Tuesday, May 25, 2010

Shouldn't it be about more than just pushing out a baby?

I'm not going to link to the birth stories I'm about to discuss because I want to respect the feelings of these moms. They are happy because they achieved something that seemed impossible: they VBACed! They VBACed against the odds- with an unsupportive doctor, or after being told they had to induce to avoid a big baby. They VBACed triumphantly: a big fat I-told-you-so to the establishment that told them they couldn't. They should be on a good strong high for a good long time- they deserve it, they DID IT, they proved they are capable.

And yet, my heart wrenches reading their stories. A woman told she had to induce because her baby was getting too big, a doctor who cuts an episiotomy that extends into a 3rd degree tear and significant internal damage, a mom whose blood pressure crashes and who passes out due to blood loss. Another woman with an unsupportive OB who tells her she better push her baby out in 10 minutes or she'll be cut open again- amazingly, mom is able to do it, but not without sustaining a 3rd-degree laceration in the process. Someone else whose epidural dose is upped right before she starts pushing, another 3rd degree tear.

Reading all these stories so recently, a part of me wonders if this is really better than the alternative RCS. Are OBs punishing women who choose VBAC, women who "force" the doctors to be on the L&D floor waiting for them to deliver, who increase the potential for a malpractice suit? Is there a subconscious bias encouraging OBs to think "She wanted to VBAC a huge baby, this is what she gets" as the scissors slice through the mother's perineum? (by the way, that baby was barely over 8 pounds...) Or, even scarier, is there a conscious thought process on the OB's part: "I told this woman I don't like vaginal births, period, so if she can't push this baby out in the time it would take me to get the OR prepped, I'm cutting her."

Or were these OBs going to be awful no matter what? Are these the OBs who talk about their dinner plans while performing RCS, completely forgetting that the mother and father are there for the birth of their baby? Would these doctors have asked the mothers to get their tubes tied as they were lying there on the operating table? Would they have lied, telling the mothers they were moments away from rupture, so they could add to their own perception of themselves as saviors?

Though I will never regret encouraging women to choose VBAC and pursue it even when the odds are stacked against them, my heart aches because the women whose stories I've read this week deserved so much more. They deserved support, respect, encouragement, so much more than the simple triumph of pushing their babies out. A long time ago I read a line about how our goal in promoting VBAC needs to be more than simply having babies come out of vaginas. These birth stories really brought that home for me, and made me realize once again the scope of what birth activists are up against.


  1. I find it really upsetting, as you said these women deserve more. They deserve their birth experiences and not just being an object by these OBs.

    Birth activists are amazing people, I really admire you! I have strong feelings about natural birth & birth experiences too but I don't think I can pass the upsets and emotional upheaval that may involved.

  2. Well said, it is very complex. I also wish care after birth and infant care was included in all the 'birth' stories because that part was very tramatic for me (and many I know.) Respect for the mother/baby shouldn't end after birth.

  3. During my c-section 5 years ago, my OB stood there talking to her colleagues about the brand new house she'd bought in an extremely affluent neighborhood in our area ($2-3 million houses) and about how they're redoing the whole kitchen so she had no dishwasher at the moment, how they'd converted the family room to an office, etc. I remember the details of this woman's house vividly, as I laid there crying uncontrollably with my arms tied down, telling my husband that my lungs felt cold, and he's asking everyone around if that's normal... And the anesthesiologist said, and I quote "Yes, that's normal... So does it have a pool?"

  4. Well said. Birth should be empowering: a step in the right direction as a woman becomes a mother, an accomplishment she can look back at as she struggle to breastfeed, or care for a fussy baby while deprived of sleep, something to help her grow in confidence and independence, as well as in the desire to do what is best for her child.

    My first birth was scary, and a week in the NICU left me feeling inadequate to care for my son. My second birth (VBAC-attempt, CS for footling breech) was much more empowering, despite a short NICU stay. (Of course not having an infection and being rushed to the OR helped...as did being a second-time mom.) But laboring on my own, trusting my doctor, and feeling good about everything I did for my son was an experience I will never regret. Thanks for your role in educating so many women.