Women they really believe that if they are good patients, if they are friendly, if they don’t question to much, if they are good-natured, their OB will treat them with the same courtesy by reading their birth plan, respecting their wishes, supporting their desire for a vaginal birth, and creating an environment where VBAC is the goal.  In short, the woman believes that she will receive a genuine opportunity to VBAC. 

However, as we read below, it is not enough to like your OB.  It’s not enough that you feel comfortable with them.  They need to support VBAC.  They need to see the value in vaginal birth.

As I read this letter again, it really breaks my heart to share with you.  This woman is fresh from her repeat cesarean and she is still mourning.  I thank her deeply for sharing her pain and regret with the readers of this site.  I hope that this woman’s pain can be transformed into greater knowledge and understanding for you.  I hope if you are considering staying with your OB/midwife just because you like them, and not because their standard of care is in favor of vaginal birth, that you reconsider your decision.

To learn more about “bait & switch” OBs, read: The Three Types of Care Providers Amongst OBs and Midwives. 

To read more birth stories of women who received less than stellar care in the hospital, please read: Hospital VBAC turned CS due to constant scare tactics and VBACing against the odds.

To support an OB who is currently being targeted by his hospital for attending VBACs, please read: VBAC supportive OB asked to stop attending VBACs by his hospital.

Dear Dr. XYZ:

It is with great reluctance that I submit payment to you for services rendered. 

I hired you for an intervention free VBAC.  Instead I had EVERY intervention I told you I did not want.  Under your care, I failed in the most basic way a woman can fail – I failed to birth my children.   You ignored each and every point on my birth plan.  I cannot help but wonder if you even read it, or if you ever had any intention of following it. 

I needed time for my body to do what it was designed to do.  I needed support from my doctor, from my nurses, and from my hospital.  What I did NOT need was to be pumped full of drugs, have multiple interventions that I specifically stated I did not want and pushed into a surgical procedure.  I am especially struck by our final interaction prior to consent.  Never, for the rest of my life, will I forget how you made your speech, and then stalked out of the room.  I recall thinking “I’m actually paying to be treated like this?  To be verbally bereted and physically tortured?” 

I have no joy when recalling my children’s births.

I have regrets. 

I regret coming in for an appointment that day when labor was in the early stages.  I regret listening to you that I should go to the hospital “just for some monitoring.”  I regret not leaving when labor stalled.  I regret agreeing to pitocin.  I regret allowing you to turn up the pitocin to a point where I could not stand it without pain relief.  I regret getting the epidural instead of just screaming my lungs out until it was over.  I regret letting you artificially rupture my membranes.  I regret allowing the monitoring – internal and external.  I regret not telling you that this was my baby, my birth experience, and I wasn’t having a C-section without a court order.

But what I regret most is choosing you as my provider.  I knew going in that you had a high C-section rate, that you had already given me most of those interventions with my first child.  But I liked you, and allowed that to influence my decision. 

How I wished I had chosen someone I loathed who would have worked with me to get the natural birth I desired.  In the end, liking you got me nothing that I REALLY wanted.

So, here is your money.  I don’t particularly think you have earned it, but I want to be free of this one last reminder of the worst experience of my life. 

Sincerely,

Jenn in St. Louis

Take the time to get and read your records.  You may find that your “emergency” cesarean was no rush at all.

Medical Records Copying Charges by State

Want to know if your doctor has been subject to a board hearing or disciplinary note? 

Here is a link to the State Board sites for all 50 states.

She links to another great website: “The Big Push For Midwives, launched on January 24, is a coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states and the District of Columbia. The website includes a page with links to news articles related to midwifery-related legislative efforts, and a map of states [which I've copied below] where licensure is available or where legislation is pending. Licensure is currently available to CPMs in 22 states.”

There is also a page on The Big Push for Midwives website that lists birth resources for the following states: Alabama, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Maine, Michigan, Missouri, Nebraska, Nevada, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Dakota, West Virginia, and Wyoming.  (Might be a good place to look if you want a VBAC and are looking for a VBAC supportive provider.)

The relevance of CPM licensure to VBAC moms?  More legal options.

From Wikipedia:

No state prosecutes mothers for giving birth outside of a hospital. However, midwives who assist at such births may be prosecuted in some areas.

In the early and mid 1900s, physicians pushed to have midwifery banned throughout the United States. Childbirth became very clinical with the mother generally subdued with leather straps and ether. In 37 states it is once again legal to acquire the services of a midwife. Many midwives continue to attend mothers in states where it is illegal, while efforts are underway to change the law.

Practicing as a direct-entry midwife is still (as of May 2006) illegal under certain circumstances in Washington, D.C. and the following states: Alabama, Georgia, Hawaii, Illinois, Indiana, Iowa, Kentucky, Maryland, Missouri, North Carolina, South Dakota and Wyoming.^[12] However, Certified Nurse Midwives can legally practice in these areas.

People wishing to have a midwife-assisted home birth in the United States should always research the applicable laws in their home state.

I know homebirth sounds like a radical thing, but I have heard story after story of women who would have never considered a homebirth until they started looking for a VBAC supportive OB only to find none and then felt trapped, out of options, and scared.  And so now these women, who would have been quite happy to birth in a hospital, are hiring midwives, regardless of wether it’s legal in their state, and having a homebirth VBAC rather than face the alternative, an unwanted, unnecessary repeat cesarean in a ‘VBAC ban’ hospital.

I hope this is going to be one of the factors that swings the conventional wisdom back to supporting VBAC because when enough women start birthing at home and that an impact is felt in hospital revenues, hospital administrators and OBs might start paying attention.  Unfortunately, by the time that happens, it might be ‘to late’ for the hospitals.  Enough women would have experienced the joy, peace, privacy, and safety of homebirth to never want a hospital birth again.

More options for women

The front page of the Jan. 20 St. Louis Post-Dispatch featured women birthing at home with midwives. The legalization of home birth midwives is a hot topic around the nation. States like Missouri and Illinois are considering licensure of certified professional midwives.

The Post did a great job highlighting birth choices. I would like to see the Belleville News-Democrat report a similar story regarding local birth options as well as how choices are becoming limited.

Do newspaper readers know that three area hospitals have banned vaginal births after cesareans, essentially coercing women into surgery? In December, the Centers for Disease Control reported the 2006 figures for births by cesarean at a national high of 31.1 percent. In 2005, 32.4 percent of births in St. Clair and Madison counties were cesareans. Local VBAC bans contribute to increases.

Perhaps with mainstream media coverage of a variety of birthing environments, more consumers will request choices. Many obstetricians today do not follow the American College of Obstetricians and Gynecologists guidelines or practice evidence-based medicine with regard to labor induction or cesarean delivery for low-risk pregnancies. If malpractice concerns preclude Illinois obstetricians and hospitals from practicing evidence-based medicine, women should be referred elsewhere.

Julie Herr

Belleville

The post below is shared with permission from an ICAN list member and I think it’s a great list of all the benefits of having a home birth.  I think not getting pressure to induce alone is worth forgoing an epidural!

“As you all know, this last one was a very difficult vaginal birth. But one month later, the thing that I am most thankful for is that I was at home.  First of all, for having a provider who understands NFP. Thankful for being overdue and not having to deal with pressure to induce.  Also for having a
midwife who put a lot of importance on my nutrition and growing a very healthy baby that could easily withstand a difficult labor.  For the freedom to use water, even though I didn’t end up birthing there.  For the freedom to basically be constantly on the move during labor, not tied to a bed.  For not having nurses offer me drugs, but instead women who, when I said I wanted a cesarean, when I said I’d rather die than do this any more, loved me and got me though.  For being allowed to push way longer than a hospital’s lawyers would have let me.  For being able to model for my children and close friends (including a Missouri state congressman) how the system should work.  And for the already hundreds of times that I have gotten up and down, paced the floors with a newborn without the pain of a surgery interfering.  Finally, for the pride I have in myself and for the protective bond that I have with this baby knowing how hard I had to work to get him here.”