An Unanticipated Choice: VBAC or C-Section?

Robin Marty

Having a baby still after a miscarriage still feels so unreal to me that having the decision about whether to undergo a scheduled c-section or attempt a V-BAC is itself surprising.

I have to admit I was pretty surprised to make it into the second trimester. Despite having a reassuring listen to the fetal heartbeat at about 10 weeks in an unrelated doctor’s appointment, I still wasn’t completely believing that it would make it through the first twelve weeks intact.  But at my 12 week checkup everything looked perfect, and I was hit with a something else I never thought about — how I want to give birth.

I had made the assumption that, just like the last time I was pregnant, my only option was to have a second c-section.  When I told my doctor, who is a general practitioner, that I was pregnant last September, he informed me that he couldn’t see me anymore until I had found a surgical OBGYN who would be performing a c-section on me, since he wasn’t qualified.  If that doctor was willing to share duties, then I could continue with my regular doctor with the understanding that I would switch to the OBGYN closer to full term, and schedule the c-section then.

But now, six months later, a change in both insurance providers and hospital policy has brought a new set of possibilities into my life.  I could actually go with a VBAC (Vaginal Birth After Delivery). And, in fact, my regular doctor was encouraging me to do so.

I need to be honest.  Part of me liked having the choice taken away from me.  A c-section appealed to my sense of order: I would know exactly when it would happen, what to expect, how long it would take, what the recovery would be like.  And yes, it is surgery, with additional complications and a longer period of recovery than a vaginal birth, but still, I knew exactly what I am getting into.

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I had a very bad birth with my daughter.  After going overdue I underwent a two-day long induction period that did not do what it should to jump-start delivery.  Unfortunately, my water broke on its own near the end of the process, forcing us to continue on right when I was about to be sent home to rest and try again the next morning.  Fifteen hours later, after four epidurals, six hours on oxygen, a raging fever, an alarming increase in fetal heart rate and a diagnosis of “failure to progress,” it was agreed that an emergency c-section was the only option. I started the induction at 9 am on Monday and at 3 pm on Wednesday was the semi-conscious mother of a fat, crying little girl with an undiagnosed infection that passed on to her due to my prolonged broken water.  She spent ten days in NICU, I spent three in my bed trying to recover from severe blood loss. 

Once we were finally all home, we quickly recovered physically, but it took me months to come to terms with the loss of a happy, engaged labor.  There was no joyous moment when the family all came in to see their first grandchild with balloons and flowers.  Instead, we escorted each grandparent into the NICU one at a time, due to the visitation rules.  In the end, I know I should have been happy she recovered so quickly, that she was released before Christmas, that I didn’t need the transfusion the doctors were debating giving me.  But still I think about that wonderful birth moment we should have had, and still find myself sad.

I realize that with a VBAC I have the chance to recreate that day, to attempt to have the experience I felt like I was robbed of before.  So many things would be different this time.  This time I know that I am Group B Strep-positive, and would be on antibiotics, making the danger to the baby that much less.  I came into this pregnancy nearly 40 lbs lighter than my previous pregnancy, making me a much fitter and healthier patient, something that has great effect on how often you end up in complications or stalled labor.  They do not give pitocin to women who have had c-sections due to possible rupture, so I will be able to move about during labor, rather than be laying in bed the entire time like I had to for my induction.  In fact, they don’t allow any form of induction at all, meaning if I do go overdue I would end up with a c-section anyway.

Because that is my biggest fear.  Not a fear of labor itself, but of going through labor, failing again, and having another c-section after already pushing my body to the brink.  If I thought in any way that I would fail, I would rather just go straight to the surgery and deal with its consequences on its own.

But I can’t help but think that if my body manages to go into labor on its own, it’s already a victory, as I never did manage to do so with my daughter.  If that can happen naturally, of course it would make sense that I could labor and deliver on my own as well, too.

I change my mind nearly constantly, and I know that luckily I still have months before I have to make a final decision.  I weigh what would be best for me, best for the baby, best for my family, who would have to help care for me somewhat, too, in the case of surgery.  And in weighing all of these pros and cons I have to take a moment and look at my own fears, and recognize that those have to be viewed as a factor as well.

But mainly, as I think my way through the scenarios I find myself amazed that I get to decide this at all, and realize how lucky I am that, after everything we’ve been through, there might be any sort of delivery at all in December.  Finally, I think I can begin to think of this pregnancy as real.

News Abortion

Anti-Choice Leader to Remove Himself From Medical Board Case in Ohio

Michelle D. Anderson

In a letter to the State of Ohio Medical Board, representatives from nine groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Anti-choice leader Mike Gonidakis said Monday that he would remove himself from deciding a complaint against a local abortion provider after several groups asked that he resign as president of the State of Ohio Medical Board.

The Associated Press first reported news of Gonidakis’ decision, which came after several pro-choice groups said he should step down from the medical board because he had a conflict of interest in the pending complaint.

The complaint, filed by Dayton Right to Life on August 3, alleged that three abortion providers working at Women’s Med Center in Dayton violated state law and forced an abortion on a patient that was incapable of withdrawing her consent due to a drug overdose.

Ohio Right to Life issued a news release the same day Dayton Right to Life filed its complaint, featuring a quotation from its executive director saying that local pro-choice advocates forfeit “whatever tinge of credibility” it had if it refused to condemn what allegedly happened at Women’s Med Center.

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Gonidakis, the president of Ohio Right to Life, had then forwarded a copy of the news release to ProgressOhio Executive Director Sandy Theis with a note saying, “Sandy…. Will you finally repudiate the industry for which you so proudly support? So much for ‘women’s health’. So sad.”

On Friday, ProgressOhio, along with eight other groupsDoctors for Health Care Solutions, Common Cause Ohio, the Ohio National Organization for Women, Innovation Ohio, the Ohio House Democratic Women’s Caucus, the National Council of Jewish Women, Democratic Voices of Ohio, and Ohio Voice—responded to Gonidakis’ public and private commentary by writing a letter to the medical board asking that he resign.

In the letter, representatives from those groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Contacted for comment, the medical board did not respond by press time.

The Ohio Medical Board protects the public by licensing and regulating physicians and other health-care professionals in part by reviewing complaints such as the one filed by Dayton Right to Life.

The decision-making body includes three non-physician consumer members and nine physicians who serve five-year terms when fully staffed. Currently, 11 citizens serve on the board.

Gonidakis, appointed in 2012 by Ohio Gov. John Kasich, is a consumer member of the board and lacks medical training.

Theis told Rewire in a telephone interview that the letter’s undersigned did not include groups like NARAL Pro-Choice and Planned Parenthood in its effort to highlight the conflict with Gonidakis.

“We wanted it to be about ethics” and not about abortion politics, Theis explained to Rewire.

Theis said Gonidakis had publicly condemned three licensed doctors from Women’s Med Center without engaging the providers or hearing the facts about the alleged incident.

“He put his point out there on Main Street having only heard the view of Dayton Right to Life,” Theis said. “In court, a judge who does something like that would have been thrown off the bench.”

Arthur Lavin, co-chairman of Doctors for Health Care Solutions, told the Associated Press the medical board should be free from politics.

Theis said ProgressOhio also exercised its right to file a complaint with the Ohio Ethics Commission to have Gonidakis removed because Theis had first-hand knowledge of his ethical wrongdoing.

The 29-page complaint, obtained by Rewire, details Gonidakis’ association with anti-choice groups and includes a copy of the email he sent to Theis.

Common Cause Ohio was the only group that co-signed the letter that is decidedly not pro-choice. A policy analyst from the nonpartisan organization told the Columbus Dispatch that Common Cause was not for or against abortion, but had signed the letter because a clear conflict of interest exists on the state’s medical board.

News Politics

Missouri ‘Witch Hunt Hearings’ Modeled on Anti-Choice Congressional Crusade

Christine Grimaldi

Missouri state Rep. Stacey Newman (D) said the Missouri General Assembly's "witch hunt hearings" were "closely modeled" on those in the U.S. Congress. Specifically, she drew parallels between Republicans' special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life.

Congressional Republicans are responsible for perpetuating widely discredited and often inflammatory allegations about fetal tissue and abortion care practices for a year and counting. Their actions may have charted the course for at least one Republican-controlled state legislature to advance an anti-choice agenda based on a fabricated market in aborted “baby body parts.”

“They say that a lot in Missouri,” state Rep. Stacey Newman (D) told Rewire in an interview at the Democratic National Convention last month.

Newman is a longtime abortion rights advocate who proposed legislation that would subject firearms purchases to the same types of restrictions, including mandatory waiting periods, as abortion care.

Newman said the Missouri General Assembly’s “witch hunt hearings” were “closely modeled” on those in the U.S. Congress. Specifically, she drew parallels between Republicans’ special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life. Both formed last year in response to videos from the anti-choice front group the Center for Medical Progress (CMP) accusing Planned Parenthood of profiting from fetal tissue donations. Both released reports last month condemning the reproductive health-care provider even though Missouri’s attorney general, among officials in 13 states to date, and three congressional investigations all previously found no evidence of wrongdoing.

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Missouri state Sen. Kurt Schaefer (R), the chair of the committee, and his colleagues alleged that the report potentially contradicted the attorney general’s findings. Schaefer’s district includes the University of Missouri, which ended a 26-year relationship with Planned Parenthood as anti-choice state lawmakers ramped up their inquiries in the legislature. Schaefer’s refusal to confront evidence to the contrary aligned with how Newman described his leadership of the committee.

“It was based on what was going on in Congress, but then Kurt Schaefer took it a step further,” Newman said.

As Schaefer waged an ultimately unsuccessful campaign in the Missouri Republican attorney general primary, the once moderate Republican “felt he needed to jump on the extreme [anti-choice] bandwagon,” she said.

Schaefer in April sought to punish the head of Planned Parenthood’s St. Louis affiliate with fines and jail time for protecting patient documents he had subpoenaed. The state senate suspended contempt proceedings against Mary Kogut, the CEO of Planned Parenthood of St. Louis Region and Southwest Missouri, reaching an agreement before the end of the month, according to news reports.

Newman speculated that Schaefer’s threats thwarted an omnibus abortion bill (HB 1953, SB 644) from proceeding before the end of the 2016 legislative session in May, despite Republican majorities in the Missouri house and senate.

“I think it was part of the compromise that they came up with Planned Parenthood, when they realized their backs [were] against the wall, because she was not, obviously, going to illegally turn over medical records.” Newman said of her Republican colleagues.

Republicans on the select panel in Washington have frequently made similar complaints, and threats, in their pursuit of subpoenas.

Rep. Marsha Blackburn (R-TN), the chair of the select panel, in May pledged “to pursue all means necessary” to obtain documents from the tissue procurement company targeted in the CMP videos. In June, she told a conservative crowd at the faith-based Road to Majority conference that she planned to start contempt of Congress proceedings after little cooperation from “middle men” and their suppliers—“big abortion.” By July, Blackburn seemingly walked back that pledge in front of reporters at a press conference where she unveiled the select panel’s interim report.

The investigations share another common denominator: a lack of transparency about how much money they have cost taxpayers.

“The excuse that’s come back from leadership, both [in the] House and the Senate, is that not everybody has turned in their expense reports,” Newman said. Republicans have used “every stalling tactic” to rebuff inquiries from her and reporters in the state, she said.

Congressional Republicans with varying degrees of oversight over the select panel—Blackburn, House Speaker Paul Ryan (WI), and House Energy and Commerce Committee Chair Fred Upton (MI)—all declined to answer Rewire’s funding questions. Rewire confirmed with a high-ranking GOP aide that Republicans budgeted $1.2 million for the investigation through the end of the year.

Blackburn is expected to resume the panel’s activities after Congress returns from recess in early September. Schaeffer and his fellow Republicans on the committee indicated in their report that an investigation could continue in the 2017 legislative session, which begins in January.

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