Titus 2:11-13

"For the grace of God has appeared, bringing salvation to all men, instructing us to deny ungodliness and worldly desires and to live sensibly, righteously and godly in the present age, looking for the blessed hope and the appearing of the glory of our great God and Savior, Christ Jesus."

Thursday, December 4, 2008

At Least Give Me a Chance...

I just spent the larger part of my morning on the phone hoping for leads to an obstetrician who will give me a trial of labor.  It seems that so many doctors are opposed to both vaginal birth after cesarean and vaginal birth of twins; so throw my desire of a vaginal birth of twins after cesarean in there, and you start feeling like there is little hope.

The doctors I'm currently seeing haven't given me an answer either way, but one midwife I spoke to this morning, upon finding out which OB practice I'm with, warned me that I need to get out of there as quickly as possible and said that with them I don't stand a chance.  The problem, she said, is that they aren't all on the same page (as I began to discover at my last appointment).  However, I won't completely give up on them until (and if) they nix my idea all together.  And if that happens, at least I've started the grueling process of finding a credible doctor who will give me a chance at labor.  (I did find a possible lead, by the way, pending review of my medical records!)

I do understand that no matter what doctor I'm with, certain factors will have to be just so in order for me to have a vaginal delivery of twins.  It's not that I would refuse a cesarean to the point of endangering my babies' lives.  But I do have a deep desire to once again experience the beauty of natural childbirth, and I am praying very specifically and very often that all these determining factors will take place in order to allow for that.  I know that God hears my petitions and knows my heart, and it's only in Him that I can place my trust.


Elizabeth said...

From what I've heard and read you may need to switch to a midwife. A friend of mine who did natural childbirth had a great group of midwives that she worked with in Des Moines. If you would like their info I could get it for you. Just let me know!

Angela said...

Elizabeth, I would love any info you can get! One group of midwives I checked with doesn't do anything "high risk," including both multiple births and VBACs. So that discounted me twice! But I would be surprised if all the midwives around here take that same stance. Let me know what you find out! Thanks!

Ben Robie said...

I am obviously (well, hopefully obviously) not a woman, but since your blog is open to public comment, I will :).

I don't think that a practice where doctors have different opinions is a bad thing. I think if they argue about it in front of you, it may be, but the more opinions the better. They are more than likely all after the same thing: the health of you and the babies (this might be to minimize their own risk, but it is still for your health benefit) Also, logically, if the risks are higher with a vaginal birth, isn't it selfish to want one just to experience the beauty of it? Isn't the actual beauty of childbirth the actual child(s)?

- Just a though from a person who can't give birth.

Anonymous said...

I would have to strongly disagree with you Ben. The benefits of allowing a woman to have a trial of labor and attempt a VBAC far outweigh the risks. Doctors force women to have repeat c-sections due to an incredibly small chance of uterine rupture. In the legal community a c-section is seen as "doing everything you could do to save mom and baby". What isn't looked at is the danger inherent in abdominal surgery both for the mother and the baby. Not to mention the innumerable benefits for the health of the baby...pressure from contractions helping their lungs function better after birth, receiving the necessary hormones for optimal functioning after birth, the list goes on and on.

It is far from selfish to want a vaginal delivery; it is wanting the very best for you children.

Angela said...

Ben, thanks for the input. I see what you're saying about differing opinions being a good thing. The reason it was deemed a bad thing in this case is because the doctors who won't agree to a trial of labor will ultimately have all the say since a collaborative decision must be made amongst the seven doctors. In response, I would have to say that I definitely respect doctors' medical knowledge and opinions. However, knowing that VBAC of multiples can be done--and has been done--I cannot settle for a definitive decision against it so early on in pregnancy. Studies have actually shown that success rates of VBACs are the same amongst women having singetons and women having twins, yet some doctors are apparently unwilling to even consider it. I certainly don't have as much medical knowledge as a doctor (in fact, I have next to none!), but I do have a great faith in God's design for childbirth. The process of childbirth truly is a beautiful thing, and though I would agree that the child him/herself is the most beautiful part of it, the actual act of labor and delivery is an amazing thing in itself--something I think only a woman who has experienced it can understand. I have had both a cesarean and a vaginal delivery, and the latter is definitely more preferable. In the case of a cesarean, bonding with baby and recovery of mom (physical and emotional) is much more difficult. There are also many health risks to the mother associated with cesareans. Ultimately, I will choose a cesarean if it is evidently best for my babies. But my fervent prayer in the meantime is that God would "deliver" me (hehe) from having to make that decision. Oh, how I pray for a full-term, healthy pregnancy ending in a safe and healthy natural childbirth!

Ben Robie said...

It sounds to me Angela, that you are a wonderful mother and have thought out your options very carefully and responsibly. I just wanted to through out an opinion from the other sex. :)

@Anonymous: My only argument is this: I know that know matter how much research I do, I know that an OB doctor has been involved in more births than I could ever compete with, and if their studying and their experience says that a VBAC is more dangerous than a C-Section, I will opt with the C-Section. I'm sure they weigh all of the considerations, including all of the ones you mentioned. I also know that there are very strong opinions on both sides of this issue.

Marti said...

Here is a comment from a woman who has had three c-sections all because my children are gargantuan. (Note: I have not had twins but have had a 10.7 baby...my words of advice: BELLY-BUTTER...slather it on in pounds.)

I can't say I completely understand your feeling to want a vag birth. I guess it wasn't something I "desired" necessarily but as a woman I do appreciate your position. I think the thought of giving birth to a 10 pounder was more than I could handle as a 1st time mommy. I think God leads us all differently on how we should bring His babes into the world. (The point is that we want them to get here safely!!!)

Anyway, back to the topic at hand. I've been reading your posts re: c-sections/vag birth and have found myself becoming almost enraged at the spot we're finding our society in.

Our country condones the "rights" of women to "choose" when it comes to ripping babies out of our wombs. Yes, I'm referring to abortion. The thought makes me choke with anger. Hopefully the righteous kind.

However, when it comes time for a family who WANTS their child to decide how he/she will enter the world...everyone but the family seems to have a say. A panel of experts without input from the patient?

Does this seem outlandish to anyone but me? Shouldn't we, as mothers and fathers, get a CHOICE? You and Travis are obviously very intelligent and wise people. Shouldn't docs give credit where credit is due? I fully realize the experience doctors have. I am thankful and usually submissive to the course of treatments they prescribe. But, based on your statements of your health and circumstances it just seems bizarre they aren't immediately granting you a trial of labor.

I say, as long as God is leading you and Travis to fight this battle, go for it and see what The Lord of All Creation will bring about.

Ben Robie said...

I talked with my brother in law last night for a little bit about this because his wife (Laura's sis) is prego and is wanting to try a VBAC as well. He said that even if the doctor or a midwife who is going to perform a VBAC sees one little blip in the labor they will scrap it and go to C-section anyways (which made me feel a little different, and helped me understand the title of your post a little better "At Least Give Me a Chance").

@Marti, that is a good point about the right to choose (how a baby is brought into the world), but the question really comes down to: Who is the most informed/appropriate person to make that choice? Is it the mother or father? My gut would tell me a doctor would be.

...and on a side note: 10 lbs babies!? Do your labors last for 11 months?

Tara said...

I completely agree with Elizabeth. I think you should pursue a different type of care provider for the birth experience you want. I highly recommend finding a qualified midwife or a even a free-standing birth center. Both options could give you exactly what you want. It may just take some effort to find one who is experienced enough to feel comfortable with a multiple birth.

I completely understand the desire for a natural, vaginal birth. It just makes sense to me. I just gave birth to my first baby (girl!) and it was an intervention-free, fabulous experience. Women's bodies were created for giving birth thus are very capable. Everything that is experienced in birth is for a physiological reason, including any pain (I hate that word...pain is not how I would describe what my body was doing). For more info on birth and how to advocate for your desired experience, check out a few of my fave books; Pushed by Jennifer Block, The Thinking Woman's Guide to a Better Birth, Gentle Birth Choices, Natural Birth the Bradley Way, and Immaculate Deception, not necessarily in that order. It's so eye-opening to read what the doctors either don't know or don't tell you. It has made me truly passionate about how pregnancy and birth are seen in the US and it makes me want to change that view. We sometimes have to remind ourselves that, for the majority of women, birth is not an illness or a condition to be treated. It's a natural part of life just like bowel movement! Do we call a doctor everytime we need to poop? No, our bodies know how to do that just like they know how to give birth. The mind becomes separate from the body during childbirth so we don't overthink things.

Another amazing resource are the message boards on mothering.com. They have a forum for everything related to conception, pregnancy, childbirth (all kinds!), parenting, and the like.

I applaud you for not giving up so easily when your initial care provider wanted to deny you what you seem to know is right. Their only medical reason for not allowing VBAC's (of multiples or singletons) is the risk of a ruptured uterus and that risk is SO very small. It's much smaller than the risk of having major abdominal surgery (C section) again. But that's one of those things they don't tell you. If you've had a VBAC prior to this pregnancy, a vaginal birth is a very safe option even if it is a multiple birth. Your body has then proven it's capable of doing what you already know it can. Be on the lookout for care providers who claim they'll allow you a trial of labor only to set a time limit on that trial. This almost always results in a repeat c section.

I wish you the best and I hope you can find someone to help you on your birthing journey. It really is amazing and absolutely worth it. I'm only 8wks postpartum and I'm already looking forward to when I get to do it all over again. :-) Oh, and find a Doula. They are an amazing resource and a great support during labor and birth. At many births they can mean the difference between forced medical intervention and a more natural approach. Check the DONA website to find one in your area.

Angela said...

Marti, I would have to admit that a 10 pound baby would scare me a bit, too! When we were praying and hoping for a VBAC on our second pregnancy, I remember specifically praying that the baby wouldn't be too large--mostly because of the fact that Abel had "failed to descend" (although not likely because of his size--at six days overdue he weighed 7 lbs. 1/2 oz.--but still I had to wonder...) but partly because I was thinking, "The smaller my first vaginally delivered baby, the better!" And God answered that prayer, as Amariah weighed in at a mere 5 lbs. 13 oz.!

You're right about the unfairness and absurdity of women being able to CHOOSE to kill their babies while other women are made to feel they cannot CHOOSE a natural childbirth. I had never thought about this before, but you definitely have a point.

To Ben, Travis and I certainly understand the importance of being responsibly well-informed, and we also understand that there comes a point where you have to trust your doctor's opinion and believe that he is surely seeking your best interest. (Perhaps this cannot be accurately said of all OBs in all situations, but we sure pray that it would be true of ours!) I'll never forget the fateful moment when, after enduring all of labor with no medications and hearing the doctor advise that it was time to go to a c-section instead of to push, I had to turn to my husband and say, "Honey, I guess at this point we just have to put our trust in the doctor." It was probably the hardest thing I've ever had to say; but after nine months of praying for God to cause the right doctor to be on call and for God to give that doctor divine wisdom, I knew I had to humbly heed his advice.

While I want to be informed enough for my input to matter and enough to make wise decisions (Anonymous, thank you, thank you, thank you for your encouraging words and for sharing some medical support in favor of vaginal birth!), I also want to pray that God--the God who formed my body in my mother's womb and who is forming these two children in my womb and who knows all things--would orchestrate every detail of this pregnancy to allow for the safe labor and vaginal delivery of two full-term and healthy babies.

I'm glad you went back to the title, Ben, because that really is the gist of this whole thing. I understand that God may choose to not answer my prayers for a successful VBAC (and if that be the case, may He fill me with much peace!), but I do hope that instead of having to pick a day weeks prior to my due date to have my babies cut from my womb, I will... at least... be given a chance.

Angela said...

Tara, thank you so much for the encouragement and resources. I will definitely look into these things. I, too, have a friend who is a doula (I read your post about your childbirth experience!), and we are thinking we'll employ her services as long as we know we are being granted a trial of labor. If I may ask, what did you feel were the specific benefits of using a doula? You seem to know a lot on this subject of natural childbirth/VBAC vs. repeat cesarean. Thanks for sharing! I agree with everything you said!


Whoa! Did you expect this much response, Angela? :)

I recently viewed "The Business of Being Born" which opened my eyes to the sometimes undeserved trust we put in modern-day OB's. This is NOT a blanket statement.

Consider a modern-day evolutionist scientist. Even though they are highly educated, they are completely wrong about a lot of things. A lot of education does not equal someone who makes right decisions. The education must be from a biblical worldview to be worthwhile.

Ben Robie said...

My only experience with labor is my wife's labor of 58 (literal) hours. In our circumstance, we were asking the doctor to perform a C-section and he would not do it (until it was deemed an emergency, which is finally was), so at least our OB wasn't "for" c-sections.

Just to get some opinions:
1. Does wanting a vaginal birth lead you closer to God, or make you any more righteous?
2. Does having a vaginal birth make you more of a woman?
3. Is pooping really equivalent to child birth?

I really enjoy talking about this, because I am actually learning a lot. Some of the comments have actually changed the way I think about VBACs in general. :)

Jessica Pennings said...

Wow Angela, I can't believe the response on this. I just wanted to encourage you to keep seeking God's will on this, while we need to be informed about all our decisions we have to make (pros and cons) it's important not to let outside sources lead us away from where God is calling obedience. While I never have had a VBAC, God did lay it on my heart during my pregnancy to have a natural childbirth free of drugs, so I understand when it is God calling us to be obedient, I know your heart and I know you are desiring to do what God is calling you to, period!

People didn't understand my choices when I was pregnant and they constantly tried to scare me and pursuade me to do the opposite of what I KNEW God was calling obedience on. People perceived that I was just trying to be a super woman trying to prove something, it was not that at all, and I know that is not your heart.

I encourage you not to give up in finding a doctor that would at least let you try VBAC. Whenever God is calling obedience there will always be something that will try to discourage us from seeing that through. God has laid this on your heart for a reason and so I just want to encourage you to persevere through what might seem like walls to climb.

I honestly believe that God blesses obedience, I know he blessed my obedience and worked out all the situations so I could follow through what he initially laid on my heart (I initially was going for the drugs so only He changed my heart). I know God will bring you across a doctor or he will work out all the situations so your current doctors will at least let you try, and if He doesn't I know he will give you peace to have a C-section. Remain faithful, continue praying and trust that He already has this worked out.

Ben, I'm surprised to see you have so much interest in VBACs, maybe you just like throwing around the word vaginal :). I don't think vaginal delivery has anything to do with bringing you closer to God or being more of a woman, maybe some woman believe that, but I know that's not Angela's heart. I think God lays it on woman's (at least believers) hearts; for my situation it was all a matter of trusting God through this process and I knew without a doubt I was to follow through natural birth to learn to trust Him and that definatly brought me closer to him in a way of trusting that I can trust Him in anything, especially childbirth. For some woman they definatly do try to prove things with going naturally, but for the majority of woman they have made their choices based on their research what they feel is best for them and for the baby and also of course the wisdom of their doctor. And no pooping is not even close to equivalent of child birth unless your pooping a watermelon (literally). :)

Ben Robie said...

@Jessica: Although I do like saying "vaginal", that is not really the point of my endless ranting. Nor is it necessarily about VBAC vs. C-Section. I guess it might be about taking advice from people that are more educated and experienced in a certain area after you prayed for wisdom for those people. This doesn't need to be applied to child birth, but in this case it is. Think of it this way:

Step 1: One prays at the beginning of a process (that does not have specific scripture commanding one way or another) to have God be in control of the situation and to give everyone involved wisdom about what is going on.
Step 2: Meet with an expert on a that particular situation.
Step 3: That expert doesn't tell you want you want to hear, but something that you don't want to do (but not against anything in God's word).
Decision Point: You asked God to provide wisdom to the situation, but you aren't hearing what you think God's plan for you is. Do you trust that God has given the "experts" wisdom, or do you trust that what YOU think God wants for you is correct?
Step 4: You make your decision to continue on your quest to get what you think God's plan for you is and the process starts over.

I know that there are many times in my life that I ask God to provide something for me or my family and He definitely does not follow the plan that I think He would have laid out. Many times, I think, "that could not be His answer because it doesn't match up with mine," and I continue to seek what I think His will for me is. When I look though my filter of what I want into a situation without asking first "Is what I'm hearing now God's answer?", it never ends up as good as it should.

@Melissa: "The education must be from a biblical worldview to be worthwhile." - I don't know that I believe this comment. My education in MIS from UNI was not from the biblical perspective and the knowledge I have about computers does not come from a biblical perspective, but I think it is worthwhile. Just like I also think that education about medicine without any biblical world view is also worthwhile.

I hope this makes sense, and I really do not intend to "stir up a hornets nest", so if I seem like I am overstepping my bounds PLEASE email me (brobie@gmail.com) and I will stop commenting.

Angela said...

Jess, thanks so much for the encouragement to persevere in what I think is right (at this point in the pregnancy, anyway). I know what you mean about people thinking you're just trying to prove by doing it the hard way. I went through that when I was pregnant with Abel (in regards to not using drugs), and I'm somewhat going through it now in regards to my wish to VBAC with twins.

Ben, interesting questions you pose. Here are my personal opinions:

1. Does wanting a vaginal birth lead you closer to God or make you any more righteous? No. But, there is definitely something very spiritual about natural childbirth as God designed it. Or, if this is an obedience issue as Jess spoke of in her comment, then in that case I would say yes--following the desire God has given you would lead you closer to God.

2. Does having a vaginal birth make you more of a women? No. But, speaking for myself and as one who has experienced both a c/s and a vaginal birth, having a vaginal birth gave me the greatest since of fulfillment and accomplishment (especially because my VBAC was "against the odds"). In no way do I think women who choose or are forced into a c/s are less accomplished women than those who deliver vaginally (who wouldn't want a c/s after 58 hours of labor, by the way?!); but to be completely honest, succeeding at the most difficult thing a woman will ever have to do--deliver a baby--is quite empowering. :-) (However, please don't think that my desire for another VBAC stems from any underlying desire to feel "empowered." It doesn't.)

3. Is pooping really equivalent to childbirth? Obviously, if you're talking in terms of pain, NO! But the point of Tara's comment was that childbirth happens just as naturally as pooping does. The body just knows when and how to do it! Childbirth should be viewed not as a medical condition or an illness to be treated (using Tara's words), but as the natural thing that it is.

Ben, as for your most recent comment, I know what you're saying about the decision process. If you read my prior comments, you know that we came to that decision point with our first baby's labor and delivery. It's a hard thing to accept the answer you never wanted to hear. And to be honest, I still sometimes struggle with the decision we made. The consolation is that Abel was born healthy and my OB turned out to be an amazing surgeon. If not for that, perhaps I would never have been able to succeed at VBAC only 16 months later.

Ben Robie said...

@Angela, well said. I hope you know that my comments/questions now are not directed at your post any more, per se, as I am in complete agreement that you should be given the chance, but I find the comments below to be a little dangerous in regards to how we think:

"I think you should pursue a different type of care provider for the birth experience you want. I highly recommend finding a qualified midwife or a even a free-standing birth center. Both options could give you exactly what you want." - How far do we take this mentality?

"A lot of education does not equal someone who makes right decisions. The education must be from a biblical worldview to be worthwhile." - Although I think the first part of this is true, do we through away every discovery/invention/etc that isn't from a biblical worldview?

"We sometimes have to remind ourselves that, for the majority of women, birth is not an illness or a condition to be treated." - In the case of a VBAC, isn't it a "condition" that must be "treated"? At that point you aren't talking about a "normal" childbirth anymore, but one through a uterus that has been "altered". Now, whether that "treatment" means keeping a closer eye on it during a normal labor, or opting for a c-section, that is up to the parents/doctors, but it is still not "natural" anymore. Right?

Elizabeth said...

Ben, your questions and those I've received from others about natural childbirth led me to finally write a post explaining myself. I think it will help answer your questions. Let me know at you think.


Melissa Ulrickson said...

Worldview: The overall perspective from which one sees and interprets the world.

Everything is either truth or untruth. If it is truth (as defined in the Bible), then it is from a biblical worldview. This can even include Ben's MIS degree, how to make a cake, and how God designed babies to come into the world.

"For the wisdom of the world is foolishness in God's sight."

When an "educated" person (often one who views life from an unbiblical worldview) claims that an induction, epidural, or episiotomy is "necessary," we can seek wisdom from the Lord. I am not saying that none of these things should ever occur, but we can trust that our Creator designed our bodies to deliver babies without modern technology!

Angela said...

Ben, I think some people probably take the phrase "natural childbirth" to different extremes; but to me it basically means spontaneously occurring, medication-free labor ending in vaginal delivery of the baby (or babies, in my case!). Agreed, more monitoring is required in the case of a VBAC, and while this may be inconvenient for the laboring mother, I don't think it disqualifies the labor and delivery from being deemed "natural."

You argue that a VBAC is in a sense a "condition to be treated." This is apparently the viewpoint of many doctors, stemming from, I would venture to guess, their training and the tiny percentage of women who have a uterine rupture. The problem with this is that studies and numerous personal testimonies have proven that "treatment" in the form of a knife isn't always necessary--or even in the best interest of the mother and child. As I was doing some research, I came across an article stating that the "ACOG [American College of Obstetrics and Gynecology] recently updated their opinion on VBAC and stated 'VBAC is safer than repeat cesarean.'" Interesting, huh?!

Elizabeth, thank you for sharing your awesome research! What great information!

Melissa, thank you for never failing to have a biblical worldview.

And to all who have contributed to this healthy conversation, THANK YOU!

Ben Robie said...

@Melissa, well said, I don't disagree. But would add that there are probably Christians that stand on both sides of the issue, both looking through "bible glasses".

@Angela, Great Find! Then, I guess everyone can agree now! wOOt!

Jessica Pennings said...

@Ben- You know I was just joking with that comment:)!

Melissa Ulrickson said...

I love being in the Church.

Tara said...

Angela, so sorry it's taken me a bit to respond to your questions re: Doulas.

In my experience, a doula is someone who can reassure you that what you are experiencing is normal and healthy where your partner may not know if it is. The literal translation of the greek word doula is "woman's servant" or what is now seen as "mothering the mother". It's a different kind of support. In my situation, my doula was someone I trusted with my life (my best friend) so she was a great person to advocate for me if I was in a place (like "labor land") where I wasn't able to advocate for myself. I have also found that Doula's are great for keeping the husbandperson/parter/or birth coach feeling comfortable with the whole journey. I think it can be really scary for your other support people when they see you in obvious pain and don't know how to help or what to do (especially as you approach and complete transition) which leaves them frazzled which in turn stresses out the laboring mother. It's an evil cycle if the "coach" isn't comfortable. Also, for me, my nurses had my Doula relay info to me from them since I responded better to her given our 20+ year relationship. If nothing else, a Doula is usually someone who has experienced natural childbirth, and what woman isn't encouraged or made to feel better by the presence of a trusted someone who has been there and done that? I hope this helps you and you continue to feel supported and encouraged as you pursue such a wonderful thing. :-)

Tara said...

I also wanted to respond to Does natural childbirth make you more of a woman?

No, it doesn't for me. My choice to give birth naturally was strictly because, given my research, it was what I deemed safest and most beneficial for my daughter and me. This was not about proving anything to anyone or going against the system for giggles. It was all about what is going to give my baby the best start possible and what I needed to do to accomplish that.

Angela said...

Tara, thanks so much for sharing your thoughts on doulas. I definitely think that is something I want to pursue.

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