I just finished reading a book called Hospital by the River, which is about an Australian obstetrician who went to work in Africa in (I think) the 1950s. The book is primarily centred on how they gave back dignity and physical repair to women who had suffered from fistulas and other similarly devestating birth traumas, and who had not been properly attended to immediately after the birth. The book does tell the stories of these women in that many of them were very young teenagers at their first birth, had mostly laboured for days with no result and eventually dead babies and many of whom had been subject to female circumcism. They also tell how many of these women went on to have safe vaginal deliveries the next time around.
Isis I don't know the answer to your question of whether a csec is warranted next delivery but I do know that there is certainly evidence that uneventful vaginal delivery is possible in situations such as yours, if this book is anything to go by.
Having had two vaginal deliveries after a csec where my uterus did not rupture all over the place as is the fear of many obstetricians, I can also vouch for the ability of the healthy human body to heal itself and be strong.
Ultimately it is your choice, no one can force a csec on you, and if you are willing to accept that in a worse case (but probably unlikely??) scenario you would need colo rectal surgery then it is your choice to accept this risk - not the right of anyone else to tell you you can't.
Debby
>From: "Isis and Andrew Caple" <[EMAIL PROTECTED]>
>Reply-To: [EMAIL PROTECTED] >To: <[EMAIL PROTECTED]> >Subject: [ozmidwifery] Julia's birth >Date: Fri, 8 Nov 2002 08:57:36 +1100 > >After following the discussions about interventions, prostin and in some >cases ob's putting the fear of danger into mother's minds, I wanted to share >Julia's birth with you all. After she was born, it was then that I decided >to become a midwife. I wanted to become a voice in the birthing woman's ear >telling her to trust herself, that she was doing fine and to guide/support >her in the special journey that is pregnancy/childbirth... > >Julia was due to be born around 18th October 2001. I was originally booked >into the Geelong Hospital Birthing Centre, but I stupidly mentioned a cyst >that I had in my head and like a hot-cake, I was shifted to the ante-natal >clinic. I kept telling them that it was just a lump of flesh and a that >neurologist had given me the all clear, but the doctors just nodded and gave >the good old- 'Just in case...' > > > >At about 30 weeks, my blood pressure shot through the roof. No other >symptoms, just a bp of about 150/105. Eventually at 38 weeks, the doctors >decided that I should have my babe induced. The medications weren't reducing >my BP. The date of the inducement was Monday 8th October 2001. I remember >the OB who booked the induction, telling me that because I was being >induced, I would most likely need to be put on a drip then given an epidural >all in order to bring down my blood pressure. Being a first time mother, >with no female support in this state, I nodded and accepted it. I had done >my research, I knew what all these interventions were, but because it was my >body that wasn't coping, I didn't bother questioning. > > > >At 8am on the big day, Andrew and I went to the hospital for the first (as >it turns out- only) application of the prostaglandin gel (or should I say- >pig jism..LOL) at 8.30am. I was at the hospital for about 2 hours while they >externally monitored Julia’s heart rate and my blood pressure. They told me >to go home and get into bed and to return at about 4.30pm. So we left the >hospital, and got home at about 11.30am. I jumped into bed to read at about >midday, feeling slight period pain. The slight period pain felt stronger and >stronger, till at 1pm I decided to get up and have a walk and a cup of tea. >Just as I thought about doing this, I heard a ‘pop’, but thought it was from >outside. I rolled out of bed and stood up, feeling 2 ‘runs’ of water, that >was definitely not me weeing myself. I then realised as well that my period >pains were quite regular and painful. They were 4 minutes apart and >definitely enough to make me take notice. We called the hospital and were >told to come in, but not to rush it. I had a piece of toast and a cup of >tea, by then the contractions were 3 minutes apart. On the way to the >hospital I was really uncomfortable. The contractions were 2 minutes apart >and quite painful by the time we got to the hospital at about 2pm. They >monitored Julia, she was fine and my blood pressure was stable. > > > >They moved me into the birthing room at about 3pm and I immediately went >into the shower, on the roller ball thingy. They did a VE and I was 3 cm >dilated at 3.30pm. The next hour went like a blur. I remember asking for >pethidine, being told to wait and that I was doing really well just >breathing and rocking through the contractions. I remember I looked at one >of the mid-wives and asked for some gas. I was on the verge of freaking out >with the pain… (Andrew has told me that I actually screamed) She had me lie >over a bean bag with pillows heaped on top of it and showed me how to use >the gas. I had the choice of the mouthpiece, or the mask. I chose the mask. >I remember she told me to make the machine rattle…. I made it almost explode >J I could feel each contraction coming, getting harder and lasting longer. >When the contraction started, I started sucking gas and rocking around. The >gas removed my sense of time, but left me aware of the contractions. I could >hear people talking and I could talk back, but I was really in my own world. > > > >At about 4.30 (apparently) I yelled that I needed to push. My contractions >were finishing with an extreme urge to push or should I say, an extreme urge >to do a BIG poo... The midwives told me that I couldn’t push, to use the >gas and breathe through that urge and that the doctor was on the way. That >was hard trying to stop my body doing what it needed to do. Well- the >doctor looked inside and said, yep, she is ready to go, 10 cm dilated and >that Julia’s head was waiting to come out. I remember thinking- 'I told you >so!!' So then the push started…. > > > >I didn't think about getting off the bed, no-one suggested I get off the >bed. In hindsight, I should've gotten off the bed. I pushed about 5 times, >each time, moving her slowly further down. The midwives told me to change >my way of pushing. I put my feet on their hips, grabbed hold of my thighs >near my knees, stuck my chin down to my chest and when time came to push, I >remember I roared. It’s funny, while I was roaring, I remember thinking to >myself that I would scare the baby… I pushed so hard, that Julia’s head was >birthed and on the next contraction, her body followed. What an exquisite >pain it was… She was born with her right hand beside her head, next to her >ear. She was born at 4.57pm, 7lbs 1oz, 52cm long with a head circumference >of 32.5cm. And a shock of white blonde hair…. Perfect… > > > >I sustained 4th degree tears, including a buttonhole, to my perineum, rectum >and sphincter…. I guess that if I could have changed anything, it would have >been to not be on my back and to have controlled my pushing a bit more, to >let myself stretch. But as it turned out, I had too much strength inside me >and no-one (including me) knew that. > > > >I managed to feed her between having an IV line put in and the surgeon >poking around to see exactly how badly I had torn. Pretty bad. I was put >under a general anaesthetic and had my bottom half sewn back together. I >had not only torn the outside, but muscle on the inside… To repair the >damage took 25 stitches. Luckily a woman OB did the repair, so the stitches >were neat and tidy. I healed really well. I have been doing pelvic floor >exercises for 10 odd years. Good for your sex life apparently LOL.. I have >no incontinence problems, except that I might fart when laughing hard, >coughing hard or in certain yoga poses.. > > > >The same woman who sewed me up, also told me at my 6 week check-up that my >next baby will be born by caesarean. 'Why?' I asked- Her response was >straight to the point. 'Because of the damage done to your perineum and the >speed at which you laboured, the chances of retearing and thus needing >colo-rectal surgery are just to great to risk...' My jaw actually dropped, >I shook my head. She smiled and told me to not worry until I fell pregnant >again. I don't believe that what she said is true. I have total faith in my >body, I know that the stranded beetle position didn't help at all, and that >Julia's hand positioning couldn't have helped... Next time, I want a midwife >to guide me... If a midwife suggests that I am high-risk and I need >'definite' major abdominal surgery over 'possible' colo-rectal surgery, I'll >trust her... Till then, I'll keep up with my dream of bringing birth back >to women... > > > > > >I love this list. All you women (and occasional man) are lovely, special >people. Thank you!! >MSN 8 helps ELIMINATE E-MAIL VIRUSES. Get 2 months FREE*. -- This mailing list is sponsored by ACE Graphics. Visit
