All About Babies, Part III Some More Things I Learned

Continued:

• Once a Cesarean doesn't mean always a Cesarean.

I feel there are two camps of moms-to-be. One group wants to have a Vaginal Birth After Cesarean because they didn't want surgery to get their baby out to being with. Another group enjoys the control and security that comes with a Cesarean. (There's a third group, a group that might want a VBAC but can't find a provider, but that is a whole separate issue. An issue of fear and malpractice insurance. :)

Whatever camp you fall into, it is clearer every day and with each new study that you don't have to have another Cesarean once you've had one. The risks of surgery are comparable to the risks of a VBAC, if you ask me.

The National Institutes of Health say that "...VBAC remains a safe alternative for the right candidates, and when those women try labor, between 60% and 80% of the time they do give birth vaginally...It urged that doctors offer mothers-to-be an unbiased look at the pros and cons, so they can decide for themselves...in 1980, government experts concluded that many mothers could safely deliver vaginally the next time, citing evidence that their risk of a uterine rupture was less than 1%."

One of my favorite bloggers, The Feminist Breeder, was featured in this article entitled Women Struggle to Avoid Repeat C-Sections: "...many women don’t know they have the option of fighting against the knife for a VBAC. Only about 11 percent of women in the United States had VBACs in 2003, down from about 28 percent in 1996, according to the National Center for Health Statistics."


But the illusion of being in control is powerful: " 'Our practice always offers the option [of repeat elective C-sections], and a lot of women choose to have another one,” she said. 'They like the idea that it’s scheduled. They go in and know what’s happening, avoiding any chance of an emergency'...C-sections have become such a common practice that 90 percent of women who give birth that way once will do so again, according to the Illinois Department of Public Health."

• There are risks to C-sections.

Risks for the mom with a c-section include: Infection of the bladder or uterus, injury to the urinary tract, and injury to the baby. For future pregnancies: Placenta previa, placenta growing into the muscle of the uterus and has trouble separating after the baby is born (placenta accreta), and uterine rupture. The New York Times article I pulled information from makes sure to say that the surgery is safe before it lists all the complications. :)

At least WebMD also specifies that c-sections are "major surgery". They also list a few more complications than the New York Times article: heavy blood loss, blood clots, nausea, vomiting, headache, bowel problems (!), oh, and rarely maternal death. Of course risks increase with each subsequent c-section.


There are potential risks for c-section children. Sections are being linked to obesity, possibly genetic issues, not to mention asthma because they didn't get their lungs squished through a birth canal. More interventions do not mean healthier children.

My takeaway is that a) elective repeat c-sections are definitely not 'safer' than VBACs and b) c-sections are major surgery. In every other discipline, great care is taken to be LESS invasive and avoid major surgery if possible. But with obstetrics, now we can just go cutting up the abdomen because the date works for everyone?

• It's NOT just about having a healthy baby.

It's about the whole experience. I keep hearing the refrain "but all that matters is a healthy baby", which translates to me as "your emotions and memories of birth really don't matter. Move on, be thankful, get over it." It's easier said than done, I suppose. There are some who believe that it's harder to bond with a c-section baby and to breast feed them successfully. Here is a link to The Feminist Breeder's 'lovely' c-section experience (here's the whole story). Also read the posted comments to hear other moms who wish it had happened differently. Here is a link to Q&A with an artist who had two Cesareans, one against her will! This is indeed how I felt:

Skeptical OB (Amy Tuteur) has a 'lovely' post about how this sort of thinking is just plain selfish. Labor and birth are all about a healthy baby, she says, no matter how you get there. She uses a horrible comparison--what if you had a wonderful vaginal delivery but your baby was dead? Would you be so happy that you had the birth of your dreams?!

Well, my husband pointed out to me that this is a logical fallacy. It's assuming that you can have one (lovely birth) OR a healthy, living baby. That's not true. What moms mourn is, I suppose, the whole package.

Despite Dr. Amy's opinion, I have to say that I don't think it's that simple. As my mom-in-law put it after my Cesarean, "Nicky, you were cut open. You need to take it easy." And that's how it felt. I wouldn't look down there, wouldn't touch my scar, wouldn't let my husband touch the scar all because it was a reminder of a cold room, helplessness, and someone cutting my baby out.

Well, those are some of the things I learned.