VBAC

Categories Book Reviews

Book Review: Cut, Stapled, and Mended by Roanna Rosewood

2 Comments by

The first chapter includes a sex scene, bodily possession, and a token reference to “a woman’s right to choose”. So I think it’s safe to say that Roanna Rosewood and I have very different philosophies of life.

The rest of this VBAC memoir confirmed that. From the beginning I was inclined to not like Rosewood very much. I felt somewhat heartened when she told the reader that though she’d been raised in the mystic spirituality of the hippy 60’s, she had considered it useless as an adult – but she quickly found that particular brand of spirituality again. Rosewood also has a antipathy towards doctors that transferred from her hippy heritage – one that I don’t share (I’m squarely in the Western medical establishment – I just believe that for the majority of cases, childbirth is not a medical event.) Furthermore, Rosewood has a complete lack of discernment regarding alternate practitioners.

The short of Rosewood’s story is that she intended to have a homebirth but didn’t prepare her body at all because childbirth is natural and why did she need to learn about it? Her waters broke to start labor, but then labor piddled around for days until her midwife insisted that she did indeed need to go to the hospital. There, she received a c-section. She felt great failure, didn’t bond with her baby, etc. etc. I felt like she set herself up for what she got.

Determined to have a home VBAC, Rosewood threw herself into physical preparation and childbirth education. She learned the stats and became one of those annoying VBAC proponents (yes, I say this with tongue in cheek). She actually learned about the stages of labor and management techniques this time around. She walked like her midwife encouraged her to so she could have some strength and stamina when labor rolled around. And she engaged in every quack therapy you can think of (and some you can’t think of).

Her second labor followed the first’s example, and she ended up with a second c-section. This one was better, because she knew what to expect and had done some things to prepare. She had skin to skin, got started breastfeeding more quickly, etc. But it was still failure.

She didn’t plan to get pregnant the third time, it was an accident born of “goddess sex”. And she didn’t plan on keeping the baby, she just kept putting off taking the Plan B her doctor had prescribed. What she did plan was a home birth, acting expressly against the policy of the OB she was also seeing, in case she needed to deliver in the hospital. This pregnancy actually seemed more medically risky – she bled clots early on and had various other scary signs – but this time she did some inner work in addition to the physical stuff. She discovered that she was a bitter woman who pushed other women away, that she had never learned how to relax and just be, etc. So she went on a voyage of emotional and relational discovery (including a “goddess week” in Hawaii). Then she had a successful home birth when her inner goddess pushed for her.

I don’t recommend this story. Rosewood is a flake. Both her methods and her beliefs are highly suspect.

Which doesn’t mean that I didn’t have a takeaway. The truth is, childbirth isn’t simply a physical thing. A woman’s mind and emotions do impact the progression of labor – and it’s important to not ignore that. Relationship with your labor support is important. Having a goal beyond “not failing again” is important.

That said, there are many differences between Rosewood’s sections and mine. I do not feel my c-section was a failure. It was not forced on me, I chose it. While Rosewood experienced a very difficult labor after premature rupture of membranes, I never went into labor. Rosewood’s initial experience of premature rupture of membranes followed by stop and go labor was repeated in each of her pregnancies. At present, I have never gone through labor and have no reason to expect that my labor should not proceed normally.

I will be preparing for my first labor and delivery, which just happens to be after a c-section. Rosewood was trying to correct what she’d done wrong in her first labor and delivery in order to avoid the undesirable outcome she had. It’s a very different experience – and one that causes us to have very different mindsets from the outset.

Rating: 1 star
Category: Childbirth memoir
Synopsis: Rosewood tries for a home VBAC twice – and learns that childbirth isn’t just physical.
Recommendation: I don’t recommend it.

Categories Book Reviews

Book Review: Vaginal Birth after Cesarean by Elizabeth Kaufmann

2 Comments by

What would you do if you had a cesarean with your first child and just happened to get pregnant with your second child when a national push to lower cesarean rates was forefront in everyone’s mind? Your doctor says you’re a good candidate for vaginal birth after cesarean (VBAC), your HMO wants to pay less money (and is therefore rooting for vaginal birth), and societal pressure pushes you toward VBAC.

In Elizabeth Kaufmann’s case, she reluctantly agreed to a trial of labor with certain stipulations. The VBAC was successful, but the baby was delivered with forceps and Kaufmann experienced significant tearing.

Then, she wrote Vaginal Birth after Cesarean: The Smart Woman’s Guide to VBAC to keep other women from experiencing the horror of vaginal delivery.

Or at least that’s how this book seems. While Kaufmann does share some potentially useful information regarding cesarean sections, VBACs, and repeat cesareans, every page is infused with her experience and subsequent antipathy toward anyone suggesting that a woman who is a good candidate for VBAC should indeed go through a trial of labor.

Who does Congress, who does the HMO, who does the doctor think they are to tell a woman how she should give birth? Since when should medical standards or money be a factor?

But those are political topics that I won’t go into here.

The part that makes Kaufmann’s book most unhelpful to the modern-day mama who wants information about VBAC isn’t her obvious bias, though. It’s that the world Kaufmann is raging against doesn’t exist.

In 1996, when this book was written, VBAC was supported by medical policy and by insurance companies – and doctors were employing the same active management to VBAC as they were (and still are) to other vaginal deliveries. Women were being induced with Cytotec, Cervidil, and pitocin. Labors that weren’t progressing according to Friedman’s curve (an antiquated description of the labor process based on a significantly different population than today’s moms and describing labor under significantly different circumstances than either normal or currently managed labors) were augmented with Pitocin. Surprisingly (can you hear the sarcasm?), these women whose VBAC attempts were managed thus ended up with increased labor and delivery complications.

And, of course, the good people who write policies decided that meant VBAC wasn’t quite as good an idea as they’d originally thought, so they set new policies in place to make it hard to try a VBAC, much less to succeed at it.

And that’s where we’re at now.

Few women are being coerced by doctors or insurance plans into having unwanted vaginal deliveries. Instead, many women who would love to deliver normally and who have a good chance at being able to, were the natural processes allowed to unfold naturally, are being denied the possibility of VBAC.

So Kaufmann’s book is simply unhelpful. It is written to try to give women who were feeling coerced into VBAC an out – but women aren’t being coerced into VBAC these days. The situation is quite the opposite.

For those who are interested in the history of VBAC, the Well-Rounded Mama has an excellent overview

Rating: 1 star
Category: Medical/childbirth
Synopsis: Kaufmann has a chip on her should and rages against VBAC policies that no longer exist.
Recommendation: Singularly unhelpful for the modern woman interested in learning about VBAC.

Categories Book Reviews

Book Review: The VBAC Companion by Diana Korte

2 Comments by

I’m sure it will come as a total shock to my readers – but I’m hoping for a vaginal birth the next time around.

I know, I know. You’re having a hard time wrapping your head around it.

Truth is, even if I weren’t all about natural childbirth and minimal interventions and maximizing chances at successfully establishing breastfeeding (all good cases for vaginal birth after c-section, or VBAC), I want to have lots of kids. And you can only have so many repeat cesareans.

So I’m planning on doing everything I can to work toward that end.

Diana Korte’s The VBAC Companion is the first resource I’ve picked up – and it’s a pretty good one. It outlines the case for VBAC, as well as the risks associated with it, and then goes right into how to plan for your VBAC.

The bulk of the book consists of finding a medical professional and a birthing location that are supportive of VBAC.

Turns out, the most important thing you can do to ensure success of your VBAC attempt is to have supportive attendants. Having a doctor or midwife who believes in VBAC, who has practices that support successful laboring (versus “trials of labor” that root against a woman), and who has successfully helped women have VBACs is HUGE.

The final part of the book was about laboring – mostly the general stuff you’d learn in any childbirth preparation class. How to manage pain and keep labor moving by moving around and assuming different positions. Which interventions help a woman to labor well and which slow or stop labor. Helpful things, but not ones unique to VBAC.

This was a good book on preparing for a VBAC. I would imagine that most women who want to attempt a VBAC will find it very useful.

I didn’t.

You see, I was hoping for something more. I was hoping for guidelines for physical fitness, exercises to do. I was hoping for weight gain guidelines. I was hoping for more specific laboring advice. Not that the other stuff isn’t important. I know the stuff this book discussed is the most important stuff for ensuring success. It’s just that I’m blessed to already have two extremely supportive attendants. I know that when I try again, my midwife and my OB are both rooting for me and are going to do everything in their power to help me to be successful.

So, I keep searching for that other stuff (I have a feeling I might not be able to find it in a book – so I’ve got a meeting scheduled with my midwife to talk about what she’s found to be helpful with other women).

Meanwhile, I can wholeheartedly recommend this book as a resource for other women who are hoping for a VBAC, especially for those who don’t know their OB, doctor, or midwife’s track record on VBAC and need help choosing a supportive professional.

Rating: 4 stars
Category: Pregnancy/Childbirth
Synopsis: Rationale for choosing a vaginal birth after cesarean and how to plan for a successful VBAC.
Recommendation: If you are interested in trying for a VBAC, this is a good resource.