Journey to Breech VBA2C

Here is one of our ICAN mama's journeys to having a breech VBAC after two cesareans:

Photo and video editing at www.OneTrueMedia.com

ICAN’s Response to ACOG AND AABC Statements on VBAC and Homebirth

Redondo Beach, CA, February 7, 2008: The International Cesarean Awareness Network (www.ican-online.org) would like to publicly condemn both the AABC (American Association of Birth Centers) and the ACOG (The American College of Obstetricians and Gynecologists) for their statements* this week that limit not only women’s choices in birth but imply that birth is a fashion trend rather than a safety concern.

Since VBAC is the biological normal outcome of a pregnancy after cesarean, ICAN encourages women to get all of the facts about vaginal birth and elective repeat cesarean before making a choice. This decision should not include weighing the choices of your doctor’s malpractice payments but only be a concern of the mother, her baby and their health and safety.

Since some mothers will make the choice to give birth outside of the hospital, we encourage the AABC to not cave into ACOG’s demands that all women give birth in a hospital facility with a surgical specialist, but instead allow women to make their own choices about care providers, birth settings and risk factors. ICAN respects the intelligence of modern women and accepts that the amount of information available about VBAC and elective cesarean should serve as informed consent.



ICAN further encourages the governments of individual states to look closely at their cesarean rates (31.1% national cesarean rate as of 2006) and the informed consent laws that apply and help women to reach a standard of care that lowers the risks of major surgery and the risks of elective or coerced cesarean without medical indication. Women and children should not bear the brunt of malpractice risks being conveyed into physical, mental, emotional and spiritual health risks in order to protect their physicians.

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. There are more than 94 ICAN Chapters across North America, which hold educational and support meetings for people interested in cesarean prevention and recovery.
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* AABC statement: http://www.birthcenters.org/files/file.php?id=2&file=file&file_type=file_type

ACOG statement: http://www.acog.org/from_home/publications/press_releases/nr02-06-08-2.cfm

ICAN of Buffalo in Tonawanda News

A story about ICAN of Buffalo! Click here.

Most of my friends and family assume that, since I had a C-section when Cameran was born, I already have a repeat Cesarean scheduled for Little Wahler No. 2’s impending birth.

Sure, it seems convenient. Go in at 7 a.m., start the meds, have the operation, and be back in the mother-baby unit before “The Today Show” is over. I could pick the day even: Do I want a St. Patrick’s Day baby? A first-day-of-Spring baby? Don’t pick March 15 — you know, the whole “Ides of March” thing can’t bode well for babies born on that day.

Am I crazy for thinking that takes the fun out of the whole experience?

History of Midwives

The fear of copyright infringement precludes me from publishing this article in it's entirity. If you choose to follow just one link from this blog ever, this is a really good one to choose. Some highlights:

History of midwives
ST. LOUIS POST-DISPATCH
01/19/2008

In the 1930s, maternal mortality rates began to decline in hospitals in the U.S. thanks to the use of more sterile surgical conditions and techniques. Medical advances in antibiotics and blood transfusions accelerated declines. Around this time, medical doctors began campaigning against midwives in the media, courts and legislature. They cited poor outcomes, though some research suggests they were ridding their competition.

Technologically intensive childbirth, however, has become the norm. The rate of labor induction has doubled since 1990, which studies show increases the chances of having a Cesarean section. The C-section rate has jumped within the past 10 years to over 30 percent, the highest ever. The major abdominal surgery involves risk to the mother and also increases risk of complications in subsequent pregnancies.

A comprehensive survey of women’s childbearing experiences released last year shows most mothers experienced each of the following during labor and delivery — continuous electronic fetal monitoring, one or more vaginal exams, intravenous fluids, epidural or spinal analgesia and a catheter. Most had little understanding of the side effects of these interventions. The survey also showed that many received interventions, such as episiotomies, without their consent.

National health statistics show that while over 4 million women give birth a year, obstetric procedures number nearly 7 million.

Today, more than 7,000 nurse midwives practice in all 50 states and attend almost 10 percent of all births, mostly in hospitals.

But natural birth advocates decry the loss of non-nurse midwives. As a result, they say women have lost the knowledge and confidence in giving birth. Advocates are pushing for the legalization of non-nurse midwives with specific training in home births. These "direct-entry" midwives learn midwifery through apprenticeship or a midwifery school that is distinct from nursing.

C-Section Concerns in the Big Apple

Rise in C-Sections Is Stirring Worry
By E.B. SOLOMONT
New York Sun

"There is alarming concern throughout the country that there are too many cesarean sections," said Public Advocate Betsy Gotbaum, who in 2006 released a report based on 2005 data detailing individual hospitals' cesarean section rates. "It's additional cost and it's additional risk," Ms. Gotbaum said, adding, "I hate to impart motives on hospitals and doctors … I can just tell you the numbers speak for themselves."

The Business of Being Born

Ricki Lake talks about why she produced The Business of Being Born on the Today Show

Study Shows Increase In Pregnancy-Related Deaths, Are Cesarean Sections To Blame?

NBC in Augusta, GA reports:

Dr. Helfgott blames the increase [of cesareans] on a new breed of mothers, he's coined it the 'now generation.'

"They want what they want when they want it. They want to be able to plan their delivery. They want to have the baby on a day that's convenient for them," said Dr. Helfgott.

Is that 'now' mentality leading to more deaths? Figures released by the National Center for Health Statistics show an increase in pregnancy related deaths. There were 13 deaths per 100,000 in 2003 and 14 deaths per 100,000 in 2004.

But, is it ethical for doctors to allow elective "on demand" cesareans if there are no medical indications? Are doctors really informing their patients of the potential, lifethreatening risks?

"DIY" Deliveries

ABC News reports on Unattended childbirth, also known as "Do it Yourself" delivery. Click here.

Support Waterbirth International!

An email from Barbara Harper:

I cannot yet imagine a world without the voice and work of Waterbirth International - we get calls and emails every day from women who need help convincing one hospital or another to let them labor or birth in water. If we die - a big part of the movement dies. Waterbirth has shown us all that women know how to give birth and babies know how to be born. Waterbirth gave us "hands-off", sit back and let the baby out. I see waterbirth mentioned on Blogs every single day, not to mention Baby Story on the TV. I took Waterbirth International to ACOG two years in a row - and was the ONLY booth showing birth films to obstetricians and especially to student physicians. There were tears, laughter and outrage - just the thing to stir up those young crop of doctors. I am finally realizing a life's dream.

But now I am faced with letting this dream go. Perhaps I have done enough. Perhaps it is time to quit.

About 18 years ago, maybe it was longer, when Mothering Magazine was facing bankruptcy Peggy did a heartfelt plea asking their readers to consider ordering a Life-time subscription. I think the subscriptions were $1000 or $1200, I can't remember now. I do remember that I couldn't imagine not reading my Mothering. So, I bought two and gave one to my obstetrician's office.

How can you help us stay open to take the next phone call? - to convince the next obstetrician to incorporate waterbirth into his/her practice - to work with the nurse midwives to install pools in their facilities? To educate an entire hospital on the benefits of allowing women freedom of movement in the water. How much is it worth to see waterbirth become the norm in the US, like it is in the UK? I think we only need a few more years to make that happen. Do women really want waterbirth to be an available choice in every hospital? I think so.

Can you help us by getting the word out on blogs and lists? I had to let go of all of the staff except one person to process orders. Miraculously, we made payroll today, but we can't hang on much longer. We need a miracle.

If I need to call every single waterbirth parent personally, I will. I don't want 25 years of work to end over a measly $200,000.

The work that we have done the last few years has been phenomenal. How God arranged for me to teach in hospitals and medical schools around the planet - Taiwan, Venezuela, Turkey, Mexico, Canada, Holland, Portugal, China, Trinidad, Croatia - I'll never figure that out. I laugh out loud sometimes when I get up in front of an audience of physicians in a medical school overseas - who all want to hear about waterbirth and the incorporation of Gentle Birth practices and principles into their routines.

Think about what you can do and call me if you want to chat or if you have some great ideas on how we can quickly move into the black and keep waterbirth alive and thriving.

We need your help. Barbara Harper needs your help. The waterbirth/gentle birth movement needs your help.

Blessings,
Barbara
Barbara Harper, RN, CLD, CCE
Founder/Director
Waterbirth International
www.waterbirth.org
503-673-0026 -office (out of US or in Portland)
800-641-2229 - toll free
503-710-7975 - cell phone

We LOVE helping women get into Hot Water!!
And have been doing it for 24 years!!

Answers prove elusive as C-section rate rises

USA Today writer Rita Rubin writes about elective cesareans here.

Some leading obstetrician/gynecologists believe only a trial in which women are randomly assigned to deliver their first babies by planned C-section or planned vaginal delivery can determine whether either is safer.

Other doctors, as well as activists, question the need for and the feasibility of such a trial. They cite several recent studies that examined rates of pregnancy-related deaths and illness in women who opted for a vaginal delivery compared with those who scheduled a C-section. Mothers who delivered vaginally generally fared better, although complications were rare even among C-section mothers.

Whether first-time mothers increasingly are requesting C-sections when they don't need them isn't clear. Eugene Declercq, professor of maternal and child health at Boston University, says he suspects more doctors are recommending them, and their patients are reluctant to disagree. For example, Declercq says, a doctor might say, "The baby is looking kind of big. We could do a cesarean."

OB/GYN Peter Bernstein of Montefiore Medical Center in New York says some doctors encourage patients to schedule C-sections because they think they're less likely to be sued than if they perform a vaginal delivery. And "women are more ambivalent about what they want."

Ok women, the health of you and your babies is at stake! Are we really "ambivalent"?

Did you really need that cesarean?

From the Syracuse Post Standard - Click here

The American College of Obstetricians and Gynecologists says many women who have had a Caesarean can later safely give birth naturally. But local doctors say the professional group made it impossible for many women to do that when it issued guidelines in 2004 imposing extra staffing requirements on hospitals that offer vaginal birth after a Caesarean. Those guidelines say hospitals must have an anesthesiologist and a doctor capable of performing an emergency Caesarean on the unit while the woman is in labor. .

My favorite quote:

Some women want Caesareans so they can schedule their deliveries at a convenient time, said Dr. Robert Neulander, a Fayetteville obstetrician-gynecologist who's been delivering babies for 24 years. He refuses to do elective Caesareans.

Go Dr. Neulander! Some might find this an affront to women's choices for childbirth... but there is also something to be said about the question of ethics behind performing major surgery without cause that can impact the mother and baby adversely. Good for him in going against the trend!

With Love, Jennifer Block

Author Jennifer Block writes an open letter to Christina Aguilera regarding her upcoming scheduled cesarean. Here is the whole letter.

You are lucky, Christina. You can get whatever kind of care you want, from an elective "C" to a midwife-attended home water-birth. For most women it's not that easy. Did you know that hundreds of hospitals have banned vaginal birth after cesarean? That's right -- while you can freely book unnecessary surgery, there are thousands of women who are being told it is their only option. And home birth? It's a great choice for healthy women with straightforward pregnancies -- in England the government is encouraging such women to give birth at home (like Charlotte Church!) -- but many insurer's won't cover it, and in some states home-birth midwives are illegal, and women who want that choice have to go underground. Can you imagine having to hire black-market surgeon?

Read Jennifer Block's blog at http://pushedbirth.com/

Award For N.J. Hospital Draws Anger

Click on story link here.

Johnson and Johnson awarded Underwood Hospital in New Jersey for their excellence in maternity care. Underwood is where Valerie Scythes (35) and Melissa Farah (28), who were coworkers and friends, died due to complications related to cesareans just two weeks apart from one another. Shame on Johnson and Johnson for not doing their research...