Friday, March 16, 2012

Priorities

Today I read the tale of JenniferG - today is the 8th anniversary of her daughter's death. Reading the story of her daughter's, Emily Hope's, birth and death - brought tears to my eyes.

I make no bones about never wanting to have to have experienced a vaginal birth in the first place - I was perfectly okay with idea that I would never know what a contraction would be like, that I would never know if *I could* have a vaginal birth. I had no desire to "see what my body could do". I had my reasons for wanting an elective c-section with my first pregnancy. A whole raft of reasons - but I never really examined what was likely a very primary motivation for lobbying for an elective c-section in the first place - the minimization of the risk of a truly catastrophic outcome for my child.

My number one priority after having worried about whether or not I'd ever get pregnant in the first place (Juno was a vasectomy reversal baby) was that after 9 months of pregnancy, I'd bring home a healthy baby.

I was perfectly okay trading an increased risk of transient tachynpea of the newborn (read short-term respiratory problem, perhaps a couple days in a NICU), an increased risk that my child could be nicked during delivery, an increased risk of infection, an increased risk of a lengthier recovery, an increased risk of placenta problems in a later pregnancy (note: I have always planned on a family size of at least 1 and not more than 2), if it meant that my child that I was already carrying would have a much lower risk of lifetime disability or death. I was terrified during labour and delivery - terrified that things would go sideways, and that my child would pay the ultimate price of a vaginal delivery - particularly, after I had chosen to avoid a vaginal delivery.

I know that birth injuries and death as a result of the normal birth process are exceedingly rare. However, I also know that they happen. I also knew I didn't want my child to be that unlucky 1 in 2,000. I babysat a kid with mild to moderate cerebral palsy when I was a teen - a red-headed smiley boy with two brothers. There was something truly tragic to knowing that he wouldn't have to struggle with his disabilities if only his birth had gone differently. I also have an uncle who is disabled as a result of a traumatic forceps delivery. I'm sure their mothers would have happily traded a four-to-five inch cesarean scar and a slightly longer recovery if it meant that their children would have the same opportunities as their siblings. What mother wouldn't?

What mother wouldn't trade a "normal birth" for a much higher chance of a "normal life"?

6 comments:

  1. NICU stay = higher risk of infections for babies.

    TTN = The NICU will insert an NG tube and IV. Both of these can introduce infections into the baby. Infections can cause severe, permanent injury as well.

    Furthermore there is new research re: allergies in infants who are delivered via c/s

    There are many risks to both vaginal and c/s births. Unfortunately with both we look retrospectively.

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  2. Mrs. W-
    I love your line..."What mother wouldn't trade a 'normal birth' for a much higher chance of a 'normal life?" Baby AND mother can have some really damaging physical and emotional trauma during a "normal" birth, that impacts their lives thereafter. Thanks for writing, I always appreciate your posts.
    -Lauren
    peaceoutofpieces.com

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  3. The first poster is wrong in her description of TTN leading to an NG tube and an IV. I've been a NICU nurse for many years and I am always amazed to see those kinds of comments from folks who have no idea about what we actually do.

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  4. I am particularly interested in this statement: "What mother wouldn't trade a "normal birth" for a much higher chance of a "normal life"?"

    Can you cite the reference that led you to conclude that c-section births have better long-term outcomes than vaginal births?

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  5. Off the top of my head the following study comes to mind:
    A Canadian study (http://www.ncbi.nlm.nih.gov/pubmed/19941705) of almost 40,000 term deliveries, 1994-2002, comparing outcomes of planned cesarean delivery for breech presentation with spontaneous labour with anticipated vaginal delivery (i.e. planned vaginal delivery) at term in pregnancies with a cephalic-presenting singleton. Life-threatening maternal morbidity was similar in each group. Life-threatening neonatal morbidity was decreased in the cesarean group. It concluded that ‘elective pre-labour Caesarean section...at full term decreased the risk of life-threatening neonatal morbidity compared with spontaneous labour with anticipated vaginal delivery.' (Dahlgren et al, 2009)

    A more elaborate and detailed analysis of the relative risks and benefits of vaginal and cesarean birth can be found at www.cesareandebate.blogspot.com and in the book "Choosing Cesearean" by Dr. Magnus Murphy and Pauline McDonough Hull.

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  6. I should also note that I have concluded that c-section is a better option for me, personally (note personal context includes planned fertility of 2 children) and that every woman should discuss her delivery options with her health care provider to determine which method is best for her in her own individual circumstance.

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