While I was pregnant with my second child I experienced what I have lovingly heard termed the "Bait and Switch." I use this term to describe the lies of omission and blatant falsehoods told to pregnant women and especially to women seeking VBACs or who are for what ever reason termed "high risk." Some of these lies aren't even lies they are just the bare bones truth but not all the facts. For instance when I was pregnant with my second child I was told "well if you have a vaginal birth after a cesarean your uterus could rupture and you and your baby could die." PERIOD. That was all my OB told me. No explanation, no talk of actual risk and what my odds were. She didn't tell me that I had a less then 1% chance of this happening. Just told me I could die and asked "Why don't you want another c-section?" Back then it wasn't because I was educated in seeking a VBAC, I just knew I wanted one and didn't have time with a toddler and a daycare at home to have a cesarean. And even though I knew what to expect with a cesarean it scared me to under go surgery again. I know why I wanted to have a vaginal birth. It was instinctual. I knew down to my toes that babies are not meant to be surgically extracted. I didn't have the facts behind me at that time but I knew what I wanted. I told my OB that I didn't want a c-section and that I didn't have time for the recovery. "Well the second cesarean is much easier to recover from then the first." (A statement which makes no sense to me.) Even with her reassurances that I would be fine and could handle it I still wanted a VBAC. She told me that I could have a trial of labor but would have to have an epidural, IV, internal monitoring, and would not be able to be induced (which was fine I never wanted to be induced ever again.) Looking back she seemed kind of disappointed when I stayed determined to have a VBAC through out my pregnancy. I refused to schedule a cesarean date. I told them it was no use wasting time on the schedule because I wasn't having another cesarean. I was determined and at 39weeks 4days I went into labor on my own and had the fastest of my labors. I was truly fortunate because when I got to the hospital I had the most surgical OB in the practice on call. She nagged me for an hour about getting the epidural that I had refused. She only stopped pestering me when I told her I was pushing and that she could put in the internal monitors but I was having the baby now. Such was my determination and will with my second. I am not alone in feeling like my "supportive" OB changed sides or that I was fighting my care provider ever step of the way at the end. All though looking back I wish that I had looked for a more supportive OB but I assumed that these were the rules and that it would be the same anywhere I went. I have known several women who having gotten to the 38 or 39 week mark, their Dr. Jekyll OB becomes the scalpel happy Mr. Hyde. I know a woman who's care provider refused to treat her and referred her to another hospital 3
hours away because she wouldn't consent to a repeat cesarean. At 39 weeks.
Which brings me to the second half of this post False Expectations. We
expect our doctor to have our best interest in mind. We
expect that we can trust them to do what is right not what is most convenient for them. We
expect them to tell the truth, the whole truth. These are not unreasonable expectations they are just rarely what happens. I don't believe that this is done out of malice although sometimes I do think it is greed. I think that OBs genuinely feel that there is nothing wrong with having a cesarean. I mean look how controlled and predictable it is (unless something goes wrong...) And above all else they are human. Of course they are ready to go home at 10pm after having attended two deliveries and a cesarean on top of the 28 or more patients that they saw in the office earlier that day. Should that be your problem? No, but it is because you are now struggling to have a normal birth attended by this tired person who sees ONE natural birth a month if even that! It's not malice it's a different point of view. It's the we are gods mentality and the confidence that a surgeon needs when making life saving decisions that make OBs
terrible at attending births. Not all OBs but many. Some OBs believe in the midwifery model of care and are only OBs so they can use the surgical skills for emergencies, I have yet to meet one but the world is a large place I am sure they are out there.
So what do you do? You ask questions and do your own research. Don't rely on other people to tell you what you should do. You know your body best. Listen to your instincts. Banish self doubt through education. After you have asked all these questions ask them again! Don't stay with an OB who doesn't give you the same answer twice. If you are in a practice with 6 doctors make sure you can see all 6! You never know who you are going to have on call when you go into labor. Environment is so important while in labor and even in getting your body to go into labor. You need to feel safe! I am not saying that the only way to have a normal birth is to have a midwife, some midwives are just as bad. I just encourage women to know what childbirth is and to educate themselves rather than relying on others to give information. YOU are your own best advocate. And while in labor have someone with you who does support all of your decisions sister, mother, partner, husband, doula, whatever you need. Advocating for yourself is important but having others to advocate with you, not for you, but in addition to you, is also a wonderful thing. Do not let anyone who is not 100% with you attend your labor. And if their feelings are hurt tell them that it hurts
your feelings that they won't support you. Stay strong and steadfast in your plans but with the understanding that sometimes the unpredictable happens and you need to reevaluate but that is the exception not the rule of childbirth.
