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New Research on Home Birth with an Obstetrician


Over the last five years Dr. Stuart Fischbein, a Southern California obstetrician, has attended 135 home births. These deliveries included VBACs, vaginal breech and vaginal twin deliveries.

A summary of these births has been recently published.

Here are some highlights along with a few additional resources I compiled where you can learn more.

On patient selection:

“This model was not limited by strict protocols and allowed for guidelines to be merely guidelines. Women over 35, VBAC, breech and twin pregnancies were not excluded from this series simply because those labels existed. Each client was evaluated on her own merits and the comfort of the practitioner.”


Q&A: What are the risks of cesareans?

no right answers right-right 238370_640

Q: “I know the risk of uterine rupture is 1-2% during a VBAC, but do you have any statistics for the risks of a repeat cesarean?”

A: The risk of uterine rupture after one prior low transverse cesarean is 0.4% – 1% depending on whether the VBAC labor is spontaneous, augmented or induced (Landon, 2004). Spontaneous means labor begins naturally. Induced means the woman is not in labor and is given a drug to try to start labor. Augmentation means labor has already begun and drugs are used to make the labor progress more quickly.

Cesareans carry increased risks of […]

Q&A: Single vs. dual layer suturing


Q: Is there any evidence to support double layer suturing over single layer?

A: Conclusive evidence on single vs dual suture does not exist. Also note that ACOG does not say one form of closure is better than another in their VBAC guidelines.

Bujold (2012) stated, “Although there is a growing body of evidence that the technique for uterine closure can be crucial for uterine scar healing, strong evidence regarding optimal techniques is scarce and there currently exist no national or international guidelines on which obstetricians-gynecologists and surgeons can rely.”

Bujold provides a good review of the literature, so you […]

Q&A: VBAC after a uterine rupture?

Pregnant Girl

I apologize for not writing in so long. I’ve been busy with various projects including producing my 6 hour program “The Truth About VBAC” to be released online this summer! Subscribe to my newsletter to be informed of this and future classes!

I’ve been responding to many questions over on my Facebook page and have been trying to think of ways to archive those discussions here for future reference. Then the obvious answer appeared… post the questions and answers here and link back to the original question posted on Facebook! So, here we go! I look forward to blogging more […]

What Jen Kamel told the Medical Board about home VBAC, Part I

prental yoga

My intention in attending this meeting was to amplify the voice of the consumer. I think sometimes it’s difficult for OBs who attend VBACs, or for those who live in communities where they have access to hospitals that allow VBAC, to understand that not everyone lives in that world. […]

Home VBAC threatened for California families


There has been a lot of confusion regarding AB1308, the legislation that went through at the beginning of this year in the state of California. It said that LMs were no longer allowed to attend home births some situations (such as breech, beyond 42 weeks gestation, etc) and other situations required a physician to sign off on the home birth.

It’s these regulations that are currently being written by the Medical Board with input from ACOG, CAM, CFAM, and VBAC Facts. It is under discussion whether a prior cesarean should be included on this list of conditions that would necessitate a […]

VBAC: A husband’s experience and lessons learned

Young Laughing Father and Child  Having Piggy Back Fun.


“I have just seen so many women who have husbands who aren’t supportive because they don’t understand. My husband would love to help more men understand.”

A couple recently shared their VBA2C (vaginal birth after two cesareans) journey with me.  It touched my heart.  My the time I was done reading it, I had tears in my eyes.

So many women do not feel that VBAC is an option for them because their partner isn’t on board.  Now I know there are women who will birth how they please regardless of their partner’s feelings or thoughts, but there […]

What your doctor didn’t tell you about VBAC

Businessman with adhesive tape on mouth on white background

Last week there was yet another “chasing our tails” debate about VBAC vs. repeat cesarean on yet another VBAC/ birth/ parenting message board on-line.  You’ve seen them.  They usually degenerate into:

“You are selfish for planning a VBAC!”

“Yeah?  Well you are uninformed for planning a repeat cesarean!”

[Insert accusations of martyrdom for planning an unmedicated birth and countless other ugly things that no one would actually say to each other in real life.]

It’s truly boring to read.  And sad.  Why the need for insults and defensiveness?

I am not someone who enjoys “debating” and finds the “education […]

Write for VBAC Facts: Hospital VBAC Ban Reversals


I’m so excited to announce a new series on VBAC ban reversals. My objective with this series is to show that hospitals do reverse their bans and to give other hospitals a blueprint for how they can do the same. So, if you work for a hospital that has reversed their VBAC ban and you would like to share your experience with other hospitals via vbacfacts.com, please contact me. Submissions can be anonymous and do not need to provide the hospital’s name. […]

OB front office staff doesn’t know what a VBAC is

Businesswoman Outdoors on Cell Phone

Trying to find a VBAC supportive health care provider can be (very, very) difficult process. Understandably, some women choose to call various providers rather than meet with them face to face. This woman’s experience illustrates the pitfalls of this method. […]

Birth Plan Radio Show Notes

old fashioned radio

I was recently interview by Roanna Rosewood of Birth Plan Radio.  You can listen to the show here.  Below you will find links where you can read more about the various topics discussed.

Show Notes

The history of VBAC bans

Jen’s unique form of advocacy.

ACOG’s 2010 VBAC recommendations

The various documents related to the 2010 National Institutes of Health VBAC Conference

Birth myths, specifically on inducing VBACs, how the risk of uterine rupture differs between women who have had a cesarean and those who haven’t, and how the risk of rupture compares between induced, unscarred moms and scarred moms.


Induction is wrong, wrong, wrong… wait, what?

Strict asian girl

I hear all the time how induction in VBAC is contraindicated. This is false. This is the kind of misinformation that materializes when we demonize all induction rather than specifying that elective inductions are not worth the increased risks.

It’s important to use clear, specific language when we talk about birth because there is a lot of confusion among moms, advocates, doulas, and health care providers about VBAC and induction. When I point out the lack of clarity many people have on the topic to “anti-induction advocates” (for the lack of a better term), they respond with the fact that […]

Why cesareans are a big deal to you, your wife, and your daughter

Surgeon Operating on a Patient

I hear a lot, “What’s the big deal about cesareans? What difference does it really make if you have a cesarean?” Of course, if a cesarean is medically necessary, then the benefits outweigh the risks. But in the absence of a medical reason, the risks of cesareans must be carefully considered. […]

Some people think I’m anti-this/ pro-that: My advocacy style

stack of rocks balancing in grass

The way I do things

VBAC Facts communicates differently than many others who speak or write about birth. Rather than advocating for a specific decision, we advocate for access to information. Specifically, the mission of VBAC Facts is to close the gap between what the best practice guidelines from ACOG and the NIH say about VBAC and repeat cesarean and what people generally believe.

In meeting this goal, VBAC Facts makes hard-to-find, interesting, and pertinent information relative to post-cesarean birth options easily accessible to the people who seek it. VBAC Facts does not advocate for a specific […]

Evening primrose oil: “Don’t use it if you are pregnant?”


Many moms and midwives use evening primrose oil (EPO) for cervical ripening. So I was absolutely shocked at the complete lack of evidence on the effectiveness and safety of EPO among pregnant women. There is one study that examined the oral use EPO during pregnancy. It concluded EPO didn’t work as we expected it to and further, women who took EPO were more likely to experience a whole host of complications. Shockingly, there are no studies on the vaginal use of EPO during pregnancy. In short, there is insufficient clinical evidence documenting the risks and benefits of EPO and without that information, should pregnant women take it? […]