At the beginning of July, I posted on my frustration at the ongoing pregnancy story of a high school acquaintance of mine (now a Facebook friend) who was being put through the worst of what our maternity care system has to offer.
You can read the story at the above link, but a quick recap: This mama was in her third trimester, first pregnancy, healthy mother, no complications, and had been told by her OB that her baby at term would be a huge, enormous, over-ten-pound monster who could not possibly be birthed vaginally, and that she needed to schedule a cesarean at 38 weeks.
* Pause to let anger subside. Breathe. *
I thought you might like to know how this story ended up, so here is the final chapter.
The cesarean was scheduled, but due to delays with the doctor being away, the scheduled date was for 39+0 weeks. However, the mother went into labor naturally, three days before the scheduled cesarean, and the baby was born that day. I do not know if baby arrived via vaginal birth or via cesarean, as the mother did not post.
Oh, and that "huge, enormous, over-ten-pound monster who could not possibly be birthed vaginally"? He was less than an ounce over seven pounds. Going by average weight gain, he would not have even broken eight pounds at forty weeks.
Yay for late-term ultrasound weight estimates.
So that was the end of the story.
And now, I'd like to follow a few rabbit trails, if my readers will kindly indulge me. Some of these will take the form of a frustration-rant, and I am also in a big hurry, so please forgive me if I am repetitive or even completely nonsensical and occasionally hysterical.
Rabbit trail #1:
I was fascinated by the wide variety of responses that I received to my original post concerning this situation. It was all over the board! Go back and read the comments to see what I mean. It ran up and down a spectrum, everything from "It is your duty to write to her and tell her the true facts of what is happening to her," to "This decision is between her and her doctor and it's none of your stinking business, so keep out of it." Quite a difference of opinion there!
Well, I'll tell you. As a personal thing, I have a strict policy of non-interference in other people's births. Even when they make me as upset as this one. Why? Here are the reasons:
(1) Advice can be really annoying. And it's a bad habit to get into (giving unsolicited advice).
(2) Usually, when people are ready to receive advice, they're already actively looking for the information themselves and don't need it.
(3) If a person is not ready to receive information, she will shut down anything that comes in the form of criticism of her beloved doctor. This is just something that women (myself included) do naturally.
So I really do my best to keep my mouth SHUT. (Unless specifically asked for information, and then I try to give gentle and encouraging information, to the best of my ability.)
On this one, I almost succeeded. Not quite, though. During this saga, I kept my mouth shut (besides notes of congratulations) - except for once, when I left one comment - something to the effect of "please be aware that late-term ultrasound is notoriously unreliable and is often inaccurate by up to several pounds." Then I left it alone, hard as it was.
What do you ladies consider your own personal policies in terms of giving advice when mothers are being taken to the cleaner's with bad maternity care?
Rabbit Trail #2:
This is something I haven't written about yet, but I found it vaguely disturbing - the fact that the mother was actually thrilled to be told that she needed a cesarean. During the decision-making process, she was actively enthusiastic about the idea and was very excited when it was finally decided that way.
Well, I'm guessing that it was for a number of reasons. First of all, cesareans really are more convenient. They're scheduled! Maternity leave, visiting relatives, vacation plans, holidays, whatever - it's all right according to plan with a scheduled cesarean. There's no doubt about that.
I discovered the lure of the scheduled cesarean last year, when a friend (having her third cesarean) asked me to encapsulate her placenta for her. It was around Thanksgiving time and we were planning to go out of town, which might have been hard - except that I knew exactly when this baby was arriving! So no muss, no fuss! It's no wonder that doctors and patients nowadays are falling into this pattern - there's no doubt that it's super-convenient. Admitted!
Secondly, and more elusively. Women today, especially first-time moms, are dead scared of labor, for a couple of reasons. First of all, we all know how much people love to tell pregnant women horror stories of labor/delivery that are filled to the brim with pain/gore/screaming/etc. etc. I think it must be instinctual, because I have to fight the natural instinct to tell horror stories too! But it sure doesn't help a young mother to prepare confidently for birth.
Secondly, most of the young women I know (real life and acquaintances on Facebook) are coming home from the hospital with experiences that would give Jack the Ripper goosebumps. I can only put it in the words of a blogger I read recently - "violent birth." Unnecessary induction, pitocin-induced labors-from-hell, epidurals, things go wrong, baby is crashing, emergency cesarean, side-effects, you name it. The cascade of interventions in all of its worst forms - over and over and over again, told until new moms believe that this is the norm. That this is just how birth IS.
Is it any wonder that a mother would welcome the thought of a neat and tidy scheduled cesarean? No contractions, no labor, no pitocin, no waiting, no fear, no nothing. Just an epidural and then "Here's your baby!" I don't blame them. Or the women who, having been through this nightmare with their first, welcome the thought of scheduled cesareans for the rest of their babes. I probably would too!
Because this is not something new. I have now seen several women told (usually for the most trivial of reasons) that they "need" to have a scheduled cesarean with their first child. And most of them go in with utmost cheerfulness. Some of that may be ignorance, but I think a lot of it is joy that they are going to escape the obstetric violence that now seems to be the norm in hospital births. (Not across-the-board - there are always good caregivers and great hospital births, but they just don't seem to be the norm right now.)
I must say, however, that it is saddening that most young mamas nowadays are not prepared for their hospital births with any sort of proper childbirth classes. I have read repeatedly about the decline of attendance in birth classes - that parents are taking more of a "show up at the hospital and let the doctor make the decisions" approach, and it is very regrettable because it leaves parents utterly vulnerable to bad medicine. Do these mamas know - are they told - that there are real risks associated with cesarean birth, for the mother, the baby, and for future babes? That there are lifelong potential health consequences for cesarean-born babies? That the risks of maternal death and stillbirth rise with each cesarean? Nope, most of them simply think of cesareans as "going out the sun-roof" with a whole lot of convenience and no negative consequences. Childbirth classes help so much with that - they allow mothers to at least make informed decisions knowing both sides to an issue and without being taken advantage of.
(And of course, none of this negates the fact that the cesarean is a wonderful life-saving procedure when used correctly - just not when it becomes a matter of regular and over-used practice.)
Why do you think that mothers welcome the thought of primary cesarean birth? Have you seem the same trend? (Personally, I know that I'd be freaking out and running screaming down the street at the thought of voluntary major abdominal surgery!)
Rabbit Trail #3:
And please forgive the vulgarity of the following discussion:
One thing that I saw during this story that was extremely, extremely frustrating and disheartening - and that was the number of women who wrote lovely comments on the mama's wall such as, "Hurray that you're having a cesarean! Now your vagina will stay all pretty!"
Um, EXCUSE ME? Are you JOKING?
I can't even begin to unpack how much is wrong with those comments (and they weren't few in number, either).
First of all, a practical note. I have had two unmedicated vaginal births, one with a slight tear. I will be quite honest - I don't notice any real difference in the before and after of my own lady parts. Seriously, things do go back to normal. They're meant to. Sure, there are slight differences between a nulliparous woman and one who has had babies, but our bodies were meant to do this. My own set of downstairs parts is just fine, thank you. It's not like one's genitals are hanging in shredded strips just because one has had a baby. Our bodies were made to open for a baby's passage and then return to normal state.
Note: I know that this is not the case for everyone, particularly for women whose births were horribly mismanaged (episiotomies, etc.) or operative (forceps, etc.). So please do not write telling me how much permanent damage birth can do - I know that it does happen. But normal birth that is managed well really has less effect (on a majority of women) than one would think. We were created to birth.
But more importantly - much more importantly - is that important? Does that give us a reason to say things like that? Let's say that what I said above is untrue - that a woman's genitalia forever look like they have been mauled by an automatic cheese grater after having a baby. (Or even that there are slight differences following normal births.)
Even in that case, why would women say that to each other? Why would we choose to hurt each other like that? How can women do that to each other?
"Well, you've had a baby. No matter that you've just been blessed to participate in the holy and eternal act of bringing a new and precious life into this world. What really matters is that your vagina is no longer pretty. Too bad for you."
Why? Because now her husband won't find her attractive any more and will leave? Because her self-worth is wrapped up in the appearance of her genitalia? Because all that matters in life is dying with a pretty body instead of one that was used for the glory of God to do great and amazing things?
And would people say that about other things in life?
"Thank goodness you didn't have children. Think of all the hours of television you would have had to miss while you took care of them! And think of the weight you might have gained! Now your tummy will stay all pretty."
"Thank goodness you didn't breastfeed and nourish a child at your breasts. Now your breasts will stay all pretty!" (Well, unfortunately, people do say this one.)
"Thank goodness you didn't take up mountain climbing! You might have gotten icky blisters! Now your toes will stay all pretty."
My point being, of course, that there is more to life than maintaining a picture-perfect body. How much more glorious to use one's body in the service of one's family and society (and in doing other great and amazing things!) than to come to the end of life and say, "I did nothing, but my body is pretty."
Most of all, it is the unkindness that strikes one, though I know it is unintentional. "You had a baby, and now your vagina will be ugly. Poor you."
We women can be kinder to ourselves.
Okay, that's all the rant for now! I'd love to have everyone chime in - kind and civil comments only, please! And again, please forgive me - I'm writing in a rush (time limits!), so this probably wasn't the most polished entry.