What would VBAC activists have done for Jennifer Goodall if her baby had died? Not a damn thing.


Yesterday I wrote about Jennifer Goodall, the Florida woman who wanted to attempt a VBAC after 3 previous C-sections, and the misinformation used by VBAC activists to support her decision.

Not a single organization or article that supported Goodhall had accurate statistics on the real risk that Goodhall faced. Most substituted statistics that applied to women who have had one previous C-section not three. All implied that Goodall was basing her decision on scientific evidence when that was completely false. All implied that the risk of C-section for Goodall and her baby was higher than the risk of attempted VBAC which was also completely false.

Fortunately, Goodall did what she should have done in the first place. She went to a different hospital prepared to handle her (ill advised, unsupported by medical evidence) attempt at vaginal birth. Not surprisingly, she failed in her attempt, confirming the concerns of the original hospital. The patients who face the greatest risk of rupture, death of the baby, hysterectomy and death of the mother are women who are unsuccessful in a VBAC attempt.

Lots of organizations were eager to use Goodall’s situation to advance their organizational agenda. They professed themselves to be deeply concerned for and deeply supportive of Jennifer Goodall. But what would they have done if Goodall’s uterus and ruptured and her baby died? Not a damn thing!

The support of Jennifer Goodall extended only up to the moment until she suffered a complication from attempted VBAC and ceased to be politically useful to them.

Consider the case of the International Cesarean Awareness Network (ICAN), one of the organizations that sponsored a Change.org petition supporting Goodall’s desire to attempt a vaginal birth. The petition was filled with erroneous, inapplicable statistics (including the thoroughly discredited “optimal C-section rate withdrawn by the World Health Organization) and grossly deceptive misrepresentations of the position of obstetric organizations.

ICAN encouraged Goodall, supplied the inaccurate statistics on which she appears to have based her decision and supported her 100%. Considering how they encouraged her to risk her baby’s life and her own life, it’s worth asking what they planned to do to help her if the decision they were encouraging turned out to be deadly.

Here’s ICAN’s disclaimer, indicating just how far they are willing to go in taking responsibility for the medical information and encouragement they offer:

In no event will ICAN be liable to you or anyone else for any decision made or action taken by you or anyone else in reliance upon the information contained on or provided through the website.


… Use of this website is at your own risk… The website is presented by ICAN for the sole purpose of disseminating general health information for public benefit. Always seek the advice of your midwife, physician, nurse or other qualified health care provider before you undergo any treatment or for answers to any questions you may have regarding a medical condition. The website and any information provided on the website are not intended to constitute the practice of or furnishing of medical, nursing, or professional health care advice, diagnosis, consultation or treatment or services in any jurisdiction.

ICAN is on record as being unwilling to stand behind their own information, acknowledges that they are in no position to assess and advise anyone of the specific treatment that is best for them, and emphasizes that only the providers actually caring for a woman are capable of offering her an accurate assessment of the risks she faces and the treatment course that is advisable in her specific cases.

The biggest irony, though, is that by putting a disclaimer on their website, ICAN is doing PRECISELY what it claims to abhor among obstetricians. ICAN is behaving defensively. The most important thing that they want you to know about their website and the information that they offer is that they will not take any responsibility to ensure that it is accurate or to prevent harms that arise from people using it. If your baby dies or you die because you actually believed what ICAN told you, too bad for you for being gullible enough to believe a website that doesn’t even stand behind its own information.

The folks at ICAN have the unmitigated gall to rail against “defensive medicine” when a hospital wants to make sure that neither a mother nor her baby die, while simultaneously practicing defensive medicine by disclaiming their own advice and support.

What would ICAN and other VBAC activists done for Goodall if her baby had died? Less than nothing, pointing to the legal language they’ve draped over their site specifically absolving themselves for ensuring the accuracy of their information, let alone whether their information was applicable to the woman who used it.

So here’s my question for anyone contemplating VBAC against an obstetrician’s advice:

Who is likely to be more concerned with whether you and/or your baby live or die, the obstetrician and hospital who are prepared to take responsibility for the outcome, or the organization and activists that are happy to support you for their own political benefit and equally happy to dump you if you actually trust them?

309 Responses to “What would VBAC activists have done for Jennifer Goodall if her baby had died? Not a damn thing.”

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  8. The Computer Ate My Nym
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    It’s a small study and I don’t think anyone would recommend changing practice based on it, but it’s an intriguing bit of preliminary data. Maybe the rate of c-section is not too high but too low at 30%.

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  11. Who?
    October 29, 2014 at 11:32 pm #

    Totally off topic but let’s all remember how very fortunate we and our families are

    • Samantha06
      October 30, 2014 at 12:08 am #

      How very sad. Yes we are fortunate indeed.

    • realitycheque
      October 30, 2014 at 9:03 am #

      Incredibly sad.

  12. Guest
    October 29, 2014 at 3:08 pm #

    I don’t believe for one millisecond that what the FB poster quoted below is truthful. I have to wonder, don’t these people know that you are married to a lawyer? How incredibly low must one stoop to fabricate reasons to ignore a voice of reason in this NCB debate?
    Amy Bavin Pintus writes on Jennifer’s FB page: When I posted about my own vbac 5 years ago she reposted my blog posts and mocked me. When I sent her emails threatening legal action she responded that she hoped my baby died. She’s awful. Reposting links to her blog and responding to her fuels the fire and makes her money…

    • Karen in SC
      October 29, 2014 at 4:30 pm #

      Too many “she”s…. I’m confused about who emailed who.

      • attitude devant
        October 29, 2014 at 4:45 pm #

        me too. who is ‘the FB poster quoted below’? and quoted by whom?

        • Guest
          October 29, 2014 at 6:52 pm #

          I’m so sorry, my bad.
          I went onto Jennifer’s FB and she had posted Dr. Amy’s article there. Predictably there were several people that agreed with Jennifer Goodall and felt that since it was written by Dr. Amy it was suspect. (paraphrasing)
          Somebody called Amy Bavin Pintus comments on her post, and claims that Dr. Amy had once told her that she, (Dr. Amy) hoped that Amy Bavin Pintus’ baby would die.
          The actual quote is included in my first comment here, but I have not figured out a way to highlight or bold things so as to differentiate between my words and hers. Sorry for the confusion! Hope this helps!

          • Karen in SC
            October 29, 2014 at 6:56 pm #

            okay, I’m sure that Dr. Amy didn’t hope her child would die. It was probably something like Dr. Amy hoped her child wouldn’t pay the price for Pintus’ plans to vbac.

          • Amy Tuteur, MD
            October 29, 2014 at 7:32 pm #

            I have no idea who she is or what she is talking about.

          • Cobalt
            October 31, 2014 at 2:10 pm #

            Here is a past post about VBA3C, with a tragic ending. The comments from 10 months ago are a bit chilling.


    • PrimaryCareDoc
      October 29, 2014 at 9:19 pm #

      Looks like she’s (Jennifer Goodall) anti-vaccination, also. A true winner.

  13. October 29, 2014 at 12:59 pm #

    Hello, This is Jennifer Goodall and I’d like to take a moment to comment on your blog post.
    Good thing I wasn’t asking ANYONE to do anything for me. If my child had died during labor that would be a truly sad event. Although I acknowledge that the risk exists, let me clear when I say that I took the time to educate myself extensively before deciding to undergo a Trial of Labor after 3 cesareans and my risk of uterine rupture (not of my baby dying) was statistically averaged out to be about 2%. Also, let me note that the risk of maternal and neonatal death are increased in mothers who choose to undergo an elective repeat cesarean without prior labor. This risk is reduced if a woman undergoes TOLAC regardless of whether she delivers vaginally or by cesarean in the end.
    “Compared with a vaginal delivery, maternal mortality and especially morbidity is increased with cesarean delivery to approximately twice the rate after a vaginal delivery.[10] The overall maternal mortality rate is 6-22 deaths per 100,000 live births, with approximately one third to one half of maternal deaths after cesarean delivery being directly attributable to the operative procedure itself. Part of this increase in mortality is that associated with a surgical procedure”

    The Evidence in Favor
    “That panel (National Institute of Health) offered convincing arguments in favor of VBAC. For starters, those women who go through labor, whether they succeed in delivering vaginally or end up with a C-section, are at decreased risk of maternal mortality compared to those who have an elective repeat C-section: overall estimates of death for women who undergo labor are 3.8 per 100,000 live births compared to 13.4 per 100,000 live births for elective repeat cesarean. The risk of hysterectomy is similar between the two groups.” – Glenn D. Braunstein, M.D.Chairman of the
    Department of Medicine, Cedars-Sinai (Article “For Healthier Moms and Babies, X-Out Repeat C-Sections”) Found at: http://www.huffingtonpost.com/glenn-d-braunstein-md/c-sections-health-mothers-babies_b_1224087.html

    “Notable differentials in mortality by method of delivery existed with a neonatal mortality rate 20% higher for infants delivered by repeat cesarean compared to infants in VBAC deliveries in the NIR group and 29% higher in the low-risk group.” http://www.medscape.com/viewarticle/717630_3

    Here’s a little more information for you to study:

    A recent meta-analysis of 17 studies including 5,666 patients undergoing a TOL after 2 or more cesarean deliveries demonstrated a 1.36% uterine rupture rate.[71] This is similar to the result of our pooled data analysis from
    10 studies published from 1993-2010, which shows a 1.81% uterine rupture rate for patients with multiple previous cesarean delivery scars.
    So…. Play that “dead baby” card again, won’t you.

    • October 29, 2014 at 1:10 pm #

      And just so we are clear, I failed in my VBAC attempt because the hospital withheld pain management when I arrived in order to create a situation where I wouldn’t be able to withstand the pain and I would give in to a cesarean. I failed because I was never given the evidence based care that all women deserve. In fact, I didn’t fail, the medical industry failed me and my son. I am thankful to all of the women who have stood up and fought along side me. Maybe after seeing the statistical medical research, that I’ve shared with you, you too will be able to offer evidence based care in the medical field.

      • guest
        October 29, 2014 at 1:21 pm #

        Do you have a copy of your medical record? It would be interesting to see the documentation pertaining to your claim that “the hospital withheld pain management in order to create a situation where I wouldn’t be able to withstand the pain and I would give in to a cesarean.”

        • October 29, 2014 at 1:47 pm #

          I’m sure that you won’t believe that, but that is your choice. Regardless of them withholding my pain medication until I gave consent, I was also not given the option of continuing labor when I arrived. I specifically said that I wanted to continue to labor and wanted an epidural, they refused and the nurse informed me that I needed to have the cesarean because there were no doctors that would care for me and that they would not let me continue to labor. I asked the doctor if I could have pain medicine and he said yes, my husband can back this statement up, however I never received it. So, whether it was the nurse’s own personal agenda to not give it to me or the hospital’s that is yet to be determined. I’m sorry but I won’t be releasing medical records via the skeptical OB’s comment section, as I’m sure you wouldn’t do that either. Again, Regardless of the pain medication issue they were not supportive of me having a trial of labor and specifically did everything in their power to be unsupportive of my medical decision. I’m curious how you feel about learning the truth in the statistics that I mentioned above, from reputable medical sources.

          • guest
            October 29, 2014 at 2:10 pm #

            I said it would be interesting to see the documentation pertaining to the hospital withholding pain medication. I did not say I believed it or not. You are assuming that. I agree with Dr. Amy. 2% is a big number, and I think it’s unfortunate that you felt the risk was acceptable. I don’t think anyone can understand the horror of uterine rupture unless you have actually seen it.

          • Anj Fabian
            October 29, 2014 at 2:22 pm #

            I dunno. Jeevan has posted a few stories and one particular image that drive the point home effectively.

          • guest
            October 29, 2014 at 2:24 pm #

            I’m fairly new here, so I haven’t seen them. Do you have a link?

          • Anj Fabian
            October 29, 2014 at 2:56 pm #


            You can search on his site for URs. In one or two of the stories, the babies survived.

          • mythsayer
            October 29, 2014 at 5:04 pm #

            Oh.My.God. I’d heard about the misshapen abdomen after a rupture. But the picture where it’s all lumpy… OMG….

          • Anj Fabian
            October 29, 2014 at 5:07 pm #

            Bandl’s Ring – that’s how I found Jeevan. I was doing an image search. It’s a helluva resource for exploring what can go wrong when women fail to get proper care or delay care.

          • attitude devant
            October 29, 2014 at 2:30 pm #

            I had one rupture where the mom lost her uterus and spent a month in the hospital. Received 100 units of various blood products.

          • guest
            October 29, 2014 at 4:46 pm #

            How horrible. You know, in a way, I wish these “VBAC at all costs” folks could see something like this to shock them out of their fantasy.

          • AllieFoyle
            October 29, 2014 at 3:16 pm #

            I was also denied pain medication during labor with both of my children. It’s regrettable, but many women will not get adequate pain relief when they request it. Your NCB and ICAN friends are doing nothing to rectify this, I assure you.

          • guest
            October 29, 2014 at 4:49 pm #

            That’s a shame. I honestly don’t understand how pain relief can be denied. In the hospital I work in, we have an OB anesthesiologist who does nothing else, available 24 hours in-house, so women rarely wait longer than 5 or 10 minutes for an epidural.

          • perpetual lurker
            October 29, 2014 at 4:32 pm #

            “I’m curious how you feel about learning the truth in the statistics that I mentioned above, from reputable medical sources.”

            I’m sorry, but this really gets to me. Do you really think a forum populated by many medical professionals, including OBs and CNMs who have spent countless hours reviewing the literature, attending grand rounds, M&M conferences, etc., not to mention treating thousands and thousands of patients, is only now “learning the truth” from you because you found medscape on the internetz? Do you not see how arrogant that is?

          • PrimaryCareDoc
            October 29, 2014 at 5:47 pm #

            Seriously. Unbelievable hubris.

          • mythsayer
            October 29, 2014 at 5:00 pm #

            Did anyone here actually say they’d learned anything from you? That’s rather arrogant. You appear to refuse to engage medical professionals (I’m not one… but I do like to read studies) when they provide you with information but you expect them to suddenly yell “Eureka! I finally understand!” when you post some studies. And I’m not convinced you actually understand the stats you posted. You said that TOL LOWERS the risk of a CS later, correct? That’s ridiculous. It’s one thing to say that TOL carries lower maternal mortality than a repeat CS. But you seem to think (correct me if I’m wrong) that the TOL actually decreases the risk to the mother if the CS later occurs. In other words, you seem to think that if the mother had a 3% chance of dying (I’m making this number up as an example) if she went right to the CS, a TOL by itself would lower the risk to 2% (not OF getting a CS, but the risks FROM the CS). How in god’s name would that work?

          • moto_librarian
            October 29, 2014 at 6:19 pm #

            So they sectioned you without anesthesia? Unless that’s what happened, you did get pain relief at some point. It sucks that you had to wait, but that hardly makes you special.

          • October 29, 2014 at 10:22 pm #

            “Regardless of them withholding my pain medication until I gave consent…”

            Ummmmm…..what? Should they have administered pain medicine on the down-low? Sneeaky-style? What the fuck, chuck?

          • The Computer Ate My Nym
            October 31, 2014 at 12:22 pm #

            I asked the doctor if I could have pain medicine and he said yes, my husband can back this statement up,

            So they didn’t deny pain medication, they just didn’t hop to it as quickly as you thought they should. Sorry, princess, but there were other people at the hospital that day who also needed an anesthesiologist.

      • mythsayer
        October 29, 2014 at 4:20 pm #

        I believe they didn’t give you pain meds when you asked. That happened to my cousin and my friend as well. “It’s too early… you need to get past a 3”. And then they both went to a 9 within an hour and had natural births. And THAT is one of the main reasons I didn’t even want to give labor a try. No desire to feel that kind of pain. I do NOT believe, however, that they withheld pain meds because they were trying to force you to have a CS. I just don’t believe that. Sorry.

        • Samantha06
          October 29, 2014 at 11:58 pm #

          I call BS on that too.

      • Sullivan ThePoop
        October 29, 2014 at 8:16 pm #

        You don’t know anything about this subject. You do not even know when a baby is preterm. Why would anyone listen to anything you have to say about this subject? I might as well get advice from my toddler nephews.

      • guest
        October 29, 2014 at 9:53 pm #

        Could you be any more patronizing and ignorant? “And just so we are clear”, you have no idea what evidenced-based care actually is, yet you come here to argue with actual medical professionals with real education and think you’re going to teach us? If that isn’t the height of arrogance, stupidity and narcissism, I don’t know what is. What’s even worse is your absolutely reckless behavior and disregard for not only your own life, but for the life of your child who had no choice in the matter. You truly have no clue what real problems are and have obviously never experienced them. Your ungratefulness practically oozes from your comments. The medical industry didn’t fail you, you turned up your nose at it, had a temper tantrum and stomped your feet to try to get what you wanted, and when that didn’t work, you cried foul. Are you so arrogant that you don’t realize there are women all over the world who would give anything just to deliver in the hospitals you despise? Why didn’t you find a doctor with the same NCB/VBAC beliefs as you? Oh wait.. there aren’t any! Except maybe Aviva Romm, but she isn’t an Obstetrician. She’s a former CPM turned family practitioner. But there’s always Robert Biter, who lost his medical license. And he has that brand new birth center in California! I bet he’d take you in a heartbeat! It’s time to grow up, Jen dear.

        • Young CC Prof
          October 29, 2014 at 10:03 pm #

          You know those people who have no children, but are absolutely certain that parents are doing everything wrong anyway?


      • Trixie
        October 29, 2014 at 9:53 pm #

        You trust nature so much that you demanded a VBA3C over medical objection, but not so much that you could withstand the pain of labor? Pick a side, lady!

        • Who?
          October 29, 2014 at 10:11 pm #

          Yes I didn’t get this either.

          After all, isn’t it surges, not pain, as your cervix sphincter opens? Doesn’t that help you unleash your power?

          Yes, I’m snarking…

          • Trixie
            October 29, 2014 at 11:44 pm #

            It’s weird, she really wanted a VBAC more than I did, and yet I managed to have one, with no pain relief even. It’s almost like…it’s mostly random chance whether a VBAC will happen or not.

        • October 29, 2014 at 10:20 pm #

          That is the most moronic statement we’ve all heard yet. I have every right to deny a cesarean at any point, however I wasn’t going against what the statistical data suggests is a completely acceptable option for most women. Not all obstetricians agree that a woman can’t or shouldn’t have a TOLA3C. There happens to be obstetricians that do respect their patients decisions and work with them to make their birth the best that it can be within those choices that the patient is making. Unfortunately they are far and few between because most seem to be very happy to perform surgery. Maybe it is because they feel they are in control during the surgery, however absolutely untrue that is.

          • Stacy48918
            October 29, 2014 at 10:23 pm #

            “There happens to be obstetricians that do respect their patients
            decisions and work with them to make their birth the best that it can be
            within those choices that the patient is making.”
            And you have every right to go find that doctor. You DON’T have the right to force a doctor to treat you in a way they deem dangerous.

          • guest
            October 29, 2014 at 10:26 pm #

            But she’s *entitled* to have it her way!

          • Who?
            October 29, 2014 at 10:30 pm #

            Why on earth would you not want anyone with your and your child’s life in their hands to feel (and be) in control?

            Would you take your child on a plane with a pilot who was going to take direction from you on how to fly, based on your love of butterflies and little hummingbirds?

          • Stacy48918
            October 29, 2014 at 10:44 pm #

            But…but…she read the airplane manual! And even played some airplane games at the arcade! They HAVE to respect her RIGHTS!

          • Trixie
            October 29, 2014 at 11:38 pm #

            So, you want medicine when you want it, but when medicine tells you something you don’t want to hear, then all of a sudden you’re more educated than all the doctors.
            Maybe more doctors would support a VBA3C for the right candidate. Maybe you weren’t that candidate.

          • Samantha06
            October 29, 2014 at 11:42 pm #

            And by God, she’s going to take legal action to prove she knows better and she has the right to get what she wants! *snark*

          • Samantha06
            October 29, 2014 at 11:40 pm #

            “There happens to be obstetricians that do respect their patients decisions and work with them to make their birth the best that it can be within those choices that the patient is making.”

            That is unless they just happen to not agree with everything you want, right? Interesting you made this statement considering your behavior with the Obstetrician YOU chose. Sounds like back-pedaling to me.

          • AllieFoyle
            October 30, 2014 at 10:16 am #

            Or maybe it is because they have insight into the risks and possible outcomes of your choice and don’t want to participate in or be responsible for a preventable catastrophe.

            Your plan was to labor until there was a medical complication. While perhaps that seems like a reasonable position to you, what do you think a complication is? It’s not a good thing or a neutral thing. It’s something concerning that needs to be addressed, perhaps urgently. Which scenario sounds safer to you: an unhurried pre-labor c-section while the baby is in no distress, or a crash section in which either you, the baby, or both are decompensating, time is of the essence, and the surgeon has to rapidly perform an operation complicated by scarring from three previous c-sections while also dealing with complications that necessitated the surgery?

            You should have the right to refuse a cesarean, however foolhardy that choice may be, but do the medical professionals have the right to refuse to participate in something they consider dangerous, perhaps to the degree that it violates their sense of ethics and professional responsibility? Do you have the right to force others to participate in something that may lead to the preventable death of two people?

            Did they actually force you, or did you consent to the c-section? I’m curious also –you believe that TOLA3C was a reasonable option for you and that there are doctors who are willing to accommodate this request– why not go to one of those doctors?

          • Samantha06
            October 30, 2014 at 12:20 pm #

            If your uterine wall was thin, which would have been a huge possibility after 3 pregnancies and c/sections, it wouldn’t take much for it to tear (rupture) with a few contractions (labor). I can’t imagine any doctor willing to take that risk. You are lucky no one, including the hospital would. That’s the kind of incompetence quacks subject. their unsuspecting patients to with disastrous results. Look at Dr. Robert Biter. He lost his license to practice medicine as a result of several incidents of malpractice. You are actually very fortunate. You and your baby are healthy and unharmed due to the prudent behavior of your doctor and the hospitals involved. You would be wise to realize that, move forward and get on with your life.

      • October 29, 2014 at 10:19 pm #

        Wait, I thought hospitals PUSHED pain management to make women fail. So, which is it?

        • Who?
          October 29, 2014 at 10:48 pm #

          I think reason and logic may have left town a while ago…

    • Amy Tuteur, MD
      October 29, 2014 at 1:38 pm #

      Jennifer, you don’t seem to realize that 2% is a BIG number.

      If only 2% of airline flights crashed that would be 160,000 American crashes per year, completely unacceptable.

      It was your right to put your baby’s life at risk if you wanted to do so, but don’t expect anyone else to be other than appalled by your cavalier attitude to the deadly risk. And healthcare providers have a right to refuse to participate in taking deadly risks.

      • October 29, 2014 at 1:54 pm #

        Could you inform me of the risk of maternal and neonatal death during a repeat 4th cesarean please? Oh, and the risks associated with a preterm infant (because ob’s like to schedule cesareans 2 weeks before the estimated due date often). And how about the other serious life threatening risks involved with undergoing major abdominal surgery? I wasn’t asking for a vaginal birth no matter what. I was choosing to labor until and only until a medical complication arose that required surgery. as a medical doctor you should recognize that ACOG recommends a woman have the right to a trial of labor.

        • guest
          October 29, 2014 at 2:22 pm #

          The problem with laboring “until and only until a medical complication arose that required surgery” is that at that point, it’s usually a crash C/Section when mom and baby are in serious trouble. No hospital wants to fight with a patient who is already adversarial and certainly not in a emergency situation. Be grateful you and your baby are healthy. If you had had your way, the outcome might not have been so pretty.

          • attitude devant
            October 29, 2014 at 2:27 pm #

            Precisely this. It just floors me that she thinks anyone who disagrees with her is simply mistaken as to the level of risk she was insisting on taking.

          • The Bofa, Being of the Sofa
            October 29, 2014 at 3:30 pm #

            I’m not a doctor, and I wouldn’t be able to make any assessment even if I did see her medical records. What I do know is that her doctors are doctors and DO have access to her medical records and are able to make an assessment based on them, and they decided she was not a good candidate for a VBACS at their hospital.

            Of course, her expert opinion is otherwise…

          • attitude devant
            October 29, 2014 at 3:50 pm #

            Let me just say as diplomatically as possible that I’m not terribly impressed with the quality and clarity of her thought processes and decision making. She seems confused about her own position and misinformed on many different issues.

          • The Bofa, Being of the Sofa
            October 29, 2014 at 4:16 pm #

            If you don’t want to say she’s full of shit, I will.

          • guest
            October 29, 2014 at 5:13 pm #

            Denial at it’s finest.. and maybe some Dunning Kruger thrown in?

        • attitude devant
          October 29, 2014 at 2:29 pm #

          No, no OB schedules a repeat c/s before 39 weeks. It’s call the “39-week rule.” Where do you get all your misinformation?

          • October 29, 2014 at 2:56 pm #

            Really? I guess all those mothers who were scheduled before that were lying. And I guess the ob’s that I have met with weren’t telling me to schedule two weeks early. I’m glad that you think this doesn’t happen, but it does and quite often. My 3rd child was a rcs, I wasn’t given the option to have a TOLAC, and the doctor tried to schedule it at 38 weeks. I pushed him to make it 38 wks and 4 days. 😉 So yes, OB’s DO schedule before the 39th week.

          • The Bofa, Being of the Sofa
            October 29, 2014 at 3:04 pm #

            If timeliness is important, it’s possible they could schedule an RCS early. What was so important for waiting in your case? Why did the doctor think it was important to do it so early?

            And I will tell you, you are not going to get too far around here telling an OB how OBs practice.

          • Sullivan ThePoop
            October 29, 2014 at 8:15 pm #

            My SIL had a C-section at 38 weeks 2 days. It was not her scheduled time, but she went into labor.

          • The Bofa, Being of the Sofa
            October 29, 2014 at 9:24 pm #

            If we are talking that, my older son was born by c-section at just over 37 weeks, too. Her water broke during the night.

            I assumed she was talking about scheduled c-sections at 38 weeks, because I couldn’t imagine anyone being so stupid as to be complaining about c-sections at 38 weeks for someone in labor where c-section is indicated (like breech)

          • AllieFoyle
            October 29, 2014 at 3:30 pm #

            From one of the websites that you linked above:

            One study indicated that despite clinical pressure to delay delivery until 39 weeks’ gestation, waiting to reach this benchmark before performing a repeat cesarean delivery may increase maternal risk. According to the study, optimal time of delivery is 38 weeks for women with 2 previous cesarean deliveries and 37 weeks for those with 3 or more.[87]

            The investigation involved 6435 women who had delivered a singleton weighing more than 500 g at a gestational age of at least 20 weeks. All women had undergone at least 2 previous low transverse cesarean deliveries and had plans for a repeat procedure; all delivered at 37 weeks or later. For women with 2 previous cesarean deliveries, the risk for adverse maternal outcomes was 3.3 per 1000 women undelivered. As gestational age at delivery increased, so did this risk, which approached 15.0 per 1000 for delivery at 39 weeks. For women with 3 or more previous cesarean deliveries, the risk for adverse maternal outcome rose from less than 5.0 per 1000 deliveries at week 37 to 30.0 at week 39 and to 50.0 at week 40.[87]


          • moto_librarian
            October 29, 2014 at 6:17 pm #

            37 weeks is term. And here’s a news flash for you: vaginally birthed babies can also have TTN, which is the primary issue with c-sections prior to 39 weeks. How do I know this? My eldest son, delivered completely naturally (not even a whiff of pitocin) had it because I went into labor after SROM at 38 + 3.

          • October 29, 2014 at 10:17 pm #

            It’s true. Vag babies often get the TTN. Happens all the time.

          • Who?
            October 29, 2014 at 10:54 pm #

            You’re prolly imagining that. Or maybe their mums and dads and extended families didn’t believe hard enough in the good things that vaginal birth brings.

            In case it isn’t obvious: Snark

          • Who?
            October 29, 2014 at 11:07 pm #

            As someone who spends a lot of time patiently explaining the apparently obvious to the determinedly oblivious, I feel for your doctor. I reckon he knew you’d want to ‘negotiate’, and would want to feel you had won. So he (who would normally have gone 39 weeks) told you 38 and graciously let you ‘push’ him to 38 and 4 days. If he’d said 39, you still would have wanted longer, which would have been more risky.

            Sometimes doing it right requires behaviour of which, as a respectful person, it is hard to feel proud. But we do get it done.

        • The Bofa, Being of the Sofa
          October 29, 2014 at 3:07 pm #

          And we also know as per the ACOG that a safe TOLAC requires certain capabilities that are not available at all hospitals, and that if a hospital does a TOLAC without having those safety capabilities, they are liable for the outcome. That is why they offered to let you do a TOLAC at a hospital that is properly equipped.

          Of course, you conveniently ignored that part of the ACOG recommendations, didn’t you?

        • mythsayer
          October 29, 2014 at 4:16 pm #

          Exactly WHAT do you think the risks of CS are? Where are you getting your information?

          “Overall rates of maternal harms were low for both TOL and ERCD. While
          rare for both TOL and ERCD, maternal mortality was significantly
          increased for ERCD at 13.4 per 100,000 versus 3.8 per 100,000 for TOL.
          The rates of maternal hysterectomy, hemorrhage, and transfusions did not
          differ significantly between TOL and ERCD. The rate of uterine rupture
          for all women with prior cesarean is 3 per 1,000 and the risk was
          significantly increased with TOL (4.7/1,000 versus 0.3/1,000 ERCD). Six
          percent of uterine ruptures were associated with perinatal death…
          Perinatal mortality was significantly increased for TOL at 1.3 per 1,000
          versus 0.5 per 1,000 for ERCD”

          So the baby has a much higher risk in this study. MUCH higher. The study found that maternal mortality was higher for the elective repeat CS; however, we don’t know what shape those women in… they may not have been in good enough health or condition to even do a TOL and any health issues may have contributed to the maternal mortality.

          So at least one study (which Dr. Amy DID NOT write… she just looked at the numbers) showed increase risk to the baby for TOL and increase risk for the mother for repeat CS. So… under that theory, you were putting the baby more at risk with a TOL. And since uterine ruptures are much more likely during TOL and they can lead to hysterectomies, that’s going to have a higher risk for TOL, too.


        • guest
          October 29, 2014 at 5:11 pm #

          “Oh and the risks associated with a preterm infant (because ob’s like to schedule cesareans 2 weeks before the estimated due date often)”.

          Preterm is less than 37 weeks. Anything over 37 weeks is considered term.

        • Sullivan ThePoop
          October 29, 2014 at 8:13 pm #

          Wow! How ignorant of this subject can you be? 38 weeks is not preterm.

          • Stephanie Lastra
            October 30, 2014 at 10:26 pm #

            which is why March for Dimes is having the 40 weeks pregnancy campaigns? Not every baby is ready to be born at 38 weeks. My third was 41 weeks and 1day, she wouldn’t have been ready at 38 weeks.

          • Young CC Prof
            October 30, 2014 at 10:50 pm #

            How do you know she wouldn’t have been ready at 38 weeks?

          • Samantha06
            October 30, 2014 at 10:50 pm #

            I was thinking the same thing.

          • DaisyGrrl
            October 30, 2014 at 11:32 pm #

            I thought the March of Dimes had glommed on to ending premature birth since eradicating polio is pretty much mission accomplished, and polio survivors are dying of old age. Hence, new mandate in order to keep themselves employed.

            As for the 40 weeks campaign, all they’re doing there is going for the low-hanging fruit. It’s much easier to convince policy makers to shift the approved date for elective deliveries than it is to research causes and develop preventive measures for extreme prematurity (you know, the kind that actually kills babies?).

          • Sullivan ThePoop
            October 31, 2014 at 8:51 am #

            Just because you were not ready 38 weeks doesn’t mean your baby wasn’t. Also, that 39 week rule is killing babies.

        • October 29, 2014 at 10:16 pm #

          37.0 – 41. 0 = Term
          35.0 – 36.6 = Late Pre-Term/Near-Term
          28.0 – 34.6 = Premature
          <27 = Severely premature/Micro preemie


          • October 29, 2014 at 10:23 pm #

            Yes and if your child is taken 2 weeks before the “estimated due date” and you are actually 1 to 2 weeks earlier than your baby would be considered Pre-term.

          • October 29, 2014 at 10:24 pm #

            You’re cra.

          • Who?
            October 29, 2014 at 10:27 pm #

            Your point?

          • Stacy48918
            October 29, 2014 at 10:29 pm #

            Standard of care includes a first trimester ultrasound, which is highly accurate for dating. Certainly never off by 2 weeks. But with all your education, you knew that, right? And you had a first trimester ultrasound, right? So your argument doesn’t even apply to you.

          • Stacy48918
            October 29, 2014 at 10:41 pm #

            And the danger at 36 weeks as compared to term/post-dates uterine rupture in TOLAC? Not even close. A 36 weeker *might* need a little NICU time to coordinate temperature, breathing and eating but is almost guaranteed to be A-OK. The uterine rupture? Well my friend and her husband are shopping for therapists and wheel-chairs for their baby girl. At least mom and baby are alive. If she’d been outside of the hospital “trusting her body to birth her baby”, they’d almost certainly both be dead. The baby definitely would be.

          • October 29, 2014 at 11:22 pm #

            According to NRP, which I teach, dates are accurate 3-5 days when evaluated in the first trimester by an OB.

          • Amazed
            October 30, 2014 at 3:09 pm #

            Errr… Jen? You have come to the wrong site. It isn’t ICAN here. We actually do know that you’re talking nonsense, so you can just stop. You aren’t fooling anyone.

        • Stephanie Lastra
          October 30, 2014 at 10:23 pm #

          but getting surgery only when its needed makes too much sense

          • Samantha06
            October 30, 2014 at 10:53 pm #

            And Jennifer needed a repeat C/Section. Period.

          • The Bofa, Being of the Sofa
            October 31, 2014 at 9:11 am #

            How was surgery not needed in her case?

        • October 30, 2014 at 11:08 pm #

          “I was choosing to labor until and only until a medical complication arose that required surgery.”

          So, labor until there’s an emergency?
          Egads! (Shakes head in disbelief…)

          These are not the words of a rational person.

          • Samantha06
            October 30, 2014 at 11:11 pm #

            I bet she has a paper-thin uterus too… *shudder*

          • Bombshellrisa
            October 30, 2014 at 11:11 pm #

            And certainly not someone who has seen what a “medical emergency” translates to when it comes to a baby.

          • The Bofa, Being of the Sofa
            October 31, 2014 at 9:11 am #

            I think people don’t know what the word “emergency” means.

            In our house, we talk a lot about potty emergencies. Like, when our child tells us he needs to go potty, depending on the circumstances, we will ask, “Is it an emergency?” If they answer yes, we know that we need to run to the bathroom as soon as we can. And even then, we sometimes don’t make it. THAT’S an emergency. When seconds count, and even then, it’s not enough.

            That’s why we teach our kids to go potty before it’s an emergency (plug here for Nina Needs to Go on Disney Jr – GREAT little show, and funnier than hell). The goal is to go potty BEFORE it is an emergency, because if you wait until an emergency, it’s often too late.

            There’s a good lesson there.

          • October 31, 2014 at 12:44 pm #

            That, my friend, is an excellent analogy. Well done.

          • The Bofa, Being of the Sofa
            October 31, 2014 at 1:07 pm #

            Yeah, thinking about it, the lesson is, we don’t even like to have POTTY emergencies, much less emergencies that are a matter of life and death.

          • October 31, 2014 at 1:31 pm #

            Exactly! A uterus will rupture “just a little bit” like a toddler will potty in their pants “just a little bit.”

          • Samantha06
            October 31, 2014 at 3:10 pm #

            Kind of like being “a little bit pregnant.”

      • October 29, 2014 at 2:52 pm #

        And also… could you tell everyone here what the risk of down syndrome is. That’s right, it’s a similar figure. Are you telling me that the risk is just too high for me that with those numbers I’m very likely to have a child with down syndrome? I don’t think so hun. (Not that there’s anything wrong with that, in fact, I forwent my screening because I personally did not care if my child had a birth defect, I would love him just as much as I do now.)

        • attitude devant
          October 29, 2014 at 2:53 pm #

          You’re comparing apples and hot tubs. Having a baby with Down Syndrome could not be more dissimilar to the catastrophic risks associated with failed TOLACs

          • Cobalt
            October 29, 2014 at 3:53 pm #

            There is a risk assessment connection: screening for birth defects allows you to possibly pursue prenatal treatment/monitoring (depending on the particular issue) and definitely allows you to choose a birthing hospital that is equipped to handle a newborn with that particular defect. Sometimes you know ahead of time you’re likely to need that high level NICU.

        • AllieFoyle
          October 29, 2014 at 3:11 pm #

          If it were actually possible for you to increase his chances of acquiring Down Syndrome by choosing a particular option, then yes, I think a lot of people would question that choice. Of course, that’s not the case. TOLA3C, on the other hand, did increase your son’s chances of death or disability.

          • October 29, 2014 at 3:50 pm #

            Did it? Please share the link with your data.

          • mythsayer
            October 29, 2014 at 4:00 pm #

            I thought you were educated about TOLAC/VBAC? If so, you should know what the risks to him were. Or did you ignore those and just pick the articles you liked?

          • Trixie
            October 29, 2014 at 9:49 pm #

            Everything she knows, she learned from an ICAN meme.

          • AllieFoyle
            October 29, 2014 at 4:09 pm #

            From medscape again:

            One of the most significant risks women face when considering a trial of labor is that of uterine rupture. This potentially fatal event may have significant maternal and neonatal sequelae.

            . . .

            Patients with more than 1 prior cesarean delivery are at increased risk of uterine rupture. The unadjusted rate of uterine rupture for patients with 2 prior uterine incisions ranges from 1.8% to 3.7%.

            One analysis demonstrated that when potential confounding variables (eg, prior vaginal delivery) are controlled for, patients who have had 2 prior cesarean deliveries have 5 times the risk of uterine rupture compared with patients who have had only 1 prior cesarean delivery. This finding contradicted several earlier studies that did not control for confounding factors, most importantly prior vaginal delivery.


        • The Bofa, Being of the Sofa
          October 29, 2014 at 3:25 pm #

          I don’t get it. My wife was AMA with both our kids, and in both cases, we worried significantly about the potential for DS.

          If there were anything we could have done to reduce the chances of our kids having DS, we would have absolutely done it.

          So I don’t understand how choosing to face a risk comparable that for DS is an argument at all.

          • October 29, 2014 at 3:35 pm #

            The Bofa: I’m sorry to hear that you and your wife were filled with worry about DS during her pregnancies. I was not and I personally did not want to spend my pregnancy worrying about whether my child would or would not have a neural tube defect or DS, because when he was born he would be my son and I would love and care for him regardless. There is nothing that you can do to prevent DS once you are pregnant, other than taking folate to help prevent neural tube defects you just have to let go and let God.

          • The Bofa, Being of the Sofa
            October 29, 2014 at 3:44 pm #

            There is nothing that you can do to prevent DS once you are pregnant, other than taking folate to help prevent neural tube defects you just have to let go and let God.

            Yeah. But what does that have to do with a rupture during a VBACS, which is absolutely something avoidable (by not having a VBACS) or made safer by doing it in a properly equipped hospital?

            Having a baby die due to rupture during a VBACS at a hospital that is not properly equipped to handle it is not a matter of fate. It is a completely avoidable situation.

            What other risks do you casually dismiss? Do you use carseats? If so, why? The chance of your child dying in a car accident in the first 18 years of his/her life is smaller than that 2% that you don’t think matters, so why bother with carseats?

          • October 29, 2014 at 3:50 pm #

            Hence the reason I wanted to labor at Bayfront, they are a Level II NICU and fully capable of handling anything. Unfortunately they didn’t feel they were capable of handling a trial of labor.

          • The Bofa, Being of the Sofa
            October 29, 2014 at 4:01 pm #

            Unfortunately they didn’t feel they were capable of handling a trial of labor.

            And you disagree?

            Is a Level II NICU adequate for a safe TOL? No, it’s not.

          • October 29, 2014 at 9:14 pm #

            A Level II NICU is certainly not capable of handling anything. Gimme a break.

          • Stacy48918
            October 29, 2014 at 10:35 pm #

            A Level II NICU wasn’t capable of handling my friend’s TOLAC VBAC rupture. Shipped her nearly brain-dead baby via helicopter to the closest Level III. Oops. Guess you should go educate them so next time they can “handle anything”.

          • mythsayer
            October 29, 2014 at 3:58 pm #

            Was about to agree… risk of DS, which you can do nothing about (to change anyway) is not at all the same as a fully preventable risk.

          • October 29, 2014 at 3:49 pm #

            My point was simply that the obstetricians don’t constantly mention how your baby could have DS and use fear tactics to force you into aborting your baby because your baby could have DS… (Maybe not the best example, but they carry a similar risk and during my pregnancies DS was NEVER even brought up, certainly not the statistic regarding how often or not it happens)

          • AllieFoyle
            October 29, 2014 at 3:51 pm #

            Yeah, maybe not the best example…

          • Roadstergal
            October 29, 2014 at 3:53 pm #

            No, but they do give you positive advice of what you can do to reduce the possibility of the various birth defects your baby might have (not smoking, eating a healthy diet including folate, etc). The goal of the doctors is the healthiest mom/baby dyad possible. It really isn’t to have a fully preventable bloody ruptured mess on their hands that they aren’t equipped to handle, so they do kinda try to encourage moms to avoid that sort of thing.

          • The Bofa, Being of the Sofa
            October 29, 2014 at 3:54 pm #

            We absolutely did screening for DS during the pregnancy because we were at high risk.

            If you really are in a group with a 2% risk of DS, you aren’t offered screening? I don’t believe that.

          • October 29, 2014 at 10:28 pm #

            You are absolutely offered screening, however you do not have to have it performed. It is your choice, just as is any other medical procedure. This is all about whether a woman remains to have her rights during pregnancy. The skeptical ob clearly said that it is my choice… but that’s just it, I didn’t have that right. I was hit with a hospital seeking judicial authority over me to specifically take away my right to choose. That is what this is about. Not whether you or anyone agrees with me, even though I have provided evidence in support of my argument and none of you have offered any statistical information from reputable sources suggesting otherwise. The issue is that every woman has the right to refuse medical intervention and procedure at any time for any reason, whether the doctor agrees or not. I would have loved to work with my practitioner to have a trial of labor in the hospital where there was access to medical intervention had it become necessary to need it, but they literally would not allow that choice, which is a violation of my Rights and against the Law.

          • Stacy48918
            October 29, 2014 at 10:32 pm #


            Just because it’s “your choice” doesn’t mean they have to stand by and help you do something they find dangerous. You have pre-warning to go find another doctor. You weren’t abandoned in labor. YOU filed to try and FORCE THEM to treat you.

          • guest
            October 29, 2014 at 10:50 pm #

            I’m sure she’ll be getting a “divorce letter” from her current physician once she’s been medically cleared at her 6 week check-up.

          • Stephanie Lastra
            October 30, 2014 at 10:20 pm #

            vaginal birth is the physiological end of a normal pregnancy, by hospitals refusing to “attend” vaginal birth they are forcing women to 1.) get surgery 2.) be alone at home…not very realistic choices for most women who simply want to try to allow their bodies to give birth while having access to medical help IF they needed it, a very reasonable desire.

          • Karen in SC
            October 30, 2014 at 11:07 pm #

            That’s a nice dream, but doing so doesn’t exempt the doctor or hospital from a lawsuit if something goes wrong.

            In a normal car ride, everyone arrives in good health. Seatbelts were unnecessary. Would you be happy to let your child ride with another parent whose decided to let each child decide whether or not to buckle up? After all, risk is quite low, probably many magnitudes lower than the risk of a uterine rupture in a tolac. Would you accept fate if your child was killed or injured or would you sue the driver?

          • October 30, 2014 at 11:28 pm #

            Stephanie, grammar rules. Please capitalize your sentences, and use proper punctuation. You’re making our eyes bleed.

          • Samantha06
            October 30, 2014 at 11:36 pm #

            “by hospitals refusing to “attend” vaginal birth they are forcing women to 1.) get surgery 2.) be alone at home”

            What??? Hospitals refusing to “attend” vaginal birth? Your statement makes absolutely no sense at all. Please explain.

          • Samantha06
            October 31, 2014 at 12:41 am #

            Perhaps you didn’t comprehend what Stacy said. Of course it’s reasonable for a woman to want to give birth with access to medical help, but it works both ways. You do NOT have the right to demand a doctor participate in a choice they deem unsafe or to provide medical care they know is unsafe just because you demand it under the guise of “choice”. That would be malpractice and you know you would sue in a heartbeat if there was a bad outcome. Everything you are bringing up has already been addressed numerous times with Jennifer by other posters. If you have any other questions, please read through the comments.

          • Samantha06
            October 31, 2014 at 12:50 am #

            Oops! Meant to reply this to Stephanie.. sorry for the double post..

          • Samantha06
            October 31, 2014 at 12:51 am #

            Perhaps you didn’t comprehend what Stacy said. Of course it’s reasonable for a woman to want to give birth with access to medical help, but it works both ways. You do NOT have the right to demand a doctor participate in a choice they deem unsafe or to provide medical care they know is unsafe just because you demand it under the guise of “choice”. That would be malpractice and you know you would sue in a heartbeat if there was a bad outcome. Everything you are bringing up has already been addressed numerous times with Jennifer by other posters. If you have any other questions, please read through the comments.

          • October 31, 2014 at 1:04 am #

            You know what else is the physiological end of a normal pregnancy? Death.

            A TOL ending in a crash CS is a very bad thing all around. Hospitals don’t like doing that for obvious reasons. So if doctors can see ahead of time that a TOL just isn’t going to work, why should they support a choice that is likely to lead to a desperate emergency situation? Why would you ever want to force a doctor to sit helplessly by as a woman labors futilely, putting her life and her baby’s life at risk, when the doctor know ze can save them both if ze just acts now but it is unethical to force action so ze is forced to wait? Do you want to give a doctor PTSD?

          • The Bofa, Being of the Sofa
            October 31, 2014 at 9:03 am #

            vaginal birth is the physiological end of a normal pregnancy

            Then again, what does this have to do with a pregnancy after 3 c-sections?

            That is no longer a “normal” pregnancy because there are structural issues with the uterine wall.

            So even if we buy the nonsense about “physiological end of a normal pregnancy”, it has no bearing to the current discussion.

          • The Computer Ate My Nym
            October 31, 2014 at 12:10 pm #

            If you’re not going to accept the help that the hospital has to offer, you might as well be home. What advantage is there to being in the hospital if you trust their judgement so little that when they tell you “this course will almost certainly end in disaster–we strongly advise against it” you blow them off? The hospital can’t force a c-section on someone and NEVER SOUGHT TO. If Goodall was in the hospital and continued in her refusal for a c-section, all the hospital personnel could do would be watch her and her baby die.

          • Who?
            October 29, 2014 at 10:36 pm #

            When would it be necessary? When you said so?

            Doctors aren’t your servants-if you don’t want their services, labour at home. You want someone pick up after your mess-and no doubt get sued if your dream doesn’t come true. You’re okay, your baby is okay, and you are still complaining.

            We’ve heard a lot about your Rights-let’s have a line or two about your RESPONSIBILITIES. Look it up, you’ll find it a revelation.

          • PrimaryCareDoc
            October 30, 2014 at 4:48 pm #

            Exactly. Jennifer, your rights don’t trump mine. Do whatever the hell you want with your body, but don’t make me attend you.

          • guest
            October 29, 2014 at 10:48 pm #

            Who? is absolutely right. Why didn’t you just plan a home birth? Because you wanted it both ways. You wanted it YOUR WAY, with the trusty doctor/hospital safety net ready to save you “just in case.” so you could avoid any responsibility, the height of immaturity. Now that everyone knows your story, good luck actually finding a doctor who will touch you with a ten-foot pole.

          • Samantha06
            October 30, 2014 at 12:12 am #

            Read Who?’s link above. Those poor souls actually have *real* problems, not of their own making. Which is more than I can say for you.

          • Trixie
            October 30, 2014 at 10:02 am #

            Did the hospital go to the judge? I thought you went to the judge.

          • Stacy48918
            October 30, 2014 at 10:35 am #

            As I understand the filing links posted before, the hospital sent her a letter declining her care. Then she and her lawyer filed to force the hospital to treat her.

          • Linden
            October 31, 2014 at 7:53 am #

            What a spectacular sense of entitlement.

          • mythsayer
            October 30, 2014 at 1:42 pm #

            She went. Not the hospital.

          • mythsayer
            October 30, 2014 at 1:42 pm #

            NO! They advised you that if you were going to deliver with them, they wouldn’t allow a TOL, but that you were allowed to go to another provider. And I asked you a question that you never answered. What did you doctors say during your pregnancy that made you think they’d go along with a TOL? Because I seriously doubt (it could happen, but I doubt it happened this suddenly) that the hospital up and changed its mind two weeks before your due date. Your doctors must have been telling you they didn’t want a TOL. Maybe they didn’t say it strongly enough and you were able to ignore their meaning, and then maybe they decided to talk to the administration and legal departments and the letter you got was the result. But if you’d answer my question, we would know what they told you. Because if they told you they weren’t cool with you doing a TOL and you never said “but we’re still trying, right? RIGHT?” then it’s on you that you stayed with them as long as you did.

            Point me to any place your doctors and the hospital filed legal proceedings to force you into a CS? Looks to me like you’re the plaintiff in that lawsuit. YOU tried to force THEM into doing a procedure they weren’t comfortable with. And I fully believe that if something had gone wrong because of TOL, you’d have sued. I fully believe that. And that’s what they were trying to avoid. It was your choice to find another provider. You should have been looking earlier. I’ll be slightly more on your side if they said they’d let you try and then pulled the rug out from under you. But somehow I doubt that’s exactly how it went.

          • mythsayer
            October 30, 2014 at 1:45 pm #

            And I absolutely agree with everyone else. If you were dead set on a TOL, why didn’t you just stay home? Is it because you wanted doctors and hospital services “just in case”? Well… that’s why they didn’t want to do a TOL. For that same “just in case” reason. I am not as harsh as some other people… I don’t think you necessarily thought you’d have a vaginal birth. I don’t think you “trusted your body”… I could be wrong. But the fact is that you wanted to ignore some serious risks. REAL risks. And the doctors didn’t want to. As someone else said, they aren’t your servants. You can’t force them to accept risks they aren’t comfortable with.

          • MaineJen
            October 30, 2014 at 4:47 pm #

            You absolutely had a choice and a right to try to find a provider who would do what you wanted. The fact that NONE of the providers you tried were willing to attend your TOL…shouldn’t that tell you that you might just not be a good candidate for TOL?

          • KarenJJ
            October 30, 2014 at 2:08 am #

            WTH? Nobody dies if a baby is born with Down’s syndrome.

          • October 30, 2014 at 3:28 am #

            Well, you had said you didn’t care, so why bring it up? Presumably your refusal to get the screening took care of that. Besides, not all Downs babies are aborted, and OBs don’t push one way or the other even if they do get bad news from a genetic screening.

            Downs also doesn’t usually kill. A uterine rupture does. There’s a teensy difference in outcomes there …

          • Young CC Prof
            October 30, 2014 at 8:23 am #

            Oh, some babies and children do die of Down’s syndrome, if there is serious organ involvement.

          • The Bofa, Being of the Sofa
            October 30, 2014 at 8:24 am #

            OTOH, knowing a baby has Downs before he/she is born means that parents can take appropriate precautions for the risk involved, and can have their baby in a place that is better equipped to handle it.

          • Liz Leyden
            October 30, 2014 at 3:56 pm #

            Down’s Syndrome often includes cardiac problems. When my daughter’s congenital heart defect was discovered, one of the first questions the cardiologist asked was whether I’d any genetic screening.

          • Stephanie Lastra
            October 30, 2014 at 10:16 pm #

            wow people, she is comparing the 2% likelihood, not saying uterine rupture and DS are the same…

          • October 31, 2014 at 1:29 am #

            But 2% chance of things with different outcomes means different risk assessment. A 2% chance of a bad thing is, well, bad, but a 2% chance of a catastrophic thing should be avoided much more strongly. Comparing apples and doorframes isn’t meaningful, so why bring it up at all?

          • Cobalt
            October 31, 2014 at 9:46 am #

            That 2% figure for Downs Syndrome risk is way off. The baseline risk for all pregnancies is 0.14%. The age adjusted risk at age 30 is 0.1%. Downs risk doesn’t approach 2% until after age 40. In the absence of screening, which she proudly declined, her estimate of risk is very poor.

          • The Computer Ate My Nym
            October 31, 2014 at 10:54 am #

            If you had a quad screen that suggested that the risk of this specific baby having DS was 1 in 50, your OB had better mention it and mention it more than once! The average risk of DS in a healthy younger woman with no history of DS births is, as has already been pointed out, MUCH lower than 1 in 50. Nonetheless, noninvasive screening should be offered to any woman though the specific tests should be tailored to her risk and her preferences. As, it seems, your OB did for you: you stated that you didn’t want to know and didn’t care about your potential baby’s health and your OB didn’t continue to push in the absence of strong clinical reasons to push further. What should this tell you about the fact that they DID push hard on the c-section issue? Perhaps that they did feel that there was a serious clinical risk there?

          • moto_librarian
            October 29, 2014 at 6:14 pm #

            And yet you weren’t to trust god enough to have an unassisted HBAC…wonder why.

          • Stacy48918
            October 29, 2014 at 6:50 pm #

            They never really do. She believes in the inherent strength and power of her own body to vaginally birth a baby, despite 3 prior failures….so that’s why she wants OBs and a hospital and a surgery suite and blood products.


          • guest
            October 29, 2014 at 6:54 pm #

            Classic hypocrisy for sure. We used to call it Burger King medicine in the ER, “have it your way”.. but then they blame us when their choices have negative consequences that we can’t just “fix”.

          • fiftyfifty1
            October 29, 2014 at 7:33 pm #

            What do you mean “can’t just fix”? Call a code! That brings people back from the dead, doesn’t it? I saw it once on Grey’s Anatomy.

          • guest
            October 29, 2014 at 7:40 pm #

            I know, you’d think us stupid medical folks would learn! And Grey’s Anatomy’s codes are so realistic too!

          • Stacy48918
            October 29, 2014 at 10:50 pm #

            I feel for you. In my line of work if a breeder didn’t approve my recommendation for a C-section, I’m allowed to say “Well then you’re free to take your bitch elsewhere.”

            Totally works at my job. ;-P

            Sorry you human doctor types can’t use the line from time to time.

          • guest
            October 29, 2014 at 10:54 pm #

            Love it! Damn, I knew I should have been a vet!!

          • Trixie
            October 30, 2014 at 9:59 am #


          • Who?
            October 29, 2014 at 9:08 pm #

            So you think that Bofa and Mrs Bofa were selfishly worried? That they would have trouble loving the child and might resent caring for him?

            Perhaps they were worried about the pain and suffering the child would experience, the surgeries, the interventions, drugs etc that go with DS, as most loving and caring parents would be.

            Or is caring about how another person might feel or what they might experience just a little too much of a stretch? Your self-involvement is just giddying…

          • The Bofa, Being of the Sofa
            October 29, 2014 at 9:20 pm #

            How about the fact that we were worried whether we would have all the necessary resources to raise a child with DS? Would we be able to give the child everything needed to succeed as much as possible?

            That’s why we did the screening, to determine whether we should start seeking out more resources to prepare ourselves for what was ahead.

            Not only would we not have trouble loving the child, we would love them so much that we wanted to be as prepared as possible to help them.

          • Who?
            October 29, 2014 at 9:44 pm #

            Yep I didn’t even get as far as those practical issues.

            So many people assume screening is for deciding whether or not to terminate-whichi it can be-but to help parents and medical attendants plan to give the baby the best possible start, with help on hand as required.

          • Young CC Prof
            October 29, 2014 at 10:03 pm #

            Prenatal diagnosis may well have saved my cousin’s son. He was born with a very serious heart defect. Without that ultrasound, he’d have been born in a small-town hospital, 30 miles from the nearest Level 3 NICU. He might have died before ever being diagnosed, or suffered badly from oxygen deprivation.

            Instead, his mother found the best neonatal heart surgery center in the region, met with a surgeon in advance, and traveled three hours to be induced. The minute he was born, he was on oxygen in the hands of doctors and nurses who knew exactly what was wrong with him.

          • October 29, 2014 at 9:12 pm #

            Actually…..once a woman knows she’s pregnant, it’s usually too late on the folate. So, women of child-brewing age are encouraged to always eat foods rich in folate in case they become pregnant.

          • MaineJen
            October 30, 2014 at 4:42 pm #

            “The Bofa: I’m sorry to hear that you and your wife were filled with worry about DS during her pregnancies.”


          • The Computer Ate My Nym
            October 31, 2014 at 10:47 am #

            I, in contrast, got prenatal screening and, in fact, preconception screening because if my child was going to be born with a birth defect I wanted to know about it ahead of time so I could be prepared to take care of him or her and provide him or her with the best possible start in life. I didn’t want to just close my eyes and let whatever might happen happen when I could potentially save my baby pain, suffering, and damage by knowing what I needed to do in advance. And no, I don’t mean abortion or at least not just abortion. I mean having the baby in a place with a high risk neonatal ICU, researching care for whatever condition he or she had, looking into options such as intrauterine surgery or early intervention (i.e. for the heart disease that often accompanies down syndrome) and so on. This seems to me to be part of loving my child and caring for him or her “regardless”.

        • LibrarianSarah
          October 29, 2014 at 4:55 pm #

          Comparing a complication that is almost certain to kill your baby to the likelihood (not risk) of giving birth to a child with down syndrome is insulting to people with downs and those who care about them.

        • fiftyfifty1
          October 29, 2014 at 6:36 pm #

          So basically you are saying that since you personally didn’t care if your child had Down Syndrome that you should also be ok with a uterine rupture and dead baby, because both outcomes are approximately equally likely. That is some screwed up logic, lady!

        • October 29, 2014 at 9:10 pm #

          Wow. Apples to oranges, and super insensitive.

        • Life Tip
          October 29, 2014 at 10:50 pm #

          This has to be the absolute dumbest, tackiest thing I’ve read in a long time.

          • Karen in SC
            October 30, 2014 at 11:15 pm #

            And I think it’s wrong. IIRC, at 39, my risk of Down Syndrome was 1 in 300. It’s been awhile though. I had the genetic screening.

          • Box of Salt
            October 31, 2014 at 5:57 am #

            That’s at 35, when it equals the risk of miscarriage due to an amnio.
            Chart with risk vs age linked above.

          • Karen in SC
            October 31, 2014 at 8:11 am #

            Thanks for the correction. I must have mixed up my two pregnancies since my first was at age 35/36. My second was age 39.

        • Box of Salt
          October 31, 2014 at 5:44 am #

          CoyoteFL (Jane Goodall) “could you tell everyone here what the risk of down syndrome is. That’s right, it’s a similar figure”

          This has been bugging me. The VBAC rupture rate that’s been quoted is 2% (1 in 50).

          The risk of having a child with Down’s Syndrome is age related, and the numbers are not comparable to the rupture risk until the mother is over 40 years old:

          A similar figure? For you and me, maybe, but not for most women who are bearing children.

          • Box of Salt
            October 31, 2014 at 5:55 am #

            Please: Make that JENNIFER Goodall.

            Apologies to anyone connected to Jane.

            I have no excuse; I am ticked off by CoyoteFL’s cavalier attitude to risk – in regards to both Down’s Syndrome and VBAC.

            Only one of those can be managed by anything other than abstinence.

    • GRZ
      October 29, 2014 at 1:49 pm #

      “Also, let me note that the risk of maternal and neonatal death are increased in mothers who choose to undergo an elective repeat cesarean without prior labor. This risk is reduced if a woman undergoes TOLAC regardless of whether she delivers vaginally or by cesarean in the end.”

      No, risks are increased with a failed TOLAC. Thus, the ENTIRE controversy around VBACs. If it was always safer to have a TOL, there would be no discussion. The problem is successful VBACs are safer than elective repeat cesareans which are safer than cesareans after a failed TOL. (ACOG, Practice Bulletin 115.) That is the whole basis of the VBAC controversy.

      • mythsayer
        October 29, 2014 at 4:23 pm #

        I think she misread that another study that Dr. Amy discussed. It found a higher maternal mortality with ERCD and a higher perinatal mortality with TOL. But that doesn’t mean that if the ERCD people had done the TOL first they would have had less risk. That makes no sense, quite frankly.

    • attitude devant
      October 29, 2014 at 2:10 pm #

      Ahhh! Jennifer Goodall, nice to see you. I have a question: why did you let your Charlotte County doctors, who were gracious enough to welcome you in their practice VERY late in pregnancy when you had been previously getting care in Lee County, be publicly smeared as anti-VBAC when you know they are not? That was perfectly lovely of you; you must be a total peach to have as a patient. I’m an OB in a different part of the country and I’m a staunch VBAC supporter but I would not have agreed to attend a TOLAC with you based on what I know of your prior history (not to mention your defiant oppositional attitude toward your healthcare providers—TOLAC is only safe if doctor and mother are working together). You can make your choices but I take my responsibility toward your health and your baby’s health seriously.

      I think you are dangerously misinformed and waaay too happy to play to your ICAN audience. Be careful out there.

      • October 29, 2014 at 2:49 pm #

        Making medical decisions off of only the fact that I have had 3 prior cesareans (at that time) is a bit hasty don’t you think? I never mentioned that they weren’t VBAC friendly, in fact, I’ve actually recommended them to a few women locally who had only one previous cesarean because they are one of the only places that offer the possibility of having a trial of labor. But when they decided to seek judicial authority over me, I have to say I became quite disgusted by their unethical medical decisions. Of course they have every right not to take me on as a patient, but as you stated and it is widely known, they chose to. Even after I had made it very clear from the very first visit that I planned to have a trial of labor they continued to support my decision and continue my care. It wasn’t until I was 38 weeks that I received a letter stating that the hospital and doctors were planning to strip me of my right to bodily autonomy and medical decision making and commit a violent crime (Battery) against me. Let me ask you this, if you were to receive a letter from your physician and/or hospital stating that they would strip you of your rights and force you into a surgery that wasn’t necessary would you agree? I doubt it. In fact, since you are so educated I’m assuming that you’d question their judgment and look for a second opinion. But then, maybe not. Maybe you’d listen to whatever your physician has to say regardless of whether or not it was completely contradictory to the data. Maybe you don’t value your right to choose but I value mine. Whether or not you agree with my decision to have a trial of labor is irrelevant here. The fact of the matter is, I have that right.

        • attitude devant
          October 29, 2014 at 2:59 pm #

          You and I both know you are mischaracterizing what happened. I’ve read your court filings, ma’am, so I know. You tried to force your doctors to act against their better judgement by taking them to court. They offered to send your records to a different practice but your lawyer tried to get a court order to let you have a TOLAC with them. (Which was a rather bizarre legal maneuver, and no one here was suprised it failed.)

          • October 29, 2014 at 3:30 pm #

            attitude, you’re hilarious. I love how you think you know what happened. It’s so sad to see you so wrapped up in something that has absolutely nothing to do with you. “they offered to send your records to a different practice” – this is absolutely inaccurate. They provided me with the paperwork to have my records transferred to another provider, which I did not have because I had been seeing them. By law, they are required to recommend a new care provider.

          • attitude devant
            October 29, 2014 at 3:54 pm #

            Am I to understand then that your lawyer erred in her court filings? Because that’s where I get my information.

            And you’re wrong: they don’t have to recommend a specific provider. We used to just hand out a copy of the county medical society directory when encouraging an adversarial patient to seek care elsewhere.

          • fiftyfifty1
            October 29, 2014 at 6:27 pm #

            “By law, they are required to recommend a new care provider”

            You’re full of crap. Doctors don’t have an obligation to find you a new provider any more than a bar that refuses to serve you because you are already intoxicated has an obligation to recommend a new bar to you.

          • attitude devant
            October 29, 2014 at 7:55 pm #

            “something that has absolutely nothing to do with you.” Umm, Jen, honey, YOU are the one courting the media limelight and talking to reporters. If you want to keep your private business private, then don’t talk to the press and don’t come here to discuss your medical care.

          • The Computer Ate My Nym
            October 31, 2014 at 10:26 am #

            By law, they are required to recommend a new care provider.

            First I’ve heard of this requirement. Could you site the specific statute?

        • mythsayer
          October 29, 2014 at 4:43 pm #

          Did you even try to find another doctor to deliver your baby? They said they wouldn’t stand in the way of you finding another provider. It doesn’t sound like you tried… at least not when you were 39 weeks pregnant and the judge ruled on your temporary restraining order. And the judge didn’t say you don’t have the right to do a TOL. The judge said you don’t have the right to compel doctors to allow you to do it under their care. In other words, you have the right to your TOL and they have the right not to take you on. By staying with them, you would impliedly have consented to the CS, because they told you they wouldn’t do a TOL. This isn’t complicated. They weren’t comfortable doing the TOL. They don’t have to bow to your every whim. Say something, god forbid (and I mean that, truly), had happened to you or your baby. Uterine rupture and baby was hypoxic and you ended up with a hysterectomy, etc. Would you have just said “oh well… I tried… and that sucked but it’s not my doctors’ fault this happened”? Or would you have filed a malpractice lawsuit? Because if it’s the latter… well… that’s what they were trying to avoid. And even if you wouldn’t have, a lot of people would. Blame them for being lawsuit happy. I read your court filings and the court’s order, too. And I’m an attorney so I know EXACTLY what they say and mean. And attitude devant is correct about what they say.

        • mythsayer
          October 29, 2014 at 4:47 pm #

          This is a legitimate question. Your court filings indicate that you were aware your doctors didn’t “approve” of or “agree with” your desire for a VBAC, but you thought they were going along with it anyway. Was something specific said that made you think that? Or was it always “I want a VBAC” and them responding “I don’t think that’s a good idea”? Did they ever specifically say they’d let you try? Like I said, that’s a real question. I’m curious whether they told you they’d let you try and then changed their minds, or if they said they weren’t happy with the idea but never said anything else, leading you to think they’d let you try.

        • Who?
          October 30, 2014 at 1:09 am #

          Please tell us about your responsibilities-I’d love to hear about those.

        • Stephanie Lastra
          October 30, 2014 at 10:07 pm #

          I applaud you for standing up for your rights and for your baby. I am sorry your being attacked by people who think its “oppositional and defiant” to insist on your bodily autonomy being respected. I bet above doctor is VBAC friendly only when her patients humbly submit to their will and never think for themselves. There are risks to repeat cs, risks to VBAC, no option is risk free. Women should not be strong armed into surgery, and I strongly disagree with vaginal birth being called a procedure. Its the end result of pregnancy, not a procedure. Again, I applaud you!

          • Samantha06
            October 30, 2014 at 11:08 pm #

            And doctors should not be strong-armed into taking unacceptable risks.

          • October 30, 2014 at 11:15 pm #

            Ummm, Stephanie? She doesn’t really mention much about the unborn kid who also had a great stake in the situation. So, I’m not really sure where you got the whole “for your baby” part of the story. It’s pretty much all about her. Sort of like her super awesome profile pic….selfie while holding her baby. I’m pretty sure she just wanted to win Vagina of the Year. I hear the crown is awesome.

          • anon13
            October 31, 2014 at 11:39 am #

            Exactly. One poignant comment someone posted about the pictures Dr. Amy assembled about babies lost during a homebirth.

            “Those babies wanted to live.” or something like that. So true.

          • Stephanie Lastra
            November 29, 2014 at 8:53 pm #

            taking a picture of yourself with your baby is …bad? okay then..

          • November 30, 2014 at 7:30 pm #

            Yeah, because that’s what I said.

          • Stephanie Lastra
            December 8, 2014 at 4:35 pm #

            I really don’t understand what your implication was, hence the “?”. I take pictures with my children all the time, so do most people, so im not sure what your point is really,

          • Samantha06
            October 30, 2014 at 11:26 pm #

            Who? had a great question that has yet to be answered. Maybe you can answer it. Exactly what do you think a patient’s responsibilities are in coordinating their care with a healthcare provider?

          • Who?
            October 31, 2014 at 12:39 am #

            Thanks Samantha. I ask that one a lot and never get an answer from the natural crowd.

            Just like I never get an answer to ‘why accept help for yourself, when your baby is dead’. One of the OBs replied and said they see it often, dead baby after entirely routine disaster that probably would have gone fine if adequate care had been consented to, and then mum demanding every bit of care going for herself.


          • Samantha06
            October 31, 2014 at 1:03 am #

            I hear you. It’s so frustrating. I don’t understand the mentality. I’ve worked in hospitals with statements of patient’s rights and responsibilities that they give out on admission. For the most part, people are reasonable, but the natural crowd just doesn’t seem to want to accept any responsibility for their bad decisions, and it’s always about them and “their rights.” They keep forgetting that it’s a two way street. They don’t seem to understand that doctors have the right to refuse to engage in unsafe practices just like patients can refuse treatment.

          • Who?
            October 31, 2014 at 12:29 am #

            By all means, insist on a vaginal birth, and your bodily autonomy, but if that’s your decision, own it, and don’t drag others into it.

            So-if you are determined to birth vaginally, do it at home where you can be sure the only way out is down, not through. For my money also, if you sacrifice baby on the altar of ‘natural’ birth don’t call for or accept rescue for yourself. That would be taking responsibility.

            The low risk option where there is a chequered delivery history is to not extend your family, to adopt, or to use a surrogate, not to wish really hard and then blame everyone else when it goes pear-shaped.

          • October 31, 2014 at 1:01 am #

            There are risks to everything we do, including drinking water. We weigh risks. For some women, the risk of VBAC is very high and massively outweighs the risk of repeat CS. For some women, the risk of VBAC is low (though still higher than repeat CS) so TOL is considered an acceptable medical risk. It’s different for each woman.

            No woman should be strong-armed into surgery, but if you have a malformed pelvis or some other reason that a baby is simply not going to come out of your vagina, you need to be told that in no uncertain terms. Women are adults. They can handle bad news. They do not need to be coddled and shielded from true risk assessments of their pregnancies. A woman with a history of being unable to birth vaginally is NOT a good risk for TOL, and it’s not strong-arming her to tell her that it is a medically unacceptable risk to try.

          • Box of Salt
            October 31, 2014 at 6:02 am #

            Stephanie Lastra “no option is risk free”

            “I strongly disagree with vaginal birth being called a
            procedure. Its the end result of pregnancy”

            Is vaginal birth risk free, Stephanie Lastra?

          • Stephanie Lastra
            November 29, 2014 at 8:51 pm #

            no of course not, that doesn’t change the fact that its a normal bodily function and the normal end to a full term pregnancy. You cant stop it from happening, it will happen! It may go wrong, in which case, I am grateful for *needed* medical interventions.

          • Samantha06
            November 29, 2014 at 10:33 pm #

            How about answering The computer ate my nym’s question, Stephanie? Should obstetricians be forced to practice unsafely because *you* or your friend Jennifer think they *should*? What about their rights to autonomy?

          • Stephanie Lastra
            December 8, 2014 at 4:32 pm #

            your question isn’t accurately describing what I am advocating for. If I want to refuse surgery to remove my baby from my womb, that is an inviolable human right (the right not to be forced into medical treatments). My body will go into labor, and barring complications, give birth to a baby. The doctor doesn’t have to be forced into anything at all. I think that refusing to simply be there in a hospital with a woman while her body is giving birth is totally unethical as the only other option is forcing surgery. I think the role of doctor is supporting a person in their health, not tyrannically lording over their bodies “for their own best interests”. Its not their job to *make* someone do what they feel is best, its their job to express what they think is the best course of action and if the patient refuses, to treat them in the best way they can. Such as admitting a woman in labor and respecting her wishes for her own body, simply being present and supporting her with whatever she needs AND desires (fluids, pain relief, whatever). You can ask her to sign a paper stating that your professional opinion is that a C-section is safest/warranted and you are waving any responsibility for complications that may arise due to that refusal.

          • Samantha06
            December 8, 2014 at 10:22 pm #

            Stephanie you are not understanding the big picture. Why is it unethical for a doctor to refuse to participate in something that he or she KNOWS is unsafe and would result in harm? I think we all agree that patients have the right to autonomy. Patients can and do refuse care. But you cannot force a doctor to practice in a way that he or she deems is unsafe. Medical care is not Burger King. You can’t just “have it your way.” What happens if mom’s “plan” goes south? Do you expect the doctor to just “save” everybody and “fix it?” Please try to think about this critically, Stephanie. It wouldn’t take much for a uterus to rupture after 3 previous C/Sections as the wall is probably paper thin. Imagine a wet paper towel or kleenex and how easy it tears. (I’m sure Jennifer’s doctor explained all this to her). And when a uterus tears from the stress of labor contractions, it’s usually a severe emergency. The doctor may only have a few minutes to get the baby out ALIVE, if that’s even possible, as the baby could already be dead. If the baby survives, there may be brain damage. Neither may survive. Why is that so hard to understand? Why would you want to have a C/Section under those circumstances anyway, when it could be avoided with a scheduled C/section? You don’t seem to get that it’s DANGEROUS to even try a stunt like laboring after three C/Sections, and no doctor in their right mind is going to participate in that. Doctors can’t just get a patient to “sign something” to “waive any responsibility for complications.” The doctor could have it notarized in gold but he or she is STILL RESPONSIBLE. A severely disabled child can require lots of care that costs lots of money. And I think you would most likely file a malpractice suit if there was a bad outcome, regardless whether you refused care or not. But the more disturbing question is why would anyone want to risk their life and the life of their baby on the altar of autonomy? Please explain that to me, Stephanie.

          • The Computer Ate My Nym
            October 31, 2014 at 10:23 am #

            Why do you think that obstetricians have no bodily or psychic autonomy and should be forced to practice in ways that they believe to be unsafe? If you’re insisting on your right to make (bad) decisions about your body, what about their right to not be forced to watch you and/or your baby die slowly in front of them because you refuse to let them do what is necessary to save you?

        • birthbuddy
          October 31, 2014 at 1:13 am #

          Yes, you have that right and the doctor has the right not to participate. Simple.

    • mythsayer
      October 29, 2014 at 4:26 pm #

      I think that’s a misreading of that study. It’s unlikely that the ERCD was the ultimate reason for the higher risk. Those women probably had health issues in a lot of cases that risked them out of TOL completely. Let’s say someone died from a hemorrhage. This study doesn’t say that if the ERCD people had done the
      TOL first they would have had less risk. That makes no sense, quite
      frankly. TOL doesn’t suddenly make you less susceptible to risk.

    • mythsayer
      October 29, 2014 at 4:28 pm #

      And farther down, I quoted a study that found that TOL is associated with higher perinatal mortality. That’s not the “dead baby card”. That’s a finding in the study.

      Don’t you find it just a little bit hypocritical to tell people to stop fear mongering by using the “dead baby card” but you are all over the place trying to claim CS’ are dangerous? BIRTH is dangerous. Everything comes with risk… it’s what’s acceptable risk. But 2% risk of UT is quite high, actually. It sounds low, but it’s not.

    • PrimaryCareDoc
      October 29, 2014 at 4:55 pm #

      People like you make me want to run screaming away from the practice of medicine. You think that your internet “education” is somehow equal to my 4 years of school, 4 years of residency, and almost 15 years of clinical experience.

      • guest
        October 29, 2014 at 5:31 pm #

        And people complain about defensive medicine. Jennifer Goodall is a classic example of the reason why physicians have to resort to that.

    • moto_librarian
      October 29, 2014 at 5:09 pm #

      Has it ever occurred to you that maybe your body just isn’t made to deliver vaginally? Is this latest c-section enough to change your mind, or are you going to try to bully another healthcare professional into a VBA4C?

      And let me be clear: I believe that a woman has the right to refuse a c-section. But no woman has the right to expect a medical professional to override her professional and ethical judgment to offer you your preferred mode of delivery. It seems pretty clear to me that you tried to strong arm your doctor and one particular hospital into allowing a TOL when they told you that your were a poor candidate. When you continued to press the issue, the hospital took steps to protect itself from litigation.

      Given that I know someone who did lose a child during a VBAC attempt, forgive me for telling you to fuck off. I am glad you and your baby survived. Try being appreciative of that.

      • guest
        October 29, 2014 at 5:29 pm #

        Amen to that! The arrogance and stupidity is profoundly disturbing. It makes it even more repugnant when you care for women from other countries who are so grateful and appreciative of excellent medical care here. It makes it so frustrating to deal with spoiled brats who snub their noses and stomp their feet when they don’t get their way.

    • Stacy48918
      October 29, 2014 at 6:48 pm #

      My good friend had TOLAC after just ONE C-section earlier this summer. Her uterus ruptured, her baby required cooling, seizured for days and is permanently brain damaged.

      You are an unbelievably selfish, uneducated idiot.

      • Karen in SC
        October 29, 2014 at 6:58 pm #

        Was that in a hospital? Just goes to show you that even when resources are available, things can still go wrong.

        • Stacy48918
          October 29, 2014 at 7:20 pm #

          Yes. With a Level II NICU. The baby was life-flighted to a Level III. Initially they didn’t think she’d survive the night.

    • Who?
      October 29, 2014 at 8:30 pm #

      In business speak they call it a risk matrix-you consider how likely the risk is to come to pass, then you decide how bad it would be if it did. 2% isn’t low, it is one per busload of people, and for vbac the risk of death or permanent injury to someone who doesn’t get to advocate for themselves, much less consent, is very very high if the risk event actually happens. Not to mention mum.

      In business, with money involved, my guess is you wouldn’t get to do it. Oh wait, that’s why insurance companies won’t cover (usually) these procedures in hospital because they really hate paying out.

      I don’t know if your stats about repeat cs are true, if they are surely they are a good reason to seriously consider either not extending your familiy or looking at adoption or surrogacy instead of risking either a damaged or dead you or baby.

      • Trixie
        October 29, 2014 at 9:37 pm #

        I sure wouldn’t put my kid on a bus if they told me one child wouldn’t be making it all the way to school that day.

      • DaisyGrrl
        October 30, 2014 at 12:09 am #

        Let’s not forget that the 2% risk she’s citing is only for rupture. There are other complications and risks to any vaginal birth (and c-sections). Depending on the reasons for the previous c-sections, the risks could be significantly higher than that.

    • Susan
      October 29, 2014 at 9:24 pm #

      “Play that “dead baby” card again, won’t you” Jennifer…. when it’s your baby it isn’t a card it’s a nightmare. Hey, when you are the nurse, like me, taking the footprints, crying with the parents, watching them struggle with the decision of when to let you take their precious baby’s body away for the last time…. it’s heartbreaking. It’s no card, its real, and it happens to people who don’t deserve it in the least.

    • October 30, 2014 at 3:31 am #

      2%. 1 in 50. That is NOT low. Presented with a bowl of candies of 100 candies, 2 of which were poisoned, would you eat one? I wouldn’t. Oh hell no. I would especially not eat one if it passed the risk to a second person. A risk with my life is my business, but a risk to someone else’s is ridiculously unethical.

      • FormerPhysicist
        October 30, 2014 at 7:45 am #

        Heck, the bag of Halloween candy I bought has 140 pieces. There better not be 3 poisoned pieces in there!

  14. Carolina
    July 30, 2014 at 11:03 am #

    This is totally, completely off-topic, but I like the commenters here better than many places on the internet. Has anyone ever going through fertility treatments and then freaked out when they worked? I just found out I’m pregnant from a frozen embryo transfer. I did four rounds of IUI, a fresh IVF, and then the FET and spent about $20k out of pocket. I thought I desperately wanted another baby. My daughter desperately wants a sibling (she prayers for a little sister every night). So why am I panicking now about money, my job, childcare, etc. and wondering if we did the right thing? Am I crazy, or has anyone ever experienced this? (to be clear, I don’t think I’m in danger mentally – just really, really anxious and scared)

    • guest
      July 30, 2014 at 11:11 am #

      I think that is a completely normal reaction for ANY pregnancy, including carefully planned ones! Regardless of the circumstances, it takes some time for the news to sink in, hence the panic. Congratulations to you!!!

    • Smoochagator
      July 30, 2014 at 11:12 am #

      Oh honey. I have felt panic every single time I got pregnant, without fertility treatments, and every single time I WANTED to get pregnant and was ACTIVELY TRYING to conceive. I think that realization that oh sh*t, my life has changed and I can’t take it back, hits every mom. It’s okay to be a little freaked out.

    • Anna T
      July 30, 2014 at 11:15 am #

      No fertility treatments, but I’ve been trying for a child for a relatively long time – my youngest is nearly 4, and I’ve wanted another since she turned about 2. I’m now 17 weeks along. And guess what? When I found out, I was just as panicky as you (although I was hoping, and praying for another child).

    • Burgundy
      July 30, 2014 at 11:17 am #

      Congratulations!! Both my husband and I got really scared when we found out we were pregnant with the 2nd one. No fertility treatments and she was not a surprised baby. I think it is just a part of being pregnant.

    • July 30, 2014 at 11:26 am #


      Like the other commenters, I felt completely panicked when I found out I was really pregnant – also not fertility treatments, but all 3 times (2 were losses – we’re ok tho) and the third. We desperately wanted a baby, had spent a year planning before we started trying, and I knew I wanted a kid my whole life. I spent the first month or so just anxious and scared and depressed each time. Like, what were we THINKING! I suspect it’s normal – I mean, having a baby IS a big deal, so it makes sense we’d all panic a bit!

      • Carolina
        July 30, 2014 at 12:31 pm #

        Thank you! I’m glad you’re still commenting here (didn’t realize you changed your username). I’ve really enjoyed your blog.

    • Amy M
      July 30, 2014 at 11:45 am #

      I did IVF, and though I didn’t freak out upon finding out about the pregnancy, I freaked right out when we found out (at 7wks in) that it was ID twins (from a single embryo transfer). Major panic attack at that point, so yeah, I think I kinda know where you are coming from. (and I hope you only have one in there.) (and that I haven’t scared you further.) (it’s pretty rare to have a splitter from an embryo transfer, especially a frozen)

      Anyway, congratulations! You will be fine and your daughter will be so excited to have a sibling when the new one comes along. 🙂

    • Carolina
      July 30, 2014 at 12:23 pm #

      Thanks, you guys! I just needed a little validation that I’m not crazy. there is a possibility of twins. We transferred two, which is recommended for my age (and we transferred two with the failed fresh cycle, so….). Cannot lie that the possibility of twins is adding to the panic. I pray it’s only one, but then I feel bad for not wanting one of the embryos to make it. Sigh… One day at a time. I’m glad there are others who temporarily freaked out over a wanted pregnancy. I thought I’d be completely jubilant, so the mixed feelings concerned me 🙂

      • anion
        July 30, 2014 at 12:46 pm #

        Ha, I’ll go you one better (I say facetiously). 🙂 My second was a surprise. I was sort-of pleased, I mean, I hadn’t really been sure I wanted another so I was pleased but freaked out/kind of unhappy, actually (I burst into tears when I saw those blue lines).

        I spent most of the pregnancy kind of ambivalent. One day I’d be excited and thrilled, the next resentful that I couldn’t have a beer or that it was hard to sleep or whatever for this baby I hadn’t planned. I’d had PPD with my first, hadn’t really been able to breastfeed due to pain/low supply, and a hard time adjusting, so I was very worried about dealing with all of that again and kind of dreading it. Our first (and please don’t think I don’t also love her fiercely and intensely) is somewhere on the very high end of the autism spectrum–she was sort-of diagnosed, and then they said no, and then they said they don’t know, and she’s kind of quirky and can be a little difficult to deal with sometimes, and I was very afraid she would feel cheated or that we were doing something that would hurt her or damage her in some way.

        Then she was born, and it was like all of the good things about being a new mom that I’d missed out on before landed on my head in a warm gooey heap. No PPD. No sorrow at all, no difficulty with anything. Those first few months I’d been so unhappy thinking about are still–to this day, almost ten years later–the absolute best months of my entire life, and that baby is the best thing that ever happened to me, and I look back and cannot imagine how I would have felt or what our lives would be if we hadn’t messed up the birth control one afternoon. 🙂 She and her older sister are incredibly close, and being a big sister helped our eldest in amazing ways.

        So please do NOT worry about feeling ambivalent. Ambivalence or fear means nothing; they’re both perfectly normal. If the choice had been given to me to get pregnant with #2 or not I’d have said no, and I was a grumpy jerk about it throughout the pregnancy, and it did not affect my feelings for my baby one bit. She thrills me every single day.

        A huge CONGRATULATIONS to you!!!

      • Stacy48918
        July 31, 2014 at 12:27 am #

        On a birth board I lurk on there’s an IVF mom that transferred three, thinking they’d get 1 baby (not the best quality embryos I guess). Well all three took and one split! So she’s currently about 29 weeks with quads -a set of fraternal di-di boys and a set of identical mo-di girls. Crazy!

      • October 29, 2014 at 10:43 pm #

        My bff had IVF twins and seriously, I’m jealous of the fact that she has these little people who actually play together! Where, I have this kiddo that I have to play with all the mite! Hahahaha….But seriously, these kids were sleeping through the night at 1 month, and they entertain each other! Two would be awesome, you could totally do it. ; ) She’s hilarious, and she happens to be a blogger if you want to reach out to her! http://bevcooks.com

    • The Computer Ate My Nym
      July 30, 2014 at 12:34 pm #

      It sounds like you’re in that particular category of nuts known as “normal” and “healthy”. You sound like a responsible mother worrying normally about how she’s going to handle things with a new baby to me. You’ll do great!

    • ihateslugs
      July 31, 2014 at 12:13 am #

      Trust me: you don’t have to go through fertility treatments to have these feelings! My husband and I started trying for number two after months of discussion and contemplation about whether or not we were “ready.” We felt we were. Boom, we got pregnant right away, and all of a sudden, many of those feelings of being sure about another child were replaced with doubt, fear, and worries that we were making a huge mistake. Fortunately, they were temporary. Now, as I hold my precious, wonderful son, I have no doubts. It doesn’t necessarily make the days any easier, and you’ll certainly have those moments when you think you must have been crazy to have another child, but you’ll love that baby with your entire heart and soul. Congratulations!

    • October 29, 2014 at 10:40 pm #

      These are normal “Holy shit I’m pregnant!” feelings, due to the fact that you’re a human being! Seriously! Take a deep breath…you got this girl! Congratulations!!!

    • MaineJen
      October 30, 2014 at 5:38 pm #

      I believe the first words out of my mouth after seeing that pink plus sign were: Oh my god. Oh my god. Oh my god. What the hell was I thinking??? LOL It takes a while for the reality to sink in. Hope everything is going well 3 months in!

  15. Smoochagator
    July 30, 2014 at 9:24 am #

    Love this article. Except for this line: “Not surprisingly, she failed in her attempt, confirming the concerns of the original hospital.”
    One of the issues you consistently raise about the NCB movement is that they tell women they or their bodies have “failed” if they do not have a vaginal birth. So let’s not make the mistake of using their rhetoric. This woman didn’t fail. She made (in your opinion, which I am inclined to agree with) a poor choice in attempting a VBAC, but when she ended up in the operating room, she was not a failure. If anything, as you point out, she was a pawn in a very political game, and had been deceived into thinking that her child’s life was less important that how that child actually entered this world.

    • Karen in SC
      July 30, 2014 at 9:58 am #

      good point

    • Carolina
      July 30, 2014 at 10:58 am #

      Agreed. There was no failure from my perspective (other than behaving like such a lunatic that CPS was threatened). She and her baby apparently survived intact. Good outcome.

    • anion
      July 30, 2014 at 10:59 am #

      Yes, but what wording would you suggest? “She did not succeed in her attempt/her attempt did not succeed,” are the same thing. “She was not able to have a vaginal birth?” Same thing. “The original hospital was correct and her baby required a c-section?” Maybe, but it still implies a failed attempt.

      Saying her attempt failed or she failed in her attempt isn’t the same as calling her a failure. What would YOU call an attempt at something that did not achieve its ultimate purpose? A win? A success? She tried to do something and did not ultimately do that thing, what are we supposed to say? “She succeeded in not doing the thing she wanted to do? Victory!”

      I get what you’re saying about calling women failures, I really do, but words mean what they mean, and I grow very tired of the idea that we have to pretend they don’t so people who want to live in approving little bubbles never have to face reality or people who lose contests don’t have to accept that they lost and everyone gets to take every word as a personal insult or affront. She tried, she failed. Doesn’t make her a bad person or a failure as a human, but her *attempt* failed, period.

      • Smoochagator
        July 30, 2014 at 11:10 am #

        I think that “she was unable to have a vaginal birth” is sufficient. Wording it in that way doesn’t assign “blame” on anyone for this woman’s C-section. I criticized Dr. Amy’s original wording – because the NCB culture often wants to assign blame for C-sections (often on the doctor for being afraid of litigation or eager to cut or too lazy to wait for a natural birth to unfold, or on the woman for being “uneducated” or not “trusting” birth) instead of seeing it as a no-fault option. This is something that Dr. Amy continually criticizes about the NCB movement, and eliminating the word “failure” from our discussion of birth has nothing to do with handing out participation trophies to kids who run the wrong way on the soccer field. It has to do with dismantling the stigma associated with having a child delivered surgically, especially when the surgical deliver may very well have saved the child’s and/or the mother’s life.

        • anion
          July 30, 2014 at 12:57 pm #

          “She was unable to have a vaginal birth” could imply either A) everything was fine but the second hospital refused to let her/the decision wasn’t hers, thus assigning blame to the hospital; or B) that she lacked the *ability* to do it and had she trained harder/learned more/believed more she could have done it, thus assigning blame to her.

          It’s six of one, half dozen of the other. I agree with the idea that a surgical birth is not a failure, but the fact is she attempted VBAC and did not succeed in that. It doesn’t mean her birth was a failure or she is a failure, it means her attempt to VBAC failed, and we shouldn’t be so terrified of the word “fail.”

          (I really mean no disrespect to you here and you seem like a perfectly nice and smart person, I just hate these semantics games.)

          • Smoochagator
            July 30, 2014 at 1:26 pm #

            No offense taken on this side and no disrespect towards you. The word just sent up a red flag for me since I’ve become more sensitive to the idea of “failure” when discussing an “unnatural” birth.

      • Sara
        July 30, 2014 at 2:51 pm #

        Saying “she consented to a c-section after a trial of labor” would suffice (I believe that’s how she stated it herself). But I get what you’re saying. Her reason for finally consenting happened to be “failure to progress” so that kinda defines it right there.

    • The Bofa, Being of the Sofa
      July 30, 2014 at 12:54 pm #

      Our bodies fail all the time.

      It’s just when our eyes fail to see properly on their own, no one attributes it to personal failure.

      • Siri
        July 30, 2014 at 1:38 pm #

        I underwent gastroscopy and colonoscopy today, and was told I have a hiatus hernia, pyloric stenosis and reflux. The surgeon told me I need to visualise a healthy GI tract, surround myself with positive people who believe in my ability to heal, and use affirmations morning and night. He also said if I’d had the procedure done at home, my chances of a normal result would have been much higher. Sigh…. why have I let myself be brainwashed by allopathic medicine?!

  16. July 30, 2014 at 1:20 am #

    I’m still trying to understand why Goodall would not have a C/S at one hospital, but at another, she agreed to it.

    • Anna T
      July 30, 2014 at 4:33 am #

      I think she agreed to it after a failed labor, which she wasn’t allowed to try in the first hospital.

      Honestly, though, I think that if Mrs. Goodall wishes to avoid a 5-th C-section in the future, her only reasonable option is to avoid another pregnancy. If she still feels the desire to expand her family, maybe she should look into adoption. I mean it. So many children are in need of love and a home. A relative of mine is currently raising a family of 8 children, 3 of whom are adopted.

      • Certified Hamster Midwife
        July 30, 2014 at 2:14 pm #

        Adoption is not cheap or easy, and it isn’t for everyone.

        • Anna T
          July 30, 2014 at 2:27 pm #

          No, certainly not, especially international adoption. My relative’s adopted children came from the Ukraine and it was a complicated affair. However, I do believe that if someone wants very much to expand their family, but medical conditions do not allow it to be done naturally and/or safely (such as, you can only have C-sections and you’ve already had as many as your doctor says you can safely have), adoption or foster parenting is certainly an option to look into.

          Another option, of course, is to be content with the number of children one can *reasonably* have (without having endless C-sections or crazy dangerous VBA4Cs).

          I live in a society of large families and I fret and worry every time I hear of someone getting pregnant again after a 5-th C-section despite her doctor’s explicit warnings. I very much want to have a large family too, but risking one’s health and perhaps life is not an act of “faith”, it’s mad.

    • Carolina
      July 30, 2014 at 11:04 am #

      I think she really, really, really wanted the TOL. Nutty.

  17. Mittstamp
    July 30, 2014 at 12:52 am #

    I wonder how long it will be before Ms Goodall gets pregnant again with baby 5, maybe this time attempting a HBA4C (I wonder if that’s been tried?) I’ve been there–After my CS I actually did think about getting PG again so I could have the “lovely. natural” home waterbirth I had wanted the first time. There might have been good reasons for us to have another child, but having a “healing” birth just wasn’t one of them. But you seem to hear a lot about this in the HB community. Where do these women stop in their goal to have a vaginal birth? Is each child whose birth ends in a CS considered a “failure?”

    • Kate
      July 30, 2014 at 1:17 am #

      The lady who runs No Longer Quivering, about the quiverfull movement, actually had a HBA4C. She has no idea if anyone else has (can’t find any other stories). And she now acknowledges how freaking insane it was.

      • MWGuest
        July 30, 2014 at 7:40 am #

        I personally know a midwife in my state (licensed CPM) who have attended HBA4C.
        There was a MANA board member – licensed CPM, too – who bragged on her blog about attending a HBA4C. Probably not as rare as you think it is.

      • Mittstamp
        July 30, 2014 at 7:41 am #

        OMG…on one hand that’s interesting, on the other hand terrifying. My DH has some QF’ers in his family (I follow NLQ but I missed that), but we rarely see or talk to them. Hard to believe, given their stance on abortion, that they believe God would want a family to take those kinds of incredible, million-to-one risks w/ the life of their baby. But the, from what I know of the QF movement, one of their mantras is “God controls the womb,” and if a baby dies, “it was God’s will.” With HB/NCB types, it’s more like “I control the performance art into which my baby will be born, along with mircomanaging every other detail b/c I really, really trust birth,” and in the event of loss, it’s either “Why me? I did everything RIGHT!” or “Some babies just aren’t meant to live.” Perhaps someone smarter than me–Dr. Amy?–could compare the rhetoric of these two groups.

      • MWGuest
        July 30, 2014 at 7:48 am #


        Here’s where a MANA board member brags about attending a VBaC after 4 c-sections at home.

        • Trixie
          July 30, 2014 at 7:58 am #

          Wow. “I was not worried about her ability to get her baby out or that her uterus would rupture. I know uterine rupture is extremely unlikely, even though there is very little research about vaginal birth after 2 or 3 c/sections, much less four. What I was worried about was what it would look like to my peer group, other midwives and birth professionals, both from Austin and around the US. What if something happened? What if??”

          Yes, who cares about two lives. What will the other midwives think?

          • MaineJen
            July 30, 2014 at 10:56 pm #

            I had to stop reading when I got to that part. Yes lady, let’s just totally discount the very real risks, and instead let’s worry about how this will make YOU look. Disgusting…

        • Mittstamp
          July 30, 2014 at 7:26 pm #

          I am so totally creeped out by this…I’m glad Mom & baby are ok but this all could have gone to hell in a handbasket in seconds. Just love the way the nurse blows off rupture as “rare” & leaves it at that.

        • araikwao
          July 30, 2014 at 11:19 pm #

          Wait, who’s doing CS at home??! (yes, I know what it meant, and I’m just kidding, ‘k?)

      • Anna T
        July 30, 2014 at 11:26 am #

        I’ve read Vyckie’s story too, including how with her third child she was in a terrible state and should have seen a doctor (actually felt she was dying), but could not afford to and was too proud/didn’t think it was right to apply for government assistance. It was heartbreaking. I think she is lucky to be alive and hope no woman is pressured/brainwashed into accepting poor prenatal and L&D care.

    • Mom of 2
      July 30, 2014 at 7:46 am #

      About HBA4C–you bet it’s been tried. I had the joyous task of taking care of one when it failed (duh) and she came to the hospital (I’m a nurse). The woman had tried VB with every pregnancy. The most VBAC friendly doc I know told her after the 2nd or 3rd attempt a baby was never going to fit through her pelvis. She tried anyway. She is lucky her and her baby are alive, though the baby had to spend time in NICU for mec aspiration (she was almost 42 weeks). After the baby was born, the NICU talk came to speak with her about the rather grim situation the baby was in due to the mec. All she could talk about after was how happy she was that she got to labor at home all day.

      • Kate
        July 30, 2014 at 9:39 pm #

        Wow. That is narcissism at its finest right there.

    • Trixie
      July 30, 2014 at 7:50 am #

      Sure, there are even people in the VBACfacts group and ICAN who put some variation of “HBA4C” in their Facebook usernames.

  18. MaineJen
    July 30, 2014 at 12:41 am #

    We need to send some burn cream over to ICAN…apply directly to the BURN.

  19. Bombshellrisa
    July 29, 2014 at 5:23 pm #

    Ina May would have made her a square for the maternal mortality quilt.

    • July 30, 2014 at 11:34 am #

      That made a literal chill run down my spine. Brrrr.

  20. Anon
    July 29, 2014 at 4:41 pm #

    I never comment on these things, but feel strongly compelled to do so here because you have it so wrong on so many levels. I can’t imagine that any one of us except Ms. Goodall herself can possibly give voice to all of the factors that went into weighing her decision. We cannot simply assume that she was not aware of all the risks and benefits of attempting to avoid cesarean surgery. Finally, what the people at ICAN and other organizations were supporting was not that she was choosing to decline repeat surgery. They were simply supporting her right to HAVE that choice.

    • attitude devant
      July 29, 2014 at 5:05 pm #

      Reading comprehension fail. You are right that only Ms. Goodall knows what she was thinking. But ICAN and RHReality Check were ‘supporting’ her at the same time that they were referencing stats that were not relevant to HER specific case. That, in a nutshell, is the problem.

    • Stacy48918
      July 29, 2014 at 6:04 pm #

      No. If all they believe in is autonomy and choice, why would they need statistics? They believe in VBAC itself – it’s safety, it’s inherent “rightness” over C-section, that’s why they feel a need to paint it as safe in all cases, no matter what. Their argument is not “choice” or “autonomy” but “VBAC is best, period.”

    • Amy
      July 29, 2014 at 8:22 pm #

      I watched ICAN completely ream a rupture-loss mom for choosing scheduled cesareans for future births, accusing her of “scaring” the other list readers and stating women who mentioned any reason for a cesarean other than transverse lie and complete previa were simply not welcome. That was the last straw for me. Before that, though, I watched the ICAN list celebrate a woman’s success in achieving “her” VBAC when her baby was born dead from cord issues. I watched them go on and on about “evidence” without citing any independent peer-reviewed studies. I watched them encourage women who couldn’t find a sympathetic provider to go for an unassisted birth.

      So don’t tell me ICAN supports choice. They don’t. They support THEIR choice of VBAC at all costs. A cesarean to ICAN is a fate worse than death.

    • Melissa
      July 29, 2014 at 11:56 pm #

      She did have the choice. The choice of going to a hospital that allowed her to have a VBAC. What Goodall wanted was to force a hospital of her choice to allow her to attempt VBA3C. A hospital is not Burger King, you do not get to have it your way if that way violates the ethical standards of the doctors you are involving in your care. As long as we hold doctors to medical ethics standards and litigation liability we can’t expect them to just do whatever the patient wants if that desire violates their ethical duties.

  21. Therese
    July 29, 2014 at 4:33 pm #

    It’s true that they wouldn’t do anything if her baby had died. But if she had died and her baby had lived, I’m sure they would have helped organize breast milk donations to ensure that her baby didn’t have to drink any formula, so you can’t say they don’t care!

    • attitude devant
      July 29, 2014 at 5:02 pm #

      RIP, Sara Hedgepeth Osceola

      • rh1985
        July 29, 2014 at 7:49 pm #

        Somehow I never heard of her before. Horrifying!

    • Amazed
      July 29, 2014 at 8:34 pm #

      At least she had a lovely vaginal birth, they would say. At least she achieved her dream birth!

      Think I’m kidding? Google Claire Teague and her lovely midwife.

  22. attitude devant
    July 29, 2014 at 3:20 pm #

    These groups remind me of the AIDS denialists who egged on Christine Maggiore. Exactly how many of them stepped up to the plate and accepted responsibility when her daughter died of AIDS? Or when Christine herself died?

    • Roadstergal
      July 29, 2014 at 7:12 pm #

      They immediately got to work denying that either of them died of AIDS.

      • Dr Kitty
        July 30, 2014 at 11:07 am #

        Kind of like that commenter we had a good while back who said that ‘flu vaccination was unnecessary, because people died from *pneumonia* not *flu*, and who didn’t seem to grasp that they wouldn’t have got the pneumonia without the influenza.

        AIDS denialists say that people die of pneumonia, or lymphoma or TB… and that they *just happened* to test positive for HIV…a virus which doesn’t lead to any health problems itself…nope.

        • Young CC Prof
          July 30, 2014 at 11:39 am #

          I’ve heard that argument from antivaxxers a lot. “They didn’t die from the disease, they died from complications of the disease, so you see, the disease isn’t dangerous.”

          It’s not the fall that kills you, it’s the sudden impact with the ground.

        • Beth S
          July 30, 2014 at 6:47 pm #

          Oh God as someone who’s lost their own father to the flu because he was contraindicated for the vaccine (double lung transplant patient) and his sister decided to come to his mother’s house sick with the flu when she knew he’d be there, I’m so glad I wasn’t around for this idiotic poster. Sure it might be the pneumonia that kills the flu patient, but if it weren’t for the fact that he’d caught the flu in the first place he wouldn’t be dead.
          Of course I told this story on one of my birth boards and got reamed for and I quote “Putting my aunt on blast like that.” At which time I went on a cursing rampage that got me banned for life.

  23. The Computer Ate My Nym
    July 29, 2014 at 2:28 pm #

    Not a single organization or article that supported Goodall had accurate statistics on the real risk that Goodall faced.

    I disagree slightly. You supported Goodall’s right to make her own medical decisions, even if they were bad decisions and also provided a realistic assessment of the risk that she faced. Other than that…yeah, pretty much.

  24. Anna T
    July 29, 2014 at 2:28 pm #

    “Who is likely to be more concerned with whether you and/or your baby live or die?”

    The mother herself is the most concerned. She is the one who will have to live with the results of whatever choice she makes. Nothing – not time, not circumstances, not having more children – can bring full healing after the loss of a child. Throw guilt into the equation – how a mother must feel when she had been WARNED against something, and proceeded at her own risk, and then the thing she had been warned about actually happens and she loses her baby – and I can hardly imagine how horrible it must be.

    Therefore, when human life is at stake, there is really no such thing as “excessive caution”.

    • Smoochagator
      July 30, 2014 at 9:32 am #

      The mother is most concerned, but in the case discussed in this article, the mother was not truly aware of the risks to her baby. Those risks had likely been downplayed and/or outright denied by the people that wanted her to have a VBAC.

  25. sdsures
    July 29, 2014 at 2:06 pm #

    I find it extremely odd that an organization, ANY organization, would start a petition in order to “help” someone get a dangerous procedure that didn’t need to happen. Goodall didn’t NEED to go through the risk of a VBAC when CS is available.

  26. Junebug
    July 29, 2014 at 1:55 pm #

    Oh they would have done something, blame her for failing. If you rupture in your vba3c it is because you didn’t trust birth, had the baby in a scary hospital hat harshed your mellow, didn’t eat enough during labor blah blah blah.

    • Lisa from NY
      July 29, 2014 at 4:19 pm #

      Don’t forget the Chinese herbs.

    • Smoochagator
      July 30, 2014 at 9:26 am #

      Not enough raspberry leaf tea to tone the uterus!

  27. Mel
    July 29, 2014 at 1:47 pm #

    Actually, ICAN et al would go one step beyond dropping Ms. Goodall if her child died: they’d victim-blame her.

    She should have been:
    -eating more kale….eating less kale…. wait,……eating the correct amount of kale (which she clearly was not doing)
    -avoiding prenatal care
    -never even speaking to an OB
    -birthing at home
    -trusting birth more
    -chanting positive mantras

    The real point of ICAN et al isn’t to support mothers; it’s to protect the true believers from the real-life outcomes. When babies and moms are hurt or die, remember the goal is to deflect the blame back where it belongs – on the obvious losers who clearly weren’t as (awesome, Goddess-loving, healthy, crunchy) as the rest of the group.

    Cognitive dissonance hurts.

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