April is Cesarean Awareness Month

"ICAN supporters around the world observe April as Cesarean Awareness Month by wearing burgundy ribbons pinned upside down. The burgundy color symbolizes birth. The pinning of the ribbon upside down symbolizes the state of distress many pregnant women find themselves in when their right to choose the method of birth for their child is dismissed. The loop of the inverted ribbon represents a pregnant belly with the tails of the ribbon denoting arms outstretched in a cry for help."

 

In honor of Cesarean Awareness Month, I want to introduce you to an organization called ICAN, and tell you the brief story of why I started a local chapter, ICAN of Northeast Iowa, just one year ago.

ICAN is the International Cesarean Awareness Network, an all volunteer, non-profit organization that helps moms and babies affected by surgical birth.  ICAN's mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC).  When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby and worth the risks involved.  ICAN provides education and support for families who are:  recovering from cesarean surgery, who want to prevent an unnecessary c-section, or families who want to plan a VBAC or a family centered cesarean.

Why I started an ICAN chapter:  My first baby was born via c-section:

Our first picture of baby Renee, Daddy got to hold her hand because Mommy was still in surgery.

Of course I wasn't planning on having a c-section, most families don't expect it for their first birth.  But after 5 days of prodromal labor, lots of pitocin, epidural, artificial rupture of membranes~ my cervix "failed" to dialate beyond 8cm.  I was told I had 2 more hours to "progress" or else I'd have a c-section, and I secretly was delighted when the time came and went and I was finally "delivered" of my baby girl.

Then it came time for recovery- whoa!  Major abdominal surgery is NO FUN, and couple that with being a first time parent and caring for a newborn, talk about exhausting!  My first frustration came when telling people about my birth, having to "explain" why I had a c-section.  "Failure to progress" is the term from my medical records. My body failed me, there must be something wrong with my cervix, I couldn't dialate all the way.  My second frustration came when (as many newly postpartum moms are want to do) I started working to try and get my "pre-baby" body back... but it HURT!  Everything I did HURT!  And my scar was painful for over a year!  Physically that certainly slowed me down, but emotionally it was another reminder that I was broken.

Fast forward 2 years and I started to look ahead at preparing for a second pregnancy. I read and researched, and discovered there was something called VBAC (vaginal birth after cesarean)- well thank goodness, because I never want to go through another c-section! And the more I read, the more I realized my cesarean was likely preventable.  My baby was never in distress, and I was physically doing just fine- there was no immediate need for the c-section. 

SO what went wrong? I only took the hospital's 1 day childbirth education class, to learn about the drugs the hospital offers, practice a couple of positions and take a tour of L+D.  I was secretly scared to push out a baby, and was also at least a little freaked out listening to the woman in the room next to me scream during her contractions.  I walked for a little while, but once I got my epidural, I was flat on my back.  At first I was angry with the hospital- why didn't they do something different!!??  But then I realized, they weren't to blame. I was.  I should have taken more time off work to take a natural childbirth education course with my husband, I should have hired professional labor support.  But I didn't know any better- so I did the best I could.

When I became pregnant with baby#2, I immediately went to interview the local hospital midwives, but was told I'd have to choose an OB because of my prior c-section.  The midwife recommended the OB in her office as being the most supportive of VBAC, so I setup prenatal care with her.  Things seemed fine at first, although I was annoyed about having to "pee in a cup" at every visit (whereas the midwives do less testing). When I made comments about my labor plans, (like wanting to stay home as long as possible before arriving at the hospital) my OB just said "we'll talk more about that later on", and the conversation was dropped.  But the big bombshell came at 35 weeks when my OB told me I HAD to go into labor BEFORE 40 weeks, otherwise I'd have to schedule another c-section.  I. Freaked. Out.

I was already doing everything I could to make sure I wasn't going to have another c-section- I hired a doula, and I had taken Bradley Method Childbirth classes! I had even changed my diet and started exercising a lot more after being diagnosed with borderline gestational diabetes!  But I knew I couldn't force my body to go into labor!  Luckily I reached out to the online community and a blogger picked up my comment on her blog and turned it into an entire post!  That in itself was a HUGE source of much needed support!  In her post she also pointed me to an awesome series of posts (called "VBAC Scare Tactics") from another awesome blog (Birthing Beautiful Ideas) which was educational and EMPOWERING!

Long story short, I got my VBAC, at 41 weeks and 3 days.  But I had to ditch my last 3 OB appointments to do it- WHICH I DO NOT RECOMMEND!  About 2 months after baby John was born I realized that I didn't want other moms to go through what I did, all alone.  I had learned about ICAN (and joined the ICAN email yahoo group), but there was only one chapter in my state, and it was 2 hours away from me, too far to drive to their support group meetings while pregnant.  But ICAN embodied everything I wanted to bring to moms in my area: awareness about unnecessary cesareans, help with recovery from cesareans, and information about VBAC.  So I started ICAN of Northeast Iowa. And later that same year, ICAN of Iowa City, and ICAN of Quad Cities also were created!  We went from 1 chapter to 4 chapters in just one year!  Now even more moms in Iowa will have access to cesarean education and support!

Q:  Is ICAN "anti-C-section"? 
A:  NO!  We're against unnecessary c-sections (of which there are MANY), but we absolutely recognize that a cesarean can sometimes be a life saving event for both mom and baby and worth the risks involved.  The cesarean rate in the USA is 32.9% as of 2009, and even doctors have been concerned about the rising cesarean rate since it was just 15%! 

Q:  Aren't you just a bunch of "birth nazi's"?
A:  ICAN wants women and families to exercise *true* informed consent.  It's important to understand the full spectrum of risks and benefits to any procedure or intervention, and that means women have the right to informed refusal, too! How a women chooses to birth, where she chooses to birth, what kind of care provider she chooses, which procedures she consents to before during and after birth - are all HER choice! 

Q:  What gives you the right to talk about birth and c-sections? What are your credentials?
A:  I'm a mom whose had both a c-section and a hard fought hospital VBAC.  And I can read.  I've read and understand the history of ACOG's change in recommendations on VBAC.  I know that the risk of uterine rupture after 1 c-section is about the same as the risk of other obstetrical emergencies happening for a low risk first time mother (see quick facts #6). I've experienced first hand how having your first c-section can severely limit your future birthing options.  I'm lucky enough to have personally met some of the most respected birth professionals in the United States and have read the published works of many more. 

Having a c-section is not just "the other way to give birth".  A healthy baby isn't all that matters, healthy moms matter, too.