Cesarean Education & Support for Buffalo, NY

Time Warp

2009-11-04T04:41:00.000-08:00

Tomorrow is my youngest daughter's fourth birthday. My VBAC baby :)

I have been thinking a lot about her birth. It's hard to think about her birth without thinking about my oldest daughter's birth. The emotions are not as raw anymore, but they are still there. Word for word, I would likely describe the experience the same way:

WEDNESDAY, DECEMBER 08, 2004

Beginning the Journey
I was an innocent woman who was pregnant. I didn't expect to be cut open and gutted like a fish to get my daughter out of my body. I trusted my doctor, that he would do everything in my best interests and it never once occurred to me that he might act in his own best interests first. Silly, naive me. As I laid on the table with my organs visible to the world, I knew I didn't like it. I didn't know how deeply my daughter's birth would effect me though. It never occurred to me that a cesarean section might carry more emotional scars with it than physical ones. I didn't know it could hurt so much. It is now just over 19 months since that OB wielded his knife and took my child out of my body. My Beloved and I have decided that this is the time to think about adding one more branch to our family tree. My LMP just ended this week, so it's possible that sometime within the next few weeks, I could be carrying a brand new little life again. Such an exciting possibility! I loved being pregnant with BabyGirl. It was a time filled with joy, anticipation, delight... it was amazing and beautiful. Unfortunately, I fear this next time of being pregnant, should we be so blessed, will be riddled with the fears, the stigmas, the labels of being "a VBAC" woman. [VBAC = vaginal birth after cesarean] I resent needing the label. As though the scar on my belly is not enough.

In the end, I got my VBAC, and it was good. Not great, but good. I still have lingering questions, and am only now beginning to process some of my feelings from that time - feelings that had no space to breathe under the emotions of my first daughter was born. There is some guilt there, but it is what it is, and if it could be any other way, it would be.

Her VBAC was the second-hardest thing for me to do, ever, still. The first hardest was to survive my first daughter's birth. I had to have that experience to get here in life, and I'm grateful for that gift even though I'd never want to open a present like that again.

Happy birthday, baby bug. I can't believe you're four already. Thank you for working as hard as you did so we could both have what we needed. Nobody could love you more than I do.

The Witch Hunt for Cara Muhlhahn

2009-10-24T09:04:00.000-07:00

Remember Cara Mulhahn, the midwife prominently featured in The Business of Being Born?

Recently, a family was shown on the Today Show in a segment titled “The Perils of Home Birth” where they spoke of how they hired her, and she labored a long time, and then her baby was born still. That family is now suing.

You bet your bippy that the media is having a field day with this. Take a look at Celebrity Midwife Cara Muhlhahn Sued for Negligence Resulting in Stillbirth
Other articles are out there too, if you google her name.

Perhaps she made a mistake. I understand she let the mother labor for days before going to the hospital – although I know many women who have labored for days and done just fine (I am one of those women.) But maybe she missed something. Or, maybe it just happened – as these things often do. If it happened in the hospital, we wouldn’t even hear about it. We would assume that everything possible was done and that it was meant to be.

Something’s got to give. Every time one side pushes, the other side pushes back. Those of us who are in favor of midwifery care and ensuring that women have access to the safest care in the style of their choosing cannot back down – we need to get stronger until our voices are heard. We can’t let all midwives get lynched for something that may have simply be an act of God.

Would I have wanted to know?

2009-10-23T21:19:00.001-07:00

I've decided to get personal today.

At this time seven years ago, I was about four months pregnant with my first daughter. My OB/GYN was a charming man whom I had chosen on the recommendation of a trusted friend because my husband and I thought we might struggle with fertility, and heard he was very aggressive in helping couples conceive. I had waited all my life to be a mother and wasn't taking any chances or wasting any time. If there was going to be a problem, I wanted it addressed and dealt with as quickly as possible.

Turned out, fertility was not a problem. Seemed like we only had to think it was a good idea, and it happened. We were elated. At the time, I had one friend who was pregnant four months ahead of me, one who was two months ahead of me, and one who would be pregnant soon after. All but one of us were first-timers. We shared stories, looked to each other for advice, complained, laughed... I remember that time fondly.

As each of us had our babies, there were certain presumptions. We presumed that if we didn't have our baby by a certain date, we would be induced. In fact, we presumed we would have some kind of intervention - whether it was induction, or pain meds, or having our water broken, or a cesarean . Most of us took "the class" at the hospital which gave a pretty thorough rundown about procedures and protocols, and read books like What to Expect While You're Expecting, which told us what to expect but gave us no indication of what to question. We planned to breastfeed. We talked about our birth plans. We oohed and ahh'd over each other's baby registries. We anticipated.

The first mom went in for her induction. She was given a sleep aid with the expectation that things would take a while. They didn't. Within a short amount of time, her labor was strong and she had an epidural. Soon after, all the while fighting off the sleep medication, she managed to push her baby out with some help and a lot of tearing. Breastfeeding was written off almost immediately because it wasn't working. It was a horrible experience for her, but nothing seemed odd about it to me. It's just how it was.

The second mom was having her second baby. She planned a cesarean since she had some kind of "failure" the first time. Her doctors were very supportive of this idea and I don't know if she ever gave much consideration to having a VBAC. When her son was born, she said, "My doctor said my uterus was so thin she was glad I didn't try for a VBAC because she was sure I would have ruptured." I was relieved for her.

Then came me. I had some amount of hope that things would be natural, but little expectation. I saw my friends, and others, before me. Nobody was doing it natural. It was a "nice idea" but I knew not to count on it, so I hoped for the best and tried to prepare for the worst and figured like everyone else, I'd land in the middle somewhere.

So, when I had a cesarean, it wasn't exactly a shock. I knew the odds... I didn't think I would be that woman, but I knew it could happen. Still, the whole thing was so surreal. What I did not expect was how I felt afterward. I hated myself for how it had happened. I didn't think I deserved her. I thought I was being irrational and stupid, which only led to me being harder on myself. So, down I spiraled.

Somewhere in there, a lightbulb switched on and I realized I had to get myself out of there. I started searching. I found ICAN, and other resources. One brazen night I just put my story out there, expecting people to tell me I was being dumb but having no other option; and they responded in droves, telling me they understood and explaining things to me like nobody ever had before.

That's when I started reading. I learned there were other books. I learned there were other websites. I learned many factors that had likely contributed to having a cesarean, and it made me mad. I felt used and betrayed by my OB and the system. I blamed myself.

But you can only know what you can see.

I remember knowing about midwives, but I made an assumption that they did not exist around here. But if I'd known, would it have made a difference? I didn't know anyone who used a midwife. I didn't really understand midwives. I might have listened to a woman who told me about what it meant with a "that's great for you, but I really do love my OB" kind of way. I might have secretly judged her for being too earthy. I never would have believed my OB would harm me, intentionally or otherwise.

I would have said a doula was too expensive. Even now, I probably wouldn't use one - though I promote the idea to other women - mostly because I would rather hide from people than have that.

I knew that the increase in cesareans was of concern, and that my own OB, by his admission, had a higher rate of c-sections than others in the area. I knew this, but I was sure I would not be a statistic. The rules of the rest of the world did not apply to me.

I would have like to know though, that I could change OB's, that someone out there would have taken me at 37 weeks when mine turned on me. I'm not sure that I would have though. You know how it is, you spend your time getting to know and trust someone, and when there seems to be more good than bad, you want to give it a fair chance. You blame your "erratic pregnancy hormones". You doubt your instincts.

If I had known then what I know now, I wouldn't be who I am - a woman who is much stronger, and a better mother for it. I know now that I would not have listened - I would have just stayed in my comfortable, ignorant bliss. What I wanted then, and what I got, was to follow the road more traveled, because it seemed to be the obvious choice. In the end though, I got burned, but I survived.

TIME is On Our Side

2009-02-26T17:02:00.000-08:00

Check out the article in Time Magazine!
... and be sure to read the "story behind the story" at The Huffington Post

Does this effect women in WNY? Yes it does!

According to the New York State Department of Health, as well as a survey taken by ICAN volunteers says that women in Niagara and OrleansCounties show that three out of the four hospitals with maternity units do NOT offer VBAC as an option for their mothers. These three hospitals are Niagara Falls Memorial, Medina Memorial and Inter-Community Hospital in Newfane. One other hospital, Mount St. Mary's in Lewiston does claim to offer VBAC as an option, but only 3.4% of women who've had a previous c-section are having them there. These hospitals only handled a total of 1,000 births in 2007, but of that, but it means around 160 women may have been sectioned unnecessarily, subjecting them to unnecessary risk.

What about the women of Erie County? While there are no bans at Women and Children's hospital, Millard Fillmore Suburban, Sisters or Mercy hospital, the rates of women who are having VBACs is on the decline from an overall percentage of 12% in 2006 to 9% in 2007. The most disturbing is Mercy, who is according to the DOH site has a 5.6% VBAC rate, but none of our hospitals are performing up to par.

Cesarean rates at all of these hospitals are high, though this year some have shown minor declines. Overall in Erie county, about 34% percent of women will have the surgery that Consumer Reports has listed as one of the top surgeries you're better off without, and this is up from 33.4% from 2006.

Is this because women are asking for cesareans? Or, could it be that women aren't being well-informed of their choices? Women don't want to talk about the risks because it is too "scary", but we need to start facing what the real possibilities are before making such important decisions.

Journey to Breech VBA2C

2008-08-06T19:00:00.000-07:00

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

2008-02-26T14:30:00.000-08:00

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.
________________________________________________________

* 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

2008-01-22T08:06:00.000-08:00

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

2008-01-20T14:59:00.000-08:00

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

2008-01-16T11:59:00.000-08:00

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

2008-01-10T08:45:00.000-08:00

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?

2008-01-10T08:38:00.000-08:00

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

2008-01-08T16:52:00.000-08:00

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

Support Waterbirth International!

2008-01-08T14:09:00.000-08:00

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

2008-01-07T20:03:00.000-08:00

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?

2008-01-07T19:53:00.000-08:00

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

2008-01-07T05:20:00.000-08:00

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

2008-01-03T11:30:00.000-08:00

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...

What Women Aren't Told About Childbirth

2007-12-27T17:55:00.000-08:00

By Manda Aufochs Gillespie and Mariya Strauss, AlterNet. Posted October 20, 2007.
http://www.alternet.org/healthwellness/65608/?page=entire

A new survey of mothers reveals some disturbing things about hospital maternity care that may make pregnant women want to take a closer look at their options.

The survey Listening to Mothers II (LM 2) was released in 2006 and reports on U.S. women's childbearing experiences. Conducted for Childbirth Connection by Harris Interactive in partnership with Lamaze International and Boston University School of Public Health, it is the first comprehensive survey of women's childbearing experiences. The survey population is representative of U.S. mothers 18 to 45 who gave birth to a single infant in a hospital, with 1,573 actual participants.

"The predominant picture that emerges from our data," the report states, "is of large segments of this population experiencing clearly inappropriate care."

The majority of women ended up attached to IVs, catheters and fetal monitors. They had their membranes artificially ruptured and were given epidurals. Most of these women had little understanding of the side effects of these interventions, including cesarean and medical inductions. The report also shows that though women understood that they had the right to refuse medical interventions, few did, and many received interventions, such as episiotomies, without their consent.

Just as troubling is what is not being done. A "very tiny minority" of women received all of the care practices that promote natural birth. "With 4 million U.S. births annually, a single percentage point represents about 40,000 mothers and babies per year," the report authors say. Despite the relative health of women in the United States, many women are not getting the uncomplicated births they might expect.

Does how we birth matter?

2007-12-22T20:26:00.000-08:00

[Can you tell I've just discovered that I can add Youtube clips to blogspot?]

This is so important. From her link, she states:

Last year, over 1 in 3 babies were born surgically. Why should we care? Because it isn't just another way to have a baby, no matter what the reason. Yes, women smile. But look again, at their eyes. And then understand what sacrifice we make, and what we lose.

Michigan: Another cesarean tragedy

2007-12-22T15:58:00.000-08:00

http://www.woodtv.com/Global/story.asp?S=7530396&nav=0RceHnLU

KALAMAZOO -- The exact cause of why Tina Hagenbuch died while delivering triplets has not yet been determined.

But the past president of an organization called The Greater Kalamazoo Mothers of Multiples told 24 Hour News 8 Tina Hagenbuch died of a heart attack after embryonic fluid entered the blood stream during a C-section.

Hypnobaby VBAC

2007-12-22T15:33:00.000-08:00

A VBAC Mama uses Hypnobabies and has a very pleasant, peaceful birth

Questioning CPD

2007-12-22T15:05:00.000-08:00

By the amazing women of ICAN :)

Improve childbirth outcomes...

2007-12-12T10:45:00.000-08:00

Women Can Improve Childbirth Outcomes By Seeking Care Providers With Low Cesarean Section Rates
http://www.medicalnewstoday.com/articles/90863.php

Caesareans 'may harm lung growth'

2007-12-12T10:18:00.000-08:00

Caesareans 'may harm lung growth'
http://news.bbc.co.uk/2/hi/health/7137945.stm

Labour may help mature the lungs

Babies born by elective Caesarean section are much more likely to develop breathing problems, a Danish study examining 34,000 deliveries suggests.
Researchers found they were up to four times more likely to have respiratory problems than those born naturally, or by emergency Caesarean section.
The babies may miss out on hormonal and physiological changes during labour which help mature the lungs, they say.
The University of Aarhus study features in the British Medical Journal.

ICAN Responds to CDC Release of Birth Data

2007-12-08T17:57:00.000-08:00

[b]Cesarean Rate Hits a New High
Recent Studies Show Cesareans Can Pose Dangers to Mothers and Babies[/b]
Release Highlights:

[i]Cesarean rate at record high in the U.S.
Cesarean rise coincides with CDC report that maternal death rate rising for the first time in decades.
World Health Organization data shows that mothers die at a higher rate in the U.S. than 40 other countries.
Consumer Reports includes cesarean on “10 overused tests and treatments” [/i]
[u][b]Redondo Beach, CA, December 5, 2007 [/b][/u]– The National Center for Health Statistics has reported that the cesarean rate has hit an all-time high of 31.1 percent.

CDC's Preliminary Data for 2006

“There’s no doubt that cesarean surgery is being overused,” said Pam Udy, president of the International Cesarean Awareness Network. “Unfortunately, despite its reputation as a harmless surgery, many women and babies are paying the high price of complications from this surgery.”

For the second year in a row, ICAN has compiled a list of research from the past year that shows cesarean surgery should be used more judiciously and that VBAC should be used more routinely. (See attached) Currently, more than 300 hospitals across the U.S. ban women from having a VBAC, essentially coercing them into unnecessary surgery and feeding the growing rate of cesarean.

The risks of cesarean were tragically highlighted this year by a rash of deaths related to the surgery, including two schoolteachers and friends from New Jersey, Valerie Scythes and Melissa Farah, who died within two weeks of each other in the spring. Both left behind healthy baby girls.

In August, the Centers for Disease Control released a report showing that, for the first time in decades, the number of women dying in childbirth has increased. http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_19.pdf Experts note that the increase may be due to better reporting of deaths but that it coincides with dramatically increased use of cesarean. The latest national data on infant mortality rates in the United States also show an increase in 2005 and no improvement since 2000. http://www.cdc.gov/nchs/products/pubs/pubd/hestats/prelimdeaths05/prelimdeaths05.htm

“At a time when maternal and infant mortality rates are decreasing throughout the industrialized world, the United States is in the unique position of having both a rapidly increasing cesarean rate and no improvement in these basic measures of maternal and infant health.” says Eugene Declercq, Ph.D., Professor of Maternal and Child Health at Boston University School of Public Health.

Another report released in October by the World Health Organization, the United Nations Population Fund, the U.N. Children's Fund, the U.N. Population Division and The World Bank, and published in the Lancet shows that the U.S. has a higher maternal death rate than 40 other countries. http://www.thelancet.com/journals/lancet/article/PIIS0140673607615724/fulltext “Women in the U.S. think they’re getting top notch care, but our death rate for mothers shows otherwise,” says Udy. The U.S.’s maternal death rate tied with that of Belarus, and narrowly beat out Bosnia and Herzogovena.

ICAN’s collection of research highlights from 2007 demonstrates the inherent risks of cesarean including a higher risk of dying in childbirth, a higher chance of suffering from potentially fatal placental problems in subsequent pregnancies, and babies having a higher chance of dying in the first year. Research from 2007 also shows that VBAC continues to be a reasonably safe birthing choice for mothers.

“The research continues to reinforce that cesareans should only be used when there is a true threat to the mother or baby,” said Udy. “Casual use of surgery on otherwise healthy women and babies can mean short-term and long-term problems.”

For women who encounter VBAC bans, ICAN has developed a guide to help them understand their rights as patients. The resource discusses the principles of informed consent and the right of every patient to refuse an unwanted medical procedure. The guide can be found at http://www.ican-online.net/resources/white_papers/wp_vbacbanqa.pdf.

Women who are seeking information about how to avoid a cesarean, have a VBAC, or are recovering from a cesarean can visit http://www.ican-online.org for more information. In addition to more than 90 local chapters nationwide, the group hosts an active on-line discussion group that serves as a resource for mothers.

About Cesareans: ICAN recognizes that when a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death. http://www.ican-online.org/resources/white_papers/index.html

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 94 ICAN Chapters across North America, which hold educational and support meetings for people interested in cesarean prevention and recovery.

For more infomation, visit www.ican-online.org or contact your local chapter leader (that's me!) at icanofbuffalo@aol.com.

Cesareans: Twice the Risk

2007-11-07T11:16:00.000-08:00

Excerpt from:
http://www.nlm.nih.gov/medlineplus/news/fullstory_56908.html
Reuters Health

Wednesday, October 31, 2007

NEW YORK (Reuters Health) - Compared with vaginal deliveries, cesarean deliveries have twice the risk of complications and deaths of both infants and mothers when the fetus is in the normal, head-down position, according to findings from a study conducted in Latin America.

However, if the fetus is turned around - in the breech position - the benefits of cesarean delivery outweigh the risks, Dr. Jose Villar, at the University of Oxford in the UK, and associates report in BMJ Online First.

[For what it's worth, and without having taken a look at this study yet but having read another study regarding the safety of breech births, I wonder how many of the deliveries had care providers who were trained in breech births? There is a technique to this, but many OBs are no longer trained in how to handle this, which may segregate the "safe" breech births from the "risky" ones...]

The rising rates of cesarean deliveries in recent years are not explained by any clear benefits to the baby or mother, the authors note. "There is therefore an urgent need to provide women and care providers with information on the potential individual risks and benefits associated with cesarean delivery."

SOURCE: BMJ Online First, October 31, 2007.

Reuters Health

Episiotomy: one of Five Operations You Don't Want to Get

2007-08-06T08:59:00.000-07:00

Five Operations You Don't Want to Get
What to Do Instead
http://body.aol.com/news/articles/_a/five-operations-you-dont-want-to-get/20070730110909990002
By CURT PESMEN, HEALTH MAGAZINE, CNN

(Excerpted Article. Other operations listed in this were hysterectomy, angioplasty, heartburn surgery and lower back surgery.)

Episiotomy
It can sound so simple and efficient when an OB-GYN lays out all the reasons why she performs episiotomy before delivery. After all, it's logical that cutting or extending the vaginal opening along the perineum (between the vagina and anus) would reduce the risk of pelvic-tissue tears and ease childbirth. But studies show that severing muscles in and around the lower vaginal wall (it's more than just skin) causes as many or more problems than it prevents. Pain, irritation, muscle tears, and incontinence are all common aftereffects of episiotomy.

Last year the American College of Obstetricians and Gynecologists released new guidelines that said that episiotomy should no longer be performed routinely -- and the numbers have dropped. Many doctors now reserve episiotomy for cases when the baby is in distress. But the rates (about 25 percent in the United States) are still much too high, experts say, and some worry that it's because women aren't aware that they can decline the surgery.

"We asked women who'd delivered vaginally with episiotomy in 2005 whether they had a choice," says Eugene Declercq, Ph.D., main author of the leading national survey of childbirth in America, "Listening to Mothers II," and professor of maternal and child health at the Boston University School of Public Health. "We found that only 18 percent said they had a choice, while 73 percent said they didn't." In other words, about three of four women in childbirth were not asked about the surgery they would soon face in an urgent situation. "Women often were told, 'I can get the baby out quicker,'" Declercq says, as opposed to doctors actually asking them, 'Would you like an episiotomy?'"

What to Do Instead

Communicate. The time to prevent an unnecessary episiotomy is well before labor, experts agree. When choosing an OB-GYN practice, ask for its rate of episiotomy. And when you get pregnant, have your preference to avoid the surgery written on your chart.

Get Ready With Kegels. Working with a nurse or midwife may reduce the chance of such surgery, experts say; she can teach Kegel exercises for stronger vaginal muscles, or perform perineal and pelvic-floor massage before and during labor. Health.com: Me and my Kegels

U.S. study to track Caesareans

2007-07-11T10:08:00.000-07:00

http://www.ohio.com/mld/beaconjournal/17457507.htm

Area hospitals to share data as doctors aim to improve care, re-establish protocols
By Tracy Wheeler
Beacon Journal medical writer

Optional Caesareans Carry Higher Risks, Study Finds

2007-03-28T11:57:00.000-07:00

http://www.bcbs.com/news/national/optional-caesareans-carry-higher-risks-study-finds.html

Caesarean sections performed without a medical reason result in longer hospital stays, higher costs and more than twice as many rehospitalizations as vaginal deliveries, a new study reports.

Kate Winslet Speaks of Cesarean Experience

2007-03-16T17:23:00.000-07:00

From http://www.guardian.co.uk/health/story/0,3605,1175608,00.html

'I was so completely traumatised by the fact that I hadn't given birth'

Kate Winslet has admitted that having her first child by caesarean made her feel a failure. Lucy Atkins knows exactly what she means

Tuesday March 23, 2004
The Guardian

Rehospitalization a Risk After Planned Cesarean

2007-03-12T22:15:00.000-07:00

Dr. Marsden Wagner Speaks on "Born in the USA"

2007-03-12T22:04:00.000-07:00

Dr. Wagner is one of the featured guest speakers at the ICAN Conference!

___________________________________________________
Born in the U.S.A.

GELLERMAN: For most of his career Dr. Marsden Wagner was your typical
American OB/GYN. A baby doctor; delivering his share of the four
million babies that are born each year in the United States.

Ninety-nine percent of those births take place in hospitals. That's
the way it should be, thought Dr. Wagner until he became the Director
of Women and Children's Health at the World Health Organization and
began to travel to places where midwives do the job.

What he saw changed his life.

Oregon moms feel the push for natural birth

2007-02-12T10:48:00.000-08:00

http://www.oregonlive.com/metro/oregonian/index.ssf?/base/news/1171081569261300.xml&coll=7

Today in the Oregonian -- Oregon moms feel the push for natural birth

Some say the pressure's such that women who opt for painkillers are made to feel like failures

Sunday, February 11, 2007

GABRIELLE GLASER

People in the Northwest pride themselves on braving the elements, from mountain climbing to whitewater rafting. But in homes, birthing centers and hospital maternity wards, a more private challenge has emerged among Oregon women, who brave the pain of natural childbirth at a rate double the national average.

Many pregnant women and new mothers say they feel implicit and explicit pressure to join the trend. Those who opt for painkillers or undergo a Caesarean section say they get sympathetic looks and encouragement to "try harder next time." For some, this intimate event has developed a competitive edge.

Gabrielle Glaser: 503-221-8271; gabrielleglaser@news.oregonian.com

Healthy Babies! Healthy Moms!

2007-01-22T13:34:00.000-08:00

As seen in Having a Baby Today and New Health Digest

Healthy Babies! Healthy Moms!
(8 ways to help you be healthy and low risk during pregnancy, labor, and birth)
By Amy V. Haas, BA, BCCE

Pregnancy can be a wonderful and exciting time of life for most women. However, women in the United States receive very little information about how to stay healthy during pregnancy unless they do a lot of individual research. In fact most women don’t realize there is anything they can do to positively impact their health during pregnancy or prevent a high-risk status, with the exception of prenatal care. While proper prenatal care is important, it is not magic. Obstetricians have time constraints, and receive little or no training in nutrition, exercise, or preventative medicine. Even women who join childbirth classes may receive limited information. Below are 8 ways to help educate you in how to stay healthy and low risk during pregnancy, labor, and birth.

1) Nutrition – If you only did one thing to help yourself stay healthy during pregnancy, good nutrition would be it! It is the single most important factor in having a healthy baby and a healthy mom. Eating well in pregnancy means following the Brewer diet, which consists of 75 – 100 grams of good quality protein per day, from varied sources. Great high protein food sources include: meats, soy products, eggs, dairy, nuts, beans, and seeds. You should also be eating 5 servings of high complex carbohydrates to ensure adequate calories for energy, and an additional source of protein. In fact 1/3rd of you protein should be coming from whole grains. This would include whole grains that are not milled or processed, and will retain the most nutrients, protein, and fiber. Eating dairy, soy, nuts, and bean products, and broccoli will assist in getting enough calcium. Additional healthy foods to include would be whole, fresh fruits, and vegetables, and don’t forget to drink to thirst and salt to taste! But try to avoid desserts and junk food. Organic food sources are highly recommended when available. Think Color and Variety! This will help you obtain all the nutrients your body needs to build a healthy baby. Eating right during pregnancy can help to prevent premature labor and birth, toxemia, placental abruption, gestational diabetes, problems with breast feeding and healing, and many other serious health problems that would place a mom in the high-risk category.

2) Exercise – Pregnancy exercises can help prepare your body for the birth of your baby, by targeting specific muscles used during labor. Regular physical exercise can help to build strength and stamina. It also makes it easier to recover after birth. Check with your care provider as to any physical limitations you may have

3) Education – Educating yourself with regard to all the issues involving pregnancy and birth will help you to make responsible decisions that are right for you and your family. As the authors of A Good Birth, A Safe Birth said, “If you don’t know what your choices are, then you don’t have any!” There are many different types of childbirth classes, and you need to research to find out which one will fit your needs. A good book to help in this search is The Birth Book, by Dr. William Sears, and Martha Sears, RN. Educating yourself well will help you to avoid unnecessary health risks common in birth in the United States today. This would include educating yourself as to the necessity of routine testing and procedures during pregnancy. Before consenting to routine testing or procedures be sure that it is being done for a true medical need or problem. You need to be aware of the risks and benefits of all tests and procedures during pregnancy. Excellent sources of information on this topic include Henci Goer’s book Obstetric Myths vs. Research Realities, and Barbara Katz Rothman’s book The Tentative Pregnancy.

4) Avoidance of Harmful substances – Everyone knows that you should avoid all street drugs during pregnancy so your baby will not be harmed, but there are many other substances that should also be avoided to have a healthy pregnancy. They include tobacco, alcohol, caffeine, pollution, pesticides, household and industrial chemicals, and any medically unnecessary medications, including over-the-counter medications. According the AAP, The PDR, and The FDA there is no drug that is considered safe during pregnancy. Sadly this would also include all medications commonly giving during birth, as they all reach the baby, and can have negative side effects for both the mom and baby. Any medication given to a pregnant or laboring woman should be for a true medical problem only. All prescription medications should be taken to your care provider and checked to see if they are truly necessary during pregnancy, and if there may be a safer medication or a smaller dose might be appropriate. Before taking anything you should always check with your care provider first!

5) Choosing a Birth Attendant wisely – When choosing a Doctor or Midwife to assist at your birth, it is important you choose one who not only matches your birth philosophy, but also respects your right to make choices that are right for you. Be sure to interview all candidates before choosing. Think about what kind of a practice you would be comfortable with. Would you prefer a large practice of doctors or midwives, or a small practice of only one or two care providers? If you discover along the way that you are no longer comfortable with your original choice, it is important to know that you have the right to change care providers. Choosing wisely the first time will create less stress in your life.

6) Choosing your Birth Place Wisely – When choosing where to have your baby it is good to know that home births have been shown to be as safe, if not safer, than hospital births. Think about where you will feel the safest, and most comfortable. If you feel safest in a hospital setting, then that may be a good choice for you. This of course, will depend on your health status. Only low risk women will be accepted for a homebirth. While it is possible to have a healthy natural birth in a hospital setting, it is certainly more difficult.

7) Doulas – Consider hiring a professional labor assistant to help you through your labor. Studies have shown that having a doula can reduce the need for medication, cesarean sections, pitocin to speed up labor, and other interventions common in birth today. It’s also wonderful to have backup for your primary labor support person in the event of a long labor.

8) Birth Plans – Never assume that everyone attending your birth knows what you do and don’t want! Create a birth plan that outlines your ultimate goals and priorities. To do this you will need to educate yourself with regard to all aspects of birth in the United States so that you know what your priorities are.
***

(For More information on each of these topics contact Rochester Birth Network at www.rochesterbirthnetwork.com 585- 234-0022)

Amy V. Haas, BCCE ©2002 -2006

Recommended Reading:

The Birth Book by William Sears, M.D. & Martha Sears, RN
The Thinking Woman’s Guide to a Better Birth by Henci Goer
The Brewer Pregnancy Hotline (The Brewer Diet) by Krebs and Brewer (Available on line at www.blueribbonbaby.org )
Natural Childbirth the Bradley Way by Susan McCutcheon
A Wise Birth by Armstrong & Feldman
A Good Birth, A Safe Birth by Korte & Scaer
Gentle Birth Choices by Barbara Harper
Active Birth by Janet Balaskas
Obstetric Myths vs. Research Realities by Henci Goer
The Tentative Pregnancy by Barbara Katz Rothman
Diary of A Midwife – The Power Of Positive Childbearing by Juliana Van Olphen-Fehr
Ina May’s Guide to Childbirth by Ina May Gaskin

Could changing the court system help prevent unecessary cesareans?

2007-01-14T12:56:00.000-08:00

I'm so intrigued by this:

http://cgood.org/healthcare-newscommentary-watch.html

It's Time for Special Health Courts in New York
Richard M. Peer, The Buffalo News, June 26, 2006

In an opinion piece in The Buffalo News, Dr. Richard M. Peer, president of the Medical Society of the State of New York, writes that “[i]t's time to give health courts a chance” because “[t]he current medical justice system is not working for doctors or for patients.” According to Dr. Peer, a vascular surgeon himself, some doctors,“[f]aced with increased liability and skyrocketing malpractice premiums, … are giving up the practice of medicine, especially those in high-risk specialties such as obstetrics, neuro and general surgery and emergency care.” He continues: “At the same time, the current system doesn't provide appropriate or timely compensation to patients who truly experience negligent adverse events. Instead, studies show that it rewards only a small fraction of plaintiffs with legitimate claims and those eventually compensated will have suffered an average of more than four years of litigation.” By streamlining proceedings and lowering the costs of adjudicating a claim, Dr. Peer argues that health courts would help solve these problems.

It's an interesting avenue - I have some hesitations about it, but it might be an avenue worthy of pursuit.

Study backs natural birth after C-section

2007-01-14T12:49:00.000-08:00

Study backs natural birth after C-section
Posted 6/29/2006 9:28 PM ET

[To view this article in it's entirity, visit http://www.usatoday.com/news/health/2006-06-29-vbac_x.htm]

A study out today could lead to an increase in the number of pregnant women who try for a vaginal birth after a cesarean section, a type of delivery called a VBAC.

The study, published in Obstetrics & Gynecology, involved 17,890 women with a prior C-section who delivered at one of 19 academic U.S. medical centers from 1999 through 2002.

It found that those who'd had multiple C-sections were no more likely to have a uterine tear, or rupture, than those who'd had only one C-section. Ruptures occurred in nine of 975 women with multiple previous C-sections, or 0.9%, and 115 of 16,915 women with just one prior C-section, or 0.7%. Women with multiple C-sections were more likely to need a blood transfusion or a hysterectomy if they tried for a VBAC, but their actual risk was just 3.2% and 0.6% respectively.

My favorite part of this article:

Gary Hankins, chairman of the American College of Obstetricians and Gynecologists' obstetrics practice committee, said he expects his group will now revise its VBAC advice for women who've had multiple C-sections.

In 2004, Hankins' committee said that the only women with multiple C-sections who are candidates for a VBAC are those with a prior vaginal delivery. The new study found that having a prior vaginal delivery made no difference.

And I really like this:

"I think the important message from Landon's paper, and from our work, is that VBAC in women with multiple prior C-sections is very reasonable," says George Macones, chairman of the Department of Obstetrics and Gynecology at Washington University in St. Louis and author of a study last year that found only a small increased rupture risk in such women.

Early Registration for ICAN Conference, April 2007

2007-01-08T09:04:00.000-08:00

ICAN Conference, Syracuse NY
April 20-22
$199 Early Registration

Heads up!!! The Early Bird deadline for conference is
fast approaching! Between now and February 28, you
can register for the low rate of only $199.
This Silver Anniversary Conference will bring
together a wide range of birth professionals, birth
advocates and consumers. It's the first time ICAN has
had an OB on the agenda.

Dr. Mark Landon, author of the first large-scale
American prospective study on VBAC, will be there to
confirm the relative safety of VBAC for most women.
We're applying for CEUs from MEAC and ICEA.
This is a terrific opportunity for birth professionals
to hear the good news about VBAC while
fulfilling professional educational requirements.

If you are a breast feeding advocate or lactation
consultant, you'll want to come hear Diane
Wiessinger's talk "What Would Mammals Do?"

If you are a birth activist, you'll want to hear
Lynn Paltrow from NAPW answer the question "Do
Pregnant Women Have Rights?" She was co-counsel
representing Angela Carder's family in the famous
1987 suit against George Washington University Medical
Center, winning a decision on appeal that held
the hospital was wrong in obtaining a court order to
perform a cesarean against the wishes of Carder (a
cancer patient), her family and the obstetrical
department.

Susun Weed, author of Wise Woman Herbal for the
Childbearing Year, will discuss "After the Cesarean:
Herbal Healing for Mother and Child."

The stellar list of speakers includes: Dr. Marsden
Wagner, Henci Goer, Sharon Storton, Esther Booth Zorn,
Nancy Wainer and many more. ICAN notables
include Kmom, Gretchen Humphries, Raechel Fredrickson,
Shannon Mitchell, Dawn Kubik and Elaine Mills.

Watch your mailbox for the latest edition of the
Clarion. It includes a four-page insert all about our
conference, "25 Years of Discovering ICAN." Or visit
our conference web site at
http://conference.ican-online.org/ .

Save money .... register today!!!

ICAN of Buffalo Announces 2007 Prevention Series

2007-01-03T15:38:00.000-08:00

Hello everybody, and welcome to the new year!

My resolution for this year is to make ICAN of Buffalo an even bigger success. To do so, one of the first changes you'll see is a greater focus on the Cesarean Prevention aspect of ICAN's mission with a series of topic-driven meetings. I am pleased to announce our first two topics in our series:

February 7th - Our first meeting of the new year will be a discussion entitled "Cesarean Prevention Through Nutrition". We will focus on how nutritional choices can decrease likelihood of preeclampsia, toxemia, gestational diabetes, prematurity and more. Meeting to be held at 10:45am at HomeGrown Baby, 3111 Delaware Avenue in Kenmore. Following will be a meeting for those in need of support for cesarean recovery.

March 7th - ICAN of Buffalo presents "Can Chiropractic Care Prevent a Cesarean?" We are pleased to welcome guest speaker Dr. Jessica D'Amore, Chiropractor from Family Chiropractic in Amherst and CBE/doula. She will be discussing the benefits of prenatal chiropractic care, the Webster technique (for turning breech babies) and other ways spinal health can be beneficial to pregnancy and birth. Meeting to be held at 10:45am at HomeGrown Baby, 3111 Delaware Avenue in Kenmore. Following will be a meeting for those in need of support for cesarean recovery.

Please note, we will still offer time for women who are in need of cesarean recovery and support following each meeting.

Other topics that are planned for the year include: "How to Get Your VBAC Back", "What You Need to Know About Pain Relief in Labor", and our Healing Circle, which was postponed until the new year.

We will also be holding some fund raisers and are looking for your help. We would like to do two "Clothing Swap Nights", one for women's clothing, and one for baby and children's clothing - we are in search of a location, donations of items to be raffled, donations of food items such as h'ors d'oeuvre's [I know I have butchered the spelling there - but it doesn't come up on my spell check!] and beverages, and people to help. The other fund raiser we will be doing will be a Cookie Lee Jewelry party, which will probably be held in February. ICAN of Buffalo really needs your support with these fund raisers in order to keep providing support and education to the community!

Another way you can help support ICAN of Buffalo is by becoming a subscriber to ICAN. $30 for a basic subscription gets you discounts to our bi-annual conference (In SYRACUSE this year! Don't miss out on this once-in-a-lifetime opportunity! - visit http://conference.ican-online.org for more info) as well as our quarterly newsletter, The Clarion, our newly reworked bi-weekly ICAN E-news, and access to all the latest cesarean updates. When you subscribe to ICAN through the Buffalo chapter, a portion of the dollars stay right here, so please consider subscribing today!

I'm really looking forward to the new year, and excited about our new approach! Hope to see you there!!!!

The Mommy Uprising

2006-12-27T11:41:00.000-08:00

The Mommy Uprising
Click here to read entire article: http://www.bostonmagazine.com/articles/the_mommy_uprising

They’re fed up with the unwanted C-sections, the endless tests, the dubious interventions, and the scary advice from overworked, malpractice-spooked doctors. And Boston women are shunning the area’s world-class hospitals to go to surprising lengths—and sometimes take big risks—to give birth on their own terms.

By Tina Cassidy, a former staff reporter and editor at the Boston Globe, is the author of Birth: The Surprising History of How We Are Born (Atlantic Monthly Press, $24). She has given birth once, by cesarean, to her son, George.
Originally published in Boston Magazine, December 2006.

Cesareans are not always life-saving

2006-12-16T13:58:00.000-08:00

This poor family - it's so tragic. And a prime example of why cesareans should not be done without extreme consideration.

From: http://www.buffalonews.com/editorial/20061213/4074903.asp

SOMERS
Mother, preemie die hours after Caesarean

12/13/2006 SOMERS (AP) - A woman who had an emergency Caesarean section after a car crash died within hours of the delivery along with her premature baby, state police said Tuesday.

Police had described the pregnant woman's injuries as non-life threatening after the Monday accident, but an autopsy showed she died of blood loss after the surgery.

Investigator Michael Davis said Lina Borshchov, 27, of Beacon, was "speaking to the EMS people and moving her arms" as she was being taken out of her smashed car on Route 100 in Somers after the crash.

Borshchov's car was hit by a a vehicle driven by Elizabeth Carlen, 84, of Millwood, when Carlen drifted into oncoming traffic while rounding a curve, police said. Carlen was killed.

Borshchov was airlifted to Westchester Medical Center in Valhalla, where doctors performed the Caesarean, Davis said. Police said Borshchov died at 11 p.m., and the baby died shortly before 2 a.m. Tuesday. The baby's death was attributed to complications of premature childbirth.

For what it's worth, it doesn't say why the cesarean was done - it may have been a perfectly good reason and this is not a criticism of the fact that the mother had one. But when was the last time you heard of someone dying after a vaginal birth?

Too Many Cesareans in Buffalo?

2006-12-12T10:10:00.000-08:00

Erie County, it is interesting to note, has a cesarean rate for 2005 of 26.1%. This is much lower than the rate for the entire US, which is a whopping 30.2%. So is this a non-issue for the women of Erie County?

My answer is, absolutely not. Women in our area are still being cut way too often. For the first time in at least two years that I've been watching, Buffalo's rate is higher than the state average - 25.4%. The CDC reports that cesareans in an industrialized country the cesarean rate should fall between 10% and 15% - the high end being at high-risk hospitals. In Buffalo, the high-risk hospital is Women and Children's Hospital of Buffalo, whose rate is 30.5% - slightly higher than the country's average. Why so high?

Here are the local cesarean percentages for 2005:

Millard Fillmore Suburban Hospital (Amherst) (2866) 25.4%
Women and Children's Hospital of Buffalo (1814) 30.5%
Mercy Hospital (Buffalo) (2588) 24.6%
Sisters of Charity Hospital (Buffalo)(2502) 24.7%

When a woman has a cesarean, every piece of research indicates that a Vaginal Birth After Cesarean (VBAC) is usually the safest bet for future deliveries. There are studies that indicate that if given the proper support and information, the percentage of women who can safely VBAC is in the 90's; and yet, Buffalo doesn't even hit the state average of 15.3%, which is a far cry from the Healthy People 2010 goal of 37%.

Here are the area's VBAC percentages:

Millard Fillmore Suburban Hospital (466) 17.8%
Women and ChildrenÂs Hospital of Buffalo (304)11.9%
Mercy Hospital (Buffalo) (332)12.1%
Sisters of Charity Hospital (Buffalo) (334)14.2%

What's really bad about this is that, from my own personal experience as well as the experiences of others, is that women are being told plenty of information about Uterine Rupture - a risk that is a possibility in any birth, not just in a VBAC, and everything that women are hearing about uterine rupture is probably pretty accurate, but emphasized in a disproportionate way to the actual risk most women face. An unscarred uterus has about a .2% chance of rupturing. A scarred uterus has about a .7% risk. But how many women hear that a major risk of VBAC is Uterine Rupture and sign right up for that cesarean? Do women know that their risk of uterine rupture in a VBAC is 30 times lower than any other pregnancy related emergency?

Women need to be given complete information before consenting to a procedure they may not want and may put the life of their baby orthemselvess in jeopardy. I pray that this blog becomes the voice of information and reason in a community that is currently too willing to accept the edicts passed down from the authoritative medical community.