When Jennifer Gooddall went to battle for the kind of birth she wanted -- a VBAC (vaginal birth after C-section) -- she never expected that she would make national headlines and receive the kind of support she did. Nonetheless, after previously having three cesarean births, the 29-year-old mom received a letter from her hospital, Bayfront Health Port Charlotte in Florida, which stated that her wishes could lead to "death or serious injury" to the baby. The hospital and a judge later determined that Gooddall could not even attempt a vaginal delivery. As a result, she was forced to deliver her fourth child via C-section on July 25.
As you might imagine, Goodall's recovery -- from the birth and the national spotlight surrounding it -- has been challenging to say the least. She spoke with The Stir about her experience, what has helped her cope in the wake of the brouhaha, and what she would say to other moms facing pushback about the kind of birth they want to have.
When did you decide you wanted to do a trial of vaginal delivery? What inspired the decision?
I knew as soon as I found out that I was expecting that I wanted to have my baby vaginally, if at all possible. I had been researching about vaginal birth after cesarean for several years after the birth of my daughter, who is now 10 years old. My first birth was very traumatizing, and I was not in control of anything. This time I was very prepared, very well educated, and I wanted my birth to be as natural as possible. I don’t believe that birth should be treated like an illness, but rather as a normal, natural and very beautiful event in a woman’s life. Finding my local chapter of ICAN [International Cesarean Awareness Network] really helped fuel my strength in what I had recently learned and brought me support throughout my pregnancy. I couldn’t have been so strong without my ICAN sisters.
What was the first conversation you had with your doctor about wanting to try a VBAC? How did they respond?
The first conversation I had with my care provider about having a trial of labor after three previous cesareans was during my second prenatal appointment, and my doctor wasn’t there. I was scheduled to see the nurse practitioner that day, and she brought up that I was having a cesarean. I quickly said, "No, I’m having a trial of labor." She seemed confused and was clearly taken aback, because she knew that the doctor would not agree with my decision.
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It wasn’t until my next appointment that the doctor started in with the statistics and the scare tactics, in order to get me to agree to a repeat cesarean. I had actually brought in my own statistical data, complete with references, for him to look over and was hoping to have a legitimate conversation about my choice to have a trial of labor. Instead, I was met with a picture on his cellphone that showed a ruptured uterus, a story of a woman who had a uterine rupture, and the urge that I should have a cesarean.
When did you realize you may have to face an uphill battle to have a trial of labor?
I knew right from the start that this was going to be a battle. I started off seeing the practitioner who delivered my third child via repeat cesarean, so I was aware that he was uncomfortable with the idea of VBAC in general, let alone after multiple cesareans. I also knew that I had a right to choose whether I had a trial of labor or not, and there was no way that I was signing myself up for a major abdominal surgery, unless there was a very certain cause for that surgery. Even if I gave the doctors the benefit of the doubt and took the highest 4 percent uterine rupture statistic from one study, that would mean that doctors are performing 96 unnecessary cesareans! I just didn’t feel like that was a good enough reason for me to sign myself up for surgery when I believe that VBAC is absolutely possible and that when a woman is in a safe, calm, and medically capable environment, there is no reason that she can’t labor.
Had you considered switching health care providers/hospitals or was that not an option?
When I received the letter from Bayfront, I was 39 weeks pregnant, and I didn’t know what to do. I immediately threw it up on my ICAN group, so that the ladies could help me with support and any other way possible. We are all in this fight together. I was referred to the National Advocates for Pregnant Women, so I sent an email and everything took off from there. I was aware that I could not continue to go to Bayfront as long as they were set on giving me a cesarean against my will, and therefore, I had to devise another plan for when I went into labor.
How did you end up taking the disagreement to court?
We wanted to try to immediately protect me from any abuses that could come from my delivery at Bayfront. I truly felt the best place for me to have a trial of labor would be in the hospital where, if any complication arose, we would be able to address it immediately. Unfortunately, the hospital felt differently and forced me out onto the street to labor. They said that they had an ethical duty to protect my unborn child and me as a patient, yet they clearly are aware that if I were to labor at home, I would not be in a hospital equipped with an operating room with an on-call OB/GYN who is trained in handling complications if they were to happen. They also seem to have forgotten that a fourth cesarean carries its own risks, including death.
They clearly threw their ethics out of the window when deciding to strip me of my rights and to force me to find an alternative option for care. It’s sad when money becomes the motivating factor for a hospital to make a medical decision. My reaction to the judge’s decision, well, I think he made a huge mistake. The judge deemed having a trial of labor a medical procedure, which it isn’t. It’s what naturally happens when women get pregnant. I’m not sure how that got misconstrued, but clearly, someone missed sex-ed class.
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How did the actual labor end up going?
I was able to have my trial of labor, at home, for 14 hours, but I wish that I had gotten to have a chance to continue in the hospital with an epidural instead of just being rushed into a cesarean. I made sure to ask the doctor who did my cesarean if I had ruptured when he opened me up, because I wanted a clear confirmation that I had not. He confirmed that I had not ruptured. I didn’t need to have this cesarean, but I know that there is a reason for everything, and that is how I am finding my way through all of this.
I'm guessing you were quite frustrated by how it all played out in the end. How have you been making peace with that?
It has absolutely been frustrating. During my pregnancy, I was able to hang in there, but after my son was born, things started going downhill. I had one week postpartum where I felt normal, and out of nowhere, this crazy postpartum anxiety kicked in. It got so bad that I felt like I was crawling in my skin, I stopped breastfeeding, and I couldn’t be productive in any way. Seriously, if it weren’t for those ICAN ladies, and my wonderful mother and sister, I’m not sure I’d be as functional as I am today.
You have your own hashtag on social media! How do you feel about the outpouring of support you've gotten in response to the story?
I am so thankful for all of the support from everyone. Having my own hashtag is so crazy! This whole experience has been very surreal, and I never imagined that fighting for my right to birth my baby would ever get this intense. I’m so glad that I can be an advocate for all of the other mothers and moms-to-be that are out there going through this struggle. There is no reason for women to be forced into surgery. I can only hope that this sheds some light on the issue so that we can continue our fight for birthing rights. I want to say 'I love you' to each and every person who has supported me through this journey.
What do you think can be done to help other pregnant women who, as you've said, "deserve better"?
I think that hospitals and obstetricians need to understand that birth is not a medical procedure, but rather a natural and normal event in a woman’s life. OBs need to stop with the unnecessary augmentation of births and save those techniques for the women who really need them. There needs to be more education for women regarding birth, how to handle birth, and what happens after birth. Clearly, it is important for hospitals to respect a patient’s rights. Obstetricians should do the same. Women should be respected as intelligent and informed individuals who are capable of making their own medical decisions -- this does not change simply because we are pregnant! No woman should ever be forced into surgery. As a woman who has gone through this, it is my duty to fight for women everywhere and to continue to work with advocacy groups nationwide, so that we can change policy and open up birthing options for women. I am standing up for women everywhere saying that things need to change. Women deserve better care.
Did you have a VBAC? What did you have to go through to make it happen?
Image via Jennifer Gooddall