Friday, December 24, 2010

Emunah and C-Sections

My trust in rabbis was eroded long ago, and several internet rabbis have done nothing to improve that situation.   I was unfortunate enough to have to learn several lessons the hard way, because I listened to certain rabbis giving advice that they had no right to give - and which I later discovered was totally wrong information.

For this reason, I feel it necessary to respond to Lazer Beam's latest blog post Emunah and Childbirth where a guest female writer (RF) pleads with women around the world to cease having babies via C-section.  She then equates having caesarean sections to a lack of emunah.  By publishing her rant, Rabbi Brody acknowledges his agreement with it, and - (worse) - implies that such an opinion is endorsed by Breslov and the great Rebbe Nachman of Breslov.

I find the entire blog post to be (1) misleading and (2) insulting.

There are many reasons why a woman needs to deliver her baby via caesarean section:

Here are the most common indications for cesarean birth:

•Previous surgery on the uterus makes a cesarean necessary
•Placenta previa, to prevent excessive maternal bleeding that may affect the fetus.
•Abruptio placenta, to prevent rapid blood and oxygen loss to the baby as a result of the placenta separating.
•Herpes infection, a cesarean will prevent the possibility of passing it on to the baby through the birth canal.
•Severe toxemia, to prevent fetal complications.
•Fetal distress, as identified through ultrasounds and/or fetal monitoring.
•Abnormal fetal position, making it impossible for the baby to pass through the birth canal. An example would be a breech or transverse presentation.
•Diabetic mother, if the disease results in a very large baby, or poor blood flow to the placenta.
•Prolapsed cord, to prevent loss of oxygen to the baby.
•Cephalopelvic disproportion (CPD), when the baby’s head is too large to pass through the birth canal.
•Failure of labor to progress, or if oxytocin has not been effective.
•Forcep or vacuum failure.
Having emunah doesn't mean you ignore your doctor's advice and run straight for your prayer book and rely on a miracle.  Having emunah means that you understand Hashem gave us doctors and operating theatres, anaesthesia, and miraculous ways of bringing babies into the world - unlike past generations where the mother and baby would both die.
Providentially, an email just arrived, showing an (old) amazing photo of a baby in the womb, being operated on.  The baby is holding the doctor's hand, almost as if saying "thank you doctor".   Rabbi Brody, it's time to think before you publish your misleading articles.......
Photo: 21-week-old unborn baby named Samuel Alexander Armas, who is being operated on by surgeon named Joseph Bruner. The baby was diagnosed with spina bifida and would not survive if removed from his mother's womb. Little Samuel's mother, Julie Armas, is an obstetrics nurse in Atlanta. She knew of Dr. Bruner's remarkable surgical procedure. Practicing at Vanderbilt University Medical Center in Nashville, he performs these special operations while the baby is still in the womb.
During the procedure, the doctor removes the uterus via C-section and makes a small incision to operate on the baby. As Dr. Bruner completed the surgery on Samuel, the little guy reached his tiny, but fully developed hand through the incision and firmly grasped the surgeon's finger. Dr. Bruner was reported as saying that when his finger was grasped, it was the most emotional moment of his life, and that for an instant during the procedure he was just frozen, totally immobile.
The photograph captures this amazing event with perfect clarity. The editors titled the picture, "Hand of Hope." The text explaining the picture begins, "The tiny hand of 21-week-old fetus Samuel Alexander Armas
emerges from the mother's uterus to grasp the finger of Dr. Joseph Bruner as if thanking the doctor for the gift of life." Little Samuel's mother said they "wept for days" when they saw the picture. She said, "The photo reminds us pregnancy isn't about disability or an illness, it's about a little person" Samuel was born in perfect health, the operation 100 percent successful.


Tidbits of Torah said...

I am quite sure Rabbi Broder has not seen this guest post. I am sure he will, after so much traffic and comments against this posting has been made will properly remove it. (I hope)

I took the liberty of copying and posting the reasons why women have c-sections.

thank you for bringing this to your readers attention.

Devorah said...

She says that Rabbi Brody "gave her the soapbox".
If he doesn't have control over his website, and doesn't know what is being posted there.... it is even more problematic.
But I tend to think he does know, and he put it there.

Tidbits of Torah said...


I thought perhaps it was like blogspot where you can add a team member to post on site. I was giving him the benefit of the doubt that he was away on a trip and allowed her to post and did not have a chance to read it.

Wondering now if he will respond. Hmmm

nanaloshen said...

This picture and accompanying story made me cry. How powerful and how wonderful. I had a C-section, the two before were natural and the three after were natural as well. I agree: sometimes they are necessary and a G-d given way to save both the mother and child. Thank you.

Devorah said...

Just one more point: the writer "prays every day that Hashem will bring birth back into the home".

There are very good reasons why we deliver babies in hospitals:
"...doctors issued a warning against the practice, saying it increased the danger for both mother and baby" (See article at link below).

Anonymous said...

I have read the article (and commented on it on another blog - I'm at a total loss about what is misleading in this post??? I think it was heartfelt, and though not actually full of facts and statistics, it was full of beautiful passion and raw emotion.

I'm a birthing doula who has worked in the labour and delivery profession - both hospital and home births as well as c/- for quite some time. I'm also a mom of 3 - one of which was an unassisted birth... so this is definitely something I am really passionate and interested in.

Devorah said...

Becoming Devoted:
The article is misleading because it implies that any C-section is not "approved of" by G-d, and if you have one, you don't have enough emunah. That is a ridiculous notion.

Anonymous said...

I can see where you are coming from. I can't say I would have published this article myself, but I think perhaps (likely) the article is being seen in a different light than it intended. Read it as a person who has just undergone a very big transformation and have a very spiritual awakening or experience and it becomes clear this isn't about hating doctors guts, so much as it is about restoring respect for what it is supposed to be about first and foremost - a spiritual event when a new soul is brought into the world - NOT a medical procedure. She didn't mention all c/s being wrong... she said many are hospital caused (which is in fact sadly true).

Long before Obstetrics was the midwife. and midwifery was a highly respected profession that was often done not for money, but out of love and respect for the miracle that is birth. now it is seen as lesser-than because of the self promotion of the field of obstetrics as a whole. That isn't to say nothing good comes from obstetrics... it's to say that you have to look at ALL the facts and weigh out options. things aren't always what they seem.

I can totally see why some will be against what she wrote... but the heart of why she wrote it I think speaks volumes. Perhaps with time a maturity she will find a clearer way of presenting her feelings. After all, passion of a recent experience often clouds our abilities to step into the shoes of another. and sometimes our passion and emotions steps on the toes of other's feelings.
of course... I don't know the lady who wrote this at all... so I can only speak from my own interpretations and experiences.

Anonymous said...

blessings. i am sure if a c section is really imperative no rabbi, let alone rabbi lazer will say no. however, i would like to say that private hospitals sometimes do unnecessary operations for money. because surgery costs alot. we have known such cases in this part of the world. an operation will cost 4-5 times more than a normal birth. as such, there is a plus and minus to everything. while it should not be said or implied that G-d is against c section or anything close to that, it must be also digested that while being a doctor is a noble profession, not everyone today chalks up to mark.
where i live, there is a joke often said, if one stands at the gateway of hell and throws a stone at random, its bound to hit a lawyer. today it can include doctors too.

Just Me said...

I commented on the post, on the Lazer Beams site.

Purposeful unassisted birthing is not responsible. It happens, sometimes. In taxi's, ambulances, bathrooms... but not by choice. No responsible birth professional would advocate such a thing. This is not only a safety issue- it can cause trauma and terrible outcomes. Stress causes hormones to react, increasing maternal blood pressure, fetal heart rate issues, as well as inefficient contracting of the uterus. The hormone flux from this type of situation is huge. It can be traumatic even for those "prepared". And last long after birth...

Responsible doulas encourage women to believe that their bodies are capable. They do not encourage going AMA. Responsible doulas will help create balance in every type of birth- hospital, c/section, and home. Not unassisted. Some doulas over step.

This woman should have been treated for PTSD, not given a forum to increase fear, distrust and general skepticism. I wrote to Rabbi Brody, personally and have so much more to say about this.

Emunah is crucial to living with change. But so is a healthy dose of truth, realistic birth advice, healthy living and faith that G-d gave us the interventions to help us.

Everything can be used for good or bad. Fear, is healthy if it prevents you from running into moving traffic. Fear is bad if it is used to justify distrust of the systems we have to help Mothers and babies.

As a postpartum doula trainer, and an RN, trained midwife and doctor of homeopathy, I see the damage fear and lack of responsible birth care, and fearful stories presented as warning(!) can bring. The fear based person makes decisions not based on the best information, but of avoidance and distrust.

Overuse and over dependence on technology has been correlated to medical interventions... but fear places all medical care as unnecessary. Very, very bad. Very. I cannot stress it enough.

The stories I can tell you...

Dr Shoshana Kesner, DHM, RN

Gandalin said...

Your post is very beautiful and very welcome. Your thoughts are I believe proper and correct. Rabbi Lazer Brody sh"l"ita is a wonderful man, but he has an animus against medicine and doctors, as did the great Master, the fount of flowing wisdom, Rebbe Nachman mi Breslov. There are certainly comments in the Gemara against bad doctors, but surely it is no more a sign of failed emunah to seek earthly medical care than it is a lack of emunah to eat material food and drink material water.

And what a story! And what a photograph!

Akiva said...

There's a middle ground here that people are missing. The woman's article on R. Brody's site is great...UNTIL the last paragraph. In the US at least, C-section rates are at 30%. Yet in Sweden they're 7% and they have a lower rate of maternal mortality than the US. Meaning 23% of those C-sections in the US are uncalled for. I would also note the US does NOT use midwives in the hospital.

And the US system is very interventionist. Not only C-sections but very high rates of episiotomies and so forth.

So I understand this woman's complaints that the "system" walked all over her and jumped fast at intervention that may not have been necessary.

Of course the end of her article is the problem. The US system should not intervene so fast and should do so at a lower level of impact. But, modern medicine has lowered maternal death rates from 1 in 100 to 1 in 20,000.

Much of that comes from pregnancy care, early detection of problems (and fixing of many of them), preparation for difficult births, and the techniques to deal with them. Encouraging women to avoid them is statistically life threatening.

There is a middle ground.

Devorah said...

There may be a middle ground for you Akiva, but for a random woman reading that article on a respected rabbi's blog.... there is no middle ground. It gives the impression that c-sections equals a lack of emunah in Hashem, and there is something radically wrong with any woman who needs one.

The article should be clarified, and should have been clarified as soon as this was brought to Rabbi Brody's attention.

Israel Rising said...

Hmmm. I don't think Rav Brody is against C-Sections when they are deemed necessary. I think the woman's message if filtered properly would be that "in the US" there are too many C-Sections. Yes, it could have been helpful for the Rav to clarify his position on this, but I don't think it is necessary. He was giving a woman the chance to write something for all to hear.

What I am disturbed about is the hint that he is misleading and/or has been misleading in the past. Rav Brody has been nothing but helpful to me and his advice got my wife and I through some tough economic times. He helps thousands across the globe and is not really an "Internet Rabbi" since I have been to his house for Shabbat and spoken with him in person numerous times.

We need to be careful about how we speak about Rabbis, especially on the Internet.

Anonymous said...

blessings. i cant say whats happening in western countries or even in the Holy Land, but friends of mine in both areas of the world are more times disillusioned with modern medicine. it has been awfully misused alot of times. though admittedly G-d has saved lives thro medication and operations. a friend of mine living in australia is now having memory lapses due to a prolonged treatment on statin drugs. for myself recently a bone specialist almost injected my spine with steroids for severe stenosis, and thank G-d my sons pushed me for a second opinion. and the second doctor told me not to go for physiotheraphy and the jabs as the pain i was having was a pinched nerve. i am having stenosis as shown in the ct scan but that was NOT causing the pain now. i personally know a doctor here who went for natural treatment for stone in the bladder, as he told me todays doctors are not curing the cause but only the symptoms. and many other cases, what vaccinations and drugs have caused more harm than good. and we do have many cases where just as lives have been lost , in other cases lives have been saved. i think it goes more for case by case. where i live mid wives still go to the rural places to deliver babies, and they seem to know more than doctors of today. i am speaking from experience from incidents that happened here. there was a case here where they amputated the wrong leg, they looked at the x ray and mixed right and left.
many medicines are causing more harm than good, as i said, in other cases they have saved lives. and much side effects also.
i do realise the topic is on c section, as i wrote earlier, many doctors do c sections and other operations for money esp in private hospitals. one has to be very careful.

Analytical Adam said...

I do have to say the real reason for an increase in c-sections was not mentioned in the article likely because Rabbi's like "Rabbi" Brody support their dishonest way of making a living and that is frivilous lawsuits that has really created real problems among OBGYN's.

Babies that were both with cerebral palsy had these ambulance chasing lawyers telling the parents they could get a settlement and would claim to a jury that is the doctor would have performed a C-section the baby would not have had cerebral palsy.

So doctors to avoid lawsuits perform more of them now. Has the rate of cerebral palsy gone down. Sadly no as this was just junk science. The result has been horrible though that OBGYNs have very high malpractice insurance because of frivolous lawsuits and I am sure many good people have decided not to become an OBGYN because of this.

But people like "Rabbi" Brody I'm sure support corrupt lawyers because they use lawyers as well to intimidate others which is why you didn't right about this in the article which is the reason why C-sections have gone up. To avoid lawsuits that time has shown were based on junk science and just playing to the emotion of a jury and claiming the child had cerebral palsy because of this "terrible negligent doctor" which of course what does a lawyer not about medicine. Nothing. More C-sections have not lowered cerebral palsy.

Devorah said...

Adam: Rabbi Brody is a real rabbi, and a genuinely good person. I think in this case he should have clarified his post, but I would never suggest that he is not to be trusted in any way. I believe him to be a good and honest person, and usually someone who gives good advice.

Tidbits of Torah said...

shame on you Adam - if you are a Jew - double shame to you.