Saying Justice

(Originally posted at Rational Jenn)

Over the last week or so, I've been thinking about all the things I'm happy about in my life: my husband; kids; family; friends; the fact that I am able to be home to raise my kids (and homeschool them, too!); my husband's new job (and the old one!); the thinking and writing I've been doing on the blog; the health of me, my family, and friends. All really wonderful things!

Then two things happened nearly simultaneously. First, I read Craig Biddle's piece entitled "Don't Say Grace, Say Justice". (Go read it!) Second, someone I barely know made a snarky comment about a subject that is very close to me: surgical births. This person was not directing her comment at me, but was making a general statement about a recent event where a woman happened to have had a c-section scheduled, but ended up delivering vaginally.

Excuse me for a moment while I venture into Mommy Wars territory. You may (or may not) know that all three of my kids were delivered by c-section. This fact isn't something I've ever felt the need to defend, or even discuss too much (especially with near-perfect strangers). But the snarking that happened the other day had two effects. First, it pissed me off a bit. Second, it made me realize that I wanted to write a bit about my experience (don't worry, no gory details!) and SAY JUSTICE to the man who delivered three of my highest values.

Let me just say a few things about c-sections before I begin saying my justice.

• C-sections are certainly not natural in any sense of the word, and I think that where possible, a vaginal delivery is best for everyone involved.

• I also think the c-section rate in this country, and especially Georgia (in part, due to the fact that we are not allowed by our legislature to have free-standing birth centers), is way too high.
  

• I vehemently discourage anyone considering having a c-section just because they think it's easier somehow. It's not. I've heard of women who want to spare themselves hours of labor and the pain associated with that. I've never experienced real labor, but the pain and discomfort associated with healing after a c-section lasts for WEEKS, not hours or days. Just sayin'.
  

• I support VBACs, including support and education to encourage women to try it and raise those VBAC rates. (VBAC is "vaginal birth after caesarean.")

Also, because of a couple of my previous "real" jobs, I'm intimately familiar with malpractice insurance, physician billing, and other health care goings-on in my state. Okay--got it? Good. (Also, I'm not a doctor, so don't take any of this as medical advice. I know YOU won't, but I always gotta worry about the FTC watching.)

Those things said, I am oh-so-thankful for c-sections! C-sections are WONDERFUL things. Yes, I said it: WONDERFUL.

And they are very safe. Not without risk, certainly, but this is the most commonly performed surgery in the country. It is safe, particularly a planned c-section. It's those emergency/urgent c-sections that are riskiest. But it's those are that are the most needed, so in those situations, it's worth that higher risk to the mother and the doctor.

Ryan was an urgent, unplanned c-section. Two weeks overdue and lodged up high inside me, he started showing signs of distress the second any kind of contractions began. Things quickly deteriorated, and in order to get him out quickly (he was stuck), the surgeon made a vertical cut after the first, horizontal cut. My doctor saved Ryan's life. After a few days in NICU (he had Meconium Aspiration Sydrome, and it was very, very bad at first--fortunately he rallied quickly), he was fine.

Because of the type of incision during Ryan's birth, I was not such a great candidate for a VBAC. I do think that if I had been in a more birth-friendly state (that is, not Georgia), it would have been easier to explore those options if I wanted to. As it is, and women who have given birth around here know this to be true, it's HARD to find any obstetrician willing to let a woman with my inverse-T incision undergo a VBAC. Yes, I could have found one if it had been important enough to me. As it happened, Morgan was in there sideways (and stuck). They didn't want to try a version (turning her from the outside, yuck) because of the previous c-section. Transverse breech is a hard indicator for a c-section anyway, and with my history, it was a no-brainer. Morgan's birth was much more relaxed than Ryan's, obviously. It was even fun and lighthearted in the OR.

With each subsequent c-section, it becomes riskier to have a VBAC, and therefore, more difficult to find a guy. I didn't even bother. I know! GASP! Given my history and situation, and the fact that planned c-sections (while not without risk!) are pretty safe procedures, I went ahead and had Sean that way, too. For whatever reason, and I never heard the full story about how this could have happened, this little baby decided to, what, turn at the last minute? Anyway, THIS is the kid born feet first. Crazy. (Not that you can't deliver a breech baby the regular way, I know!) I have never regretted for a second scheduling his surgery.

Because of my surgeon, all three of my babies landed safe and sound. Things were pretty dicey with Ryan there for a while, but he was fine because my surgeon knew what to do and did it. His skills and knowledge got us all through the surgeries safely. I have never second-guessed my decision to have the two repeat c-sections, and I am forever grateful that he knew what to do with Ryan.

So this is my Justice-Saying. Sure, kind of a strangely particular topic, but as I said--what happened the other day really got me thinking about my birth experiences and how grateful I am that my doctor studied hard and practiced a lot and used his brain and worked in a hospital with the latest technological equipment and knew just what to do to take care of us.

Dr. Michael Echemendia, I can never thank you enough!