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Tuesday, July 28, 2009

What I Love About My Cesarean

Cross-post from ICAN Blog:

Jasmine Ojala is a mother of two children and a member of ICAN of the Twin Cities. In this post she shares her reflections on what she’s learned from her births.

I have learned and grown so much through my two birth experiences. I had a traumatic cesarean three and a half years ago and a beautiful unattended homebirth just under 2 years ago… but, I am still so raw and emotional when it comes to my cesarean… I know there are many others here who can relate… I carry a lot of guilt around for the decisions I made during my cesarean born baby’s pregnancy, labor and delivery. I know now that I was very ignorant about my rights, my options, the scientific facts, etc.

Thinking about the VBAC a lot today, and with every wondrous, beautiful thing that happened with my VBAC baby’s birth, it has made me mourn even more deeply what I missed with my cesarean born child’s birth. I should be happy that I even got to experience a birth like that at all, painless-orgasmic-peaceful, everything I wanted… but I am just even more angry now that I /really know/ what I lost out on before… My husband is so supportive, but I think he secretly thinks I should be "over" everything by now, especially since the VBAC. But, I am still talking about, pouring over and investigating anything and everything I can get my hands on even remotely relating to birth. He doesn’t get it. He understands that I do what I am doing now to help any woman I can, even if I only can help one…. But I can tell it is getting old for him.

Anyway, I recently did the thing where you write out the positive things about your cesarean experience. So here is my list in no particular order:

1. I am not so ignorant anymore. The cesarean brought me out of my self-imposed ignorance. That was one of the best things the cesarean did for me. It taught me that I have a mind and I can study and I /should /put that to use. And I have.

2. The cesarean served as a way for me to receive some attention that I was craving from my mother. That may sound horrible, and I guess in some ways it is, but I didn’t realize that until I started to make my list. My mother has never been a "mothering" type- I hardly ever saw her, much less spent time with her. But she sure was a-motherin’ me after the cesarean. It was nice to have a mom.

3. Recovering from the trauma of the cesarean provided me and my husband with the opportunity to communicate on a whole new level. We have always had great communication but I had trouble allowing my "weakness" or "vulnerability" out in the open. I don’t like to ask for help- I don’t like to not handle things myself. The aftermath and recovery from the cesarean eliminated all choice I had in the matter, and all the better too, we are even closer now.

4. The cesarean opened my eyes to birth in our culture and opened up my options and alternatives for future births. I know many other women have said this before, but I would not know what I know now and be the person I have become if it weren’t for the cesarean. It is a shame that a major, traumatizing birth experience is what I needed to shake my beliefs and values like that but unfortunately, in our culture, that is usually how it is done. I wish that could be changed. Why is it that I needed a sledgehammer to the guts in order to ‘wake up’??

5. The cesarean has also shown me my great capacity to love my children and myself. I have a love for my children that is open and endless. I know I would sacrifice myself for them in a heartbeat because I’ve already done it once. I have learned to love my body too- it tried so hard. I used to think it failed me, but the reality was that I failed it, and my body was so resilient. Despite all the obstacles I allowed in it’s way, I *almost* gave birth. My body took to healing itself right away and did a great job… I love this magnificent body and mind of mine that can conceive, bear, birth and raise such beautiful people!

6. I have learned much about my own strength and my abilities to cope and grow. I feel like I am a better person, a stronger person, a more patient person. I am a lot more empathetic than I’ve ever been before. I also have a deep respect for myself that never existed before. I see myself the way I really am, rather than what I think I "should" be.

7. The cesarean taught me that no matter how much control I want or how much I think I have, life isn’t fair and never will be. Sometimes things just happen.

8. I learned it is up to me to deal with the consequences of my decisions, good or bad- no matter who/what I may feel is at "fault." That is what I love about my cesarean.

But you know what- I still desperately wish I’d had a blissfully ignorant vaginal birth. There is much longer list of all the things I hate about my cesarean, but that is too familiar a story.

Saturday, July 11, 2009

Pitocin: A Cautionary Tale

Cross-post from ICAN blog:

The blogosphere lit up this last week with posts about “pit to distress” (see here, and here), the practice of administering the maximum dose of Pitocin (synthetic oxytocin) to a laboring women until the baby shows signs of distress. Such overuse (and misuse) of Pitocin in labor raises the risk of cesarean, traumatic vaginal delivery, and other negative outcomes. Yet induction and augmentation with Pitocin is virtually unquestioned by birthing mothers and their medical providers.

This week’s announcement of Ohio’s largest jury award for medical malpractice tragically illustrates this problem. The jury awarded a family $31 million in compensation for their son’s severe cerebral palsy brought on by a uterine rupture during a mismanaged VBAC labor. The complaint cited the continued use of Pitocin despite the hyperstimulation of the mother’s uterus as demonstrated by an inappropriate contraction pattern. Although some might point to the VBAC labor itself as the cause, in fact the misuse of Pitocin in this case is most likely to blame for the rupture and ensuing disability. Use of Pitocin in VBAC labor is known to increase the likelihood of uterine rupture.

Such heartbreaking incidents highlight the need for reform in current maternity practices. Many routine obestetic interventions are not based on the best available evidence and increase risk rather than safety for mothers and babies. In addition, care providers frequently do not proivde women with full, informed consent/refusal about all interventions, despite ethical and legal mandates to do so.

In light of this reality, women who are pregnant or planning to become pregnant should educate themselves about routine obstetric interventions, such as induction/augmentation of labor with Pitocin and consider the risks/benefits for themselves and their babies. Doing so should influence decisions about type of provider, model of care, and place of birth.

Wednesday, July 8, 2009

Respectful Cesarean?

"Yeah, right."

At least, that was my response when I first saw the title of Joni Nichol's talk at ICAN's International Birth Conference in Atlanta last April. But after a few minutes of listening to Joni's descriptions of cesarean births with soft music playing in the OR and parents talking to their babies as they are born, I was warming up to the idea.

Joni is a midwife practicing in Guadalajara, Mexico. Her description of respectful cesareans included the following elements: cesarean is used only as an absolute last recourse, it is preceded by spontaneous labor whenever possible, the place of birth changes but not the philosophy of care, and the experience is made personal, positive, and memorable. Joni's talk left me dreaming of what changed attitudes in our medical community could do for women who truly need cesareans but who still want a peaceful, beautiful birth experience.

You can read about a respectful cesarean here on Joni's website.

Wednesday, July 1, 2009

Prevent Cesarean Surgery video

This excellent video won first prize ($1,000) in the "Birth Matters Virginia" video contest.

“Such great myth-busting and important information for all women, I loved your use of natural scenes. I'd love to see this video getting lots of airplay in the public arena.” –Dr. Sarah Buckley, MD

“The directness and statistics worked well together…” –Ricki Lake and Abby Epstein

“Very well done.” “One of my favorites. Talk about evidenced-based care; this really motivates someone to take action.” “This really puts it out there. Cesareans aren’t pretty.” “This was so emotional for me. The film does an excellent job questioning the idea that c-sections are easy, normal, and no big deal.” --from the BMV Judging Panel