Informed Choice: "What is it, Really?" OR "Hindsight is 20/20"

I know, I know, I've already blogged on the importance of becoming educated on the birth world when/before you have kids, but remember how I also said that I thought I was educated with my first, did better with my second, and am going even further now? Most first-time moms fall into the "trust your doctor/mom/society/etc." trap, and find out later that they were flat-out wrong, had outdated information, or were lied to. I know I did. To illustrate my point, let me start with a few fictional (though realistic and very common) scenarios:

1. A pregnant woman, carrying her first child, walks into her OB's office for her 40-week appointment. S/He has been talking about induction since she was 36 weeks, but she did her research and learned the statistics on induced labor (higher risk of c-sections, epidurals, infant distress, adverse effects of pitocin, reduced breastfeeding success, etc.), and as she wants a drug-free labor, she adamantly refuses induction for those very good reasons. So her OB insists on an ultrasound to check on baby's well-being, since it's her due date, and continuing past 40 weeks "can be risky." She agrees, thinking that that's better than more induction talk. But the ultrasound tech tells her that it looks like the baby is at least 9 pounds, maybe 10, and her OB thinks that she could have a very hard time birthing the baby naturally like she wants, and they either need to induce now or do a c-section. She trusts them, because this is a subject she's never heard of or read about, and gets induced. Baby is born, healthy and just fine, but only 7 pounds, and the pitocin-induced contractions were too much for her to take and she got the epidural. She is upset because her birth didn't go the way she wanted, all because a scare tactic that she had no foreknowledge of was used on her.
2. A VBAC-hopeful mom goes into labor, and heads to the hospital. She never labored with her first baby, which was a c-section due to frank breech positioning. She is excited to find that she is dilated to 6 already and her water has broken, but since she's a VBAC, they insist on internal fetal monitors and she gets stuck in bed. Unable to move, her labor stalls, and since she doesn't dilate "fast enough,"they take her in for a c-section for "failure to progress." She later learns that there is no evidence for continuous monitoring, laboring on her back in bed is the worst possible position, that there can be a natural "plateau" in labor, where it seems to stall and then kicks back into gear (usually if you move around), and that no two women are going to dilate at the same rate, and if mom and baby are fine, there's no reason not to wait it out. She wishes she had been told that, and that her doctor would have kept her informed.
3. A mom is told she has to have a c-section for a breech baby, so she goes through with it. She later finds the research that shows that breech babies can be birthed vaginally, though it can be difficult and most OB's don't even learn how to do it anymore. She's upset because her surgical birth may not have really been necessary.
4. A mom has an emergency c-section due to legitimate fetal distress, and she has no regrets. She gets pregnant again, hoping for a vaginal birth this time if all goes well, but her OB tells her the policy is "once a section, always a section." She tries to fight for a VBAC, but her OB spouts all the risks, and over-exaggerates them, and tells her that a c-section would be "safer" than "risking" her baby's life in a VBAC, and fails to mention the potential risks of a repeat cesarean. She believes her OB, trusting that s/he has her best interests at heart, and schedules a repeat section for both her second and third babies. At her 6-week postpartum visit after her third baby is born, the OB tells her that she shouldn't have any more children, because her uterus is too thin and scarred, and she would most likely develop placenta accreta (where the placenta imbeds too far into the uterine wall) and have to have a hysterectomy or she could die, or her uterus could rupture because it's so thin, or she could have a placental abruption (where the placenta detaches too early) or placenta previa (where the placenta lies over the cervix), and risk any future children's lives. She is devastated, because she and her husband wanted at least 4 children, and she feels lied to in that these risks were not presented to her early on, and she would have preferred to "risk" a VBAC than to guarantee herself these complications.

Hindsight is 20/20. Even these moms who thought they were educated, thought they knew the facts, thought they were armed to stick up for themselves, got blindsided and felt duped afterwards. How do you avoid falling into this trap, you ask? Find the latest research. Look up the ACOG guidelines on anything (test, procedure, etc.) your doctor suggests before consenting. Check out any of the websites I've linked to. Get a doula. Get a second opinion. Don't let yourself be belittled or talked down to by any care provider, and if you ever feel that way (even if they're ultimately right), find a new one. Make sure you're receiving evidence-based care, not "well, this is the way we've always done it" care, and you more than likely won't be disappointed. But as I already stated, above all, research, research, research anything and everything before consenting, so you have the current and relevant information in hand, and never be afraid to stand up for yourself. It's your birth experience, not theirs, and you should be in control of it.