Elective Vaginal Birth?

Who here remembers Gattaca? What about The Island? Two great movies that broach the idea of utopian, controlled, asthetically pleasing, antiseptically and genetically altered existences deemed for our 'well being' and longevity. Frightening but intriguing fictional plots...

What about Patient-Choice Vaginal Birth under fire? As frightening but not as fictional. Give me your thoughts ladies (and gents)... I want your passion, I want your agreement or dissent, I want your critique and, more than anything, I want to hear that you are giving this some real thought -- we are closer than you might think to loosing many basic human rights when it comes to our reproductive health. And we are letting it slip right between our trusting and wide open fingers.


mm said...

Can't make a coherent thought come to words.

Sheridan said...

Yes, moms should have the choice to have the births they want. INCLUDING vaginal breech births, VBACs, elective cesareans, normal unmedicated vaginal births.

Moms should be given the information about risks and benefits in calm rational ways and then should be supported in their choices.

Of course for moms to have options especially for breech births, care providers have to be TRAINED to do them! I think this is important. Let's train the care providers to provide all kinds of births, including NORMAL unmedicated births.

Team Harris said...

(Sorry... I read this over and it's disjointed... just my thoughts as they flow.)

What a well written article. I was happy to see something like this come from a medical perspective.

My thoughts... yes, I have to support the choice of elective cesarean. Why? Well, I don't believe in it, but I support women. I believe women need to take responsibility for their own health and should be able to choose the way in which they give birth. I believe in instinct and intuition. If a woman has a distinctive intuition that a vaginal birth would be harmful for her child, she should be able to take advantage of a cesarean. (I say this because I know of a woman who had just such an impression, after birthing other children naturally. She did receive her elective cesarean and it was found that she had a velamentously inserted, very short cord. She listened to her body.)

It is an atrocity that we are allowing surgical choices but not normal, natural ones. But there are some inherent problems with even offering VBAC choices. Yes, there are dangers associated with VBACs... most of which would be avoided altogether if women were at home with a good midwife. The problem is that a woman thinks she is having a great birth experience because she is "allowed" to have a VBAC. Then she enters the hospital and is still subjected to monitoring, IVs, epidurals, and laboring/pushing on her back. All of those things submit her to increased risk. And if anything goes wrong, it will be blamed on the VBAC, not the other interventions. (The same is true for non-VBAC vaginal births. If something goes wrong, it must have been the small pelvis or the prominent tail bone or the large baby or the posterior presentation... it's never the fault of the interventions.)

This is why I cringe when women write out birth plans and then plan to birth in a hospital. Sometimes it works... most often it does not. For example... a woman may say she does not wish to have an epidural. Okay, fine. But does she realize that she'll likely be pushing on her back and she may have a practitioner who does not know how to support the perineum? Does she realize that in that circumstance she's still likely to create perineal damage? Yes, she's avoided the epidural, but the outcome was not as good as it could have been. What she wanted was an intact perineum (or minimal tearing)... but she just didn't realize that avoidance of an epidural alone was not the way to solver her concern.

Another thought... are physicians *truly* giving INFORMED consent to women electing csections? Are these women being told ALL of the possible outcomes? Are they being told that their infants are at HIGH risk of respiratory distress? I have to wonder.

And lastly... let's discuss breastfeeding. Mandatory c-sections (if that is what it eventually comes to) will be a boon to the nasty formula industry. It is a known fact that women who have c-sections take longer to achieve a full milk supply. Practitioners play into this and often tell mothers to supplement their infants with formula, which carries a whole host of risks and dangers. If ALL women eventually have a surgical birth, could this be the beginning of the end of breastfeeding? Many will say that's a silly argument... but then again, I always thought mandatory surgical birth was a silly idea too... and yet it's becoming a reality right before our very eyes.

I am willing to bet that as these political agendas come to pass, the homebirth movement will grow. Unfortunately, however, women will have to birth in secret and will have to find underground midwives to help them. While I am not against unassisted birth at all, I do find it a dangerous option for women who do NOT have faith and trust in their bodies. I don't think UC is a good option for women who approach childbirth with fear. Those women really need support. But will they be able to find it unless they choose surgical intervention?

All of this makes my stomach churn. This is something reminiscent of a scifi thriller... and yet it's a very real hell. When will people wake up and realize they are handing over their rights without a second thought?

Kim said...

I agree 100% with Team Harris! I'll support women in choosing c-sections, because I'm a woman, and I support making INFORMED choices.

The author says it well - we don't have "choices" when a vaginal birth is not 'allowed' because of litigation/malpractice fears. Your choice is then to go completely against the medical profession and birth underground or have your c-section. What kind of a choice is that??!?


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