But Why is VBAC so Important?

I am sure that I am not the only person to ask myself this with the announcement of the National Institute of Health VBAC Conference announcement.  But unlike most, I know more than my fair share about VBAC after having a cesarean with my first child it became more than a healthy obsession to me. But sadly the more I learned, the more sad I became about the access to VBAC nationally.

In a 2009 survey from The International Cesarean Awareness Network, it was found that nearly 50% of all hospitals in The United States has some sort of a VBAC Ban in place. Whether it be a formal policy written by hospital administrators, or a de facto ban, meaning there simply are no providers who will take on a patient who wishes to have a Vaginal Birth after Cesarean.

But what does this mean for women nationally? For the women who have had cesarean sections, whether medically necessary, or unnecessary?  It means that once they have experienced once cesarean birth, they have no choices regarding future pregnancies or deliveries. Essentially leaving them with no real informed consent.  To me, as a huge activist, that is not only a violation of a patients rights, but it is a major human rights and bodily anatomy violation.

Right now, 90% of women who have had one cesarean section will go on to deliver all of their children through multiple major abdominal surgeries, the next more risky than the last. When the safe and relatively low risk  option of a VBAC is not available.  But lets look at the numbers regarding the risks of VBAC as opposed to repeat cesarean sections.
The major risk associated with a Vaginal Birth after a Cesarean section is something most near the most not knowing the risk is so low. Uterine Rupture.  Not something we should discount or not worry about, but when we look at the statistics, the average healthy woman who has had one previous cesarean section has a 0.6% chance of experiencing a uterine rupture.

When I went through the process of filling out and signing my VBAC consent form for my second pregnancy, there was paragraph after paragraph panting VBAC in a scary pictre, then a small paragraph with the minor risks of a repeat cesarean, almost like the practice of Obstetricians backing my midwives wanted me to change my mind and run in fear.
This form was not informed consent by any means, it was skewed, biased, and provided misinformation, but sadly this is what we are seeing Nationwide today.

But I can hope with the NIH VBAC conference we can start to see a change in the way that VBAC is handled nationally.
Women have the right to real informed consent, and give birth vaginally if that is what they choose for their own birth.

For more information on Cesarean Awareness, and Advocacy, check out The International Cesarean Awareness Network.

Join the National Institutes of Health’s Consensus Development Conference on Vaginal Birth After Cesarean Delivery: New Insights

March 8–10, 2010

Natcher Conference Center | NIH Campus| Bethesda, Maryland

For most of the 20th century, clinicians believed that once a woman had undergone a cesarean, all of her future pregnancies required delivery by that procedure as well. In the 1980s, vaginal birth after cesarean (VBAC) also began to be considered a viable option for these women. Since 1996, however, VBAC rates in the United States have consistently declined, while cesarean delivery rates have been steadily rising.

What accounts for these changing practice patterns? Frequently cited concerns about VBAC include the possibility of uterine rupture during labor, infection, and other complications. However, repeat cesarean delivery carries risks for both mother and baby, and may impact future pregnancies.

An improved understanding of the clinical risks and benefits of both procedures, and how these risks interact with legal, ethical, and economic forces to shape provider and patient choices about VBAC, may have important implications for health services planning.

Be part of a pivotal discussion that will explore these issues. On March 8–10, 2010, in Bethesda, Maryland, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Office of Medical Applications of Research of the National Institutes of Health will convene a Consensus Development Conference on Vaginal Birth After Cesarean.

After weighing the scientific evidence from a systematic literature review, expert presentations, and audience input, an unbiased, independent panel will prepare and present a consensus statement of its collective assessment addressing six key conference questions.

The conference is free and open to the public. Your input is valuable. Please join us!

Information and Registration

consensus.nih.gov | 1-888-644-2667 | consensus@mail.nih.gov

Can’t attend?

Webcast registration consensus.nih.gov/vbacvideocast.htm

Pre-order statement consensus.nih.gov/vbacstmt.htm

Continuing Education for this activity is pending. Please see the final announcement for details.

What does it mean to be a birth activist?

Luckily, I know many women who are great activists. I have to admit I’ve had a couple of women tell me that they didn’t feel like they were activists. They felt that the word was too strong.

an especially active, vigorous advocate of a cause, esp. a political cause.

Hmmm, doesn’t sound too strong to me, but I understand, in a sense, what they mean. When asked what activists did, many came up with picketing, or going door to door. While I certainly haven’t had the opportunity to do either of those, I think that is largely because the Internet has changed activism, hopefully for the better, if not easier. Many women said that they see themselves more ad advocates:

a person who writes or speaks in support of a cause or person.

So does the different between activist and advocate have to do with passion? What are your thoughts on the differences between advocacy and activism? How do you identify yourself?

Take Responsibility

Liberal news magazine The Nation ran an article on “Ten Things You Can Do to Improve Your Healthcare” by Donna Brook, poet and associate editor of Hanging Loose Press.  Her “ten items focus on prevention, the key to saving money and minimizing suffering.”  I give Brooks kudos for encouraging all to take measures to improve our individual health — not the least of which includes our maternity care, not opting for elective c-sections or choosing a provider known to have a high c-section rate.  Number 5 on the list:

“If you are pregnant or looking for an obstetrician, keep in mind that the US rate of C-sections is more than double what the World Health Organization considers acceptable. You should not have this major surgery–with all its risks–simply for the sake of convenience. Read more at thebirthsurvey.com.”

As universal as maternity care is, more people need to know and hear about responsibly choosing a care provider and seeking transparency.  What are you doing to help spread the word?

Angie’s List Induction-Turned-Cesarean Commercial

Screen cap of laboring woman being rushed to surgery

Transcript of an actual Angie’s List review:

At my 41 week appointment, my OB decided to induce me, but I guess I took longer than he expected because just as I went into hard labor, he told me he was leaving for an important meeting. On his way out, he said goodbye, dressed in his tennis clothes. One hour later, I was getting a c-section… while he was out practicing his serve.

Congenital Heart Defect Awareness Week

Starting on February 7th, and going through till February 14th, we will be celebrating Congenital Heart Defect Awareness week. I was first touched by this subject on Twitter when I met a mother who had lost her daughter, Cora, to an undetected congenital heart defect shortly after she was born. Since that time, Kristine Brite, the mother of baby Cora has become an internet advocacy all star making strides to help others know about the issue and prevent other mothers from going through what she had to endure.

According to Congenitalheartdefectfact.com an estimated 10,830 babies are born a day, and 411 of them are born with a congenital heart defect, making it the most common birth defect according to the March of Dimes.

“In the US alone, over 25,000 babies are born each year with a congenital heart defect. That translates to 1 out of every 115 to 150 births. (To put those numbers into perspective, only 1 in every 800 to 1,000 babies is born with Downs Syndrome.)”

Knowing this information, and learning about Cora’s Story has made me realize that in the United States this is an issue we need to work on tackling, and work on testing, and mandatory pulse oximetry testing in newborns, which Kristine Brite is currently working towards, even only two short months after the loss of her baby girl.

On Sunday February 7th, 2010, at 3:00pm EST, to help kick off Congenital Heart Defect Awareness Week, Kristine Brite will be joining myself for the Momotics Radio show to help kick off CHD awareness week with Cora’s Story.

Please join us and help spread the word on Cora’s Story.

Loves Letters

It’s February and our minds turn to love. Everything seems to be hearts and flowers no matter where you go. So I’m going to take a minute here to spend some time sharing the love, naming thank you notes.

I actually do call these loves letters when I talk about them in my childbirth classes or to my doula clients. You write love letters to people who went out of their way to help you during your birth. (There is a flip side to this and while those letters are equally important, we’re going to save that for another day.)

Thank you notes should be personal. Share how their actions helped you specifically, but quickly, no need to be wordy. If you can do it hand written, that is always a nice thing to do. But sometimes, that’s hard or you don’t feel like your handwriting is legible. Consider enclosing a photo of you together with this person if applicable. (More tips on writing thank you notes.)

If you gave birth in a hospital and you are writing to someone from that institution be sure to consider the following:

• Include as much identifying information as you can about the recipient. It may have been difficult to get a last name during labor or you’ve forgotten it. But addressing it to Eve, BSN on 3-11 p.m. 12/8/09 will get to the right person.
• Copy that person’s supervisor. This can mean a difference come raise time or even promotion wise.

Some families want to do gifts. While this can be appropriate consider your recipient. Many nurses say that while they love the trays of cookies or flowers, the thank you note would help them more with their bosses.

Midwives, doulas, childbirth educators and lactation consultants may have varied needs for recognition with a boss. That will depend on a variety of factors. But if you want to do a gift in addition to your letter, consider donations to favorite charities, a scholarship fund for their profession, or a local fund set up to help cover childbirth class or doula fees, breast pump rentals and the like.

Show us your examples of loves letters you’re written or received as it pertains to birth in the comments!