Obstetric Lie #86- You Need A C-Section

I wish I didn't have to write this post.
I sincerely wish that every woman that birthed via abdominal surgery needed that surgical birth.

But that is simply not true.

Let me tell you a story.

When I went into labor with my first child I knew that it would be a long labor.  It was the day after my due date and I started leaking fluid.  Contractions started but they were about an hour apart, maybe thirty seconds long and not very strong.

I stayed home and labored.  (I am not recommending you do that, this was my choice and I was comfortable with it.)  I took my temperature often and waited for labor to get harder.  Maybe I could have made it happen faster but I was a little scared of the pain, so I waited and rested and just labored in the comfort of my home.

About 40 hours later my husband was convinced I needed to go to the hospital.  I was past the point of protesting so I went, even though I was convinced that I would continue to labor for much longer.  When we arrived I was eight centimeters dilated.

I got in a tub and quickly went the rest of the way.  I started to feel a little pushy and they dragged me out of the tub (policy) and I started pushing.  I pushed from about twelve AM until about four AM.  Four solid hours of pushing.

And then I birthed my eight pound six ounce baby boy.  He came out of my vagina.  People literally gathered in the room to see this woman who had pushed for that long and had birthed vaginally.  I did have an episiotomy and a second degree tear but he was out.

It was a glorious feeling.  I can not even describe it to you.  If you  have birthed your babies like that then you know what triumph really feels like.  It is the reason crazy women like me stay up late into the night pounding away on silly little keyboards.  It is the reason we have to bite our tongues when we see somebody making choices that will most likely end in a surgical birth.  The glory of triumphant natural birth is something we want all women to be able to experience. 

But few of them get to experience it.

About 30% of women will deliver via cesarean surgery.

When we talk about medically necessary cesarean we enter murky waters.  Why, you might ask?  Well, it is actually kind of easy to decide that a woman "needs" a cesarean for some reason, even if she doesn't.  I found this particular post, written by an obstetrician both deeply disturbing and very informative all at once.

The doctor speaks of a patient coming in who is minimally dilated (to a one) and he proceeds to describe how he augments her labor.  He points out something that is telling:

"The truth is, an obstetrician can persuade almost any patient at any time that a cesarean is the best choice. I could have told this woman that the transient dips in the heart rate concerned me and that I recommended surgery to prevent her baby from being harmed. Few patients, hearing those words, would refuse. If I performed a cesarean, I could eliminate the risk that something would go wrong later. In the mind-set of an obstetrician, this is critical."

Few patients hearing this will refuse.  Did you catch that?  Parents want a healthy baby.  It is more important to them than surgery.  I consented to an episiotomy I didn't want because I wanted that healthy baby.  I chose it over a vacuum extraction because I felt it was safer than the vacuum for my baby, but a cut on me only hurt ME.  Even though I wasn't a mother yet, I loved that baby more than anything else.

Though those who hate natural birth accuse natural birth advocates of choosing the "experience" over the health of the baby, they are dead wrong.  We care about our babies.

Many women who choose home birth do so not because they don't care about their babies- but they realize that the quote from above is brutally honest.  And they do not want to be lied to by somebody in authority and over such a delicate and important subject.  We want healthy babies-  but we also believe that we can most often safely birth our babies without a surgery.

This doctor goes on to describe how the birth of this child, to a mother desiring a natural birth, ends.  Again, this is very telling.

"SOME 20 HOURS after she arrived, my patient’s cervix finally became fully dilated. With the next contraction, she pulled her legs back and pushed as hard as she could. But now the baby’s heart rate, which had concerned us throughout the labor, dipped again with each push. Research suggests that even the most worrisome heart rate pattern rarely predicts injury. Still, I had to make a decision.

In my gut, I believed that my patient’s baby would make it safely to delivery. But I couldn’t predict how long it would take: an hour, two? Forceps or a vacuum wasn’t an option – the baby’s head was still too high up within the pelvis. I’ll admit that it crossed my mind that when my shift ended in two hours, my colleague would be annoyed to take over responsibility for a patient pushing that long and with a less-than-perfect heart rate pattern.

I sat down in a chair beside my patient’s bed. “I’m not worried about your baby right this minute,” I told her. “However, you have a lot of pushing yet to do, and I’m concerned that your baby will not tolerate it. My recommendation is that we do a cesarean now. I think it’s the safest thing.”

Under bright lights, 20 minutes later, we delivered a little girl, who emerged screaming and pink. My patient and her husband were delighted and thanked me for guiding them to a safe delivery. I didn’t spend time second-guessing my decision: Everyone was healthy; the new family was content. None of us mentioned the fact that surgery would now almost certainly be required for the birth of their future children."

Did you hear that ladies?  This obstetrician, trusted to assist this mother in her birth, pretty much admits to doing an unnecessary, "medically necessary" cesarean.  And he admits it will probably result in other surgical births.

And he doesn't care.


How dare anybody lie to a woman about this?  How dare they?  

This is disgusting.  It is an abomination.  Unnecessary surgery that DOES increase risk to mother and baby is an appalling betrayal to what medicine is supposed to be.  It is supposed to save those who need it.  It is supposed to ensure life and health.  It is not meant to be wielded for money or to prevent lawsuits or cover anybodies ass.

Birthing is a sacred time for mother and baby.  We must birth with those and in a place where this is known and respected.  We must birth safely and in health and in trust of those around us.  But we must be able to trust them.

Women deserve to know that they NEEDED a c-section.  They deserve to have a c-section that saved their baby.  They should never have to question the motives of a care provider.  These lies are pushing women out of the hospital and instilling fear.  No blogger does this- the profession does it to themselves.

Why does this make me mad?

I could have been that woman so very easily.  I would have consented to a c-section to save my baby from trauma.  I would have done it in a second.  Any woman would.

Instead I was encouraged to birth my baby under my own power.  Three nights after it had begun and after four hours of pushing, I did just that.  My son is healthy and strong and he changed my life forever.  He probably would have been healthy and strong with a surgical birth too- but we would have missed out on something that we both deserved- the journey of triumphant birth.

I can tell you without a shadow of a doubt that my birth, my entire life, could have very easily been changed in those hours while I birthed my son.  I am so grateful that my life was changed- but not by unnecessary surgery.
 
We must demand care providers who we can trust when they say "You need a cesarean."  Then we must prepare ourselves to birth without surgery.

PS- One difference between me and the woman in that story is that I birthed with a midwife.  Food for thought.