You Need A Ceasarean Because…

Since falling pregnant, I have had more to do with the medical community than anyone ever really wants. From a misdiagnosis, to being told I was having a miscarriage, to sickness and wrong medication given to hospitalisation to the eventual home water birth, my medical file probably became thicker in those forty weeks and six days than in my entire life up to that point.

I spent a lot of my pregnancy in my sickbed on forums, in chat rooms and just generally communicating with other mothers and mothers to be and I have found myself exasperated at times with some of the things people think and believe.

Here in England the problems are bad in a certain sense, but completely different to the problems in the US and in South Africa, the two countries most of my forum friends are from. The reason for that is simple: private health care.

Costs for c-sections and natural births are varied in private health care and hard to find although the Agency for Healthcare Research and Quality in Rockville, Md., says that the average cost of a vaginal delivery is $5,574, while the average cost of C-section is $11,361. In the UK a natural birth with no additional hospital stay will cost from £1,324 to £2,612 (assisted delivery) to £2,532 to £3,311 for a c-section. I guess it’s easy to assume then that the same rate of scale is applicable for South Africa and the rest of the world.

I know of one doctor in the private field who plays golf every Friday afternoon, so anyone coming in to his service on a Friday morning in labour is cut open – what does he care if she has a harder time breastfeeding, can’t lift her child for weeks, may have trouble bonding with her baby and has to suffer with the wound from major abdominal surgery? He has a game to play.

While I completely accept that there are medical reasons for some caesareans, the incidence of unnecessary sections in especially the US (30%) and SA (80% private, 20% state) is absurd.

(I know a lot of people feel guilty for having a c-section, or worse, devastated that they ended up with one: this isn’t about you. It’s about highlighting some of the absolute rubbish that people are sometimes told and I’m putting it down here in the hope that it’ll give someone, somewhere the evidence they need to fight back and or at least find a better gynea or doctor. If you had a c-section, it doesn’t always mean you were lied to, there are cases where it is the best option, but unfortunately not all are. If you’ve had a c-section and really wanted a natural birth, there is always next time. Make sure you find a doctor or hospital that is supportive of VBAC – Vaginal birth after c-section or HBAC – Hombirth after c-section and make sure you do your research. It is possible!)

So, here are some of the best excuses I’ve heard for why doctors have recommended caesarean sections, and as I come across more, I shall update my list.

• Your baby is back to back
  Well, this might be anecdotal, but you do NOT have to have a CS for a back-to-back baby. I know, because I had one. All 48 hours of labour. But since 1/3 of women have back to back babies I think it’s safe to say that you’ll survive labour if this is your main complication. The reason so many babies are back-to-back these days is because we no longer do much physically demanding work, we don’t scrub floors on our hands and knees,don’t plough the fields and we slouch on a sofa or in the car. Some good walking, housework or yoga are just some of the things you can do to turn the baby. If your baby stays back-to-back you’ll have a longer and possibly more painful labour, but it is certainly do-able and the reward is worth it.
• You are only 1.53 cm tall (i.e. you’re too short)
  Well, that’s just crazy talk. If Christianne Ray could do it at 84cm, I’m sure most of us won’t have a problem. Unless you’re really tall in which case you might struggle to fit in the birth pool, but you can still have a natural birth.
• You/your pelvis is too small or your baby is too big
  This beautiful article written by Gloria Le May (with 20 years midwifery experience) explains how from 34 weeks ‘the hormone relaxin causes the pelvis to become loose and stretchy and how that along with a pliable, shrinkable baby head means that every person alive today comes from a lineage that was able to birth vaginally. She goes on to explain how doctors used the ‘big baby’ lie in the beginning to make women have ceasareans, but then found themselves embarrased down the line when those same women went on to have successful natural births for their second and subsequent births to even bigger babies. This lie was then replaced with the next one: The cord was wrapped twice around the baby’s neck.  (As it happens my daughter’s was twice around her neck. We just unwrapped it and she’s totally unaffected.)This is a great extract from Wikipedia:

  Women’s pelvises loosen up before birth (with the help of hormones), and an upright and/or squatting woman can birth a considerably larger baby. A woman in the ‘stranded beetle position’ (lying on her back) is more than likely not going to push a bigger baby out, due to the size of outlet that this position creates. Since obstetricians continue to place women in this torturous position for their own personal requirement of ‘access’, not considering the birthing mother’s needs to be in a better position to open her pelvis, it is inevitable that women will be subjected to the false diagnosis that their pelvis is too small to birth their baby.

A true case of the baby’s head being too big is called cephalopelvic disproportion (CPD), which is a rare condition brought on by, for example, gestational diabetes (but not always) or if the mother had rickets as a child and is extremely hard to diagnose. It is often the ‘reason’ given to Failure to Progress. Even with these conditions, expectant women should be given a ‘trial of labour.’

Gloria Le May’s final word on the too small/too big argument is this:

That’s the bottom line on pelvises – they don’t exist in real midwifery. Any baby can slide through any pelvis with a powerful uterus pistoning down on him or her.

• The scan shows it’s a big baby
  BigBaby.org.uk lists a good amount of research that shows that growth scans are both inaccurate in most cases, and lead to a 20% increase in unnecessary caesareans. The author says:

  I’m sure many people can recount a story of a friend or relative who has been told their baby would weigh 10lbs only to birth a perfectly average sized 8lber, or those, as myself with my first baby (who subsequently weighed 10lbs) who were told “it’s completely average, a 7lber” only to find they were expecting a whopper.

• Your baby is losing weight in the womb
  Well, I honestly don’t know what to do with this one. I have searched through all my ‘usual’ resources and even looked for others and I see no evidence whatsoever that this is even possible. Yes, a baby can stop growing in the womb, which is a bad thing, but if your doctor tells you that your baby is losing weight, find a new doctor!  (If you know of cases of this happening or have actual evidence, please do let me know!)

That’s all for now, but sadly, I can assure you I’ll be back with more of the delightfully dumb things some snip-happy doctors try to, and often succeed in making us believe. If you know of others feel free to add them here!