Nov 30

Posted by My OB said WHAT?!?.

“Cesarean Sections From Now On, OK?”

“Cesarean sections from now on, OK?” – OB to mother who had a repeat cesarean after trying for a VBAC.

49 people dislike these words.

There are 25 comments to this post.

HeatherB had this to say, Nov 30, 2011 @ 10:59 am (Quote)

You’re fired from now on, OK?

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BeckyJ had this to say, Nov 30, 2011 @ 11:21 am (Quote)

…..because it’s more convenient for YOU?….

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Jessica had this to say, Nov 30, 2011 @ 11:26 am (Quote)

Because no one’s ever had a successful vbac. At least no one under your care, right?

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Jane had this to say, Nov 30, 2011 @ 11:26 am (Quote)

Okay, if something life-threatening and unpredictable happened to the mom during the VBAC and the doctor only barely saved her life and the life of her baby — if the doctor was badly shaken by this emergency and just as disappointed as the mom that they had to go to the OR…then under those circumstances, this almost sounds like a compassionate way to say, “Ma’am, it isn’t safe for you to attempt a VBA2C.”

But if the repeat C happened because the doctor imposed so many conditions on her being “allowed” to labor and the doctor said this in a self-satisfied “I know better than you” tone, then the doctor is definitely in the wrong.

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CNicole had this to say, Nov 30, 2011 @ 11:37 am (Quote)

I was told almost this exact thing after my repeat cesarean. What made it worse for me, it was while I was being stitched up from a very much unwanted and unnecessary cesarean (if the 10:30 on a Friday night and a resident – who made the call – who got to teach, are any indication) and I had literally just met this woman (the attending) in the OR just as I was being prepped for the cesarean.
I just said to myself, “You’re wrong, but I am not having anymore kids so it doesn’t matter”

My first cesarean was due to distress after AROM, my second was a sabotaged VBAC attempt and “failure to progress” -as if getting to 9+cm and loads of pressure is that)

Both ACOG and SOGC say that VBA2C is a reasonable option (it is just not easy to find a care provider)

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Niamh had this to say, Nov 30, 2011 @ 11:48 am (Quote)

This one is mine. The OB (surgeon) who did my repeat c-section was not my regular OB… I actually had in-hospital midwives (who were fantastic, btw… but also constrained by hospital policy), the surgery and recovery was the first time I had ever met the OB.

Anyway, I had a c-section with my first (long story, but I was very dissatisfied with how my labor went, how I was treated, how interventions were pushed on me when I was in a delirious state… etc etc. My main issue with that c/s is that I don’t KNOW if it was needed or not). So the second time, after knowing what to expect, I wanted to take CHARGE of my birth! We were in a totally new state for the second birth and I liked this hospital better than my first. Like I said, my midwives were absolutely WONDERFUL. They really were. They were unfortunately limited in what they could allow me to do because they were in-hospital midwives. But they FULLY supported me attempting a VBAC and not using ANY interventions.

Fast forward to the day I go into labor… I was *incredibly* sick that morning. I mean, throwing up ALL day. I couldn’t keep anything down… not even water (I was really trying to keep hydrated, but I was just throwing up constantly). That night, my water broke. I labored for a while at home, then DH and I headed to the hospital. At first I totally declined the IV (as I had planned to do), but because I was severely dehydrated, I really did need it, so I accepted (confirming that it was just fluids and that nothing else will be pushed through it without my consent). My labor progressed quickly, but even the fluids from the IV were not bringing up my hydration. The midwife was very comforting and we held out for a while, but the dehydration was causing my daughter to go into distress. We waited a while to see if she would get better, but finally, my midwife was very concerned and we decided to do a repeat c-section. I’m ok with this c-section because I know it was needed and because the labor (outside of the IV) was done naturally.

The surgery went very well, no problems at all. Healthy baby girl born. Everything seemed fine. It was an emergency c-section, yes… but there were no real complications. The OB did a fine job at the surgery, I’ll give him that.

Then, when I was recovering, the OB popped in to check my incision and said THAT to me. Frankly, I just inwardly rolled my eyes, smiled and nodded my head. But yeah… won’t be following that advice!

I’m newly pregnant with our third (5 weeks) and changed my insurance so that I can go through a birth center this time with a Licensed Midwife who is not constrained by hospital policies. And it may even end up even being a home birth! The only reason we went through hospitals with our first two is because we are a military family and going through health care outside of the military hospitals is USUALLY incredibly difficult. But this time, I don’t care how difficult it’s going to be! We’re not going to the hospital again unless I absolutely have to!

I guess you learn more and more with each birth!

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Niamh Reply:
November 30th, 2011 at 11:57 am Niamh(Quote)

Also, yes.. even though the midwives were great, there was a LOT of restrictions placed on me. They pretty much pegged me as “c-section” from the first appointment. The midwives REALLY pushed hard to get the hospital to even ALLOW me to attempt a VBAC. Scheduling a c-section was completely out of the question for me. Halfway through the pregnancy I was even forced to see one of the other OBs… so they could “talk to me” about my choice in not having a repeat c-section. That appt, btw, was a total joke. The whole time the OB was trying to sway me against attempting a VBAC and offered to schedule a c/s “just in case” like 3 different times.

So yeah… when it ended up being another c-section… I was not surprised at all that the OB said this to me. But it was still ridiculous.

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Lora Reply:
December 1st, 2011 at 8:35 pm Lora(Quote)

“They pretty much pegged me as “c-section” from the first appointment.”

Whenever I hear a first-time mom who was sectioned tell me that her doctor says she can “try for a vaginal birth next time,” I think of these examples. It’s like these very doctors who make it nearly impossible to VBAC don’t realize that they make it nearly impossible to VBAC. ARGH!!!!

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Ashley Bean Reply:
November 30th, 2011 at 12:11 pm Ashley Bean(Quote)

We’re a military family too and I delivered my son with the military doctors. I learned from that experience and ran like hell from them with our second. I switched to the local birth center as soon as I could. We’re very lucky here to have a birth center that so readily accepts tricare and makes it easy to switch, but you’re right…its not always easy to get away from military docs when you’re mil dependent. I wish you tons of luck with baby #3 =] congrats

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AmandaPN Reply:
November 30th, 2011 at 12:32 pm AmandaPN(Quote)

Okay, not to hijack, but could you enlighten me on the process for using Tricare elsewhere? Do you have to go off of Tricare Prime and onto Tricare Standard? Does it cover the birth 100%? What if something else happened to me, would it be covered 100%? I’d love any info you can give me – even if you want to go to my blog or something. I actually haven’t had bad experiences with military – c/s with my first (can’t blame them for it – I knew induction was a risk and I still took it), VBAC with my second), but I think I’d love a homebirth someday. Can you legally have homebirth in military housing?

We’re a military family too and I delivered my son with the military doctors. I learned from that experience and ran like hell from them with our second. I switched to the local birth center as soon as I could. We’re very lucky here to have a birth center that so readily accepts tricare and makes it easy to switch, but you’re right…its not always easy to get away from military docs when you’re mil dependent. I wish you tons of luck with baby #3 =] congrats

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Niamh Reply:
November 30th, 2011 at 12:44 pm Niamh(Quote)

Amanda, I have to switch from Prime to Standard to go through my current midwife. It doesn’t cover 100%, BUT it covers everything up to a certain price amount (and it’s a very sizable amount) and everything after that is out of pocket. At least 80% of our price for the midwife will be covered by Tricare Standard.

I am NOT sure if you can have a home birth in military housing. We live off-base.

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Robyn Reply:
November 30th, 2011 at 3:34 pm Robyn(Quote)

There are unplanned home births. Much as the military would like to think they have control over every aspect of your life, they can’t control your uterus when it hits that pushing phase. Saying it’s illegal to have a home birth in military housing is like saying it’s illegal to give birth at Walmart.

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Mama Wrench Reply:
November 30th, 2011 at 12:50 pm Mama Wrench(Quote)

TriCare: Prime will cover 100% IF it’s an emergency situation (e.g., you’re out of town on leave and go into labor more than 20 miles from a military hospital.) The midwives I originally had with my first were willing to attend my birth on military housing, but it would have been 100% out-of-pocket since I’m active duty and therefore not allowed to switch to Standard.

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Ashley Bean Reply:
December 1st, 2011 at 9:16 pm Ashley Bean(Quote)

Well you got your answer anyway AmandaPN, but I just checked my email after several days (and 150+ emails later) of ignoring it. lol. Sorry I missed you. Yes, the easiest thing to do is switch to standard. The amount you’ll pay out of pocket depends on the birth center/OB. I had to pay $175. $150 for my deposit to hold my spot at the birth center since they only take 20 women per month and $25 deductable from Tricare. There are ways to stay Prime and still go off base, but the only ways I know of are if the base is too overcrowded and can’t take anymore patients or if the base OB refers you off base. some of the base OBs will do that for you as a kindness, but most will only do it if they don’t have the resources and you’re high risk, so then they’ll move you to a high risk OB.
Its definitely worth the money to get away from the military doctors. Definitely check into it.

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Tee Reply:
November 30th, 2011 at 12:40 pm Tee(Quote)

Wow! I’m sorry that you weren’t able to have your vbac with your second child but I have to admit, your attitude is refreshing. I am a HUGE natural birth advocate and so often, I hear women swear against a c-section no matter what the circumstances are. I’ve seen women that truly need the surgery for themselves or their baby and refuse it. That bothers me just as much as women that willingly agree to the section for no good reason.

I hope you get your vbac with baby #3! Congratulations on your pregnancy!

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Details Reply:
November 30th, 2011 at 4:18 pm Details(Quote)

Tee, these women (plural) who have truly needed the surgery for themselves or the baby and refused it – DID THEY DIE? I doubt you have ever seen ONE let alone TWO women who have refused surgery and died or lost their babies. Normal sane women do not do that. I have never seen anybody on this site say anything like that. I have seen a lot of women who are angry and bitter and afraid to go back to a hospital or back to an OB. But I’ve also read of women on this site who had to transfer from planned home births and some of them were treated well and some of them were punished for shunning the system. But I’ve never once seen one of them post that they wished they had stayed home and died rather than be carved open like a Thanksgiving Turkey for the sake of their babies. Women DO NOT object to necessary surgery. We object to unnecessary surgery and to be treated like idiots. As I said I doubt you have seen one woman actually in that situation let alone 2. I’m sure you’ve heard a lot of bravada maybe at rallies or something. But you have not SEEN it actually happen during labor.
I agree that Niamh is in a good place mentally. She isn’t bitter or angery. And that is wonderful. But it isn’t like there is some huge contingent of crazies on this site or out in the world at large who actually behave like that in real life (during a rally sure, people get excited and say things they would never follow through on if it was their own kid on the line.)
Niamh good luck and God bless you and your family.

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Tee Reply:
November 30th, 2011 at 5:23 pm Tee(Quote)

To answer your question, yes. I know one woman that came very close to losing her life because she refused a section. She was in a coma. I know two women that lost their babies due to refusing a section.

Details, just because you’ve never seen something doesn’t mean it doesn’t happen. Before I became disabled, I was a midwife. I have a lot of experience with birth and have seen a lot of things. To say that “women do not object to necessary surgery” simply isn’t true. I know women that have and have lived to regret it.

One more thing… I am seriously offended by your accusation that I’ve lied. I’ve never been to a rally, don’t even know where you would find one. The experiences I speak of are personal. I don’t mind you questioning my experiences but I absolutely mind you accusing me of lying. That was uncalled for. Seriously rude.

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Details Reply:
December 1st, 2011 at 5:13 am Details(Quote)

Wow, forgive my ingorance and my violent reaction to the concept that many natural birth women are crazy and a normal and sane natural birth women is “refreshing.” If you hadn’t used the words “so often” making it sound in my mind like “more often than not” I would hope I would not have responded as I did. I’m terribly sorry.

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Knitted in the Womb Reply:
December 1st, 2011 at 11:06 pm Knitted in the Womb(Quote)

Actually, yes, I know a woman who refused what was really a necessary repeat cesarean (she attempted a VBA3C after having a rupture with her CBA2C) whose baby died and the woman ended up in ICU for several days. Yes…she did ultimately have a cesarean…but it was too late to save her baby or to preserve her own health.

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Tee Reply:
December 2nd, 2011 at 12:21 am Tee(Quote)

I really hate to hear that. So sad. I’m sure that Momma feels a tremendous amount of guilt for choosing to forego the section. ::sigh:: I’ll be praying for her.

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Jane Reply:
November 30th, 2011 at 12:44 pm Jane(Quote)

Ugh. They have no clue, do they? I’m sorry you were treated so dismissively.

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Mama Wrench Reply:
November 30th, 2011 at 12:53 pm Mama Wrench(Quote)

I was actually told that statistically, you’ve got a higher likelihood of a successful VBAC in a military rather than civilian hospital, since they’re not subject to litigation in the event of a bad outcome so they’re not motivated by avoiding lawsuits.

Of course, that can be a double-edged sword, too. I gave birth at a military teaching hospital…. whooo boy, that was an adventure….

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Holly Reply:
December 9th, 2011 at 9:34 pm Holly(Quote)

Whoa.. wait.. Now I am not “sue happy” nor do I condone frivolous lawsuits but wait.. Military docs aren’t subject to lawsuits if they do something stupid and cause an injury or death? Whoa!! Ok, just cause my HUSBAND is military and decided to sign HIS life away to the military doesn’t mean that I agreed to do the same with me and any future children when we got married! Are you SERIOUS? Is there NO recourse for a military doc related screw up?

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Mama Wrench Reply:
December 10th, 2011 at 3:22 pm Mama Wrench(Quote)

It depends on what injuries are incurred and on whom. If you’re active duty and they make a mistake that only effects you, you can’t sue them — your reparations are in the form of medical benefits upon discharge. If the baby is injured, depending on the type of injury, you may be able to sue on behalf of the baby. A military spouse may be able to sue depending on type of injury. But service members are barred by federal law from suing for medical malpractice. Here’s a partial rundown of military malpractice law challenges.

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