories that include great information why Cesarean Awareness is important are  :

• United States Urged to Confront Shocking Maternal Mortality Rates
• Too Many Women Dying in US While Giving Birth
• Are C-Sections Too Common?
• Women Need a Chance to Avoid Repeat Cesareans
• Newsweek : VBAC Access Makes Medical Sense
• ACOG Spokesman : The Rise in Cesareans are Not Good for Anyone
• Cesarean Rate Jumps a Record High since 1996

Get out and get involved!

Listen to the Momotics Radio Show all month Cesarean related shows!

April 7th – Isa Herrera author of Ending Female Pain
April 14th – Dr. Stuart Fischbein discussing VBAC and preventing cesarean births
April 21st – Barbara Stratton, the ICAN VBAC Ban chair will be discussing VBAC bans nationwide.

I will also be on The Feminist Breeder’s Radio show this coming Sunday night at 10pm CST (11 pm for us east coasters) to kick off Cesarean Awareness Month and talk about the Post Cesarean Feelings Survey I recently worked on with The Healthy Baby Network.

HAPPY CESAREAN AWARENESS MONTH!

March 30th, 2010

Post Cesarean Feelings Survey Question #3 & #4

Since I have been moving through the questions relatively easily, on to questions #3 and #4 from the survey. Question number three turned out to be a very popular question with many comments. In fact I had to read through 20 pages, yes, 20 pages of comments to see which should be used or stood out the most.

Question #3 was :
Question #3 – If Elective or Planned, What was the reason?
Previous Birth was Cesarean, Doctor Recommended :  33.9%   112 mothers
Knew what to expect, was the birth I wanted: 10.3%  34 mothers
Fear of labor & Natural childbirth : 2.4%  8 mothers
Previous Traumatic Birth, Cesarean was Less risky : 6.4%  21 mothers
No VBAC Support or availability : 5.5%  18 mothers
Other : 56.1 %  185 mothers
531 mothers skipped this question

There is so much more that could be shared about this subject in general, but I am just going to share some quotes from others instead of breaking this one down because it can certainly be a touchy subject, or carry feelings for some women.

April shared this quote with us as well as gave us permission to use it

“[The] Doctor scared me into it by telling me the baby was too big to have [give birth] to without losing her”

While we do not know how big April’s daughter was born at, in my follow up e-mail contact with her she said

“Hopefully it can help someone else not be scared into a decision they may later regret.”

Lindsey shared her experience with her quote

“[I had] no trust in my body, or support from my OB”

Which was a comment that was frequent while looking through the results of the survey, and the comments that were being left by the mothers who took this survey. I think one of the common misconceptions today is women are looking to their Obstetricians for support that they are not going to receive. With the maternity care system today, the way it is set up, we should be utilizing doula’s more than we do, especially for this type of support. Or opt for care with Midwives.

We had mothers who had truly medically necessary cesarean births also :

Anya told her story of a very scary situation leading to the birth of her child “Baby was IUGR – had to come at 36 weeks with less than 24 hours notice” IUGR stands for Inner Uterine Growth Restriction.

Corrina shared “Baby #3 needed to be born via cesarean because of previous uterine rupture”

Though I wish I could say the medically necessary cesareans really took up the majority of the comments, there were some comments that just made me want to yell. LOL

But the one comment that stood out to me the most was :

I had a ‘medwife’, whom I didn’t know was beholden to the hospital. They later bought out her practice. She’d had a number of other births that day and was tired. This was the easy way out for her. I trusted her completely to take care of me and to see that I would have a vaginal birth. I was completely blindsided; my ‘birth’ was the furthest thing from my mind.

It is horrible that any woman would have to endure this kind of treatment because of their provider simply being tired, and something like this came up recently around the internet with “L&D Staff Behaving Badly“  which became widespread across the internet.

More and more women are starting to have cesareans for suspected fetal macrosomia which is just a fancy tern for a suspected big baby. But since we are all aware of the lack of accuracy in ultrasound measurements in the last trimester, these estimates should really be taken with a grain of salt.

“I was told I was having a 10-11 lb baby that I probably wouldn’t be able to deliver naturally, who ended up being 7 lbs 13 oz.”

“insulin-dependent GD, drs feared 11-12 lb baby, turns out he was 8.6, my smallest”

Then we had a couple mothers with HSV2 which essentially is genital herpes. There is a lot of misinformation today which makes mothers with this virus feel as though a vaginal birth is not an option for them. ICAN has a great bit of information for mothers who do have this virus, Herpes in Pregnancy which offers a great amount of information to mothers.

“Had HSV2 and since I did not know much about it, I didn’t know whether I contracted before or after pregnancy and was told a cesarean was playing it safe. I was, however, told that I could birth vaginally for subsequent births.”

It is sad to read some of this, but uplifting to see that there really are and have been some medically necessary c-sections taking place in the sea of unnecessary surgery.

I must say I am pleasantly surprised about the extreme number of news articles regarding the skyrocketing cesarean rate and how truly dangerous it is to our mothers, and babies. Women are still dying at alarming numbers and I hope that with all this coming out practice patterns of OB/GYN’s will change, because they certainly are the ones driving these numbers, not women.

Question #4 talked about support persons in labor and read :

What support did you have during labor?
Midwife : 18.2%
Doula : 9.3%
Spouse/Partner : 90.7%
Family/Friend : 37.0%
Hospital Staff : 49.2%

I do not have very much to say about this in general, but there are a couple alarming trends with this.
One thing that I am not happy to see is women depending on hospital staff for support during labor. Unfortunately in hospital situations and settings we know that nurses as well as hospital staff are completely over worked, and there are some serious shortages across the nation. Depending on a hospital staff member could be a contributing factor to the cesarean rates.

Another issue I can see is the lack of professional support, like using a doula which is connected directly with lowered cesarean birth rates. Women are depending on their partner, or husband which is what I did with my first child. I thought that I could “train” him to be my doula during my labor, but I think we all know how that ended.

Women really need to know how valuable the support of a doula is. With more insurance companies starting to actually cover doula services I hope that more women start to utilize them for births in a hospital setting.

March 28th, 2010

Weekly Round Up

I have found that some of my readers really enjoy the weekly round up posts, so I am going to continue them as long as I have things to round up each week! Hahah!

This week there were quite a few things to highlight, but certainly not as much as there has been in the past.
I will start off with highlights from my house this week :

• Everyone got sick. Real highlight huh?  Both boys got croup for the first time.
• Camden went to his first Easter Egg hunt!
• Benjamin is starting to try and pull himself up to stand. (I am done for once that happens)
• I opened my own Online Mark Store!  Come by and see if there is anything you are interested in, their products are awesome!!

On the internet blog circle :

• When Labor & Delivery Staff Behave Badly : I have seen posts about this all over the internet on various blogs, but because I love Gina, and she actually had a picture of the exchange, I decided to feature her post. I love some of the comments on it. Last night my Husband sat down and read it while we were having our Pizza dinner and he stopped eating and told me he was completely disgusted. Not much can make make him stop eating!
• Dou-la-la knocks one out of the park with her Weekly Movie about The Food Revolution that aired on ABC Friday Night. Baby was asleep, DH had the toddler with him at the fire house, and I watched it. I was completely disgusted and astounded that this is such a problem and I really hope this opens the eyes of the American public.  Another great post about Jamie Oliver’s Food Revolution comes from Peaceful Parenting.
• Amnesty International Slam Dunk’s craptastic “Dr” Amy’s post on Maternal Mortality in the United States.  I can say that there are only a hand full of people in life I “hate” because it is such a strong word, but the more I read this bitch write, the more I think she is just an internet troll with no real education.
• Great post in Mothering Magazine which turned out to be a very interesting read : Is Aluminum the New Thimerosal?
• Even though I was taking with local superstar Amy Romano about this a couple weeks ago, I finally had the chance to see it : This 1-Year-Old Happy Meal Has Aged Surprisingly Well.
• The ICAN Blog covers the ACOG Spokesmen talking about the rising cesarean section rates.

I hope you enjoy these highlights as much as I did this past week. If you have any highlights you would like to have included in my weekly round up posts, please e-mail them to me at Danielle.Elwood@gmail.com.
You can also leave a comment on the Momotics Facebook Fan Page or Tweet a suggestion at me on Twitter.

March 24th, 2010

NCHS Cesarean Statistics Report

Since the NIH VBAC Conference, and the Post Cesarean Feelings Survey posts that have been going on, I have been trying to avoid any other cesarean related posts or information for the simple overkill factor. But these numbers that came out today from the National Center for Health Statistics just could not be pushed to the side, or left for a later date post. I was just really passing them by until I sat down this evening and read the post about them over on The Unnecesarean.

Now, if you follow me, you know how I feel about the cesarean rates, and elective cesareans, but these numbers should be scary and alarming to all women of childbearing age, or who plan to have children in coming years.  A couple pieces of information I found most important :

• In 2007, 32% of the approximately 1.4 million births in the United States were by cesarean section, the highest rate ever recorded in the United States and higher than the rates in most industrialized countries. The cesarean rate increased most rapidly between 2000 and 2007
• The number of cesarean sections increased by 71% from 1996 to 2007 (797,119 to 1,367,049).
• Cesarean section was the most frequently performed surgical procedure in the U.S.
• According to the NCHS, suggested explanations for the rise in the cesarean rate for eleven consecutive years include many nonmedical reasons, such as maternal demographics, physicians’ practice preferences, maternal request and fear of litigation.

One thing I wanted to point out is that maternal request cesareans showed to make up 0.4% of cesarean sections taking place, so the excuse that women are just telling their Doctors this is what they actually want is something that does not hold much weight with me.

But why is this such a problem?
Because more and more women are opting for this procedure under the assumption that it is the least risky option or way to birth a child, when in fact it is not. Having your scheduled cesarean is nothing like going in to have your teeth cleaned. It is serious major surgery that holds serious risks including a 4 times greater risk for maternal death than a vaginal delivery. 9 out of 100,000 women who opt for an elective repeat cesarean delivery, whether it is the second c-section, or more will die.

Not to sound all gloom and doom, but I dont think our women today are being given accurate information on these risks.

Anyways, I just wanted to share that stuff before I went to bed.
I hope ya’ll have a nice night.

March 21st, 2010

Weekly Round Up

This is becoming a nice habit of mine, and I love taking the time to post my favorite blogs, news stories, and stuff going on in our own household for the week.

First I will start with our family this week.
Benjamin is getting another tooth, his top right one and it has made for a rough week on top of the house full of sniffles.
The boys & I hung out with Amy Romano this week and her little guy Dexter, it was a beautiful day, and I foresee some writing for Lamaze in my future.
Our wireless router finally showed up!
I got a new tattoo and made an appointment to get another fixed up and shaded!
Got picked up for another article in The Fairfield County Weekly.

My favorite blog posts from this past week :

• The Feminist Breeder’s awesome blog post using a Dr. Seuss book to describe modern day birth advocacy.

• Michael a local doula, hypnobirthing Momma, and a friend of mine gave birth early after a difficult pregnancy (after two previous home births) to a little girl and posted the video. It is super amazing!
• Great informational post on Episiotomies by At Your Cervix.
• Dou-la-la knocks it out of the park this week with two posts, one on why public nursing matters, and Bag the Bag sling in light of the sling danger mania this week!
• Gloria Lemay Quotes an OB/GYN on Unnecessary Cesarean Births.
• Jill at the Unnecesarean made an awesome graph of the c-section rates from 1970 till now, very telling!
• Jennifer Block talks about the Amnesty International release calling the US Maternity Care System a crisis.

In the news :

• Doctors say Benefit of Baby wearing out weights the risks!
• Mothering Magazine takes on Baby wearing in their Special Report
• Michael Moore takes on Stupak, and I love every minute of it!  If you aren’t extremely liberal like myself, you probably will not enjoy this one!

Still I have been doing this week that you should really check out if you missed it….

• Wednesday night I had Dr. Nicolas Fogelson OB/GYN on my radio show discussing delayed cord clamping.
• In light of the recent nice weather, locally there has been one fatal motorcycle crash, and another seriously injuring a friend of our family, both caused by negligent drivers of cars. Remember this time of year, with the nice weather, you are sharing the road with motorcycles!
• Post Cesarean Feelings Survey ended on Monday, and since then it has been a crunch to analyze the numbers, and get consent for comments, and everything we need to do to work on this project more.  The first two posts with information were posted. The first post included the results of the survey as a whole, and the second post on the results of questions #1 and #2 was posted yesterday.  Keep an eye open this coming week for a couple things… More survey’s with a time limit of a month, and the post for questions #3 and #4!
• Check out the Health Baby Network’s post about the Post Cesarean Feelings Survey also!

See ya next Sunday for a hopefully awesome wrap up of this coming week!