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Need some help and kind of in a hurry! I have to have this thing turned in tomorrow.

Posted by on Oct. 12, 2009 at 11:20 PM
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My midwives asked me to write a sort of letter in my own words to explain how and why I came to my decision about having a HBA2C. Would you gals take a look and tell me what you think? Feel free tell me if there are any mistakes I should correct. Thanks!!

(Sorry! I know it's a little long.)



To whom it may concern:

          Cesarean sections have undoubtedly saved countless mothers and babies. The ability to diagnose life threatening obstetric emergencies and if medically necessary, perform a cesarean section in many cases gives a chance at life in instances that would have otherwise had heartbreaking outcomes.  In fact, I can say without a doubt that my oldest child and I were in fact saved by a cesarean section and given the chance to be a family.

In as much as this surgical procedure has saved lives, I also feel that it's overuse has caused unnecessary morbidity and mortality in uncounted patients.  I believe it is reckless and self satisfying to present the safety of a cesarean section as equal to that of a vaginal birth in any more than the 10-15% of cases that the World Health Organization has established as justified. Being that the current cesarean rate is 33% in the United States, it is safe to say that not only are more than half of these procedures unnecessary, but also, the risks associated with them are completely avoidable. I can attest to this personally as I did have a second, unnecessary cesarean section with my second child due to ignorance and lack of support that resulted in a host of preventable complications.

With this current pregnancy, I was lucky that someone mistakenly told me that I could indeed have a vaginal birth after two cesareans (VBA2C). The mistake was not in the fact that I could have a VBA2C, but that they told me that I could. It put the determination and drive in me that if there was any possibility that I could have a vaginal birth, I would.

In my research, I have come to find that not only is a VBA2C completely possible but is in fact a safer method of delivering my child than a third cesarean. In my own research, I have found that the rate of uterine rupture for women with two prior cesareans during a trial of labor is well established between 1-2%. While the rate of rupture for VBA2C is slightly higher than that of VBA1C, the statistics show that the morbidity rates (such as that for hysterectomy and post-operative fever) of VBA2C are better than that of a third c-section. Transfusion rates as well as maternal morbidity of VBA2C are comparable to that of a repeat third cesarean.  I would also like to add that there has not been enough research done that clearly separates the rates of uterine rupture into categories that define the severity of the rupture.

While it is not necessarily medically relevant to some, I have to include that my spiritual beliefs strongly support the need for the physiological process of birth. The mind/body connection is very valid and powerful and the religious beliefs of a patient should always be considered when applicable. In my case, I believe strongly that my Heavenly Father made the process of vaginal birth one that strengthens and prepares women for motherhood and in contrast, he did not facilitate the advent of the cesarean as a mode to make this process more convenient.  I have prayed and will continue to pray for my own revelation in this matter and I have faith that the Spirit will guide me to my Father's will.

Once I had come to the conclusion myself that medically, emotionally and spiritually a vaginal birth was the best option to deliver my baby, I became aware that some people and organizations such as the American College of Obstetricians and Gynecologists (ACOG), do not share the same opinion. Not only that, but about 50% of hospitals have banned VBACs and even more are not allowing trials of labor for VBA2C.  I have studied the recommendations and statistics presented by the ACOG in the matter of VBA2C and I feel they are biased and unsupported. There is simply not now or will there ever be enough evidence to deny any well informed woman a chance at her ideal birth.

For me, an ideal birth would include a cesarean as a last resort and not an only option. It would include being able to move freely to alleviate pain and discomfort and nourish my body with light, healthy foods and liquids throughout labor. I would be able to be an active participant in my labor... the one who is doing and not being done to. The birth of my child would be supported by well trained healthcare professionals who not only understand the physiological process of birth but also my own physical, emotional and spiritual needs. All of these desires in my case are best fulfilled by a homebirth with professional midwives.

I understand that by choosing a homebirth, I am also choosing to be without certain potentially lifesaving capabilities of a hospital.  I have not come to this decision lightly and after having interviewed and received care from Terri H. and Jennifer D., I am confident in their abilities as midwives and in their abilities to recognize the need for transfer. For me, the choice is to be at home where there is potential for things to go wrong as opposed to a hospital where I feel things will most certainly go wrong. I have only this one chance to bring my son into this life and I will not spend it fighting with anyone.  My body and my child are my responsibility and being told what I can and cannot do for myself and my child is simply not the best environment for a once in a lifetime experience.

 I know in my heart that regardless of the outcome of my homebirth, I will still feel I made the best decision with the available options for me and my child. I know this more than anything, because it is clear to me that I will not in fact be at home laboring and birthing unless I, my husband, and the midwives feel it is safe to do so. I know that if the decision is made to have a third cesarean section for this child that it is indeed a necessary procedure that I will be able to accept and embrace. I will not however choose to have major abdominal surgery for reasons that include liability and convenience.

 I am blessed that my Heavenly Father has offered this trial to me so that I may grow and be strengthened.   I feel through this journey I am able to make a truly informed decision for the sake of my family. I am confident and determined that someday soon all mothers will be able to give truly informed consent when it comes to the care of their children and themselves.  The bottom line for me is that I am not a pregnant woman with a potential set of pathologies, but a woman who is loving and nourishing a life that is growing inside her and who knows that her Heavenly Father loved her enough to provide her support and comfort in this anxious and yet amazing moment of her life.

 

                                                                                                                                                                                                                                                                                                                                      Sincerely,

 

                                                                             Stephanie A. W......


by on Oct. 12, 2009 at 11:20 PM
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Replies (1-6):
kaysun
by Member on Oct. 13, 2009 at 9:10 AM

sounds good. Good luck!

toolmommy
by New Member on Oct. 13, 2009 at 8:53 PM

Thanks! The midwives loved it and it was exactly what they needed. The OBs at the MTF where I am having dual care want me to a sign a form for them saying that I understand the risks I am taking with my HBA2C... This letter is what they will get as well.

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kaysun
by Member on Oct. 14, 2009 at 2:50 PM


Quoting toolmommy:

Thanks! The midwives loved it and it was exactly what they needed. The OBs at the MTF where I am having dual care want me to a sign a form for them saying that I understand the risks I am taking with my HBA2C... This letter is what they will get as well.

don't sign that form-if something should go wrong they may use it against you-for prosecuting purposing I would just give them a signed copy of your letter. they can not make you sign that form-I would not like I said it could comeback to bit you. People can be like that and use little tings like that to force what they want on you.

toolmommy
by New Member on Oct. 14, 2009 at 3:58 PM

Do you mean not to sign the form for the military doctors?

Quoting kaysun:


Quoting toolmommy:

Thanks! The midwives loved it and it was exactly what they needed. The OBs at the MTF where I am having dual care want me to a sign a form for them saying that I understand the risks I am taking with my HBA2C... This letter is what they will get as well.

don't sign that form-if something should go wrong they may use it against you-for prosecuting purposing I would just give them a signed copy of your letter. they can not make you sign that form-I would not like I said it could comeback to bit you. People can be like that and use little tings like that to force what they want on you.


kaysun
by Member on Oct. 15, 2009 at 3:45 PM

Yes, not your letter that is fine. But, of course it is up to you. I mean why would they have you sign a form stating that you are putting both your self and your child in danger if theydid not have some alternative motive for it. Totally your choice that just my takeon it. I think you would be better off just handing them your letter saying I,ve done my research, and I do not believe I am putting myself or child in danger (ect) and therefor can not and will not sign your form.

Quoting toolmommy:

Do you mean not to sign the form for the military doctors?

Quoting kaysun:

 

Quoting toolmommy:

Thanks! The midwives loved it and it was exactly what they needed. The OBs at the MTF where I am having dual care want me to a sign a form for them saying that I understand the risks I am taking with my HBA2C... This letter is what they will get as well.

don't sign that form-if something should go wrong they may use it against you-for prosecuting purposing I would just give them a signed copy of your letter. they can not make you sign that form-I would not like I said it could comeback to bit you. People can be like that and use little tings like that to force what they want on you.

 


toolmommy
by New Member on Oct. 15, 2009 at 6:33 PM

I feel exactly the same way. I am not signing a form to release them from the liability of something they have nothing to do with; its does sound fishy. I'll happily hand this this letter signed, though.

Quoting kaysun:

Yes, not your letter that is fine. But, of course it is up to you. I mean why would they have you sign a form stating that you are putting both your self and your child in danger if theydid not have some alternative motive for it. Totally your choice that just my takeon it. I think you would be better off just handing them your letter saying I,ve done my research, and I do not believe I am putting myself or child in danger (ect) and therefor can not and will not sign your form.

Quoting toolmommy:

Do you mean not to sign the form for the military doctors?

Quoting kaysun:


Quoting toolmommy:

Thanks! The midwives loved it and it was exactly what they needed. The OBs at the MTF where I am having dual care want me to a sign a form for them saying that I understand the risks I am taking with my HBA2C... This letter is what they will get as well.

don't sign that form-if something should go wrong they may use it against you-for prosecuting purposing I would just give them a signed copy of your letter. they can not make you sign that form-I would not like I said it could comeback to bit you. People can be like that and use little tings like that to force what they want on you.




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