Kourtney Kardashian: Inspiring Women with her Zen-like Childbirth?

Two weeks ago I wrote about the way childbirth is generally portrayed, even mocked, in popular culture and how that often negatively colors women’s beliefs about birth. Sunday, however, on the season finale of the E! network reality show Keeping Up With The Kardashians, surprisingly, amazingly labor and birth were shown in a largely positive light. In the episode, which had a record 4.8 million viewers, Kourtney Kardashian, 30, calmly gave birth to her first child Mason Dash Disick (born on Dec. 14, 2009).

I have to admit I don’t actually watch the Kardashians, but thanks to Jezebel, I was able to watch some clips from the episode. (Go watch. I’ll wait.) My friend Denise, who blogs at Eat Play Love, told me that she saw the whole episode and said, “I have to admit for the K-women coming off as such primadonnas the episode/birth was shown in a great way. I was shocked.”

Instead of the typical Hollywood water-breaking all over the floor in one big “sploosh!” followed by the frantic Oh-my-God-I’m-freaking-out-and-have-to-get-to-the-hospital-RIGHT-NOW, after Kourtney’s water broke and was shown(!) slowly trickling out onto the floor, she was totally calm, did some laundry, said she needed to shave, took a shower and put on make-up all before going to the hospital. A reality TV show actually showing reality? Wow!

Then there was the birth scene at the hospital, which appeared very serene. Kourtney was surrounded by her family who all looked on in awe as baby Mason was born. She appeared very calm, even zen-like. Once the baby was half way out, the doctor asked Kourtney if she wanted to grab him and she did. She reached down between her legs and pulled her baby right out of her vagina and onto her chest. It was amazingly peaceful and really quite beautiful.

Of course that had to be followed by some commentary from her sister Khloe saying, “that’s not normal.” But uh, yeah, actually it is. That’s what normal birth can look like.

Photo credit: The Unnecesarean

I can’t find any information about whether Kourtney received an epidural or gave birth unmedicated, but she certainly looks very zen in the video. She said in this interview about labor, “It was surprisingly easy and just an incredible experience. I always thought your first is supposed to be really hard, but it was easy.”

Regardless of whether or not she had an epidural, the fact that E! showed (millions!) what a normal, peaceful birth can look like is seriously huge, especially when you consider the demographic watching this show. According to this LA Times article, “Kardashian viewers tend to be single, college-educated women with no children, white-collar jobs and annual salaries of more than $60,000.” Keeping Up With The Kardashians “is the highest-rated series on cable among women ages 18 to 34.”

The Unnecesarean had this to say:

Kourtney Kardashian and E! showing a generation of young women someone reaching down and pulling their baby out of their vagina was one of the coolest things I’ve seen in a long time. Cedars Sinai in Los Angeles has gained a reputation as the celebrity c-section center, but there’s some mother-friendly stuff going on in the clips on Jezebel.

I didn’t watch the whole episode, but I smiled at the clip of her water breaking. When do you ever see that televised beyond the ridiculous images of actors having a gallon of water dumped between their legs, then instantly doubling over with contractions and being rushed down the hall to L&D on a gurney?

Momotics said Kourtney Kardashian renewed her “faith in birth.”

I was SO impressed to see Kourtney so calm, and cool while giving birth to her son Mason who was born in December. It seems like Hollywood has had a huge rash of scheduled cesareans, inductions, and over all just horribly medicalized births and this was just a huge refresh to the Hollywood natural birth stigma.

Carla Fran from Millicent and Carla Fran calls Kourtney “awesome.”

I cannot believe, I repeat, I cannot believe that the Kardashians are paving the way for positive images of childbirth. Last night’s finale showed Kourtney Kardashian going into labor, and pretty much backing up what doulas, Rikki Lake, and your friendly neighborhood midwife have been saying all along.

This finale is tremendous because of the audience the show has. If young girls see pop icons like Kourtney Kardashian having this kind of birth experience, their expectation of the event in their own lives is changed. I hope an entire generation of people saw this and thought “I didn’t know it could be like that.”

It would seem that’s exactly what some women thought. Here are a few of the comments on the Jezebel blog:

  • Kali Mama: “While am all for freedom of choice and choosing your own birth plan, big props for girlfriend not being too posh to push. No elective c-sections or nothing.”
  • Doyouloveit: “For years I’ve been chanting that I will get a C-section if I ever procreate, ‘Knock me completely out! I want to wake up like it’s Christmas morning with a baby under the tree!’
    But wow! Kourtney was really inspiring! Why can’t it always be shown this beautifully? Great documentary film making, Keeping Up With The Kardashians!”
  • Lilspitfire: “I am not a big fan of reality TV but the way they showed childbirth in this episode was nothing but positive.”
  • La Madrugada: “Okay, as someone who’s going to give birth to her first kid in a month and a half, I have to say, this is AWESOME. I’m not a huge fan of this show, but seeing a woman laughing and relaxed while in labor is extremely cool.”
  • Gra: “I have never given birth and therefore had NO IDEA that this was even possible. Its weird to realize that everything I know about labor and birth is based on what I’ve seen in the movies.”
  • Hotpants McGee: “It’s so crazy to say this, but I think I learned something from a Kardashian! Kourt was AMAZING. I had no idea you could just pull it out! I still can’t believe it. She could have just stayed home and done it all by herself!”

Yep, the Kardashians are changing the way women view birth – for the better. Who woulda thunk it?

Cross-posed on BlogHer

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For Better or For Worse? Childbirth in Popular Culture

After watching the live cesarean birth on the TODAY show last week and then the commercial for Jennifer Lopez’s new movie The Back-Up Plan during the Superbowl*, I’ve been thinking a lot about the way childbirth is portrayed in popular culture – on TV and in the movies – and how that influences us. In a perfect world I’d like to believe that women (and men) would learn about childbirth from reading books and websites and talking to their care provider (doctor or midwife), to a doula, to their mother, aunts and friends, but the truth is that unless ya live under a rock, women (and men) also learn about childbirth every time they are bombarded with images on TV and in the movies that depict childbirth as something scary, painful and out of control. Whether we want to believe it or not, our perceptions of birth are bound to be influenced – for better or for worse – by what we view and hear in popular culture.


Movie: The Back-Up Plan, photo credit: Jezebel

On Rixa’s blog Stand and Deliver she lists 61 film clips she compiled for a conference presentation about depictions of childbirth in cinema. That’s just movie clips. Think about all of the episodes of A Baby Story, or ER and many other TV shows where women are giving birth. Each one further reinforces popular culture’s birthing stereotypes.

Birthing Beautiful Ideas believes:

it’s pretty foolish to dismiss the effects that popular culture has on a woman’s beliefs and decisions about pregnancy and childbirth. In fact, I would venture to say that these effects are pretty widespread. Of course, I’m not saying many of us literally turn to pop culture when we’re deciding whether or not to consent to an episiotomy or to request pain medication in labor or to choose one care provider over another. That would be stupid, right? But that doesn’t mean that what we see on television or read in a (non-birth-related) book or watch in a movie has no effect at all on our thoughts about pregnancy and childbirth. Quite the contrary, in fact.

Because every time a woman reads that she “won’t be able to make it without an epidural”…

…every time she sees natural childbirth portrayed as something only for hippies and freaks…

…every time she sees a movie in which birth is a crisis or a catastrophe or a comedy of errors in which the mom is a crazed, expletive-hurling woman who is seriously out of control…

…those images and words start to affect the way she thinks about birth in general, and they may even have an effect on her specific beliefs about birth.

She goes on to give a real-life example (a positive example) of how a TV show changed her beliefs about birth. She describes an episode of Sex and the City where Miranda gives birth. Miranda asks Carrie to be there for the birth and tells her that when it’s time to push, she doesn’t want everybody getting all “cheerleader-y” on her and shouting “PUSH! PUSH! and shit like that.” She said that when she saw that scene, “it signaled a major change in the way I thought about how I was going to give birth some day.” Her birth paradigm shifted and she believes she has the ladies of Sex and the City to thank for that. She’s currently a doula and future lactation educator who’s working on a PhD in philosophy.

Not all examples of how popular culture influences women are as positive though.

Heather from A Mama’s Blog told me that watching TLC’s A Baby Story – which she described as “high drama” and ending more often than not in a c-section – “seriously warped” her view of childbirth.

The Feminist Breeder said:

When I first found myself pregnant, I was just like the vast majority of pregnant American women who never get truly informed about the birth process, and instead spend their pregnancies watching “A Baby Story” and reading Jenny McCarthy books. I got my hands on “The Girlfriend’s Guide to Pregnancy” by Vicki Iovine, which told me that Lamaze was useless, as were all other birthing classes, and what I really needed to focus on was how quickly I could get the epidural.

Yeah — I got the epidural. The epidural that only went down half my body, that caused me uncontrollable shaking, that shut down my labor, that necessitated more pitocin, which put my baby in distress, which then necessitated a nice, traumatic cesarean surgery. Yep. That epidural.

Honey B., in her post Childbirth: Hollywood’s Take, wrote that after year of watching A Baby Story, 18 Kids and Counting, Knocked Up, Four Christmases, etc., she realized how much of what she thought she knew about childbirth was based on TV. She then shares sarcastically all that Hollywood taught her about birth. (The descriptions are longer on her blog.)

Natural Birth: The choice of masochists, women who don’t shave their armpits and have children named Moon Flower, and optimistic first-time mothers who don’t know any better. (My note: Case in point, The Back-Up Plan‘s home birth scene)

Birth with Epidural: This is the smart woman’s choice. This is what she does for the second birth, after going through the above ‘Natural Birth’.

C-Section (Emergent): These are completely normal, and happen all. the. time. And the doctor always knows best.

C-Section (Planned): This is the choice of the truly enlightened woman, the Real Housewives of Orange County type who view pregnancy as an invasion of their body. (My note: Perhaps this is why, according to the most recent data available (from 2006), the United States’ c-section rate was 31.1%, ranging from 21.5% in Utah all the way up to 37.4% in New Jersey. The World Health Organization actually recommends that the cesarean section rate should not be higher than 10% to 15%. When the rate is higher than 15% there is some research which shows it results in more harm than good. But who wants to talk about that in movies?)

Mallory who blogs at Pop Culture believes, “Childbirth in Hollywood movies is from a male perspective; rarely does childbirth show angles from the female viewpoint during the actual birthing.

We show killings, bombings, shootings, rapes and torture in movies, so why not show a woman giving birth accurately? Is it really that obscene and disgusting?”

Naomi, a birth doula, wrote her top 10 suggestions for an easier birth. Number two is “Prepare for an easier birth, now!” She cautions:

Don’t watch A Baby Story! Instead (if you are interested in watching birth videos), watch movies like The Business of Being Born, Orgasmic Birth, Pregnant in America, Water Birth, Special Women, and normal birth videos on YouTube which represent birth as it usually is. TV specials on birth are designed and promoted to offer drama and attract viewers, not to support women preparing for birth.

I also want to add What Babies Want and Birth Into Being to that list.

Teba told me that her sister was there when she had a home birth two months ago. “She said after seeing birth in movies she never imagined it could be so peaceful.”

That’s just it. Birth can be peaceful. It doesn’t have to be a hysterical emergency, but as a result of popular culture, most women are never exposed to anything that suggests a peaceful birth is even a possibility.

How has popular culture affected your beliefs and decisions surrounding childbirth?
* I didn’t actually watch the Superbowl, but have Lynn to thank for telling me about The Back-Up Plan commercial.

Cross-posted on BlogHer

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Follow-up to TODAY show guest post: childbirth resources


If you are visiting from the TODAY show blog, welcome and thank you for visiting. :) If you haven’t yet read my guest post on the TODAY show, you can read it here: Viewer: Learn more about cesarean births. I’d love it if you would like to contribute to the discussion and leave a comment over there.

Because there was only so much information I could include in my guest post, I’ve put together some additional resources here for those of you who are interested in learning more about c-sections, VBAC, giving birth vaginally to larger babies, and more. I believe in informed consent. Knowledge is power.

Information about Cesarean Sections and VBAC:

  • International Cesarean Awareness Network – “The International Cesarean Awareness Network is a non-profit advocacy and support group whose mission is to improve maternal and child health by preventing unnecessary cesareans through education, provide support for cesarean recovery, and promote vaginal birth after cesarean (VBAC).”
  • Childbirth Connection’s Cesarean Section Resources
  • The Reality of C-Sections by A Mama’s Blog – Heather writes about the many things about c-sections that she didn’t know and wished she had been told before she had her own c-section, as well as includes pictures of actual c-sections (something we didn’t get to see on the TODAY show).
  • VBAC Facts – Jennifer, teacher of The Truth about VBAC classes, deeply believes that women, after educating themselves on the risks and benefits, should be the ultimate decision makers on their medical care – not OBs or insurance companies.
  • Maternal Death Rates Rise, C-sections Now Considered a Factor – another post by Heather from A Mama’s Blog
  • The Unnecesarean – The Unnecesarean provides information about preventing an unnecessary cesarean and resources for making fully-informed decisions about childbirth while offering an irreverent take on the maternity care crisis in the United States and beyond.

Giving Birth Vaginally to Large (Macrosomic) Babies – Information & Birth Stories:
Although your doctor may suspect that you might have a larger baby, that does not mean you should automatically schedule an induction or a c-section. Ultrasound exams are notoriously inaccurate for predicting the weight of a baby and can be off by a pound or more in either direction. There’s no way to know how much a baby will actually weigh until it is born and weighed. If you are told you are going to have a large baby, weigh the risks and benefits of any intervention and make the choice that is right for you and your baby.

  • Big Baby Bull****
  • Baby Julian – My son (pictured above) was born at home and was a surprise footling breech. He weighed in at 9 lbs. 8 oz., and was 22 inches long.
  • Baby Lazlo – Justine gave birth to her 11 lb., 23-inch son at home
  • Baby “D-Man” – Kat’s son weighed in at 11 lbs., 3 oz.
  • Baby “Muski” – Kate’s son was a VBAC and weighed 10 lbs., 3 oz.
  • Baby Peggy – Annette‘s daughter was 9 lbs., 6 oz.
  • Baby Jaxon – Jaclyn’s son weighed 9 lbs., 4.4 oz.
  • Baby Iris – Sybil‘s daughter was 9 lbs., 14 oz.
  • Baby Mikko – Lauren’s son was 11 lbs., 13 oz.
  • Baby Emma – Jessica’s daughter was 9 lbs., 2 oz.
  • Baby “Boychick” – Arwyn‘s son was 10 lbs., 6 oz. and born at home
  • Baby Julian and Baby Emma – Annie‘s two kiddos (not twins) were 9 lbs. and 9 lbs. 8 oz.
  • Baby “Junior” – Candace’s son was 10 lbs., 4 oz. and sunny side up
  • Baby “M” – Jennifer’s son was 9 lbs., 10 oz. – a home birth after cesarean (HBAC)

Additional Childbirth Resources:

  • Business Of Being Born – A documentary that “interlaces intimate birth stories with surprising historical, political and scientific insights and shocking statistics about the current maternity care system.”
  • Pushed Birth a book by Jennifer Block – “The painful truth about childbirth and modern maternity care”
  • Ina May Gaskin – Author of Ina May’s Guide to Childbirth. “Discover the proven wisdom that has guided thousands of women through childbirth with more confidence, less pain, and little or no medical intervention.”
  • Doulas of North America – A doula is “a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period. Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.”
  • Considering an induction? Use the Bishop’s Score for Labor Success – “This tool measures certain components with regard to the mother’s cervix and baby’s position to evaluate her readiness for an induction and ultimately increase the chance of having a vaginal birth. This scoring system can also be used to determine the likelihood of spontaneous labor.”
  • Post-Partum Crotch Care 101 – A humorous, but very practical list. This is one of those things that nobody ever talks about, but is good information to have.

Are there any childbirth resources YOU think should be on this list? Leave a comment and let me know. Thank you. :)

Disclaimer: The information included on this blog is not medical advice and should be used for educational purposes only. It should not be used as a substitute for the advice of a medical professional (doctor or midwife).

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Live c-section on the Today Show

Thanks to ICANtweets I learned that the Today Show aired a live Cesarean section from Beth Israel Deaconess Medical Center in Boston as part of the “Today Goes Inside the OR” series. A healthy 10 pound baby boy was born via scheduled c-section to Carrie and Josh Johnson. According the The Today Show’s Dr. Nancy Snyderman, they elected a c-section because babies “run big” in the parents’ families and Carrie was “past her due date.” Dr. Snyderman adds, “And those are two indications that a Cesarean section is a lot safer than having a vaginal delivery.”

A lot safer? Really? You might want to weigh the risks for yourself.

Photo courtesy: tifhermon (Flickr)
Photo courtesy: tifhermon (Flickr)

Here’s the link to watch the Today Show c-section video

I found it hard to watch how the baby was handled and the way mom seemed to be left out of the process. Why can’t they clean up the baby where mom can see?

I also found a few other things quite disturbing.

At one point in the video, the doctor doing the c-section comments to Dr. Nancy that one reason for having a c-section is if the mom has had a c-section before. Then when asked if this mom gets pregnant again and has a “normal size” baby if she can have a vaginal delivery? The doctor responds, “absolutely, absolutely.”

That sounds like she’s giving mixed signals to me. Not to mention that many doctors and hospitals no longer allow vaginal birth after cesarean (VBAC) due to insurance costs. I left a message with Beth Israel hospital to find out what their policy is re: VBACs. I’ll update if I hear back. Joy Szabo had to move 350 miles from home to have her VBAC. And some women are being denied insurance after having a c-section.

After the baby was weighed (10 lbs.), Today Show co-anchor Meredith Vieira commented: “They chose the right way to deliver that’s sure by section.”

Dr. Nancy Snyderman agreed: “They sure did.”

So having a larger baby vaginally is the wrong way to have a baby? I strongly disagree. I think so would Justine who had her 11 lb. son at home on Jan. 6. And Kara who gave birth to an almost 10 lb baby vaginally. And Cathy who describes herself as petite and said both of her boys weighed 9 lbs. 4 oz. at birth. And Arwyn who said, “At home in the water was the right way to “deliver” my 10lb 6oz baby!”

What did you think about all of this?
Email the Today Show your thoughts at: TODAY@nbcuni.com

Read more about my reaction to the live c-section.

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Is there more to the Christmas “miracle” mom & baby “mystery?”

In what’s being called a Christmas “miracle,” a mother suffered cardiac arrest and died while in labor on Christmas eve 2009, her lifeless baby was born after an emergency cesarean section, and then “inexplicably, astonishingly” both suddenly came back to life. At least, that is the picture that was first painted by ABC News.


Photo credit: ABC News

Tracy Hermanstorfer of Colorado was without a heartbeat for four to five minutes while her husband Mike undoubtedly stood by in shock. “‘Half of my family was lying there right in front of me — there’s no other way to say it — dead,’ Mike Hermanstorfer told ABC News’ Colorado affiliate KRDO. ‘I lost all feeling. Once her heartbeat stopped, I felt like mine did too.'”

First I must say that I’m so very thankful that Tracy and her son Coltyn were revived and both are doing very well. I can’t imagine what her husband Mike must have gone through in those moments. I wish the Hermanstorfer family a happy, healthy and uneventful new year.

While the story of a Christmas miracle such as this warms one’s heart, many people, myself included, thought there must be more to the story than the media was reporting. Dr. Stephanie Martin, the doctor who responded to the Code Blue and performed the emergency c-section, said she cannot explain the mother’s cardiac arrest or the recovery. “We did a thorough evaluation and can’t find anything that explains why this happened,” she said. In the video linked above Diane Sawyer says, “To Tracy’s doctors, the events are still a complete mystery.” A complete mystery? Really?

If you watch the ABC News interview (below) with Tracy and Mike Hermanstorfer and Dr. Stephanie Martin it looks like the “mystery” may have been solved after all and there could be a very valid explanation for why Tracy went into cardiac arrest – the epidural. Cardiac arrest is a very rare, but very real possible complication of epidurals.

Tracy was pregnant with her third child and had given birth to the previous two without an epidural. However, after her membranes ruptured (water broke), she went to Memorial Hospital in Colorado Springs and was given pitocin to speed up her labor. She found the contractions were “a lot harder” than she remembered so she opted for the epidural. It was not long after she received the epidural that Mike noticed Tracy’s hand was cold, her fingertips were blue and a nurse noticed the color in Tracy’s face was completely gone.

Henci Goer, “an acknowledged expert on evidence-based maternity care” and blogger at Science and Sensibility, transcribed the relevant parts of the ABC interview.

ABC: Code Blue was declared, a scary thing in any hospital. [Dr. Martin arrives in response.]

Dr. Martin: . . . When I ran into the room, the anesthesiologist had already started breathing for Tracy. There were preparations already being made to start a resuscitation should her heart stop. About 35 to 40 seconds after I got in the room, her heart did stop and we started making preparations to do an emergency cesarean delivery right there in the room in the event that we were not successful in bringing Tracy back. Unfortunately, in most of these situations, despite the best efforts of the team, Mom is often not able to be revived, so we anticipated that possibility and when it became clear that Tracy was not responding to all the work that the team was doing on her, we had to make that difficult decision to do the cesarean section, primarily in an effort to give Coltyn the best chance at a normal survival and also hoping that it would allow us to do a more effective resuscitation on Tracy, and fortunately, she cooperated and we got a heartbeat back immediately after delivering Coltyn.

Henci explains her assessment of the situation:

So, according to Dr. Martin, Tracy is an example of how things can go suddenly and horribly wrong for no discernible reason in a healthy woman having a normal labor. All I can say is that Dr. Martin must have slept through the class on epidural complications. Tracy’s story is the classic sequence that follows what anesthesiologists term an “unexpectedly high blockade,” meaning the anesthesiologist injected the epidural anesthetic into the wrong space and it migrated upward, paralyzing breathing muscles and in some cases, stopping the heart. High blockade happens rarely… It does happen, though, and I am willing to bet that high blockade and its sequelae happened to Tracy.

The moral of the print version would be: have your baby in a hospital where you can be saved should this happen to you. The video interview, however, reveals a different picture. The real moral of the tale is that the safest and healthiest births will be achieved by avoiding medical intervention whenever possible.

Danielle from Momotics asks, “Why was there a need for pitocin? Because no one wants to be sitting around waiting to deliver a baby on Christmas eve?” She also wants to know why the possible correlation between the epidural and the cardiac arrest isn’t being talked about in the media. “Why is the mainstream media not reporting these things? Mass hysteria? Loss of money for the pharmaceutical companies that make pitocin and these anesthesia drugs?”

Jasmine who writes for The Examiner offered up her own take on the situation:

Knowing the side effects of both pitocin and the epidural, Hermanstorfer’s history of having unmedicated births, she probably experienced a dropped heartrate from the pitocin which may have caused her cardiac arrest upon administering the epidural. We all like the story of hearing “miracles” and they do happen, however, we have to know a little more about modern medicine and the side effects and dangers of modern drugs.

Nicole from It’s Your Birth Right speculates a few possibilities of what may have gone wrong. She admits that there is no way for her to say for sure what happened in Tracy’s case, but she wants people to know that having an epidural does carry risks.:

I just want it to be clear that Epidurals can indeed cause cardiac problems and can also stop a woman’s breathing immediately after administration. Does it always happen? NO. Does it usually happen? NO. Can it happen? YES. And did the media completely ignore the possibility of the epidural having anything to do with the cardiac arrest? YES.

Nicole adds:

Often when I tell people I don’t want an epidural they don’t understand why. THIS is why. The risks in my humble opinion are high for a procedure that is considered elective.

Often when I tell people epidurals carry risks that are not discussed with women resulting in misinformed consent for a procedure they know little about, I am considered an extremist. PLEASE if you want an epidural, that’s your choice but get INFORMED!!!

Here are the reported side effects of epidurals on both mother and baby.

Conspiracy theories aside, I think one of the reasons the possible cause of Tracy’s cardiac arrest wasn’t reported by the media is because it diminishes the feel-good Christmas miracle aspect of it. I think the media sensationalized the story to draw as much attention to it as possible. They succeeded.

The truth is we may never know what caused Tracy Hermanstorfer’s heart to stop beating, but it seems likely that the sequence of events – pitocin, epidural, lying on her back (which can cause “problems with backaches, breathing, digestive system, hemorrhoids, low blood pressure and decrease in circulation to your heart and your baby. This is a result of your abdomen resting on your intestines and major blood vessels (the aorta and vena cava).”) may have had something to do with it. While this story had a very happy ending, most like it do not. What can we learn from this? Educate yourself, learn about the risks of common interventions, and hire a doula.

Once again, I wish Tracy and Mike Hermanstorfer and their family all the best. :)

Cross-posted on BlogHer

Joy Szabo Travels 350 Miles for Vaginal Birth

Joy Szabo recently drew nationwide attention when she refused to have a repeat cesarean section at her local Page, Arizona, hospital. Instead, Joy and her husband Jeff decided that Joy (alone) would move 350 miles from home to Phoenix where they could, according to CNN, get “the birth they wanted” – a vaginal birth after cesarean (VBAC). Many are calling Joy’s vaginal birth a victory, but Jenn at Knitted in the Womb acknowledges that while on one level getting the VBAC is a victory, on a larger scale she wonders was it really a victory?

Photo courtesy CNN
Photo courtesy CNN

Here’s a little history. While seven months pregnant with her fourth child, Joy Szabo was told by her local hospital that she would be required to have a repeat cesarean section rather than allow her to have the birth she wanted, a VBAC. It didn’t matter that she had already had one VBAC at this hospital, the policy had changed and VBACs were no longer permitted there.

VBACs carry a less-than-1-percent increased risk of a uterine rupture, which could cause brain damage in the baby or even death, according to the American College of Obstetrics and Gynecologists.”

According to CNN:

After their discussion with their doctor, the Szabos made an appointment to speak with Page Hospital’s CEO, Sandy Haryasz. When the couple told her about their desire for a vaginal birth, they say Haryasz would not budge, even telling them she would get a court order if necessary to ensure Joy delivered via C-section.

The Szabos thought that seemed extreme and rather than succumb to the hospital’s new policy, a few weeks before her due date Joy moved into a Phoenix apartment 350 miles away from her husband and three children while she waited to go into labor. At the Phoenix hospital Joy gave birth to her fourth son Marcus Anthony in an “uncomplicated vaginal delivery.”

Emily from Laundry and Lullabies said, “Joy, you’re an inspiration. Thank you for standing up for yourself, for bringing attention to the state of maternity care in America, and for making it just a bit easier for other women to follow your example.”

Danielle who blogs at Birth, Babies & Everything In Between believes VBAC is much safer for healthy, low risk women than elective repeat cesareans. She likes to use the example of Michelle Duggar to demonstrate the safety of VBAC. Michelle has had four c-sections and 13 VBACs and recommends the organization International Cesarean Awareness Network (ICAN) for those wishing to gain information about VBAC.

On the Duggar’s website, Michelle describes how things have changed from her first pregnancy to her 18th.

I would say the greatest change that I have seen in the field of obstetrics, and I might add that it is very troubling to me, is the idea that once you’ve had a C-section you must have a C-section for any other pregnancy. It is much healthier for mom and baby to avoid major surgery and all the complications that go along with a C-section if possible. Granted, there are health situations that would warrant such, but for years obstetrics encouraged TOL (Trial Of Labor after previous C-section) with many successful healthy vaginal births. It was quite alarming to be told that I could no longer have a vaginal birth due to hospital or insurance companies regulations. It appears that what is best for the patient is not the priority with this decision. I feel our health care is being jeopardized by this unhealthy approach. Doctors are having to tell their patients that they no longer offer VBAC assistance due to hospital regulations and some might even state to the patient that they are not safe so as to avoid confrontation. Statistics prove much differently. For the many women that find themselves in this situation, ICAN is an organization that is very helpful in gaining more information on this topic.

Jenn at Knitted in the Womb, who I mentioned above and questions the “victory” aspect, says:

I am glad that Joy got a vaginal birth, and on that level the birth was a victory. But on the larger scale level…the extreme hoops she had to go through make it less than that. The “victory” that I see missing is an acknowledgment by the Page Hospital administration that A) VBAC is safe and B) even if they disagree with “A,” they have no right to force a person to have surgery. For a woman who does not have the financial means to do what Joy did – move away from her home for over a month – surgery is still a forced situation.

…this could easily be used by hospital administrators as “precedent.” “You want a VBAC? So sorry, we don’t offer that here. Do what Ms. Szabo did, go move to be near ‘hospital X.’”

I agree with Jenn in that the CNN article headline, “Mom fights, gets the delivery she wants” is misleading. When I first read it, I expected that Joy Szabo had fought the Page hospital and had her VBAC there. I wasn’t expecting that she had to move six hours from her home, leaving her children and husband, to get a VBAC at another hospital.

Yes, the fact that she got a vaginal birth is a victory, but this story also shows that birth advocates still have a lot of work ahead of them. As more hospitals ban VBACs, there will be more and more cases of women who are forced to make difficult choices.

The fact that this situation got the national attention that it did, that CNN covered it and posted “some tips for what to ask your doctor (or midwife) in the delivery room if the suggestion is made that it’s time to give up on a vaginal birth and head to the operating room” is a step in the right direction. It might not be the big victory that many of us are hoping for, but it’s a small victory and that counts too.

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Cross-posted on BlogHer.

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