CDC recently released statistics showing that in 2004, the maternal
death rate increased for the first time since 1977. Though the reasons
for this increase are many, the rise in the Cesarean rate simply can't
the "no-news-to-us" category, these study conclude that "active labor
in healthy women last[s] longer than is widely appreciated" and that
"labor should be allowed to progress past the ... limit[s] artifically
imposed on women in some birth settings."
This article advocates for an evidence-based approach to the
"complex counseling, decision-making and management issues when
considering VBAC delivery."
The Short and Long of It
Refrigerator magnets are full of short and trite -- but true -- witticisms that speak to us every day. lily8398yahoo.com">Lily, from the ICAN listserv, responded to a thread about our daughters with this brief remark that is nothing short of powerful:
know, my daughter is 6 months old. I look at her beautiful belly every
time I change her diaper and I kiss it and pray that it never ends up
scarred like mine.
this little gem and tack it to your refrigerator. Every day
you'll be reminded of why ICAN is working so hard.
And sometimes, it takes a few extra words to let everyone, including ourselves, know how we feel. jer.willowgmail.com">Jer took pen to paper five years after her second cesarean and let it flow:
years ago you made me go to a grotty downtown hospital in Los Angeles
for an induction because you were too scared of "big babies." Even
though I was a VBAC-- even though you'd promised me the vaginal birth
of my dreams in your "famous" birth center-- you signed me up for the
drawn-out inhumane torture that is an induced labor. You stalked into
the waiting room, barely looking at me, and barked, "Let's get this
over with." You dehumanised me -- you insisted that I change out of my
passionately red shirt, the one that made me feel powerful, into the
rough hospital johnny. You lied to me-- with a smile on your face. You
told me, "You're already effacing and dilating -- you just need a
whisper of pit, and you'll shoot that kid right out." According to my
labor records, I was induced on a markedly unfavorable cervix.
you vanished-- one of the very few things I have to thank you for, in
fact; I don't think I could have lasted as long as I did with your
particular brand of "encouragement." Seventeen hours I labored-- not
long, in the grand scheme of things; I've heard of much longer labors--
but they tethered me to the bed, they wouldn't let me up even to pee
(which you had promised I would be able to do!)-- they expected me to
use the damned bedpan! They cranked pitocin into me at appalling rates.
They broke my water at 2 cm in order to place a stupid internal
monitor-- they let a resident do it; he hung it up in my cervix the
first time, then placed in wrong in my poor baby's scalp the second
time. Third time's the charm, I guess; by then I had that line, my IV,
a Foley catheter, an external monitor, a tocometer, a blood pressure
cuff, and another wire or lead or some such I've never been able to
At 5 or so you popped back in, all
cheery and grinning. You made me lay on my side-- I didn't want to, it
felt so wrong!-- and you checked me-- I didn't want you touching me!
But you groped around anyway, where two nurses, a resident, and an
intern had been intruding all damned day-- then you stood up, stripped
off your gloves (spattering my face with lubricant jelly, by the by),
and announced, "Well, Jennifer, I don't think I'm going to be able to
stay for this one." Pat pat. "You'll be fine." And you were gone.
disappeared, leaving me to an unknown physician-- not even the one
you'd paraded in front of me that morning, the one who wished me "happy
laboring and I hope I don't see you again." No, this one was a
Reproductive Endocrinologist-- I have no idea what his name was,
something long and hard to pronounce; all I remember is seeing his
specialty embroidered in red on his stark white coat. He stormed in,
aghast that I was a VBAC and had been laboring-- gasp!-- twelve
hours. He lectured me on the dangers I was incurring; he demanded of
the nurses, "Is her pelvis adequate? Will she accept an epidural?" Then
he checked me-- take a number!-- and pronounced me "a bare five."
He informed me that IF I got an epidural and IF I made progress over
the next two hours, he would let me continue. If not, he would section
Did you know what you left me to, you who claim to
be "with women"? Was your dinner relaxed and enjoyable? I didn't get
dinner; I wasn't permitted to eat from midnight that Friday morning
until THE NEXT TUESDAY. Is it any wonder I had nothing left to be able to defend myself?
CRNA who came to place my epidural was cold and hard. She threw my poor
husband out and proceeded to torment me with two epidural sticks. The
first missed altogether; the second buzzed and ached like I was being electrocuted.
I was terrified that she would do it again, so I lied and said yes, it
was fine, thanks. In truth I had complete sensation on my right side--
the left was numb, and now all those horrible pitocin-fueled
contractions ended abruptly at my umbilicus.
But I kept
laboring. I have this feeling that you believed-- hoped-- I would crack
and ask for a section. Anything to make you feel satisfied, justified
in your cruelty! If I have one moment's pride remembering that day,
it's that I didn't cave-- I fought on, labored to complete and pushed--
It didn't happen, of course. Tied down, drugged
up, abandoned by my "care provider"-- how could it? Without freedom of
movement, my baby couldn't negotiate my pelvis. He got his head
crooked, just a little, and kept banging his little forehead repeatedly
on my pubic bone. A couple of decels-- after a few minutes' false hope,
in which my nurse thought I would deliver and set up the room for a
vaginal birth-- and people were shouting, my doula bailed on me, and I
was being wheeling into the OR, my heart shattered into a million
I was so afraid, you see. Not of the delivery-- not
that my baby might be in danger-- but of the pain. I could still
feel. They were going to cut me, and I could still feel it!
CRNA didn't believe me-- she assured me, "We'll just top off your
epidural." I was pleading for general anesthesia, crying and begging.
Exasperated, she turned to the RE-cum-butcher and said flatly, "She
wants to be put out." He refused and repeated the "topping off" line.
Thankfully, someone was listening -- when the CRNA went to add medicine
to my line, the epidural catheter fell out completely. I got my wish --
one of them, anyway -- a black rubber mask came down, and I was gone.
of course, I had to wake up. Do you know -- do you even care? -- how
hard that was? How can I explain the profound disappointment at opening
my eyes when I wanted to die?
"You're being stupid,
melodramatic." I imagine that's what you're thinking -- from your
perspective, no doubt you're right. I'm just another mom who labored
and failed. Another day in L&D. What difference does it make to
you? You got rid of me before I could impact your precious statistics--
so you could tell the next VBAC hopeful who came to you, "Oh, yes, we
do VBAC, with a 100% success rate. VBAC doesn't faze me at all."
years. Five years, N. You still haunt my dreams sometimes-- you and
that nameless RE. You abandoned me and consoled yourself with
platitudes about it being my fault, I didn't tell you I had a history
of "big babies"! You threatened me with a dead baby, you coerced me
into a 40-week ultrasound, then risked me out and demanded that I
submit to induction. Because of you, I have no memory of my baby's
first days-- I have no recollection of him at all between one hazy
moment in the recovery room and staggering out of my wheelchair at
discharge to install his carseat. I do remember my incision opening up
on one side-- I won't forget the panicked run to an ER to find out if I
would require further surgery, or the six weeks of drainage and pain
that seemed to last for months. I don't remember my baby's first 6
months, I was so mired in depression and post-traumatic stress--
flashbacks, nightmares, sweating panics-- the shame of having to ask a
doctor for medication so I could function.
You didn't only
take my birth, though. I lost more than my son's infancy. For a long
time, I lost myself. I had no faith in anything; I felt like I was
alone and screaming in the wilderness. I could no longer trust any
medical person or birth professional. Midwives and doulas became the
enemy. I had always wanted a large family-- now I couldn't contemplate
another pregnancy if it meant another damned surgery.
two years I seethed and boiled, full of rage and pain. I inflicted my
agony on the wise, patient, compassionate women of ICAN, who listened
to me and assured me I wasn't alone. I had my mettle tested; the fire
burned away the slag and left cold iron determination. I would never,
never permit someone like you to come near me again.
pregnant again and made the conscious decision to avoid your ilk from
the moment I knew I'd conceived. I cared for myself and my growing baby
the way I wished you had cared for me before-- compassionately, with
love. I welcomed labor when it came at 41+ weeks. I spent those
hours at home, quiet in the dark, singing my birth song. I roared my
son out-- I birthed him into my own hands, on my feet-- not lying tied
to a bed, whimpering, but drawing on the power that is the birthright of every childbearing woman-- the right you and your colleagues deny us every single day.
did what you told me I could not: I gave birth, after not one but now
two cesarean surgeries, to a baby you would classify as big. He was ten
pounds, five ounces-- the same size as his older brother, the one you
insisted would die or have to be cut out. That should be enough--
I was elated, and still am, when I look back on his birth. But I'm
still angry -- angrier than ever.
Because I know now. I know
what could have been, even in that cold, dirty hospital. I know what
you stole from me. I will never forget... and I hope, N, that you
Lake is a mother, former talk-show host, homebirther, and doula.
Drawing on all of these talents and experiences, she recently
produced "The Business of Being Born", a film about childbirth in
America. Shown at the Tribeca Film Festival to excellent reviews,
the film has recently been purchased for limited release and special,
private screenings. If you are interested in hosting a screening
in your own town, please contact infothebusinessofbeingborn.com">infothebusinessofbeingborn.com.
Many heartfelt thanks go to Ama Mama of Encinitas, CA for screening this film in October -- with portions of the proceeds going to ICAN.
When you are searching
online, go to www.goodsearch.com
and type in "International Cesarean Awareness Network" as the
organization to support. ICAN's main address is Redondo Beach, which
should pop up automatically (typing "ICAN" won't get it to come up).
Each search gives $.01 to ICAN. It may not sound like much, but the
add up! Don't forget, you can add GoodSearch to your toolbar
make it even easier to search and do good at the same time!
Come together the second
Monday of every month to chat with fellow ICANers. In a "chat
room" set up on MommyChats,
talk with fellow ICANers about birth, VBAC, cesarean healing, and
whatever other topics that come up. Ask questions, share
stories...it's all there on ICAN's MommyChat. The next chat
be Monday, October 8th. "See" you there!
In a culture where cesarean section is viewed as simply
another way to have a baby, we seldom hear the voices of women whose
experiences have not been so easy. This groundbreaking book answers the
question "What's so bad about a cesarean?" in a raw, honest,
heart-shattering way. If you care for or about women and babies, hear
The Gentle Birth World Congress and Baby Expo is a unique
opportunity to participate in the creation of solutions to the current
maternity care crisis. Join obstetricians, midwives, nurses, childbirth
educators, lactation experts, doulas, alternative practitioners,
hospital executives, insurance companies, parents and press, as they
declare, “enough!”. Be part of the
solution! Sept 27-30 2007 Oregon Convention Center (Portland) gentlebirthworld.com
mission is to improve maternal-child health by preventing unnecessary
cesareans through education, providing support for cesarean recovery,
and promoting Vaginal Birth After Cesarean (VBAC). This newsletter is
for informational purposes only and does not replace the advice of a
qualified birth professional.