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.

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.

The Duggar Family

I would like to extend my well wishes and thoughts to the Duggar Family though this difficult period of their lives after welcoming their 19th baby, Josie Brooklyn Duggar yesterday, December 11th 2009 via emergency cesarean section for Pre-E after a hospital stay due to gallstones. Baby Josie was born at 25 weeks gestation at 1 pound 6 ounces.

Over the past 24 hours I have seen some of this most disgusting comments via the internet on news articles, and just message boards. Whether Michelle was on her 3rd or 30th child, Pre-E can happen to anyone at any age and during any pregnancy. This family may live differently than the vast majority of Americans, but seriously, if you want to say something negative, say it when mother and baby are far out of the woods, not when a micro preemie is fighting to live.

Some people never cease to amaze me.

Michelle has been such an amazing asset to the VBAC community in having 12 VBAC’s herself.
I can only hope in future years she will continue to work with and praise ICAN like she has in the past.

The Infamous Cascade Chart

As someone strongly involved in the birth community, this is probably one of my favorite pictures floating around the internet that I run across every once and a while.? One day when I find out the person who actually put these thoughts and cascade of interventions into a physical chart to view, I am going to kiss them!

I have always loved how it starts with induction, because lets face it, so many women today are starting their labors with some kind of artificial labor stimulant. Whether it be pitocin, or the oh so dangerous cytotec. I can personally say I have been the victim of the cascade myself with my first child. Had I seen this before my pregnancy with him, I would have never opted for the induction. Many do not realize that induction in many cases will fail, almost half of the time according to the most recent figures, and when I quote that, I am quoting Robbie Davis Floyd in a 2008 interview, I believe it was in Pregnant in America but my birth/pregnancy movies and interviews all start to blur together when you watch so many of them. These babies are not ready to be born in many cases, especially when we are seeing these inductions before the “due date” or the 40 week gestation mark. Although we know that “due dates” aren’t much to put stock into, many women and providers use them as some type of eviction date, which history has shown to be a pretty bad idea. No one is going to be pregnant forever and many women left alone will go into labor on their own. Now granted, there are cases that induction is medically necessary and for these special cases, I am completely thankful. Without induction these women would be subjected to cesarean sections instead of labor inductions which could in turn be even more hard on their body, and experience over all.
What we do not understand with the induction of labor is, we are creating unnaturally strong contractions in attempt to simulate something similar to natural labor. As someone who has experienced pitocin labor, and natural labor, I would take a million natural contractions over being on the receiving end of pitocin again. The comparison in my opinion is not even in the same ball park. Another issue with these contractions as most know, is the fact that they are more likely to cause fetal distress on the baby because they are not natural contractions or what normal contractions are supposed to be. So in turn we are putting our children under unnecessary stress. Especially if they are not ready to come and join us in “our world” yet. Again something I learned with my first.
Then we have the provider who comes in and looks at the fetal heart monitoring and says, “Oh No! Your baby is in danger!!” So off to the operating room we go for an “emergency” cesarean which in reality was caused by the pitocin to begin with. You would think by this point there would be a bit of common sense in the Obstetric community to say, ya know, I think we are causing these actions instead of blaming the increasing cesarean rate on “patient choice cesareans” which only make up 3% at most of the incredibly high cesarean rate in our country.

But a cesarean is only one path that this induction cascade can lead to. There are still women out there that will have a vaginal delivery when subjected to a labor induction, but in turn these women have greater risks for other procedures including episiotomies which have all in all been proven to really have little to no benefit to women in the long run. While episiotomy rates are starting to decrease, they are still over used in many communities. For example, here in my state of Connecticut, some hospitals have an over 25% episiotomy rate, when science tells us there really shouldn’t be over 10%. Trying to obtain these numbers are like pulling teeth too FYI!

We also have vaccum extraction. I had never really discussed this or spoken with someone who experienced this until I met my Chiropractor in the summer of 2008. He was discussing with me why Chiropractic care in infants is important, and then he described his own daughters birth, they had applied the vaccum to the top of her head, and while “assisting” her out, they pulled so hard the vaccum literally flew right off of her head. My Chiropractor described it so vividly… “I thought her HEAD popped RIGHT OFF! I was horrified to even look!”? My heart broke for him because no parent should have to go through that kind of fright during the birth of their child!

These all often lead to epidurals, which especially if you are going to have a cesarean section, you will either have this or a spinal block. All types of anesthesia that will have a direct impact on the baby. Although I have experienced women told there will be no effects on their baby at all.
I am sure most know about the “breast crawl” and I can say after watching a baby who’s mother did have an epidural, as opposed to a mom who had a natural birth, there is no comparing the instincts of the baby. While I had epidurals with both of my children, I didn’t have the opportunity to breastfeed then until they were a little over an hour old. My first was almost 2 hours. For more information on epidural effects on babies, click this link!

The last thing I want to touch on is the separation of mother and baby after a cesarean section which is very common. It is pretty uncommon for an newborn to be allowed to stay in the OR with mom, although it does happen sometimes. I can really related to the lack of bonding, breastfeeding problems, and reduced bonding because of this because I deeply experienced this with the births of both of my children. While I bonded, it was not that “instant motherly love” I am sure most feel. It hurts me to this day to know that my bonding was an almost learned bonding because I knew as a mother it was something I needed to do in order to protect my babies.? While most women who have had cesarean sections are not quick to admit this, I think by discussing this and acknowledging that this is a true problem it will only help to improve it for others in the long run. I also noticed that mothers who do experience this may be ashamed or fearful to admit this because it make portray them in a less than perfect light, or maybe others may look down on them because of this, but they should not be ashamed. It happens and there is nothing we can do about it but help other women to not go through what we did!

Be empowered by your birth, no matter how you birth!
If it is a bad experience, help to educate others so they do not go through what you did, so they can avoid the pain or heartache you have dealt with!

Danielle’s Birth Stories

I have been meaning to sit down and really write out my birth experiences from my two boys, so I figured this week, since we are focusing on birth stories, what a great time!

I will start with the pregnancy of my first child, Camden. When I got pregnant, I was not all that educated about natural birth in general. I had worked as a doula, but through a crappy agency which I separated from rather quickly. So when I found out I was pregnant, I figured seeing a female Obstetrician would be like seeing a midwife. WRONG!!!!!!! But, I was pleased with my provider for the most part. I was considered a “high risk” patient because of surgery which I had on my cervix in my teen years, so of course like so many other women, I blindly followed what my Doctor told me, because of course, Doctors are never wrong…. right?
As my pregnancy went on I started seeing another female Obstetrician in this practice I proceeded to dub “The Wicked Witch” she was mean, old, cold, and simply rushes me without ever answering any of my questions or concerns. Then it seemed as though, every time I would schedule an appointment with MY OB/GYN I would always end up seeing this other Doctor. It was driving me crazy! Same went for if I had to call the “on call” for the evening, something felt wrong or something was off, and this same Doctor would always insist I went to L&D and be checked. By the time my son was finally born, I am sure they were all glad they wouldn’t be seeing me again!
Then in early November, our family was struck by a tragedy. My husband’s brother died suddenly at the age of 23, which sent our whole family into a tail spin, this was 4 weeks before my due date. From that time on, I proceeded to get sick daily, sometimes several times a day, I started losing weight despite eating like I regularly did before. At my last visit at 39 weeks and change, the Wicked Witch expressed concern that I was losing weight (15 pounds by this point) and that we should go ahead and schedule an induction before it has an impact on my son. Of course like any mother would, I freaked out and agreed. I didn’t want to have something happen to him, and in a way, I was happy because I was uncomfortable like EVERY pregnant woman was in the end.
I went in that Tuesday to get induced. It was December 11th 2007, and we showed up at 6:00am, and they escorted us up to my L&D room, and looking back on it, I wish I knew what I was getting myself into.

My L&D Nurse came in for my little questionnaire/intake and when I said I did not have a desire for an epidural, she and the Wicked Witch OB laughed at me, and told me I would change my mind shortly. From then it just proceeded to get worse!? By 9:30 I was hooked up to pitocin, which in my opinion is PURE EVIL!? Like they had said, after 2 hours of pitocin, 3cm dialated, I was begging for an epidural. I got the epidural but it didn’t seem to do much for me. The OB came back around at noon time, checked me and said I made no progress. I was still at 3cm, -1 station, 80% effaced. Which was a total blow to me because I was hurting and I thought I would have progresses SOME! She told me she was going to go have lunch, see a couple patients and she would be back around 2pm.? My husband and my mother went to get something to eat, I tried to rest a little bit, and eventually she came back. At 2pm, there was again no progress. And this is when she said, well, I am going to come back at 3, and if there is no progress then we are going to have to book an OR. I knew then my worst nightmare was coming true. This cascade of interventions was directing me straight to a cesarean section. From the start of my pregnancy, when I was told about placenta previa (which corrected itself) via ultrasound, I cried at the thought of a cesarean.
She came back at 3pm, and there was no progress, or at least that is what she told me, and they started preping me for surgery. The OR was cold, and bright, and without my husband, it would have been even more terrifying.? In the back of my head I was happy I was about to meet my son, but I was scared to death.
He was born at 4:37pm screaming, 7pounds and 7oz. Which then one of the OB/GYN’s commented, someone of my size (petite frame and short stature) would have never been able to birth that baby. Ya ok!? My mother, my size, gave birth to an over 10 pound baby, HER FIRST CHILD!

My recovery sucked, and during that time, I reached out to ICAN and learned there was no chapter in my area. So, I started one.
In September 2008, we learned we were expecting our second child, and even before I got pregnant, I knew I never wanted to go through another cesarean, nor would I willingly go through it.
My pregnancy was? uneventful, NOT HIGH RISK, attended by amazing Midwives, and so much different from my first.
On May 16th, I was doing a baby fair at our local hospital for our ICAN chapter, talking with mothers all day, giving out information, and around noon time, I started to feel… off. Something just wasn’t right.? Thankfully for me, my Chiropractor was at the booth right next to me at the baby fair so I made my way to him and got adjusted. Once I got adjusted it all clicked. I was going into labor at a baby fair. Were we in a movie?

Next thing you know, the women doing the booth with me said I looked white as a ghost, like I was ready to pass out, so they made me have some water, and eat candy. Lovely combo, but it helped! I wrapped up the fair and headed home. I called my doula and let her know what was going on, but I wasn’t certain I was in labor yet.
I laid down when I got home and tried to take a nap, but I couldn’t get any rest at all. My contractions kept getting closer and stronger. It seemed as though my labor was progressing fast, and I wasn’t sure what real natural labor was like because of my induction the first time around. I called my doula back up and she decided to head on over, and off to the bath tub I went to relax and try to work through the contractions.? Back labor, all the pain was in my back, and later on I found out my little guy was posterior.? By the time my doula got to my house, and things really started to rock n roll, it was around 8pm.? I watched the season finale of Brothers & Sisters which I had DVR’ed, listened to music, and spent a ton of time on the birth ball. Hours seemed like minutes, and next thing I knew it was midnight and I called my midwife. I told her I had been laboring for a while, and things were getting more intense, contractions were about 90 seconds apart, and we still had a 45 minute drive to the hospital I picked, which was one of the most VBAC friendly in the area. So around 12:30am we headed off to the hospital in a 3 car caravan. Myself? laying in my doula’s backseat trying to sleep in torrential rain on the highway. My best friend in her car, and my husband in our car.? We arrived at the hospital between 1 and 1:30am.
We got all checked in, and my midwife greeted us, and gave me a little check. I was 2-3cm which made all of our jaws drop. My labor was so intense we all swore I would be further along!? I decided to get on my hands and knees with the birth ball for a while, then take a shower, I thought about getting in the tub, but it was nearing 4-5am and we all wanted sleep. I couldn’t rest for the life of me.
At this point I asked for an epidural so I could sleep. I knew no matter how much I planned that I would not have one, things change when you are in the actual situation.
I got the epidural around 6am.
I was able to sleep until at 8, when my midwife came back and checked me again 3cm at most.? What was going on?? Why was I not dialating? What was wrong with my body?? Contractions started to slow, then get back to being a minute apart, then slow, then get quicker. Something was just not right, and on top of it all, I am sure the epidural was not helping either.
Around noon time my midwife popped back in and checked my cervix one last time.

Still 3cm and now my cervix was starting to swell, and we were having complications.
I was devastated, my VBAC was crashing and burning in front of my eyes.
My body was defective, I could not birth my baby, my own plan had blown up in my face.
My epidural to sleep, selfishly kicked me right in the ass!

My Midwife consulted the on call OB/GYN who came in to talk to me, along with the Resident who was on call. They were both amazingly warm, friendly, and comforting, and at that point I knew that a cesarean would be how my son was born. But I was not as bothered by it this time around, because after nearly 26 hours of labor, something was wrong, seriously wrong. My mothers intuition turned on and my son was in trouble.

At 1:59pm Benjamin Emil Elwood was born, bruised and looked like he had been through a war! When they opened me up, he was jammed behind my pelvic bone, which his forehead was pressed up against it all that time. He wasn’t coming down, his head wasn’t applying pressure to my cervix for it to dialate. At that moment I knew I made the right choice consenting to the cesarean.? I knew in the long term, it helped my son, and that was simply the way he needed to be born. During the days after my midwife would come see me every morning, sit, chat, and just helped me get through it all. I still today, cannot write about this without crying because the scars from his birth are still fresh. Nearing 6 months old, the pain of the failure is not any lighter. It seems like it was yesterday.

The story I tell is a story of a completely unnecessary cesarean section with my first child, and a life saving cesarean with my second.
The story I tell is a story of pain, and hurt, and betrayal by the one person I trusted the most, my Doctor.
The story I tell is a story of hope for other mothers to learn and become educated from my words.
The story I tell is the story of my sons, the loves of my life, and the ones who have made me the mom, advocate, and woman I am today.

All in all, I am now the North East Regional Coordinator for ICAN, a chapter leader, and the head of a maternity care campaign in my state of Connecticut. My experiences, my children, and my battle has made me become so active that I have been honored to support other women who have been where I have, and I have helped others to prevent unnecessary cesareans.

I love what I do.
I love the birth community.
I love ICAN.
I love being a Birth Activist!

Once a Cesarean, Always a Cesarean : The Tides Must Change…

As a mother who has had two cesarean sections, and someone who deeply works in the birth community, the rising numbers of cesarean sections across the country, as well as across the state of Connecticut is deeply concerning. Not just as someone who is educated about this, not just as a mother who hopes to have more children some day (and not be forced to have unnecessary surgery), but it is also becoming concerning to maternity care providers nationwide.

This morning I read an article in one of my favorite parenting magazines, Mothering. It was about the state of birth in the United States and the lack of access to real education, information, and providers who will attend a Vaginal Birth after a Cesarean Section, also better known as VBAC.? Numerous studies, publications, and scientific evidence have proven VBAC to be safer than elective repeat cesarean sections, which is really a no-brainer. Cesarean sections are major abdominal surgery which any surgery carries risks. There are some cases in which the risk of the procedure is out weighted by the medical need for the procedure, but certainly not at the numbers we are seeing them today. Connecticut currently holds a 34.6% cesarean section birth rate. Meaning when you step foot inside a hospital to give birth to your child, your risk for a cesarean birth is 1 out of every 3 women that steps foot in that hospital, some hospitals in the state have up to 45% cesarean rates making your risk go up even higher.

In some hospitals across our state, there are something called VBAC Bans. Hospitals that will simply not accept any woman who is planning or wanting to have a vaginal birth after a cesarean section. Meaning, either these women need to travel out of their area, opt for a birth at home, or consent to a repeat cesarean which they have no desire or need for.? Why is this all so alarming??? Below is a quote I took from the article about this subject in Mothering Magazine?

In 2002, 26.1 percent of US women gave birth by cesarean. The majority of these were elective repeat operations and first cesareans for dystocia, or failure of labor to progress, a highly variable diagnosis. The cesarean rate is the highest ever for this country. Eighteen percent of women had a primary cesarean, a rate also unprecedented.2 Of concern is the fact that young women between the ages of 18 and 24 have the highest number of first cesareans.3 A cesarean rate of no more than 15 percent is recommended by the World Health Organization,4 and a goal of the US National Health Service is a cesarean rate of 15 percent for first-time mothers by the year 2010.5

What stands out the most is the fact that after studying, running statistics, surveying, researching, and publishing reports, The World Health Organizations states for a country of our status, there should not be a cesarean birth rate over 15% and we are OVER double that number at this point in time.? Why again is this so concerning? In my opinion, and again this is just my personal opinion. I am not a Doctor, I am not a medical professional, I do not work as a medical professional in any capacity at all. I am simply a mother, who has extensively researched this, for the health and well being of myself, and my children.? I do not believe that women are fully being informed of their risks or even learning how serious this surgery truly is. It is the most popular surgery among women today, women electing to have cesarean?s with their first pregnancies, women electing to have major abdominal surgery for no medical reason in the thousands of elective repeat cesarean?s that are taking place today. Why? It completely boggles my mind. As a parent, I can simply not wrap my head around electing to put myself, and my baby at risk for no valid reason.

Below is another quote taken from the very well written and educational Mothering article.

Dangers for the Mother: Although cesarean section is safer than ever before, it is still major abdominal surgery with inherent risks. A woman who has one cesarean will always be at risk for a uterine rupture in a subsequent pregnancy, whether she labors for a VBAC or has an elective repeat cesarean delivery.With one prior uterine scar, the risk of a uterine rupture is 1 in 500, compared to 1 in 10,000 for a woman without a cesarean scar. Each additional cesarean increases that risk. Postoperative complications include risk of injury to other organs (2 percent), hemorrhage (1 to 6 percent of women will need a blood transfusion), blood clots in the legs (0.06 to 2 percent), pulmonary embolism (0.01 to 2 percent), infection (up to 50 times higher), and complications from anesthesia. A woman is four times as likely to have a placenta previa (low-lying placenta) in her next pregnancy, putting her at risk for miscarriage, bleeding during pregnancy and labor, placental abruption, and premature delivery. One birth by cesarean puts a mother at 10 times the risk for placenta accreta (placenta grows into or through the uterus), for which women often require a hysterectomy to stop the hemorrhaging. The incidence of placenta accreta has increased tenfold in the last 50 years.

A US study found that mothers are four times more likely to die from a cesarean unrelated to health problems, compared with women who have vaginal births.

These are not small risks, they are not minor complications, and some of the impacts on the infant can become lifelong issues especially with the increased risk for breathing problems in cesarean born infants.? These are not things I am making up, I simply am not sugar coating them like some women would prefer that people do. I knew going into the birth of my second child that having a VBAC was important, not only to me, but to my child, while that plan did not work out, he got several benefits of? attempting a VBAC.? One being, he came when he was ready. Had I scheduled a repeat cesarean, he may have been born prematurely given I had been given two different due dates. One sooner than the other.? The March of Dimes has also spoke out against elective cesareans before 39 weeks gestation because of the great risk for a baby that is simply not ready to join the world.

One thing that many women neglect to talk about is the emotional impact of a cesarean section on the mother. In the months after I had my first child via cesarean I heard a lot of ?Just be happy you have a healthy baby?? of course I am happy that I have a healthy baby, but that doesn?t change the fact that many women do feel negatively about their birth experience, and even in some cases they are traumatized.

No, this does not only happen in women who have had surgical deliveries, but it is so prominent in the cases of cesarean sections that there is an international organization that aids these women in their recovery, and offers them an amazing support system for their recovery, and future births. ICAN also known as The International Cesarean Awareness Network.? If there was no need for this group, it would not exist, nor would it have thousands of members internationally. But people do not want to really understand that there are negatives of the large number of cesarean sections taking place today.? Another great quote from the Mothering Article reads?.

Emotional Scars of Cesareans: Personal accounts from women who have had a cesarean, as well as emerging research, suggest that despite a healthy baby and a timely physical recovery, some women experience cesarean birth as a traumatic event. An unanticipated cesarean is more likely to increase the risk for postpartum depression and post-traumatic stress disorder (PTSD). As in other traumatic human experiences, the symptoms of birth-related PTSD may emerge weeks, months, or years after the event.9?11 Women re-experience the birth and the emotions associated with it in dreams or thought intrusions. They avoid places or people that remind them of the event. Some mothers have difficulty relating to their infants, and some will avoid sexual contact that may result in pregnancy. They will also exhibit symptoms of hyperarousal, such as difficulty sleeping or concentrating, irritability, and an excessive startle response. Untreated post-traumatic stress often leads to clinical depression.12

A traumatic birth of any kind can leave a woman feeling disempowered, violated, or betrayed. Unless she has had the opportunity to process the event, in her next pregnancy a woman who has no way of controlling what she perceives as events that are likely to reoccur will sometimes choose to repeat a cesarean with a known physician in a more controlled environment.

It is comforting today to see the emotional impacts of this surgery, and the experiences being addressed in such a large scale publication. In my time working with ICAN and running the chapter here in the state of Connecticut, I have been contacted by numbers of women who are in need of a shoulder to cry on, someone who understands when they say they hated their birth experience, someone to talk to about them not connecting with their newborn like they feel they should, someone to just listen. If you think that all these women are ok, you are wrong.

Sure there are thousands that just go on with their lives, and there are thousands who know their cesarean was medically necessary for one reason or another, like I experienced with my second cesarean, which I fully knew was necessary. But believe me, out of the circles of women you may know, there is at least one that is hurting from her experience, but is ashamed, scared, or intimidated to share how she really feels for the fear of the oh so common, ?Just be glad you have a healthy baby? because that is hurtful.

Until you have walked in someone elses shoes, you should always think twice about what you have to say about their personal experience. That goes especially to those who have never had children, or had a cesarean section.

Original post featured on Pregnancy, Parenting, and Playtime which I also write for.

NHS YouTube Video Campaign Teaches Teens that Birth is Humiliating

The Leicester NHS Trust posted an anti-teen pregnancy campaign video on YouTube aimed at teaching school-age girls and young women that sex (or unprotected sex) should be avoided because it can result in pregnancy, which will end with birth, which is excruciating, humiliating and shameful.

From The Sun on May 15, 2009:

The video appears to have been filmed with a mobile phone camera to give an air of authenticity and had more than 1,000 hits before it was removed.

At first it looks like another sad example of happy-slapping featuring a gang of secondary school pupils crowding round in a school playground.

Excited children are seen running towards a crowd with youngsters egging on what seems to be a fight.

A girl in the centre is seen screaming while another has blood on her cheeks.

But as the camera moves in closer one of the teenagers can be seen on the ground in the middle of labour.

In explicit detail it shows the girl giving birth and the baby being delivered by a fellow pupil as other students yell and jeer at her.

The footage was intended as a shock tactic to highlight rocketing teen pregnancies by harnessing the publicity power of the internet.

But Leicester NHS did not anticipate YouTube?s stringent content rules and today their clip was replaced after less than a day online with a message saying ?This video has been removed due to terms of use violation?.

Renee of Womanist Musings has the video linked in her post ?Naughty Girls Give Birth in Public in Great Britain.? Please visit her site to view the video which is no longer available on YouTube and read the rest of her sociological analysis of the video, some of which is excerpted below:

This little video teaches young girls that should they engage in sexual activity, the punishment for their behaviour is a painful labour. It is very reminiscent of the punishment assigned Eve for giving Adam the apple in the garden of Eden. The father is quite typically absent from this scenario mirroring the privileging of masculinity in our social discourse. It is women that are constructed as ?controlling? sex and therefore the abandonment of men of their parental obligations is rarely a subject that receives much discussion. Note that this ad is supposed to serve as a warning against teenage sex and yet it is aimed solely at girls as though she became pregnant by herself.

[?]

This advertisement teaches young girls that pregnancy is a punishment rather than a natural outcome of sex, this further supporting the idea that unless conception occurs inside the patriarchal family it is a sign of lasciviousness whereas; a man is not stigmatized for participating in pre marital sex. Though this ad is projected to teach kids to act responsibly when it comes to sex, it comes across as highly sexist in its determination to make women responsible and produce fear about a natural biological process.

From a birth activist perspective, this campaign?s premise is extremely troubling. Many women experience psychologically and emotionally traumatic births for reasons such as inadequate emotional support, a fearful birth space, a birth space full of strangers or care providers who resort to humiliation or bullying to gain compliance. In other words, the feelings that some women experience in a hospital would mimic the presumed feelings of this teenager giving birth while taunted by schoolmates.

The goal of this video was clearly to show birth as a humiliating, painful and scary consequence to bad behavior, which is one of the reasons that Catherine Skol is suing obstetrician Scott Pierce. Pierce allegedly told a nurse that Skol deserved to feel pain for not calling before coming to the hospital and that sometimes ?pain is the best teacher.?

So where will teenagers see positive birth videos? Unfortunately, they will not see them on YouTube, which routinely censors or removes birth videos or requires that viewers be 18 years of age. One of the many negative consequences of moving birth from a home model to an industrialized hospital model in the last 70 years is that birth is that the birth process has become unfamiliar to most people. This goes for all mammalian births?how many of our parents or grandparents moved away from rural areas where they regularly saw animals give birth?

Internet birth activism and flooding social media outlets with positive and realistic images of normal birth have never been more relevant or necessary.