Scars remind us where we've been. They don't have to dictate where we're going

Sunday, April 3, 2011

The Power of Words

Before I tell this story, I want to be sure that I am clear in one thing.  I adore the OB who delivered E.  Adore.  He was warm, kind, gentle, never rushed with me in our postpartum visits, he complimented my cervix, he let me know he understood my desires for a home birth, etc etc.  I don't have one complaint about him--he really was so key in helping me gain trust in obstetricians again.

But when I went to my first postpartum visit in his office, his nurse called me back, flipped through my chart and said "Oh, that's right. You were the failed VBAC."  Obviously she just recently graduated valedictorian from Sensitivity U.  I simply replied with "hmmmm," but what I was really thinking was that there was nothing "failed" about my birth.  I labored for hours (and hours and hours and hours) with E, when it became clear that I couldn't continue at home, K & B transferred me quickly, the doctor monitored me for a little bit and when it was determined that a cesarean was best, E was delivered quickly and safely, with my consent.  That birth was all winning in my book.  I didn't really feel like going into all that with her--I think "hmmmm" covered it, and I'm pretty sure she knew what I meant. :)

But it really got me thinking (and maybe I over analyze because I majored in English as an undergrad....words are kind of my thing), but I have only really ever heard "failed" used in a woman's birth in regards to cesareans. Bear with me here.  One common reason for a section is "failure to progress."  Then we have the "failed VBAC."  So, what kind of message is this sending to women?  Fail has a horribly negative connotation, right? So when you say to a woman that she had to be sectioned because her body failed, or that a repeat cesarean was necessary because she failed at a VBAC, it really can have the potential to color her perception of her body and its abilities.  And I wonder---if I had just been a homebirth transfer, with no prior cesareans, and had a vaginal birth, if she would have said "Oh, that's right.  You were the failed homebirth."  Or if I transferred and had a VBAC, same thing.  I doubt it.

I think we need to take the word "failed" out of the lingo surrounding birth.  It would really do a lot of good if things could be reframed in a more positive way.  Because I had such an amazing birth with E, the "failed VBAC" comment rolled off my back, but if that same thing had been said to me after A's birth, I'm sure I would have been crushed.

So let's be careful of what we say and how we say it---you never know how your words will impact someone.


  1. AGREE!!! failed sucks! but they dont even have to say it! When we took B in at 2 days post partum for the fever, oh my god. Everyone from the first hospital to the ambulatory transfer people, to the second hospital said the word "homebirth" with seething disdain. Like the ambulance driver needed to know B was a HB? Once we were admitted... haha, every dr and nurse had to make a "WHAT WERE YOU THINKING/LOOK WHAT YOU DID" comment, like his fever was because he was born at home. Cuz babies never get sick in the hospital. They labeled my homebirth as a failure because my baby got a fever afterward. Im still waiting to meet my first compassionate none-judgmental pedi or L&D nurse. We should just start calling them out right to their faces. I think embarrassment is the only way to get them to change how they treat us!

  2. Lauren, I actually thought about you while I was writing this and was curious as to how you were treated with the transfer. Now I know :( Did anyone say anything outright to you or was it more the quiet disdain (which sometimes I think is worse)?

    You know, I wish they would think about what their attitude has the potential to cause. What if a HB mother knew she would be treated that way and didn't want to deal with it so she waited a little longer than she otherwise would have to take her baby in? (Not saying that HB mothers are negligent or anything like that, just who on Earth would want to deal with that if they can avoid it?!?!) I just find it so interesting that some CP like to say "Well, I would never do this because I have seen XYZ" and while I totally understand that, I'm thinking "Yes, but don't you understand that you don't see the countless other cases where everything is fine because mom and baby never have to come to the hospital?!" And then when a baby or mother is transferred, doesn't that prove just how safe HB is? We aren't birthing at home because we want to endanger the lives of our children, we are doing it because we have evaluated all the evidence as thoughtfully as possible and made the choice we think is healthiest for ourselves and our children. And if we need their help, we get it. That sounds like a great system to me :)

  3. This is interesting. I think many women imply 'failure' to the women who ERC. I think this is wrong too. Not saying you do this, I know you don't. BUT, why aren't mamas like us who do CHOOSE ELECTIVELY to have cesareans out of concern. Sure, I could have kept laboring, especially with the epi, but it would have risked both our lives. I CHOSE to ELECT a cesarean there. I feel like I made the greatest choices in my birth. I did have the best birth. I wish I was given different circumstances to choose a different best birth, but not every woman is handed a 8 hour contraction, push twice, no tear, no complication birth.

  4. Ruth, I'm not sure I understand. I guess I don't define either of our births as "elective." in your case, with an abrupted placenta, a cesarean was absolutely indicated. And with non-reassuring tones, I feel like mine was necessary as well (particularly since I had been ruptured for awhile, though no signs of infection). I actually have not encountered anyone defining E's birth as ERC or saying I "failed" from that POV. When decisions are made in the best interest of mom and baby, I don't think "fail" is appropriate under any circumstances.

    And you are right, I never judge a woman choosing an ERC. Remember my post about the mom who chose that after a traumatizing VBAC? :) All I care about is a woman making choices that are best for her.

    Sorry for typos or rambling....on my phone :)

  5. Yeah, we should definitely consider a birth a success if its a choice a mother made after having all the options and pros/cons given to her. The most important thing is, has she been given the chance to hear the truth about her options. My little guy had a huge drop in his heart rate after my 3 or 4th push and I was told I needed to "get him out immediately" which resulted in a terrible tear :( I guess I "elected" to tear, but it felt more like my only option. Push and tear or don't and keep your vagina nice, but risk losing my baby...

  6. Lauren, I am so so sorry for your tear, but I feel like I should also say again how proud I am of how hard you worked to get your baby born quickly and safely. Seriously, I say it every time, but I mean it! You are a hero! :)

  7. In my first, it was an FTP thing. My second was done after the Dr. suggested it, and I didn't really even push the fetal scalp sampling testing. I really had a gut feeling at that point that something wasn't right, and it turned out during the surgery that the abruption was noticed.

    What I mean is, I think women would feel better about their CBACs and other CSs if instead of saying 'I failed to vaginal birth, homebirth, VBAC, etc', saying 'I choose to at this point have a cesarean.' It just sounds different and looses all the negative connotations, and reinforced the empowerment of the woman's choice.

  8. Well, I guess I'm coming from a place where I don't think I "chose" to have a cesarean. Consent when there is evidence that a cesarean is safer is different than choosing. And I'm just not sure saying to a woman that she chose a cesarean would actually be a good thing. Just my opinion

  9. I see where you are coming from. I know that I in no way chose to have the circumstances that brought need to my cesarean. Not at all. I don't think you did either of course. What I'm saying, is that in the crappy hand that some moms get dealt, that they didn't choose, in the midst of it, they chose the best choices available for the safe of their baby. Granted those choices were limited, and usually not what they had in mind in the first place.

    I guess when I look at my cesareans, especially Annabelle, in order for me to feel more empowered, I have to see where I came into play, and what role I had in it and what decisions I made and how I was part of the process. A lot of things went out of control, and were not what I had planned to have happen, but given the crappy situations, I chose the best options I could through out my entire care.

    You know what I am trying to say?

  10. I'm trying to, but I think it may just be that we are at different points in processing our births. I just don't look at Emre's birth and associate a crappy hand with it at all. And I'm not sorry for either of my I guess we may just be in different places WRT our feelings about our births

  11. What I mean by crappy is more unplanned. That things happened that wasn't ideal to happen for me or baby. That's where I'm at, and even though those things happened, I still had a role to play. I think it's great where you are at. I'm happy for both of my births as well, and am in no way sorry for them. I have learned more about myself in those births than I honestly think I will ever learn in the rest of my life. :)