VBAC Facts Academy, the Trump University of natural childbirth

Scam Computer Key

Like most sanctimommies, Jen Kamel of VBAC Facts is ostentatiously suffering from sadness:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There’s a sucker born — hopefully vaginally —every minute.[/pullquote]

It breaks my heart when I hear of a first time mom having a cesarean at 9cm simply because she went two hours without cervical change. Such a waste…

Kamel follows with a parade of horribles, including:

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Will she have an easy recovery?

Does she have friends and family to support her emotionally, physically, and maybe bring her a warm meal?

Will she mourn her cesarean? If so, will she stuff those feelings deep down because, as she is told over and over, it doesn’t matter how the baby gets here?

Will her partner be a safe place or will they, too, tell her it was “for the best?” …

Kamel is grooming women to believe that a C-section means they are defective. To wit:

Will she believe her body is broken? …

Kamel hopes so, because she plans to profit from women’s despair.

You can mitigate your sad fate by simply sending Kamel $330 — 3 easy payments of $110/no refunds — for Kamel’s insights about VBAC at VBACFacts Academy, Kamel’s version of Trump University.

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It’s Marketing 101: convince people that they have a problem they didn’t know they had, then sell them the “solution.”

Who is Kamel and why would you care about what she thinks? As far as I can determine, Kamel’s professional education and experience is limited to commercial real estate. She has no medical, nursing or midwifery training. She’s cared for ZERO pregnant women; she’s delivered ZERO babies.

Kamel comes from the “Seen on TV” school of marketing:

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Kamen apparently thinks her potential clients are morons. A  PDF of her slides is worth $30? Her handouts are worth $60? Membership in her Facebook group is worth $100? They are worth nothing because the exact same “insights” are available FOR FREE on any natural childbirth website including VBAC Facts itself.

I bet I can save you the $330 by summarizing the entire 6 hour video series in a few sentences:

Kamel believes vaginal births are best. If you had a C-section it was unnecessary. Regardless of your personal health history you are an ideal candidate for a VBAC. Ignore anyone who tells you otherwise.

In other words, VBAC Facts Academy is a scam on par with Trump University.

Who’s foolish enough to pay for this crap? Beats me.

Like hucksters everywhere, Kamel seems be channeling the ultimate huckster, PT Barnum. Her motto appears to be:

There’s a sucker born — hopefully vaginally —every minute.

  • J.B.

    Semi-OT: the mansplaining over Trump is just mind boggling. Urrgh!

  • Clorinda

    My babies have all been smallish (under 8 pounds, some under 7) but with large heads. They’ve also enjoyed sitting diagonally with their heads on my hip bone so the heads were never near enough the cervix to encourage the start of labor. With the other complications that came with pregnancy, I came to terms with c-sections and was happy to have my babies here. The one time I might have gone in to labor on my own was the one I was most scared of labor. One of my friends had just had a crash c-section due to placental abruption and hemmorrhaging when her water broke. She had polyhydramnios. So did I. Fortunately, we held out to 38 weeks and had the c-section like normal.

  • valeriereinhard

    ARG. What an annoyance! I’ve had 4 C-sections. M y first was because of an emergency (I developed HELLP, wasn’t progressing, and my doc wanted to get the surgery done before my platelets bottomed out, which they did less than 24 hours later), and the subsequent C-sections were as a matter of precaution, given my history. I hate hate hate that they are painted in such a negative light. Sure, they were SURGERY, but it wasn’t the nightmare that these crazy people make it out to be. I’d happily do it again, especially if it meant that it would improve the health of me and/or my baby. I had some crazy woman shake her head in pity about my first C-section, telling me how I can’t let the medical establishment control my body, and how if I’d only switched immediately to an extremely high-protein diet, my preeclampsia would have been controlled (hahahahaha!!! oh my, that was rich). I have such a different perspective. I’m simply in awe of the medical advancements that SAVED THE LIVES of me and my son. I’m grateful, and think my OB is a hero, quite frankly.

    • corblimeybot

      People who promote the Brewer Diet for pre-eclampsia just need to be kicked out of society entirely.

      • guest

        Yes.

    • Sonja Henie-Spinning Jenny!

      What “crazy people” are making C-sections out to be a nightmare. I’m saying the recovery time is longer than from an uncomplicated vaginal delivery.

      • Amazed

        You’re also saying that elective c-sections come at the expense of safety.

        • Sonja Henie-Spinning Jenny!

          Elective, yes, meaning at patient request for no medical reason. You’re trying to trap me, aren’t you? See what the ACOG says: “Given the balance of risks and benefits, the Committee on Obstetric
          Practice believes that in the absence of maternal or fetal indications
          for cesarean delivery, a plan for vaginal delivery is safe and appropriate and should be recommended to patients.”

          • Amazed

            Trying to trap you? Please. I’m just quoting what you say.

            When does the ACOG say that purely elective c-sections are more dangerous? Because I seem to remember a certain percentage of c-sections that should not be exceeded. Turned out it was just Marsden Wagner’s personal opinion without any reasons behind it.

          • Sonja Henie-Spinning Jenny!

            “When does the ACOG say that purely elective c-sections are more dangerous?”

            Right freaking here: “Potential risks of cesarean delivery on maternal request included greater complications in subsequent pregnancies, such as uterine rupture, placenta previa, placenta accreta, bladder and bowel injuries, and the need for hysterectomy. A Canadian study of primiparous women with singleton pregnancies showed an increased risk of postpartum cardiac arrest, wound hematoma, hysterectomy, major puerperal infection,anesthetic complications, venous thromboembolism, and hemorrhage that
            required hysterectomy in patients who had a planned primary cesarean delivery (6). These are also factors that may be influenced by parity and planned family size. Uterine scars put women at increased risk of uterine rupture in subsequent pregnancies. Although the risk of peripartum hysterectomy in a woman’s first delivery is similar for planned cesarean delivery and planned vaginal delivery, there is a significant increased risk of placenta previa, placenta accreta, placenta previa with accreta, and the need for gravid hysterectomy after a woman’s second cesarean delivery (Table 1). This emphasizes the need to consider the woman’s total number of planned or expected pregnancies if cesarean delivery on maternal request is discussed during her first pregnancy, with the realization that many pregnancies are unplanned.”
            http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Cesarean-Delivery-on-Maternal-Request

          • Amazed

            I must have imagined the “potential” bit here.

          • Sonja Henie-Spinning Jenny!

            Maybe you could trouble yourself to read the entire link.

          • Amazed

            Maybe I did. Oh I forgot. The only opinion that count is yours.

          • Sonja Henie-Spinning Jenny!

            Good God, you guys in this cabal are getting nasty. There are people who have been arguing THEIR opinion all day long, then they say I think mine’s the only one that counts.

          • Amazed

            Of course. After all, no one else tried to argue from position of authority (and avoided commenting when it turned out that someone’s authority on healthcare is greater than theirs.)

          • Sonja Henie-Spinning Jenny!

            Yes, I’m a real shyt. Thanks Amazed.

          • Sonja Henie-Spinning Jenny!

            OH, but, but, but. Several people on here say they are doctors, one an OB. But they’re not arguing from authority. But I am. Right.

          • Amazed

            So they’re lying? You are the only Bearer of Truth?

            They’re only allowed to bow to your greater wisdom when they answer a question you ask smugly?

          • Sonja Henie-Spinning Jenny!

            Yes. Good For You for figuring it all out. Hopefully, you can identify sarcasm.

          • Amazed

            I thought we have already established that we in our cabal are the nasty witches persecuting poor little you. Of course I undersand sarcasm, that’s one of my evil weapons against brave pro-vaginal champions.

          • Sonja Henie-Spinning Jenny!

            You don’t know me from a hole in the ground, that’s for sure.

          • fiftyfifty1

            The only way to know someone on a written forum like this is by what they themselves write.

          • Sonja Henie-Spinning Jenny!

            Well I never wrote anything about being “pro-vaginal”. Cripes!

          • fiftyfifty1

            Sonja: Vaginal worked out well for me and it should be pushed on others.

            “The Cabal”: Vaginal doesn’t work out so well for everybody, so MRCS should be an option as well.

            Sonja: Argh! Why are you people so antivaginal and nasty?! Go fly a kite!

          • Amazed

            “I seem to be the only pro-vaginal birth person participating.”

            I thought it was you who wrote this. Did you mean something else?

          • Sonja Henie-Spinning Jenny!

            I’m answering this realizing that nothing I say will be accepted by you guys. I meant I’m not part of any “pro-vaginal birth/anti-Csection birth” movement.

          • Roadstergal

            You might not be part of a movement, but it’s what you’re saying here. “I seem to be the only pro-vaginal birth person,” assuring women who had easy CS recoveries that they would have had even easier VB recoveries, discounting the stories of women who had both and the CS recovery was easier, arguing that ‘recommendation’ means ‘only do the thing even if the woman really wants the other thing after being told risks and benefits.’ You’re coming across as not just pro-VB for yourself – which is totally fine and we totally support you in – but “VB for all pregnant women, unless I think their medical reason for not wanting it is good enough.”

            Honestly, I don’t understand your motivation. I’d just urge you to look at the diversity of people from more than one country who are all getting this same message from you, and if that’s not your message, to take a moment and try to set out clearly what your message is.

          • Sonja Henie-Spinning Jenny!

            No, that’s not what I’m saying, nor what I have said. YOU and your compatriots on this board have put words in my mouth that I did not say. I have said absolutely NOTHING you have in quotes, claiming I’ve said it.

            Now for my “motivation”. I came to this board for an interesting discussion. What I found instead was a very anti-vaginal birth approach; claims that there are few uncomplicated vaginal births which was not my professional experience. But if I mention my experience, I’m doing an “appeal to authority”, while people with no such experience, and in some cases no health care provider experience at all, claim to know far more.

          • Roadstergal

            Nobody here said that there are few uncomplicated vaginal births. What has been said is:
            -An uncomplicated vaginal birth is not a guarantee, and a complicated vaginal birth can go pretty badly – including going to an emergency C/S

            -Even an uncomplicated vaginal birth can have painful/uncomfortable/embarrassing effects that a woman may legitimately wish to avoid

            Do you disagree with these two statements?

            “I have said absolutely NOTHING you have in quotes”

            ???

            https://uploads.disquscdn.com/images/109a0ed862c9bbd593d0b832154f10e7342e83cb52b4c9e8fb7c3676aba03687.png

          • Amazed

            There is a saying here, I can’t really translate it in English and I certainly have no idea of the equivalent. “Even alone, a warrior is a warrior”. Meaning, you don’t need to be part of a movement to show your pro-vaginal, anti-c-section bias. You’ve quite successfully written other women’s stories as anecdotes, refused to address the issue of different recoveries from c-section and vaginal birth, both uncomplicated, in the same woman, tried to rewrite the meaning of medical terms like elective and planned c-sections, advocated verbally bombarding women with the risks of c-sections as opposed to making a profesisonal recommendation, spoken from the position of professional authority and then refused to acknowledge other people’s greater authority, behaved disrespectfully to people who nonetheless treated you with respect.

            You know, you don’t need to be part of a movement to be pro- or anti-. You present yourself as both. If I, and so many others who posted here an/or liked our posts understanding your words this way took you to be pro-vaginal defender, perhaps it’s worth considering how well you express yourself.

          • Sonja Henie-Spinning Jenny!

            Go Fly Your kite!

          • Amazed

            Why, stay classy, Sonja.

          • Sonja Henie-Spinning Jenny!

            I will. Funny, you’re posting an attack on me,quite personal, and you’re surprised, I guess, that I don’t just thank you!

          • Sonja Henie-Spinning Jenny!

            http://www.bartleby.com/73/2019.html
            ““When I use a word,” Humpty Dumpty said, in rather a scornful tone, “it means just what I choose it to mean—neither more nor less.””

          • Amazed

            Oh, and maybe you could trouble yourself to figure out what’s missing from the link. The Canadian study? It only looked at planned c-sections. Planned does NOT mean not medically indicated. It just means planned. Young CC Professor, a regular poster here, had such a c-section. It was medically necessary, although it was probably logged in as a MRC because no one was dying at the time. Her placenta was giving up the ghost. She would have been included in this study, had she been Canadian.

          • Sonja Henie-Spinning Jenny!

            You are showing your ignorance. Young CC Professor had a medical reason for C-section.

          • Amazed

            It was planned. The Canadian study only looked at planned first-time c-sections. The only risks they excluded was a multiple pregnancy.

            She would have been included.

          • Sonja Henie-Spinning Jenny!

            Well, she wasn’t in that study, so it’s totally irrelevant, except that you want to use it to prove your point.

          • Azuran

            She might not, but many actual Canadian women who also had planned c-section for medical reason ARE in the study and are messing up with the result.

          • fiftyfifty1

            “Well, she wasn’t in that study, so it’s totally irrelevant, except that you want to use it to prove your point.”

            So let me see if I’ve got this right:

            Amazed: Cases like CCProf’s where a CS is indicated got lumped in with MRCS in the Canadian study.

            Sonja: You’re a dummy! Cases like hers weren’t included.

            Amazed: Actually cases like hers were included; only twins were excluded from the analysis.

            Sonja: …Nope! CCProf isn’t even Canadian. So it’s totally irrelevant. Gotcha there you dummy!!!!

          • Sonja Henie-Spinning Jenny!

            I did not call anyone dummy. It’s Amazed who’s assuming things not in evidence.

            So no, you haven’t “got” this right.

          • Amazed

            Not in evidence? Haha. Once again, do tell me where the Canadian study includes things like “purely elective” and “not medically indicated”?

            And you did call “us” nasty, so don’t play all hurty feelings. BTW, one of the things I never understood with you vaginal all the way folks is how you lump more abrasive posters like me with people who have stayed unfainlingly polite in the face of your implications of ignorance and biases, let alone your freaking insults. We’re all nasty.

            Do take your head out of your vagina and learn not to read what isn’t there. Oh, and while you’re there, learn some manners. Whining how people are nasty just doesn’t look good when mixed with dismissals like yours.

          • fiftyfifty1

            You said she was ignorant, but it turns out that the ignorant person was you. And you still won’t admit she was right about the study design.

          • Amazed

            She doesn’t even know that I was right. She interprets MRC to mean totally medically non-indicated and that’s it.

          • Roadstergal

            This is exactly what we’re talking about. The data they used showing the risks of C-sections do not exclude women who had medically indicated C-sections!

            It’s just the distinction you were juggling with about the difference between elective vs non-medically-indicated C-sections. The data that would properly inform a woman’s decision whether to have a non-medically-indicated C-section is data comparing outcomes for women who had no medical indications for a C-section and planned a vaginal birth (including outcomes for failed vaginal births that went to CS _in that planned VB group_), vs women who had no medical indications for a C-section and planned a C-section. To the best of my knowledge, this data aggregation does not exist, and I think that’s a problem. Do you have it? Because I really, really want to see it.

            Not having this data, the ACOG and NICE both support MRCS, while recommending VB.

          • Amazed

            My suspicion is that if there was such a thing as an optimal c-section rate, it would have been increasing steadily and would have kept increasing. Then, the question wouldn’t have been “Is a c-section indicated for you?” but rather “Is a vaginal birth contraindicated for you?” As the world hurtles forward, vaginal births will keep getting unsafer, with women being older and heavier when they give birth, with all the comorbidities that we still haven’t found effective treatments for. At the same time, c-sections will keep getting safer because it’s easier to better a procedure than the human body and its natural direction of wearing out.

          • KeeperOfTheBooks

            Plus, from a hereditary perspective, matrilineal “bad pelvis” lines may come into play. A woman who would have died in childbirth 150 years ago had a healthy daughter 20 years ago who inherited her non-vaginal-birthing-friendly pelvis and who, when she got pregnant/went into labor, had another daughter with an equally “faulty” pelvis due to genetics. It’s a guess on my part, but I don’t think I’m totally out there with it.

          • Who?

            I wonder this too, and also with assisted reproduction. A person who exists only because their parents had access to fertility treatment or IVF might or might not share the issues the parents had-for instance, if their parents were older, they might be fine if they procreate young.

            On the other hand, if the issue was more deepseated, they might have similar problems.

          • Amazed

            There is this. Just like any other ailment that was fatal for children once but now can be treated, although not without the genetic predisposition to have children who inherited it. THAT’s why we’re supposedly sicker than our glorified ancestors. Like breast cancer. When you die in childbirth at age 23, it’s hard to develop BC at older age. That doesn’t mean there is something wrong with us now that wasn’t before.

            OT: In 17 days, my grandmother turns 85. Quite immobile but with her mind (almost) intact, the exception being some minor misfunctions in her memory. Two types of cancers survived. Diphteria and full-blown eclampsia as well. All those treated very aggressively. Huzzah for aggressive medicine!

          • N

            On my fathers side, VB was never a problem.
            Anecdotal as most of what I have to say: On my mothers side: my mother’s mother grew up without her mother, because she died. Of what? No one knows. Was it shortly after giving birth to my granny? No idea, but possible. My grandmother herself had no known problems giving birth. My mother had me with a lot of pain and forceps and a little damage down there. My sister was easier and my brother came very fast without any problems. My mom’s sister on the other hand, had her first two kids with very difficult births, forceps, and damage, so that her Ob told her as she was pregnant with baby N°3 that a C-section in her case would be better, to not risk those complications AGAIN! And here I am. I must be like my aunt and perhaps my grannies mother: Baby 1 wouldn’t turn his head down, stay in breech position until the end, Baby 2 managed to turn her head down but never descended during labour. And baby 3 preferred to lie in a diagonal position. There must be no “normal” exit in my body. Hail C-sections!

          • N

            Oups, it happened again, stupid errors. And I guess as a guest I can’t correct them. Sentence-mix-up in the first 3 lines. Sorry for that.

          • Roadstergal

            “Should be recommended,” not “should be the only supported option.” Not even “should be encouraged,” which you’ve mis-stated it as elsewhere.

          • Sonja Henie-Spinning Jenny!

            “Should be recommended” and “should be encouraged” are pretty much the same thing.

          • Azuran

            Hum, no, they are not.

          • Eater of Worlds

            “I recommend this doctor and I encourage you to go see them”

            “I encourage this doctor and I recommend you go see them”

            Shockingly, you can’t just switch the words around and have the same meaning.

          • Azuran

            You should look up the definition of ‘recommended’

          • Sonja Henie-Spinning Jenny!

            Recommend: http://www.merriam-webster.com/dictionary/recommend

            Simple definition:

            “1. to say that (someone or something) is good and deserves to be chosen
            2. to suggest that someone do (something)
            3. to make (something or someone) seem attractive or good”

            Full definition:

            1.a : to present as worthy of acceptance or trial
            b : to endorse as fit, worthy, or competent
            2 : entrust, commit
            3 : to make acceptable
            4 : advise “

          • Azuran

            Good, now compare it to the definition of ‘encourage’

          • Dr Kitty

            No, elective means “scheduled”, as opposed to “emergency”, when you phone the anaesthetist on call and have them meet you in theatre because the section has to happen NOW.

            Pretty much all twin, repeat and medically indicated CS are scheduled (usually between 38-40 weeks) and are therefore elective.

            Maternal Request CS is what you mean- and that can still have a “soft” medical indication like past history of sexual assault, previous traumatic birth, PTSD, tokophobia, anxiety disorder etc.

            It is very, very rare for a woman to request a CS “just because”.

            Sometimes providers don’t really want to know why, sometimes women don’t really want to tell them (particularly if there is a history of abuse), but the “too posh to push” stereotype is a rare beast indeed.

          • Sonja Henie-Spinning Jenny!

            You can argue semantics from here to eternity. I think you know what I mean. My interpretation of what ACOG means is people with no contraindications CHOOSING to have C-sections; C-section on demand IOW. Until this thread, I would have thought it is very unusual to request a CS “just because”. For decades, we’ve been hearing about “too many C-sections” and how the US should reduce its C-section rate.

            http://www.webmd.com/baby/features/elective-cesarean-babies-on-demand#1

          • momofone

            The problem, as I understand it, is that no one has clearly defined what constitutes “too many.” I’m not a medical person, so if I’ve misunderstood, please let me know.

          • Amazed

            Arguing semantics? Wow! That’s quite the wishful reading here. It isn’t arguing semantics, it’s explaining what the studies you hold in such regard say. They don’t say “people with no contraindications CHOOSING to have C-sections”. You interpretation is wrong. Dr Kitty is telling you what the ACOG really means. And yes, what the Canadian study included in your precious link means. It means that the YCCPs of Canada who only had singletons are included and messing up with the results.

          • MaineJen

            It’s not semantics…it’s an actual medical term with an actual meaning. Which Dr. Kitty just told you.

      • Who?

        Trouble is you can’t tell, in advance, what will or won’t be an uncomplicated vaginal delivery.

        • Roadstergal

          Exactly this. The ‘risks’ of uncomplicated vaginal delivery might be low, but the ‘risk’ of not having an uncomplicated vaginal delivery is a different consideration.

          • Who?

            Yup. I had two big babies the old fashioned way, both late, both mec, few stitches the first time and no harm done. I’d call that dumb luck.

        • Sonja Henie-Spinning Jenny!

          No, of course you can’t. But that’s not the point! The point is a vaginal delivery should be recommended absent risk factors.

          • Azuran

            And it is. But that doesn’t mean that MRCS should not also be proposed as a viable option. Doctors totally should and will tell patients if they think vaginal birth is safer. But that doesn’t mean they shouldn’t also talk about the option of a c-section.

          • sdsures

            Exactly – laying out the options harms nobody.

          • Who?

            Why?

          • Sonja Henie-Spinning Jenny!

            I give up with you guys.

          • Who?

            My question was serious. Why would some who wants only a couple of chidren not choose a cs based on their own values, and why would anyone else care if they did?

            What’s a week or two extra recovery, over a what 80 year lifespan?

          • Sonja Henie-Spinning Jenny!

            Here are the variables with moderate evidence in favor of elective (totally for patient preference) C-section: Lower likelihood of maternal hemorrhage

            Here are the variables with moderate evidence against elective C-section:
            Maternal length of stay
            Neonatal respiratory morbidity

            Subsequent placenta previa or accreta

            Subsequent uterine rupture

          • Who?

            Ok. The first two get sorted by your health insurer and the team on hand, respectively.

            The second two mother balances against the chance she may end up having a non elective cs anyway, and the chance of damage to her pelvic floor and perineum if the vaginal birth is completed.
            Her choive.

          • swbarnes2

            How likely is a uterine rupture for a woman with one C-section planning on having a repeat? How likely is that other stuff to be a problem if a woman plans on a second C-section before labor starts?

          • Who?

            No idea. Those are good questions though. More information is always good.

          • sdsures

            I’m picturing THAT scene from “Alien”. 😀 https://www.youtube.com/watch?v=LsD6AL3HJtM

          • sdsures

            I always hear this song sung by the alien in Spaceballs when I watch the original Alien scene. 😀 https://www.youtube.com/watch?v=y-sBROXalU4

          • Eater of Worlds

            I love that scene. The reason they were so shocked during it is that they weren’t told the specifics, so what happened really was a shock to them.

          • sdsures

            Yep!

          • Roadstergal

            I’d be really interested in knowing. That’s the big bugaboo, after all, but if someone is like Dr Kitty – planning only two children, wanting two C/Ss – how do the stats fall out?

          • Erin

            From the leaflet I’ve been given, risk of rupture if you have an elective section prior to the onset of labour is less than 0.02%.

            Obviously though (as someone mentions to me at every single appointment) you have no control over whether or not you go into labour prior to a section date.

          • sdsures

            Yep, the baby doesn’t give a sh*te! 😛

          • Erin

            My friends (and sometimes I wonder!) think I’m going to end up with either a vbac or a home vbac just because I’ve tried so hard to get the section I want planned.

            So I’m trying to encourage the littlest member of the family to stay put, fingers crossed they don’t take after their brother and decide that they don’t want to wait til week 39 to be born. My husband caught me explaining to the Bump that they want a birthday as far as from Christmas as possible for better present separation and to hang on in there. I had a minor panic when he pointed out that if they did understand me, they might decide to turn up for Christmas.

          • Roadstergal

            Some of the OB folk here have discussed the ‘Neonatal respiratory morbidity’ part as being mostly TTN due to not being put through the baby-juicer of a VB. They noted it is, as per the name, transient, and tends to resolve with no long-term consequences. Again, I defer to their expertise, but that would again be a reason why ACOG and NICE wouldn’t see it as being a big enough deal to not support MRCS (which they do support).

          • Spamamander

            Heck my son had a vaginal birth and needed a bit of “help” to get kick-started breathing because he quite literally came in one big push, no “baby juicer”. He was fine.

          • KeeperOfTheBooks

            Why is a longer stay a bad thing?
            While my hospital, being a BFH, wasn’t exactly awesome, they did let me pretty much stay in bed and, thank to my wonderful BFF who came to help with baby, I got to lie in bed a lot for the two days I stayed.
            I requested early discharge so that I could be home in time to watch the toddler so DH could go to work. Upon getting home, I then had to do 2+ hours of housework just to get the place liveable, as my BIL had stayed over and left food/dirty dishes/clothes/et all *everywhere*.
            Frankly, I wish I’d stayed the 4 days.

          • Azuran

            I make my medical recommendation based on what my patient needs, and I keep them as long as they need. I
            I would expect that a doctor would provide me with whatever I need, and not be concerned with how long I’m going to need to stay.
            You should aim to get your patient better, not get them home faster.

          • Sonja Henie-Spinning Jenny!

            One problem with being in the hospital for any reason is hospital-acquired infection.
            http://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf

          • Azuran

            But the solution to this should not be to race to throw patients out as soon as possible. It should be to fight against hospital acquired infection.
            The rates of which, probably do vary a lot between hospitals, and even between department in the same hospital.
            The risk for a healthy mother in a maternity ward is probably much lower than the 7/100 stated in your article. Risks seems to be higher for babies in NICU, but you obviously can’t just send sick premature babies home. So really the solution is elsewhere. And you’ll notice that in the section ‘solution’ of your article, there is no mention of trying to reduce hospital stay.

          • Sonja Henie-Spinning Jenny!

            Hospital acquired infections have been a problem for at least the 40+ years I’ve been in nursing. One reason hospital stays in the US have become shorter is to avoid such infections.
            http://www.secondopinion-tv.org/episode/hospital-acquired-infection
            “The longer the hospital stay the higher risk there is of contracting an infection.”

          • Azuran

            And you should totally work to reduce the rate of infection. But the answer isn’t to rush people out of the hospital before they are ready or limit treatment options to the ones that require shorter hospital stay.

            Hospital acquired infections are a problem in my work to. In answer, we raised sterility, we improved cleaning and disinfection, we did more training with the staff on how to prevent transmission. We didn’t start refusing medical procedure or send sick patients home.

          • Roadstergal

            That’s another thing that makes the decision tricky. Sure, an uncomplicated VB might put you at a lower risk of infection than a planned C/S. But there’s no doubt that the highest risk of infection is a VB that gets complicated, then goes to emergency C/S. Again, you have a: confounders to the VB vs C/S statistics, and b: a more predictable course with a planned C/S (including taking pre- and peri-operative steps to reduce the chance of infection) than with a VB, where you’re betting on it being better, but it could be much worse.

          • Sue

            What are the statistics for the labor and post-delivery ward, as opposed to surgical and medical wards with sick elderly people with multi-system disease?

            (Hint: rhetorical question)

          • sdsures

            That’s why everyone who is admitted to hospital, for ANY reason, is tested for things like MRSA a few days or a week before admission, which you may not realize you’re carrying without a test. A quick couple swabs with Q-tips, and you’re done.

            You’re a nurse – why aren’t you familiar with this protocol?

          • momofone

            I was physically ok to leave after 48 hours, but fortunately my insurance covered 96. My son was in special care, and though I could have been discharged, it was so much easier on all three of us not to have to be. My son was in the hospital four days longer than I was, and we stayed in a hotel, but the extra couple of days we were able to be there (and, honestly, in the care of the nurses and doctors, who were all wonderful to us) made life much easier.

          • sdsures

            I imagine this would be especially helpful to a first-time parent – a couple extra days to get back on their feet and adjust to being a new parent.

          • Who?

            I’m hardly one of the guys. I just don’t understand why you want to mind someone else’s business for them.

          • sdsures

            Nurses aren’t even allowed to recommend procedures (of any discipline) to patients. That’s what doctors do.

          • Roadstergal

            “Doctor, I’m not sure about whether to go vaginal or CS.”

            “Well, we’ve gone over your risk factors – you’re having a really textbook pregnancy, and we’ve talked about the risks vs benefits of vaginal births and caesarean sections, given that you want only two kids. We’ve discussed how an attempted vaginal birth might turn into a CS, no matter how ideal things look going in. Given the state of current evidence and your situation, I would recommend a vaginal birth.”

            “Thanks, doctor. I’m going to think about this and talk about it some more with my partner, with your recommendation in mind.”

            “Feel free to ask any more questions, I’ll support your decision either way.”

          • Sonja Henie-Spinning Jenny!

            Aww!

            What about “I do not recommend a C-section for the following reasons:
            1. You’ll have a longer hospital stay
            2. There is a higher risk of neonatal respiratory distresss
            3. There is a higher risk of subsequent placenta previa, or accreta in future pregnancies.
            4. There is a higher risk of uterine rupture in future pregnancies.

            The only advantage is that there is a lower rate of hemorrhage in the mother.

          • Roadstergal

            I’m trying to show you the difference between ‘recommend’ and ‘encourage.’

          • Sonja Henie-Spinning Jenny!

            Oh, do enlighten me!

          • Who?

            I’m not sure you’re making the point you hope to.

            Risk 1 may or may not be a problem, and risk 2 is a known, and therefore prepared for issue.

            Given there is no guarantee the vb won’t morph into a cs, the issues around 3 and 4 aren’t a done deal until the birth is.

            Less risk of haemorrage this year sounds like a good thing.

            It’s ultimately about perspective.

          • Roadstergal

            Ah, ninja edit after I replied…
            So, you think that the current ACOG guidelines are not sufficient, in simply recommending a VB in this circumstance. You think an OB should go farther and actively discourage a C/S, bringing back up risks that have already been discussed, rather than provide the evidence and recommendation and then let the woman make her decision.

            Why do you think the data supports changing the current guidance?

          • Sonja Henie-Spinning Jenny!

            Quit trying to tell me what I think, K?

            What’s wrong with a little informed consent? Plenty, I guess, if it doesn’t fit in with your biases.

          • Roadstergal

            Informed consent is giving a list of risks and benefits, and possibly providing a professional recommendation, if merited. It’s what I laid out in my little pretend conversation.

            But you seem to think informed consent isn’t enough. A woman who is offered informed consent and chooses a C/S should be actively discouraged from or even denied one. Yes?

          • Amazed

            Don’t try to argue sense with her. Her reply to my (and your) explanation about the limits of the Canadian study was “Well, YCCP wasn’t included in this study anyway, so it’s irrelevant”.

            Don’t expect an honest answer.

          • yugaya

            Ontario studies from which two midwives excluded cases that should have never been a planned homebirth with the excuse of clerical errors. For the period during which in that province a documented pattern of midwives making *clerical errors* of not keeping accurate patient records, especially not accurate about the risks that would have risked out women, has emerged during perinatal coroner reviews.

            Yeah, such biased exclusion criteria enabled these two Ontario studies to conclude that homebirth is *just as safe*. Reality is, there were a dozen homebirth tragedies that fit that exclusion criteria, and even one of them noted in the homebirth cohort would have made such a conclusion impossible.

          • Amazed

            Yeah, there is that. But just like the UK study, what matters is how homebirth SHOULD be happening, not how it IS happening.

          • Sonja Henie-Spinning Jenny!

            Quit playing these games.

          • Roadstergal

            No games, as I mentioned. While we can discuss the quality of the data behind the risks and benefits currently listed for CS and VB, the bottom line is that while the ACOG and NICE recommend VB to low-risk women, they support the right for these women to choose CS. Your comments continually indicate that you disagree with that and think those guidelines should not allow MRCS at all for low-risk women.

          • momofone

            Length of hospital stay seems kind of weak to me, but still a matter of personal preference. For people who have other children at home, longer hospital stay may actually be a benefit, as could the ability to schedule the birth based on when help would be available. The other reasons would of course have to be weighed against the reason for the current c-section, and it seems to me that the mother is in the best position (along with her OB) to decide how comfortable she is with those risks.

          • sdsures

            “2. There is a higher risk of neonatal respiratory distresss”

            How?

          • Roadstergal

            It was one of the data points that the committee considered had ‘moderate’ evidence in their discussion. See the discussion on TTN, below.

          • Sonja Henie-Spinning Jenny!
          • Sue

            TTN (transient tachypnoea of the newborn) is not “respiratory distress” – it;s just transient, benign faster breathing.

            On the other side of the balance, Cesarean-born babies have significantly less injuries or hypoxia.

          • Lizz

            Your average hospital stay after a c-section is three days and personally I stayed a day and a half after my second because baby was at another hospital(transfer of preemie) and I was bored out of my mind.

            Is it bad because of financial reasons or taxing of healthcare resources?

          • FallsAngel

            Some people do not like to be hospitalized, want to go home ASAP. So for some people, it can be a negative to have a C/S and stay longer than with a vaginal delivery. I could not find anything to verify that the “average” stay after C/S is three days. In general, you will stay longer after a C/S than a vaginal delivery.

          • maidmarian555

            Well I was in 36hrs after my op. So was my best friend. I don’t know anyone that’s stayed in more than 1-2 days max after a C/S. Admittedly we’re in the UK and it’s probably fair to say that the NHS really don’t want you to overstay your welcome unless you are dying but I think if you want to make a realistic and sensible case for not having C/S then “having a long hospital stay” probably shouldn’t be on the list. And frankly, that’s rather superficial in the wider scheme of things anyway.

          • FallsAngel

            I didn’t say a “long” hospital stay, I said “longer” meaning longer than with a vaginal delivery.

          • maidmarian555

            I also don’t know anyone who’s had a vaginal delivery that was out any faster than I was. I’m just saying that if you have a straightforward C/S with no complications, you don’t need to be in hospital any longer than you would with a straightforward vaginal birth with no complications. I wish people would stop perpetuating this myth. It’s just not something that should even be a consideration when weighing up the benefits/risks of C/S vs vaginal birth because if all goes well it won’t make any difference at all.

          • Lizz

            All I could find was a few patient help pieces but both ACOG and NHS are very similar to what the hospital told me at my prenatal class and the forms I have saved from my own sections as well as my doula training. Anecdotally I’ve never met anyone either online or in person who stayed more than 4 days including my cousin who had a crash c-section after a full abruption at work. If you’re doing well though they will release you early-ish, three or so days is hardly a rule. I think I was 59 hours inpatient with my son because he had to wait for the lady who was doing hearing tests to get us in and 36 hours with my daughter because I was so stir crazy I was cleaning my own room and taking back my eating tray for them.

            “A hospital stay after a cesarean birth usually is 2–4 days. The length of your stay depends on the reason for the cesarean birth and on how long it takes for your body to recover. When you go home, you may need to take special care of yourself and limit your activities.”http://www.acog.org/Patients/FAQs/Cesarean-Birth-C-Section
            http://www.nhs.uk/Conditions/Caesarean-section/Pages/Recovery.aspx

            I’ll keep looking for patient studies rather then patient help sheets.

          • sdsures

            “Some people do not like to be hospitalized”

            We all have to do things we don’t want to, or would prefer not to. Suck it up and behave like an adult.

          • sdsures

            BBC article from yesterday: “Things new mothers aren’t always told” http://www.bbc.co.uk/news/magazine-37630561

            I think that it would benefit both parents and babies if medical professionals took the time to include risks of known simple consequences of vaginal birth such as incontinence, etc. It’s not so much of a “risk factor” as it is an expected side effect of most VB – right?

          • Roadstergal

            Wow, that’s quite an intro piece!

            I agree with you. I still remember that comment in an article from a UK OB saying she didn’t give honest risk/benefit information to her patients, because then too many would choose C/S.

            The general sense among my friends is that ‘natural is better’ and that a C-section is the worst outcome. It’s not really clear as to why, it’s just what they’ve been told for so long that it’s ingrained, now.

          • sdsures

            🙁 Guess I’m just a /monster/ then, needing a medically-required CS. My babies will be fat, diabetic and asthmatic. #sarcasm

          • sdsures

            “I still remember that comment in an article from a UK OB saying she didn’t give honest risk/benefit information to her patients, because then too many would choose C/S.”

            That sounds like medical irresponsibility on her part.

          • Roadstergal

            I wish I still had that link. I remember seeing it in the comments of this blog about a year or so ago.

          • sdsures

            Please let me know if you come across it.

          • Dr Kitty

            https://www.medicalprotection.org/uk/for-members/news/news/2015/03/20/new-judgment-on-patient-consent

            https://ukhumanrightsblog.com/2015/03/13/supreme-court-reverses-informed-consent-ruling-sidaway-is-dead/

            This is what you want, the obstetrician specifically said she didn’t warn diabetic women about shoulder dystocia because “too many” would choose CS.

            “The obstetrician added

            “if you were to mention shoulder dystocia to every [diabetic] patient, if you were to mention to any mother who faces labour that there is a very small risk of the baby dying in labour, then everyone would ask for a caesarean section, and it’s not in the maternal interests for women to have caesarean sections.”

            So the obstetrician herself accepted that mothers would generally opt for a caesarean if so warned; that was a reason for not warning.”

            The Supreme court ruled that the patient should have been informed of the risk and given the option of CS.

            In particular, the judgement of the court was that it is up to the patient to decide which risks are worth taking, even if risks are rare, or consent cannot truly be said to be informed.

            Simply because VB is “natural” doesn’t mean that you can avoid discussing the risks involved if there is an alternative treatment (CS) which the patient may find more acceptable.

      • Azuran

        That is not a guarantee, it’s a ‘perfect scenario’ situation. That’s the whole point we are trying to make.

        • Sonja Henie-Spinning Jenny!

          We, we, we! What is this cabal, anyway?

          • Amazed

            Everyone who’s reading you. That’s, everyone who’s running with a fork after you for just being pro-vaginal birth.

            That’s the only scenario you seem to accept anyway.

          • Sonja Henie-Spinning Jenny!

            Go Fly Your kite. You already said that once.

      • Who?

        Some people don’t want to take the chance that their vaginal delivery will be uncomplicated. Some would gladly give a couple of weeks post delivery to recover in return for a better shot at being continent long term.

        • Roadstergal

          Some would rather plan for a certain length and nature of recovery, rather than hope for an easy VB and risk an unknown set of complications and duration of recovery.

          Some like the odds on an easy VB, take that route, and do quite well. They’re both legitimate ways to go.

          • sdsures

            The risks of the unknown versus the known play an *enormous* amount in the process of decision-making. It extends not just to personal decision-making, but also to the wider fields of finance and business strategy. #geek

            The shorthand is the child’s game “Would you rather?”

      • corblimeybot

        The entire NCB movement, for starters?!?

        • Sonja Henie-Spinning Jenny!

          Personal affront? What the H*ll are you talking about?

  • guest

    Wow, this one makes me ragey. I had a c-section at 8 centimeters, not for failure to progress but fetal distress. But Kamel apparently thinks that protecting my daughter’s health was a “waste” (you’d be protecting it with failure to progress, too). My daughter is not a “waste.” She is loved. She is amazing. And she is alive.

  • Tori

    I don’t know if it’s so much that people are foolish but incredibly vulnerable. I remember a discussion with my ob, and he was talking about someone coming in concerned that they had read in the paper that “babies born by section are more likely to be obese”. Of cause any association is just that, and any link will be multifactorial in causation, but as a vulnerable pregnant woman or new mother, reasonable thought wasn’t my first point of call with my breastfeeding troubles either.

    • Erin

      I think that’s definitely true. After my section I read so much about section babies being more likely to have asthma, obesity, problems at school and a whole host of other issues. The guilt made my pnd and other mental health issues so much worse. Then I read about postnatal depression potentially harming child development and pretty much snapped. I honestly believed that I didn’t deserve him, that I’d ruined his life and everything I read backed that up (hadn’t discovered Dr Amy at that point).

      It’s crazy really, I put my baby first and yet I’ve been punishing myself ever since.

      • Tori

        I’m so sorry to hear what happened to you. I don’t know if you’re familiar with Winnicott (or even if you like his perspective if you are), but the phrase “good enough mother” is one I love. As well as “ordinary devoted mother” who keeps her baby in mind, which is exactly what you were doing and are doing! “Ordinary” sounds harsh, but it’s actually very kind. For me I feel I have permission to fail sometimes – and he’d say intermittent maternal failings are important as they enable the child to learn to tolerate frustration, or something like that. I don’t have to be “exceptional” as a parent, but good enough. Winnicott’s writing is abused by AP and I think he’d be horrified at the pressure AP places on mothers.

        My ob warned me antenatally that I might need to supplement a bit because I had a big baby expected and it might be hard to keep up, and he was telling me beforehand so I didn’t get too distressed afterwards. Fast forward 6 weeks postnatally, there I still was, in tears in my postnatal appointment because I was ‘supplementing’ 75% of baby’s caloric requirements with formula because you know, big baby and then being diagnosed with IGT as well, and all I wanted was to breastfeed because otherwise my baby would be ‘harmed’. It might have been easier if I’d listened better beforehand, and seen a LC or at least bought some bottles and formula to save that late night grocery store run after the LC told me to start some formula over the phone!! I think my distress was exacerbated by visitors not respecting our personal space as a new family which I needed too. It wasn’t the most rational time of my life.

  • yugaya

    “It’s a shame when cesareans occur outside guidelines which ultimately
    increase future risks.” But it’s not a shame when VBACs occur outside of
    basic safety guidelines which ultimately does not increase future risks
    – it kills babies in real time right there and then. What a hypocrite. I can’t believe that someone falls for this crap and pays this idiot for these lies.

    • moto_librarian

      THIS!!!

  • yugaya

    Jen Kamel’s removed from her website HBAC birth story. Including the part where she felt victorious because her vagina just got shredded and the part where she brags about the size of the b̶i̶r̶t̶h̶ ̶p̶r̶o̶p̶̶ baby: https://web.archive.org/web/20140211021043/http://vbacfacts.com/about/hbacbirth/

    She even fell for her fake midwive’s bullshit about purple line. O_o.

  • StephanieJR

    I’m calling Exploding Uteri as a band name.

    • mabelcruet

      How about Exploding Uteri and the Shredded Labia? I’m imagining the Shredded Labia as a three-piece do-wop backing group like the Supremes…

      • Charybdis

        Will they dance?

        • mabelcruet

          I think they kind of flap in the background.

          • Roadstergal

            *dying*

          • kilda

            I keep coming back to read this just to giggle.

    • valeriereinhard

      lol, perfect!

  • Cyndi

    I must have been so naive 37 and 33 years ago when my kids were born. During my pregnancies I hoped and prayed for healthy babies, and once I went to the hospital in labor I was good with delivering a baby whichever way would present us with a healthy and uninjured child. I welcomed my epidural with #2 as those weren’t available when #1 was born. I had a 4th degree lac with her, and that hurt and I hated it, but I got over it. What is up with all the birth related angst?

  • kilda

    Fixed it for her!

    It breaks my heart when I hear of a mom losing her baby at birth simply because she believed her homebirth midwife when she said there would be plenty of time to transfer in an emergency.
    Will she have an easy recovery?
    Does she have friends and family to support her emotionally, physically, and maybe help pick out the clothing to bury the baby in?
    Will she mourn her baby? If so, will she stuff those feelings deep down because, as she is told over and over, some babies just aren’t meant to live?
    Will her partner be a safe place, or will they too tell her that her baby wasn’t meant to live?
    Will she believe it’s her fault because she should have trusted birth more?
    Will her already broken heart break that much more when her milk comes in, for the baby that isn’t there?
    Will her pain need sedatives and antidepressants, to help her get through the days and nights after her loss?
    Will she wake up throughout the night in tears because she dreamed she was holding her baby, only to realize it was just a dream, again?
    Will she fall into depression in her grief? Will she feel alone or will she reach out for help?
    How long will it take her to feel like her again? Until she can see a baby, or a baby and mother together, wihout being shot through with unspeakable pain?
    How long until she realizes that her baby could still be alive if she had been in a hospital, with trained medical help?
    Will this impact how she trusts doctors, nurses, midwives?
    Will she question everything?
    Or will the same midwife tell her that another home birth will heal the pain in her heart?
    Will that midwife remain silent on the risk of stillbirth, shoulder dystocia, post-dates?
    Will they scare her and her partner with stories of unnecessary C sections leaving devastated women in their wake?
    Will she attempt a birth at home again, because she’s received inaccurate and incomplete information? Perhaps from a midwife who believes talking about complications can make them happen, so she doesn’t give her the full truth? Or maybe she just believes that babies know how to be born, and oxytocin can fix anything, so she doesn’t even say that the hospital is an option?
    We’ve seen this story a thousand times….and our hearts are heavy every single time.
    Women, and babies, deserve so much better.

    • Karen in SC

      I want to vote this up 1000x

    • Kq

      Fearured comment please.

  • Kathleen

    OMG – all the way through that I was like – she might wonder, but only AFTER she reads your f-ing post!

  • lilin

    I have to ask, so what if your body is broken? Why does every part of you have to be wonderful and perfect? You’re not perfect and not every part of you can do exactly what you want it to do. That’s probably the most “natural” thing about any mother anywhere.

    • TheArtistFormerlyKnownAsYoya

      And where does this “broken body” BS come from, and why does the idea only torment women who haven’t had the ideal birth as imagined by other women? Do men wring their hands over feeling their “body is broken” if they get heart disease or cancer? Um no, they seek medical treatment.

      • Roadstergal

        I think impotence/erectile dysfunction is the closest thing to threatening a cultural construct of ‘manhood’ in the way not having a VB threatens a cultural construct of ‘womanhood’?

        Actually, all of the “low T” bullshit is a good comparator, too. Funny how men immediately run to medical options for their threats, though!

        • TheArtistFormerlyKnownAsYoya

          Absolutely. I knew cancer was a terrible comparison as I wrote but it was far too early and I was far too undercaffeinated to come up with a better one – ED is perfect though. You don’t see a lot of men whinging and pontificating over their body being “broken” in some terrible, fundamental way due to having ED. And if they do feel manhood is threatened I feel like the general consensus is that this is not the best reaction and it’s simply a medical problem that can and should be treated.

      • Chant de la Mer

        Didn’t it start with ina may and her comments about how women’s bodies weren’t lemons, they were made to birth babies? Until that statement became gospel I don’t think anyone really considered a csection a failure of a woman’s body.

    • nomofear

      My body’s so broken. I’ll never make it as a NFL linebacker, even if I got a sex change.

  • Madtowngirl

    I’m pretty sure my inability to breastfeed had more to do with my anatomy and medical history than my c-section. But sure, go ahead and blame a procedure that almost certainly saved my child’s life. I mean, we’re supposed to “breastfeed at all costs,” right?

  • Daleth

    I love the title of this post. Oh, so much.

    Given that Jen Kamel is a realtor who has somehow convinced people she has special knowledge and understanding of VBAC, I wonder if you, Dr. Tuteur, should start selling your real estate wisdom for $330 a pop!

    • Dr. Tuteur’s real estate seminars would be more informative than the VBAC Facts Academy and Trump University combined.

  • blueyedtexan

    What I never understand, and what I hear so often when it comes to this topic, is why they seem to automatically assume that all the issues she listed can;t also be caused by a vaginal delivery? My first baby, my most “normal” delivery, at least up until she was born and I started bleeding out, was by far the worst recovery I had. I have permanent nerve and bladder damage. I couldn’t drive for 6 weeks, I was not allowed to climb stairs or walk while holding my baby for at least 3 weeks. This was due to the physical damage as well as the use of narcotics for the pain. I woke up in pain from my vaginal delivery. I had a catheter in place for 10 days post delivery due to the pelvic trauma and they were trying to rest my bladder. I had PPD. My milk took forever to come in. My scars were weirdly numb and painful at the same time but they were located on and in my vagina and perineum, and around my urethra, an area I would say is much more sensitive than my lower abdomen. All of the things she lists can easily happen in a vaginal birth as well. My last child, was a c-section, and guess what, he was my easiest recovery.
    I know that statistically vaginal is supposed to be an easier recovery, but of course that depends on how the delivery goes. I just hate that my experience when I tell it get’s brushed aside or I am told I am lying or trying to bury my trauma (yes this happened online and once in real life by a NCB, VBAC advocate) from my c-section. It’s all so frustrating. It’s like they truly think birthing a baby from your vagina will guarantee that none of the above will happen and it will magically make everything better.

    • The Bofa on the Sofa

      “All else equal, a vaginal birth has an easier recovery than a c-section. But all else is never equal.”

    • Roadstergal

      “I know that statistically vaginal is supposed to be an easier recovery”

      I’m not even sure about the data on that. A UK study that looked at several million births came to the opposite conclusion. I think that the _best_ vaginal birth recovery is better than the _best_ C-section recovery, but you’re not guaranteed the former, and a scheduled pre-labor C/S gives you the best shot at the latter. It’s a crap-shoot, but women are typically told the risks of C/S and not the risks of VB when they’re pregnant.

      In the US, we have increasingly small families (1-2 kids being more the norm) and first-time moms with more risk factors than in the past (older, heavier, more chronic disease represented as life and fertility are opened up to those with chronic diseases). Those would all seem to skew the risk/benefit towards C/S.

      • Sonja Henie-Spinning Jenny!

        I find it quite hard to believe that a C-section, which is after all major surgery, would be easier to recover from than a normal vaginal delivery. I’m not talking about the type of delivery that blueyedtexan is talking about, I’m talking about the average “NSVD”.

        I’m also not sure that some of these risk factors automatically mean a higher chance of C-section. Would be interested in seeing some data on that.

        • Roadstergal

          It’s all the question of what’s a ‘normal’ vaginal delivery, which is why I noted that the ‘best’ VB will be better than the ‘best’ C/S. What’s ‘normal’ will depend, for the woman, on her own situation, and for overall statistics, the background of most of the woman in that country.

          The data I saw for VB vs C/S overall in the UK was from the Birth Trauma Association, but I’m having trouble finding it now – I originally saw it posted by one of the regular commentators here several months ago, and I hope someone here remembers it and can find it. For the US, the ACOG committee had to note: “The available data on cesarean delivery on maternal request compared with planned vaginal delivery are minimal and mostly based on indirect comparisons. Most of the studies of proxy outcomes do not adequately adjust for confounding factors and, thus, must be interpreted cautiously.” Needless to say, confounding factors always skew towards C/S looking worse, because a: it’s the emergency recovery for a VB gone bad, and b: even an MRCS can have some reasonable medical risk factors going into the decision.

          I’ve had friends with textbook VBs that have been super-short recoveries, and some where the residual pain and bleeding, despite easily falling under the heading of ‘normal,’ took months to recover from. I mean, for me, who has had far too many long-incision surgeries under G/A – I would take a C/S in a heartbeat, but I recognize that I have my own incredulity bias in “I find it quite hard to believe” that jamming a full-term baby’s head through my nethers would be easier to recover from.

          I’m not an OB, but others who are have mentioned obesity, diabetes, and AMA as risk factors that could lead to a C/S. I’ll let one of them weigh in on whether I’m remembering that accurately or not.

          • Sonja Henie-Spinning Jenny!

            What’s AMA?

          • swbarnes2

            Depending on the context, Against Medical Advice, or Advanced Maternal Age

          • Sonja Henie-Spinning Jenny!

            I was thinking of the first, but the second did not occur to me. Thank you.

        • Dr Kitty

          Most women with a first NSVD will not have intact perineums after delivery. So even the average first delivery still requires a recovering from a second degree tear.

          • Sonja Henie-Spinning Jenny!

            Yes. Is that worse than recovering from major abdominal surgery?

          • corblimeybot

            Well I haven’t had major abdominal surgery, but I did have colorectal surgery while pregnant, and then another colorectal surgery a year and a half later. Recovering from my vaginal birth was significantly worse.

          • Sonja Henie-Spinning Jenny!

            But that’s anecdotal! My anecdotes: I had two vaginal deliveries, and I am not a large person (5’1″). The dr. thought I might need a C/S the first time. I had episiotomies both times. I also had a hip replacement. I’d rather have a baby, thank you very much.

          • corblimeybot

            It might be anecdotal, but it was very meaningful to me that vaginal childbirth caused me permanent pelvic injuries from the actual process of a too-large child existing my vagina. And that two colorectal surgeries resulted in far less suffering for far less time.

            I am not a large person, either. I’m also 5’1″ or 5’2″ depending on who’s measuring.

          • Sonja Henie-Spinning Jenny!

            “it was very meaningful to me that vaginal childbirth caused me permanent
            pelvic injuries from the actual process of a too-large child existing
            my vagina.”

            You didn’t say that in your first post, either. I am sorry these things happened to you.

          • moto_librarian

            How many women are suffering from long-term pelvic floor damage related to childbirth that are simply too embarrassed to get help? Do you have experience in gynecology or urogynecology? Short-term urinary and even fecal incontinence often happens during postpartum recovery, but if you don’t deal with women well after the fact, how would you know how many of them still have issues? Given the number of incontinence products marketed (including a new pad for bowel incontinence and an OTC pessary), I’m betting that there are a lot of us suffering in silence.

          • Amazed

            Long-term pelvic floor damage aside (and my mom had that too), she started pushing with 28 teeth in her mouth. When she left with brand new me, she only had 27.5. Pretty sure that this short-term consequence wouldn’t have been a matter with a c-section delivery.

            Granted, a few decades ago c-sections were far less safe than they are now, so a maternal request c-section scenario would hardly apply. Still, teeth are the same then as they are now. I’m quite sure my mom’s scenario still happens today.

          • corblimeybot

            Also, on Dr Amy’s blog, we seem to have a general philosophy: It’s worth going to a lot of trouble in obstetrics to reduce bad outcomes that are, strictly speaking, somewhat uncommon.

            Because of our awareness of stuff like, 1 in 100 is worse odds than it sounds, and because the impact on that 1 in 100 patient is so devastating. I don’t actually believe that a crappy recovery from a vaginal birth is nearly as uncommon as 1 in 100, although I do believe women don’t talk about it enough for us to know what the numbers are.

            But either way, I don’t think it’s appropriate to tell that 1 person, “your suffering is an anecdote.”

          • Sonja Henie-Spinning Jenny!

            “your suffering is an anecdote.”

            I didn’t say that; in fact you didn’t refer to your vaginal births as “suffering”. I’m displeased that you’re twisting my words.

          • Roadstergal

            The doctors here can weigh in, but I’d consider a hip replacement to be much more ‘major.’ I’ve had three long-incision surgeries, and the healing from the incision and muscle pull-apart was legitimately easy. My husband is doing all he can to put off joint replacement for his osteoarthritis, because our Ortho assures him that the joint replacement will be more painful and a substantially longer recovery than any of the GA surgeries she’s given to either of us (we break bones a little too often).

            It’s great that you had two easy vaginal deliveries, and nobody disbelieves that you had them and they were great experiences! My mom was likewise tiny (five feet even) and had four uncomplicated VBs. But nobody is guaranteed one, and as the folk here relate, even a ‘normal’ VB can be very traumatic.

          • Sonja Henie-Spinning Jenny!

            Actually, I hemorrhaged after the first and had to have a D&C the day of delivery and about 5 units of blood. I never said it was “easy”. Easier than recovering from major abdominal surgery? Yes, I believe so.

            I don’t think this discussion is going to resolve anything. I seem to be the only pro-vaginal birth person participating. That’s pretty amazing to me, after hearing for 30 years (at least) that the US does too many C-sections. Mind you, I mean pro-vaginal when there is no medical reason for doing a C-section.

          • momofone

            But does being grateful for c-sections make one anti-vaginal birth?

          • Sonja Henie-Spinning Jenny!

            As in, “I’m not anti-vaginal birth but. . .”? I feel like I’ll be damned if I do and damned if I don’t here, so I’ll just speak my mind.

            When a poster states that recovering from an uncomplicated vaginal delivery is more difficult than recovering from an “uncomplicated” C/S, yes, that’s anti-vaginal birth. As you said, recovery from your C-section was no big deal. I felt the same way about my vaginal deliveries, both of which involved episiotomies and one of which involved post-partum hemorrhage. I don’t think I ever even used the donut thing to sit on at home. It’s possible that if you and I changed places, we’d feel the same way. I think Dr. Kitty said it well when she said “(o)n average CS recovery takes longer and is more painful”. To say otherwise negates just about everything I learned about surgery. Also, as Dr. Kitty says, caring for the newborn takes up all your time anyway. Well, she said it a little differently, but still, that’s what happens for the first few weeks.

          • momofone

            And that’s fine, but sharing my experience doesn’t equate to being anti-vaginal birth. I don’t much care how anyone gives birth, to be honest, so I don’t get the pro-this and anti-that deal. I have given birth one way. It was awesome, and the recovery was too. In no way does that mean I’m opposed to other people’s doing what works for them; it just means one way is not always easier or more difficult, and of course that varies a lot by individual. I hoped for a vaginal birth because I’d been told how hard c-section recovery would be, and that was not the case. I think it’s ok to challenge what we’ve learned, whether it’s about surgery or about anything else; how else do we learn more, or change our perceptions, or figure out that yep, we were on the right track in the first place?

          • Roadstergal

            “When a poster states that recovering from an uncomplicated vaginal delivery is more difficult than recovering from an “uncomplicated” C/S, yes, that’s anti-vaginal birth”

            Who said that? I specifically said – twice- that the ‘best’ vaginal birth is an easier recovery is easier than the ‘best’ C/S. The tricky part is that the former is not guaranteed or predictable.

          • Sonja Henie-Spinning Jenny!

            Well, you did say this:

            “I’m not even sure about the data on that (that statisically a vaginal birth is an easier recovery) A UK study that looked at several million births came to the opposite conclusion.”

            I’d love to see that study and see what it really says. There’s little doubt that vaginal delivery is usually safer.

            The American College of Obstetricians and Gynecologists recommends vaginal delivery rather than C-section by request.

            http://www.acog.org/About-ACOG/News-Room/News-Releases/2013/Vaginal-Delivery-Recommended-Over-Maternal-Request-Cesarean

            This article, while written for laypeople, has a lot of good information and has references as well.
            http://www.babycenter.in/a1024955/caesarean-birth-risks-and-benefits

            ETA: Here’s the whole ACOG article: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Cesarean-Delivery-on-Maternal-Request

          • Roadstergal

            And that’s the problem. “Uncomplicated” is not guaranteed. The ACOG committee discussion of VB vs CS that the press release comes from is much less black-and-white – I quoted from it yesterday:
            “The available data on cesarean delivery on maternal request compared with planned vaginal delivery are minimal and mostly based on indirect comparisons. Most of the studies of proxy outcomes do not adequately adjust for confounding factors and, thus, must be interpreted cautiously.” They recommend VB “In the absence of maternal or fetal indications for cesarean delivery,” which is a big umbrella.

            I’m not sure what you’re trying to say. What we’re saying is that VB vs CS defies a simple answer, mostly because VB is a crap-shoot. The answer is ultimately individual to the woman’s own circumstance and preferences. Recovery is a crap-shoot. What complicates these blanket statements that ‘on average, VB recovery is easier’ is that CS, to put it bluntly, always works. The baby always comes out. Estimates of average CS recovery time and difficulty are perforce always complicated with confounders – an exhausting and painful failed VB attempt will ‘show up’ in statistics as a difficult CS recovery.

            If you are trying to tell us that you would rather have had the VBs you had than a CS, we believe you, we’re fine with that, mission accomplished. Plenty of posters here have had VBs they’re happy with.

            If you want us to tell you that you having a CS would automatically have been a worse recovery than your VBs, we can’t.

            It’s hard for a woman to make a decision solely based on recovery time*. The only thing that I can feel is supported by evidence is that a VB _can_ be easier to recover from, but a pre-labor CS is generally more _predictable_.

            *And, of course, how do you define recovery? No longer requiring pain meds? Walking around? Having sex? Enjoying sex? Urinating and defecating without pain? Continence? The only study I know that actually compared, in a controlled way, planned prelabor C-section to attempting a vaginal birth was the breech trial, which is a very specific circumstance.

            And this whole discussion doesn’t even bring up safety for the baby, which is a consideration for a lot of women when deciding whether a delivery is, as you say, ‘safer.’ There are a lot of variables that come in to deciding mode of delivery, and the data to support one or the other isn’t always as clear and solid as we want.

          • Sonja Henie-Spinning Jenny!

            “We, us”. Who is this “we”?

            The ACOG article is divided up into maternal and neonatal outcomes for risks and benefits. I don’t think I need to copy all that for you.

            There is also this: “Maternal outcomes that seemed to favor NEITHER delivery route included postpartum pain, pelvic pain, postpartum depression, fistula, anorectal function, sexual function, pelvic organ prolapse, subsequent stillbirth, and maternal mortality. Evidence for thromboembolism was conflicting.” (Emphasis mine) This does address some of your questions, your meaning either plural or singular.

            There is a summary at the end which says: “Only five outcome variables have moderate quality evidence regarding delivery route (planned cesarean delivery versus planned vaginal delivery) for term singleton gestations with vertex presentation:
            1) maternal hemorrhage, 2) maternal length of stay, 3) neonatal respiratory morbidity, 4) subsequent placenta previa or accreta, and 5) subsequent uterine rupture (2) (Table 2). The remaining outcome assessments are based on weak evidence, which limits the reliability of the results.”

            All but #1) favor vaginal delivery.

            Here is the conclusion:

            “In the absence of maternal or fetal indications for cesarean
            delivery, a plan for vaginal delivery is safe and appropriate and should be recommended. The following is recommended in cases in which cesarean delivery on maternal request is planned:

            Cesarean delivery on maternal request should not be performed before a gestational age of 39 weeks.
            Cesarean delivery on maternal request should not be motivated by the unavailability of effective pain management.
            Cesarean delivery on maternal request particularly is not
            recommended for women desiring several children, given that the risks of placenta previa, placenta accreta, and gravid hysterectomy increase with each cesarean delivery.”

          • Roadstergal

            Me and the mouse in my pocket, likely.

            Yes, I’ve read that. The problem with all of the issues you mention is that the supportive data is, as ACOG noted, “minimal and mostly based on indirect comparisons” and “do not adequately adjust for confounding factors,” even the ‘moderate quality evidence’ outcomes. Exactly the problems with the data showing the superiority of breastmilk to formula – which many professional organizations still over-state.

            Like I said, the only paper I’m aware of that directly compares planned pre-labor C/S to planned VB is the breech trial. If you’re aware of others, I’m definitely interested! Otherwise, you’re dealing with confounders like the situations noted above, where a woman is in labor for a long time, the baby gets stuck or is in distress, she has a C/S, and the recovery is difficult – and that’s not, to me, convincing evidence that a planned prelabor C/S would not have made for a far easier recovery, without the pushing, the exhaustion, sometimes the pelvic trauma of a stuck baby and then reaching up to un-stick it. You don’t know going in to a VB if it’s going to be easy or hard, but it’s the very hardest cases of attempted VB that turn into C/S and get counted as difficult C/S recoveries.

            Again, pulling back, what is your end game, here? We’re all happy you liked your VBs and have zero desire to take that away from you. Are you trying to convince us not to support maternal-request caesarean?

          • Sonja Henie-Spinning Jenny!

            First I want to here who “us”/”we” is. Is this some organized pro-C/S group? As I told azuran just a moment ago, this is not a feminist issue. I remind you of something you said on the tetanus thread:
            http://disq.us/p/1cxjkfo
            “That’s the thing, though – they honestly think they Know Better Than The Experts, and are therefore doing what is in the kid’s best interests.”

            You (plural this time) think you know more than the experts, the ACOG.

          • Roadstergal

            No, I don’t know more than them. I recognize that they’re in the difficult position of making a blanket recommendation in a situation that defies blanket recommendations. They recognize, in their discussion, that the data is weak, and therefore made a recommendation. Not a statement that caesareans are unsafe – a recommendation that all else being equal, vaginal births are a good way to go, but MRCS should be respected within certain guidelines.

            NICE in the UK also supports MRCS (“For women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS”).

          • Sonja Henie-Spinning Jenny!

            They didn’t say the data was weak for these five outcomes:
            1) maternal hemorrhage, 2) maternal length of stay, 3) neonatal
            respiratory morbidity, 4) subsequent placenta previa or accreta, and 5)
            subsequent uterine rupture

          • Roadstergal

            No, they said it was moderate. Again, looking at the recommendations from both ACOG and NICE, they support MRCS. You’re saying they shouldn’t?

          • Sonja Henie-Spinning Jenny!

            They recommend vaginal birth. They also say if the women is planning to have more children, C/S is NOT recommended.

          • Roadstergal

            Yes, they recommend VB if all else is equal (lots of factors go into that decision, including the number of children wanted), and then give guidelines around how to do MRCS if the woman wants it nonetheless. You seem to be saying that they shouldn’t offer MRCS at all – that they should change the guidelines. Yes?

          • Sonja Henie-Spinning Jenny!

            I’m not playing your game. I’m fine with the recommendations as stated. There is also the issue that the doctor needs to follow his/her own conscience in this decision, sort of like some pediatricians that won’t take patients who don’t vaccinate.

          • Roadstergal

            This isn’t a game. We were talking about some of the issues with the studies supporting the current guidelines, and you said we were being arrogant for thinking we knew better than the guidelines. So I’m pointing out that the guidelines from two countries’ professional organizations support MRCS in the absence of maternal or fetal risk factors, even if we took the flawed data supporting them as read.

            This is not the same as vaccination at all. Show me the AAP’s stance supporting chicken pox parties as a viable, if second-tier, alternative to vaccination.

          • fiftyfifty1

            You are seriously equating a woman who requests a CS with a mother who refuses to vaccinate?

          • Amazed

            There is also the issue that you seem to have decided beforehand what every doctor’s conscience should be dictating him/her, aka “C-sections unsafe unless indicated”.

          • Amazed

            Those recommendations sound quite strange to me.

            I’m pretty sure that induction on maternal request wouldn’t be performed before a gestational age of 39 weeks either. It’s the gestational age that’s the problem here, not the method of birth.

            So, we can’t guarantee you effective pain relief but shut up and suck it? Freaking negligent care, of you ask me.

            Caesarian delivery is not un-recommended for women who don’t desire more than two or three children, as do the vast majority of women since there isn’t “each caeserian delivery” to facilitate the problems that were mention. There will be only 2 or at most 3 c-sections.

          • Azuran

            Well, I will agree with the last sentence of the first link, But I will extend it. We need to do more research on short, medium and long term risks of pre-labour c-section, intra-labour c-section, emergency c-section AND vaginal birth. Current research is sadly still full of confounding factors and often clearly biased and does not look at much at the negative impact of vaginal birth. Many of the negative outcomes attributed to c-section in those studies could have been cause by the attempted VB.

            And we need to actually consider the actual real life consequences posed by the reported negative effect. For example, people keep saying VB is better because you can breastfeed sooner. Does that even really matter? Does it really have any kind of measurable health benefits for the baby? Is it really a valuable reason to push VB?

          • Sonja Henie-Spinning Jenny!

            The ACOG article itself says re: breastfeeding: ” However, at 3 months and 24 months after delivery, breastfeeding rates seemed not to differ by mode of delivery (3, 4).”

            And I didn’t say anything about breast feeding! As far as “pushing” vaginal birth, yes, I agree with the ACOG that vaginal delivery should be encouraged over C-section by request. What are your medical credentials for thinking otherwise?

          • Azuran

            Patient autonomy for one. If a woman has been informed of the risk and benefits of both VB and c-section and wants a c-section, she 100% has the right to get one.
            I’m pretty sure that having a vasectomy has more risks than using a condom, yet no one is saying men should just use condoms.
            I’m also pretty sure that eyesight surgery has more risks than me using glasses for the rest of my life. Yet I have 100% the right to make the decision that I want to have corrective surgery.
            The same should be true for maternal request C-section.

            The risks and benefits will vary greatly from one person to another. And different people value things differently. Which means that something that is horrible to you can be very ‘meh’ for someone else. So no, VB is not necessarily preferable to 100% of women who want a c-section and should not be presented as such. Women should have options.

          • Sonja Henie-Spinning Jenny!

            False analogy.

            The physician has a right to refuse to do something s/he thinks is unsafe, or not medically advised. Don’t turn this into a feminist issue; it’s not.

          • Azuran

            I’m not turning this into anything feminist. It’s basic medical autonomy.
            One way or the other, that baby has to go out. It’s not a situation where VB can be guaranteed to be safe either.
            Both VB and c-section have risks, therefore, there should be a choice.
            If you believe women can be forced to have VB, then women can also be forced to have c-section.

          • Sonja Henie-Spinning Jenny!

            There are no guarantees in childbirth, or in parenting. However, I don’t see this as an issue where a woman should expect to go to an OB and just demand a C/S.

          • Azuran

            Then why is it ok for men to get vasectomy and people to get corrective eye surgery, or even getting plastic surgery when not getting the surgery has basically 0 risks?

          • Sonja Henie-Spinning Jenny!

            Please stick to the topic and stop moving the goalposts.

          • Azuran

            Which is: Patient medical autonomy.

          • Sonja Henie-Spinning Jenny!

            Without regard to mother or baby safety apparently.

          • Azuran

            Not at all. BOTH VB and c-section have risks for both the mother and the baby.
            It is up to the mother to decide which risks she wants to take and which one she doesn’t

          • Irène Delse

            If you have worked in hospital, you should be aware of a key element of medical ethics: it’s up to the patient to decide what risks he or she is comfortable to take. Just saying “X has less risks’ isn’t enough, not since 20 or 30 years at least. And you may be surprised how many of the regulars here are working in healthcare and/or sciences. (Or rather, you shouldn’t be surprised, all things considered.)

          • fiftyfifty1

            “Now unlike I think almost everyone on this thread (I have no idea what kind of a doctor Dr. Kitty is) I’ve worked OB, post-partum and pediatrics.”

            My you do make unfounded assumptions, don’t you? Dr. Kitty is not the only doctor in this thread (hint, I’m another one) nor the only one with experience delivering babies, caring for women PP and peds (hint, that’s me too).

          • Sonja Henie-Spinning Jenny!

            Good to know. You’re awfully judgemental on me, for a doctor. You’ve made several major leaps to unwarranted conclusions.

          • fiftyfifty1

            ” You’re awfully judgemental on me, for a doctor.”

            Oh doctors are like everyone else. They negatively judge people who spout off when they don’t know what they are talking about. But of course we put that aside when we are dealing with a patient in a professional setting. But you’re not my patient and this isn’t my office.

          • corblimeybot

            Well, I’m not a doctor or a nurse in any sense. I’m just someone whose vaginal birth sucked, and whose general quality of life took a semi-permanent hit thanks to vaginal birth. I get the idea that means that Sonja (who I’ve always respected and whose current behavior is confusing the hell out of me) thinks my actual misery is just anecdata to be waved away.

            My own ob-gyn provider told me if I ever wanted another child, that “after what you went through, no one here would deny you a c-section in the future.” Is her opinion good enough, I wonder?

          • Roadstergal

            It’s almost like “disinclination to take on the risks of a VB” counts as “maternal indication” for a C/S…

          • Who?

            One of Dr Kitty’s ‘soft contraindications’ I think.

          • fiftyfifty1

            I think “Sonja Henie” and “Sonja Henie-Spinning Jenny” are maybe different people?

          • Heidi

            No, I’m pretty sure they are the same person. I only have one person blocked on my Disqus and it is her. I blocked her as Sonja Henie and Disqus is blocking Sonja Henie Spinning Jenny, too. I frankly found her to be a bully.

          • corblimeybot

            I’d like it if that were true, but the writing style is the same. Along with the “go fly your kite” style euphemisms. 🙁

            Unless you’re kidding and I’m too tired to pick up on it, ha.

          • fiftyfifty1

            No, I wasn’t kidding. But it sounds like you are right and they are the same person. I wasn’t sure because the name had changed.

          • Amazed

            More anecdata to be waved away: my mother only had two children because after the hell of nearly bleeding out [postpartum (like Sonja) and going through the hell of recovery, and we won’t even discuss her first difficult birth in detail, my father put his foot down and told her in no uncertain terms that the idea of being a widowed father of two or three did not appeal to him in the least. I wonder if that counts as a permanent damage of vaginal birth. I gather that Sonja’s husband was made of stronger stuff.

          • corblimeybot

            My grandfather made a similar stand after my grandmother nearly died of pre-eclampsia with both her pregnancies. The doctors also pleaded with her to not have any more children. I guess they were also weenies.

          • Dr Kitty

            I’m a GP FTR, with clinical postgraduate experience in OB/GYN, paediatrics, psych, medicine, surgery, ER and more.

            I see on average 3 women every week for their six week postnatal check up and more for smears, contraception, general gynae, mental health, psychosexual dysfunction, antenatal care, preconception advice, urological problems, breast feeding issues, bereavements after miscarriage and stillbirth, infertility etc (say what you like about primary care, no two days are the same ).

            And I don’t think anyone said what you think they did.

            *I* said most first time mums don’t have intact perineums and are recovering from a second degree tear, and that *some* women have worse recoveries after VB than after CS.

            Others have mentioned that VB recovery *for them or women they know* was worse than CS recovery.

            Of course a P4 with a 3 hr labour, a 10 minute second stage and an intact perineum is going to have an easier time than someone recovering from a CS, no one is disagreeing with that.

            But, while you can predict what recovery from an elective CS will be like, you don’t know if your VB will leave you with an intact perineum or with a 4th degree tear and a colostomy until you’ve actually delivered, and some women do not want that gamble, preferring the devil they know to the devil they don’t.

          • Irène Delse

            You seem to like using vocabulary from the skeptical handbook, but fail to use it properly. It’s not “moving the goalposts” to use an analogy. Try mounting a reasoned argument instead of throwing accusations.

          • fiftyfifty1

            “Please stick to the topic and stop moving the goalposts”

            That’s not moving the goalposts, it’s making a legitimate comparison. Why DO you think it’s ok for people to request non-medically-needed surgery in these other cases, but bad when it’s a birth? What is it about birth that makes it a special case in your eyes?

          • Sonja Henie-Spinning Jenny!

            A vasectomy and corrective eye surgery, or even a nose job is the equivalent of a C/section? Tell me how.

            You know, I’m getting really annoyed at the direction this post is taking. It went off the rails, IMO, when a poster tried to claim that recovery from a C-section is easier than a recovery from an uncomplicated vaginal delivery. It’s NOT. Period. There are many times when C-sections are necessary, but it’s totally untrue that major abdominal surgery, PLUS an incision through one’s uterus is easier to recover from than an uncomplicated vaginal delivery.

          • swbarnes2

            Well, between genitals, eyeballs, and abdomen, I’d much much rather have a doctor cut into the last. I’m guessing a little less precision is required, and an “opposie” is easier to repair without lifelong consequences.

            But I don’t think that’s what you meant. So you should just say what you meant. Asking us to make your arguments for you is not helping your case at all.

          • fiftyfifty1

            These surgeries are similar to MRCS in these ways:
            1. They are not a medical need (i.e. there are alternatives to the surgery).
            2. They are low risk overall, but not no risk.
            3. The risk varies from person to person.
            4. To choose them, a person should be well informed about the risks and benefits.
            5. Once the person is informed, they are allowed to choose.

          • Roadstergal

            They’re all elective surgeries generally done without G/A?

            (I don’t know about the nose job for the last bit, I haven’t seen one of those done.)

          • Sonja Henie-Spinning Jenny!

            What is your health care background, anyway? Just curious. C-sections usually more anesthesia than a vasectomy or eye surgery, which are usually done as out-patient surgery with local anesthesia. No four day hospital stay.

          • fiftyfifty1

            ” Just curious. C-sections usually require more anesthesia than a vasectomy or eye surgery, which are usually done as out-patient surgery with local anesthesia”.
            MRCS is done under spinal typically. This is more involved than most vasectomies which are typically done under local. Elective eye surgeries are usually done under local plus sedation. I had one patient die from this actually…a long string of flukes that started with a reaction to the sedative. Facial plastic surg is done under GA with intubation which is more involved and has higher risk than a spinal.
            So CS is not an outlier here. So once again…what do you see as special about birth that it shouldn’t follow the same ethical guidelines as these other procedures?

          • Amazed

            What does it matter? When fiftyfifty1 told you her healthcare backfround, you ignored it – I suppose, because it surpasses yours. Instead, you complained that she was being judgmental.

            I understood your posts the exact same way fifty did. All those posters who replied to you understood you the same way. As my grandfather (not a healthcare professional, if you’re interested) says, “They don’t understand you? Well, then talk in a way that will make it possible for them to undestand you!” That part was about your constant complaints that you were being misrepresented because you didn’t EXACTLY write what everyone gathered you meant.

            For the record: Roadstergal DOES have a healthcare background.

          • Roadstergal

            Oh, I’m not a HCP. I do not have the patience for patients. 🙂 I admire my co-workers who can deal with that side!

          • Amazed

            No but you ARE a researcher in this field, right? I am not a HCP either but I can’t say this much about myself. You are rpobably better equipped to understand medical studies than the average poster, say yours truly, and it’s the science side we’re talking about here.

          • Roadstergal

            Yeah, I’m probably better than the average clinician at reading and understanding papers, particularly when they involve biomarkers/bioanalytical assays and biostatistics. And far worse at knowing what to do with a sick person standing in front of me. “Man, you should see a doctor!”

          • Sonja Henie-Spinning Jenny!

            “Oh, I’m not a HCP. I do not have the patience for patients. 🙂 I admire my co-workers who can deal with that side!” said Roadstergal.

            http://disq.us/p/1cxxd3l

          • fiftyfifty1

            Oh, a nose job is done under GA. Basically all facial plastic surgery of any scope is. The GA, of course, is one of the risks that patients need to understand before electing the procedure. GA is very low risk in some patients by higher in others. Joan Rivers died from plastic surgery, and if I remember right, it was a complication of the GA.

          • Azuran

            I’ve heard of someone who died following a nose job. It was following a very serious medical mistake during the anaesthesia, but she still died.
            So yea, nose job has a risk of death.

          • Azuran

            I could lose my eyesight. Seems like a pretty serious consequence to me.

          • fiftyfifty1

            ” it’s totally untrue that major abdominal surgery, PLUS an incision through one’s uterus is easier to recover from than an uncomplicated vaginal delivery.”

            Well, I guess I will have to repeat my story, because you are wrong:
            I had my first vaginally and was told that everything was normal, that I had “only a couple of skid marks”. My chart says “normal spontaneous vaginal delivery” and lists no complications. And yet I’m one of Those Women who couldn’t sit or have sex for a year. You said it’s important to compare vag birth and CS *in the same person*. Well it turns out you can do that with me! My second birth was a CS. And the CS recovery was easy-peasy.

            That was my experience. Are you saying I’m lying?

          • Irène Delse

            Good point. Medical paternalism can happen under various guises. It’s fascinating how VB advocates think it’s OK to pressure a woman into a VB because it’s statistically safer and, suddenly, turn around and become staunch advocates of patient choice if it’s a case of medical indication for C-section!

          • Roadstergal

            I go back to my collarbone break a lot, because I think there’s parallels there.

            I had a full-on break, two big pieces of bone, one moderate, some little fragments. A friend of mine had a similar break in the same year.

            My ortho recommended surgery. She gave me the risks and benefits of surgery vs healing without surgery, and let me make my choice. It was an easy choice for me.

            My friend’s ortho was agnostic. He gave my friend the risks and benefits, and my friend wasn’t sure, but eventually decided to go the ‘natural route’.

            Our choices were respected. It was recognized that recommendations are just that, there are risks and benefits to each way of going, and it was up to us to choose which we preferred to take on. I’m sure there are some who would see a bone healed without surgery who would be upset that I could ‘just go to an ortho and demand surgery’. But it was a reasonable option, and I took it.

          • Azuran

            And there are also probably time when they would have either strongly recommend surgery, or strongly recommend against it. Because every case is different, with it’s own set of circumstance. You just can’t have blanket statement for treatment in medicine.

          • Irène Delse

            Ouch. I’d be glad for the option of surgery in that case, myself. I am not very patient and I’d rather do something rather that wait it out.

          • Roadstergal

            One of my reasons for going surgery is because I knew I would struggle to be compliant with the bracing and movement restriction I’d need for the healing time without the plate.

            The surgery was magical, even though the incision started close to my throat and went out to my shoulder. One day of pain that was easily managed with drugs, and then a few weeks of soreness that ice and PT took care of. Surgery on Monday; I was riding my bicycle by Saturday and did a motorcycle track day on Sunday.

          • fiftyfifty1

            “I’m not turning this into anything feminist. It’s basic medical autonomy.”

            It seems that for some people it is a radical “feminist” idea that women should have the same autonomy over their bodies that men enjoy. It really gets under their skin apparently.

          • Roadstergal

            So you think the official ACOG stance should be changed from:

            “In the absence of maternal or fetal indications for cesarean delivery, a plan for vaginal delivery is safe and appropriate and should be recommended”

            to

            “In the absence of maternal or fetal indications for cesarean delivery, cesarean delivery should not be performed”

            Yes?

          • Sonja Henie-Spinning Jenny!

            Why do you ask that?

          • Azuran

            It’s not a hard question. Either they have the choice, or they don’t. Your comments let us believe that you think women should not have the choice.

          • Roadstergal

            I’m trying to clarify what you mean.

            Guidelines, as written, recommend VB if all else is equal in a low-risk pregnancy, and still allow MRCS even in that situation. You seem to be saying they shouldn’t.

          • fiftyfifty1

            ” I’m two years older than your still living grandmother born in 1951.”

            Ah, so you’re the age of my mother. Like you, she had all vaginal births with straightforward recoveries, and liked her experiences. And yet, unlike you, she somehow is able to recognize that what worked well for her is not the answer for everyone. She was quite supportive of my maternal request CS. She saw how badly I had been laid up with my “minor injury” vaginal birth, and how much the urine and bowel incontinence issues were bothering me, and supported my decision 100%.

          • Sonja Henie-Spinning Jenny!

            When did I ever say that, fiftyfifty1? Please post a direct quote.

          • fiftyfifty1

            What specifically are you referring to? The part where you said you preferred vaginal birth for yourself? The part where you don’t support MRCS?

          • Azuran

            About 2-3 days ago, When I commented on people knowing people who lost kids before vaccine where a thing, and used my grandmother as an example.

          • Sonja Henie-Spinning Jenny!

            Wait. I said I did not recognize that what worked well for me is not the answer for everyone? Do you have a quote?

          • fiftyfifty1

            “Wait. I said I did not recognize that what worked well for me is not the answer for everyone? ”

            Yes, you had vaginal births that worked for you and so you don’t think that women should be able to go in and “demand a CS” (as if that is how it happens).

          • Sonja Henie-Spinning Jenny!

            I’m glad you can read my mind.

          • fiftyfifty1

            “I’m glad you can read my mind.”

            Nope, not a mind reader. Just a reader of the words you yourself write.

          • corblimeybot

            I fail to see what’s wrong with women’s medical autonomy being a feminist issue?

          • Azuran

            Seeing as you seem to care so much about people’s medical credentials. I’m a veterinarian (which you can easily see by simply putting your mouse over my image)
            So, while I do not have medical knowledge about Obstetric in human. I have a lot of knowledge in veterinary obstetric. I also have tremendous amount of experiences about discussing medical options with my client, risk/benefits and medical autonomy. It’s basically the heart of my job, since my clients have to pay out of pocket, everything I do must be approved by the owners beforehand.

            I’m spending my day, laying out diagnostics tests and treatment plans to owners. Where I am explaining to them the cost/risk/benefits of 2 to 4 different treatment option. Discussing with them which one is the best option FOR THEM, depending on the medical history of their pet and the owners own set of personnal circumstances.
            Then, when they make their decision, I work with them, whatever that decision might be, even if I would have chosen something else for myself, or even if their choice is the most dangerous one.

            There are indeed sometime clients with ridiculous demands that I will have to deny because they make no medical sense. (and I can back up my refusal with actual medical facts). Or others that I have to refer to specialists because I don’t have the ability to treat them. Sometimes, there is just no plan B availlable.
            But I would never lie about or hide a potential treatment option, even it it’s not the best plan availlable for this particular patient, or not the one I would prefer.
            Medical consent and autonomy is probably the biggest part of my job.

          • Sonja Henie-Spinning Jenny!

            “There are indeed sometime clients with ridiculous demands that I will
            have to deny because they make no medical sense. (and I can back up my
            refusal with actual medical facts).”

            Oh? What about patient autonomy? Why should they go with your recommendation; you only went to school for 4 years or so after college to be a vet.

            I wasn’t talking about lying or hiding anything. I’d appreciate you not stating I did.

          • fiftyfifty1

            “I wasn’t talking about lying or hiding anything. I’d appreciate you not stating I did.”

            Talking about the risks of CS without also talking about the risks of TOL is a form of hiding facts. Talking about how an ideal vaginal birth is easier to recover from than an ideal CS without adding that many vaginal births are not ideal and that many TOLs end in emergency CS, is a form of lying by omission.

          • Sonja Henie-Spinning Jenny!

            Many? Show me some stats!

          • fiftyfifty1

            “Many? Show me some stats!”

            Depends totally on the person. For example age is a huge factor. A teen nullip is unlikely to need a CS, while a first time mother over the age of 40 has nearly a 50% chance of ending up with a CS one way or the other. Or how about levator ani avulsions, the injury that I had during my normal, uncomplicated vaginal birth? Also very age dependent:

            “Levator avulsion is common (about 20% in parous women, Dietz and Steensma, 2005, Dietz 2007), and associated with maternal age at first delivery- a worrying finding in view of the continuing trend towards delayed childbearing in western societies.The likelihood of major levator trauma at vaginal delivery more than triples during the reproductive years- from under 15% at age 20 to over 50% at 40 (Figure 6, Dietz 2006). Taken together with the increasing likelihood of Caesarean Section, it seems that the likelihood of a successful vaginal delivery without levator trauma decreases from over 80% at age 20 to less than 30% at age 40 (Dietz 2007).”
            (http://sydney.edu.au/medicine/nepean/research/obstetrics/pelvic-floor-assessment🙂

            What do you think?

          • Azuran

            Please note that ‘no medical sense’ basically mean stuff like:
            -Amputating a dog’s leg because he had a broken finger.
            -Doing a c-section with only an epidural on an awake dog.
            -Amputating both of a parrot’s wing to prevent it from flying.
            -Doing CPR on that dog that died 12 hours ago.
            -Removing all of a dog’s teeth because it bit a kid.
            -Castrating a cat with no general anesthesia, no sedation, no local anesthesia, basically just tie him down and do it.

            I don’t think a MRCS comes anywhere near close to this. And those are not a case of medical autonomy. You can’t walk up to a doctor and ask to have your arm amputated for no medical reason either.

          • Dr Kitty

            Breast feeding sooner- ha!

            Both of mine were latched on within 30 minutes of delivery and we’re currently working out how to persuade #2 that at 13 months he *really* doesn’t need to suckle at the boob from 5am-7am every morning while humming loudly to himself, because I’m not loving being a human pacifier.

          • Roadstergal

            The thing that annoys me the most is that, almost exclusively, these studies look at successful vaginal birth vs C/S. An unsuccessful attempt at a VB followed by a C/S never goes into the summary statistics for VB. Again, a C/S always gets the baby out.

            I think there’s a lot of parallels with formula and BF. Women have been so convinced that the ‘rescue’ option is horrible and to be avoided, that they let things get pretty far gone before taking it.

          • swbarnes2

            But compare that to, say, the ACOG article on water birth. That one is full of “There are no benefits, there are lots of case studies showing bad outcomes, you really shouldn’t do this unless you want to be a guinea pig in a proper research trial”. In the C-section article, it’s really only saying “tell your patients this is a bad idea if they are lots of kids.” The preference for vaginal birth is pretty weak.

          • Roadstergal

            Really, I read it as “If mom doesn’t care too much one way or the other, and if there’s no medical issue that indicates CS, go VB.” But I’d love to have one of the resident OBs chime in.

          • swbarnes2

            Right. It does say “Cesarean delivery on maternal request particularly is not recommended for women desiring several children”. It does not say “Cesarean delivery on maternal request is not recommended for women, period”.

            It does say “Cesarean delivery on maternal request should not be performed before a gestational age of 39 weeks.” This is the kind of the opposite of “Cesarean delivery on maternal request should not be performed should not be performed, period”.

          • Azuran

            I don’t think they do maternal request induction before 39 weeks either. There might be medical reason for an earlier induction or c-section. But they aren’t going to take the baby out at whatever random time a woman decides she wants it out.

          • Roadstergal

            Everyone here is pro-vaginal-birth, I think, but many are also pro-CS. They both have risks and rewards, advantages and disadvantage, and to say one is blanket better than another without the consideration of the individual and the circumstance just isn’t on. Just like saying formula feeding can be great and way better than breastfeeding in some circumstances doesn’t mean we’re not also pro-breastfeeding.

            We’re all different, and for you, the risks of a C/S were worse to you than the risks of a VB, and that’s fair. But for women who look at the two and the risks of C/S are more acceptable – that’s fair, too. Some women have had both and the C/S was easier. Some women have had both and the VB was easier. I don’t deny that either one exists, but I don’t say that either is generally representative.

          • For me…It’s more that I, personally, as a non-parent have set a fairly high threshold for myself before I allow myself to interfere with what people do with their kids.

            Anti-vaxxers I’ll regularly smack down because they’re affecting not only their own kids but other kids too.

            Obviously, beating your kids (general-you) is bad.

            Homeschool vs public school vs private school? Your family, your choice. To me…vaginal births/caesarians fit into the same level here.

            BUT ….

            If you are an adult and your choice only affects you, I don’t give a damn – you’re old enough, big enough and ugly enough to sort yourself out.

          • Azuran

            We are neither pro vaginal birth nor pro c-section, we are generally ‘whatever works for you’. Both have advantages, both have disadvantages and both have risks of complications. Many people had either awesome/horrible VB/C-section.
            Birth is unpredictable, and you can never know where you are going to end up, and everyone has unique circumstances. There is no universal right or better way to give birth. What is best for you depends on a ton of factors.
            What we support is that every women should receive proper and honest information on both options and have a discussion with their health care provider about their own set of circumstances and risks so they can decide what they feel is best for them, without any shame. And once they do, we can only hope that everything goes well.

          • Dr Kitty

            No pro or anti anything for people in general, but definitely anti VB for myself personally.

            To me the risks inherent in surgery were outweighed by the benefits, but that was FOR ME, PERSONALLY.

            You get to make different judgements based on your past history, life experiences and values. That is ok.

            You preferred VB and were happy with your experiences- great.
            I didn’t and was happy with mine- also great.

            It is unhelpful to project your own value judgements onto the decisions of others, particularly judging whether their CS was “necessary” or “medically warranted” or similar.

          • moto_librarian

            My first vaginal delivery did the damage to my body. I was low-risk, had a textbook pregnancy, and the much-vaunted “natural” childbirth. It resulted in a cervical laceration, 2nd degree tear, and pph that nearly required transfusion. My child only weighed 6 lbs., 4 oz.

            There are two problems with your premise. The first is that you can’t say with certainty that recovering from a c-section would or would not have been easier than recovering from your delivery that required transfusions and a D&C. You are making an assumption there, and trying to apply it to others. The other problem is the need for a “medical” reason to do a c-section. No one warned me that vaginal delivery could result in prolapse and fecal incontinence and urgency in my 30s. I get pretty pissed when people talk about women wanting to preserve their pelvic floor health and sexual function as “vain,” and I suspect that this is the position that you are advocating. Had I been given the full risks and benefits of vaginal delivery, I may well have chosen a c-section. I am now looking at an 8 week recovery for rectocele repair.

          • Sonja Henie-Spinning Jenny!

            Did you read the ACOG paper?
            “Maternal outcomes that seemed to favor neither delivery route included
            postpartum pain, pelvic pain, postpartum depression, fistula, anorectal
            function, sexual function, pelvic organ prolapse, subsequent stillbirth,
            and maternal mortality. Evidence for thromboembolism was conflicting.”
            http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Cesarean-Delivery-on-Maternal-Request
            I am sorry you’re having all these problems.

          • moto_librarian

            I’m not seeing anything about nerve damage specifically, and my urogynecologist is convinced that vaginal delivery and the cervical laceration repair are responsible for that.

          • fiftyfifty1

            ” I seem to be the only pro-vaginal birth person participating. ”

            The only pro-vaginal person participating? Huh?! What about me? I love a nice vaginal birth! What doctor doesn’t? I wish I could guarantee *every* woman a nice vaginal birth, that would be amazing! (but since I can’t, I respect a woman’s choice of a MRCS if she understand the risks and benefits and doesn’t plan a large family).

          • Sonja Henie-Spinning Jenny!

            Well, you’re the first one to say that even that much.

          • Azuran

            We’ve basically all been saying pretty much what FiftyFifty1 just said.

          • Roadstergal

            …seriously, most of us have even said that outright, with some variation on the wording.

          • Dr Kitty

            I’ve never been in labour, never had a vaginal delivery (and never want to).

            Pain wise, I’d put spinal surgery at the top, Stephens Johnsons syndrome with oral ulceration after wisdom tooth extraction a close second, a particularly bad bout of endometriosis where I was throwing up from pain third, ovarian cyst rupture and appendecectomy fourth, fractured tarsal with plantar fasciitis fifth, CS sixth, laparoscopic endometriosis surgery seventh.

            Personally, I’d take a CS over a filling, such is my dental phobia!

          • MaineJen

            1. Labor
            2. Ovarian cyst
            3. Broken tailbone
            4. Abcessed tooth.

            Actually 2-3-4 are kind of a tie…

          • Dr Kitty

            That is what I figure 🙂
            Seen enough people in unmedicated labour to know I have no desire to experience it for myself.

            OT:
            The fast healing post-op thing runs in the family.
            3 months after emergency spinal surgery my sister walked down the aisle and did her first dance with her new husband in 6 inch heels! In June it was touch and go if she’d ever walk again.

          • Deborah

            You know what I thought was the worst? INFLUENZA.

          • Roadstergal

            My friend’s recovery from her emergency, unwanted C/S was substantially faster and easier than her VBAC recovery with one episiotomy. It’s simply not a given one way or the other.

          • momofone

            I’ve never given birth vaginally, but my c-section recovery was easy. I realize that’s anecdotal, but I think it’s a big assumption to make that it would be harder than recovery from vaginal birth. I had heard horror stories about how my whole (8-week) maternity leave would be spent recovering, and I’d be exhausted, etc. After a week I was back to normal, and I don’t think I was any more exhausted than any other mother of a week-old baby. My tonsillectomy recovery was orders of magnitude worse.

          • Dr Kitty

            Don’t know- depends on the person.

            I was pushing a pram around IKEA four days after my second CS, driving 2 weeks postnatal, sex 4weeks postnatal, gym 6weeks postnatal.
            But then I went back to work 4 days after laparoscopic endometriosis surgery and 10 days after an appendecectomy…

            I have patients who have to sit on cushions for weeks after vaginal delivery and can’t even contemplate intercourse for months even with supposedly “minor” perineal trauma.

            YMMV in other words.

            On average CS recovery takes longer and is more painful, but individual experiences vary, and hey, you have a newborn- you are probably going to spend 2-4 weeks basically cycling between the sofa and bed anyway…

          • Sonja Henie-Spinning Jenny!

            Thank you for saying that, especially your final paragraph.

          • Dr Kitty

            You presume that I would have had an easy recovery from a VB, but, when given the choice I opted for CS both times.

            “Ease of recovery” wasn’t my priority. 🙂

          • fiftyfifty1

            “Something tells me if you had had vaginal births, you wouldn’t have had to sit on cushions for weeks after and not even contemplated intercourse for months with supposedly “minor” perineal trauma. You have to compare vaginal to C/S in the same person.”
            Not so fast! I wouldn’t make that leap if I were you. It’s not about whether somebody is a wimp vs. stoic. I am one of those women with a very difficult recovery from vaginal delivery even though I was told at the time that I had sustained nothing more than “skid marks”. I could not sit at all for weeks. I tried intercourse once during the first year and had to stop because it hurt so bad I couldn’t breathe. Turns out I had a levator ani avulsion (deep internal damage that can’t be seen on the outside skin), and it’s actually fairly common, especially in first time moms over 30, which I was. For my second child I had a CS, and recovery was very easy in comparison. I can say I was never really in pain, sore abdomen,yes, but I was just as sore the next day after attending a “boot camp” abs workout when I was out of shape. The day I got home from the hospital, my little son wanted me to dress up in a party dress to celebrate, and so I did. I have photos of myself and him dancing to the Beatles in the living room. I went on a long walk pushing the stroller the next day. I had painless sex as soon as the bleeding stopped, which it did with a couple of weeks.

          • Sonja Henie-Spinning Jenny!

            You missed my point, but oh well!

          • fiftyfifty1

            Well, what is your point?

          • Sonja Henie-Spinning Jenny!

            I was replying to someone who was “pushing a pram around IKEA four days after my second CS, driving 2 weeks postnatal, sex 4weeks postnatal, gym 6weeks postnatal.”

          • Dr Kitty

            And you presumed to tell me that I would have had a better, easier recovery if I had a VB, without knowing ANYTHING about me and why I opted not to have one…

            But, FTR, hx of spinal and pelvic surgery, a congenitally deformed bony pelvis and babies who are on 9th centile for weight with 50th centile heads which never descended into my pelvis.

            If the OB who is the go-to for complicated deliveries and happily does vaginal breech, twins and rotational forceps tells you he wants you to have an epidural on arrival and prepare yourself for a 90% chance of CS, with a long, difficult labour and a probable forceps delivery if it gets that far… yeah, CS seems like the best option.

          • fiftyfifty1

            Oh, but she didn’t mean YOU Dr. Kitty! You have a legitimate reason for CS. She means those other silly women who are too posh to push and/or who claim they have pain after vaginal births and act all injured when probably they are faking it.

          • fiftyfifty1

            ” was replying to someone who was “pushing a pram around IKEA four days after my second CS, driving 2 weeks postnatal, sex 4weeks postnatal, gym 6weeks postnatal.”

            Yes, and your hunch was that since a CS hadn’t slowed her down, that she wouldn’t have been slowed down by a vaginal birth either. And I told you not to make that assumption. My CS was every bit as easy as Dr. Kitty’s. Mine didn’t slow me down either. I was back to my normal routines (sex, exercise etc) within a couple of weeks. And yet I was also one of those women who couldn’t sit and didn’t even contemplate intercourse for months with supposedly “minor” perineal trauma. How does that jibe?

    • Daleth

      Everything she lists AND a bunch of other horrors can happen in a vaginal birth. Third and fourth-degree tears; babies injured or killed due to shoulder dystocia; etc….

    • MaineJen

      I absolutely had lingering pain/stitches from vaginal birth. And PPD. And had the usual struggles learning to breastfeed my first (because guess what…it’s not magically easy). In fact, all the issues she mentions can and do happen with VBs as well.

    • Glia

      I have heard a LOT of stories that go something like “I was in prodromal labor for three days, and then I was in active labor for eight hours, and my contractions weren’t productive enough, so I was put on pitocin for another 10 hours, then I pushed for three hours, and my baby was really stuck in my pelvis, so I had a c-section. I felt bad after that. Therefore, c-sections have really difficult recoveries.” The c-section is the entire problem, and a repeat MUST be avoided. The difficult labor that led to it obviously played no part in making the recovery harder.

      • Kathleen

        Look, I get wanting to avoid another c-section if you can, because hey, yes, it’s major surgery. But it’s not like a vaginal delivery is all unicorns and roses and rainbows either and all women are different…all deliveries are different. So I have a friend who had a c-section and yes, it was traumatic because it was an emergency and she was hemorraghing and all that…I understand her wanting a vbac because her recovery was horrible. I wouldn’t risk my baby or my life if my doctor told me it probably couldn’t happen, but I might still try. But some c-section recoveries might not be that bad.

        • Glia

          Exactly. Mine was basically fine. It gives me a different perspective when I read stories like that, because my planned pre-labor section was a great experience, so when someone blames just the section for the difficult recovery after a birth like that, my first thought is “yeah, but you didn’t JUST have a section to recover from”.

        • Clorinda

          By my third c-section the nurses were joking about having me go to other ladies’ rooms to give them pointers on how to pull yourself up in bed, how to get started walking around, how to ease incision pain, etc.

        • Erin

          I always tell friends who are chasing vbacs a tale of two recoveries. One is the recovery from a quick and “easy” natural birth, the other a recovery from an emcs after a long labour (75 hours of contractions), pushing and forceps.

          One literally had an ache, was up and dressed by themselves 4 hours later. Was wandering around the hospital including climbing stairs by the 24 hour mark and never had any physical issues to recover from.

          The other spent the first couple of months in agony, essentially sitting on those hemorrhoid rings you get, with every wee making her curl up in a ball in pain, was incontinent and still 9 years later can’t exercise without wetting herself. Sex is still painful.

          The former was me and my emcs, the latter my sister in law. We both had babies with heads on the 90th percentile, but mine got stuck, she only wishes hers did.

          It varies so much. I am however hoping that everyone is right about planned being easier because I could do without the ache.

      • N

        My second child was a tried VBAC. She didn’t descend. SO after 24h of labour, and the last 4 hours contractions so intense that the midwife thought I must have an opening of 8cm at least, but there was no opening, because the baby didn’t find a way to descend, it was C-section-time. I must say I was exhausted after that, and my baby slept for 24h did only wake up 2 or 3 times for a couple of minutes to latch on the breast, and went to sleep again. It never occured to me that the exhaustion came from the C-section. It came from the previous 24h of labouring without any result.

        • blueyedtexan

          yep, my last baby was not an emergency section but unplanned. Same reason, he never dropped. I never dilated past a 3. Well for a bit we thought I had gone to a 4 but they broke my water and I went back down to a 3 (it was just the bulging bag pressing on my cervix). Baby was 10 pounds and never dropped past a negative 2 station. I labored 36 hours, the first 24 was very early and light at home. Thankfully I had an epidural and was able to nap that afternoon for a bit and I snoozed on and off the previous night or else I can imagine I would have been in far worse mental and physical shape after the section.

      • blueyedtexan

        yes, several friends of mine had long labors and even got to the pushing phase when they had to me rushed to a emergency c-section. Of course they were exhausted and sore and their recovery seemed to take a while. These same friends went on to have planned sections the next baby and they were pleasantly surprised at how much easier their recovery was. Lots of things go into how your recovery is going to be whether you have a vaginal or c-section delivery. People like Kamel seem to forget this or at least push aside these possibilities.

  • Heidi

    So I had a fairly straight-forward vaginal birth. It was an induction, so I guess me and my birth were “defective,” but I think I checked in at around noon and had my baby at 7:41PM. It took an hour or two before they even started the induction. Nothing scary or traumatic happened. I had a second degree tear, and from what I understand, that’s pretty common in a first time mom with a vaginal birth. It wasn’t a walk in the park. I took hydrocodone for the pain – a narcotic! They knew I was taking a narcotic that could cause constipation so they hooked me up with some Colace. Imagine that? I still needed help for the first few days, too! My in-laws picked up food, ran to the store, and helped with household chores. I couldn’t sit on my wooden dining room table chairs, I had to bring the Boppy as a donut of sorts to the pediatrician, while I managed not to swell during the actual pregnancy, post-partum I couldn’t wear any shoes but house shoes for a while so I was encouraged not to be on my feet when I didn’t absolutely have to be. Sex took months, not a mere six weeks, to be a fun and not an owwwy thing. I had no problem getting pregnant nor staying pregnant but my breasts didn’t make enough milk. I didn’t think of myself nor my breasts as defective, though. I decided to keep them. But Jen here is telling me I am defective. What a nice lady!

    • Erin

      We can be defective together if you want?

      Actually between us, we’d make a “proper” woman, wonder if that counts?

      Although her blog does paint a slightly different story.

      “One of the reasons why I started VBAC Facts is that I saw people cherry picking information, misinterpreting the conclusions of medical studies, and basically manipulating the facts in order to convince other people to make the same birthing decisions they did.

      Because they judged those that birthed differently than them.”

      http://vbacfacts.com/2016/07/06/judgment-birth-community-fitting-cesarean/

      The question is I suppose whether she actually believes that or not.

    • MaineJen

      My son was born at 19:41 too! And he was an induction. Took a little longer though (started at about 6-7AM)

    • MI Dawn

      Yours sounds like mine. Induced both times (yay, pre-eclampsia for the win), episiotomy instead of a tear. Colace, narcotics, lots of help. On the otherhand, I was a #1 Cow. I could have won awards at the state fair for boob juice.

  • Trixie

    Gavin’s mom replied on the thread, and Jen first argued with her, without expressing any sorrow or condolence for her loss, and then deleted and banned her. Jen Kamel: She cares so much that she silences loss mothers who threaten her profits. Stay classy, Jen!

    • Daleth

      What scum she is.

      • yugaya

        Absolute scum. One does not sink lower than that.

        • Amazed

          Not so fast, neighbour. Whenever we’ve thought this, they’ve always found a way to surprise us.

    • Amazed

      What? That’s rich, even for her. Danielle didn’t even have a VBAC, for fuck’s sake. She got another kind of murdering loon, not Jen Kamel’s. Why ban her?

      We’re talking about Danielle, right? Don’t tell me that while I was away (long story, being able to peek here from time to time but being allergic to stings sucks mightily), there was another Gavin who died needlessly?

      • StephanieJR

        I’m actually unfamiliar with this case?

        • Amazed

          http://www.skepticalob.com/2014/02/jan-tritten-crowd-sources-a-life-or-death-decision-and-the-baby-ends-up-dead.html

          Read at your own peril. Some pills (or natural remedies) for high blood pressure are recommended. The story is guaranteed to make it rise.

          Gavin Michael, that was the baby’s name. Actually, it was thanks to this post that his grieving grandfather, seeking some logic and answers on the internet, came to realize just how much of a scumbag their “midwive” was.

          There are subsequent posts about this case. Or you can just google “Danielle Yeager”, “Gavin Michael” and “Christy Collins”. The asshole lied to Danielle all the way and then tried to blame the tragedy on her.

          • StephanieJR

            Thanks for linking; jesus that’s a haunting story. I don’t even know where to begin with the utter horror of it.

          • corblimeybot

            Danielle is a goddamned amazing person. I’ve followed her Facebook page (In Light of Gavin Michael) for a long time. She is a picture-perfect example of how a rational and intelligent person can end up with a homicidally negligent midwife, and have no clue that the midwife is a fraud.

            And Christy Collins’ fraud played out so publicly, on such a huge scale, with so many idiot participants. Lot of NCB people reeeeeeally want Danielle to go away and stop talking about Gavin Michael. I’ve seen them make bullying comments on her page.

            I’ve also seen NCB people bully Caroline Lovell’s mother on her Facebook page, too.

          • Amazed

            It’s a nightmare. I can’t imagine what it felt like to see the “professional” whom you have FORGIVEN for wasting your child’s life because you thought she truly didn’t know and was crushed by her own incompetence, slam you on Facebook, blaming you for your baby’s death.

          • MaineJen

            I will never stop being angry at the “Mom says she doesn’t want to transfer care” or whatever lie Collins spun. No fluid=absolute emergency, and a “midwife” should absolutely know that.

          • Dr Kitty

            This is the truth.

            Let’s say I have a 70year old with new indigestion, but no weight loss or vomiting or other worrying symptoms. I explain that the guideline says we should arrange an OGD (camera test of upper GI tract), but they are scared of hospitals and don’t want to. So, we’ll make a plan- maybe blood tests and antacids for a week or two and if things are no better or the blood tests are abnormal we’ll re-visit the camera test. But I’ll tell them that although the clinical suspicion of nasty things is low, it can’t be ruled out and that if their symptoms change we will need to have another conversation about cameras.

            HOWEVER, if that 70 year old comes back in a week reporting difficulty swallowing, no response to antacids and I notice abnormalities in their blood, we have a very, very different conversation about the camera test, along the lines that this looks like it may well be something that could kill them if left untreated and we need to get it sorted ASAP.

            I don’t think Collins ever changed from “well, just for safety we should maybe get it checked out, but if you really don’t want to we’ll come up with a plan B” to “it isn’t safe for you to stay out of hospital at this point. I am arranging for you to see an OB”.

            When you have a patient who trusts you they rely on your advice- if you appear unconcerned they will think that there is no need to be concerned.

          • Amazed

            I was stunned by Collins’ blatant impudence when she claimed that “midwife was on top of the situation” when it still wasn’t known that SHE was the midwife in question. Asshole learned nothing.

      • Trixie

        Yes. Danielle gave a lengthy and heartfelt comment and Jen tore her to shreds and then deleted and banned her.

  • CSN0116

    You can charge people money to join your FB groups?

    • Trixie

      I don’t think you can.

    • momofone

      I love this! Anyone who wants to be friends, just send me $100 and your name, and I’ll be glad to “friend” you!

    • moto_librarian

      Hmmm…It would be a shame if someone sent a message about this group to FB about a potential violation of its TOS.

      • yugaya

        Excellent idea!

    • moto_librarian

      I recommend reporting her FB page as a scam.

      • Trixie

        It’s not her public page, it’s her private closed or secret group, which you have to be invited to.

        • moto_librarian

          I reported VBAC Facts (her business page) as a scam. Because it is.

    • StephanieJR

      I thought people you paid money to to be your friends were called escorts?

  • MaineJen

    …Is this a real thing?

    I don’t know if I’d believe this is a real thing, if I couldn’t see the screen shots for myself. How on earth she thinks her 6 hours of blathering and a bunch of powerpoint slides are worth $330…it is to laugh.

  • Anonymous

    Silly thing here, but why on earth would you want to eat during labor, especially with the risk of a cesarean looming. Wife didn’t eat b/c we thought our first was going to need to be delivered surgically but that didn’t happen. Wife was fine, baby was fine, but OB was seriously concerned because of how tiny my wife is. Wife, my mom, her mom, me, dad, etc all were expecting the surgery so she didn’t eat b/c she was afraid of getting nauseated after.

    • Anonymous

      Oh, and wife had a very, very easy recovery. 3 yrs on she’s got no visible scarring. Not that it was ever very large.

      • Erin

        I’ve actually been “shamed” more for my easy section recovery than I have for having a section in the first place.

        Apparently getting up and dressing yourself four hours afterwards upsets the narrative some what 🙁

        • StephanieJR

          The fuck? You need better people. I volunteer to come and hit these idiots with sticks, if you like.

          • Charybdis

            I’ll help too! I have a lovely “persuader” that I can use. Pinata party at Erin’s?

          • BeatriceC

            Me too. I have a trio of attack parrots that pack a mean bite.

          • demodocus

            i have minions

          • BeatriceC

            I have those too, but they’re temporarily incapacitated.

          • Erin

            Can I hire all of you plus the parrots, the sticks and the minions to be my “doulas” please.

            My new consultant* told me I could have whatever I wanted in theater if I had a spinal…attack parrots would be amazing, especially if they’d attack anyone who mentioned the importance of breastfeeding, skin to skin or tried to quote the 10 steps at me.

            *He’s lovely but I think lacks imagination or just doesn’t know me very well yet.

          • BeatriceC

            Ohh! Attack Parrot Doulas. There’s something that should be a thing. They understand quite a lot, so I’m sure they could be trained to attack at the mention of certain phrases. You might be on to something here.

          • BeatriceC

            They look so innocent. We all know it’s just a facade. 🙂

            (ETA: I feel compelled to point out that the black cage in the corner isn’t one of the regular daytime cages; it’s Charlotte’s travel cage. Leo’s cage is cut out of the picture, closer to me as I took the picture, right next to Goofy’s cage, which is only partially visible.)

            https://uploads.disquscdn.com/images/1980473972a1d96dbf337e7c14038a8aaf4bf4e99c6e0f1ba7b6b28a60c78416.jpg

          • StephanieJR

            You could borrow my bunny when ‘skin to skin’ comes up- you’d probably get to relax whilst snuggling her, and the baby doesn’t have to be all cold and unhappy because they’ll be warm and clean (plus Amy loves the attention).

            https://uploads.disquscdn.com/images/c006aed01c737271fb1aaf64c15027e3b6736c492682c232ab8f785e5a68846b.jpg

          • Charybdis

            You seem to be running through consultants at a rapid pace…perhaps if they actually LISTENED to you they wouldn’t have to keep lobbing new people at you.

            We can be your entourage….like celebrities have. You know, so you don’t actually have to deal with them. Those of us from the US can show up with RTF formula nursette bottles, pacifiers, hats, etc, along with our minions, “persuaders” (barbed wire wrapped baseball bat, sledgehammer, taser, cattle prod, sticks, stones, tire irons, whatever…), attack parrots, etc. We check people at the door to see if they are on “Your List” and if they are not, well, then, sorry. No entrance for you: “Sorry, Erin is not “at home” now; she is not receiving today. Perhaps you could come back on her “receiving visitors” day. Do you have a card *proffers silver tray for card*? Good day. *close door*”.

            That way you don’t have to deal with them except for the bare minimum.

          • Erin

            He’s only my second 🙁

            I’m not THAT bad a patient.

            Although he seems to lack a sense of humour which could be problematic as I become very sarcastic when stressed.

          • Charybdis

            I fully admit that I’m not familiar with the NHS system of doing things, but I thought you had said that you were having a hell of a time with the midwives, etc. involved in your care this pregnancy and that they keep trying to change things each time you have an appointment. Is the consultant like a liason between you and other medical personnel?

            I don’t think that you are a bad patient; you had a shambolic experience with your first child and you are not letting them gloss over what happened. This makes people uncomfortable because you are not giving them an opening to so they can foist what THEY want to see happen on you. Don’t let them, stick to your guns.

          • Erin

            I’ve had two or three heated discussions and one full blown raging row but primarily with midwives, especially the mental health midwife I was briefly assigned and the community midwife I was sent to see because they wanted me to see someone more regularly than is usual for a second timer and I refused to set foot in the mental health midwife’s presence ever again.

            The only Doctor problem I had was getting them to agree to a General Anesthetic in the first place, which was pretty messy but I knew I was going to win, I just didn’t want to have to fight the way I did.

            I think it’s the difference in the way they speak to you if that makes sense. Midwives seem to pretty much hold your hand and tell you that what you’re planning is bad for the baby in a fake sympathy way. The Doctors have been way more snarky but at the same time actually sympathetic.

            On a scale of bad patients, I might not quite be down with the ones who throw punches or use ambulances for lifts but I’m definitely on the lower floors. When I worked for the Local Authority & the Civil Service I’d get really annoyed with clients who assumed I’d be a waste of space, work shy, arrogant, biased, casually cruel or just not give a damn about them. I only asked one thing of everyone I worked with, “don’t lie to me” and I fought for every single one of them. I argued their cases to my superiors, I argued with the police over them and I took on (and won) the Benefits agencies getting pretty big debts wiped out and given the thank you cards I received, I made enough of a difference.

            Now, I’m doing exactly what I used to get annoyed at others doing to me. I’m making assumptions about people. I’ve written them off before we even start talking because I’ve lumped them all together with those responsible for statements like “he didn’t descend because you weren’t over being raped”. I’m expecting bad “care” so I’m probably treating people badly in return and I am old enough to know better than that, especially given that I can be nice to little golden fishes called Anna…

            My Psychiatrist asked me if I were the Consultant OB what I’d say to me. It was a scarily revealing question so now, having caused havoc all over the place, I’m trying to figure out whether I do (and can) trust the new OB enough.

            Sticking to my guns would be easier if I was less emotional and/or hormonal. Also probably reading every article in the University Library about the Baby Friendly Hospital Initiative didn’t help.

            I’m sure I wasn’t this hormonal the first time around.

          • demodocus

            *your* minions?! Ha! Just means they have to be sneakier

          • BeatriceC

            They’re not quite two weeks post-op. Though the casts and braces came off today, so I have to be on the watch again.

    • Erin

      But but the Baby Friendly Hospital Initiative tells you should!

      (Sorry, I’ve spent the morning trawling the University library for articles and studies on the BFHI so it’s currently my favourite topic of discussion – hopefully I’ll get distracted onto something else soon as most people don’t share my fascination with the problems implementing it in Austria or what’s deemed “acceptable reasons” to formula feed).

      Personally I was in too much pain to eat much in labour. It might be weird but a large mass attempting to leave my body via my spine really puts me off my food.

    • Ash101

      I was induced, so would have loved to eat in that 24-hour period before labor actually started. But, I stuck to broth and don’t regret it. Didn’t end up needing a C-section but if I had, it was important I not eat!

    • J.B.

      With 1-2 day not active labors and average to short active labors, you can bet I ate. Little bits here and there to keep the blood sugar up. However, if not active (but still f*cking painful) labor continued for another day I would have been begging for induction!

    • Rose Magdalene

      I ate a little during labor with my first. My friends bought me a sandwich and I took a bite here and there between contractions. I never got to finish that sandwich. Once the csection was called I was told no more sandwich understandably. Some women are in labor for days. Fasting and getting little fluid for days when the body is doing something increbily physically taxing can’t be all that great.

      I’ve heard the reason that hospitals used to say no to food and water was because there is always a chance that a crash section might need to be done. There is a small chance if a woman needs to be put under that she might vomit and breath it in while unconscious.

      Both hospitals I birthed at allowed eating during labor, even the “csection happy” one. So I’m guessing the medical establishment believes the benefits outweigh the risks.

    • guest

      I wanted to eat because I was hungry – particularly because triage held me for five hours before making a decision, during which time I had no access to food, and then there decision was immediate induction, only water and Gatorade by mouth. I get migraines when I don’t have regular meals, and I get hangry.

  • BeatriceC

    You can do everything right and still have catastrophic complications. I’m short tempered today, so I apologize. This pathetic excuse for a human should have to suffer like the babies she condemns to death and the mothers who must bury them. She should feel that agony every minute of every day. It should haunt her like the villain in a horror movie, never letting her rest, driving her to insanity. And perhaps even that would be to good for her.

    • Karen in SC

      Go, Bea!

  • Roadstergal

    It breaks my heart when I hear of a first-time dental procedure being a root canal simply because the decay had spread to the root. Such a waste.

    Will she have an easy recovery?

    Does she have friends and family to support her emotionally, physically, and maybe bring her a meal she can suck through a straw?

    Will she mourn her root canal? If so, will she stuff those feelings deep down because, as she is told over and over, it doesn’t matter how the tooth gets fixed?

    Will her partner be a safe place, or will they, too, tell her it was ‘for the best’?

    Will she believe her jaw is broken?
    Will the surgery impact her desire to feed? Will she be told it’s common for dinner to be delayed due to root canals? Or will she believe the stove is defective, too?

    Will her pain be managed with Advil or will she need to choose between the pain and the constipation, cottonmouth, and nausea of narcotics?
    Will she wake up throughout the night with stabbing pain because she dared to grind her teeth in her sleep?

    Will she struggle with post-dental depression? Will she feel alone or will she reach out to help?

    How long will it take her to feel like her again? Until her tooth isn’t simultaneously numb but hypersensitive?

    How long until she realizes that her root canal could have been avoided with a more patient care team, cleaning, tooth removal, etc?
    Will this impact how she trusts dentists?
    Will she question everything?

    Or will the same dentist tell her how dangerous keeping a rotting tooth in her head is, but leave the final decision ‘up to her’?
    Will that doctor remain silent on the complications of root canals?
    Will they scare her partner with stories of abscesses, bone loss, and spreading infections?
    Will she schedule a root canal because she’s received inaccurate and incomplete information? Perhaps from a doctor who doesn’t ‘do natural management of infected pulp’ so they don’t give her the full truth? Or maybe they work at a root-canal-only practice, so they don’t even say there are other options?

    I have seen this story a thousand times… and my heart is heavy every single time.

    This is why I do the work I do.

    Women deserve so much better.

    • Roadstergal

      (In the process of writing this, I found out that – of course – Mercola has an anti-root-canal screed on his site.)

      • MaineJen

        So much better to die of sepsis from an infected tooth. It’s natural.

      • Heidi

        I accidentally stumbled upon that Mercola BS when I was having a crown put on my tooth (sans root canal). He claimed something about bacteria being lodged into the bloodstream, I believe, and maybe not being able to escape? He also claims he can cure vision without the use of corrective lenses! Just give him a hundred or two and he’ll send you the PDF!

    • AirPlant

      I am scheduled for a crown this Friday and I am actually going through a super weird mourning. Like a part of my body will be gone and I will be left broken and defective and in pain. I know with my rational mind that I am being a drama queen and lots of people go through this and it is better than allowing the crack to spread, but I can’t shake the horror of what is about to happen.
      .
      I am so glad that the woo hasn’t fully reached dental work yet, I think my mental health would never recover.

      • Roadstergal

        After a delightfully mis-spent youth with no tooth issues whatsoever (despite my love of sweets, yay genetics and fluoridated water), I finally had a root canal two years ago. Earlier this year, the top of it snapped off, and the doc did the implant thing where he put a titanium screw into my jaw, then attached a whole new false tooth to it. I think that’s the dental version of IVF + C/S + formula feeding? And it looks so lovely and works like the best ‘natural’ tooth I’ve ever had. (The only negative is that I have a screamingly high metabolism, so I have a certain ‘the drugs are wearing off’ wave I’ve developed when I need another injection, like a dental safe-word.)

        • AirPlant

          That is good to know! The dentist said that a modern crown can be expected to last 20+ years but the internet says 5-7 and I am really just terrified of having to repeat this over and over on all of my teeth forever. To make it worse pain meds don’t really ever kick in fully for me so I can feel everything and once the pain and the panic was bad enough that I had a full on panic attack in the chair and I am really scared that the nitrous will not be enough to take the edge off. They said I could be knocked out, but our finances are a bit tight right now and the crown is already putting a strain on things so if I can do it awake I feel like I have to.
          .
          It almost seems like over the top anxiety got me into this mess and now it is going to drag every ounce of pain out of the solution that it can…

          • Roadstergal

            Owwwwch! 🙁

            It makes me think of the old-school surgical solutions – getting the patient as drunk as possible…

          • Erin

            The last bit of my root canal was done without anesthesia.

            On the pain scale, I’d rate back to back labour first, then dropping an exceedingly heavy book on my toes, then the root canal and then my section recovery.

            I guess I’m doing it wrong 🙁

          • Roadstergal

            A Dutch co-worker (I have three Dutch co-workers, two of them who had the typical Dutch homebirth experience) was telling me about having a tooth break and expose the nerve while on a flight to a conference, and having to wait until she got back to have it tended to. She was trying to explain the intensity of the pain to me, and the only comparator that came to her was her unmedicated childbirths.

          • AirPlant

            for reals: a part of me just wants to take a shot on the way in. It really can’t hurt, right?

          • An Actual Attorney

            Fwiw, I too have bad dental anxiety. I wince in pain before I even sit in the waiting room. I have had several dentists give me a small Rx for Xanax before my appointment with instructions to pop it a half hour before the procedure. It means I can’t drive myself home, but so worth it. And while I may have other drug seeking tendencies, multiple dentists have brought this up without me asking, so it must be not uncommon for those of us who freak out at the dentist.

          • AirPlant

            I asked for a xanax.

            The dentist suggested soothing music and a comfort object. That seems like it will work just the same…

          • An Actual Attorney

            Then I would definitely go for the shot.

          • Nick Sanders

            Seems to me like a Xanax would be extremely comforting.

          • AirPlant

            I thought so too, but they looked at me like I was one step away from asking for narcotics and now I feel like a giant asshole for asking.
            .
            They do keep telling me that they will stop the second that I feel any pain though. Which is super comforting when you remember that they have never successfully blocked my pain…

          • kilda

            that is ridiculous. Yes, meds like xanax are habit forming and should be used with care. If you were asking for it on an ongoing basis that would be one thing. But we’re talking about a single anxiety provoking event on a single day. One or two doses of xanax to deal with a phobia such as the dentist or flying is a perfectly reasonable request.

            No one is ever going to become an addict by taking a xanax to get through a dentist appt.

          • Charybdis

            You shouldn’t. Dentists are aware that people tend to have anxiety about dental procedures. We have dental practices here that ADVERTISE that sedation is available if you are anxious and that you can sleep through your dental procedure, even if it is just a cleaning. You aren’t asking for an unlimited supply..one or two for the night before the procedure and for an hour or so prior to the procedure.

            Tell them that although you appreciate their concern that you are some sort of drug addict or that you are just trolling for a fix, you have an actual issue with anesthesia and that this is causing your anxiety. It is not unheard of nor out of the question for there to be requests for sedation, so why are they being obstructive about it?

          • BeatriceC

            Oh, man. That reminds me of that astoundingly cruel depression meme floating around that shows a picture of trees on the top and pills on the bottom and says the trees are an antidepressant and the pills are just making money for pharma, or something like that. I want to throw my computer through the window every time I see it.

          • AirPlant

            Well, my comfort object is a fat and cranky cat, so I am sure that won’t be a problem, right?

          • StephanieJR

            I actually have just lain back and thought of snuggling my fat and needy bunny a few times…

          • Charybdis

            Tell the nice dentist that if he doesn’t want to be bitten or have a terrified, tense patient to work on, the xanax (or similar) really might be in everyone’s best interest.

            You have anxiety over a specific procedure and have issues with the anesthetic not working well on you. FFS, you can take a xanax/valium BEFORE your procedure. You aren’t asking for an unlimited supply.

            Or perhaps punch him in the testicles. Then offer soothing music and a comfort object for his pain.

          • Dr Kitty

            I have a dental phobia and absolutely get diazepam before anything.

            Which is why my dental check up schedule is seriously behind- pregnancy, breastfeeding and diazepam don’t mix terribly well.

            Thanks for reminding me to order some from my doc and arrange a check up for a no work/ no kids day.

          • StephanieJR

            I always found the anxiety and waiting the worst- I’ve got two more appointments this year, and one of them is on my birthday! Would love to be high for that…

          • Patricia

            Tranquilo. My crown lasted 20 years.

          • Heidi

            Are you getting a root canal, too? I have three crowns but never had a root canal. It wasn’t any different than getting a regular filling for me as a patient. It just took a little longer and a second visit to get the permanent one. (I evidently grind my teeth and have cracked them. I actually think I clamp my jaw down in my sleep because no one has noticed me do it.)

          • AirPlant

            I don’t need a root canal, thank goodness. Just a crown for a cracked molar. I almost think it would be easier if it was a painful root canal situation because then my lizard brain would understand the need, but right now you can just see the crack and the dentist wants to take care of it before the tooth is compromised so I am going to be going from no pain to pain.

          • Charybdis

            Yeah, you definitely want to get it taken care of before the crack gets worse. I developed a tiny crack in one of my molars because I am a jaw clencher and tooth grinder at night. It didn’t always bother me, it would twinge a bit if I bit down on something in the “wrong” way. Took the dentist a few minutes to actually find the crack. It resulted in a root canal, as I had developed an abscess. It wasn’t bad at all, it was more painful because of the infection and as they got further in, they added local anesthetic directly into the tooth to help.

            As I remember my one crown that didn’t need a root canal, it wasn’t bad at all. Some numbing so that it didn’t really hurt as they were shaping the tooth was all. Plus nitrous because I had a bad experience once and tend to tense up in the chair for things other than a cleaning or x-rays. It will be okay.

          • AirPlant

            Thanks, that is really comforting. I have gotten through fillings before with nitrous and there are no signs of a cavity on the tooth so the dentist is assuring me that it will most likely be as mild as a crown can be. I just don’t know how to not be scared. Normally I would research but googling is just making the anxiety worse. Real stories help.

          • Charybdis

            They took impression molds of my teeth first so they could have a template for the crown. Then came the numbing and nitrous. They ground the molar down to a circular stump, then made and fit the temporary crown. After making sure that fit well and cautioning me to be careful with that side, I was free to go. They send out to a dental lab for the actual making of the crown and then somewhere 7-10 days later, the permanent crown comes in and you go back to the dentist for the permanent one. They pop off the temporary one, clean the tooth stump surface and then place the permanent one on.

            My temporary crown popped off once. No big deal, although touching the stump of tooth left with my tongue caused a sensation very like licking the snaps on a nine-volt battery. Before you get the temporary crown, pop into the drugstore and get you some temporary filling material. It is usually found by the denture cleaners. IF your temporary crown comes off, you can reattach it by using some of this putty stuff. It’s not absolutely necessary, but if you have some on hand, then you don’t have to worry about finding some at 10:30 on a Saturday night.

          • guest

            I had a root canal and a tooth extraction (separated by 20 years, same tooth) with no pain prior to the procedures. I also had two root canals after suddenly waking up one morning in excruciating pain. The former is FAR preferable – the pre-root canal pain is much worse, and after they give you pain meds.

        • Mishimoo

          My current dentist has finally figured out how to perform a decent nerve block for me. I actually felt nothing with the last fillings for the first time ever! It’s not just that I’m resistant to the anaesthetic, it turns out that my jaw anatomy is also weird and shaped differently to other people, so it’s really difficult to do nerve blocks in my mouth. He’s suggesting midazolam for my wisdom teeth removal, just to make it easier for me, which is nice.

      • StephanieJR

        I did cry a bit about losing some of my teeth; partly over how stupid I was over my dental care, partly due to knocking my consistently low self esteem. You’re allowed to be sad, so long as it doesn’t take over your life.

      • guest

        That feeling is worse when they actually have to pull one of your teeth. I had a root canal fail after twenty years, and now I have a space where a part of me used to be.

        Woo is spreading through dental care, though. I have neighbors who seek holistic dentists, and who think the mercury in their fillings is harming them. (Ironically, having those fillings removed puts them at greater risk than leaving them in.)

        • Who?

          We had a very bad experience with the ‘holistic’ dentist who bought my friend’s dad’s practice, where we’d always gone. I was somewhat new to parenting, and ‘holistic’ was a new thing then (late nineties, early noughties) and it was a nightmare. He didn’t like fluoride, or fissure seals. In my ignorance, I thought there must be a basic standard of care, and that he was providing it. My second child has him to thank for the mouthful of small fillings she now has, and for the major damage to one tooth which is likely to result in her needing a crown sometime in the next 10 years.

          He also convinced me all my mercury fillings needed to be taken out and replaced.

          I dumped him when he told me my skinny, active kids were likely allergic to dairy and wheat, and should therefore go on a diet, recommended by him. I told him I’d be excluding food groups only on medical advice and under the services of a dietician (which is a real qualfication here) and he got his knickers in a knot, so that was that.

          The new dentist couldn’t believe the nonsense he was peddling.

          He’s still practising out in the ‘burbs, no doubt getting them in in droves.

          • guest

            I’m sorry that happened to you. The woo-ites can be very convincing, which is why I get angry about it. I support any adult doing what they want to their own body as long as it doesn’t harm others, but spreading misinformation DOES harm others.

      • mabelcruet

        I have had one root canal done in a back molar. My dentist at the time was the partner of a friend of mine, and we got on really well. During the procedure he angled a mirror so that I could see the gaping enormous hole in my tooth, and then he proudly showed me each little white worm like nerve as he dug them out of the root. It was horrific!! I have never forgotten it, I think I have PTSD 🙂

    • Dr Kitty

      Kiddo number 1 has two hypoplastic premolars that need removed.
      We met with the wonderful specialist NHS paediatric dentist (I have a dental phobia, but am ok as long as it isn’t me in the chair) who is arranging for us to see an orthodontist for an opinion as to whether we should just get the two offending bottom teeth out, or get the balancing teeth out on the upper jaw as well.

      There are obvious pros and cons.

      DH and I both needed sound teeth extracted as teenagers for orthodontics, so getting more teeth out now may mean fewer extractions and less time in orthodontics down the line, but will depend very much on the orthodontist’s opinion of how kiddo’s adult teeth and jaw are likely to turn out.

      I’m not desperately keen on her having four teeth out, but I figure four extractions at once under GA in a hospital OR either proper analgesia and done by a specialist is probably preferable to two extractions now and more extractions later under LA by an ordinary dentist.

      Anyway, we’ll see what the orthodontist says, then the paediatric dentist and I will agree a plan and arrange a date for the extractions. There is no urgency because she has no pain at present.

      BTW- this is all free NHS dentistry because she is under 18.

      • FormerPhysicist

        I had OD hypoplastic tooth out (and the matching one on the other side) before braces. It was a wonderful decision I do not regret. Dentist thought we could save the tooth for maybe 10-15 years, then she’d need an extraction and implant.

      • guest

        I had GA for baby tooth removal (two) and an impacted adult tooth when I was 12 or so. Coming out of GA was confusing, but all in all it was a non-traumatic experience.

      • AA

        Dr K–I know that you are not from Scotland, but since you’re in the British Isles, could you give me quick advice? I leaving for the UK on Sunday for two weeks. Planning to go to the Scottish Highlands at some point during the trip. If I don’t have waterproof boots, are my feet going to freeze off while walking about in nature (but not camping)?

        Given that I’m only bringing a carryon, wise choices about shoes are imperative. I don’t have any ankle waterproof boots.

        • Erin

          Depends on your definition of “walking about in nature” really.

          If you mean getting off tarmac/gravel paths, then yes, you will probably have wet/cold feet without waterproof boots.

          I was at a Castle the other weekend which is almost in the Highlands and at 2 in the afternoon, the grass was still wet from the morning dew. It hadn’t rained for days but my feet were soaking in about 3 minutes.

          However, there are a lot of pubs with open fires for drying said wet cold feet out.

          Ceud mìle fàilte! (Yep, that’s me showing off pretty much the only gaelic I know).

        • Dr Kitty

          If it were me I’d be wearing hiking boots and thick socks.
          It is about 10C at the moment, with mud, rain and wind chill pretty much a given.

          If I’m doing anything more than a walk in the park I’m in hiking boots. Mine are the type that are like sturdy trainers though, not the full alpine leather ones!

          You can always buy boots in the UK if what you bring isn’t suitable, but it will work out more expensive than in the US.

          • AA

            thanks for the advice!

  • The Bofa on the Sofa

    Kamel is grooming women to believe that a C-section means they are defective.

    “Last month my company both invented and cured restless eye syndrome. Ka-ching, ya blinky chumps!”

  • Sean Jungian

    Haven’t finished the post yet but just had to run down here to say “ostentatiously suffering from sadness” is SO spot on and one of THE most annoying bullshit things I see from sanctis.

  • Taysha

    “Will she have an easy recovery?” Yes

    “Does she have friends and family to support her emotionally, physically, and maybe bring her a warm meal?” Mmm, yes. I also got laundry done, help with cleaning bottles and my mom ironed. Because she likes that.

    “Will she mourn her cesarean? If so, will she stuff those feelings deep down because, as she is told over and over, it doesn’t matter how the baby gets here?” Uh, No. Best thing ever. Like, for realsies.

    “Will her partner be a safe place or will they, too, tell her it was “for the best?” It was, so he’s welcome to say it as often as he wants. Also – woo, meds!

    This is like a fabulous example of shaming and accusation. A lawyer friend of mine would have a ball with it.

    • Karen in SC

      KQ could break it down as well.

      • Kq Not Signed In

        I could indeed. Apologies in advance for any errors in spelling or formatting – typing from work so not logged in and won’t be able to edit.

        Will she have an easy recovery?
        This question applies to any and all deliveries.

        Does she have friends and family to support her emotionally, physically, and maybe bring her a warm meal?
        As does this one. Unless her friends are so incredibly indoctrinated in the woo that they’d refuse to take care of her after a csection. You know, because she was a terrible failure that might spread negative energy or something.

        Will she mourn her cesarean? If so, will she stuff those feelings down because, as she is told over and over, it doesn’t matter how the baby gets here?
        Grammar point: I think you mean she’ll mourn her vaginal birth – the thing she didn’t get. You mean “regret” her cesearan.
        Also: if she’s sad about her C/S, helping her understand that it doesn’t matter how the baby gets here is how you help her.
        Also: It doesn’t matter how the baby gets here.

        Will her partner be a safe place or will they, too, tell her it was “for the best?”
        Translation: if her partner doesn’t support her being a victim, they are the enemy. Come closer to me, isolate yourself from people who are trying to point out that your baby is alive and that’s a good thing.

        Will she believe her body is broken?
        She sure will if you get your way. YOU clearly believe it’s broken.

        Will the surgery impact her desire to breastfeed? Will she be told it’s common for milk to be delayed due to cesareans? Or will she believe her breasts are defective too?
        Wow, you’ve got quite the lactivist conspiracy going on here. Don’t tell a woman there’s ever a chance of milk being at all delayed – just let the baby suck and starve! But seriously, if she’s already got you questioning your own body and abilities, why not add “bet your stupid breasts don’t work either” to the list.

        Will her pain be managed with Advil or will she need to choose between pain and the constipation, cottonmouth and nausea of narcotics?
        You’re not even going to mention how narcotics also cause itching? Man, they’re so bad. Also, this question is still legit about vaginal birth. Also also, TRUE WARRIOR MAMAS suffer. Advil is okay IF YOU MUST DO DRUGS, but otherwise you’re a bad person.

        Will she wake up through the night to stabbing pain because she dared to turn in her sleep?
        HAHAHAHAHAHAH sleeping through the night when you have a newborn! HAHAHAHAHHA *gasp* oh man. I’m sorry. I just can’t even on this one.

        Will she struggle with post-partum depression? Will she feel alone or will she reach out for help?
        Uh, good question for EVERY NEW MOTHER EVER. But still. Make sure you reach out to ME so I can tell you exactly WHY you should be depressed about your broken body, bad choices and all around failures.

        How long will it take to feel like her again? Until her scar isn’t oddly simultaneously numb yet hypersensitive?
        This one needs unpacking. First off, new moms can take months or years to feel like “herself” again. That is, motherhood does a number on your self image and identity no matter what. I have yet to meet a mom who didn’t find her essential SELF altered or unrecognizable. Horomones, exhaustion, new identity (as a mother or a mother of X), new person in their life (FOREVER)…So yeah, that’s a universal that can draw in a struggling new mother. That’s me! I know that feeling! As for the scar thing – she doesn’t mention how long it takes a fourth degree vaginal tear to stop feeling any different from normal.

        How long until she realizes that her cesarean could have been avoided with a more patient care tam, epidural, position change, etc.?
        Translation: How long until she stops listening to doctors and family and friends and loved ones and only listens to MEEEEEEEEEEE

        Will this impact how she trusts medical professionals?
        Take my class and turn that into “this WILL impact how she trusts medical professionals!”

        Will she question everything?
        Oh, she will when YOU get a hold of her. Spoken like a true conspiracy nut. “I’m just asking QUESTIONS!!” But seriously, this is just to prime the pump for the next trick.

        Or will the same doctor tell her how dangerous vaginal birth after cesarean (VBAC) is, but leave the final decision “up to her?”
        See? Stop listening to DOCTORS, listen to MEEEEEEEEEE

        Will that doctor remain silent on accreta?
        Because I won’t! I’ve got SCAAARY stories that I am going to tell you ALL ABOUT this SCARY SCAAARY complication!

        Will they scare her partner with stories of exploding uteri and dead babies?
        Man, that one needs a .gif because I cannot stop picturing exploding uteri. Like fireworks. But seriously: Doctors have SCAARY stories that they are going to tel you ALL ABOUT these SCARY SCAAAARY complications! But you shouldn’t listen to them! LISTEN TO MEEEEE! And if they tell your partner, don’t listen to them either!! LISTEN TO MEEEEEEE!

        Will she schedule a csarean because she’s received inaccurate and incomplete information? Perhaps from a doctor who doesn’t “do VBAC” so they don’t give her the full truth? Or maybe they work at a VBAC ban hospital, so they don’t even say that VBAC is an option?
        Pile it on! I AM THE ONLY ONE YOU CAN TRUST LISTEN TO MEEEEEEEEEE

        I have seen this story a thousand times…and my heart is heavy every single time
        …because clearly, they did not LISTEN TO MEEEEEE

        This is why I do the work I do.
        Because I must be validated and adored and LISTENED TO and maybe worshipped just a little, like my picture sitting on the Birth Altar – you have one of those right?

        Women deserve so much better
        I DESERVE TO BE LISTENED TO PAY ATTENTION TO MEEEEEEEEE

        • Erin

          “As for the scar thing – she doesn’t mention how long it takes a fourth degree vaginal tear to stop feeling any different from normal.”

          According to my Mother in Law, the answer to this is NEVER!

          • BeatriceC

            And if you happen to split your perineum open along the scar (even with a third degree tear) many years afterwards, the answer is “twice never”.

        • StephanieJR

          I regret that I have but one upvote to give.

        • Karen in SC

          Excellent! thanks!

        • Rose Magdalene

          What got me over my csection guilt was reading stories about nightmare vaginal births. Once I learned that VB isn’t all rainbows, unicorns and empowering goddess moments, I realized that I was lucky. Nope I didn’t want that first csection, but I walked away healthy with a healthy baby and a healthy undamaged vagina. Didn’t suffer PPD or PTSD either.

          Getting away from the NCB movement also helped a whole lot too.

  • moto_librarian

    Here’s what I would like you to know, Jen Kamel. It’s entirely possible to experience many of the things that you blame on c-sections after a vaginal delivery. I was on opioid pain medications for the first 5 days postpartum because the pain from the cervical laceration was so bad. While my delayed milk production was ultimately unrelated, serious postpartum hemorrhage can seriously impact a woman’s ability to make milk, and I had one of those too. I also was on the verge of PPD, not because I had a c-section, but because my unmedicated vaginal delivery was such a horrible experience, and I couldn’t understand what I had done wrong to cause it. That self-blame comes from assholes in the NCB movement who elevate childbirth as an the penultimate event of a woman’s life. They constantly disrespect OBs, refuse to acknowledge the very real risks of uterine rupture, and pass out idiotic platitudes rather than facts. You have a lot to answer for, Jen.

  • namaste863

    $330 for cheesy 30 second videos and fucking power point slides? Do we look like we were born yesterday?!

  • Roadstergal

    “Will she mourn her caesarean?”
    If she doesn’t at the outset, Jen will make damn sure she does by the end.

  • CelinaA

    I’d argue that VBACFacts “Academy” is worse. At least TU doesn’t try to monetize endangering women and children’s lives. (As revolting as both organizations are.)