4.22.10: They're surprisingly quiet on the matter.
A couple weeks ago I asked readers if the rising c-section rate bothered you or if y’all were OK with the way things are going. I also asked what you’d be willing to do to bring the ever-rising rate down. The number of answers I received was, frankly, underwhelming. Unlike my recent blog about whether kids should be banned from airplanes, which garnered something like 150 comments (when it was posted on Yahoo Shine); my c-section survey only netted five.
That left me wondering if women are generally satisfied with the status quo (1:3 births are by c-section) or feel like they just don’t have much control over it. Are they already doing everything they can and are overwhelmed with the idea of having to do more? Maybe they know they’re at “high risk” for a c-section and are resigned to it. Maybe they feel hopeless or maybe they want c-sections for the convenience factor. I don’t know. Maybe, it just wasn’t all that interesting of a question. The responses I received were insightful and appreciated. Here’s a rundown:
Erin felt bossed around with her first labor, which resulted in a c-section. This time she’s pushing for a VBAC. She thinks women need to be more vocal about what they want.
Jenny had a c-section with her first due to a small pelvis and a long labor. She’s resigned to having her other children by c-section but wishes a VBAC were an option. She thinks more women need to speak up and demand it, or change doctors.
An anonymous reader says, “ Doctors jump to [c-sections] so fast. I was happy to go with a midwife who was a very great support for me. But even she jumped quickly to talking about a c-section when my daughter was still breech at 35 weeks.
Ashley says, “I feel as if I didn't really have a say in what happened during my first pregnancy. My doctor told me I'd be having a c-section because my baby wouldn't turn (breech). I was only 36 weeks when the decision was made and had the c-section at 38 weeks. I feel that if I would've been allowed to wait another few weeks, I could've delivered naturally.”
Nicole has chosen not to have any more children rather than risk another c-section. “A c-section saved my daughter's life (23-week micro-preemie.), and for that I'm forever grateful, but I wouldn't do it again for anything.”
Lindsay has decided on a home birth attended by a midwife to ensure she’ll avoid the interventions that might lead to a c-section.
What’s interesting to me about these comments is that most of them were made by women who’d had c-sections already. They each voiced some level of disappointment and frustration about the process that led to their surgery and a resolve to do things differently next time.
A reader emailed with a question I think gets to the heart of the matter for most of us. She’s expecting her first baby and is dedicated to having a natural birth. She knows however, that at some point, she has to let go and trust that her doctor has her best interest at heart. She wonders where you draw the line between trusting and questioning your doctor’s opinion for the sake of getting the birth you want. “What if you make the wrong choice?” she writes. “If it really is a safety issue, and you don’t do what’s best for your baby, how could you live with yourself?”
And that, in a nutshell is the quandary. We need to be able to trust our doctors, nurses, midwives and health care system to take care of us during our most fragile and vulnerable stage. For most of us, that’s really all we can do. But when we’re operating at the extreme levels we are now, some of that trust is gone. It shouldn’t be up to us to defend ourselves or fight for our rights to labor. That should come from the people taking care of us. Change needs to come from the top down.
That’s exactly what one hospital in New York is doing. An article yesterday in The New York Times highlights two different New York hospitals with two very different c-section rates. New York City has about a 36% c-section rate. Staten Island University Hospital has a 23% rate and Richmond University Medical Center (a mere six miles away) has a 48.3% rate. Staten Island University Hospital has two policies that make all the difference: They don’t allow unnecessary inductions for first-time pregnancies at any point before the 41st week, since they are a main cause of C-sections. They also do not allow C-sections for no reason other than the mother wants one.
Thank you readers for your insight and willingness to share your stories. I truly believe change is on the way; that we can have safe, relatively comfortable, lovely births. I know that most doctors and healthcare providers have huge hearts, brilliant minds and a deep commitment to doing a good job. That combined with a change in health care policy is going to do a world of good.
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