False Expectations and The Great Switch

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.

Revolution: Shaking Things Up

The Beginning Starts with You 


I have always thought of myself as a simple sort of girl. I feel like I have a normal life for a woman pushing 30. I have moderate views and I am pretty mainstream when it comes to most things. Like I said normal. Which is why the more I look around the more worried I become.  I see a lot of women, young and old, who #1 have no sense of self worth and #2 have little confidence in their abilities as women, especially when it comes to giving birth!


I feel like the damage done to young girls through influences like Hannah Montana and Brittney Spears. Marketing that pitches push up bras for 8 yr olds. and the obsession our culture has with sex and body image are more damaging than we realize. I see it all the time, especially from other women. We judge others according to standards of thinness and make assumptions due to someone's appearance. These attitudes get passed on to our children and the cycle continues. 


And then for our little boys. Boys don't cry, they don't like pink, and <gasp> don't wear paint on their toe nails! The only way to convince a little boy he doesn't want to like pink, wear sparkly clothes, or have fun paint on his feet is to tell him it's undesirable. "Eww girls!" And the cycle continues. Why do we want to teach our future husbands that girls are less? That you wouldn't want to be a girl? Why can't we realize that the attitude that girls are less and "you don't want to be a girl" leads to domestic violence and prejudice. If girls are less then boys are superior in every way, right? All the while teaching our girls that they need to be the sexiest women they can to counter act having to compete with men. And that they can do anything a man can do. Which isn't true either. The power of a woman's body is an amazing thing but it is NOT the same as a man's. I feel that women are actually stronger than men but not in the measurable, I can bench press twice my body weight way(even though some women are that strong.) A woman's strength lies in her endurance. Women have been found to be able to endure more pain and more stress with less discomfort than men. It is a scientifically proven fact.


We as a society are afraid of our bodies. We are ashamed and embarrassed of basic bodily functions. Why are men embarrassed to buy tampons or sanitary napkins? No one thinks that they are for him. And why would it matter if they were? Oh that's right "girls are Eww!" Remember? Don't say the words penis or vagina. Lets make up cute little nick names for them because we shouldn't really talk about them at all but sometimes out of necessity HAVE to. We don't like to talk about sex with our children other than the bare bones facts. Most sex talks with teenagers if they happen at all consist of either "Don't have sex" (because that always works) OR "Always use a condom." No explanation on how the male or female bodies work. Just a vague idea of the shape of things from health class, where everyone titters in embarrassment and barely pays attention. I remember that they showed the birth of a baby in health class to the girls but not the boys. No explanation of how babies grow, how they are born, just if you get pregnant this is what will happen. This one class in school and what we see in TV from sitcoms like Friends or movies like Knocked Up are most peoples only experience with birth. Birth has been banished to the hospital and slap stick humor it's no wonder that we distrust and fear the power that is birth. 


Making a baby isn't a neat, clean process. Why should getting the baby OUT of your body be expected to be neat and tidy and orderly.  Your baby was made from semen that was ejaculated into your vagina and a little egg released from your ovaries. Your body then nourishes and sustains another sentient being! AMAZING!! And even more amazing then the growing of the baby is the hormonal and chemical cascade built into your body that lets your body know that it's time for the baby to be born and then creates an opiate effect in your body to manage the discomfort of ejecting a 7 lb (or more) baby through an opening that for the past 10 months has been keeping it in. It's a lot of work but it's pain with a purpose and if we learn to trust our bodies and not interfere with the natural process things go exactly as they are supposed to. There are always exceptions to the rule and there will always be people who do everything right and still end up needing technology. The people who NEED interventions are a lot fewer than the ones who are actually getting interventions. But why should a woman suffer through childbirth when we have all this excellent technology to "help" her? I refute this statement, a woman in labor doesn't need help she needs support. With a loving partner and knowledgeable, patient care provider most women can have wonderful birth experiences with out having to be "helped." The only thing they need saving from is the interventions and invasive technology.  Pregnancy isn't an illness! For the majority of women it is a normal, necessary (for the continuation of the species) biological process. Not a disease! 


If we were taught about birth and embraced the human body in all it's grossness. Icky bodily functions and all! We would know that a little feces in labor is to be expected and even to be looked forward to because that means that baby is pushing its way out. And you guessed it men need to learn these things just as much as women do! Many a labor has stalled or failed because the male partner is terrified and unable to be the support that his partner needs. A woman in labor needs to feel loved, supported, and safe. Who better to do that then her partner? I know birth has traditionally been a woman's domain. Before birth was moved to the hospital laboring woman were supported by the women in the community, people they had connections with and felt safe with. Not some random stranger (nurse) that they never met before and barely makes eye contact. The father should feel welcome and comfortable in his role in the birth. In order for this to happen he needs to be educated. If birth were a commonly occurring event in our lives we wouldn't be scared. We would know what was going to happen. Birth education needs to happen at home when children are young and continue through adult hood. Birth is much to vast of a topic to be covered in two hours a week for 6 weeks of your life.  
The reasons the maternity care system is broken are to numerous to go into at once. Suffice it to say that there are many things that need to change and would be more beneficial to mothers and babies and fathers too. I feel like FEAR of birth is the first obstacle to over come so that is where I started. I am writing this down and sending it out to touch others. Because I have been touched by a ripple in the birth revolution and I hope to touch more people through my words. If I make one person think a little harder about why they are anxious or uncomfortable about birth I feel like I have succeeded. I don't want people to agree with me I want them to think. And to think for themselves not just take someone else's word for it. 





"We have a secret in our culture, and it's not that birth is painful. It's that women are strong." - Laura Stavoe Harm