Respecting Women, Trusting Birth

I came across this first article earlier today about a mom in Arizona, pregnant with baby #4. Brief birth history for her is #1-vaginal, #2-cesarean section, #3-vaginal birth after cesarean (VBAC). Her local hospital has implemented a ban on Vaginal Births After Cesarean, or VBACs (pronounced vee-backs), in the time between birth #3 and her current pregnancy. Thus, she is no longer "allowed" to have a vaginal birth, despite having one a couple of years earlier with baby #3. The story is sad for the family, but unfortunately, not an uncommon experience in the birthing world. VBAC bans are on the rise. Check out the International Cesarean Awareness Network (ICAN) for more info.

At least Joy Szabo is not taking it lying down. I wholeheartedly applaud this mama's actions and taking responsibility of her birth experience! This situation irks me for obvious reasons (I am a VBAC-mama myself and a childbirth educator in the Bradley Method), but I think it also highlights several problems with our healthcare system. I won't bore you with a lengthy discussion, but there are a few key points I want to discuss:

1. Blatant disrespect of pregnant, laboring and postpartum women. I suppose this can be true of all "patients" in general. (I use quotes b/c I don't really feel a pregnant women is a patient at all. She is simply experiencing a natural, normal and healthy part of life.) Now, I have worked in hospitals and believe me, I am fully aware of the "difficult patient" (Seinfeld, anyone?). However, I do concede that, at the end of the day, it is the patients that are in charge of their health. Hence, they can either accept or decline whatever treatments they desire. The same is true for pregnant women. Women need to take control of their healthcare and start assuming responsibility for their births. While we cannot control what kind of labor/birth we are given in life, we can plan, prepare, educate ourselves, eat well, exercise and maintain positive emotional support for the process. Too many women have given up complete control of their healthcare to physicians and the medical community. Yes, doctors are trained in areas that I am not. Yes, they have more experience with medical situations than I do. However, I do have the ability to read and discuss a situation clearly. Discussions need to be taking place b/t childbearing women and their careproviders. Discussions that involve *all* the benefits and risks, alternatives to anything that pops up out of the norm, education on various procedures and options. Lastly, women need to be allowed to make their own decisions regarding their labor/birth and what is best for their babies. These discussions should NOT be happening in labor, when a woman is preoccupied and vulnerable. Positive changes in healthcare will not occur until patients truly are treated as part of their own medical team.
   
2. Imposing a more costly procedure (i.e. major abdominal surgery via c-section) for a much less costly procedure (i.e. vaginal birth). I still am baffled by a system where health insurance companies will pay 3-4x the amount of money necessary to cover a c-section when vaginal births are much, much cheaper for everyone involved. My c-section and newborn care in 2004: $12,000+, my vaginal homebirths in 2006 and 2009: roughly $2,000 each. I should also add that I did not pay one dime for my c-section and yet, we have paid for our two homebirths out of pocket because insurance will not cover it. I may not have been a math major, but I can see the insurance companies are the ones getting swindled. Until unnecessary (and costly) procedures are put in check, our healthcare spending (and deficit) will continue to climb.
   
3. Complete disconnect between respect for unborn baby in a "wanted" birth and one who is "unwanted". This Arizona mom was *threatened* with a court-ordered cesarean, if she did not willingly go under the knife. HUH??!!! In these situations, the logic holds that mom is not doing what's best for baby (i.e. forgoing an unnecessary cesarean for a vaginal birth), so a court needs to intervene and do what is best for baby (i.e. cut him out). Clearly, this mom does not know what she is doing and is incapable of making prudent decisions for her children. The hospital must step up to cut baby out so he/she is "safe" and alive. Why oh why, then, are women allowed to walk into Planned Parenthood clinics (at the same gestational age as Joy's expected baby) and procure abortions?! Why is Joy's baby "protected" by a court system, but the baby in Planned Parenthood is not? Simply because Joy wants her baby and another does not? Wanting to care for your newborn is not what gives value to his/her life. A baby's life is inherently valuable, regardless of his race, size, age, ability and others' feelings towards him. A baby's life is valuable because he is human and because he exists. U.S. healthcare (and our society in general) will continue to be in an abysmal state unless we start recognizing the immeasurable value of human life and respecting it across the spectrum.
   

After being bothered by the previous article, I then came across this wonderful post by Dr. Christiane Northrup (posted by a friend on Facebook, thanks Beth!). It was a much needed read from another woman of a like-mind. Moreover, she is an OB/GYN who actually respects the process of birth! We are in desperate need of more physicians like her. We are also in desperate need to hear her message over and over again . . . TRUST YOUR BODIES, ladies. Trust your babies. Trust birth.