this article was written by a woman who has had a cesarean before her vbac.
1."Before cesareans, women were dying all the time in childbirth."
- It's amazing how many times this is brought up. People have brought this up to me not only about c-sections, but about home birthing, unassisted birthing, and whatever birthing when it's not in the hospital. Women, go google the reason for maternal deaths in childbirth from generations ago. What you will find is NOT that women died from childbirth itself - because if that were the case, the human race would have died of long ago. Women - and babies - were dying from disease, NOT childbirth itself. There was no Aseptic Technique ( google it ) brought about yet. Doctors would go from doing an autopsy on a person with Scarlet Fever, to catching a baby and examining the woman. The disease was spread. There was no running water. The conditions were not as they are today, so I fail to see how this argument is even relevant if the person posing this argument would actually take 5 minutes to really think about it. Women were also dying from childbirth in that they weren't able to push their baby out. And nope, not because the baby was "too big", or the women were born "too small"....women were wearing corsets from before puberty, and this was causing malformations in their pelvis. How many modern women do YOU know of that have been wearing a very tightly laced corset from the time they were, say 13? So, women were also dying because the poor baby would get stuck. Let's also not forget that the c-section rate in the 50's was somewhere around 5%. We now have the highest maternal and infant mortality rate that we've had in DECADES, and it goes along with our current induction and cesarean rates. Our c-section rate is now 31% as a nation.
2. "I have to be induced because my baby is getting too big."
- Again, unless you've been wearing a corset since puberty...this is not going to happen. Period. The vast majority of the time, these weight estimates are based off of ultrasound very late in pregnancy. After the 1st and second trimesters, ultrasounds are off by up to TWO FULL POUNDS, either way. And it's not very likely that it'll be 2 lbs bigger than what they are estimating. This happens ALL the time. Then, when the woman ends up with a c-section because the induction failed ( duh! Inductions fail all the time - body's not ready, baby's not ready ) she finds out that the baby only weighed 7lbs instead of the 9 they told her. ( Which, by the way...9lbs is nothing. ) Women don't understand that the things that you allow into your labor can - and will - often seal the outcome of the delivery. Whether you believe in God or Evolution...neither belief system would allow for women to grow babies that are too big to physically birth. The species would have died off. If you think you're having a big baby, then it's even more important to do OFP exercises ( google it ) to ensure that baby's in a good position, it's important to NOT allow any interventions ( induction, epidural, laboring in bed, pushing on your back ) and allow the process to happen naturally.
3. "I had to have a c-section because my baby's cord was around his neck."
- This is probably one of the biggest myths out there. 1 in every 3 babies is born with the cord wrapped at least once. It's NOT a reason to do a cesarean. I have personally been present for births where the cord was wrapped 3x, and most recently....the cord was wrapped 2x around the neck, around baby's hand, and around baby's abdomen which pinned the hand to baby's face. She was born in the water in a birth center. ; ) Babies will have cords long enough to facilitate a vaginal delivery. It's extremely rare that a baby will have a cord too short to do so. And really, there is NO way of knowing before you've gone through NATURAL delivery.
4. "Once your water breaks, you HAVE to deliver within 24 hours."
- As long as everything is kept OUT of the vagina ( including gloved hands! ), women can go for days, and even weeks without problem. The baby will continue to make amniotic fluid. As long as the mom and her care provider keep an eye on mom's temperature and the baby's movement, there is NO reason to induce labor or perform a c-section. The only risk that broken water poses is an infection. Your temperature will tell you if an infection is beginning. Each vaginal exam that is done after water breaks, increases your risk of infection by 15%. MOST women will be in active labor within 24 hours of water breaking, and the majority who didn't will deliver within 72 hours of water breaking. The best thing to do if your water breaks at home and you're not in ACTIVE labor, is to wait it out at home. Drink plenty of fluids, take your temp. hourly, and keep an eye on the movement of the baby.
5. "Once a Cesarean, Always a Cesarean."
- This used to be true, but mainly because doctors were using classical incisions ( vertical ) during cesareans, instead of the low transverse that is done now. With a classical incision, the incision stems upward into the uterus, where it contracts. The lower segment usually does not contract as hard as the upper segment. The main risk in a VBAC ( Vaginal Birth After Cesarean ) is a Uterine Rupture ( where the uterus opens ). This risk is approximately 0.3-0.7%. Which means that in a VBAC, you have a 99.3-99.7% chance of NOT rupturing, if you don't induce labor. When you induce, the risk of rupture is increased. The risk of a cord prolapse, which is a life-threatening emergency for baby, in ANY labor is up to 2%. Does that mean that no woman should take the risk of ANY vaginal birth, and all should be c-sections? Of course not. So then why do women believe that the *LESS THAN 1%* risk is too high? Mostly because their doctors ( by the way - OBs are trained *surgeons* ) play up the risks of VBAC, and underplay the risks of cesareans. A VBAC is not only a viable option, but one that is encouraged by all of the major health organizations, even including ACOG ( American College of Obstetrics and Gynecology ).
6. "It's not a big deal to induce, as long as you're 'term'".
- Well, this depends on what you consider to be a big deal. If you don't consider trying to force your baby out before he's ready, and possibly causing breathing complications in him...then sure, no big deal. Babies are actually 2 weeks behind what we are gestationally. Due dates are estimated based on your LMP, NOT when the baby was actually conceived. Conception is usually 2 weeks after LMP, or there about. When you induce at 38 weeks, you're essentially inducing a 36 week baby. Period. And let's not forget that the BABY is the one that initiates labor. The baby's lungs release a hormone called Surfactant, and this hormone begins the labor process. When you induce, you're trying to induce a baby who's not ready to be born. Babies are not on OUR schedule. So which is more important? Your comfort, or baby's safety? Often inductions will end in a c-section. Most women will come away from a failed induction-turned c-section, saying that either their baby was too big, their pelvis was too small, or their body just didn't dilate. When an induction fails, your body does exactly what it's design to do - protect the baby. It didn't end up in a cesarean because the baby was too big, your pelvis was too small, or your body just didn't dilate....it ended in a cesarean because your body was protecting the baby inside who wasn't ready to come out. And then what happened? Baby was cut out of you instead. Induced labors also carry double the risk of an Amniotic -fluid embolism...which can be deadly...than natural labor.
7. "Epidurals don't pass to the baby, they're not risky."
- Dentists usually will not administer anesthetics to pregnant women. Doctors caution against using even the most mild of medications. Doctors warn against smoking in pregnancy, drinking in pregnancy, and consuming unhealthy food. Why do women believe that anesthesia going into their spinal column, integrating into their spinal fluid and through their system will not affect the baby? I really don't get it. Babies who are born after epidural births are more likely to need resuscitation, more likely to be lethargic, more likely to have lower apgar scores, and LESS likely to be breastfeeding at 6 months of age. Wait - oops...I brought up breastfeeding. Tisk tisk. Back to epidurals. Epidurals have a very high risk of causing BP problems in mom - causing the need for a c-section. Epidurals take away your mobility 100% of the time, which means that you will be lying on your back all throughout labor, on the major artery that sends blood to the baby. Epidurals often cause labor to slow or stall completely, which then facilitates the need for pitocin. Pitocin often causes the baby to go into distress, along with the cocktail in the epidural, and then facilitates the need for a c-section. Epidurals lead to the interventions of an IV, continuous monitoring ( which have up to a 95% error rate...meaning that up to 95% of the babies who were c-sectioned for "fetal distress" were perfectly fine and not in distress at all. ), pitocin, and Epidural births often end in the need for a vacuum extraction or the use of forceps. Epidurals often take away the ability to push effectively, combined with the fact that you're on your back, pushing a baby UP over the pubic bone. You're literally working AGAINST gravity. SO, are they really without risk?
8. "I had to be induced because they found low fluid."
- The modern route of action for this is completely backwards. Amniotic fluid is the baby's urine. If you're not drinking enough water, the baby is not able to process the amniotic fluid. When low fluid is found via u/s ( which, by the way....WHY is an u/s being done in the first place? ) the practice is SUPPOSED to be to have the woman go home, drink a gallon of water, and have the fluid levels re-checked by a *different* technician ( readings can be off depending on who's doing it as well! ) 24 hours later. 98% of the time, the fluid levels will have gone up. In those that don't, the practice is SUPPOSED to be to have her repeat above, and see what levels are again, by a diff. technician. If the levels still ARE low ( under 5 ), then it should be left up to the mom, will FULL INFORMED consent to make a decision. She should have time to go home and research, without being pressured. Sometimes this will necessitate an induction, but there are better ways to go about an induction without bombarding your baby with drugs. ( Foley catheter induction, no drugs, no pain meds...go from there ).
9. "Stripping Membranes is perfectly harmless."
- Does anyone actually know what HAPPENS when membranes are stripped? The care provider inserts his/her fingers INTO the cervix, hooks the finger in between the cervix and the amniotic sac ( if even possible...most women that request this aren't barely a fingertip dilated ), and sweeps all around in between the two. On top of being EXTREMELY uncomfortable, and often painful, this does NOT guarantee induction of labor. And by the way - this IS a form of induction. This also poses a great risk of infection, because the care provider is pushing vaginal bacteria up INTO the cervix, and in between the cervix and sac. There is also the added risk of weakening the lining of the amniotic sac, causing the waters to break prematurely. If *this* happens, which is not uncommon, then you're on the timeclock. Your body wasn't naturally ready for labor, so it'll probably take the longer of the scenarios described a few paragraphs above regarding the time limit on water breaking..and your care provider usually WILL be quicker to add intervention. After all, it *started* with intervention. ; ) Why not let your baby come when he is ready, rather than try to hurry up a natural process.
10. "I pushed for hours and my baby would not come out. I NEEDED a c-section."
- The first questions I ask women who claim this, are usually answered with a "yes". Were you induced? Did you labor in bed? Did you have an epidural? Did you push on your back? ANY of those can cause a baby not to descend properly. But the most important question? Did you begin pushing when you felt the unbearable urge to push - or did you push when and how they told you to? ( "Okay, you're 10cm, you can begin pushing now.....1-2-3-4-5..." It's called "purple pushing" ) This is a HUGE factor in women who push for hours. Instead of laboring the baby all the way down, they begin pushing as soon as they hit 10, whether they feel the urge or not. Your body WILL labor the baby down. Sometimes women are at 10cm for a few hours before feeling that urge. THAT'S OKAY! Think about it this way. If you knew you were going to have to poop sometime soon, would you go ahead and sit on the toilet and begin trying to push the bowel movement out? What would happen if you did this? Wouldn't you be there forever, and eventually end up hurting yourself? Or would you wait for the urge to pass a bowel movement first? Another thing to note....in a bowel movement, which is not much different than the physiological process of birth, you are sitting. You are not lying in bed. Try pooping while lying in bed, instead of sitting upright. ; )
There are so many, many other myths that can and should be dispelled. So many women believe what they are told, instead of doing the research for themselves. If you'd TRULY like to learn more about Obstetrical myths, there is an EXCELLENT book by Henci Goer. "Obstetrical Myths Versus Research Realities". Every myth dispelled is referenced by medical study. These are not opinions, they are backed my medical research. Maybe sometime soon I will add to this list. : )
1. From the CDC ( Center for Disease Control ) : At the beginning of the 20th century, for every 1000 live births, six to nine women in the United States died of pregnancy-related complications, and approximately 100 infants died before age 1 year (1,2). From 1915 through 1997, the infant mortality rate declined greater than 90% to 7.2 per 1000 live births, and from 1900 through 1997, the maternal mortality rate declined almost 99% to less than 0.1 reported death per 1000 live births (7.7 deaths per 100,000 live births in 1997) (3) (Figure 1 and Figure 2). Environmental interventions, improvements in nutrition, advances in clinical medicine, improvements in access to health care, improvements in surveillance and monitoring of disease, increases in education levels, and improvements in standards of living contributed to this remarkable decline (1). Despite these improvements in maternal and infant mortality rates, significant disparities by race and ethnicity persist. This report summarizes trends in reducing infant and maternal mortality in the United States, factors contributing to these trends, challenges in reducing infant and maternal mortality, and provides suggestions for public health action for the 21st century. http://www.cdc.gov/mmwR/preview/mmwrhtml/mm4838a2.htm
2. From Obstetrics and Gynecology: Conclusion: Because elective induction of labor increased the cesarean rate and did not prevent shoulder dystocia, we conclude that mothers with macrosomic fetuses can safely be managed expectantly unless there is a medical indication for induction. http://www.greenjournal.org/cgi/content/abstract/81/4/492
5.Overall, attempted vaginal birth for women with a single previous low transeverse cesarean section is associated with a lower risk of complications for both mother and baby than routine repeat cesarean section. The morbidity associated with successful vaginal birth is about one-fifth that of elective cesarean.
6. Preterm Birth Late in Gestation Triples Infant Mortality
7. The incidence of cesarean section for dystocia was significantly greater (p < 0.005) in the epidural group (10.3%) than in the nonepidural group (3.8%).
8. These findings suggest that maternal oral hydration increases AF volume in women with decreased fluid levels.