![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
rivkaWow, ![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
tammylc wasn't kidding when she said that there wasn't much out there on the web for women having Cesarean births.
Not much you'd want to read, anyway, if you think you're going to have one.
The first hit on Google for "cesarean section" is at childbirth.org, usually a good general information site. But their C-section page starts with a link to "Books on Labor, Birth, Cesarean and VBAC [vaginal birth after cesarean]" in which only one book about C-sections is recommended. It's called The Silent Knife: Cesarean Prevention and VBAC. The other books with "Cesarean" in the title are all about VBAC. The childbirth.org list of links continues: How to avoid an unnecessary section, risks of Cesarean section, Cesarean fact sheet (which contains not one piece of positive information about the procedure), VBAC checklist... halfway down the page there's a link to a short FAQ on planning your Cesarean, something about "family-centered Cesareans," and a link that doesn't work but claims to be about breastfeeding after C-section. But to get there, if you're reading down the list, you go through a poem about being DISEMBOWELLED ALIVE (emphasis theirs) and literally more than a dozen articles about C-sections being bad and unnecessary and dangerous.
Yes, I know that there are too many C-sections performed in the United States. But the World Health Organization estimates that the rate should be around 10-15%. That's still one in ten births. Shouldn't there be at least a little bit of positive information out there for those women?
My midwife recommended a twenty-year-old book called The Cesarean Birth Experience. The physical stuff is probably somewhat out of date - although from the other reading I've done, it doesn't seem that much has changed. The sections on emotional and family aspects, and the advice about making your Cesarean as birthlike as possible, are wonderfully helpful and reassuring. But the book's out of print. (I found it on Amazon - it wasn't at my library.)
The single most breathtakingly hurtful thing that I have seen: an offhand comment on a message board, one woman talking about another. "Both of her kids were C-sections, so she's never given birth."
Ow.
My midwife says: "This is still your birth." I'm trying to have that be my mantra.
Since I saw the midwife last week, there is new news.
I spoke to one anesthesiologist on the phone and brought my X-rays by the hospital to show a different anesthesiologist. Both of them seemed to think that there would be no problem performing spinal anesthesia. This completely contradicts what I was told by the asshole spine specialist last November, who told me that "no anesthesiologist will do an epidural for a woman with scoliosis." As you can probably imagine, I'm *very* angry with him now, all over again. He really has caused me needless suffering.
But at any rate: apparently, my spinal fusion is higher than most, and my lower vertebrae look just fine. That's where they'd want to do a spinal or epidural anyway. The anesthesiologist who saw my X-rays said that, if there is scar tissue in my spine, I might be more likely to get patchy or one-sided relief from an epidural - but that I also might be able to have one with no problems. She had no reservations about the spinal at all, although of course she said she couldn't promise me anything absolutely.
I asked her if she thought that different anesthesiologists might have different opinions about whether a spinal was possible. She didn't seem to think so, but she wrote a brief note about my case and told me she'd post it where the rest of the team could see it, so that everyone would be aware of my condition and it wouldn't take them by surprise. I was really pleased by that. In fact, the whole encounter with both anesthesiologists made me feel good about my choice of hospitals.
I feel much, much better about the prospect of a C-section knowing that, in all likelihood, I will be conscious for it. For me, the real goal hasn't been a vaginal birth (because I was always aware that my hip problems might make it impossible) but a conscious, aware birth. The intense stress about a C-section was mostly because I thought it would require general anesthesia. I don't *want* a C-section, but I think that now I'll be able to handle one.
Which is good, because we talked to the senior midwife again about percentages and she thinks the likelihood of C-section is "more than 50%." She didn't want to get more precise than that. We asked her how much it would reduce the risk of C-section to try an early induction, and she said "a little bit." She doesn't, at all, like the idea of trying a Pitocin induction. She unenthusiastically said we could think about trying Cervidil, which is a cervical ripening agent.
curiousangel and I talked it over and made the following decisions:
- We don't feel that an early induction would be worth the risk. When I posted about the situation to misc.kids.pregnancy, the women there gave me a lot of information about the poor success rates for early induction, especially in a woman who has never given birth. Plus we're concerned about potential problems if we birth the Li'l Critter before she's fully cooked, and we're concerned about the possibility of an intervention cascade (induction leading to epidural, leading to C-section). It doesn't seem worthwhile for a small increase in the likelihood of a vaginal birth. So we plan to wait for labor to begin spontaneously.
- I'm going to continue to take Evening Primrose Oil capsules in an attempt to get things started a bit earlier. I am firmly resisting the urge to eat less so that the baby stays on the small side, because I know that the probable result would be an unhealthy baby.
- While it's nice to know that an epidural is a possibility if the midwife is right about me having severe pain from the baby's head hitting the bony prominence in my pelvis, we are continuing with our plan to labor without. I feel like my best chance of birthing vaginally is to be maneuverable and not tied down in bed. However, I am not ruling out an epidural if the bone-on-bone pain turns out to be truly intolerable.
- We are preparing for a C-section in addition to continuing to prepare for a natural birth. I'm revamping the C-section preferences in our birth plan to be more detailed and to reflect the updated news from the anesthesiologists.tammylc's birth plan has been very helpful here. I am also trying to prepare myself mentally and emotionally for a C-section, while continuing to practice my relaxation techniques and study up on labor.
- We don't intend to schedule a C-section. It seems worthwhile to give labor a try, even if the chances of a vaginal delivery are less than 50%. We might revisit this decision, however, if I go significantly past my due date and the baby seems large enough to reduce the likelihood of vaginal birth still further.
- We are focusing on the part of this where, at the end, we have a baby.
Thanks, everyone, for your help and support over the last week or so. It's been wonderful.
tammylc wasn't kidding when she said that there wasn't much out there on the web for women having Cesarean births.Not much you'd want to read, anyway, if you think you're going to have one.
The first hit on Google for "cesarean section" is at childbirth.org, usually a good general information site. But their C-section page starts with a link to "Books on Labor, Birth, Cesarean and VBAC [vaginal birth after cesarean]" in which only one book about C-sections is recommended. It's called The Silent Knife: Cesarean Prevention and VBAC. The other books with "Cesarean" in the title are all about VBAC. The childbirth.org list of links continues: How to avoid an unnecessary section, risks of Cesarean section, Cesarean fact sheet (which contains not one piece of positive information about the procedure), VBAC checklist... halfway down the page there's a link to a short FAQ on planning your Cesarean, something about "family-centered Cesareans," and a link that doesn't work but claims to be about breastfeeding after C-section. But to get there, if you're reading down the list, you go through a poem about being DISEMBOWELLED ALIVE (emphasis theirs) and literally more than a dozen articles about C-sections being bad and unnecessary and dangerous.
Yes, I know that there are too many C-sections performed in the United States. But the World Health Organization estimates that the rate should be around 10-15%. That's still one in ten births. Shouldn't there be at least a little bit of positive information out there for those women?
My midwife recommended a twenty-year-old book called The Cesarean Birth Experience. The physical stuff is probably somewhat out of date - although from the other reading I've done, it doesn't seem that much has changed. The sections on emotional and family aspects, and the advice about making your Cesarean as birthlike as possible, are wonderfully helpful and reassuring. But the book's out of print. (I found it on Amazon - it wasn't at my library.)
The single most breathtakingly hurtful thing that I have seen: an offhand comment on a message board, one woman talking about another. "Both of her kids were C-sections, so she's never given birth."
Ow.
My midwife says: "This is still your birth." I'm trying to have that be my mantra.
Since I saw the midwife last week, there is new news.
I spoke to one anesthesiologist on the phone and brought my X-rays by the hospital to show a different anesthesiologist. Both of them seemed to think that there would be no problem performing spinal anesthesia. This completely contradicts what I was told by the asshole spine specialist last November, who told me that "no anesthesiologist will do an epidural for a woman with scoliosis." As you can probably imagine, I'm *very* angry with him now, all over again. He really has caused me needless suffering.
But at any rate: apparently, my spinal fusion is higher than most, and my lower vertebrae look just fine. That's where they'd want to do a spinal or epidural anyway. The anesthesiologist who saw my X-rays said that, if there is scar tissue in my spine, I might be more likely to get patchy or one-sided relief from an epidural - but that I also might be able to have one with no problems. She had no reservations about the spinal at all, although of course she said she couldn't promise me anything absolutely.
I asked her if she thought that different anesthesiologists might have different opinions about whether a spinal was possible. She didn't seem to think so, but she wrote a brief note about my case and told me she'd post it where the rest of the team could see it, so that everyone would be aware of my condition and it wouldn't take them by surprise. I was really pleased by that. In fact, the whole encounter with both anesthesiologists made me feel good about my choice of hospitals.
I feel much, much better about the prospect of a C-section knowing that, in all likelihood, I will be conscious for it. For me, the real goal hasn't been a vaginal birth (because I was always aware that my hip problems might make it impossible) but a conscious, aware birth. The intense stress about a C-section was mostly because I thought it would require general anesthesia. I don't *want* a C-section, but I think that now I'll be able to handle one.
Which is good, because we talked to the senior midwife again about percentages and she thinks the likelihood of C-section is "more than 50%." She didn't want to get more precise than that. We asked her how much it would reduce the risk of C-section to try an early induction, and she said "a little bit." She doesn't, at all, like the idea of trying a Pitocin induction. She unenthusiastically said we could think about trying Cervidil, which is a cervical ripening agent.
curiousangel and I talked it over and made the following decisions: - We don't feel that an early induction would be worth the risk. When I posted about the situation to misc.kids.pregnancy, the women there gave me a lot of information about the poor success rates for early induction, especially in a woman who has never given birth. Plus we're concerned about potential problems if we birth the Li'l Critter before she's fully cooked, and we're concerned about the possibility of an intervention cascade (induction leading to epidural, leading to C-section). It doesn't seem worthwhile for a small increase in the likelihood of a vaginal birth. So we plan to wait for labor to begin spontaneously.
- I'm going to continue to take Evening Primrose Oil capsules in an attempt to get things started a bit earlier. I am firmly resisting the urge to eat less so that the baby stays on the small side, because I know that the probable result would be an unhealthy baby.
- While it's nice to know that an epidural is a possibility if the midwife is right about me having severe pain from the baby's head hitting the bony prominence in my pelvis, we are continuing with our plan to labor without. I feel like my best chance of birthing vaginally is to be maneuverable and not tied down in bed. However, I am not ruling out an epidural if the bone-on-bone pain turns out to be truly intolerable.
- We are preparing for a C-section in addition to continuing to prepare for a natural birth. I'm revamping the C-section preferences in our birth plan to be more detailed and to reflect the updated news from the anesthesiologists.
tammylc's birth plan has been very helpful here. I am also trying to prepare myself mentally and emotionally for a C-section, while continuing to practice my relaxation techniques and study up on labor. - We don't intend to schedule a C-section. It seems worthwhile to give labor a try, even if the chances of a vaginal delivery are less than 50%. We might revisit this decision, however, if I go significantly past my due date and the baby seems large enough to reduce the likelihood of vaginal birth still further.
- We are focusing on the part of this where, at the end, we have a baby.
Thanks, everyone, for your help and support over the last week or so. It's been wonderful.
