Thursday, May 31, 2012

Oh, dear lord...No.

Y'all know I'm typically for natural stuff...Or as natural as it can possibly be once the horse manure is washed off, anyway.  I had two c-sections, and then have fought--sometimes tooth-and-nail--past lies and non-evidence-based medicine in order to have two "normal" births.

(I actually dislike the term natural when applied to birth, because that implies that there's something unnatural about some of them, & while surgical birth isn't natural, the shit-slinging over what is natural birth goes far beyond orifice.  But I digress.)

Anyway, though this is apparently not new at all, it is to me.  Only recently in my due date club and on the mailing list I belong to for Child Birth International (my doula training), have I come across the term natural c-section.

Immediate response: Huh?  C-sections aren't natural.  But the same people who brought you the no-stab knife have brought you the natural c-section:

At the start of the procedure, surgical drapes block the incision area from the parents' view until delivery of the infant's head. The field is then cleaned and the woman's partner may view the birth at that point.

The obstetrician then slows delivery so uterine contractions can help clear the infant's lungs, "just as happens at vaginal delivery," Fisk noted. The baby's shoulders are eased out "and the baby then frequently delivers his/her own arms in an expansive gesture."

The mother can then see the half-delivered baby, and watch the rest of the birth. The newly delivered infant is placed directly on the mother's chest for bonding.
Yeah...Imma skip that, thanks.  I glanced up during one of my c-sections, and found that the big round reflector behind the light above the operating table acted as a nice mirror.  I'm really, really nearsighted & didn't have my glasses on, but the view of a couple of my internal organs on my abdomen was just not something I'd ever want to see.

And then there are the other issues with this...

For one, I don't want surgical birth normalized any further than it just has to be.  Current c-section rates in the US are above 30%, on average.  It doesn't take a rocket surgeon to realize this is bullshit--our species would not have survived if a third of its females were incapable of giving birth.  Further, there are specific medical practices which have or have had much lower c-section rates: The Farm, a Tennessee commune which has done midwifery as a sideline since the 1970s, has about a 1-2% c-section rate, and obstetrician Robert Bradley (creator of the Husband Coached Childbirth natural birthing method) had about a 3% rate.*

Most c-sections are listed as elective, which is honestly bull on its own.  Most of those "elective" surgeries are ones women are told they must have.  I still remember going to get my staples removed after my first surgery, holding my 6lb baby girl, and the nurse asking me if she had been "too big."  (My two vaginal births, by the way, were to babies over 8lbs each.)  The technical term for it is cephalopelvic disproportion, and while it does happen sometimes, it doesn't happen anywhere near as often as it's used for justification.  Multiple births these days are typically c-section as well (though I do know one woman who had her triplets at home, and have read about another woman whose triplets were actually a VBA2C), to the extent that women who even want to try to have them normally are often forced to birth in an OR, "just in case".

Given all of this, calling this odd protocol "woman-centered" is frankly disgusting.  Woman-centered birth would involve, ideally, not telling a woman her body is incapable of fulfilling one of its most basic biological functions, wouldn't you think?  But that's what most c-sections are, a patronizing "You just can't do this, little lady, let me take care of it for you."

Which really pisses me off.

*One of the big reasons Ina May Gaskin and Robert Bradley share such a low c-section rate is their disbelief in unnecessary inductions.  A lot of "failure to progress" surgical births come post 'elective' induction (note that a lot of these inductions are about as elective as the c-sections), and a lot of inductions are scheduled for no reason other than that a woman has gone over her estimated due date--as though your uterus suddenly explodes out a dead baby if you reach 40 weeks 1 day.


greg said...

My wife had two C-Sections...the first was because our daughter was in cardiac distress, and they wanted her out RIGHT NOW. Less than 45 minutes from when we got to the hospital to baby in hand. It was one of the few times I was HIGHLY impressed with Navy Medicine.

2nd time was she had spent 3 months on bed rest with her cervix sewn shut(a cerclage) to keep the baby in. Her doctor recommmended it, my wife agreed. She went though a little mental 'beat herself up' for not trying a VBAC, but I supported her 100%.

Personnaly, when I first read about a 'Natural C-Section', I was picturing no anestesia, which was terrifying.

I was in the room for both of my wife's...and I made the mistake of looking over the curtain...just like gutting a deer, except a baby came out instead of tenderloins.

Sabra said...

I'll admit that "no anesthesia" was my first thought too!

And for the record, I absolutely support any woman's decision to not have a VBAC. Since I insist on being allowed to, it would be incredibly hypocritical of me to not allow others the same free decision. The risks were negligible in my mind, but other women can look at the same research and draw the opposite conclusion. All I want is for women to have the power to decide, which ACOG says they should.

breda said...

Now I don't have any first hand experience with childbirth, but it seems to me that many C-sections are the result of induced labor and pitocin.

yay or nay?

Sabra said...

You're definitely right, Breda. What I have seen happen a LOT is that a woman is due, say, June 15. By that time, prenatal appointments are weekly. So at, say, the June 7 appointment, the doctor schedules an induction for June 16 or 17, just because by then the due date will have passed. Not because pregnancy suddenly becomes dangerous to mother or baby, not because Mom's body is ready, not because the baby is ready ('cause, duh, if that was the case, labor would have started already).

So you have a woman whose body isn't ready to go into labor, you try to force the issue, and you stir in a heaping helping of poor labor management and it makes a c-section that much more likely.