Wednesday, April 29, 2009

This is going to get UGLY!

You'd better stand back because this is going to bet ugly!

On Monday I had my dreaded "VBAC consultation" with an obstetrician. I wasn't looking forward to this meeting for several reasons:

  1. It seems ridiculous to me to require a woman to have to sign a form stating that she would like to be "allowed" to use her vagina for one of its intended purposes
  2. I knew that the consultation would center around the doctor looking over my birth history and then HE would decide if I was a good candidate for VBAC
  3. I had a surgical birth for reasons not likely to recur
  5. I have already signed a form stating I understand the risks and benefits of VBAC and cesarean

Overall, the consultation went just as I'd expected. The doctor first asked me if I was having a repeat cesarean or a VBAC (obviously he didn't know I'm seeing the midwife, who is not a surgeon and cannot perform a c-section). Then, before he even examined my prior birth history, the doctor launched into a list of the benefits of a planned repeat cesarean and the risks of VBAC. Yes, it was a discussion of "risks vs benefits", but do you notice what's missing? There was absolutely NO discussion of the risks of repeat cesarean or the benefits of VBAC!

Finally the doctor looks over my birth history (because, don'tchaknow, a doctor has to deem a woman a "good candidate" for a "trial of labor"), and he noticed my children's birth weights (3lbs 10oz at 37 weeks and 5lbs 2 oz at 41 weeks). Then, he dropped a bombshell:

"Well, we can let you try a VBAC if you want to, but I don't really see
it happening. Your other children were so small and this baby is going to be a
normal size. I give you a 50/50 chance. It's just not likely to happen."

First of all, there is no "we". You're not even my care provider, doc! I am giving birth. M-E. Not you. Second, you don't "let me" do anything. You give me the information I need to make an informed decision and then you stand back and let me decide. As far as "not really see[ing] it happening," oh you have no idea how I would adore dragging your butt out of bed and having you watch me push this baby out!

NOW, WHAT IN THE WORLD do you mean I can't give birth to a "normal-sized" baby? I've heard of doctors giving mothers the "big baby card" and the "dead baby card". I have even been given the "small baby card". No wonder the cesarean rate in this country is skyrocketing! You just can't please these doctors!! "You can't birth this baby because she's too small" and "you can't birth this baby because she's just the right size". A nation of schizophrenic obstetricians... and women simply line up to be strapped down--MADNESS!!!!

Now, dear doctor, here is my "VBAC consent form":

  • I had a cesarean for reasons not likely to recur.
  • I had a low, transverse incision with an uncomplicated physical recovery.
  • It has been 4.5 years since my cesarean.
  • I have had a subsequent vaginal birth (VBAC).
  • I understand that, having had a successful vaginal birth, my risk for uterine rupture is less than 1%.
  • I understand that the risks of a repeat cesarean include: death, hemorrhage, blood clots, injury to bladder, bowel, uterus, injury to baby, excessive blood loss and hysterectomy.

I declare myself an autonomous woman, of sound mind and body, and hereby state my decision to have a VBAC.




Charity said...

love it! You tell em!

Diana J. said...

Great job! Keep up the awesome work!!

Jill said...

Oh my GAWD that pisses me off!!! Way to make up your own form, that rocks! I hope you said everything in this post verbatim to that fearmongering asshole!

Anonymous said...

I couldn't have stayed civil. DH would have had to gag me and pull me out of the room.

Rixa said...

Rolling my eyes! did you ask him why he didn't talk about the benefits of VBAC and the risks of repeat cesarean?

vbacwarrior said...

I had been planning to wear a very long t-shirt to labor in that says "I am not hospital property" on the front. DH suggested I now add the following to the back of the t-shirt, the part that covers my butt: "50/50 chance my (you know what)"

Tina said...

Wow, now having a normal sized baby is a risk factor for VBAC? I thought I'd heard it all. Schizophrenic is right! That's just insanity.
You go girl. I wish you all the best for an amazing birth. :)

Saved Sinner said...

That's ridiculous I can see why you're annoyed.

Knitted_in_the_Womb said...

Did he not really read your chart and assume that you'd had cesareans for both babies?

And on what basis does he assume that this baby will not be small like your previous babies?

It's all insanity of course...insanity. You have us in your corner!

Mitchell Clan said...


Birthkeeper said...

FANTASTIC!!! Such a wonderful post!! I wanted to stand up and clap and cheer!!

Wendy said...

Well said! Thank you.

Brenna said...

Love your own version of the VBAC consent form. My OB consult was very similar except I got the big baby card. How do these docs know what we are and aren't capable of? Ridiculous!!

Samanthavv said...

That's crazy!

I pretty much told the OB that my midwife is under that I wanted a VBAC and he said as long as the baby is presenting well, then he's fine with it. I didn't have to sign anything. He just told me to do some research, read some pamphlets and make sure that it's what I want to do!

Sorry you had to deal with that!

I'm 5 days from my due date! So we'll see how mine goes!

Anonymous said...

Did you actually give this "consent form" to the OB? Since I'm having to work with an OB (multiple gestation risks me out of midwifery care at home and in the hospital), I'm wondering if I need to do something similar.

My OB is the most likely OB in town to support my choice to VBAC, but given my situation (previous c/s, twins, and a hysteroscopic procedure performed this summer near my scar), he balked about a VBAC. That was my first appointment, and I told him that it was probably not the time to talk about it. However, that time is approaching.

Anyway, good for you for standing up to this. It's ridiculous behavior on the part of the OB.

Kat said...

Yikes! I can't believe it! I mean, I can, but every time I hear a story like that I wonder why our movement is still so small. But it's coming, slowly but surely! Thanks for your blog!
I am doing a post today or tomorrow that is a story from a doc who backs up a trusted midwifery practice around here. It is horrifying.

Missy said...

Wow! I'd like to say that I can't believe the OB said all that, but it seems to be very common these days..unfortunately. Good for you for knowing better and not letting his comments change what you know is right for your body. You are an awesome example!