In this day and age it is WONDERFUL to open a newspaper and see an article more focused on educating than on fear mongering. It’s true that I didn’t actually open the physical paper this time; I was told about it from a friend in the Ottawa area and immediately set about tracking in down online. She told me to check it out and then right away I was hearing about it all over the internet.
The entry in discussion here is the Ottawa Citizen’s August 1, 2009, “Why So Many C-Sections?” article. It is to be the first in a three part series. Perhaps author Sharon Kirkey will be better equipped to answer the question that has plagued many health care providers over the past decade or two; why indeed are so many women giving birth in a surgical fashion?
Something I have witnessed myself, in the role of labour support, over the past decade is well expressed by Dr. Michael Kline, emeritus professor in the departments of family practice and paediatrics at the University of British Columbia. He believes part of this increase is due in part to the “industrialization of childbirth, where, in today's risk-averse society, women in labour are being treated "as an accident waiting to happen" and where doing something is always better than doing nothing.”
MOMS-TO-BE MAY BE DISCOURAGED FROM TRUSTING THEIR INSTINCTS
I see it when I work with moms who steadfastly know their due dates, who understand that there may be a risk to postponing induction and who are interested in waiting to see if their body can have a chance to begin labour on its own. It isn’t just the medical establishment who encourage moms to begin with cascade of potential interventions; it begins with friends and family members too.
We have long believed that we don’t know our own body well enough to make the best decisions on its behalf and that our health care practitioner knows more than we do. It is true that they do in MANY cases however it should not be overlooked that we are the “masters of our own destiny.”
If we expect labour not to hurt, therefore employing an epidural to numb the labour sensations, then we have to expect that there may be ramifications for those actions. If we decide we need labour to start before contractions have begun on their own then again there are bound to be consequences for setting that course. We lack the intrinsic faith required to know that our bodies will do what they are created to do. And those around us, including care providers, often feed our lack of faith.
Klein goes on to say: “Physicians and society have helped women basically believe that childbirth is no longer a natural phenomenon, but an opportunity for things to go wrong . . . But the fundamental issue is, we aren't improving outcomes by doing more C-sections. For the first time in Canada, we are seeing the key indicators for mothers and babies going in the wrong direction."
VBAC RATES VARY ACROSS THE COUNTRY
And don’t even get me started on the VBAC rates in this country. For those moms who ARE told they have to have a caesarean birth (and YES it does happen for valid reasons too) the numbers of Vaginal Birth After previous Caesarean section are astoundingly low. In hospitals where VBACs are supported and are even encouraged the success rates are often well over 80%. “But less than one in five women in Canada with a previous C-section delivered vaginally in 2007-08. Eighty-two per cent had a subsequent C-section.”
If this is not the first of my blog entries you have read then you know that one of my primary frustrations is our lack of ability to believe that we can do what we set out to do. In this case what we are setting out to do is to give birth to our children. Yes, as I have said, caesarean births to happen for very valid reasons, sometimes. Further reading of Kirkey’s article will enlighten you to some of the reasons that they happen when, perhaps, they didn’t need to.
If you have a few minutes to check out the article, I would recommend you do. Kirkey promises that the subject on Sunday, August 02nd, 2009 will be about the “after effects” of having birthed by Caesarean Section.
POSTED BY SAM
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9 comments:
Thanks for this post and for sharing the Citizen article.
I'm glad to see people talking about the negative effects of c-sections and the risks to future pregnancies. It's not discussed nearly often enough.
The increased risks of placenta accreta, miscarriage, stillbirth (and more) following a c-section should be made known. Knowing that we wanted a large family, and knowing that these risks increase dramatically after 3 c-sections kept me fighting for a vaginal birth when everyone thought I was crazy to try.
I'm also interested in reading the "after effects". After 4 c-sections I have almost no feeling in the area surrounding my belly button, my scar and everything in between, even thought it's been nearly two years since my last c-section. I wonder...if women knew about ALL the risks beforehand would they make a greater effort to avoid a c-section?
@Family Nature
You raise VERY valid points and I agree that while people often talk about the increase in the number of caesareans being done, rarely do people ever talk about the ACTUAL consequences of birthing in this fashion.
Have you spoken to any alternative therapists who might be able to slowly restore sensation in your lower abdomen?
You have to remember there are mamas out there (like myself) who very much wanted a natural vaginal delivery and ended up with an emergency c-section. Why? Because preeclampsia came on like a thunderbolt for me - this can be a life threatening condition that if untreated immediately can cause dire consequences. Every pregnant woman needs to know about it and know the signs.
For me, it resulted in a vertical section incision rendering it very unlikely I could ever have anything but a repeat c-section. Are there some women who opt for section? Yes, and they are misguided, IMO, because natural birth is the best. But again, look at the statistics, older women giving birth, multiples in pregnancy and the risks go up for complicated deliveries. Please keep this in mind when you think about why so many people are having c-sections these days
@Anonymous
I totally agree that there are reasonable considerations in favour of mothers having caesarean sections. I am pretty sure that I stated that in my post. I was really trying to highlight some of the information she shared in, what I thought was, an excellent article overall. It was my hope that readers of my post would go on and read her article as well since she has some fantastic points to make.
If you read today's post (in reference to Kirkey's 2nd of three articles) I have also addressed some of the emotions around having had to have a caesarean section when it wasn't what mom wanted.
There are excellent resources out there if you need or want them.
Sadly, despite everything we know about the risks of induction, of epidural, and of other various interventions, all of these things are being offered to women as some sort of "liberation." I don't believe for a second that (for example) 60-something percent of women in the state of Florida NEED those cesareans, or that they would be needed if those mothers had prepared themselves for a 100% natural birth. Women who prepare themselves for birth as a natural event have so much more success in avoiding cesareans and traumatic birth experiences. But many women don't even think to learn about natural birth until they're feeling the effects of the cesarean scar on their psyche. It's not their fault. It's the world we live in. We're all so convinced that technology will liberate us, when in these cases it does nothing but shackle us, strip our natural autonomy, and ultimately provide worse outcomes. We've been hoodwinked for so long though, it's really difficult to undo it now.
@FeministBreeder
I absolutely agree with you. We can't have it all ways and until we are ready to admit the technology isn't the cure-all for everything, I think we will continue to see the numbers grow!
As Sam already knows, I had my first daughter via c-section due to the fact that she was breech even after an unsuccessful ECV. I am now approachinng the due date for my second child (due Sept) and so far we are head down! I am absolutely committed to avoiding a c-section if at all possible and very much want a natural birth with the support of my midwives and doula! However, it is taking alot of concentration to block out the negativity that surrounds my decision. So many people have commented that it would just be so much more "simple" to just have another c-section, (many of whom have never had one), that I am "risking" my health and the baby's etc. I am a healthy young women, and God willing I have a baby that stays head down, I very much look forward to allowing my body to works it's magic and birth this baby the "good old fashioned way" : ) I am so happy to see an increased number of people who understand and are willing to talk about the risks of such pervasive and unnecessary cutting these days!
This series is appearing in the Edmonton Journal as well. I hope a lot of people are reading it & it gets at least some of them thinking.
@Cathy:
I can't wait for you to labour and birth your next baby! There is going to be a party in your room! It will be so much fun!!!
@Lisa:
I am with you. I hope it gets everyone thinking too! And I am VERY happy to know that it is a national piece! Thanks for that information.
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