Small Pelvis Leading to C-Section

Grabbing from my Topics I'll Write About" post, I'm going to spend the next week focusing on a very common subject to educate other women who have my same "problem:" The small pelvis during childbirth.

Before I gave birth to my son, this topic went right over my head. In fact, my friend who gave me the idea of blogging for money posted a couple of blogs about this subject last year on her site even though she didn't have this issue. She'd had a c-section with her first baby due to her daughter being breech and wanted a vaginal birth with her second. It used to be that once you had a c-section, you always had to have one. But many women are requesting the births that they want, and their experiences go smoothly. There are a lot of myths out there--and so I'm proud of my friend for finding these out so that she could have the natural birth that she wanted with her youngest daughter.

Reading her posts during my pregnancy made me realize how important it is for women to take charge of their labor experiences. When I became pregnant I started off just assuming that whatever the medical profession said was the rule. After all, they were the ones who went to school, who was I to question anything? I knew nothing--I mean nothing--about pregnancy or labor prior to my experience. But, after spending day in & day out researching everything I could, I became much more knowledgeable, confident, and formed opinions for how I wanted my experience. I realized that I'm the owner of my body, and it is okay to trust my gut instincts even if it disagrees with a doctor.

Sure enough--if I hadn't learned so much about c-sections from my friend's site, I am 100% sure I would have had one with L.J. My situation was one of the most common reasons to have one: I had a small pelvis combined with a posterior baby. Plus, I pushed for four hours (usually the max time doctors let a patient push is two hours). But, I'd told my doctor that I really, really, really didn't want a c-section. (More on that in a minute.) Thankfully, I have a doctor who actually respects me. She is a woman who has had three children (two of them are twins) and so I believe she was able to identify with me as a mother giving birth opposed to just a doctor. She knew that although the "rule" was to send me in for surgery--my situation was not as "life or death" as we're made to think. The reason why c-sections are so common nowadays is so doctors avoid lawsuits if something does go wrong. It's safer for the doctor but not always best for the woman in labor.

Each woman should be treated on an individual basis and allowed the chance to see where things progress before the decision is just simply made for them. Most cases that I've heard and read about didn't have that opportunity. Not long after a woman pushes and the babies don't move, the doctors say, "C-section time."

That's because most women don't discuss their feelings with their doctor (and might not even know they have an opinion one way or the other until it's too late). It took me five months of pregnancy before I began to create a birth plan, and fortunately my doctor did everything she could to help me have it. She kept an eye on L.J. during my pushing phase so that he would be okay--and she canceled her other appts. to spend the necessary time with me. (Other women I know had doctors who got tired of them not progressing and so they scheduled c-sections so that they could get on to their other patients. How's that for feeling like a priority?)

But, even though I'll still be using my wonderful doctor with my next pregnancy, she did say that I need to be open to having a c-section next time, as women with a small pelvis have over 60% chance of having the same thing happen next time (for me that means a posterior baby, which makes for a dangerous pushing phase). I'm glad I'm getting the time to prepare for a c-section this time, as I didn't last time and so I would have been disappointed if my first experience had ended up in one. I'd always imagined giving birth, from the time I was a little girl. If I end up having one next time, I won't be as disappointed--but I'd still like to attempt not to have one, just for all of the other reasons (it's a longer, harder, more painful recovery, the baby's lungs don't become as healthy, it's less emotionally satisfying and post partum depression is more likely, you're not able to have more than three children. . .not that I want more than three, haha).

Therefore, I'm educating myself on the small pelvis issue to try to do what I can to have an anterior baby next time who "slips right out!" Yes, there are actual tips--which I'll share with you next time. (For part two, click here. For part three, click here.)

For today, I'll end with a post I copied from my friend's blog, when she wrote about C-sections:

My 5, 2007:

A cesarean may be one of the most common surgeries performed today, but they are definitely not simple. Women and men may be duped into thinking cesareans are a breeze. Everyone and their dog gets one right? Believe me, I have been through a cesarean and it was not a breeze. You may not appear as wounded and bruised on the outside as rhinoplasty photos, but it is a whole different story on the inside. To show you how complicated and serious a cesarean really is, I did some research as to what really goes on during the surgery. You will be amazed!

First of all, there are plenty of things that have to happen immediately prior to the cesarean. The mother must have an epidural or spinal type of catheter inserted between her vetebrae to block the pain. Her pubic hair is shaved and a urinary catheter is inserted. Usually a sheet is hung in front of the mother’s head to prevent her from seeing the surgery on her abdomen. She is given oxygen and typically has her arms strapped down to the bed. Once her belly is sterilized with an iodine solution, the cesarean can finally begin.

Now comes the moment of truth. Now a days, the most common type of incision that is made is a horizontal incision right at the start of the pubic hair line. This incision must cut through FIVE layers of tissue. These include: skin, fat, fascia, muscle, and the peritoneum. Once the internal organs are exposed, retractors are placed on the top and bottom of the incision to enlarge the area. This is when the surgeon finally makes an incision in the uterus. Now the baby can be born.

Since the birth of the baby is not the last step of a vaginal birth, it is not the last step during a cesarean either. The placenta must also be removed from the uterus. Pitocin is used to stimulate uterine contractions to help remove the placenta. Once the placenta is removed, the uterus must be stitched up. This is one of the most amazing and jaw dropping parts. The surgeons actually remove the uterus from the mother’s body and place it on her stomach to complete the stitches. Once the stitches are complete, the uterus is pushed back through the incision into the abdominal cavity.

Several layers of stitches are needed during a cesarean. Not only does the uterus receive sutures, but the fascia and the muscle do as well. Then the patient may recieve outter stiches or staples that are visible on top of the skin.

Cesareans are not a walk in the park. A woman’s entire abdominal cavity is opened and removed. There is a reason the typical hospital stay is 3-4 nights following a cesarean. It is major surgery that should not be taken lightly.

To be honest, I didn’t really know what happened to a woman’s body during a cesarean before I had my own. I didn’t expect to need a c-section, so I only studied up on vaginal births. However, I hope that all pregnant women are educated about what a cesarean encompasses and how serious the procedure actually is. Perhaps this knowledge will help rid the public of the notion that c-sections are simple procedures that can and should be done every day.

I found a great website that gives amazing information about c-sections and what happens during the surgery: Storknet.com