Sunday, January 27, 2008

Have Spinal Column, Will Travel

So, last night. Tampa's Business of Being Born.
Round and Round it goes.

The CNM's "educate women"
The OB "I practice ethically"
The Doula's "empower women"
A woman in the audience "respect life"

I have a singular frustration as I wake today. It's the same frustration I've awakened with and gone to bed with for the last month. I'm sharing it because it's becoming a bit of an obsession and reframing the argument has to become a reality.

Cesareans are NOT about Malpractice. They are about what an OB is or is not willing to do to keep himself from being subject to malpractice. Would you let someone hold your wife down and cut her baby out of her stomach if they were standing on a street corner telling you they would get sued if they didn't? An OB tells you "I have to practice this way" because he worries about his practice being lost, his livelihood, his home, his ability to pay his bills. He lives in this fear. She lives in this fear. Women OB's are not only as bad, they are often worse, pushing themselves to live to the standard of practice while raising families and trying to fight back against long hours.
Wow. Feel sorry for the OB's, right?
Until you realize the following:
They cut women to get home on time.
They induce women to manage care and timing of their office visits.
They induce or section women in order to keep their cost of doing business low.
They cut women who had a prior cesarean because they are afraid of being sued.

What they don't do is look at the woman in front of them and wonder if she will die at age 45, leaving teenagers or toddlers without a mother due to the bowel adhesions she received from that cesarean. It's not lawsuit material.
They don't look at that same woman at a year postpartum and see her lying on the floor sobbing due to the PTSD results of her failed struggle against failing at birth and having her baby taken from her. She can't sue. She's actually "healthy" after all...physically. Right?
They don't look at that same woman after three cesareans, unable to stop crying because the stillbirth in her arms is the result of those other surgeries. That first OB can't be sued for this.
They don't look at that same woman at six months, unable to have sex because she still has pain. One man successfully sued for not being able to sleep with his wife.
They don't look at that same woman at 6 weeks, having a hard time walking up the stairs because of the infection in her incision that still hasn't healed. This isn't lawsuit material because it's actually a NORMAL complication of cesarean.
They don't look at that same woman sitting in the NICU, staring at her 2 week old who has a respiratory infection. This isn't lawsuit material because once again, it's NORMAL.
They don't hold her hand in her bed while she's trying to figure out how to nurse across a scar when she can't even hold her baby.
They don't hold her hand while listening to complete strangers discuss the news of the day and take her baby to another room.
They don't hear the voice of someone else telling them that their body has failed and it's time to let someone else take over and take her baby out of her.
They don't sit in her labor room trying to fight the pain of the contractions and giving in to the epidural because she's terrified of what will happen next.
They don't help her cry at night, not knowing how to say no to an induction tomorrow which she doesn't need and doesn't want and is secretly terrified of.

They go to their practice, they see her for 5-15 minutes, they weigh her, assess her and leave. And worry that they will get sued because deep down they know they are not giving care. They are providing a business service without compassion and they only look at the plumbing.
God forbid they notice the house has fallen down and the woman is trapped inside. After all, if they don't see her as a person, they can't get sued.

Friday, January 11, 2008

Business of Being Born in Gainesville

Last evening, at a rather successful fundraising/community awareness event in Gainesville, one woman stood up to say that she's had three cesareans and she doesn't need a ribbon to mark her or anything else. She's fine and cesareans don't have to be a bad thing.

After rehashing why she might have felt the need to do this, it all comes down to the fact that she's right. She doesn't need a ribbon. She's scarred for life, three times. She's going to spend the rest of her life being a statistic with higher risks. Her future insurance companies might deny her for coverage, her future doctors might refuse to take her if she doesn't agree to surgery (regardless of medical condition or health), her risks for hysterectomy, adhesions, bowel obstructions. More surgery. She may or may not wind up with more health problems, but the risks are certainly weighed in favor of it. Enough said.

But she missed the point. Cesarean Awareness is not about branding anyone. It's about being aware of those risks, doing what we can to mitigate the risks, doing what we can to prevent cesareans, doing what we can to encourage women to healthy pregnancies and healthy births that don't end in surgery or if they have surgery, learning new ways to help make these risks lessened.
I don't wear my ribbon to remind ME I had a cesarean, I wear my ribbon to bring attention to the risks and to bring attention to the fact that EVERY childbearing woman should know what I know. She should have informed consent. She should be angry that MORE THAN 1/3 of all births are surgical. She should be livid that women are having to go home after major abdominal surgery and care for their infants alone.

There should be change and for all that this woman was trying to show she's ok on the outside, it's the same old ruse of the cesarean. It's what's on the inside that counts.

Monday, January 7, 2008

Futility of Educating Oneself?

A link to share with you about a story on childbirth education:
USA TODAY

Maybe most of these women just see the futility of going in to learn about something that DOESN'T APPLY TO THEM???

"don't make me feel guilty"...for what? Understanding the ramifications of your actions?
"don't make me feel bad about wanting an epidural?"...An epidural is a medication often used during labor which affects the entire process and all parties involved in the biology and raises the risk of cesarean if used inappropriately, i.e. the way it's currently used in American medical care.
"don't make me feel bad about choosing a cesarean"...you want surgery instead of going through a normal process. Maybe learning the facts about it isn't making you feel bad, it's making you realize that it's not the same thing as ordering a biscuit with your eggs.

Chilbirth educators aren't dismayed or upset by the amount of women going in for surgery or using drugs, they are floored at the ignorance and apathy of an entire generation of women who don't seem to give a damn about the process, the ramifications on themselves or their future health or their infants. But underlying all of this is a dark secret. It's not really just the moms who everyone is angry at. It's the system. The Obstetricians who feed the fears and cause so many of the issues through iatrogenic induction, monitoring, regulation of food and water. These women are often seeing this "way of birth" through the TV, through movies. They begin to breathe it as small girls when their first baby has a Fisher-Price bottle welded to it's hand or three different kinds of "juice" and "milk" in it's box. When we see birth, we are blinded to the ability of the woman and the normalcy of having a baby out in the middle of nowhere without doctors and a neonatal nurse and an OR. We learn to watch TV to see the "bravery" of a woman on a soap opera abandoned in a snowy mountain retreat giving birth to her infant with no power and when the channel is flipped, we see a screaming woman or worse, one lying defeated in bed, giving her life's choices away in sorrow as the overwording tells us "Well, after 3 hours with no progress, Jamie's doctor decides to do a cesarean"...
Really? Where the hell is Jamie in this process? Does she look like she wants a surgery on top of this? Did anyone talk to her, get her out of bed, feed her LUNCH and buy her some time? Her body quit and so did she.
There, lying strapped to monitors, starving for food, unable to drink more than ice chips and being told her body has failed. "here, we'll do this before something else goes wrong" and the implication is...she will never complete, never succeed. Why Try?
Because if you don't...this is what will happen to you. You will be Broken.
That's the message of a lack of childbirth education and/or the stronger women who are finding their information in books or on the web. Either you quit ahead of time and let go, believing all to save your own sanity and ignorance or you learn and fight the system. Fight those who will tell you over and over again that you cannot do this. You cannot birth a 10lb baby. You cannot birth with low fluid. You cannot birth a 6lb baby. You cannot birth with high fluid. You are going to kill your baby.
So why go to childbirth classes. You've already talked to your OB and he's told you all he needs to. Or she has. A woman OB had to submit to the same system and have her humanity and female fellowship drained out of her or she, too, would have been a failure.
Face it. The futility of fighting the system leaves one drained and incapable.
It's easier to just stay home and watch "A Baby Story."

Sunday, January 6, 2008

Pushed to Write about a Stranger's Cesarean

http://www.huffingtonpost.com/jennifer-block/open-letter-to-christina-_b_80115.html

She says it so much better than I can...
I wish that Christina would wake up and say ICAN before she is in the throes of healing like the rest of us.

Once again, a stranger on the web reaches out. I guess I'm not in such bad company.

Blogs and Cesarean

Many people don't realize that when they post on their blog, it can be meta-searched and when they post about their cesareans, vast arrays of women read about it. This sort of vicarious watching becomes almost painful when you see someone young and naive take a nose dive into major surgery for no apparent reason.

Recently, a young woman on a blog posted how her baby was "SO BIG" at well over 10 lbs at 38-39 weeks and so she would have to have a cesarean.
Wait. Since when is having a baby an indication for cesarean? Oh. Since she lives in the US.
Wait. Didn't anyone warn her about the possible ramifications of major surgery? No. Her friends and family all loved and supported her without one mention of complications or risks or why is she making this choice?
Wait. Does she know that ultrasounds aren't reliable and that 10 lb babies are born all the time vaginally? I don't know.

So, a week later, she goes in for the elective surgery that will put both her, her baby and any future children at risk for their entire lives. Her entire gyn history and future merge at this one point and begin to make decisions FOR her rather than WITH her. She will have to fight to birth vaginally, should she ever choose to, or she will have to add surgery on top of surgery, increasing risks at every turn and will most likely have an earlier hysterectomy than her vaginally birthing sisters.
For a baby that one week later still wasn't 10 lbs.
For a general surgery that her husband wasn't able to be at.
For an increased risk in other complications that have already begun to occur.

Does she know these things? Will she care one day?
I don't know. Probably, she isn't even aware of all of this.
My heart broke for her and her baby in an odd sort of way. In all that vast sea of "oh, it's ok, cesareans are easy, I did it...blah blah blah...we love you and your baby...we'll care for you..we'll make you meals."
Not one person said "You can do this. You don't need surgery to birth your baby. You deserve better. Let's just try and I'll be there to hold your hand."
Not ONE person believed in her?
just one. A "stranger" on the internet. I believed.

Wednesday, January 2, 2008

A Father's Role

Recently, there have been studies posted in various places about father's increasing a woman's perception of pain and father's increasing the cesarean rate through fear tactics or coercion from the obstetrician involved. What you don't see is the father's role in VBAC or in protecting mothers FROM the treatment involved with birth. So, this is a short, quick five questions to make men think.

1. Why is external fetal monitoring used? Does this work?
2. Why is a woman's amniotic fluid sac usually broken? Is this accurate?
3. Is induction proven to be effective or safe in a normal full-term pregnancy?
4. What is the most common indication for cesarean section?
5. Is it normal birth to be on monitors, lying in a bed, denied food? Would you do it?

I know this is a setup..but if men know better...why do they not speak up for change? Why is it only a woman's job to fight for better births in this country? Do men care that their wives and partners are being treated the way they are or does it feel safer to not speak up and tell the hospitals or obstetricians or nurses "no." Or is it that they are so terrified to be removed, they consent to abuses? Is there a reason why so many men are terrified of homebirth beyond being scared of personal responsibility for the outcomes? Is it worth consenting to the abuses in hospitals? Is there a reason to not step up and say "I will not tolerate you doing this to my wife/my child." JUST to get medical care? Or should we be demanding better care?

Hard thoughts. Hard choices. But where do Real Men stand?

New Year

The past few months were a trial run to see if I enjoyed keeping the blog and posting information occasionally. As the New Year begins, 2008 will see far more posting about various studies and issues and more information for both first-time and multiple mothers and the people in their lives. I hope that you find the blog helpful in your days to come and check back to see the upswing in posts.