Top Ten Signs Your Doctor Is Planning To Perform an Unnecessary Cesarean Section on You

1. Arrives to L&D immediately after office hours and says, “I just don’t think this baby is going to fit.”

2. Third Trimester, Routine Office Visit, “I think this is going to be a big baby. You should just have a C/S”– Did you know?  ACOG has very specific guidelines for when it is appropriate to offer a patient an elective C/S for MACROSOMIA (fancy word for large baby).  ‘Prophylactic (elective) cesarean delivery may be considered for suspected fetal macrosomia with estimated fetal weights greater than 5,000 gms (11 pounds) in women without diabetes and greater than 4,500 gms (9.9 pounds) in women with diabetes.

3. “We should induce at 39 weeks because your baby is getting too big” – Did you know that, according to ACOG:

‘Induction of labor at least doubles the risk of cesarean delivery without reducing shoulder dystocia (rare situation where baby’s shoulder can get stuck at delivery) or newborn morbidity(complications).  Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.’

4. Performs routine ultrasounds at end of pregnancy to see how big your baby is. Did you know that ultrasounds at the end of the pregnancy can be 1-2 pounds off?  Ask some VBAC patients who were talked into a C/S for this, then had a vaginal delivery of a bigger baby the next time.

5. “You have a positive herpes titer (or history of herpes); the baby will get it if you deliver vaginally.” Try some Valtrex for the last month of the pregnancy that is pretty much standard of care now.  It prevents outbreaks and allows for a normal vaginal delivery.

6. “Your baby is breech. You need to have a C/S” Ever heard of or performed an External Cephalic Version (process by which a breech baby is turned to the proper position)?  It really does work.

7. “You have pushed for 2 hours” (with an epidural that prevents you from feeling anything so you are probably not pushing effectively; this is evident on exam because the baby’s head is still perfectly round, but you do not need to know that) “It’s just not going to come out”

8. “I scheduled you for an induction at 39 weeks. It is just soooo… much more convenient for you!” (and so much higher risk of ending in a C/S, especially if you are not dilated when you start the induction).  At least 80% of my VBAC patients were induced the previous pregnancy.  For whose convenience was the induction?

9. First Visit (7 weeks), “Congratulations you are having twins.  I will go ahead and schedule your C/S at 38 weeks, but don’t worry if you go in to labor early I will cut you right away!” Translation, “I am scared out of my mind for you to deliver your babies vaginally because I am not trained on what to do when the second baby is coming, plus it pays more to cut you open.  Oh yeah, I don’t have that great a rapport with you because I only spend 2 minutes (fundal height, heart beat and ‘I’ll see you next time’) with you each visit, so I am afraid I will be sued for trying to do the right thing.”

10. First Pelvic Exam in Office (7 weeks), “Hmm, your pelvis is pretty narrow”.

Bonus Tip:

11. 38-week visit, “Your blood pressure is a little high today. You are probably developing preeclampsia or toxemia.  That can cause you to have a SEIZURE!  The treatment is to deliver the baby.  You need a Cesarean Section, as this is the quickest way to resolve it.  Let’s get you up to L&D NOW!” Translation – Preeclampsia or Pregnancy Induced High Blood Pressure is a pain in the butt.  If I induce you, it could take 24 hours or more and then I would have to manage your blood pressure, and put you on Magnesium.  This is way too inconvenient.  Do not worry you can try to have the baby vaginally next time.  Yeah right!

Well, I hope you future moms find use for these tidbits of info.  If anyone wants to add anything, please feel free.  Your experience may help other women in the future. Remember, there are only a few emergent reasons for a C/S such as fetal distress, unexplained heavy vaginal bleeding, etc.  It is okay to ask your doctor questions.  We are not supposed to bite.

Jonathan Weinstein, MD, FACOG

Obstetrician/Gynecologist

Husband to a Labor and Delivery Nurse with 27-years’ experience

Father to two beautiful children, Zoe and Ashton

June 8^th, 2012

After a long flight, I am finally here in Nairobi, Kenya. The airport is humid, and air conditioning is more of a luxury here rather than an expected amenity. I am shocked to find out that everyone’s luggage made it to our destination. We quickly grab our bags and follow our guide who directs us to a large bus that is waiting to take us to our hotel. Our Kenyan drivers for the week load our heavy bags effortlessly onto the top of the bus like they weigh nothing. Our group is in awe of how easy they make this look even though the Kenyan men are half the size of our American male team members.  Soon we are in the crowded bus traveling through the streets of Nairobi, car horns are a constant sound, and the smell of diesel fuel is a fragrance that I would become all too familiar with during my trip.  It is dark, so it is difficult to see how unpleasant life is for the people of Kenya. Right now, Nairobi feels like any other big city in the US.

June 9^th, 2012

Waking up in my bed at the Hotel Delta in downtown Nairobi, I am quickly reminded where I am. My mosquito net doesn’t let me forget my constant fear of getting malaria while I am here. I am anxious to start my journey so I am up early for breakfast. It is a combination of some thin sweet tortillas, hard boiled eggs, sausages, and dry toast.  After breakfast in the hotel lobby, I overhear our team leaders talking with our Kenyan guide who has become very ill with typhoid and malaria over the last few months. He has not received medical care because of the costs and is in desperate need of treatment or he may die. He has lost a lot of weight and does not look like himself. He is sent to the hospital by our team. I am immediately humbled by the severity of the situation, healthcare is something that we take for granted. Sadly, I find out later after returning home that he passed away on June 20^th, 2012 leaving behind his wife and child.

June 10^th, 2012

I was not prepared for the village of Maai Mahiu. This was the place that Kansas2Kenya has been working for 7 years to bring much needed community development and medical care. The community team has just left and has provided the village with clean water. Much needed progress for this small community. Our bus turned down the pot hole covered road to the village, in the distance the beautiful rift valley is a stark contrast to the shanty houses that line the road. A single church is the focal point at the top of the hill. Children begin to come out of their tiny houses and run beside the bus, waving and cheering “Mzungu” which means white person in Swahili. I immediately have tears in my eyes. I did not expect this. These children in this community are so welcoming. This is the reason we are here. This is a moment I will never forget. We spend time in the village taking pictures of the children, holding them, and playing with them. One little girl asks us if we have medicine in the bus and she asks us why we are not staying to help. How do we explain to her that political corruption has forced us to go to another village, but that she is just as important? She is only about 10 years old, but already she knows how hard life can be.

June 11^th, 2012

Today is our day of worship. We have the opportunity to attend church in the small village of Nakuru at St. Christopher’s Anglican Church. The service is incredible. The choir sounds so amazing, their beautiful voices echo throughout the small building. This does not feel like a choir in the middle of Africa. I feel like I am in the presence of a professional show choir. We are welcomed by the congregation, and I again have to fight back tears. The whole church is filled will people clapping and greeting us. Despite the poverty, each woman is neatly dressed in clean, fancy dresses, the men in dress slacks. After the service, we watch the school children play soccer and tour a medical dormitory funded by the church. I am surprised at the faith of these people. It is clear to me after today that faith is the foundation in Kenyan life; it is a little bit of hope in a world so filled with despair.

June 11^th, 2012

Chaos is the best word that I can use to describe today. It is our first day of clinic in the tiny mountain village in the Mirangine district. It is an hour and a half journey up a bumpy mountain road. What remains of the concrete is cracking and crumbling. There are numerous holes that our bus driver tries to avoid by weaving all over the road.

People are already lined up waiting outside the concrete building we are calling our clinic. My room has four concrete walls, a table and chair, and hard metal exam table. It reminds me of a jail cell, but it will work. I am nervous about today and on top of it the bus forgot all my women’s health supplies. So now I am really working without any resources. I have no idea what to expect, but I will try to improvise and make it a successful day. Overall I just hope that I can make a difference and provide the care these people need.

I am able to borrow some supplies from the maternity clinic next door and patients begin to come in. I greet them with “Jambo” (hello) and “Karibu” (welcome) to help them feel more comfortable in such an unfamiliar setting with an unfamiliar person. Somehow this does not matter to them; they still put all their trust in me, hoping that I can cure them. I see mostly abdominal and back pain, pain that has been there for 10 years probably from years of hard manual labor, a type of labor that many Americans have probably never experienced. I see a woman with a breast mass that is most likely cancerous. She is hopeful and puts all her faith in me, a “mzungu” (white person). I tell her that there is nothing I can do, that she must go to the hospital to have a biopsy, but I know in my heart that this is not possible for her, and that she will probably die without ever receiving the medical care she needs. I make myself move on trying to focus on the problems I can fix, but it is difficult to think about those I can’t.

“No one likes a bully” they are aggressive jerks!  Bullies are found everywhere!  Bullies are defined as people who use intimidation and sarcasm to “get their way” and “in their minds” they somehow believe they have the authority to demean anther person.  Bullies are self-governed by their narcissistic motivation to elevate themselves.  Bullies actually get satisfaction when they belittle another individual.  The bully will do anything and everything they can verbally to tear down another person. They do this by laughing at them, not listening, interrupting and even “telling them off”.  Bullies thrive on being right and letting everyone know it!

Everyday while working with women,  I listen to stories from clients  about how they believe they failed at birth.  I hear words like ” failure, wimp, didn’t try, “they made me get an epidural”, and “not a ‘real’ natural birth”.  They will tell their “birth story” and over and  the common thread of defeat is ” I feel like a failures” because they did not experience birth like their friends, co-worker, and family.  Women will talk of a so called “friend having a painless easy birth” and question why they could have them same, they must have failed.  The feelings of failure arise from conversations whereas women challenge each other on their birth options and outcomes.  Often, one can hear the conversations “well I had my baby at__________, why would you ever think of anything else? If you go to that facility  ____________they will _______, and _________, or ________.”

Sometimes one can hear ” that can’t be safe”……. or ”you’re crazy to consider that”

Just fill in the blanks, it can be fun.  No matter where you are the birth bullies try to make their personal opinion and outcome the one that is best for others.  It can be such a strong influence that one can feel reject and like a failure if they don’t even try what the bully suggests.  Bullies often use fear to make to coercive their opinion.  They will attempt scare you into believing that options are not options by using the biggest scare tactic of all, “they will take your baby”.

My philosophy is that all babies are born.  Think about it -they are born.  Very few are born in a “blissful breathing baby out with harmonious singing and happiness and no pain.”  This is not the norm, and it definitely doesn’t happen often.   Believe it or not, in our world today, over 90% of all  babies are born as “natural .”    The birth itself  is also one of the most powerful athletic events of all times!  This event surpass all team sports,  olympics,  gold medals and trophies.  This event uses an entire body to rhythmically and gently move a living being out of another. Yes, there is pain, exhaustion, physical, mental and emotional work and most importantly there is great reward.  Birth requires training, health, and strength, it is not for wimps, failures, and cowards. Even bullies can give birth!

Every athlete in our world endures pain, training, exhaustion and reward.  Athletes need encouragement, coaches, trainers and the cheering audience, not bullies.   GOD’s plan was for women to be the champions.  He chose women because they are strong, wise, fearless and able to complete the task.  Each women who desires and is chosen to given birth will win and receive the prize!  It is a miraculous event that can happen.  BIRTH IS FOR CHAMPIONS -NO BULLIES ALLOWED.

The bible describes the evilness of the tongue in Psalms 52, reading the the tongue is deceitful, devises destruction like a two edgedsword.   Reading these scriptures one can understand how words can be so painful that the cut to the heart of an individual. Our words to one another are very strong, and can either uplift or tear one down.  I am challenging myself and you to champion positive influencing words to empower women in having an INCREDIBLE BIRTH DAY!

I. I believe. I believe that we.  I believe that we will win !  I believe that we will win ! We were sad to see the Kansas City Sporting lose the semi-final match Sunday night.  Going to soccer games has been a way for the New Birth Company family to connect outside of the Birth Center.   (I have this First Comes Sporting, Then Comes Birthing idea, but that is for another post)  Futbol, music and birth are global languages.  You can go anywhere in the world, hum a tune, dance a jig or kick a ball and create a connection despite language barriers.  Pregnancy and birth are another.  Today we were delighted to host guests  from Maison de Nassaince, a birth center in Haiti.  Ms Odean, the head midwife…is a “sage femme extraordinaire” as Cathy introduced her to our team.  Dr. Betsy Wickstrom is its co-founder  whose name may be familiar to our moms as one of our referral partner physicians.  It was a close the loop moment for me today.  Almost 5 years ago I went to Haiti & met the midwives who introduced me to Cathy.  And there we all sat in the birth center together….a dream that has become reality.

The reason I love the “I believe” chant is that it has double meaning to me….when I hear 20,000 Sporting fans, I imagine we are cheering for women in labor. We are cheering for natural childbirth with licensed and certified midwives in hundreds of  free standing birth centers serving women and their communties.  We are cheering for Cathy and her work with birth attendants in Tanzania this December.

I believe that we will win !  Do you?  

http://www.youtube.com/watch?v=zvpFTpMzXoA

We are eager for you to meet Rebecca Thesman. She has joined our NBC  family to provide us with Relaxation Retreats and Journaling. She has many years of experience in both fields; she will be posting her life experiences and training that have led her down these paths. We are thrilled to have her and know you enjoy having her part of your life as well.

Friday, Nov. 18^th is a perfect day for the New Birth Relaxation Retreat. With a holistic focus on body, mind and spirit – we’ll learn some techniques to de-stress our bodies and untie mental knots. The Relaxation Retreat is two hours of restoration where tension is released. We’ll learn some meditation techniques and leave with tools we can apply during our stress-filled lives. This retreat also includes a free smoothie and New Birth’s CD of music to guide you through birth. Register now to save your place at the Relaxation Retreat Nov. 18^th from 10-12.

Join our Relaxation Retreat

Cathy and I were at the birth center last night, walking through all the rooms (with our hard hats on), and checking the list of requirements for Occupancy and Licensure.  Since today is my “birthday”, I called Mom (Jolene) on the way home to hear her retell the story of her ”BIRTH DAYS”.  I’m one of four kids.  When I was born in the mid 70′s, Mom was given an enema, moved to a brightly lit surgical delivery room, given local anesthetic, wrist restraints (!!!) and gave birth in the flat on back lithotomy position.  My younger sibling’s birth days were much better…natural, mom walking, born onto chest, warm water and soft lighting.   Mom talked about Grandma (Martha) who gave birth in the late 40s.  During that era, many women gave birth by “twilight sleep”, which resulted in a knocked out woman thrashing around, thus the wide use of wrist restraints.  Mom doesn’t know if this was the case for Grandma or not.  Martha died when Mom was only 34…my mom didn’t have enough time to ask her.  Grandma’s mother Anna Katie (Great-Grandmother) died herself after birthing her 7th child when she was 32.  My grandma was only 6 when she lost her mom.  And so Anna Katie birthed Martha, and Martha birthed Jolene, and Jolene birthed Kendra and Kendra birthed Madelin.  One way we rebuild our birth culture is to remember our past and understand it.  The best way to do that is to remember the birth stories of our own families.  To listen and not judge.  But to expect something better for our daughters and sisters and friends.  We shall not forget so quickly that all of us deserve incredible birth days. 

Ask your mother, aunts & grandmothers about their birth stories….write them down…remember them…and pass them on to your daughters (and your sons)…and give them a big hug of thanks from New Birth Company.

Kansas City, is home of several refugees from many countries of the world such as Sudan, Somalia, Bhutan, Iraq, to name a few. I have had the opportunity to befriend a family from Bhutan over the last several months. I have learned much about Bhutanese culture and work ethic.
Here is a background picture of Bhutan:
They are a kind loving group of people with a deep connection to family. Refugees are “out casts” or evicted from their country. Not because they were a bad people, rather due to corruption or persecution due to race, religion, nationality, membership in a particular social group, or political opinion their homeland government.
Bhutanese refugees come here to start life all-over again. These refugees arrive with little more than the clothes on their backs and significant needs: housing, employment, and education, as well as social and emotional support.
The Bhutanese refugees came from Bhutan. Officially the Kingdom of Bhutan, is a small landlocked state in South Asia, located at the eastern end of the Himalayas and bordered to the south, east and west by the Republic of India and to the north by the People’s Republic of China. Bhutan is separated from the nearby country of Nepal to the west by the Indian state of Sikkim, and from Bangladesh to the south by West Bengal. Bhutan is a mountainous country with an area of approximately 46,500 square kilometers. The land rises from an elevation of about 100 meters above sea level in the south an altitude of more than 7,550 meters in the north. Most of the population is concentrated in the valleys. About 70% of Bhutan’s people derive a living from agriculture, livestock rearing and forestry. Bhutan’s developing economy has close ties with India as a result of its geographical position and historical relationship(KAMUNYU, BOWER, CHEBUGUT).
Bhutan has never been colonized by any nation, even though it fought a number of wars with Tibet and British at the time when the British ruled India. Neither Tibet nor British succeeded in occupying the country and the country remained strongly unified and fit in tackling the battles. While they lived in Bhutan, the Government limited contact between Bhutan and the rest of the world, making access to the country very hard and access to the people even harder.

The Mishra family are my friends. I first met them as they entered the KC area in November 2010. I actually did their entry physicals and then later connected with them at a ministry called Misson Adelente. I have since learned that they are master spinners. They spin wool for a living. As a matter of fact, I learned that while they lived in the refugee camps in Bhutan they used a broken bicycle as their spinning wheel! They were gather wool from sheep, goats and yak and spin the wool to sell in the market. This talent fed their family.
Here is Kansas City, with the aid of Dr. Elizabeth McGhee we purchased a spinning wheel for them We also acquired wool for them to spin. They are now spinning raw wool and hoping to utilized the proceeds from the sell of the fresh yarn to feed their family.
The wool is obtained from range-fed sheep. It is 100% natural fibers hand spun, hand dyed with natural prairie dyes. They 2 pyl yarn is thin, and spun by the master spinner Laxima and his wife Bata. If you are interested in purchasing the hand spun woolen yarn, please call Cathy at 913-825-6953. The cost is $25 per ounce.

I understand why ancient cultures would advise pregnant women to only view objects of beauty and think pleasant thoughts.  You know that feeling when you are pregnant and all the worries of the world are not on your shoulders but land in your womb inspiring a round of braxton hicks contractions?  Thinking about the debt, feeling the heat, making a living in this economy, and that’s on top of mommy’s heartburn, hemorrhoids and minimal requirement of 7 strategically placed pillows if I have a chance of sleeping.  (Let’s help her out daddies, friends and family !)

When it comes to really big problems, I think it is easy for us to either pass them off as “too big” or to engage in the non-productive squawking that drive up ratings on TV.  What can I, one pregnant woman  in a country of millions do to impact something as hard to get our arms around as the deficit and the debt?  Very simply, you can give birth.  You are a healthy woman capable of giving birth outside the hospital….because you aren’t sick !  Our country is faced with some really hard choices…and I hope there are enough resources to care for the sick and frail.  Kudos to our New Birth Company moms for choosing out of hospital birth and doing your part to reduce the cost of healthcare in America.  Thank you !

More midwives (and birth centers) would save mother’s lives abroad and dramatically decrease the cost of healthcare here at home….Good to see the experts starting to publicize what all of us in the normal birth movement know to be true.   http://www.huffingtonpost.com/2011/06/20/more-midwives-prevent-deaths_n_880366.html