I had a conversation with a midwife last week that inspired this post. I think before I get started that I should throw out a little disclaimer. I don't care how your baby comes into this world, as long as the baby comes out kicking and screaming their little head off, and as long as mom is safe and happy to be a mom. Which means I support and encourage you to have a vaginal, un-medicated birth just as much as an induction with an epidural or repeat c-sections as long as its medically indicated and it's the wish of the mother. No one has the right to make you feel bad or guilty for your decision on how your child came into this world. And nothing is more important than educating yourself on the various ways possible so you can make the most informed decision possible to have the best birth experience possible.
So back to the midwife and I's conversation. I thought the intent of the conversation we were to have was about educating herself more about women with disabilities and pregnancy. Just as every able-bodied woman is different, so, too, is every woman with a disability different and their disabilities make their birth experiences vastly different as well. At first I was pleased to find out that she had actually had two patients with varying degrees of disability. Its rare to find practitioners that have actually worked with a woman with a disability through her pregnancy. I thought she was getting a different perspective on a disability type she hadn't worked with before. Her first question was about how I had given birth to my first. I told her that I had had an induction at 39 weeks, and that she had never engaged in my pelvis, went into distress and that had ultimately led to an emergency c-section. Then she asked if I had my son by c-section as well. I told her I had, at which point she went into a tirade about the evil medical establishment and how I could have had a VBAC (Vaginal Delivery After C-Section) but doctors were too worried about lining their pocket books instead of doing what was best for me. I got a little upset at this point, though I tried very hard to be as polite as I could about it. She didn't know me from Adam and I was a little miffed that she forgot to do a very important thing before she went off on her tangent - she forgot to ask me if my second c-section had been medically warranted and if I had done any of my own research.
Because despite her good but intrusive intentions, I had done my homework. In fact, I had done a lot of it after my daughter was born and was pregnant with my son. I'll be honest - I felt a bit cheated of my wanted birth experience after my c-section. People automatically assumed that I had had my c-section because I was in a wheelchair and not because of an emergency. I was supposed to prove that despite my disability, I could give birth to children vaginally. One of the first things I learned when I was pregnant with my daughter was that the uterus is an automatic muscle. Its gonna do what its gonna do (ie.push out the baby) whether I help it or not. So even though I don't have a lot of the strength down there that other women do, I should have still been able to push a baby out, thus showing everyone that women with disabilities do have babies the 'normal' way. It didn't matter that she never came down past a -2 station even after being in active labor for more than 10 hours. I still felt like a failure.
So with my son, I wanted to ensure as much as possible I would not have another c-section, if I could help it. That's when I really started to hit the internet as well as having lengthy conversations with Judi Rogers, the pregnancy and childbirth specialist at the Through the Looking Glass organization, a resource for parents with disabilities among other things. She helped me understand VBAC and encouraged me to pursue this despite my doctor and husband's trepidation. But I don't just do stuff because it sounds good. My doctor had warned me that he felt my pelvis was too small. So I got a second opinion. I went to another OBGYN to get his opinion. He, too, said he felt my pelvis too small for a safe vaginal delivery. The straw that broke my proverbial camel's back was a perinatologist I was already seeing that told me the same thing, but told me why. During puberty a woman's hips spread. But with women who were paralyzed and using a wheelchair full-time before puberty find that their hips do not, or at least not as much as if they had been able-bodied. The truth was my pelvis never shaped themselves to allow a baby to come through - boy-shaped, he called them. Devastated as I was, it was still good to know the 'why' even if having another c-section was something I did not want to do.
If this midwife had really be interested in my story, she would have found all this out first before assuming that I had just let my doctor lead me about by my nose. And by the end of the conversation, I knew that all she was interested in doing was preaching to me about the evils of modern medicine. I knew this because I tried to give her more information about Judi Rogers and Through the Looking Glass, but she really wasn't interested. You'd think she would be interested, considering Judi has been compiling birth and pregnancy information for women of all types of disabilities for nearly 20 years, and its this midwife's life's work to educate the ignorant about VBAC. This information would be especially useful if she were to work with other women with disabilities in the future.
This conversation reminded me about how so very important it is to be educated, especially about your body. If I were to be asked any advice about this topic at all, I would say immediately to be your own advocate. If something doesn't sound right to you, find out why! Doctors are not evil, nor are every one of them out to line their pocketbooks or schedule procedures to suit their convenience (though they are out there). A lot of them do not have a lot of experience with disability and pregnancy. So they may be running under out-dated misconceptions or be ignorant. There are places to find out more information, and certainly if you find a physician who is willing to either work with you or find out for himself, so much the better.