Article: Risks Fail to Deter Caesarean Births

[BellyBelly]

Flea, its very, very common your story. Often women will be raced into surgery because 'the baby is too big for the pelvis' when the baby is simply posterior or malpresented, which will likely not happen again - but they left in the mindframe that their body cannot birth vaginally, ever.

Deb - exactly my point!!! Yes it will take alot to change it, but do you know what will make it happen? Women, jumping up and down and yelling and screaming that we are not going to take this $hit anymore! Women saying NO!, changing carers to get the birth they want etc. But the problem is getting people to do it - we are all very busy mothers, but to make change, we have to do something. Hence why I have been so vocal on BB. I have seen members slowly see whats REALLY going on. If I can help just one person, then they help one, and they help one... it's great. We'll get there, change is just slow.

Know that you deserve better women and demand it!!! Fight for it - birth can be the amazing and beautiful experience you want it to be, no matter if it's vaginal or c/s - it doesn't have to be traumatic, disempowering and depressing. Sure things don't always go to plan, but heck, if you feel supported and have a carer who gives you balanced info, and YOU INFORM YOURSELVES it it a much, much better experience - don't just take what you are given. I have been having huge chats to the woman who does the Pink Kit - thats why she is doing it! Couples NEED to educate themselves, properly, or they are at the mercy of the system.

[BellyBelly]

You would have to have 10 babies to have an 'ideal' birth, so please don't get hung up on that hon. An ideal birth is where you feel supported, your birth preferences are taken seriously and your feelings are considered at all times.

[Inanna]

Flea,
As Kelly says your story is so very common. I am always saddened and angered to hear stories like yours. I am sorry that your birth didn't turn out how you planned. However, these stories are what provide the motivation to make things better.

You followed the guidance of your doctor. However, again with position changes, loving support and time your baby likely would have (and did it would seem) change position.
This is the difference between obstetric care and midwifery/woman centred care. The most essential organ for giving birth is your head it has been said. This is true but it could also be said that it is TIME and SUPPORT. Obs (love em) are action men. They are doers, fixers. Most often birth doesn't need to be fixed. Midwives and women operate on an intrinsincly different level. We use intuition and feeling and touch along with our knowledge.
Your baby and his birth have taught you some things that will change your next experience. That is so wonderful Flea - look to the positives that have come from that and the knowledge that you have gained...

DISCLAIMER: Please know that I am not saying that there are no doctors that have the above qualities. As I have said I have seen quite a few display these very same attributes.

Women are also responsible for the high rate of caesarian as I mentioned in my last post. Women have given over their birthing power. In our Grandmothers time or Greatgrandmothers time birth was a community event. Women supported one another. Neighbour women helped with the woman down the road. Someone boiled the pot, kept a meal warm, watched the younger children and supported and nurtured the mama to birth. Herbs were given, time was given and much love and support.

Yes, women died in birth and how fortunate we are to have the medical services available to us now. Howver we have taken a complete about face. Birthing Mamas are now patients in a system. WE are told what we need and why and that if we dont' do it that our babies will die. We need to be responsible for our own care. We need to inform ourselves. It's not difficult to access information in this age and we owe it to ourselves, our children and our future children. One of the most proactive ways of doing this is to insist on midwifery care. Midwives will give you time, support and an every increasing bank of education from which to draw on. They will refer you on when you have a medical condition but until you do you are not a patient but a birthing Mama.

I laboured with my first child for a very long 33 hours. I was planning a homebirth and I had the tub set up and home. My labour started with a bang and contractions remained at 2-3 intervals for the first 24 hours. I transferred to hospital. I just KNEW something wasn't right. I felt that the position was wrong. The midwives at the hospy were wonderful and confirmed that she was posterior and she was in a similar position to your baby Flea. The doctor (quite a prominent fellow now and I tell you he was an &^*(*&^*&) came to tell me I required a c/s. I asked why and he told me it was rediculous to labour for this long. I was "stupid little girl" for attempting a homebirth and this baby needed to come out. My CTG was fine, there were no indicators of fetal distress. I felt that my baby was doing just fine and that her and I together would birth. I said I was fine but I needed some pain relief just so I could deliver vaginally. He left on his heel. Now, Ruby was a brow presentation and I pushed for a long time. But, I chose to birth her the way I did. I chose to birth vaginally - I knew I could. I have never known such elation as I did when she came out.
Had I been a different woman without the knowledge I had and the trust I had in my body and my instincts I would have had a c/s and faced the very difficult road of VBAC for my next birth. I had a 2nd degree tear that I chose not to suture. My perineum healed within 10 days with absolutely no problem (I used a nice litle recipe I have of herbs I would be happy to pass on! :wink It took incredible strength to do what I did and I feel very proud of that. The midwives (there were 4 in the room at the end - teaching hospital brow presentation - big news) were as triumphant as myself. However, they really went into bat for me. They stood by me and guided me. The doctor (oh how I would LOVE to say his name) poked his head in the room and told me he was washing my hands of the situation.

The system is not geared that way - though it is slowly changing. It is hard for some midwives to be strong woman advocates. It is hard to challenge and to rock the boat. This is why having a Doula, a Midwife or a woman that is an advocate of woman's choice and experienced with the birth process at your birth. She can be your voice if you can't find it. For me if my child was at risk I would have made different decisions but she wasn't and so I sat with what I knew.

I think that having your partner at the birth is wonderful and I believe it's important. However he loves yhou and is not detatched. My husband trusted my instincts with Ruby's birth but I could see his fear as well. Having another woman there that is your support and his too is INVALUABLE.

This is how we have to see the system change. WE need to change it. We need to empower ourselves with knowledge and seek out a carer that will be comfortable with that. I birthed my last baby in a private hopsital. It was such a weird thing for me to have an obs. I had my own midwife but my choice of obs was settled only when he would agree to not enter the birthing room unless there was a medical indication. He agreed to this and sat outside the room eating donuts, reading the paper and chatting to our kids as they came and went. My midwife left briefly now and then to let him know how I was doing - but of course he could *hear* how I was doing. It's amazing how much you can know about labour just by using your ears... He honoured my choice. Partly because he knew of me and he also knew that I was educated. He had faith in the midwife and in me and he was at hand if needed.
After Eva was born and I was dressed and in bed he knocked on the door to give me a hug and to congratulate me. Now we need more of this. Obs that don't need to "deliver" babies. We need obs that will honour choice and listen to what women want.
Women don't know that they *can* ask for this.

Why is it that women think they can ask for a c/section but they can't ask for a natural birth in a tub with their midwife?

Anyway you'll all be a bit weary with me. You can probably tell that it might be just one of my little passions!!!

We can all ask for this. We can seek out a doctor who will listen. They ARE out there. Slowly the doctors that don't want to play the womans game will either wake up, have a tanty or leave (my bet is on tanty first!)

I am NOT a doctor basher - some of my best friends are doctors. I just don't believe that birth is doctors business.

Due to my history I do require an obstetrician and close monitoring for future pregnancy's. One of the reasons I decided upon the obs I now have is that she is a woman and I know my history is gonna make any obs unlikely not to want to be in the room. But also she is the kind of doctor who is happy to sit on a stool in the corner and take notes. She is not the PUSH PANT THATTA GIRL! type...

We can all ask for this. It is our right!

woops I noticed that some of my post is missing - I must have talked too much!!!! I can't remember what else I said...

[Inanna]

Shannon,
I missed your post. Mylast one took a while inbetween chopping apples and wiping a bottom! (I washed my hands in between!)

I can't say it any better than Kelly. An ideal birth is where you are supported, honoured and nurtured in a safe environment.

If you need some help to facilitate that than you can contact me my love...

[Debbie Lee]

Deb - I'm gonna print out your posts and use them as motivation. I wasn't sure how hard I wanted to push for a VBAC (or if it's what I wanted... just didn't feel all that passionate about it) but now I wanna go in there guns-a-blazin' and get the damn birth I bloody well want!! LOL
Thankyou.

[BellyBelly]

Then choose your carers wisely. Make sure your Ob will be respectful and you feel happy with him, then there are Private Midwives, Doulas or Birth Attendants who help with all of this. Meet a few and ask what they can do for you. Grab a copy of the Pink Kit. Preparing yourself so you can be informed, nurtured and in power is something you can do for yourself, you just have to actively seek it.

[Debbie Lee]

I dunno about you, Shan, but I find a lot of male doctors are over-confident and ****y (and I'm sure some female doctors are like that too... I've certainly met some doozies - the reason why I choose to have a male doctor because the female ones I have dealt with have been aweful). They're really good at appearing "superior" and they kind of get off on making the "patient" feel like their word is gospel. They're the guys with all the initials after their names. They are the ones that constantly have the red carpet rolled out for them. It's hard to argue with someone that believes they are right no matter what.

[BellyBelly]

The main complaints I hear about female Obs is that they are 'cold' and some women have even reported them as being firm or rough with them. Yep the guys the ****y thing Not labeling though, this is just what I hear

[Inanna]

Shannon,
Something that may help aside from the other great advice from the others in here.
Make a wish list of what you want your birth experience to be. I don't know anything of your previous births. Have you had a previous c/section?

I *think* you said you were going public at Cabooluture Hosp is that right?
Caboolture have a midwifery led programme that I have heard some good things about. I know we have *talked* about this at some stage so sorry if I am repeating myself. This will help you on your way to getting what you want.

[Fi]

I was very lucky to have my midwife mainly dealing with the resident and other dr's for me. She helped to push what we wanted, but she also told me to ask all the q's i needed to.
I guess cause I'm an engineer and pretty used to having to force my way with older men in the workplace for project work, I dont have an issue with drs. Lucky I spose.
But if you have a kickass midwife that knows how to play the system it helps .
I would have to say I actually got the ideal birth this time, I'm very lucky, I guess it made up for the horror of Jenna.

[Inanna]

Theresa - I hear you sister!
I know how very difficult it is to get a vbac in SEQ - so in the far more conservative (I am assuming Rocky area - I lived in the Rocky area and worked there abaout 15 years ago now!) it would be even more difficult.

Your experience with your first birth sounds scary. You are so right what mother would argue? However, as you have found we need to seek out more answers by asking more questions. We then need to get second opinions etc All really difficult stuff when we are in the awkward physical postiion of late pregnancy AND the vulnerable emotional position of pregnancy. This is again why we need to find a care provider who has ideals and values congruent with our own - preferrably a midwife/doula who can help you when things don't go quite according to plan...

Education is empowering!!!!

[BellyBelly]

I think it's important to mention too that we shouldn't get into a state of not being able to trust Obs, while many of them make me feel cross too (I have been accused by a BB member of Ob bashing even, when it wasn't my intent at all!), we also need to be able to rely on them in time of real need.

I am not saying you were saying this Theresa, I agree with all you've said - it's just something I wanted to point out. We need to be wary of what is going on, know we can get a second opinion or say no, and realise that we are the magic answer in all of this.

We can become more educated, informed etc which no-one else can do for us - the Obs wont change in a hurry - but with our own education, we can make the choices and decisions which are going to be better for US Ideally women will get their faith and confidence back into their own bodies that they feel comfortable enough to see a midwife during pregnancy for their care, given its a healthy, normal pregnancy, because they completely kick butt. They spend lots of time with you, they come to your home, do all the checks the Obs do at visits, let the siblings help and have that awesome womanly touch. Brings back what we used to have, trusted 'wise women' who you share a life journey with - you get attached to your midwives and fall in love with them!

Long way to go yet - midwifery led care in NZ has had it's problems and caesars are back to 30% - further proof that we can't rely on any person but ourselves to make birth better - we can have great carers, but it takes more... us learning! And how do we find out that we need more education than what we have? We just don't until we've been through birth, but it's through word of mouth, forums like this we can make the biggest difference.

[Inanna]

Oh yeah I know him. He has an *interesting* bedside manner. He is actually a very good high risk obs. I have admired him for some things. I am not surprised he is wanting to retire - he has held down the fort for a long time.

As Kelly says obs most certainly have their place. There are many babies and Mamas that wouldn't be here without them. We just need to keep 'em for when we need 'em!

[Inanna]

He did my first pap smear!!!

[BellyBelly]

Women can choose to say no to an episiotomy - so there's an answer to your quote. Not many woman will really require an episiotomy and most midwives in private practice have done none or even only one episiotomy. Obs do the episiotomies a majority of the time - so don't choose one as your lead carer! Easy fixed. And just to clarify, in an episiotomy, did you know that its not the actual vaginal canal that gets cut, It's actually the perineum, the skin between the vagina and anus. Yes a delicate area but I wouldnt say the woman's MOST sensitive area. Not that I am advocating episiotomies I think they are very much over performed and thats all to do with finding out about your carer and his/her beliefs.

We are all entitled to our own opinions, but you still get surgeons new to the job as you do midwives. Its pot luck in hospitals, you can't choose your midwife but you can choose your Ob. In a caesar, your organs can be accidentally cut (hmmm major organs vs episiotomy cut?), as can your baby's (hmmm #2 baby being cut vs episiotomy), you can still have major complications. To think that a caesar will prevent any complications in not a very informed comment, and to compare it to an episiotomy?!

It's all about choosing a carer who you supports you and your choices, does not have high intervention levels and believes in the woman's ability to give birth. Given that so many women are fearful of birth and thinking a caesar will fix that, just goes to reflect the kind of care we are getting. One day of labour or six week recovery period... let alone everything else... hmmmm not a tough choice for me. Choosing a private, personally hired midwife is even better.

[Phteven]

I've had a c-section and an epi and trust me when I say that in comparison to the c-section the epi was minor surgery.

[Inanna]

Yes, healing from an episiotomy I have heard is tortuous. The perineum (the space between your vagina and your anus) is opened with "sissors" usually to have the baby born more quickly and most often to facilitate a forceps delivery or a manipulation of the babies position.

Episiotomy is most often done to facilitate an instrumental birth (one where forceps are used primarily). In the bad old days all women were given an episiotomy.

It has been shown that women that tear in childbirth have a quicker and more successful rate of recovery than women who have an episiotomy. For this reason many of the front runners in obstetrics avoid episiotomy now days - except in an instrument birth.

Midwives don't generally speaking facilitate forcep births so the man or woman on the end of the episiotomy sissors is most certainly a doctor!

Midwives getting back to bed. I can ASSURE you if you need support and someone to sit by you as you labour through the night it won't be the $2000 + obstetrician. It will be a midwife! Generally speaking (and of course it's not always true) but generally so. Midwives are very dedicated supporters of the natural birthing process who will work a double shift just to see that little head poke out and a slimy baby held in her Mamas arms...

You are right. If you want a c/s and you are fully informed of the risks and consequences involved and you have a doctor who is happy with the decision than it is your decision.

[Debbie Lee]

humm i hardly call it minor surgery it the womens most sensitive part and having it sliced open is not minor in my eyes.

Hmm... I'd prefer an episiotomy (or tearing better still) to major abdominal surgery that cuts through layers of muscle. Comparatively is IS minor compared to a caesar which deals with your internal organs. There's also risk of the baby being cut during a caesar. Doubt that risk exists with an episiotomy???
Of course having the area around your hoo-haa cut or torn is scary (and I imagine quite painful) but I'd say having your guts ripped open is just as scary! LOL