I am writing this post with a broken heart for a dear friend. After nine months of planning for a natural, unmedicated delivery, her journey ended with a c-section. There were no complications, she didn't go into labor, she didn't even get a chance to try.
At her last appointment (40weeks, 1day) she was told that her baby was too big. The doctor estimated the baby to be 10.5lbs. He told her because she had not progressed in dilation from the previous week, and because the baby was not properly engaged, that it was likely due to having a baby that was too big for her hips (yep, he told her that her hips were too narrow). He recommended that she didn't even try to go into labor because it would likely be a two-day labor, which would stress the baby out. A C-section was what he recommended. He then told her horror stories about shoulder distocia (shoulders getting stuck when the baby tries to deliver) and told her that with her baby's heart condition, he wouldn't be able to tolerate a long labor. I gently gave her information that I had, but she had already made her decision. There are a number of things wrong with his statements. Upon hearing all of this information, my insides were ready to jump out of my body.
My job with this delivery, was not only to act as a doula and birth advocate for a dear friend, but also to show support and love to a couple who were expecting a baby with a heart defect that would require heart surgery months down the road. Basically, I was right there to remind them that everything was going to be okay, and to have faith that God had a plan for them and their son. I gave them the information I had, and they had to make a decision they were going to feel comfortable with.
In my Midwifery studies, I have learned a lot about birth. Much of which completely contradicts what the doctor had told my friend. I almost wish I could have been there to challenge him at their last appointment, but I am not a medical professional. I am still learning.
There was a lot of incorrect information in his "diagnosis" and recommendations to my friend.
1. His estimate, was just that: an estimate. Doctors love to say that ultrasounds are accurate within a pound. Lets do the math: 10lbs 8oz minus 7lbs 11oz is almost a 3 pound difference. In a baby, 3 pounds is a HUGE difference!
2. Assuming because the baby wasn't engaged properly, that the baby couldn't fit into her pelvis. This is a crazy assumption in my opinion. Babies engage in their time. Seeing that she was 40wks 1d, she still had plenty of time for that baby to engage. She also had plenty of time to dilate. Some babies don't engage until a woman is in labor. The average gestation of moms who don't get medically induced is actually closer to 41wks, not 40wks. I think it's time we give women a due date at 41weeks, not 40.
3. Telling her that her hips were too small. While I understand that in certain situations hips make a difference, most of the time they don't. The baby has to pass through your pelvis, not your hips. Your hips are amazingly flexible and stretchy when you are in labor. Hormones are released to make it easy for the baby to come through. Not to mention the baby helps out with the skull plates that overlap to make it smaller.
4. No progress in dilation also means the baby can't fit into your pelvis. NO, NO, NO!!!!! Dilation means nothing. There are women that sit at 4 cm for weeks, and there are women who show no dilation at all until they go into labor. The fact that she didn't progress, does not mean anything except that the baby isn't ready yet.
5. Assuming a long labor. You do not know how a woman is going to labor. While most labors aren't short, they aren't all two+ days in length.
6. Assuming the baby couldn't tolerate it. This doctor in conjunction with a pediatric cardiologist had told my friend not long before that she could labor however she wanted and that the baby would be just fine. Now all of a sudden this is not true (with no new information to contraindicate the previous information).
7. Assuming the baby could not fit based on pre-labor calculations. When a woman goes into labor, her body goes through a lot of changes. One cannot know how much the pelvis will open and how much the baby's skull plates will overlap until labor is in progress. Therefore assuming that there is cephalopelvis disproportion (big baby can't fit through pelvis) prior to labor cannot be accurate in most cases.
I am a strong believer that your body produces babies it can handle. Our bodies are amazing and I don't think we should ever discount their abilities when it comes to laboring and birthing a baby. I had to share this story, because after continuing research on the topic when all of this information came about, it seems that a lot of women experience this exact situation. My heart is broken for my friend who seems dissapointed in her birth because her doctor was grossly wrong. I know what it is like to grieve a birth and I don't want that for her. My heart is also broken that we have doctors who scare women into c-sections because it is easier and more convenient for them and they don't trust in a woman's natural instincts and the process.
I appreciate that we have the medical technology to perform c-sections when they are necessary. They do save lives and I thank God for that, but I don't appreciate that they are being utilized for convenience of the doctor.