Jill Arnold’s Story: Turning Childbirth into a Career of Studying C-Section Rates

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Jill Arnold shares with us how her “unremarkable” birthing experience became something remarkable as she learned more about the rise of C-sections and began to share that knowledge with others. Read her inspirational submission to #PVImpact17

image001My patient story was completely unremarkable. Or rather, it should have been.

On August 25, 2005, I was admitted to the hospital around 7:00 pm. I was having contractions but was only 1.5 centimeters dilated. I labored with my husband and my doula and my daughter was born at 11:55 pm.

Prior to birth, an ultrasound estimate of fetal weight at 37 weeks showed that my baby was going to be 10 pounds. As I’m 5’11”, I wasn’t surprised.

A midwife called me out of the blue a few days later to tell me that I needed to schedule a cesarean because my baby was too big to birth. I was stunned. That night, I used my university library access to read whatever research I could find and learned that third-trimester estimates of fetal weight are notoriously inaccurate.

From that point forward, the hospital’s goal seemed to be to backfill my record with test after test that might indicate I was high-risk and therefore in need of a cesarean, none of which were grounded in evidence.

During labor, a doctor I’d never met try to bully me and my husband into having a cesarean. My husband was walked into the hall and admonished and I was told that I was putting my baby’s life at risk.

After giving birth, I experienced PTSD-symptoms for more than a year. Once I’d teased out anything else that could have caused it– becoming a mom for the first time, life stressors, the pain of childbirth—it all boiled down to not processing being told that my baby was going to die. I was living with the dissonance of seeing that my baby was thriving but carrying a nagging sense of something having gone very wrong with her birth.

After my second daughter was born two years later, I started a patient blog called The Unnecesarean that began as a forum for people who had given birth to big babies to tell their stories. The site included the evidence that I had read in that last week of pregnancy that gave me the confidence to push back against their cesarean recommendations. For years, I maintained the site, which grew larger than I had ever anticipated.

Though I alluded to it, I never shared my personal story on the blog. It was, after all, a totally unremarkable experience in the grand scheme of things. I went to a hospital and gave birth. We went home.

In 2010, around the time that the masthead of my website showed up on the screen at a 2010 NIH meeting, I switched gears and I have been telling my story ever since.

In 2012, as a single mom working at the kitchen table without any income or advanced degree, I published all of the best hospital-level data on cesarean rates that were available at that time. Consumer Reports contacted me later that year and I spoke at their Safe Patient Project Summit in December.

Soon after, they told me they wanted to license my data. Those data are my story and the story of all of us who were pressured into a medically unindicated cesarean.

In 2014, Consumer Reports rated hospitals on their C-section rates and told the story much more loudly than I ever could. Then Leapfrog Group added cesarean rates to the annual survey, which suddenly gave us hospitals themselves chiming in as contributors to the story. The narrative shifted in the media and within the medical community to a widespread acknowledgment of overutilization of the cesarean.

Now we’re all telling the story of cesarean rates, and that’s pretty remarkable.

Jill Arnold is not the only one with a story to tell regarding C-sections. Check back with us soon for another mother’s challenge with giving birth.

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