After long anticipation I finally got to view More Business of Being Born. The original documentary had me enthralled with all the things that I learned about birth and really introduced me to how I now feel about the birth experience. Any time I would hear of somebody becoming pregnant around me I would automatically refer them to watch this movie. I did not see the movie until after I had Sadie but even if I had, unfortunately circumstances surrounding my first pregnancy were such that a medical birth was very necessary.
That being said, I was very excited to hear that they were making a sequel of sorts. This documentary came in four parts, each discussing an aspect of the birth experience. The final segment focused on VBAC (vaginal delivery after cesarean). This was the segment that I was the most eager to view. BOBB had been responsible for jump-starting my passion for birth and I was really looking forward to hearing what they had to say about this very real subject that directly effects me.
The whole segment seemed to be alot more cautious than the rest of the series. It seemed much less gung-ho and more ehh-you really have to weigh you options. I think I was more-or-less expecting this show to solidify my opinion on how I would face my next birth, but really being that I have already researched the crap outta vbac, they didn't really tell me anything I didn't know.
The dilemma is always this: It is recognized that c-sections are risky and are major abdominal surgeries and assume all that comes along with that. Repeat c-sections carry that much more risk and the risk manifests itself in things outside of the hospital and recovery. It can affect mother-baby relations (bonding & PPD), breastfeeding, fertility, can cause placental problems in future pregnancies, infection, rise in the occurrence of hysterectomy etc. This list goes on and on!
BUT,
These risks are "small" in comparison to what's being threatened by most care providers. They will tell you that attempting a VBAC will be way more dangerous due to the possibility of uterine rupture. This can be catastrophic and end the baby's life as well as your own.
From these facts alone you may easily decide that vbac is not a viable or even reasonable option. Medical professionals will present this scenario as an absolute and something that you should be very afraid of.
But the truth is uterine rupture is very rare. In the case of 200 vbac-ing women only 1 will experience rupture. Let's take it even further. Only 1 in about 2000 ruptures will be catastrophic causing you to lose your life, your baby's or your uterus.
Contrary to these facts are the ones that represent the risks associated with multiple c-sections. With out quoting exact numbers (because there are soo many and over a wider period of time!) the risks are much higher that you will experience complications from even just ONE Cesarean than to attempt a VBAC!
Alright so now that that myth is dispelled, lets move on to the next problem.
The fear does not only sit within us as women. Doctors and insurance providers are extremely frightened of VBAC (although they seem to little by little be getting better as ACOG's position is changing). Hospitals that do offer the option have tons of rules surrounding it! A VBAC mama's labor must progress extremely "normally" or be doomed to the operating room. Its difficult enough to survive the "system" when you're low-risk and perfectly healthy and now there's even one more odd to be stacked against you. Any little hiccup will cause alarm and then you're done. The end. Repeat c-section.
Faced with this adversity many women have to consider their other options. In my case, there are no birth centers around that will accept vbac patients and so I'm left to consider a home birth. Actually the option is very attractive to me. I'd love to labor in peace and poor lighting in my home with all the comforts therein. I could move around and eat as needed with little to no pressure from a hospital system to progress or else. I could get all primal about it and really own my birth. Do it my way. Catch my baby and hold her to my chest having her latch on and bask in the glow...it all sounds so wonderful to me.
But in the back of my head there's always that nagging fear of what if. What if I am that one women who has catastrophic complications? Or what if the baby were to need resuscitation or care and we weren't equipped at home. These things could happen in any birth, not just VBAC. And I would be the one responsible.
I don't know. Part of me feels like there are risks with anything. Normal, low risk moms have complications at the hospital all the time, even some that end in death. While these are tragic, are they any more likely to occur at home? One thing to note is that neither infant nor maternal mortality rates have dropped in the last twenty years while c-section rates have drastically risen. Being in the hospital having a c-section just doesn't seem to be the answer.
The bottom line is, do I risk a repeat c-section and all that comes along with it just to labor in an unsupportive, scared and clinical environment that may or may not offer safety if an emergency should occur?
or
do I hire a midwife, settle in at home, trust my body and hope nothing bad happens?
If everything were to go perfectly, which scenario would I prefer?
Thankfully I don't have to make this decision right now but it's definitely an issue that holds weight in the not-so back part of my mind.
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