Vagina Warriors Strike Again

Right before I gave birth to Hazel, I posted about the vagina warriors.  Perhaps you’ve encountered them?  They’re the women who go around making mean and judgmental comments about other people’s birth decisions.  Not as their doctor, or their birthing coach, or their friend or sister, but women (in my experience, it’s always women) who go around making mean and sarcastic statements to other women. 

It turns out they still exist.  And, now, at 34 weeks pregnant with my fourth child, I’ve encountered them again.  This time, on the Internet.  It was my mistake—I made an offhand comment on a friend’s Facebook page.  I then was doused with a condescension, lack of listening, and viciousness by strangers to me.  I should have walked away, but I don’t let myself be bullied.  I think mean girls are awful, and I have no problem telling them they are awful.  I think the world would be a much better place if people took their big feelings, their passions, their interests, and expressed them articulately and respectfully instead of tearing other women down.

There are a lot of women out there in the world who delivered their children via Cesarean.  Sometimes it was necessary.  Sometimes it was elective.  Sometimes there were ways they could have avoided it.  Sometimes they didn’t want to, sometimes they weren’t given all of their options.

The rate of Cesareans is still really high in our country—a third of births are delivered that way.  I think that there is a discussion that needs to be held in the medical community about why those numbers are so high.  I imagine that the reasons why are numerous, overlapping, and include so many things, including but not limited to:

  • our litigious society making obstetricians (with one of the highest rates in the medical profession of being sued, if I remember correctly) afraid to let women make choices about their deliveries,
  • the better access to better neonatal care (what percentage of babies born prematurely are delivered via c-section?  And how does that impact the higher rates?),
  • the rising ages of women having children (and therefore having higher risk pregnancies),
  • the obesity epidemic in the United States
  • the use of epidurals (which can slow down the progression of labor, which can lead to the use of oxytocin to increase the rate and strength of contractions, which can lead to a harder labor, which can lead to fetal distress, which can lead to c-sections)

These are just some ideas that I have about it, as a non-medical professional, but as someone who reads a lot about birth, delivery, pregnancy, etc.

So, my friend whose Facebook page I commented on, is a doula.  She is a lovely, beautiful woman, and her goal, as far as I understand it, as a doula is to help women become empowered with all of the information they need to make the best decisions for themselves and their families.  She is a warm, kind woman whose presence in a woman’s labor and delivery will surely bring a lot of comfort to women and their partners.  Of that, I have no doubt.

She posted on Facebook about the rising rate of c-sections and some research she was doing about the different levels by state, and in different countries.  I read along because, as someone who has had multiple c-sections, and as an accountant, things like numbers and statistics and trends about cesareans are interesting to me.  The comments began innocuously, as people commented on the research and comparisons between different, neighboring states.

Someone commented, “It’s amazing how willing people are to undergo MAJOR surgery and how willing these doctors are to perform it. I totally agree, there are definitely situations in which you can’t escape it, but electing to have major surgery boggles my mind. “

Someone else (I’ll call her Heather*) then commented, “Shocking isn’t it? Amazing how women can’t seem to do what has propagated our species lo these thousands of years. And how the rates of induction/ surgical birth spike before holidays. Tis the season! ”

These comments rubbed me the wrong way.  You know why?  Because they’re mean.  Because they’re judgmental.  Of other women.  Of me.  I boggled someone’s mind with my decision to have major surgery.  I can’t seem to do ‘what has propagated our species lo these thousands of years’.

According to my (very limited) research, in the 1600s and 1700s in the United States, women were about 1% likely to die every time they tried to have a baby.  And women had more babies.  So, over the course of their lives they were more likely to die in childbirth than now.  A hundred years ago, about 600 women per 100,000 died.  Now it’s about 15 per 100,000.  And that’s just maternal mortality (great research when you’re pregnant and preparing for mind-boggling surgery, by the way, which is why my research was not overly extensive), not taking into account infant mortality.  But hey, let’s sing the praises of the good ol’ days!  Because birthing children was never complicated, was never messy, and was always a shiny happy event taking place in a manger with donkeys and cows watching and women being supportive of each other and living to tell the tale, without any gore or horror or intervention or death.

Source-less chart showing maternal mortality rates over the years

Source-less chart showing maternal mortality rates over the years

It’s easy to look back on the good ol’ days through rose colored glasses.  And it’s one of my pet peeves.  We didn’t ride in car seats and we turned out okay. (Except for all those kids who died, of course.)  Our parents and teachers used to beat us and we turned out okay. (Except for all those people who didn’t, of course.)  Romanticizing the past is incredibly annoying.

So, being me, being outspoken, being annoyed, I responded.  “I’m willing to undergo major surgery to have my babies…. otherwise, the rest of my brood would have a relatively high likelihood of being motherless mongrels. Thank God for modern medicine, without which my firstborn would have died in vaginal childbirth. Judging me for making the safest decision for my body and my family is not acceptable-I make informed decisions with the help of my doctors and independent research, and I am no less a woman or a mother because my babies were all delivered via cesarean. ”

I didn’t realize that I was opening the door for the vagina warriors to come and get me.  I have to say that I was even more surprised to find out that most/all of the women who proceeded to attack me on this Facebook thread were doulas and other birth workers… you know, people who are supposedly trained to help and empower women.  Women who claim to be supportive.  Women whose nasty, mean girls comments to me left me in tears and unable to sleep last night.  Women who probably slept fine themselves, feeling proud that they have “big balls”.  After dozing off to dream about a pack of baboons wrestling my child out of my vagina, and waking up in tears, I decided to blog about it.  Because women shouldn’t be made to feel bad for the ways they’ve delivered their children.  Because women shouldn’t be mean to other women.  Because women who work with other women should be supportive and loving and compassionate, the way that my friend whose Facebook status prompted all of this.

Here’s how it went down.  I am changing names to protect the mean girls, but directly quoting them and me, while leaving out posts in the middle that were not directed towards me.

Heather: katyjane, I don’t think anyone here, anyone who works with birth on a regular basis, is being judgmental of any particular case. It’s the overwhelming statistics and global comparisons. In a country where the c/s rates are increasing, if they were all necessary, the maternal morbidity and mortality rates would be decreasing. The opposite is true. We can’t work in birth without experiencing the necessary surgical births and would all echo Dani’s sentiments about the wonderful option that it is when necessary. But, believe me, there are plenty of women who are not well informed enough to make the best decisions for themselves and their future children. I have worked with them and their doctors. It’s perplexing.

Regina: katyjane, unfortunately 50% of our cesareans are not necessary (WHO) and lead to harming moms and babes. That is where the frustrations come from.

katyjane: Please understand that my frustration comes from the judgmental comments about c-sections and the assumption that most people who have them are making poor health choices for their bodies. Saying judgmental things and then claiming they aren’t judgmental but based on statistics is disingenuous. 

My first baby was an emergency c-section, without which he may have died. He spent five days–full term, 8 pounds, 3 ounces, in the NICU as he dealt with the consequences of meconium aspiration and accompanying pneumonia. 

I probably would have been a good candidate for VBAC. But you know what was horrible? Recovering from emergency surgery, almost vaginal delivery, and going home from the hospital without my child, along with the complications from breastfeeding that entailed that caused me intense nursing pain for six months. So, with my second child, I had an elective c-section. I had a beautiful birthing experience with her, she was born healthy and strong, breastfed like a champ. I probably could have had her vaginally. I didn’t. I chose to have what might have been a “medically unnecessary” major surgery, even though women have been birthing children out of their vaginas for all of time.

I then had my third c-section a few years later, and will have my fourth this coming January. Three elective c-sections. !!! 

Remember, even though you might be commenting generally about the state of c-sections, when you make comments about something that is actually what women are doing and choosing, it comes across as judgmental. If we want to throw stones, I’m sure your house is made of glass, just like mine. If I was working with you as a birth educator or in whatever your capacity is, and you made these kinds of comments to me, I would fire you. 

Is a c-section major surgery? Yes. Do some women make the choices for the wrong reasons? Probably. Do some doctors take away their patient’s choices, or explain things poorly? Probably. Is that most women who have c-sections? Who knows? Who are you to judge? 

Perhaps the increase in the rate of c-sections is correlated with other things that are also increasing, and not just dumb moms and litigation-fearing doctors. The higher rate of prematurity might require more c-sections. The increasing rate of obesity in our country might contribute. The higher age of mothers might contribute. Perhaps all of those things contribute.

This comment I made was responding to the tone of the earlier comments.  I understand that people get frustrated… but there is an appropriate avenue for expressing that frustration, especially as a doula or a birth worker.  Someone’s Facebook page is not that, because you are expressing your frustrating at their 400-500 friends, who may or may not be affected by your sarcasm and ranting.  Obviously, though, what I posted meant that I should be condescended to next.

Regina: Im sorry you allow yourself to feel judged by this thread. I could speak on all of your points with my own experiences but that would be pointless and not serve the original point of the post, the overuse of cesarean section, which add to our shamefully high infant and maternal mortality and morbidity rates.

I don’t do well with being condescended to.  I really, really don’t.  “allow myself to feel judged”?  Come on.  I have allowed myself to feel judged, but other women are bullied into letting people cut them open with scalpels?  They aren’t allowing it, right?  They’re bullied, I’m supposedly allowing myself to be judged.  That nonsense brought out the Southern in me.

Katyjane: Oh, Regina, sweetie, bless your heart; a bunch of strangers will never make me feel actually judged.  But working in the birthing industry, I do think you ought to be aware of how your comments could come across and how you could be making other women feel. As women, we should be building each other up and being supportive of each other. Comments like “Amazing how women can’t seem to do what has propagated our species lo these thousands of years.” and “It’s amazing how willing people are to undergo MAJOR surgery” are not proactive in a discussion or thought process about what could be causing higher rates of c-sections in our country, or the effects that that has. They do not further a conversation, but make it an emotional one, a sarcastic one, and an unsupportive one. 

Blair: We see a lot of birth as Doulas and Midwives, and knowing Regina as a close friend as well as a colleague like I do, I stand by her comments. I don’t see judgment in them. Sometimes things are read into which aren’t there.’

katyjane: Please know that my responses were solely in response to the specific condescending and judgmental comments that I highlighted above. I agree that the c-section rate in our country is too high and needs to be addressed, with all the factors that impact it. I don’t agree with being sarcastic or condescending when discussing those things, because they affect so many people.

Heather Katyjane, we have spoken in person about your choices and I thought I communicated my respect for your circumstances. It is certainly not disingenuous to address global statistics, at least for myself in a public health perspective. And that is one of my callings, it’s what I do as a profession. You specifically quoted my response to the original post, so I am responding from a personal and professional position. I can speak from experience, I can say. I have been present in the room with teen girls who were terrified of birth. I know the docs who wanted to go home. I can say. I have been working within this birthing environment for 13 years. There are things that I know that are completely unrelated to your particular experience. You are an n of 1. When we (health care professionals who are trying to be change agents in a failing health care system) become frustrated with a state of non-change, and we see the harm that ensues from a general lack of information and so many cases of choices that are certainly NOT informed, we will speak up. I will. And that is BECAUSE it affects so many people.

Katyjane But Heather, look at the comment you made that I quoted. It is a sarcastic comment, no? I understand being frustrated, but sarcasm doesn’t ever promote change, only divisiveness. A discussion of why c-sections happen is worth having. The factors that contribute to the increase, the problems with our health care system in general, the lack of information and resources and support that women are given when they are pregnant. All worth discussing and working towards fixing and bettering. HOWEVER, sarcasm doesn’t add anything to the conversation, aside from a negative tone. 

So, you can and should speak up to change the things that are wrong with the system. I will do the same, and for me, that includes calling people out who are making sarcastic statements that do more harm than good. And, I will say, a sentence like, “Amazing how women can’t seem to do what has propagated our species lo these thousands of years.” doesn’t take into account the number of women who used to DIE in childbirth, and the high rate of infant mortality that accompanied that. It turns out that the good ol’ days maybe weren’t as good as we like to think. Sometimes it worked out. Sometimes people died. Modern medicine has changed things–in some ways for better (better prenatal care, better neonatal care, etc), and in some ways for the worse. Our litigious society and ideas that if anything ever goes wrong in a hospital there should be a lawsuit is worse because doctors often react out of fear instead of compassionately. 

There are conversations to be had, education to be promoted, and outreach to be made. Sarcasm will not ever have a positive impact on any of those though, because as soon as someone is sarcastic, their listeners tune out.

Heather I commented on a post made by a fellow birth worker. If you take issue with my sarcasm, I can’t help that. I just hope that you understand this is not about you or your circumstances. Again, all of those things to effect change, I DO. It’s not generally effective on a person’s facebook thread. Expressing frustration with a global trend, I reserve the right to express myself as I see fit.

Katyjane Please express yourself as you see fit. But know that as yours wasn’t a comment made just to birth workers, but to all of my friend’s friends, that in some ways, you may do more harm than good, making more women feel isolated, more women feel like their experiences weren’t “good enough” or “valid” because, after all, if women have been pushing babies out of their vaginas forever, everyone ought to be able to do it. I would think, as a birth worker, you would always want to promote compassion and kindness, and reserve your sarcasm for private conversations with like minded individuals. But, maybe that’s just me. 

I take issue with sarcasm in general, though, because my experience tells me it always does more harm than good. That said, I wish you best on your journey and hope that you are able to implement the changes you wish to see.

Regina: This became a problem when Heather said, “Shocking isn’t it? Amazing how women can’t seem to do what has propagated our species lo these thousands of years. And how the rates of induction/ surgical birth spike before holidays. Tis the season!” In fact, her statement is factual. Like her, her language is colorful. However the fact remains that the human race would not have made it this far if one in three of us were unable to birth our children without being “saved.” Nor is she incorrect in pointing out the induction rates and surgical birth rates are higher before holidays. Hell, they are higher Monday to Friday and during the daylight hours. It is not a real mystery as to why women are suddenly better able to achieve vaginal birth on weekends, and during night time hours. They are being left the hell alone. Or better yet, take the same low risk group of women and divide them into two groups. Those who birth in hospital and those who plan to birth out of. Again… no surprise here. Those who avoid the OB and Hospital are suddenly better able to achieve vaginal birth. Not only that but they are able to birth without having their vaginas cut, their nourishment withheld, and even manage to come out with their dignity intact. Heather knows this. I know this. I too have been in the business for 13 years. And honestly I hate to dumb down the conversation by feeling the need to include the following statement: “Yes, I know cesarean section is a needed surgery. Thank God for it. Without it some moms and babies would not live.” I think we ALL know that. Really we do. But we also know that Moms are dying, babies are dying, at a much higher rate than is acceptable. Other nations have figured this out. They spend a fraction of what we do on obstetrical care. They have better outcomes. No, this can not be swept aside because of our weight issues, nor our poor overall health care system, nor any one thing that makes it easier to excuse. It is quite simple. We are fucking it up. Yup. Badly. And the more money we throw at it, the worse it gets. So if I sound angry…. well, yup. I am. I have seen doctors lie to my clients. I have seen them bullied, talked down to, had procedures done to them against their will… against consent. I’ve worked with moms who have suffered PTSD because of this. Moms who hated their baby for the first few months of life because of the unneeded abuse (yes, abuse) they suffered at the hands of their “care provider.” I have watched them hit rock bottom and most climb back up. I have also been with them when I knew as well as their doc or midwife that a cesarean was exactly what was needed no matter how badly they wanted to avoid it. I have held them when they cried and were forced to give up something that was more meaningful to them than anyone would ever know. And then stayed with them throughout their healing process. Birth workers give more of themselves then most people will ever know. We take home the pain, the sadness, the loss. We cheat our families, missing birthdays, Christmas, dance recitals, first days of school. So really…. if we sound a little passionate, hell… a little radical… cut us some slack. The women that you are claiming we are putting down or not respecting are the women we are giving our heart and soul too. You don’t see that. You mentioned something about Firing me if I were your birth teacher. I can tell you, no. You wouldn’t. Because you would know me. You would know how much I want to help you if you have come to me. You would know that I would give so much of myself to you. Because you sought me out for a reason. To educate you. Not to blow smoke up your ass.

Blair What Regina said.

Nancy Amen! Regina, I love you!

Katyjane Point to me where I said that c-sections are the most desirable outcome of delivery? Or that they are always and only performed in a medically necessary situation? Oh wait, I didn’t, because I know that isn’t the case. The rate of c-sections is ridiculously high. My first c-section probably wouldn’t have happened if I had known about midwives or doulas and worked with one, but I didn’t. I recommended that my sister use a midwife and a doula when she got pregnant so she could avoid being in my situation. I love the supportive nature of these roles. 

That said, sarcastic comments about c-sections are just offensive and don’t get anywhere closer to fixing the problem. In fact, they can be hurtful. And they don’t help solve the problems that cause the higher incidences of c-sections in our country. 

I appreciate the work that you do in your chosen profession. That said, the fact that you give a lot of yourselves to your job isn’t unique to birth workers. Soldiers are gone for months, years at a time from their families. Heck, lawyers work unreasonable hours to provide for their families. When I was working as an auditor, I missed birthdays, I missed seeing my kids awake for months at a time, for something much less noble. Everybody makes sacrifices in their lives for their jobs, whatever profession they choose. I never claimed that you, or anyone, was putting anybody down, but rather saying that sarcastic comments about c-sections, whether made in frustration or whatever, are not productive but can in fact be hurtful. I stand by that. I have been told too many times by too many women that I didn’t actually birth my children. That I should have done stuff differently to avoid c-sections. That I should have insisted on VBACs, regardless of all other situations, as if the end all be all is to push a baby out of my vagina, when my end all be all is to deliver my children safely. 

If anyone that I hired in my life spoke to me in a sarcastic tone or made condescending remarks about my decisions, you can bet that I would fire them. I might not fire you–because I bet you wouldn’t say what you’re saying in the way that you’re saying it if we were face to face the way that you’re comfortable posting them on facebook, with the relative anonymity of the internet. But if you did, if you implied that my decisions and my feelings and my experiences weren’t acceptable, you can bet that I’d fire you. I had absolutely no problem kicking the pediatrician out of my hospital room when my third child was born because I insisted on breastfeeding and she said that I was making a mistake in not giving my large baby formula. I would do it again in a heartbeat.

And this is where it got mean and nasty and vicious.  I went out on a date with my husband, and glanced at my phone at one point, and saw the following, and my heart sank.

Blair Ugh. Disengage. Someone clearly has a case of the “me me me I cannot see of hear beyond me” there I said it.

Regina And with that ladies, i am going to grab a nap. A mama is warming up and its gonna be a long night. If anyone would like to point out to Katyjane that I have no idea what she is talking about in trying to tie all of this together, and that no one has insulted her, well… good luck with that.

Blair Your choice to be offended by everything is exactly that, a choice. You don’t know Regina. And you are wrong about your assessment of her. Bet you all the money I have she isn’t the type to hide behind the internet either. Don’t ya know? Doulas have big balls. 

Now, I realize that it is a bit classless to repost an entire Facebook thread onto my blog.  My friend, after this nasty exchange above, basically asked for everyone to stop.  But, I couldn’t sleep last night without having bad dreams.  And this is a disturbing trend among women (a trend that has probably lasted for thousands of mind-boggling years of women being mean to each other).  So, hoping that my friend will forgive me, I am responding here.

These are women who have chosen to spend their lives theoretically supporting other women in their choices around childbirth.  Yet, they are going around talking about it publicly in a shaming and degrading way.  I agreed with their facts—if they knew me in person, if they knew the kind of person and woman and mother I am, they would never have said these things to me.  The Internet gives people a platform to be nasty, and that’s awful.

Nobody listens to you when you’re mean.  Nobody listens to you when you’re sarcastic.  Nobody listens to you when you cut them down.  I did not have a case of “me me me I cannot see of [sic] hear beyond me.”  I acknowledged all of their factual points, and suggested they communicate them in a more respectful manner.  I never once claimed that people were insulting me, but rather, speaking in such a way that could be hurtful to the very people they claim that they dedicate their lives to serving.

Doulas and their big balls can be mean, it turns out.  To pregnant mamas, it turns out.  To other women, it turns out.  And they don’t appear to feel badly about it.

My self-worth or self-esteem is not determined by a bunch of bitches on the internet, by a pack of vagina-warrior baboons.  But there are other women who have had to come to peace with emergency c-sections that affected them deeply, and insensitive comments by birth workers do not help with that.  I am perfectly happy with my C-peats, and it is not something I have negative feelings about.  But other women don’t need to hear that they had “mind-boggling surgery” or an eye-rolled statement about how women have been pushing babies out of their vaginas forever, as if those of us who do not, who cannot, for whatever reason, are inferior.

I am not inferior to vagina warriors.  I am a mother to three beautiful children, all of whom were delivered by cesarean.  I am an informed woman who makes informed choices for my family through research and discussions with my health care professionals.  I am a pregnant woman who cries when people are mean, but gets angry enough to try to stop them from doing it to other women (even though that apparently falls on deaf ears at times).  I am nice, sometimes to a fault, but also not a pushover.  I am supportive to the women in my life, and will support women in their informed decisions even if they are different from the ones I would choose myself.

And if you attempt to be mean to me, or people that I care about, or just in general, I will call you on it.  Because the world doesn’t need more mean.  The world doesn’t need more nasty.  I don’t care how passionate you are, there are better ways to express yourself than nastiness and sarcasm.  I don’t care how long you’ve been doing your job, there are more articulate ways to get your point across than defending mean comments.

*Names were all changed to famous mean girls from the movies and television.