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“Unless You Push, It Doesn’t Count”

November 17th, 2005

So I’m at school, waiting to pick up Wacky Girl, and one of the mommies is yap-yapping on her cell phone in my ear about, “The c-section rate in this country is 30 percent, and most of them are unnecessary, and it’s all about medical malpractice and yadda-yadda, a lot of women think it’ll just be easier to schedule a c-section…”

And I’m thinking, “I’ve heard this before. I’m so frickin’ beyond sick of this topic.”

Oh, to know what everyone else should do, each and every one of them. I’d bottle it and sell it, for sure. Okay, I did not have 2 c-sections because i wanted a tighter snatch, or because I was scared of labor, or because I thought it’d be easier. I had the first one cuz i was in labor for 65 hours, WG was running a fever and had an infection, there was meconium in the fluid, she was posterior and I was having fucking horrible back labor, I, too, had an infection and was running a fever (up to 102 degrees) and it was a medical decision, okay? and I don’t regret it.

Of course I don’t regret it, assholes who think we should have made a different choice. What choice should I have made?

There are a ton of stories like mine out there, and a lot of them go to make up that 30 percent. Of course some c’s are unnecessary and some are about medical malpractice, duh, but i don’t think the majority are, and I know mine weren’t. And yes, I did have a g.d. doula and a midwife, but guess what? It didn’t help my baby get born vaginally. Fucking coulda/woulda/shoulda armchair quarterbacking — both kids are here and healthy and that’s all that matters to me.

An opinion: Childbirth is not the hard part of parenthood.

I started regular contractions at home Weds. 3 p.m., after getting membranes stripped in the doctor’s office that a.m., cuz I was a week overdue and freakin’ huge.

Went to the hospital at 2 a.m. Thu., when the contractions were 2 minutes apart and I was having back labor and puking. (Midwife and doula met us there.) More contractions, more trying, small amount of dilating (I didn’t get past five centimeters cuz posterior babies’ noggins don’t knock against the cervix and help it dilate — they hit your spinal column instead. Thus, back labor.)

Finally had a c-section 8 a.m. Saturday (you do the math) and hello, 10 pound 2 oz. huge-headed Baby #1, Wacky Girl. Doctor: “If you’d been on the Oregon Trail, neither one of you would’ve made it.”

Second c (hello, 9 pound, 6 oz. big-headed Baby #2, Wacky Boy) was because I hemorrhaged post-partum twice and nearly bled out (ie — died) and ended up in the ER because there had been so much trauma to my sad uterus after all those contractions and stress with WG. I talked it over with the doctor and we scheduled the c-section. I thought it was better that my kids have a mom who was alive than one who was a “real” woman and delivered vaginally. “I pushed mine out! Hut-hut! Yaaaaaaaaaa! Yours doesn’t count! Nyah-nyah!” And yes, I’ve gotten so much shit about it in the last six years that I am completely pissed off now.

You’d think i’d be less pissed off by now. No, more.

(Private note to Hockey God: Baby, I know I’ve given you so much grief — ie “Why the hell didn’t you get me a doctor sooner, asshole?” Honey — I’m sorry. I’m glad our kids are okay, I’m glad we’re both okay, I’m happy I didn’t bleed to death, and that’s all that matters. Sorry, for all the times I’ve yelled at you.)

Here are the quotes, pre-delivery of WB:

My cousin: “You’re not going to even *try* vaginally?”
My friend: “Don’t be scared, just try it!”
My other friend: “Chicken!”
Another idiot friend: “You’ll want to at least try VBAC — I’m mailing you this book.”
An idiot friend’s wife: “Unless you push, it doesn’t count.”

To all of them: It counted. So please get off your vaginal high horse and shut the fuck up about all the unnecessary c’s. Some are, some aren’t. It’s not a goddamn competition, okay? Love each other, and respect each other’s decisions and birth stories. I repeat: It. Is. Not. A. Competition.

And if it was, I’d win — mine are the prettiest.

12 Comments

  1. Heather says

    I had two C sections: the first after 36hrs of labor and 3 hrs of pushing because I got strep-b in my uterus (also known as “flesh eating strep that killed the muppet guy Jim Henson”) and because the doctor showed me an xray that proved I had cephlo-pelvic disporportion and fused pelvic bones (baby’s head was way too big and my pelvic bones did not flex apart like they should.) The second time I believed the stupid witches who told me I had an unnecessary C the first time and that I should have a VBAC and my frickin’ uterus ruptured and my poor boy’s head went out my old incision! We both almost died because I wanted to try a VBAC.

    I thank God for C sections because otherwise I am quite certain I would not be typing this, and my wonderful children would not be here either. If people do not agree with my choices, they are kindly invited to butt the hell out of my uterus, thanks.

    You tell ‘em, Wacky Mommy!

    November 17th, 2005 | #

  2. Amalah says

    All I had to do was mention that my doctor told me a c-section was a possibility on my site and the anti-c-section people went nuts and emailed me all sorts of horror stories and told me to get a new doctor because mine was obviously full of shit.

    I tried for a vaginal; I had a c-section. My doctor was not full of shit. My pelvis was way too narrow for my 10-pound baby and hello! The cord was around his neck and there was meconium in the fluid and everytime I pushed his heartrate plummeted and his head hit bone. Why risk it? Get. The. Baby. Out.

    Will I try a VBAC if I have another? Eh. I don’t know, because I recovered beautifully from my c-section and my baby is alive and well, and I realized that IT DOESN’T MATTER HOW THEY GET HERE, AS LONG AS THEY ARE HERE. And frankly, Noah’s birth was enough high drama for one lifetime, thank you very much.

    November 18th, 2005 | #

  3. Wacky Mommy says

    Hallelujah to that. And welcome, Noah, Gorgeous Baby of the Universe.

    November 18th, 2005 | #

  4. Roxie says

    All those women who feel superior because their child was born vaginally can fuck off! I did it both ways. Child one was vaginal. Child two was . . . “I think I’m in labor, but something doesn’t feel right” Every hospital in town was full except OHSU. Screw that carefully thought out birth plan. When the doc looked at the ultrasound of my little baby, he told me that I should have a c-section NOW. I objected with “what would happen if I don’t”. The response, your baby may die. So, I signed the papers stat and 5 minutes later had the cutest, dimple cheeked little boy with a perfectly round head. He would have never come out on his own (our own).
    Now my sweet boy (who is ten) apologizes for the trouble he caused by being breech! Of course I reassure him and let him know that neither one of us would be around if we had to do it the “natural” way and that I am so glad he was born in this day and age.
    Baby number three was a vbac. He was a big baby, with a huge head. It was a long labor. All I can say is that with the help of an epidural it was fairly uneventful as deliveries go.
    Of the three deliveries, the one that I recovered from easiest was the c-section. I was back in my regular clothes within two weeks. And that post delivery bleeding that lasts a whole g.d. month with a vaginal delivery was practically non-existant with the c-section.
    Do I feel like I’m the “winner”? Hell, no! Just like everyone else who has had a baby, I’m just glad that they are here with me. Being their mom makes me a winner!

    November 18th, 2005 | #

  5. Wacky Mommy says

    i love dimply babies and their sweet mommies.

    November 18th, 2005 | #

  6. liv says

    LOL WM, you are soo great and soo true! okay, i delivered vaginally, but i don’t feel i am superwoman! i just wanted a healthy baby, that’s all…

    November 19th, 2005 | #

  7. Wacky Mommy says

    My doula was so funny — her boys are grown now, but she said that for years she thought she was sooooo cool cuz she had fast, easy deliveries. She was like, “I thought I was the shit. And then I realized it had nothing to do with me.” Forces of nature and all that, I guess.

    November 19th, 2005 | #

  8. zipdodah says

    Hi, my name is Zip – I have a confession – I was a pusher in desperate need of a C section…. My first WG was a 10 pound linebacker…Won’t go into any more details, but I was close to grabbing my leatherman out of my purse… I don’t care how you do it…..just GET.IT.OUT. This idea of c-sections NOT being necessary are like the ladies that say they will have their babies “in silence with no drugs”….RIGHT…..Be healthy, be happy, all women are different. Now how about those drugs eh?….”she’s out? already? wow….that was soooooo easy!” ;-)

    November 20th, 2005 | #

  9. zipdodah says

    Oh, and on another note…why the HELL do people feel the need to talk on their damn cell phones so loud for others to hear? you.are.not.THAT.important.
    Get in your car, a phone booth, or a flippin Honey Bucket…..we DON’T want to listen to your mindless tongue-waggin’

    November 20th, 2005 | #

  10. ADD mom says

    Okay – so I already wrote this once – guess that I did it wrong – don’t want to type it all again – is there spel check on this – hahahaha
    I have twins – I had a c-section- yeah, it would have been great to do it the old fashioned way, I have had friends disappointed in that – I am sorry that my kids did not come out of my whoo haww – does that make me less of a woman – my husband sure as hell does not think so – my sex life has never been better – Oh ,and did I mention that I was unable to breast feed more than an ounce at atime, so after 5 weeks of pumping every 4 hours with this huge expensive double pump, I stopped. Well, hello- my kids are the healthiest kids that I have come into contact with. So Just get off your high horse with this whole issue – do what you can and appreciate what you have -

    November 21st, 2005 | #

  11. WD says

    Good story in today’s Washington Post, “Once a C-Section, Always a C-Section?”:http://www.washingtonpost.com/.....02295.html *Women Who Want to Try Labor on Later Deliveries Are Increasingly Refused* (free subscription required).

    Here’s the text of the article:

    By Rob Stein
    Washington Post Staff Writer
    Thursday, November 24, 2005; Page A01

    When Karri Rickard moved from Pennsylvania to Maryland, it never occurred to her that she would have a problem finding a hospital to deliver her baby. But she did. So much trouble, in fact, that Rickard and her husband are giving up their home in Frederick and moving back to Pittsburgh.

    “It’s sad, because we’re happy here,” said Rickard, 32, who headed back to Pennsylvania this month with her husband and four children. “But we want to be somewhere where they’ll let me trust my body.”

    Karri Rickard, with Caitlyn, James and Justin, had a Caesarean for the birth of her first child. Because Frederick Memorial Hospital does not allow an attempt at labor after a prior C-section, Rickard and her family are moving from Frederick back to Pittsburgh, where she will have that option.
    Karri Rickard, with Caitlyn, James and Justin, had a Caesarean for the birth of her first child. Because Frederick Memorial Hospital does not allow an attempt at labor after a prior C-section, Rickard and her family are moving from Frederick back to Pittsburgh, where she will have that option.

    Rickard’s problem is that she delivered her first baby by Caesarean section, and Frederick Memorial Hospital refuses to allow women who have had a surgical delivery to risk going through labor. So Rickard is moving back to be near the hospital where she delivered her other children without surgery and plans to try again with the baby she is expecting at the end of January.

    “My last labor only lasted two hours. There’s no reason I shouldn’t be able to try going through labor again,” Rickard said. “It’s my body.”

    Around the country, pregnant women are facing similar problems as an increasing number of hospitals refuse to let women try labor after an earlier C-section, citing concerns about safety and being sued if something goes wrong.

    The trend is helping push the Caesarean rate to record highs, according to data released last week by the Centers for Disease Control and Prevention. Nearly one-third of births are now C-sections, up 40 percent from 1996. The rise is driven by a number of factors, including more women opting for surgical deliveries of their first babies. But another reason is the 67 percent drop since then in the number of women attempting labor for subsequent pregnancies.

    “It has been dropping quite dramatically,” said Joyce A. Martin of the CDC’s National Center for Health Statistics. “It’s one of the factors.”

    The trend has sparked an emotional debate among women’s health advocates, hospitals and doctors over the risks of repeat C-sections vs. vaginal birth after Caesarean — known as VBAC — and who gets to decide.

    Some say the reduction in VBACs marks a necessary correction that protects the health of women and their babies. They point to data showing that VBAC deliveries carry a significant danger of serious complications, notably about a 1 percent risk of a ruptured uterus. That can be fatal to mother or baby unless an emergency Caesarean is performed immediately.

    Others say, however, that women are being robbed of their freedom to choose how they want to deliver their baby and forced to undergo a surgical procedure that can unnecessarily complicate childbirth and has its own risks, primarily of bleeding, surgical infections and blood clots.

    “We’re grown-ups. We’re not infants. We should be able make our own choices,” said Tonya Jamois of the International Cesarean Awareness Network, which advocates against unnecessary C-sections. At least 300 hospitals have banned VBACs, according to a survey the group conducted last year.

    Officials of hospital associations in the D.C. area said they knew of no other maternity hospitals — besides Frederick Memorial — that refuse to allow VBACs. Most hospitals say the decision should be left to the woman and her doctor. In some areas, however, including parts of the Eastern Shore, individual obstetricians or group practices have decided not to do VBAC deliveries, “which effectively eliminates that option for some people,” said Nancy Fiedler, spokeswoman for the Maryland Hospital Association.

    While agreeing that women should be able to make individual decisions in consultation with their doctors, many experts say the safety risks and chance of a malpractice suit make it understandable that many hospitals and doctors are unwilling to attempt VBACs.

    “From the point of view of public welfare, I understand and support the view of these doctors and hospitals who would be unwilling to attempt VBAC,” said W. Benson Harer Jr., a former president of the American College of Obstetricians and Gynecologists. “The risk may be low, but when something does go wrong, it is often a disaster. In a way it’s playing Russian roulette.”

    The restrictions on VBACs are the latest twist in a long-running debate over C-sections and childbirth in the United States. In the 1980s and 1990s, medical authorities launched a campaign to reduce the number of C-sections, particularly the practice of routinely performing the procedure on all women who had had one before. Repeat Caesareans were criticized as often unnecessary, subjecting women to costly and potentially dangerous surgery that complicates their recovery. Many women’s health advocates viewed Caesareans as epitomizing the male-dominated, overly medicalized birth process.

    But doctors became alarmed by reports of women experiencing dangerous complications. In 1999, the American College of Obstetricians and Gynecologists recommended that vaginal birth after a C-section be attempted only in hospitals where a doctor and other staff members were standing by to perform an emergency C-section if necessary.

    “There were horrific cases occurring among women going through a trial of labor,” said Charles Lockwood, chair of obstetrics at Yale University, who helped write the guidelines. “There’s a lot of hard, irrefutable data on the increased risk. It would have been immoral to not have come out with the new recommendation.”

    The guidelines prompted many hospitals, especially smaller and more rural ones, to discontinue VBACs. Rising malpractice insurance rates and fear of lawsuits have accelerated that trend.

    “There isn’t a single state in the nation where at least some hospitals haven’t abandoned VBAC altogether or cut way back,” said Bruce Flamm, who studies the issue at the University of California at Irvine. “I don’t see anything that’s going to reverse this trend.”

    Some women find that their obstetricians, fearing lawsuits, also decide it is too risky to try labor.

    “A lot of doctors do a bait-and-switch kind of thing where they tell a woman in the early stages of pregnancy, ‘Yeah, we’ll do a VBAC.’ And then all of a sudden their tune changes. At that time, a woman has a hard time finding other options,” said Jamois, who argues that C-sections also have risks.

    Frederick Memorial stopped performing VBACs last year because of concern that the procedure was too dangerous and fear of a devastating lawsuit if something went wrong.

    “Patient safety is the most important factor,” said Edwin Chen, who heads the obstetrics department. “But we also had to be concerned about the danger of being sued and going bankrupt. Then we couldn’t provide any care to anyone.”

    Although many women say they understand and are willing to accept the risks of VBAC, Harer said that often changes if a woman suffers permanent physical damage, loses a baby or is left with a child with permanent disabilities.

    “This is an incredible burden on the family and one for which our society does not provide real support and care. So the only way the parents can really hope to have any normal life and get support for the child is to sue the doctor and the hospital,” Harer said.

    When Rickard discovered that the closest hospital that would be willing to allow her to try labor was 45 minutes away from her Frederick home, she decided she had no choice but to move to be near the hospital she used before.

    “I have four children. Why have six weeks of recovery when after two hours I should be up taking a shower?” Rickard said. “My husband left his dream job down here to move us back to Pennsylvania to make sure I didn’t have to have a C-section.”

    Women facing similar situations in other parts of the country have simply given up.

    “It’s so unfair,” said Daphne Mertens, 27, of Emporia, Kan., who reluctantly acquiesced to a Caesarean last month after she was unable to find a nearby hospital willing to let her try labor. “I should have been able to make an informed decision about what’s best for myself and my baby.”

    In other cases, women are opting for the more dangerous choice of having their babies at home without a doctor. That’s what Barbara Roebuck, 38, of North Platte, Neb., did after her local hospital refused to allow her to try labor. The nearest hospital that would was four hours away.

    “I felt I had no choice,” said Roebuck, who gave birth at home in June with just her husband and two friends present. “I did lose a lot of blood. If my uterus did rupture, I knew I would not make it. I would have felt a lot safer if I was in the hospital. But I knew if I walked in the door there they’d just cut me open.”

    That scenario is what most alarms both doctors and advocates.

    “I can’t think of anything more scary than a woman with a scarred uterus attempting a vaginal birth at home,” Flamm said. “I’m sure it’s happening, and I’m sure some women have already died because of this, and some babies have died.”

    Flamm hopes hospitals will find a middle ground, perhaps bringing in extra staff when a woman attempts labor, or perhaps referring patients to nearby academic medical centers that have more staff.

    “There’s got to be some compromise,” Flamm said. “The stakes are just too high.”

    November 24th, 2005 | #

  12. Barbara says

    I am the person who hooked Karri Rickard up with the reporter for the Wash Post article above.

    Since I run a support group for women who have had cesareans, I don’t at all see this as a situation where women feel that having a vaginal birth makes them superior.

    What I see is women who have suffered from their cesareans…pain that lasts months or years, pain during sex, postpartum hernias that required more surgery just weeks into new motherhood, bonding problems, depression (a known side effect of any major surgery), breastfeeding problems, subsequent infertility, emergency hysterectomies to stop cesarean hemorrhages (one is a 22 year old first time mom induced for no medical reason), and the frustration at having a baby but being unable to do laundry, carry the baby up stairs, grocery shop, walk the dog, or do anything else necessary to run our households.

    One mom, who elected her second cesarean (and so had no emotional problems with having a cesarean), has suffered an incarerated bowel. Meaning, during her recovery, she developed severe pain. Went to the ER, the opened her up and discovered one of the internal suture layers (seven layers of cutting/suturing during a cesarean) had come open and a portion of her bowel came thru and became trapped. She nearly died. They weren’t able to completely fix it so she was sent home to care for her infant and 2 year old with the instructions not to lift anything, not even her own baby. Months later, she was still only allowed to lift 5 lbs (her baby was of course heavier than that)and despite precautions, is still at risk that her entire bowel could die. She is not allowed to have anymore children. What she said to me was, “Barbara, I had NO IDEA that cesareans could have such serious complications.” She is an educated woman with a high level career.

    So for me it isn’t about high-horses but rather women not getting the information on the possible risks/complications. My cesarean was a result of medical mismanagement of my birth. Many of them are. Afterwards, I bled for 4 months, had bonding troubles with my son, was only able to breastfeed through extreme efforts on my part (plus a paid, in-home lacatation consultant), had postpartum depression for 2 years, couldn’t take even a 10 minute gentle walk for 6 months, and had daily pain for 1 1/2 years. I’ll find out soon whether my problems conceiving #2 are related to cesarean-caused infertility.

    I am totally in support of women choosing to birth however they want. But I feel that women aren’t getting the information to make informed consent. Now that I am also a doula, I see first hand how some cesareans are unnecessary. How about the woman who was doing fine but the resident doctor wanted to go to sleep? So, she ordered the nurse to ‘start Pitocin and increase the levels until the baby crashes then we’ll do a section.” (Its called ‘Pit to distress’)

    If you are interested in learning more, I suggest joining the email support list for the International Cesarean Awareness Network http://www.ican-online.org (look under ‘community’). There is a current discussion going on about women’s experiences with their post-cesarean pain.

    -Barbara

    December 3rd, 2005 | #

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