Letter from the President

I wanted to share this with everyone, because I feel like this was a very important letter from the President in this quarter's Clarion.

Spring was busy. I gave two presentations over and hour long. One was about doulas encouraging VBAC to an audience of doulas. The other was on the personal impact of cesareans on families to a more mixed audience of doulas, childbirth educators, and nurses. While both went well, the one on the impact of cesareans has mixed reactions from the audience.

I am a mom. I gave the mother's point of view on cesareans. I spoke from my experience. I am also ICAN's president, and I spoke on behalf of many women. There is a wide continuum of experiences regarding cesareans. I acknowledge them but do not speak for them all - there are enough obstetricians wearing rose tinted glasses romanticizing cesareans - I speak for the women who have scars on their heart as well as their abdomen.

I want to be clear : We are seeing only the tip of the iceberg in regard to the impact of cesareans on women and their families. The reality is that the impact is far larger and deeper than we know. As the cesarean rate increases, so does our glimpse into the reality of the immense proportions of the epidemic and its impact on our lives. Cesarean surgeries impact the health of both mother and baby. Cesareans impact the workplace, as the time mother - and fathers - need off is lengthened. ICAN has recently been tracking a trend among health insurance companies to deny coverage or charge higher premiums to women who have had prior cesareans. The sill have both a financial and a health impact on families. Cesareans impact the woman's image of herself. Cesareans impact relationships between ever family member

The session covered these and other ways cesareans impact the family - everything from breastfeeding and bonding to the reaction of husbands. It was quickly apparent, from the first question after the presentation, that the real impact on families was not acknowledged. A nurse asked, "What about smaller hospitals who can't provide VBAC's?" "What about them?" I asked. I continued that that was an excuse -- that doctors, hospitals, and insurance companies are all pointing fingers at each other as the reason they can't provider VBAC for moms, meanwhile women are being left without a place to go birth or with coerced cesareans.

The nurse said that we are sending women into an adversarial situation. I got a little upset. I replied that we encourage women to interview care providers carefully to find someone supportive, that if a hospital has a ban, we suggest meeting with administrators to clarify our rights. We have moms who are still denied a VBAC, so we encourage them to look at all options, including changing hospitals, and interviewing homebirth midwives. Sometimes that doesn't work, and moms labor in the parking lot to avoid cesareans. She said that didn't make any sense -- that we need to look at the informed consent angle. I laughed out loud. "I'm ICAN's president. Do you think we don't understand what patients rights are about? Why do you think we are upset that they are violated everyday? Everyday we have women who contact ICAN --saying that they are being denied a VBAC, that there is a VBAC ban -- that they want to know their rights, their options"

She argued with me, saying that wasn't true. Someone else yelled out that if that were true, we could sue. "We have tried" I said, "and no lawyer will take the case -- that there aren't any 'sue-able damaged.'" I told the story of a woman in Michigan who has a horrible story of abuse and coercion and was interrupted several times -- people not believing the story. I finished the story, though I barely got through it. Women were shaking their heads and muttering "that can't happen."

It was very tense and frustrating to me. The undeniable looking the other way by professionals to what is really happening is discouraging and disappointing. It confirmed to me we have to continue speaking the truth. After the conference, a woman approached me and said, "Thank you. The emotion you showed touched me. I can tell you hold man women's stories. Thank you for carrying them and for sharing them."

Let me share my personal mission statement : I will know I have achieved my goals when, while being introduced, when I tell women what I do, I get a beautiful peaceful birth story back, instead of the painful, traumatic stories I do now.

May that day come soon.

- Pamela Udy