Saturday, July 12, 2008

"Prevent Cesarean Surgery" Video



This is a great video about why cesareans should not be done casually or without real necessity. It also discusses ways to lower your risk for having a cesarean.

This video is definitely worth your time to watch, even if you are not intending to become pregnant any time soon (or ever). Too few people realize the real risks of cesareans or the implications of the rapidly rising cesarean rate. In particular, cesareans impact fat women disproportionately, so it is an issue of great importance for fat-acceptance activists.

Here are some excerpts from the short description on YouTube:

Prevent Cesarean Surgery is a short inspirational and entertaining production. Using real quotes spoken by women who have had both a cesarean and vaginal birth, music, photography, and statistics, it presents invaluable information that is research-based.

All women of childbearing age will benefit from this educational movie. It is a must see! Cesarean rates in the United States are at a record high for both new and experienced mothers. Despite vast amounts of research regarding the increased risks for both mothers and babies who experience cesareans compared to vaginal birth, there is a growing acceptance of this surgery in our culture.

This movie addresses the question "Why should we try to avoid unnecessary cesareans?" It also presents advice for how to increase the chance of having a normal safe vaginal birth based on recommendations from organizations such as the World Health Organization, Lamaze International, and the Childbirth Connection.

6 comments:

AnnieMcPhee said...

I saw something recently on one of those birth shows that was scary. The woman had gone in for her exam and was found to be 3 cm and 80% effaced - so she and the doctor were excited that "her induction" would be able to happen in the morning. Whu?? Clearly she was coming close to going into labor - why on earth were they taking the sign of impending labor as an indication that it was time to start her on Pitocin??? It makes no sense. Stay away from the Pitocin after labor begins naturally as well as before. That's another way to avoid Caesareans. And they do need to be avoided unless something is seriously *wrong* - which is maybe 5% of the time. Good for you for taking on such an important topic. By the way, have you seen "The Business of Being Born"? I absolutely, positively loved it - and apparently it had such an impact that the ACOG and the AMA *specifically* mentioned Ricki Lake in their new tantrum - er, resolution - against homebirth. In fact, they are attempting to write legislation outlawing it altogether. A thousand plagues upon them.

nuckingfutz said...

Annie, she could have been like me. I NEVER went into spontaneous labor on my own. EVER. I even went nearly 3 weeks overdue with one child, having contractions every 7 minutes for over a week, an no labor. I needed the pitocin in order to actually get the child OUT of my body.

However, I do agree with what you said in general. Just pointing out that it's not a one-size-fits-all equation. :)

Well-Rounded Mama said...

I hear what you are saying, I do. No judgment is being made here, and I hope no one reads that into any of this.

But...could they have gotten your due date wrong? Are your cycles 28 days? If they are longer and they didn't adjust your due date, they had the wrong due date. Perhaps you weren't that overdue after all.

Of course, some people do just gestate longer than others. Research shows that larger women tend to gestate longer, which doesn't get taken into account by doctors. Whether that's a problem or not hasn't really been looked at in the research; they just assume it is. Personally, I think it's just a variation of normal, not something pathological. Doctors assume that because you're fat, it must be abnormal and wrong....but perhaps it's just a variation of normal.

But no one stays pregnant forever. Eventually you would have gone into labor on your own. However, going "postdates" does present some potential risks and you have to weigh the risks/benefits of inducing at that point. Some people decide to induce and some do not. That's a very individual choice and I respect either choice, truly.

As another 43 week (by LMP, not by adjusted dates) mama, I understand how difficult that dilemma can be. I did eventually go into labor and had my baby just fine, but it was very difficult being patient, and you do have to look at the various risks/benefits closely. Definitely not an easy decision sometimes.

But you're right, nothing in life is a one-size-fits-all equation. Sometimes interventions are harmful, sometimes they are truly needed, and sometimes they are a judgment call and you can make a case for using them or not, either way. I completely hear what you are saying. Thank you for pointing that out.

nuckingfutz said...

Oh yeah, my cycles are legendary. The only times they've ever been off was when I was actually pregnant. So there's not much chance the doctors could have been off.

But I should also say that my doctors were more concerned about the baby's welfare than it having anything to do with my size. Even with my first, when I had pre-eclampsia, they were more concerned about my blood pressure and the effect on the baby than anything. And they knew it was all down to the condition, not my weight. Not once in all of my pregnancies was I ever made to feel that something was down to my weight. I got lucky in that regard.

I do think, though, that had I been allowed a little more time, my last pregnancy/birth might have turned out easier. After hearing my history, my doctor decided to induce me 2 days before my due date. Baby didn't feel like coming out, so she flipped sideways. Doctor was worried that she was getting too big (he swore up and down she was going to be over 9 lbs., while I told him he was crazy) so between him, my grandmother, and my hubby, they all ganged up on me until I agreed to have another cesarean (I had cesarean, VBAC, VBAC, cesarean, in that order). Not only was she NOT an overly big baby (8 lbs. 4 oz.), but she was breach, that's why labor wouldn't progress. That doctor, I think, got a little paranoid. But the others? I can't say that I would fault them personally (their profession in general, yeah, but not those particular doctors). As a matter of fact, the same doctor delivered my first and third children - the first being via cesarean, and the third a VBAC. So he was definitely not a "let's cut them open just because they're fat" kind of doctor. Again, me=lucky.

AnnieMcPhee said...

Nuckingfutz, nothing is one-size-fits-all, especially not birth. No argument there. In the case I mentioned, it was simply their plan all along to induce, and considering Pit is used in up to 80% of births nowadays, something is definitely very wrong. And excessive, unnecessary interventions (culminating in a 30% Caesarean rate, 40 in some places) are a problem for all pregnant women - fat or thin. The likely reason it affects fat women slightly more is that they are labeled high risk, in general, immediately. However, nowadays there pretty much is no such thing as anything but, but with fat as usual it's just more so. Which leads to the woman often being strapped down on her back with a monitor the minute she goes into early labor, leading of course to more interventions and thus more operations. It's odd, really, because anytime you hear of someone who didn't know she was pregnant and ended up having the baby on a toilet because she thought she had a stomachache, it's always a fat woman. Doesn't seem to me there's usually a high risk JUST because of fat.

Out of curiosity, did they try breaking your water to spur on labor? I ask because I was induced with my son due to pre-eclampsia (though I now know I was on the low end of the BP for that and there was no protein, etc. so it was probably unnecessary) and I started at 2 cm. After a full day on the pitocin I made no progress whatsoever. Fortunately, due to a particularly rough internal exam my water broke and 1/2 hour later I was fully dilated and pushing, another half hour later it was over. Same as when my water broke with my other child. They should try those kinds of measures before using drugs that cause extremely intense contractions that can send the baby into distress. Naturally I didn't know that at the time.

For what it's worth, the only thing I heard about my weight was in the last month if I didn't gain enough or if I gained too much for that particular week. They had a very linear idea of how much weight should be gained each week, and it didn't occur to them that gaining less one week and more the next might balance out lol. No one ever suggested I was at risk due to my weight, that my weight was the cause of pre-eclampsia, or what have you. Of course that was nearly two decades ago. I really feel for anyone trying to give birth in these times. Thin or fat :(

I think everyone knows that sometimes interventions are essential, including C-sections. But the rates are abysmal, and it's gotten pretty clear that a majority of them should not be happening. It's not always just because the doctor wants to get home for dinner (though that certainly happens, and far too often) - there is also the axiom that if they do a C, no one can sue because they 'did everything they could.' Shudder.

Well-Rounded Mama said...

Nuckingfutz, it's so cool that you had 2 VBACs! These days, that's another way that fat women are discriminated against.....many doctors are refusing to "let" fat women VBAC. Or they say they will, but end up scaring the mom out of it at the end, esp in regards to their weight. Or, as in your last case, that the baby will be "too big."

Now, many of us DO still VBAC, even today (I did twice also) but more and more, obesity is being seen as a reason not to "allow" a VBAC. Another way in which our choices are being taken from us, just because of our size.

I hope you will sumbit your birth stories to my other website, www.plus-size-pregnancy.org. [There's a form you have to fill out, and you have to give permission for the stories to be printed.] But it's soooo important to show that YES, fat women can birth vaginally, even after a prior cesarean. All your stories (cesarean or VBAC) are welcome, because we are trying to show the diversity of women's experiences, and sometimes a cesarean is necessary or prudent under the circumstances.

But it's particularly important to document that fat women DO have VBACs too, since they are working hard to try and take that away from us, telling us it is very unlikely that we will succeed. We have to show them that we DO succeed and that size is not a reason to automatically re-section a woman.

Hope to see your stories there!