Mothering Outside the Lines

You may have noticed the press release with the winking ACOG eyeball can no longer be found on this Website.

As reported by Babble.com, the press release first appeared on CNN.com’s iReport but was pulled after it was discovered to be a prank.

As this post from another Babble.com blogger indicates, the subject of the press release–America’s skyrocketing C-section rate which is in violation of women’s fundamental rights–is anything but funny.

As the press release circulated via email and Twitter, bloggers have been writing about it:

*the Deranged Housewife “It’s clear to me that when it comes to the birthing choices of women, ACOG doesn’t really give a crap.”
*C-section Recovery Kit blog, and
*Owning Pink.

Yes, the press release was a prank.

I know because I wrote it.

Is it really a surprise that ACOG didn’t suddenly decide to advocate that women have their babies in the safest way possible?

Here’s how the real press release should have read:

For Immediate Release: ACCORDING TO BIRTH ADVOCATE JENNIFER MARGULIS, PH.D., ACOG HAS NO PLANS TO STOP ELECTIVE C-SECTIONS

The American Congress of Obstetricians and Gynecologists (ACOG) has made no announcement that it is devising a comprehensive plan to lower C-section rates in the United States. Instead, Greg Phillips, Associate Director, Office of Communications, The American College of Obstetricians and Gynecologists, has said that the April 1 press release indicating the organization would be spearheading a campaign to end elective C-sections “did not come from us and is clearly an April Fool’s joke.”

C-sections in the U.S. have gone up 700% since they were first measured in 1965, when the C-section rate was only 4.5 percent.

The nation’s C-section rate has been rising steadily for the last eleven years. It’s now over 31 percent. This is a deplorable situation that harms women and their newborns, but one that ACOG has continually downplayed or ignored.

Advertising itself as an organization that advocates for quality healthcare for women, ACOG has no plans to ask obstetricians to halt elective C-sections.

Though many birth advocates, obstetricians, gynecologists, nurse practitioners, midwives, and women’s rights advocates believe that C-sections should only be a last resort and should never be performed for the convenience of the doctor or for financial or liability reasons, C-sections are routinely done in this country when there is no medical necessity for them, often for the convenience of doctors or for fear of lawsuits.

Though the use of electronic fetal monitoring has been shown to increase unnecessary C-section rate without any proven benefit to the mother or infant, ACOG also has no plans to call on American hospitals to stop the routine use of electronic monitoring during labor.

ACOG has no new guidelines to encourage women to have freedom of movement during labor, labor standing up or squatting, and to eat and drink at will. In fact, given the organization’s repeated negative stance on out-of-hospital births, it can be inferred that ACOG actively opposes freedom of movement during labor.

Cesarean can save lives. But doctors and consumers have to remember that this is major surgery that carries major risk. Some examples: 29-year-old Abbie Dorn, suffered severe hemorrhaging and brain damage after her uterus was nicked during a Cesarean section at Cedars-Sinai Medical Center (2006), 32-year-old Diane Rizk McCabe died following complications from a Caesarean section at Albany Medical Center Hospital (2007), and Karen Vasques, 27, died during a C-section at Beth Israel Deaconess Medical Center (2008).

Maternal mortality has risen every year in the United States for the past 25 years, while over the same period the rate of C-sections has gone up 33 percent.

The skyrocketing rate of C-section in America has had devastating consequences but ACOG, the most highly respected organization of obstetricians and gynecologists in the United States, refuses to lead the fight to stop it.

Many people took offense at the original satire that I wrote to highlight how serious the problem is.

I had no intention of duping or disappointing those who really are leading the fight to stop a systemic problem in our medical system that has spiraled out of control.

I know that OBs who do not rush to C-section breech births, twins, and women who have had prior cesareans are often under tremendous pressure from the hospitals where they work, and from their colleagues, to do more surgery. There are many wonderful OBs who do not overuse the C-section operation, and they, too, advocate returning to a healthier balance and letting a woman’s body do what it evolved to do.

My dear friend who is having a baby on Friday via C-section was told by her OB that he forbids trial of labor. She is young and healthy. She has big bones and wide hips. But since she had an unnecessary C-section in her twenties, her doctor will not allow her to go into labor naturally.

A new mom recently posted her birth experience on a baby message board. Unfortunately, the only atypical aspect of her experience is that the doctor pretended to allow her to try for a VBAC. Here’s part of her story:

“After switching doctors several times during the course of my pregnancy, at the time I delivered I was under the care of an OB & Midwives group. I was told that I was a good candidate for VBAC, was offered water birth if things went well, and believed that I was in the best possible circumstances to avoid surgery & any un-needed medical intervention.

I arrived at the hospital dialated to 4. An hour & a half later, my water had broken on its own and I was dialated to 6.

Since I was laboring on a birthing ball, the midwife wasn’t confident about the fetal heartrate monitor, it was showing decels, so I was asked to consent to an internal monitor (screws into the baby’s scalp during labor). I refused the first time I was asked, then consented the second time. I consented because I thought my husband was beginning to panic and hoped that it would ease his stress. When I consented to it, I looked at my husband & said “That is medical intervention #1.”

Before the monitor was even plugged in, we were told that we were going to be moved to the OR “just in case” while being monitored more closely. The midwife had called an OB to consult & we expected to meet him in the OR.

On the way to the OR, my husband was sent to a dressing area to change into scrubs & I was sent straight into the OR. My husband & I were separated.

As soon as I reached the OR, the staff began prepping me for surgery. I stated that I did NOT want a c-section. I demanded to see my husband and stated that IF I was to receive a c-section my DH & I would make that decision together. I was told that my husband was on his way. I was also told that my baby needed more oxygen & I was told to breathe deeply in a new mask because it had a better seal on my face (the oxygen I was breathing before was thru a smaller mask).

The new mask wasn’t oxygen, I was gassed against my will.

I am unaware of what was done to me from the time I was gassed up until I awoke in recovery. I am assuming that I only had a C-section. Any further details have not been shared with me.

When my husband exited the dressing area & went to go to the OR, he was told that he couldn’t go in because I was already being anesthetized for surgery. He was not asked to consent on my behalf. He was not told that I had refused consent. He was not told that I had requested his presence. He was not told WHY I was having surgery.

I found out that my son had been born, and that I had been operated on, when I woke up in recovery. No medical professional came to me and spoke to me about my surgery. I have never been told WHY I required a c-section. I only know the name of the delivering physician because it’s on my son’s birth certificate. I never met him. He never came to talk to me before or after surgery. I also never saw the midwife again after I was wheeled into the OR…

I’m having an extremely hard time coming to grips with having been lied to and operated on against my will. I love my son, but I did not give birth to him. I was not present at his birth. That moment in my life has been taken from me … I don’t know if I’ll ever again be capable of trusting a medical professional to respect me as a whole person, instead of just a slab of meat ready for their whim. I thought that it was required of medical professionals to obtain informed consent whenever possible prior to performing surgery.”

Can we agree that what’s really cruel are experiences like these, not my April Fools joke?