Wednesday, August 6, 2008

Why It's My Choice

Funny thing is I didn't expect the intensity of the comments posted so far from my prior post. Naive? Perhaps.

Funnier yet, two of the three posters sent me to ICAN-Online, which is the website I referenced in that very post.

The point of concern with the commenters is that I am allowing my obstetrician to decide how I will deliver M2 (i.e., VBAC or C-Section). However, I don't consider myself an unknowing participant in this endeavor. I've read up on VBACs, spoken to people who have chosen in favor and against them, and I have developed all sorts of opinions that are completely independent of my doctor's. My first labor has a lot to do with where I am today, so I'll start there.

I had a doula, and every intention and expectation to follow through with a drug-free childbirth. I expressed my desire for as little medical interference as possible in my birth plan, though I was not interested in going the route of using a midwife.

My doctor began seriously suggesting that we induce at week 40, but my husband and I stalled until week 41. At that point, I was put on pitocin and she broke my water, only to discover there was meconium in the fluid (descriptions on Natural and Kids This was potentially due to my pregnancy having gone into week 41, although I suspect that's debatable. She did an amnioinfusion (diluted the amniotic fluid with saline to wash meconium out of the amniotic sac before the baby has a chance to inhale it at birth), which was to be one of many bags I was hooked up during my labor. Being hooked up to various bags prevents you from moving around, which in turn prevents you from dealing with your pain in a medicine-free way. I labored through the night with the help of my doula, but after 7 hours, I was exhausted and there was no position in which I didn't feel pain, even between contractions. I went for the epidural. After that, my doula stayed and helped us get through things, emotionally and physically. At one point, we were informed that during contractions, our son's heart rate was normal, but on the low side of normal. They took me off of the pitocin to see if that remedied the problem, but it didn't. What it did do was slow down the contractions. Between the slowing of the labor and the concern over my son's heart rate, the doctor "seriously" suggested a c-section. I don't know about you, but if someone says your baby's life is in danger and you should really have this done to help him, I'm not about to point to my birth plan and remind them of how much I really don't want a c-section.

So, he was born kicking and screaming, and hasn't stopped since. While a c-section was the one thing I truly didn't want, I genuinely couldn't put my preference above the well-being of my child. And I can't say that I truly blame the doctor, either. Being an obstetrician comes with it's set of troubles, which includes soaring malpractice-insurance premiums. It's an environment which impels a conservative approach (i.e., better safe than sorry).

I seriously considered going to a new doctor, but in the end, I guess you could say my reason to stay with the same doctor was the age old reason: better the devil you know than the devil you don't. When I was pregnant last time, I asked her all sorts of questions, including her c-section rate (~15%). And since I have no way of knowing how another doctor might have handled the same situation, how can I know things would have turned out different. What I do know is that my recovery went very well, and I haven't experienced any real pain or complications from the surgery. I've spoken to a few people who have not been so fortunate. I don't really like her bedside manner, but now that I know the nuances of her demeanor, I can take her "matter of fact" approach with a grain of salt. That, and I can mock her's hilarious.

Besides that, I know that a lot of doctors will not do a VBAC. She said she was open to the possibility, and quelled my concern of uterine rupture by saying the rate was well below 1%. But it's still a serious concern of mine. I know women who've experienced it, and it's not something I'd like to deal with first hand.

Maybe I'm just trying to make lemonade out of these lemons, but I can find merit to a VBAC and a c-section. My body has not really experienced labor, so there would be new and wonderfully painful things to recover from there. I have friends and family who seriously worry about a VBAC. I try to reason out why it's possibly safer than a c-section, but I can't help but think of the little things that can go wrong. Rare? Ya. Impossible? No.

Either method isn't making me jump up and down with excitement. But I'm not pregnant because I want to experience labor. I'm pregnant because my husband and I want to share our meager little home with a kid. We're doing that existential thing where we breed because we can and that's what we're biologically meant to do. Well, maybe that's an argument for another day, but my point is that I never cared about the empowerment or experience of labor, I just want to assure the safety of the baby and me. If I can still pick up and hug my toddler after the fact, that's just gravy.


Karin Person Finley said...

"but my point is that I never cared about the empowerment or experience of labor, I just want to assure the safety of the baby and me."
And honestly for me, that is what VBAC is all about - the safety of my baby AND ME, I want to be sure I would be around for my husband and my other children. And to say you don't care about the empowerment and experience of labor - that makes me sad and it could be something you regret for the rest of your life - but hey "at least you'll have a healthy baby" - that's all our society seems to care about anyway.
And your reference to ICAN in the "quick, quick" post was lost on me as those are usually links to cupcake sites like babycenter - sorry I missed that.
Like I said, good luck, I hope whatever YOU choose works out for you.

MetaMommy said...

I don't need to be "empowered" by labor to feel valuable. That's not what makes me tick. And I'm not one to regret things. Everything in life is a learning experience, both the good and the bad.

I enjoy a good dialogue, but honestly, I'm not getting the impression that you're looking to provide helpful insight as much as you are trying to stubbornly prove you're point. I'm sure you have no ill intentions with your comment, but it comes off like you think your way is right, and that's that.

When it comes to pregnancy and labor, I often hear all are different. Which is why I don't understand why so many people have so many conflicting opinions for me. I've had family, friends, and strangers (at the farmers' market) tell me how I should deliver. And whatever I choose, someone will be disappointed. Which I just don't understand. I don't see how it impacts others, especially if said others won't be doing my laundry or changing MetaToddler's diapers.

As for my choice, I'm not a victim here. I chose my doctor knowing full well that a VBAC was possible, but unlikely. I also know the process of recovering from a c-section well more than any alternatives. Am I looking forward to it? No. But I wasn't looking forward to laboring forever, either. My mother and sister lost a lot of blood during their natural labors. Isn't there danger in that, too? And I already can't care for my family at week 39, so waiting several weeks would be time lost with them, too.

I'm sure I'm coming off rather defensive, but it is very personal to me. I've made my choice, and I've no intention of changing it. And I'll just leave it at that.

Thanks for the well wishes, though :-)