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Hospital VBAC turned CS due to constant scare tactics

A huge red flag for me is when an OB states upfront at the first prenatal visit, “the main goal is a healthy baby and mom.”  Why would the OB say something that is really so obvious, it should go without saying?  Because by explicitly vocalizing it as a response to a VBAC inquiry, the OB infers that the goal of VBAC and the goal of a healthy baby are incompatible.  It’s a way of distracting the mom.  It’s a way to wear down her confidence.  It’s a way to slowly erode her desire to VBAC until she can’t, or doesn’t want, to fight anymore and schedules that cesarean or crumbles during labor and consents to a cesarean. The OB behaves as if you can only have one thing: a VBAC or a healthy baby.  This philosophy makes the distinct connection between CS = healthy baby and VBAC = dead baby and, given those options, who would pick a VBAC, right?  What insane woman would chose a VBAC if it meant her baby would die?  But the fact is, 1 in 2000 VBAC babies have a “bad outcome.” (Landon 2004)  But by stating that a healthy baby is the goal, the OB implies that “the VBAC issue” has to remain “flexible” and thus the seed of doubt is planted at the very first prenatal visit.  Throughout the pregnancy, the OB nurtures this seed of doubt through VBAC consent forms, repeated discussions on the “risks of VBAC,” and even scheduling a cesarean at 40 weeks, “just in case.”  Ultimately, the mom is lead to believe that she will get a “chance to VBAC” when in reality, her OB knows that all he has to do is refer to that seed of doubt to get quick consent to a repeat cesarean. 

I can’t tell you how many birth stories I have read where the “supportive” OB starts out saying this and then the mom ends up with another CS after a barrage of scare tactics.  Some women are able to fight, amazingly, like this woman, and others aren’t, which is what the birth story below illustrates.  Note that the exact same tactics are used in both birth stories.  The question is, will the OB be able to wear you down or not?  Unfortunately, there are more stories that end just like the one below.  The key difference I see between the two birth stories is that the woman who VBACed had a doula and she called BS on the OB several times. 

But, it’s understandable that women, like the one below, would consent to a repeat CS.  I can’t imagine being in labor and arguing with hospital personnel.  And even if you know if the OB has a penchant for lying, how do you know when your baby is truly in distress or not?  How do you know if that CS is medically necessary or not when your OB lies to you throughout your pregnancy and labor?  No one wants a dead or injured baby and it’s a very sad state of affairs when OBs lie to us and play the “dead baby card” in order to get us to consent to another CS.

My heart goes out to this woman.  Many women believe that just because their OB will “allow” them a trial of labor, that this means their OB is supportive of VBAC.  However, OBs like this are the worst kind.  The kind that act like they are supportive, but are not.

I’m going through her birth story for the benefit of other pregnant women seeking VBAC. I write about the stuff that happens in hospitals, but, for a lot of women, it’s really helpful to actually read a birth story where this stuff actually happens to a real, live birthing mom at the hands of a real, live OB.

This woman believed that she would get a fighting chance to VBAC, but there were so many red flags.  I want to highlight these warning signs so other women will recognize them when their own OB uses the same tactics on them.

You can read the whole birth story here, but below is the nitty gritty:

On scare tactics starting the first OB visit:

I was instructed to read through the risks of VBAC and give in my consent in writing…. this during my first visit to the doctor. (Oct 26th 2007). I was very surprised at first, but didn’t want to rush at things… so postponed the decision making by a couple of weeks.  All the while, my heart was set on the VBAC option.

Note that the form did not list the risks and benefits of VBAC versus the risks and benefits of cesareans.  It only discussed the risks of VBAC.  Now, is that true informed consent?  No, it’s not.  It’s a scare tactic.  Plain and simple.  What is incredible is, as we will learn, this OB is the “best VBAC OB in town.”  Frightening that this is how the “best” OB behaves.  This is why it’s so important to find a truly supportive OB or midwife.

So while I postponed my decision (rather I postponed handing over the written consent to the doctor), my gyno always seem to scare me with the risks and hardly highlighted the benefits of the normal delivery.

This is another red flag.  If your OB is constantly trying to scare you about the risks of VBAC, this is not a supportive provider and the search should commence for a new one.  If an OB is so preoccupied with the risks of VBAC, they will find some reason, valid or not, to section you.

Even before I gave my written consent on my preference I got a call from doctor’s office about scheduling my C-section for the 13th May. (my due date was 26th May). This irritated me to great levels. While one of the major benefits I was going to get by opting for C-section was a date of my choice, the doctor had deprived me of the same by just giving me one option.  Besides, I knew that I was making good progress and could go in for VBAC.

Another red flag is scheduling a cesarean “just in case.”  If an OB does this, they are not supportive of VBAC.  Rather than giving you the opportunity to go into labor, they would rather perform surgery.  This is not an OB who is supportive of vaginal birth period let alone VBAC.

After a lot of discussion with BP [her husband] and my family doctor, I opted for VBAC and gave in my written consent for the same. The doctor did not seem very pleased with the option though.

The fact that the OB was “not pleased” further illustrates how even though they gave the mom the “choice” to VBAC, the OB was not really going to support the mom’s choice if it was for VBAC.  But, since the OB gave her the “choice,” the mom feels like she will really be given the opportunity to VBAC.  What she doesn’t realize is that the OB will find some reason to section her.  I can tell this woman is a nice woman and she trusts her OB.  She really thinks she is going to be given the opportunity to VBAC and it’s very, very sad.

The following exams went smooth with the doctor saying that the baby had started to descend. But my cervix remained closed till 37 weeks.

This is completely normal for a cervix to be closed at 37 weeks.  It means nothing in terms of when the baby will be born.  The fact that the mom even mentions this makes me think she was told his information in the context of, “Well, your body isn’t even dilating, so we will probably have to have a cesarean.”

I was monitored for “Non Stress Test” for 2 weeks.

She does not mention why this is done.  Were these tests performed simply because she was a VBAC?  NSTs are notorious “fishing expeditions”… they find reasons to perform that cesarean.  Whether it’s your amniotic fluid is low, your amniotic fluid is high, your baby is big, your baby is small… if your OB isn’t supportive, and anyone who routinely has their patients on NSTs from 38-40 weeks is non-supportive, they will find a reason to section you.

During my 40th week appointment, the doctor examined me and said that I had made no progress at all since 37th week. The baby’s position and the cervix measured the same.

This is absolutely normal.  This does not mean that her body won’t go into labor.  A woman can walk around at 4cm for weeks or her cervix can be totally closed and she can go into labor that night.  This is not a “hard sign” of labor, but rather can be used as an indicator.  But the OB is twisting this fact to make this mom think that “no progress” between 37 – 40 weeks is somehow abnormal and a “bad sign.”

She also scared me that the baby was big and it could be a very hard delivery for me. (my built is rather small)

This OB is slowly whittling away at this mom’s confidence.  And the big baby card is a huge one.  If you read my birth story, I had a 9lb, 10oz baby at home.  And there are plenty of “small women” who give birth to “big babies.”  This is simply yet another scare tactic this “supportive” OB uses.  Even ACOG doesn’t recommend induction or cesareans solely because a big baby is suspected.  ACOG’s Practice Bulleting No. 22 on Guidelines for Fetal Macrosomia published in the November 2000 issue of Obstetrics and Gynecology states:

While the risk of birth trauma with vaginal delivery is higher with increased birth weight, cesarean delivery reduces, but does not eliminate, this risk. In addition, randomized clinical trial results have not shown the clinical effectiveness of prophylactic cesarean delivery when any specific estimated fetal weight is unknown. Results from large cohort and case-control studies reveal that it is safe to allow a trial of labor for estimated fetal weight of more than 4,000 g. Nonetheless, the results of these reports, along with published cost-effectiveness data, do not support prophylactic cesarean delivery for suspected fetal macrosomia with estimated weights of less than 5,000 g (11 lb), although some authors agree that cesarean delivery in these situations should be considered…. Although the diagnosis of fetal macrosomia is imprecise, prophylactic cesarean delivery may be considered for suspected fetal macrosomia with estimated fetal weights of more than 5,000 g in pregnant women without diabetes and more than 4,500 g in pregnant women with diabetes.

Apparently our OB is willing to go against ACOG guidelines to scare this woman into another cesarean… and it worked.

I was just 6 days away from my due date and still there was no sign of labor and the baby was supposedly big … thats when my fears got me and we decided to schedule a C-section. So the next day was chosen for the baby’s arrival.

The OB wins.  After months of non-support, scare tactics and, frankly, BS, this “supportive” OB finally achieves their goal: a scheduled cesarean.  But then this mom gets a lucky break…

Anyways, we went to the hospital as per plan around 9:30am. I was hooked on to the monitor. As luck would have it, I started contracting within minutes. The contractions were regular and were about 3 mins apart. Yep … I started having labor contractions. The nurses who were monitoring me repeatedly started asking me if I really wanted to go in for C-section which was scheduled at 11:30am. They felt I was making good progress in the short span I was hooked. My cervix was examined and turned out I had dilated to 2 cms. All these changes in less than 24 hrs of my check up with the doctor.

As I said, the fact that her cervix was closed meant nothing. 

The hospital nurse explained to me that I still had the option to change my mind to VBAC if I wanted. She said, that they could monitor me for a couple of more hours and see my progress. The idea suited me and BP (my mom was completely opposed to this idea) and we decided to wait for a few hours.

Yeah for supportive nurses!  They can make such a difference!  But, now more scare tactics, but they are of a different nature.  They are scare tactics and outright lies tied to doctor’s convenience.

I got a call from the doctor immediately … I must say it almost sounded like a threatening call. She said if I didn’t go for C-sec at the decided time, she was not going to be available for the entire week and that some random doctor from the hospital. We still continued to go with the VBAC option.

And the OB caught in a lie, she was not leaving the hospital…

When I asked the hospital nurse who my doctor would be, she said your gyno has asked to be informed about your progress. She will continue to be there for you. So all the phone talk that the doctor had with me was just to scare me ?????

… isn’t that despicable?  I can’t believe OBs lie like that and then show up without being completely embarrassed that they are caught in a lie.  But this OB gets a buddy to go in…

A couple of minutes later, another hospital doctor came to examine me. She said though my contractions were regular, since this was going to be my first vaginal delivery, it could take hours before I delivered. She also confidently said that the baby’s head was big and the baby would be at least 8 lbs. She was sure it was going to be a very tough delivery.

This must be yet another “supportive OB” trying to scare her about pain, length of labor, and size of baby.  Where is the support?  And I love how the OB equates 8 lbs with “big baby.”  ACOG doesn’t support cesareans for big baby unless the baby is at least 11 lbs.  But, I’m sure this OB neglected to mention that.

She also said, she was not a specialist in VBAC and that my regular doctor was the best doctor in town. (even better than her). Basically she scared us :(

Yeap, her regular OB was the “best doctor in town.”  What a sad fact for that town.  And that final scare tactic worked… and even more lies from her OB… turns out she was available after all.

And there we gave in to the pressure and decided to go with C-section.  I was wheeled to the Operation theatre within minutes and my doctor arrived in less than 5 minutes. (don’t ask me where she was all this while ….wasn’t she supposed to be unavailable after 11:45am??? )

And yet more lies revealed…

She was weighed to be 7.2 lbs and measured 19.5in (not a very big baby you said … well I thought the same too … so I was tricked to believe it was a very big baby).

This woman is not the first, and unfortunately not the last, woman to be tricked into a cesarean due to the “big baby” BS.  It makes me so mad and sad.

Anyways she was healthy and that mattered most to BP and I.

… just like the OB set up the mom to think in the beginning despite the fact that a healthy baby can be born via VBAC or via cesarean.  The fact that the “options” are posed in such a way to make you think otherwise is a disgusting word game complements of “supportive” OBs.  They act as if the only way to have a healthy baby is via cesarean.  At least, that is what they want you to believe. 

I really hope that if you are pregnant, and your care provider is treating you the same as the one detailed above, you will look for a truly supportive care provider.

And to this mom, I’m sending her big hugs.  I’m so sorry this happened to you.  Yet another unnecessary cesarean.

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9 comments to Hospital VBAC turned CS due to constant scare tactics

  • Gina Hoods

    I am very disheartened by the tone of this website. I am a board certified Ob/gyn and a very strong advocate for VBACs, IF a patient chooses one within the hospital guidelines. I DO believe and say to my patients my goal is “a healthy mom and a healthy baby” because I truly believe this statement. You would not believe the number of patients who believe that I want to do XYZ to go home to my family, go shopping or improve my golf game. A vaginal delivery is easier for me in the long run because I have less paper work, less rounding and have avoided performing a major surgery on a patient. I have no desire to perform a patient’s 6th c-section!

    But each patient who chooses a VBAC has to realize there ARE risks associated with the procedure. I would be committing malpractice if I did not inform each patient of the risks and benefits of both options. The risk of uterine rupture is than 1 percent, but if it happens to my patient she will be upset that I did not inform her of the risks. The “seeds of doubt” you discuss are all things that I have told patients considering a VBAC. I prefer to stretch the informed consent process over the entire course of the prenatal visits versus just one 5 or 10 minute conversation. If I have discussed all the options ahead of a patient’s actual labor, if I come in and say that I need to perform a repeat c-section for XYZ reason, I am not having that discussion for the first time in the LDR, but rather we have discussed the possibility months ago. I use my prenatal visits to build a repoir with my patients and to educate her/her family about the scenarios we may face in the delivery room.

    In an ideal world, every patient would be presented with the option to have a VBAC if she desires. Unfortunately due to the malpractice climate some doctors and hospitals no longer feel comfortable giving patients this choice. The rhetoric in this article does nothing healthy to advance the cause of ensuring this happens. It only serves to create mistrust between patients and doctors who are true advocates for patients.

  • [...] “You’re 6 days away from your due date and there’s still no sign of labor and the … — said to scare a woman into scheduling a C-section instead of a VBAC. [...]

  • pinkluna

    Dear Gina good for you to be supportive and talk about all possibilities, but the truth is most of the others don’t and do as this sad story tells if not worse, here in Italy where I live they perform C-sections for the most idiotic stupid things and I had a c-section because THEY took me to it, not because it was necessary or wanted, at all, in fact they did all they could to ruin my labor and make a healthy pregnancy end up with a c-section. The hate and mistrust is therefore created by what these doctors do to us and since the majority is like this cause they believe to be gods just cause they studied medicine, there is nothing to be surprise of and you can’t be offended if you know the truth that surrounds you. And you should know it.

  • Miriam

    Many of the stories on this website point to the ob/gyns as the bad guys. While I believe there may be some doctors that use tactics and lies, it is overlooked that the doctors are just as misinformed and scared as the patients!
    I would like to add a little clarity based on my experience as a patient who has had 2 c-sections. I had a section 5 years ago due to “failure to progress”. (5 minutes after the consent, while the doctor was prepping for surgery, my body signaled the progress I had been “failing” to reach with the most incredible urge to push. However, I thought he knew best and stupidly agreed to continue with the c section.) I have regretted it ever since. However, I believe that the doctor truly was concerned and I trusted it, despite the fact that I personally believe I could have delivered vaginally.
    The reason I believe some doctors’ concerns are sincere if not valid is because of the education, both formal and informal, they have received. My ob/gyn was a specialist in many fields of womens’s medicine and so I trusted that. Little did I know I was signing on an expert in surgery. A doctor’s entire training revolves around how to interfere with something very natural… childbirth. They are taught about evey possible bad case scenario, so they are prepared, so they are trained in intervention.
    Then they go into the field and begin to learn the hospital and insurance policies that insist the doctor use these scare tactics becase they have been bitten so badly financially by unsatisfied women who sue them into making this policies in the first place. The problem is the high costs associated with lawsuits and therefore, the rest of the vbacs suffer. In my case, I was not ever “allowed” a second c-section because the hospital had lost a single lawsuit against a woman who hemmoraged during her vbac. It was my “bad guy” doctor that has to pay the high cost of mal-practice to the point that, combined with the overhead of his office, he had to deliver 150 before he began to make any money. So out of fear he falls back on his training which tells him that women need help to get a baby into the world.
    Instead of blame (another product of fear) we should look to ourselves and educate each other about how to accept disappointment and best of all, how to avoid it by educating ourselves. We can have more confidence for it’s own sake instead of walking into birth/labor with the attitude of going to war with our practitioners.

  • mumofar

    I am all for what Gina and Miriam have to say above, I hate to see Obs demonized. However, it does make me very angry that these women were not properly informed. I hear so many women saying they were coerced into an unnecessary c-section and I’ve always wondered how it happened. When I hear their stories, it was the smallest things made out to be huge risk factors, things I think, now, I would just shrug off.

    My story was similar in ways though. I ended up with a complication that I was told necessitated surgery and a concurrent c-section. I still haven’t worked out if there was any possible way I could have avoided it even though I have researched high and low. My main objective now is to avoid the situation the woman in your story, and others like her, got into.

    Thanks for your analysis of her story, it helps a huge amount to see your feedback about each step of the process that led to c-section. I understand that, to do this, you also need to point out where the Obs were at fault. They are there to save lives, and they do a great job at that, it’s just a shame there is now too much surgery due to everyone’s fear – whether it be fear of death or fear of being sued or fear of not getting home to the family in time for dinner…

  • Jasmine

    Sorry this is long, but reading this made me very sad.. I was lied to for my first c-section.. I was in labor, a hurricane was hitting, it was 1am.. I was unable to get to my hospital because of all the flooding and when the doctor came in I could instantly tell that she was annoyed that she had to be called in and I ruined her night.. I was fully dialated quickly but when it came to pushing, that’s when things went south.. We pushed for about an hour and a half, she huffed and puffed, sighed every 2 seconds then said she could feel the baby’s head coming through the cervix but he just wasn’t coming through.. She told me i was going to need a c-section which meant pawning me off on the hospital surgeon.. May I point out that i did not feel the need to push the entire time and was stuck in my back trying to push.. I asked if the bed could be adjusted she said it wasn’t adjustable but i was scooted to the bottom of the bed and somehow stirrups were right by my face.. I asked for pillows and explained that i can’t push laying down, the answer was “No”.. When she suggested the c-section SHE TOLD ME, that I was tired but I told her i wanted to continue.. Then a little later she again said, it just isn’t going to happen, i didn’t want to stop but then she said that she was concerned that the baby’s heart rate was dropping.. There was no machines going off or anything but this was my first time and i didn’t know if that was unusual or not.. But when the doctor told me we had to get the baby out quickly and made it sound like he was in danger, I immediately agreed to surgery.. She happily left and the nurses began to empty my bladder after 4 hours since urinating.. The nurse was stunned at the amount that was in there, and the other nurse had to get another bag to attach.. I filled almost 2 bags full of urine.. After that, I was being wheeled to the OR and as we were going down the hallway my contractions intensified and that uncontrollable urge to push came.. I kept telling the nurses “i have to push, i have to push” the nurses kept telling me to breathe through it, but my body was doing everything that it was supposed to.. The contractions were so strong and powerful, baby was pushing down with them, my whole body was pushing; it was beyond my control.. Oddly even though my son was in “danger” and needed to be delivered quickly, i was still given the option to have an epidural or general anesthesia which made no sense.. I chose to go under because of what the doctor had made seem a very urgent situation.. Before passing out I still felt my body and my baby still pushing, my broken body wasn’t broken, i was tricked.. I had a hard time accepting that experience and suffered from depression, the anesthesia affected my memory so much that i don’t remember seeing , holding or even breastfeeding my baby.. All i have are picutres of a zombie holding my child and a lumpy, hideous scar that got infected afterwards.. It was truly a tramatic experience.. I am due any day with baby #2, and determined for a vbac.. I’m very petite and i’ve been told many times of the concern that my first born was not a big baby (7lbs 9.2oz) and i “might” not be able to deliver naturally, but it was implied that i wouldn’t beause on my size.. However, i already know that is a load of crap because i had my pelvis examined and measured and was told that i had a very round and roomy pelvis and would be able to deliver a nice “fat baby, no problem” I have been asked multiple times if i’m positive i wanted a vbac and have been given the “a healthy baby is the most important thing” line and i will admit there have been times i began to doubt myself but through support groups, educating myself the best i can and through sites like yours, i have been able to fight off those negative thoughts and press on to what i anticipate to be a very successful vbac.. The lesson I learned from my c-section is that just because there are doctors does not mean that all of them truly have your best interest at heart and that is why i will not take any crap this time around and why i advice everyone i know looking to vbac, about to have their first baby or trying to avoid another pregnancy complication, to educate themselves as much as possible so they can be prepared for any red flags that might suddenly pop up from their caregiver. Red flags that may indicate that this person is only looking out for number 1..

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