Letter to the OB I fired.

Dear Dr. ******,
You probably wouldn't remember me, it's been 11 years since my second child was born, but you were the OB who attended the births of my two oldest children. When I met you, I really liked you, you were nice, calm, and efficient.

I think it's important that you know why I discontinued seeing you for my pre-natal care and birth of my third and youngest child.

You suggested induction with both of my pregnancies with them. With my oldest child, I was 40+2 weeks, my second child I was 38 weeks when you recommended induction. Looking back on it, you never gave me a reason why, I was low risk and healthy, I did not need a medical intervention for any reason. I guess it's just a good way to keep to a schedule...

I and my babies are very fortunate to have escaped a cesarean section birth, since those moms and babies both have a bigger chance of dying postpartum, and having an artificially induced labor results in a c-section 50% of the time.

The fact that I had vaginal births does not mean I had normal births, however.

The pitocin with baby #1 resulted in a stronger, harder, more painful labor that led to my request of an epidural, which then led to me being so numb I couldn't feel, I couldn't figure out how to effectively push, which then led to you asking me to let you use forceps to PULL OUT my baby without any explanation from you as to the very real and very dangerous risks in forceps delivery. The extent of your advice? "I can use forceps or you can push for 2 hours". Well, when you put it like that, why not? My child might have been brain-damaged, maimed, paralyzed or killed, when I could have just pushed a little longer. Hmmm. Come to think of it, my baby was born at 5:00 p.m. Just in time to make it home for dinner! Those two hours would have made for a late dinner I suppose. The unnecessary episiotomy I'm sure quickened things up a little too. It took forever to heal, since my perineum from being sliced into was weakened and allowed for an easy tear past the cut. I wonder if this over medicalized birth had anything to do with the postpartum depression I went through, how I wished so much to be able to get a "do-over".

I was determined to avoid this with baby #2, but I still wasn't as informed as I should have been, as at the time I still didn't realize it wasn't my body that had a problem, but the healthcare I was receiving. So, when you suggested induction again, which isn't a hard sell to a very pregnant woman excited to see her baby, I agreed. With the stipulation that I did it without pitocin. I wanted to have an epidural free birth, so I didn't want the more painful pitocin induced labor. I trusted you when you suggested cytotec instead. Yet, in 1999, that drug was determined to be dangerous to pregnant women, with a label saying such on the package itself. My child was born in 2000. How could you ignore the warnings? Now that I know what I do about cytotec, I believe I experienced a partial uterine rupture, what this drug has caused for many mothers, some even resulting in a complete rupture and killing both mother and child.

After my third dose of cytotec, I was still not in labor, at all. No contractions at all. In fact, when the nurse was giving me the third dose, she informed me if it didn't work, I would have to get pitocin anyway. Within minutes however, I felt a very hot, sharp pain run from underneath my belly to the top, as if I had been sectioned in half vertically, and I felt a small gush of fluids. Very intense contractions then started, one on top of the other, without more than 30 second breaks. My baby was born an hour later from that first sharp pain. I'm certain I partially ruptured my uterus and I cannot fathom just how catastrophic it could have turned out, especially had the pitocin been added.

I remember being scared to become pregnant again, not knowing why I had felt such abnormal pain, worried my uterus might be weakened. Luckily, when I explained this fear to my midwife when I did become pregnant with my third, she reassured me the trauma had healed by then, several years later. In fact, my third pregnancy and birth was very healthy, happy and completely unmedicated. Except of course for the local anesthetic I received for the very small tear that ran down right where my episiotomy scar is. I was cut twice there unnecessarily, making my perineum less elastic. Otherwise a perfect baby and birth, that happened when my baby and body were ready.

You have a responsibility to the women in your care to explain informed consent, to give the pro's and con's to interventions and to lead them to sources so they can find important information on their own.

As important as it is to take care of the medical needs of a pregnant and birthing mother, so is respecting the fact that this is a very spiritual, life changing moment for her. She hopefully has a good support team surrounding her, and understanding that as her physician is what all women who become mothers under your watch want.

As much as I liked you personally, I knew I had no choice but to seek a more normal way to give birth for any more children I may have, and as information is becoming more and more accessible, I am one of many, many others who now know that a cesarean section rate above 15%, an induction rate at 50%, and an epidural rate at 90% is NOT a good thing. We now know we have options. We know the benefits of normal, not medicalized, births. You also may be a skilled surgeon, but VBAC's are actually LESS risky than a repeat cesarean.

Please, be open to what I have said, I ask this in behalf of all mothers.

Thank you for your time.

***** *****