I have hesitated posting this for months because I know two dear women who are active in the community I'm about to describe. Dear friends, forgive me in advance if I offend you. But once again, this issue keeps me up tonight. This blog has always been about honesty and advocacy, as well as processing of my own thoughts, so the time has come to export this out of my head.
I bear two scars from the birth of my son: one that lies a few inches below my belly button, and one that lies several inches above it. The physical one has long since healed. The one in my heart still pains me to this day, even though my son is nearly 6 months old.
"Unnecessarean." It's a term coined by the unmedicated birth community to describe c-sections that they deem were needlessly performed. It's a term wrought with looks of pity, heavy sighs, and moral superiority. I'm sure some of them even pat themselves on the back for being so clever in their verbiage.
The unmedicated birth community has unilaterally, universally decided that their way is best, and that their methods should always be employed first. Modern western medicine ought always be a last resort. After all, women have been having babies for thousands of years, right? They even go so far as to call their community "natural," as if the births among the rest of us are "unnatural."
We were overjoyed to find out we were pregnant. Almost immediately, we were asked all sorts of questions. Where were we going to deliver? At home or in a hospital? Did I want an epidural? How did I feel about c-sections? I will be honest and say that at that moment, I couldn't have cared if the baby teleported out of me, or came out during one of my many barfing sessions, so long as he arrived safe and sound in my arms.
I began doing some reading. A couple of friends had completed Bradley classes. My best friend recommended them. Another dear friend said she hated every second of them, but still recommended them. So, we eagerly enrolled. I will say that from talking to other women, a person's satisfaction and success with the class seems to depend largely on the teacher.
I knew from the get-go that I didn't want a C-Section. But not for the reasons that the unmedicated birth community says I shouldn't have wanted one. After 7 years of infertility, you start to feel like everything is assisted. And you start to feel like your body can't do anything the way it ought to. And in 30 years, I've never broken a bone, had a major dental procedure, undergone major surgery, or been a patient in a hospital. So, the thought of surgery freaked me out. Not because I thought it was going to put me or Matthew at risk, but just because, hey! It was major surgery! Who looks forward to that, even under the safest of odds?
Enter the Bradley classes and books, and the literature and battle cries from the other side. The Bradley workbook has a handy little chart that says essentially that there is always some position, maneuver, technique, or other alternative method to get you out of whatever jam you're in that's threatening to end in a c-section. And that's the end of their story. If you end in a c-section, it's most likely because you didn't advocate for yourself enough, you didn't educate yourself enough, you gave your doctor or the hospital too much leeway, or you simply didn't try hard enough or wait long enough.
I'm here to tell you that despite what your 30 year old books and one-sided classes say, that's simply just not always the case. Sure, women have been giving birth for thousands of years without modern technology. And they and their children have also been dying in the process for equally many years. Matthew would have been among the victims, and it's likely that eventually, I would have been too.
I say as loudly and strongly as I can: You are not helping women when you teach them that they ought to fear and distrust their doctors and that the hospitals are out to get them! Before the classes, it never would have occurred to me that a woman who had undergone a c-section would feel shame or failure. But in the eyes of these women, she is less-than. I am less-than.
If a woman doesn't trust her doctor, she shouldn't be in her care to begin with. You should be encouraging your clients and friends to develop relationships of trust and open communication with their care-providers. But to posture yourself as knowing more about both birth and a given woman than her many-years educated doctor and to bully her when she is already hormonal and frightened woman with scare tactics and one-sided information is unconscionable. To do it in the name of "advocacy" is laughable.
Is it true that there are some doctors who perform needless procedures on their patients in the name of convenience and expediency? Sure. But those guys are lousy doctors. You should focus your efforts on THEM, and not on procedures that some...many...women end up legitimately needing. Sure there are jerk doctors. And there are even some women who schedule c-sections for vanity or convenience--but that's not most of us. There are also midwives and doulas who are overconfident in their abilities and tarry too long in employing professional medical help, sometimes resulting in tragic deaths of babies and their mommies. The unmedicated birth community doesn't corner the market on caution, safe deliveries, or patient care. I CHOSE a hospital birth. It's not because I didn't know I could give birth in a bathtub in my house or in a cozy little birthing center. It's arrogant to assume that a woman who doesn't do things your way does so simply because she doesn't know any better. For a community that claims to value women so highly, you certainly don't seem to think much of most of us.
There are two sides to every coin. You think an ultrasound is unsafe. I think that doing external versions on babies without being able to see if you're going to entangle or compress their cord or fluid is unsafe. Bradley says there is no reason to take any medication of any kind at all during pregnancy. Another author I read said that not eating well is akin to child abuse. We came to the conclusion that my rapid weight loss and inability to eat ANYTHING (I went 6 consecutive days not being able to keep one bite of food or drop of liquid down) was more risky than medication, and that eating SOMETHING, even if it was a sugar-filled "nutrition" "shake" was better than nothing at all. I labored for 14 hours without an epidural. You think they're unsafe and that the body does better without them. When I finally got one is when my body finally was able to return to normal function. It's up to a woman and her husband to determine what risks they are and are not willing to take. And unless you are that woman or her husband, it's not your business what she decides. It doesn't serve any constructive purpose for you as a community to editorialize procedures, practitioners, facilities, and births that you know only anecdotally at best. Why do you have any opinion at all on what kind of birth I had?
When I finally went to c-section, I had been in labor for a total of 30 hours, including 6 hours of pushing. I'd also had two other incidents of false starts--one was 7 hours of intense contractions about 2 weeks before he was born, and another episode was 4 hours, about a week after the first. I went in to the hospital already dilated to a 6 before active labor had begun. But for some reason, though it tried with all its might, it just didn't work right.
Matthew was just stuck. You know what my Bradley teacher said was the proper response when a doctor tells you that your baby is stuck? That "babies don't know they're stuck, or in the wrong position, or can't fit so that's not a real reason."
After 30 hours, I can tell you it IS a real reason. My doctor, bless his heart, tried EVERYTHING. I asked him at the very beginning of my labor what he and his wife wanted when they had kids. He said that they wanted an unmedicated birth. So several times I asked him, "if this was your wife, knowing what she wants for a birth experience, what would you do?" And he'd answer me accordingly.
We tried different positions. We tried different lengths of pushing. We tried different degrees of force. The doctor reached in and tried to turn the baby to un-wedge him. At one point he told me to stop pushing and sleep for an hour to see if rest would rebuild my strength. At another point, he reached up inside to hold the baby and feel my cervix to feel first-hand if I was pushing properly and forcefully enough. Matthew just wasn't coming. For whatever reason, my pelvic cavity wouldn't accommodate him. All the pushing was just forcing his poor little head down, but the rest of his body wasn't coming.
And then, his vitals plummeted. My sweet doctor, who had avoided the "c word" as long as he could, put his foot down and said we needed to go. There were no alternatives left. When my sweet baby came out, he wasn't breathing. I didn't know that at the time. I didn't know it until just recently, when I received a bill for "infant resuscitation" and nearly threw up on reading it. I recently had the courage to look at the pictures my husband took in the operating room. Matthew was purple. Instantly relief and gratitude for the wisdom of my doctor and God's provision of excellent care swept over me. The baby was wedged so hard in there that they literally had to pry him out with the surgical equivalent of a crow bar. The doctor said that I could have pushed for days longer and the baby still would not have come out. Matthew would have died, and in the "good-ol-days" before c-sections, I would have, too.
I anguished about the decision to have a c-section. I begged my mother and husband not to tell ANYONE that I had had one. I refused to shower for days because I couldn't bear to take the bandage off and see the scar. When I finally did, I wept big, ugly, uncontrollable tears, to the point where I scared my husband when he found me curled in the shower, sobbing. All I kept thinking was that I had failed my son and I thought that if people knew I'd had a c-section, they'd think I was a coward who gave up. Eventually I realized that no one outside that community would even care how I gave birth. But it never would have occurred to me that I would have had reason to feel shame had those silly thoughts not been planted in my head by well-meaning extremists.
I accept responsibility for my feelings. I realize now that I was hormonal and unreasonable and irrational. But I felt betrayed by the very people who said they are out to help and protect women. I wonder how many women would have been spared a lot of fear and shame and guilt if they had received a more balanced education about c-sections. Birth can be scary. It ought to be surrounded with grace, unbiased information, encouragement, and empowerment.
I think it's wonderful that you want women to know that they have options when it comes to birth. And as much as my Bradley class was terrible in actually preparing me for the REAL world of births that don't go exactly according to plan, I do appreciate that it educated me on what my rights were in the hospital. But that's about the end of the benefit it provided us. My dad's best friend is a widely respected OB and has been for many, many years. My mom asked him after my birth if it was normal for women to feel so much anxiety in the birth process. He said he'd only seen it in women who had gone through Bradley training and that actually, he no longer would work with any patients who chose to go through those classes. That tells me that we were not alone in our experience.
Scare tactics might be effective in the short term. They sure get a lot of attention and press-time. And witty little monikers even make you sound clever. But at the end of the day, you don't know what's going on in each woman's situation. Sometimes there just AREN'T any more options. You can post your blog articles and your status updates and disguise your judgment in witty quips, but for as many women as you help, you isolate equally many more. We ARE listening. We are curious about what you have to say. But when we hear judgment, it makes us reluctant to seek your help. "Unnecessarean" isn't clever, or funny, or witty. It's insulting and condescending. If you want to describe YOUR OWN caesarean as "unnecessary," it is your right to do so and I am sorry for you that you ended up with a care provider you could not trust. But to sloppily label a whole category of births simply because they share a procedure in common is completely irresponsible and irreverent.
Please don't call my birth unnecessary. It saved my son's life, and I will forever thank God for it.