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Kyle Green | The Roanoke Times

Dawn Kubik takes a moment's break from looking through paperwork related to the this weekend's All About Birth Expo, which will fill part of the Roanoke Civic Center with educational sessions and health-oriented vendors.

Kyle Green | The Roanoke Times

Dawn Kubik (left) says she was duped into having her children — Eddie, 4, and Ilene, 6 — delivered via Caesarian section. The 35-year-old mom says she often had nightmares about what should have been peak experiences in her life.

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Dawn Kubik knows that pregnant women can't hear enough of other women's birth stories -- especially first-time moms-to-be.

The force behind this weekend's second All About Birth Expo, Kubik is making a panel discussion called "Real Life Birth Stories" the highlight of the event, with Roanoke-area parents describing birth scenes that range from 100 percent natural home births to hospital Caesarean sections.

Last year more than 300 people turned out for her first expo, held at Roanoke's Higher Education Center. Kubik is hoping for such a large turnout this year that she put her own money on the line to rent out the Roanoke Civic Center Exhibit Hall, which she has filled with educational sessions and health-oriented vendors.

Though she's not "anti-Caesarean," Kubik and the chapter she heads of the International Cesarean Awareness Network strongly feel the country's increasing Caesarean rate is a bad trend for mothers and infants alike. She wants women to be fully educated about their options.

In 2005, Virginia's Caesarean rate was 31.4 percent, slightly higher than the national average of 30.2 percent. Both figures are more than double the recommendations put forth by the World Health Organization. That frequently puts the 35-year-old Kubik, a former Air Force intelligence officer, at odds with the medical establishment.

Her views are honed by personal experience. She said she was duped into having both of her children, now ages 4 and 6, via C-section -- and has often had flashbacks and nightmares about what should have been the peak experiences of her life.

'Failure to progress'

"I started the ICAN chapter because I wanted to do something positive with my anger, sadness and frustration," Kubik said. "Birth is something that sticks with you for life.

"You talk to grandmothers, and they remember giving birth like it was yesterday."

Kubik does, too. Her labor with her younger child was stalled -- at 9.5 centimeters dilated, a half-centimeter shy of being able to enter the final pushing stage -- when her doctor began pushing for a C-section, citing her "failure to progress."

The doctor had already agreed to Kubik's birth plan, a document outlining her wish to be given ample time to deliver naturally and without medical intervention if possible. But after four hours of arguing with the doctor, Kubik signed off to submit to the Caesarean.

It's a decision she regrets, believing that she was rushed for two reasons: because the doctor had a sports game early the next morning and feared being sued if something went wrong.

Longtime Lamaze-certified childbirth educator Vicki Honer sympathizes with moms and doctors alike on the issue of Caesareans. "I respect the medical people: They're trying to please the moms, deliver beautiful and healthy babies while at the same time trying not to deal with lawsuits," Honer said.

But she also challenges the first-time parents she teaches to be assertive without being aggressive. Chances are greater for a vaginal delivery when the mother can walk around during labor and not be strapped to a fetal monitor for the labor's duration.

Honer blames the rising rate of Caesareans on doctors' fear of lawsuits, rising malpractice rates and consumer request.

"We're in an age now where people have grown up with 'everything is do it right now,' and some just aren't ready to wait for labor to happen."

C-section requests

Dr. Debra Clapp, a veteran obstetrician/gynecologist in the Roanoke Valley, said her C-section rate has jumped significantly in the past two decades, from 16 percent to 25 percent. "There are ladies who have great pelvises -- they're not carrying around an 11-pound sumo wrestler, and they're healthy and have a great attitude. That's as good as it gets," Clapp said.

"But we live in a world where we no longer have 110-pound mothers who run all week and then squat in the field and have 5-pound babies. We have ladies who get winded walking from the exam table to my office."

Not only does Clapp see more overweight pregnant women, but many are also older -- and more likely to deliver larger babies because of gestational diabetes or other factors that make them high-risk.

"I do have more patients asking for C-sections," she added. "Twenty years ago, I would've never done a C-section because a patient requested it."

But some mothers-to-be request scheduled Caesareans because they fear they'll suffer later from childbirth-related incontinence.

And women from some cultures have asked Clapp for scheduled C-sections, saying, "No one in my family delivers vaginally, like an animal."

Clapp encourages women to educate themselves about all birth-related risks and options. "It's best to say, 'This is my plan. I'll make my decisions as I go.'

"I encourage folks' being flexible and to keep in mind that in 50 years it doesn't matter how you got this kid out as long as you and the baby don't die trying."

Not 'anti-Caesarean'

Not every woman agrees that the end justifies the means. Kubik corresponds regularly with 1,200 women on an ICAN list-serve -- many of whom believe their C-sections were not medically necessary. "It's a big sisterhood of women who have been there and done that," she said.

"It hurts us when people say we're anti-Caesarean," she added. "But ultimately we believe that doctors could do a better job of respecting women and their choices. It's got to be a two-way street."