Volume 43 ~*~ 15 September 2007

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• Albany, NY Woman Dies from Complications from Cesarean

  An infant and a toddler are without a mother, and a father is without his wife in the wake of Diane Rizk McCabe's death from complications from her Cesarean.

• Rising Maternal Death Rate: Rise in C-Sections Can't be Ignored

  The 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 be ignored.

• The New Normal?

  In this provocative piece, the author looks at what "normal" birth means these days.
   

• Friedman's Curve Gets a Second (and Third) Look

  In 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."
  

• VBAC Decision-Making: An Evidence Based Approach

  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.  Lily, from the ICAN listserv, responded to a thread about our daughters with this brief remark that is nothing short of powerful:

You 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. 

Clip 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 took pen to paper five years after her second cesarean and let it flow:

Five 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.

Then 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 adequately identify.

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.

You 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 me stat.

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?

The 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-- 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 pieces.

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!

The 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.

Eventually, 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."

Five 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.

For 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.

I got 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.

I 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 won't, either.

yours in triumph and righteous anger,

Jennifer Bax 

Screenings of The Business of Being Born

GoodSearch

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 pennies add up!  Don't forget, you can add GoodSearch to your toolbar to make it even easier to search and do good at the same time!  

Talk It Up

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 will be Monday, October 8th.  "See" you there! 

Cesarean Voices

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 these voices.

Get your copy now from the ICAN Store!

Gentle Birth World Congress

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 * info@gentlebirthworld.com * 503-673-0026

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ICAN's 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.

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