I guess I'm a natural birth advocate. I mean, for myself anyway.
I really wanted a natural birth with my first child. I didn't get it. As you go through experiences you become humbled and change your point of view. Going through the birth of my son taught me that all women's desires and experiences are different - and I had no right to project what I wanted for my own birth onto anyone else.
I believed everything natural birth advocates said about what is best for baby. So much so that I used to judge women who wanted epidurals and inductions. If you believe what natural birth advocates tell you, you believe that epidurals drug your baby, inductions mess with its heart rate and denying a mother and child the opportunity to "bond" properly with the help of hormones released during natural labor is cruel..
I still probably believe all of that stuff is true. But I didn't get any of it with the birth of my child and my baby is fine. My emergency c-section forced me to realize that although that birth experience may not have been my ideal - many women are fine with it and still have healthy babies. I am now the biggest advocate for to each her own. If I fundamentally believe in a woman's right to choose what happens with her body - and I do - than that also applies to how she decides to approach her birth.
There is something that is troubling to me though. I think that the amount of judgement that exists on both ends of the spectrum is clouding a woman's ability to see what is really going on in maternal medicine today. Yes, natural birth advocates are vocal. They can be really judgmental. Frankly, they can be really annoying. But that simply doesn't change the fact that if you want a natural birth in this country the cards are stacked against you.
This has been on my mind a lot because I am currently eight months pregnant and attempting to pursue a VBAC, or vaginal birth after caesarean. I'm currently residing in Florida, where insurance practices make VBACs practically non-existent. Insurance practices. I'm not okay with that. I think it's good and well for us all to wax poetic about a woman's personal choice - but in the real world, sometimes that choice is non-existent: From VBAC facts.com:
45% of American women are interested in the option of VBAC (14), yet 92% have a RCS (15). Some women chose their RCS or it was medically necessary. Others felt like they didn’t have much of a choice for numerous reasons including hospital VBAC bans (16); immense social pressure; or the misrepresentation of VBAC risks (17).
Hospital VBAC bans exist. Basically, in 1999 the ACOG made a recommendation that a doctor be "immediately available" to perform a cesarean, "yet they provided no clear definition or standard for where the obstetrician and/or anesthesiologist should be or what they could be doing."
What this means for me is - in order to be assured of a TOLAC or a truly attempted VBAC in the state of Florida, I have to find a physician willing to attend my entire labor. Those are the rules. He or she just can't waltz in the last half hour of my labor as many OB's are known to do. So, if I have a long labor, this may require my OB blocking off an entire day of other appointments and patients so they can be by my side in the unlikely scenario that something goes tragically wrong. Catastrophic uterine rupture - which is what they are worried about here - happens in less than one percent of women who VBAC.
I cannot find a doctor willing to sign up for this. I simply can't. I moved to Florida when I was seven months pregnant and it took me weeks to find a doctor who would take me because I was "too far along." Too far along to be given care? Does that make sense to anyone?
I finally found a wonderful group of midwives who will be giving me all of my prenatal care. The catch here? They don't have privileges in a hospital. They only do home births. They are certified nurse midwives and they have a lot of experience with VBACs at home, or HBACS. They are very comfortable with the procedure. I am not. I want to be in a hospital. I want all the medical help that is available at a hospital on the off chance that I do need quick intervention.
So that's the rock and the hard place I am stuck between. Get a home birth that I am not totally comfortable with, or go to the hospital to labor and get whatever on-call physician is present to deliver my baby. And it is very possible that the on-call physician will be unwilling to attempt a VBAC. I am terrified and frankly pissed off that I can't be in a hospital and be assured that I will be given a chance to birth my child naturally. I am all for necessary medical procedures - but I don't want to have a major surgery that is incredibly hard to recover from if the only indication is "VBACs are dangerous." Because I am telling you right now no one is forcing me into a medically unnecessary procedure. I'll be one of those women on the news who requires a court injunction. Well, probably not - but you get my drift.
Not all women that want natural births are judgmental, sanctimonious homeopaths. Some of us just don't want insurance companies dictating whether our child will be sliced from our wombs.
(photo: gosphotodesign / Shutterstock)