Thoughts on Informed Consent, Refusal and VBAC

If you’ve been listening to the news lately, you’ve probably heard a lot about vaginal birth after cesarean (VBAC). The NIH held a consensus meeting to decide what was appropriate in VBAC care. The general thought was that the overall VBAC rate should increase and that the rate of primary cesareans should decrease due to the risks of surgery to the baby and mother. The panel had several recommendations that can be boiled down into:

• ACOG and ASA should revise their guidelines on the “immediately available” guidelines.
• The decision to do a VBAC or a repeat c-section should be made between a woman and her practitioner, after an informed discussion.

The problem with the last statement is that true informed consent and discussion is very rare in obstetrical care. The closest that we tend to come is the woman who is choosing a VBAC. She is likely to spend the last several months of her prenatal care being told of the risks of VBAC and the parameters in which it will happen. In contrast, had that same woman chosen to have an elective repeat cesarean, she would simply be handed an appointment card for her scheduled surgery and then sign a sheet of paper that would have to suffice as informed consent, all done a few minutes before her surgery. Neither of these is truly informed consent.

So how can women get informed consent, particularly when it comes to a hot topic like VBAC? My advice is:

• Do independent research.
• Seek out information from neutral sources.
• Talk to other mothers who have had a VBAC.
• Talk to other mothers who have had a repeat c-section (planned and not).
• Prepare for your birth by childbirth class, doula support and emotional support.
• Consider alternatives including midwifery led care.
• Make a decision only after a lengthy discussion with many people, including your practitioner.

Providers have to consider multiple issues when recommending one mode of birth over another: health of mother and baby, liability for complications, availability of self and staff during uncomplicated and complicated births, personal beliefs, medical malpractice insurance (if they choose to carry it), what other practitioners will think of their choices, etc.

Women have their own issues to consider when deciding her mode of birth: health of baby and mother, likelihood of the success of VBAC, physical and emotional pain after the birth, personal beliefs, etc.

The final point is that of informed refusal. ACOG has a policy of informed consent and refusal. This states that they believe that a woman who has all the information, is allowed to make a decision to choose not to receive the recommended procedure or therapy that is being suggested by her doctor.

At the panel yesterday, when asked specifically about the policy of informed refusal as it included forced repeat c-section, either by practice policy or individual recommendation, they basically said that this was unclear. Some advocates took this to mean that the consensus panel was suggesting that women did not have the right to choose a VBAC if that wasn’t the recommendation of her doctor or that if she did, it was acceptable to coerce her with threatened legal action. In other words, a woman is free to make any decision she would like, unless it conflicts with what her practitioner decides.

That leaves us in a sticky spot. What’s a birth activist to do?

Related:

• Maternal Decision Making, Ethics and the Law
• Refusal of Care Based on Religious Beliefs
• Women Need a Chance to Avoid Repeat Surgery

But Why is VBAC so Important?

I am sure that I am not the only person to ask myself this with the announcement of the National Institute of Health VBAC Conference announcement.  But unlike most, I know more than my fair share about VBAC after having a cesarean with my first child it became more than a healthy obsession to me. But sadly the more I learned, the more sad I became about the access to VBAC nationally.

In a 2009 survey from The International Cesarean Awareness Network, it was found that nearly 50% of all hospitals in The United States has some sort of a VBAC Ban in place. Whether it be a formal policy written by hospital administrators, or a de facto ban, meaning there simply are no providers who will take on a patient who wishes to have a Vaginal Birth after Cesarean.

But what does this mean for women nationally? For the women who have had cesarean sections, whether medically necessary, or unnecessary?  It means that once they have experienced once cesarean birth, they have no choices regarding future pregnancies or deliveries. Essentially leaving them with no real informed consent.  To me, as a huge activist, that is not only a violation of a patients rights, but it is a major human rights and bodily anatomy violation.

Right now, 90% of women who have had one cesarean section will go on to deliver all of their children through multiple major abdominal surgeries, the next more risky than the last. When the safe and relatively low risk  option of a VBAC is not available.  But lets look at the numbers regarding the risks of VBAC as opposed to repeat cesarean sections.
The major risk associated with a Vaginal Birth after a Cesarean section is something most near the most not knowing the risk is so low. Uterine Rupture.  Not something we should discount or not worry about, but when we look at the statistics, the average healthy woman who has had one previous cesarean section has a 0.6% chance of experiencing a uterine rupture.

When I went through the process of filling out and signing my VBAC consent form for my second pregnancy, there was paragraph after paragraph panting VBAC in a scary pictre, then a small paragraph with the minor risks of a repeat cesarean, almost like the practice of Obstetricians backing my midwives wanted me to change my mind and run in fear.
This form was not informed consent by any means, it was skewed, biased, and provided misinformation, but sadly this is what we are seeing Nationwide today.

But I can hope with the NIH VBAC conference we can start to see a change in the way that VBAC is handled nationally.
Women have the right to real informed consent, and give birth vaginally if that is what they choose for their own birth.

For more information on Cesarean Awareness, and Advocacy, check out The International Cesarean Awareness Network.

Cesarean Recovery

With the number of cesarean sections increasing in our country annually, many women do not really understand or know that recovering from a cesarean section is much different from a vaginal delivery. After my first cesarean section I learned this the hard way and wish I had a couple tips on making recovery more bearable.  But we often forget that the recovery after a cesarean birth is not just physical, but it is also emotional for a large portion of cesarean section mothers.

The different types of healing to be considered are in the hospital, long term, when you return home with your new baby, and also things you should be aware of such as when to call your health care provider post cesarean. (I also want to thank ICAN and their Recovering from a Cesarean White Paper in aiding to my post today)

While in the hospital :

• Get as much help as you can from family members, your partner, nurses, and other hospital staff. That is what they are there for and during the hours, and days immediately after your surgery, you will need it even if you do not want it.
• Stay hydrated and eat. You may not want to eat, but working on eating a well balanced and healthy diet, as well as staying hydrated (stay away from sugary drinks such as fruit juice and soda) will help to make you start to feel semi human again.
• If private rooms are available opt for one so someone (family member or friend) can stay with you to help you during this time.
• Use a pillow between your legs, and/or on your side to help sleep to be more comfortable. In the days, and even weeks following your cesarean it will not be easy to get comfortable. This is completely normal.  It took me almost a full 2 months to even get comfortable in my own bed at home after my second c-section.
• Take pain medication that is being offered if you are in pain. With my first child, I was breastfeeding and was overly concerned about any of the medications being transfused though my milk so I opted for over the counter pain medication such as motrin instead. But it certainly made my recovery longer, and made taking care of my son harder. (As ICAN recommends, ask your provider about a stool softener, as narcotic pain medication can cause constipation.)
• Get up and walk around.  It may hurt like hell, but it will help to get you back on your feet sooner rather than later. The longer you wait, the more painful it will get up, and the harder it will be.
• The use of a pillow to protect your stomach while coughing, standing up, nursing or moving around in bed is a smart idea.
• Do not hesitate to ask for a lactation consultant in the hospital. Breastfeeding after a cesarean section is more difficult not just for mom because of her incision, but also for baby. Check out the ICAN white paper on Breastfeeding After a Cesarean.

The first couple days in the hospital may feel like you are dying, I know because I have been there, but in most cases, you will only get better. When you get home, there are some more great tips for healing, although your housework may suffer for the first couple weeks, I am sure no one will mind too much.

When you get home :

• Focus on yourself, and your baby. You just had major surgery and your baby needs you.
• Have your partner help/do the household chores. Laundry, dishes, cooking, or anything else that needs to be done. Don’t worry, you can put off the dusting, cleaning the bathroom, mopping, and all the big chores for a couple weeks, your house won’t be mad at you!
• Do not lift anything that is heavier than your baby for at least 4-6 weeks. Those infant carriers/carseats are tempting to pick up, especially when going to an appointment for you or your baby, but stay away from it. You do not want to hurt yourself, or have an extended recovery.
• Ask others for help. If you have older children it may be helpful for your partner to take some time off from work, or have an available family member come over to help you. During the first weeks after my second cesarean section my toddler not only got the flu, but I was the only person he wanted making it difficult on me because I could not pick him up.
• Take it slow!  Get back into your normal household routine over a long period of time. You do not want to over do it because you will certainly pay for it later on.
• Have access to baby stuff such as diapers, bottles, burp cloths, wipes, or whatever you and your baby need for a couple hours in several places around the house. If your bed is the only place you are comfortable, make sure you can set yourself up to be able to hang out with baby, change diapers, and everything else you need right there.
• Co-Sleep!  Room in with your baby, so when it comes time for midnight feedings, you do not need to get up or go far to take care of your little one.
• If you have school age children, have others help to prepare their lunches, lay out clothes for the next day and anything else that needs to be done. To spend quality time, sit on the couch, or someplace comfortable and assist them with their home work, or read a book. Find ways to spend time other than anything that may put a physical strain on you.
• Considering hiring a post partum doula. They can really be heaven sent in a post cesarean situation!
• Don’t push yourself. If you want to take a shower and get dressed for the day, make that your only goal for the day.
• Pajamas are your best friend. They are comfortable, and help to remind others you are still recovering from major surgery.
• Remember how important it is to continue to remain well hydrated, and eating healthy.

Many do not think of the long term or emotional recovery of a cesarean section. I personally did not even encounter the emotional recovery until my cesarean baby was 3 months old. Be gentle on yourself, you aren’t the first to go through this, but many people around you may treat your feelings like nothing because cesarean sections have become so common. I can’t tell you how the phrase “a healthy baby is all that matters” feels to me still today.  Do not let others discount your feelings on your experience.

For your long term recovery…

• Contact your local ICAN (International Cesarean Awareness Network) chapter. These are women who have been there, and done that and know how you feel and what you are going through. They are an excellent support system internationally and are such a huge blessing for many mothers. I know they were to me!
• Write out a birth story, express your feelings on paper, or on a blog, get it out. Keeping your feelings inside may be harder in the long run.
• Keep your baby as close to you as possible for as long as you can.

If you experience any of the following symtoms or problems, you should contact your care provider immediately.

• Any type of bleeding from your incision.
• Leaking, redness, or any type of fluids coming from your incision.
• If your pain does not decrease over time.
• Symptoms of post partum depression such as anxiety, fear, problems sleeping, depression, or anything else you may equate with something more than just the baby blues.
• Cramping or pain in your arms or legs that will not go away.
• Continuous headaches, migraines, or backaches.

Over all, be gentle on yourself.
You just went through major surgery!

The Duggar Family

I would like to extend my well wishes and thoughts to the Duggar Family though this difficult period of their lives after welcoming their 19th baby, Josie Brooklyn Duggar yesterday, December 11th 2009 via emergency cesarean section for Pre-E after a hospital stay due to gallstones. Baby Josie was born at 25 weeks gestation at 1 pound 6 ounces.

Over the past 24 hours I have seen some of this most disgusting comments via the internet on news articles, and just message boards. Whether Michelle was on her 3rd or 30th child, Pre-E can happen to anyone at any age and during any pregnancy. This family may live differently than the vast majority of Americans, but seriously, if you want to say something negative, say it when mother and baby are far out of the woods, not when a micro preemie is fighting to live.

Some people never cease to amaze me.

Michelle has been such an amazing asset to the VBAC community in having 12 VBAC’s herself.
I can only hope in future years she will continue to work with and praise ICAN like she has in the past.

Why Our Women are Afraid of Birth

Deliver Me

It is Tuesday, at 10pm while I settle in after getting my little ones to bed. I flip through the channels and settle on discovery healthy which is a personal favorite of mine, but it really has only recently become a favorite because of shows like I didn’t know I was pregnant. It fascinates me that women could make it though a full term pregnancy and not know they were pregnant, but that is just me, and the experiences that I had with my children is what makes me wonder how the heck women could not know they were pregnant.  But that is completely besides my point today.
So as I watch this show, I am noticing a trend. High risk, high risk, high risk, previous cesarean section, scheduled cesarean section, high risk, healthy first time mother, scheduled cesarean, high risk. Well I mean, that is how it is in Los Angeles right?  You would think so!  But apparently because only these crazy, scary, uncommon births make something called ratings, that is all they are going to feature on TV. Because in reality, no one wants to watch a natural birth or a home birth because no one is running around with a scalpel screaming about the emergency that childbirth is. Nor is the mother screaming for her epidural because she just cant deal with the pain of the 3 hours of labor so far.
But what we should be thinking about most importantly is the message this is sending. What is this teaching first time mothers or even young women that may not be planning on having children soon but will some day?  It is teaching them how scary, dangerous, and medical birth is supposed to be. But is that really how birth is? Of course not. Anyone who has taken the time to read the studies, and just not follow what mainstream society thinks is the right way to handle pregnancy will know that birth is not scary or dangerous or a huge emergency. While it can be in some cases, in most cases it can and will be beautiful when just left alone.

When a woman becomes pregnant today, if they do not already have an Obstetrician they have been seeing for well women care since 16, or whatever age their parent decided it was the right them for them, what is the first thing that they do? They ask around their circle of female friends for the best Doctor out there because isn’t that what we all want? We want the one who is the BMW of pre natal care. Little do women know that they are really going to end up with the 1990 Dodge Dynasty when they take this route because hands off is better.
But because our society has told us this is the way things should be, they run off like lemmings right off the cliff of medical interventions landing in the valley of cesarean sections.

Maybe if the television channels like Discovery health followed a dozen home births or even aired The Business of Being Born they could get a popular, and controversial other side to what they are constantly airing. Maybe it will boost their ratings even more, maybe not?  But what it will do is give the other side of the whole issue. Let’s get Marsden Wagner to do a half hour special on Birth in The United States and see how many women run off to the midwives.  Instead they air these disgustingly inaccurate “Freebirthing” shows. They find the one idiot who is going to make women who choose unassisted birth look like a bunch of uneducated yokels.  Which is exactly what they did with their special on Unassisted birth.

I guess in the end, like anything else the television airs, it is biased and we shouldn’t expect much different.

No Intervention Necessary: Woman Has Surprise HBAC

This surprise out-of-hospital birth story focused on the toddler-as-midwife angle. Just as interesting, however, was the fact that this woman avoided surgery. She was scheduled for her fourth cesarean on December 6, 2009.

Congratulations to the family.

Two-year-old Jeremiha Taylor doesn’t have to ask his mother where babies come from — he helped deliver his little brother at the foot of his family’s living room couch.

“He’s my little hero,” Jeremiha’s mom, Bobbye Favazza, 27, of Olive Branch, said Tuesday. “It was like he knew what to do.”

Favazza gave birth to a 7-pound, 4-ounce baby boy, Kamron Taylor, on Friday morning. Firefighters arrived moments later to cut the umbilical cord.

Greg Mynatt, an emergency services supervisor with the city, said the 911 call about Favazza was probably the third this year about a woman in labor, but usually the mother makes it to the hospital before delivery.

Even rarer is a child assisting with delivery. Mynatt did not recall it ever happening here.

“This would probably be the first,” he said.

Jeremiha can count to five, feed himself and go to the potty himself. He communicates in short sentences.

Of course, nothing about his brief childhood had prepared him to assist in delivering a baby, but Favazza said that of her four children, Jeremiha is the bold one, the one who “will try anything.”

Favazza had made proper plans. Baptist Memorial Hospital-DeSoto was expecting her — on Dec. 6, for her fourth caesarian section — not on Friday the 13th.

Looking back, Favazza realized she was in labor all through the night before the birth, but she did not realize it at the time. The discomfort was minor compared to the labor pains she remembered before giving birth to her sons, ages 2 and 3, and daughter, 5.

On Friday morning, Favazza complained to her mother, Leigh Favazza, about the pain, but neither woman believed delivery was imminent.

Leigh Favazza considered taking the day off from her sales job if indeed her daughter was going to give birth, but first she had to get her granddaughter, Keely Taylor, settled at school.

Leigh Favazza left the house to take the 5-year-old to the bus stop at the end of Maury Drive, then she headed for Olive Branch Elementary School to drop off snacks for her granddaughter’s classroom. While en route, Bobbye Favazza called.

“Mom, I’m having the baby,” Bobbye Favazza said.

Leigh Favazza hung up and called 911. It was 8:26 a.m. She was frantic. Her daughter was alone in the house with a 2-year-old, a 3-year-old, a bull mastiff and a poodle and her water had just broken.

Bobbye Favazza’s oldest son, 3-year-old Jamison Taylor, had awakened to discover his mother bleeding and in pain.

“He sat on the couch right here and cried,” Bobbye Favazza said. “He was terrified. He’s my emotional one.”

The 2-year-old was calm.

“I laid on the couch and he went and got a towel,” Bobbye Favazza said. “He grabbed a towel on his own.

“It happened so fast. My water broke and the baby came two to three minutes later. I just pushed and he caught him.”

Bobbye Favazza said she held her baby, still attached to her by the cord, as she walked a few feet to unlock the front door for emergency personnel. They cut the cord.

Jeremiha, quizzed about the birth of his brother, can point to the spot at the end of the couch where Kamron Taylor was born.

“Over there,” he said.

“Sometimes these things happen, especially to mothers who’ve had multiple births,” said Mynatt, the city’s emergency services supervisor. “The time gets less and less with each delivery.”

Mother and son were discharged from Baptist-DeSoto. Neither suffered any complications.

“I’ve had three,” said Leigh Favazza, the proud grandmother, “and I can’t imagine having any of them like this.”

The Infamous Cascade Chart

As someone strongly involved in the birth community, this is probably one of my favorite pictures floating around the internet that I run across every once and a while.? One day when I find out the person who actually put these thoughts and cascade of interventions into a physical chart to view, I am going to kiss them!

I have always loved how it starts with induction, because lets face it, so many women today are starting their labors with some kind of artificial labor stimulant. Whether it be pitocin, or the oh so dangerous cytotec. I can personally say I have been the victim of the cascade myself with my first child. Had I seen this before my pregnancy with him, I would have never opted for the induction. Many do not realize that induction in many cases will fail, almost half of the time according to the most recent figures, and when I quote that, I am quoting Robbie Davis Floyd in a 2008 interview, I believe it was in Pregnant in America but my birth/pregnancy movies and interviews all start to blur together when you watch so many of them. These babies are not ready to be born in many cases, especially when we are seeing these inductions before the “due date” or the 40 week gestation mark. Although we know that “due dates” aren’t much to put stock into, many women and providers use them as some type of eviction date, which history has shown to be a pretty bad idea. No one is going to be pregnant forever and many women left alone will go into labor on their own. Now granted, there are cases that induction is medically necessary and for these special cases, I am completely thankful. Without induction these women would be subjected to cesarean sections instead of labor inductions which could in turn be even more hard on their body, and experience over all.
What we do not understand with the induction of labor is, we are creating unnaturally strong contractions in attempt to simulate something similar to natural labor. As someone who has experienced pitocin labor, and natural labor, I would take a million natural contractions over being on the receiving end of pitocin again. The comparison in my opinion is not even in the same ball park. Another issue with these contractions as most know, is the fact that they are more likely to cause fetal distress on the baby because they are not natural contractions or what normal contractions are supposed to be. So in turn we are putting our children under unnecessary stress. Especially if they are not ready to come and join us in “our world” yet. Again something I learned with my first.
Then we have the provider who comes in and looks at the fetal heart monitoring and says, “Oh No! Your baby is in danger!!” So off to the operating room we go for an “emergency” cesarean which in reality was caused by the pitocin to begin with. You would think by this point there would be a bit of common sense in the Obstetric community to say, ya know, I think we are causing these actions instead of blaming the increasing cesarean rate on “patient choice cesareans” which only make up 3% at most of the incredibly high cesarean rate in our country.

But a cesarean is only one path that this induction cascade can lead to. There are still women out there that will have a vaginal delivery when subjected to a labor induction, but in turn these women have greater risks for other procedures including episiotomies which have all in all been proven to really have little to no benefit to women in the long run. While episiotomy rates are starting to decrease, they are still over used in many communities. For example, here in my state of Connecticut, some hospitals have an over 25% episiotomy rate, when science tells us there really shouldn’t be over 10%. Trying to obtain these numbers are like pulling teeth too FYI!

We also have vaccum extraction. I had never really discussed this or spoken with someone who experienced this until I met my Chiropractor in the summer of 2008. He was discussing with me why Chiropractic care in infants is important, and then he described his own daughters birth, they had applied the vaccum to the top of her head, and while “assisting” her out, they pulled so hard the vaccum literally flew right off of her head. My Chiropractor described it so vividly… “I thought her HEAD popped RIGHT OFF! I was horrified to even look!”? My heart broke for him because no parent should have to go through that kind of fright during the birth of their child!

These all often lead to epidurals, which especially if you are going to have a cesarean section, you will either have this or a spinal block. All types of anesthesia that will have a direct impact on the baby. Although I have experienced women told there will be no effects on their baby at all.
I am sure most know about the “breast crawl” and I can say after watching a baby who’s mother did have an epidural, as opposed to a mom who had a natural birth, there is no comparing the instincts of the baby. While I had epidurals with both of my children, I didn’t have the opportunity to breastfeed then until they were a little over an hour old. My first was almost 2 hours. For more information on epidural effects on babies, click this link!

The last thing I want to touch on is the separation of mother and baby after a cesarean section which is very common. It is pretty uncommon for an newborn to be allowed to stay in the OR with mom, although it does happen sometimes. I can really related to the lack of bonding, breastfeeding problems, and reduced bonding because of this because I deeply experienced this with the births of both of my children. While I bonded, it was not that “instant motherly love” I am sure most feel. It hurts me to this day to know that my bonding was an almost learned bonding because I knew as a mother it was something I needed to do in order to protect my babies.? While most women who have had cesarean sections are not quick to admit this, I think by discussing this and acknowledging that this is a true problem it will only help to improve it for others in the long run. I also noticed that mothers who do experience this may be ashamed or fearful to admit this because it make portray them in a less than perfect light, or maybe others may look down on them because of this, but they should not be ashamed. It happens and there is nothing we can do about it but help other women to not go through what we did!

Be empowered by your birth, no matter how you birth!
If it is a bad experience, help to educate others so they do not go through what you did, so they can avoid the pain or heartache you have dealt with!

What is ICAN?

Check out ICAN’s latest video: What is ICAN?

Do you think that places like YouTube and videos make spreading birth activism easier?

Danielle’s Birth Stories

I have been meaning to sit down and really write out my birth experiences from my two boys, so I figured this week, since we are focusing on birth stories, what a great time!

I will start with the pregnancy of my first child, Camden. When I got pregnant, I was not all that educated about natural birth in general. I had worked as a doula, but through a crappy agency which I separated from rather quickly. So when I found out I was pregnant, I figured seeing a female Obstetrician would be like seeing a midwife. WRONG!!!!!!! But, I was pleased with my provider for the most part. I was considered a “high risk” patient because of surgery which I had on my cervix in my teen years, so of course like so many other women, I blindly followed what my Doctor told me, because of course, Doctors are never wrong…. right?
As my pregnancy went on I started seeing another female Obstetrician in this practice I proceeded to dub “The Wicked Witch” she was mean, old, cold, and simply rushes me without ever answering any of my questions or concerns. Then it seemed as though, every time I would schedule an appointment with MY OB/GYN I would always end up seeing this other Doctor. It was driving me crazy! Same went for if I had to call the “on call” for the evening, something felt wrong or something was off, and this same Doctor would always insist I went to L&D and be checked. By the time my son was finally born, I am sure they were all glad they wouldn’t be seeing me again!
Then in early November, our family was struck by a tragedy. My husband’s brother died suddenly at the age of 23, which sent our whole family into a tail spin, this was 4 weeks before my due date. From that time on, I proceeded to get sick daily, sometimes several times a day, I started losing weight despite eating like I regularly did before. At my last visit at 39 weeks and change, the Wicked Witch expressed concern that I was losing weight (15 pounds by this point) and that we should go ahead and schedule an induction before it has an impact on my son. Of course like any mother would, I freaked out and agreed. I didn’t want to have something happen to him, and in a way, I was happy because I was uncomfortable like EVERY pregnant woman was in the end.
I went in that Tuesday to get induced. It was December 11th 2007, and we showed up at 6:00am, and they escorted us up to my L&D room, and looking back on it, I wish I knew what I was getting myself into.

My L&D Nurse came in for my little questionnaire/intake and when I said I did not have a desire for an epidural, she and the Wicked Witch OB laughed at me, and told me I would change my mind shortly. From then it just proceeded to get worse!? By 9:30 I was hooked up to pitocin, which in my opinion is PURE EVIL!? Like they had said, after 2 hours of pitocin, 3cm dialated, I was begging for an epidural. I got the epidural but it didn’t seem to do much for me. The OB came back around at noon time, checked me and said I made no progress. I was still at 3cm, -1 station, 80% effaced. Which was a total blow to me because I was hurting and I thought I would have progresses SOME! She told me she was going to go have lunch, see a couple patients and she would be back around 2pm.? My husband and my mother went to get something to eat, I tried to rest a little bit, and eventually she came back. At 2pm, there was again no progress. And this is when she said, well, I am going to come back at 3, and if there is no progress then we are going to have to book an OR. I knew then my worst nightmare was coming true. This cascade of interventions was directing me straight to a cesarean section. From the start of my pregnancy, when I was told about placenta previa (which corrected itself) via ultrasound, I cried at the thought of a cesarean.
She came back at 3pm, and there was no progress, or at least that is what she told me, and they started preping me for surgery. The OR was cold, and bright, and without my husband, it would have been even more terrifying.? In the back of my head I was happy I was about to meet my son, but I was scared to death.
He was born at 4:37pm screaming, 7pounds and 7oz. Which then one of the OB/GYN’s commented, someone of my size (petite frame and short stature) would have never been able to birth that baby. Ya ok!? My mother, my size, gave birth to an over 10 pound baby, HER FIRST CHILD!

My recovery sucked, and during that time, I reached out to ICAN and learned there was no chapter in my area. So, I started one.
In September 2008, we learned we were expecting our second child, and even before I got pregnant, I knew I never wanted to go through another cesarean, nor would I willingly go through it.
My pregnancy was? uneventful, NOT HIGH RISK, attended by amazing Midwives, and so much different from my first.
On May 16th, I was doing a baby fair at our local hospital for our ICAN chapter, talking with mothers all day, giving out information, and around noon time, I started to feel… off. Something just wasn’t right.? Thankfully for me, my Chiropractor was at the booth right next to me at the baby fair so I made my way to him and got adjusted. Once I got adjusted it all clicked. I was going into labor at a baby fair. Were we in a movie?

Next thing you know, the women doing the booth with me said I looked white as a ghost, like I was ready to pass out, so they made me have some water, and eat candy. Lovely combo, but it helped! I wrapped up the fair and headed home. I called my doula and let her know what was going on, but I wasn’t certain I was in labor yet.
I laid down when I got home and tried to take a nap, but I couldn’t get any rest at all. My contractions kept getting closer and stronger. It seemed as though my labor was progressing fast, and I wasn’t sure what real natural labor was like because of my induction the first time around. I called my doula back up and she decided to head on over, and off to the bath tub I went to relax and try to work through the contractions.? Back labor, all the pain was in my back, and later on I found out my little guy was posterior.? By the time my doula got to my house, and things really started to rock n roll, it was around 8pm.? I watched the season finale of Brothers & Sisters which I had DVR’ed, listened to music, and spent a ton of time on the birth ball. Hours seemed like minutes, and next thing I knew it was midnight and I called my midwife. I told her I had been laboring for a while, and things were getting more intense, contractions were about 90 seconds apart, and we still had a 45 minute drive to the hospital I picked, which was one of the most VBAC friendly in the area. So around 12:30am we headed off to the hospital in a 3 car caravan. Myself? laying in my doula’s backseat trying to sleep in torrential rain on the highway. My best friend in her car, and my husband in our car.? We arrived at the hospital between 1 and 1:30am.
We got all checked in, and my midwife greeted us, and gave me a little check. I was 2-3cm which made all of our jaws drop. My labor was so intense we all swore I would be further along!? I decided to get on my hands and knees with the birth ball for a while, then take a shower, I thought about getting in the tub, but it was nearing 4-5am and we all wanted sleep. I couldn’t rest for the life of me.
At this point I asked for an epidural so I could sleep. I knew no matter how much I planned that I would not have one, things change when you are in the actual situation.
I got the epidural around 6am.
I was able to sleep until at 8, when my midwife came back and checked me again 3cm at most.? What was going on?? Why was I not dialating? What was wrong with my body?? Contractions started to slow, then get back to being a minute apart, then slow, then get quicker. Something was just not right, and on top of it all, I am sure the epidural was not helping either.
Around noon time my midwife popped back in and checked my cervix one last time.

Still 3cm and now my cervix was starting to swell, and we were having complications.
I was devastated, my VBAC was crashing and burning in front of my eyes.
My body was defective, I could not birth my baby, my own plan had blown up in my face.
My epidural to sleep, selfishly kicked me right in the ass!

My Midwife consulted the on call OB/GYN who came in to talk to me, along with the Resident who was on call. They were both amazingly warm, friendly, and comforting, and at that point I knew that a cesarean would be how my son was born. But I was not as bothered by it this time around, because after nearly 26 hours of labor, something was wrong, seriously wrong. My mothers intuition turned on and my son was in trouble.

At 1:59pm Benjamin Emil Elwood was born, bruised and looked like he had been through a war! When they opened me up, he was jammed behind my pelvic bone, which his forehead was pressed up against it all that time. He wasn’t coming down, his head wasn’t applying pressure to my cervix for it to dialate. At that moment I knew I made the right choice consenting to the cesarean.? I knew in the long term, it helped my son, and that was simply the way he needed to be born. During the days after my midwife would come see me every morning, sit, chat, and just helped me get through it all. I still today, cannot write about this without crying because the scars from his birth are still fresh. Nearing 6 months old, the pain of the failure is not any lighter. It seems like it was yesterday.

The story I tell is a story of a completely unnecessary cesarean section with my first child, and a life saving cesarean with my second.
The story I tell is a story of pain, and hurt, and betrayal by the one person I trusted the most, my Doctor.
The story I tell is a story of hope for other mothers to learn and become educated from my words.
The story I tell is the story of my sons, the loves of my life, and the ones who have made me the mom, advocate, and woman I am today.

All in all, I am now the North East Regional Coordinator for ICAN, a chapter leader, and the head of a maternity care campaign in my state of Connecticut. My experiences, my children, and my battle has made me become so active that I have been honored to support other women who have been where I have, and I have helped others to prevent unnecessary cesareans.

I love what I do.
I love the birth community.
I love ICAN.
I love being a Birth Activist!

Chiropractic Care during Pregnancy

One thing a lot of women do not know is the importance of having a balanced pelvis during labor. Which is why as a birth advocate I feel strongly about Chiropractic care during pregnancy. Not only does it help you live a healthier life, but it also helps you to get your baby into the optimal position for birth.

Many women question me when I bring this subject up, asking how someone who has a big belly is able to lay down and really get adjusted properly. During pregnancy, many Chiropractors will steer clear of adjusting the spine itself, and stick to the pelvis, neck, and round ligaments in something known as The Webster Technique.

The Webster Technique was founded by Dr. Larry Webster, also the founder of the International Chiropractic Pediatric Association, as a safe method to restore proper balance and function to the pelvis for pregnant mothers. The Webster Technique has also been proven to have a high success rate in preventing breech presentations.

Sacral misalignment causes the tightening and torsion of specific pelvic muscles and ligaments. ?It is these tense muscles and ligaments and their constraining effect on the uterus which prevents the baby from comfortably assuming the best possible position for birth. The Webster Technique is defined as a specific chiropractic analysis and adjustment that reduces interference to the nerve system and facilitates biomechanical balance in pelvic structures, muscles and ligaments. This has been shown to reduce the effects of intrauterine constraint, allowing the baby to get into the best possible position for birth.

The above is taken from the International Chiropractic Pediatric Association Website explaining further the Webster Technique and how it works.

Why do I wholeheartedly believe in Chiropractic care as well as The Webster Technique?? My own personal experiences, which all started in June of 2008 when a woman came to my monthly ICAN meeting with a breech baby, frantic because she was planning a home birth in the month of August, and if her baby did not turn into a head down position, optimal for birth, she would have no option but to be admitted into the hospital and have a cesarean delivery, which for her was a nightmare situation. In our area, there are no known providers who will deliver a breech baby of any type.
Thankfully for this mother, our guest speaker for the month was a local Chiropractor, Dr. Jason Jenkin’s who has since become an amazing mentor and friend in my life. He spoke about The Webster Technique, and this woman started seeing him immediately in hopes of this method helping to turn her baby into the optimal position for her to have a successful home birth.
I nervously and skeptically kept track on her care through e-mails, phone calls, and facebook chats. And then her baby turned. Nice, head down, and ready for his peaceful birth at home!

Shortly after this, mom went into labor on a beautiful summer day, and little boy was born into his own mothers arms, in the water, in a beautiful home birth. When she e-mailed me about her birth, I sat and cried while I read, and became a firm believer in something I have known to be “Chiropractic Miracles”.

Since that time, this specific Chiropractic office has had several success stories with pregnancy related care, including my own Chiropractic care during my second pregnancy. Including adjustments the day I went into labor, as well as the next day after my son was born.

As one of my steps in helping to have a great birth, and avoid a cesarean section in a society where 1/3 of births are by surgery, I highly suggest Chiropractic care!