Monday, January 25, 2010


I just read this fascinating book on (what else) childbirth. It's called Pushed by Jennifer Block. Block is a journalist who did a thorough review of chidbirth and maternity care in the US. The book is interesting because she weaves together birth stories, interviews with doctors and midwives and basic facts and statistics.
For example, she compares the risks of VBAC to the risks of a c-section. As it turns out, a VBAC may actually have fewer risks than a casearean, but very few OBs will admit to that.
She explains why routine interventions such as Iv fluids and continuous monitoring do not necessarily lead to better outcomes.
What was interesting to me was that she quoted much information that many women don't have when making decisions about their maternity care, such as the true risks of cesarean sections. While a wonderful option when necessary, the risks are nothing to sneeze at either- both infant and mother mortality rates are higher for c-sections. There is the risk of infection and the prevalence of adhesions, as well as a higher risk of terrible complications in a following pregnancy such as placenta accreta or placenta percreta, where the placenta grows onto the uterine scar and sometimes even out of the uterus and into the bladder. Very few doctors will mention these risks when discussing a cesarean with their patients.
I am not trying to scare anyone here, but what this book really underscored to me is that knowledge truly is power. As women we have the responsibility to educate ourselves about the physiological process of childbirth. What is typical? what is cause for concern? what are our options? what are the risks involved? Even though we are not medical professionals, we need to at least be able to ask intelligent questions in order to make the best decision possible.
This reminds me of one of the first births I attended. The couple had decided to try to have a natural childbirth because they did not want the baby exposed to any drugs. In the end she was induced because she was almost 2 weeks overdue and the doctors were concerned. Once she had pitocin, it made the contractions unusually strong and she was considering an epidural. Her husband freaked out because he didn't want the baby exposed to meds. He said- maybe it's safer to just have a cesarean than to have an epidural. To which I responded "NO"- because a c-section is major abdominal surgery. Aside from that, the local anesthesia used for a cesarean is actually a (you guessed it) very strong epidural! This proves my point- do your research, understand the process, so you can make good decisions for yourself AND the baby.
Don't take my word for it- read the book. I highly recommend it.

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