As another caesarean awareness month rolls around I still struggle to see any headway being made into reducing caesarean numbers and improving VBAC numbers. In fact caesarean rates are going up, while VBAC rates are going down. Women planning a VBAC (and most others...) are being subject to more and more restrictions and have more and more hoops to jump through.
Which is complete and utter bullshit. Pregnant women shouldn't be jumping through hoops!!
So I jumped in to the VBAC support group that I run (come and check us out VBAC Australia Support Group on Facebook) and asked the question:
This caesarean awareness month what do you wish that others knew about caesareans and birth after caesarean?
Being a VBAC support group this group is filled with women who have had at least one caesarean and who are currently (or in the past were) planning for a vaginal birth after their caesarean.
Here is what they had to say.
"It's not just birth - it's major surgery!"
There were two major categories for this one.
1. "You are just expected to carry on and look after baby like you didn't just have major surgery"
Under no other circumstances would you be expected to be up and about and fully responsible for the care and wellbeing of a completely helpless human less than 12 hours after having major abdominal surgery. And if you are having a second or third or fourth caesarean you go home (usually) 3 days post surgery and have to look after other children as well. And that advice to not pick up anything heavier than the baby? Yeah - tell that to the toddlers who need cuddles.
2. We need more acknowledgement that caesareans can and do have significant ongoing health implications - for mothers and babies.
Again - it's major surgery!
The list of potential complications, some of them life threatening, is pretty long. A mother is 3 - 4 times more likely to die during a caesarean than a vaginal birth. Baby is more likely to need special care. Then there is all the emerging and ongoing research regarding implications of disrupting the hormonal process and the microbiome. All of this is the same whether you have a planned or unplanned surgery. And whether it was necessary or not.
Ashleigh wishes that people knew: "That an elective csection can result in life-threatening complications. I ended up with Ogilvie syndrome and it was very scary for a few days. I was one of the “lucky ones” because my bowel started working again after a few days, but know of someone else (in the same hospital) who needed a bag for 6 months (!) then needed to be put back together again...also from a csection."
There are also ongoing implications for mothers in terms of fertility, risks in future pregnancies, options and recommendations for future births, infections etc etc. Most of which are not very well acknowledged.
"Most caesareans are not necessary"
And most are lacking in full, valid, powerful consent.
This is a very confronting topic. Especially when the above point is taken into consideration. A caesarean is major surgery with major implications. Yet many are completely unnecessary or become necessary only through iatrogenic complications.
Babies that become distressed after an (usually unnecessary) induction. Women not given enough time (for labour OR pregnancy). Women frightened into a planned caesarean due to the care provider's estimate of baby's weight (not evidence based). Or women being told that they just have to have another caesarean because they've had one or two before. The majority of these can be avoided with woman led, midwifery care rather than our current medical model.
I speak to women every day who tell me that they were told that they would "need" a repeat caesarean for whatever reason, and then they had a perfectly safe and normal vaginal birth. Meaning that they escaped a completely unnecessary caesarean. As I was being wheeled off for my second caesarean I was told that I just wasn't designed to birth my babies and "no more trying for a vaginal birth for you". At my booking in appointment for my third pregnancy I was told that I would just be booked in for a repeat caesarean. I ignored those "experts" and had my most trouble free pregnancy and birth - at home.
Which brings us to....
"Australia's maternity care system isn't all it's cracked up to be"
I often say that "It's not our bodies that are broken, but the system". Our system simply is NOT designed to provide women with care that promotes normal physiological birth. How we ended up in a position where cookie cutter, policy based, non-individualised care from strangers is safer and better than woman led, midwifery care I don't know. Well...I do.
Patriarchy, capitalism, and all the ways that we hate women come together in the epic shitstorm that is our maternity care system.
Combine that with the fact that less than 20% of the RANZCOG guidelines are based on actual high level evidence (most are based on consensus evidence - ie: a bunch of OBs deciding that "this is what we've always done and it seems to work") and I'm actually surprised anyone comes through our system unscathed and unscarred.
"A healthy baby is NOT all that matters"
THIS should possibly be #1. We really wish everyone would stop telling us that "a healthy baby is all that matters" or that we "should just be grateful for your healthy baby".
Firstly - MUMS MATTER TOO!
We matter on two counts - just coz we are people (such a crazy notion, I know!) and also because who the hell is going to be responsible for looking after the baby? Post natal support for women who have a normal birth and are well is severely lacking - post natal support for women who are traumatised, unwell, suicidal, depressed, unable to walk, unable to care for themselves due to just having major surgery....well it's completely non-existent.
A healthy mum is necessary for a healthy baby and a healthy family.
Secondly - Our baby may not actually be healthy. My first baby was whisked away to special care 5 mins after birth. I had 2 people tell me to just be grateful for my healthy baby BEFORE I HAD EVEN SEEN HER!!! Either my baby wasn't healthy or the hospital is in the habit of taking healthy babies to special care....
Thirdly - Thanks but WE ARE GRATEFUL. As complex human being we are completely capable of being both grateful for our healthy baby AND traumatised by our birth experience or the treatment we received.
My absolute biggest thing I'd love for society to know:
STOP MAKING ASSUMPTIONS ABOUT MY BIRTH, MY BABY, AND MY EXPERIENCES.
We're all different.
Lots of love to you all this caesarean awareness month.
PS: Want to take the first step to busting birthy bullshit? Sign up for my newsletter and grab my free ebook and you'll get some epic tips to help you navigate the system with power and pizzazz.
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