My good friend, who doesn’t even know I exist, is vaginal breech birth activist Robin Guy. She was musing over the sad state of affairs we have with vaginal breech birth when she said, “Why is it that I need someone’s permission to use my vagina on this one day?” Robin was talking about her own breech experience, but it rings true for anyone who wants a VBAC, has twins, or is just trying their darnedest to avoid an avoidable primary cesarean.
Some time last week, there was a photo of a VBAC consent form zipping its way around Facebook, inciting rage and horror and all manner of vitriol. The form requires women who want a VBAC with this doctor to sign saying they understood that, basically, if he deems any little thing to be “off” with labor or pregnancy, he will cart them off to the OR without so much as a pip.
It really seemed like he (yes, he) offered VBAC solely so he could trounce on a woman’s birth wishes at any moment he felt a twinge. Yeah, it was that bad. I will examine you at 36 weeks. If your cervix is not “ripe” you will be scheduled for a cesarean for 39 weeks. Someone joked that the second page went on to say, “You will address me only as lord.”
I want doctors and other professionals around to advise me. I want a lot of them, in person, in books, on the internet where I hope they actually have some credentials. What I want even more than a plethora of information, though, is the right to make my own decisions about my own body. Keep your fear off my body. I have enough anxiety of my own, thank you.
When people start legislating and removing rights from women so that they can feel in control of mother nature, bad things happen. There is absolutely no reason a woman, in control of her mind, should be physically forced, with straps and drugs, or emotionally threatened into a surgery she does not want. That is medieval. And it happens a lot.
It’s not a small deal to subject people to life-altering and possibly life-threatening surgery against their will.
And it’s a sad state of affairs where, without actually forcing, you just make it impossible to birth comfortably, safely, or legally otherwise. Sure, anyone can just stay home and have an unassisted VBAC, vaginal breech birth, or any kind of birth. Most of them will turn out just fine. But given the choice of birthing alone in the tub or scheduling a cesarean, most women will have never thought of the first option.
Because it’s not a great option, really. I have nothing against unassisted childbirth, for people who want it. But if you are nervous about the birth (for whatever reason) or want a care provider who can help you during that vulnerable time, you’re safer having one. But you’re hard pressed to find one most places.
Midwives who aren’t certified nurses are illegal here in Maryland. Still. Despite many other states having no trouble and multiple attempts at the legislature here. There aren’t enough midwives to go around. People who want low-intervention, vaginal births (gasp!) can’t all get them.
Midwifery care is infinitely superior for women with low risk births. Some women prefer to see an OB, but have a hard time finding one who won’t pressure them into cesarean for any number of reasons. Any amount of increased risk (breech, previous cesarean, advanced maternal age, baby measuring large) or annoyance (such as slow labor) and it’s off to the OR we go. There’s so little choice.
After reading the literature, I considered having my own vbac with midwives at the hospital. But there were so many stipulations and requirements and environmental factors that I knew could mess up my labor, ending in another cesarean. If there was a hospital you could go to to have your baby, where they would leave you alone until you asked for something, I would absolutely go there. For a VBAC I’d leave home. I’d pay double.
But my options, with a vbac, were an illegal midwife at home or a 40% chance of a repeat cesarean with a heavily monitored hospital birth. At least I had those options. When I had my breech, my choices were: scheduled pre-labor cesarean with a doctor I respected; emergency surgery in labor by a mystery doctor who might be angry that I didn’t schedule; or unassisted vaginal breech birth at home. Gosh.
Can we get some evidence-based care, here? More training for doctors so they can attend more kinds of births? Options and respect for women who want to make their own decisions?
Permission to use my vagina, please?