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The best compilation of VBAC/ERCS research to date

“There is a major misperception that TOLAC [trial of labor after cesarean] is extremely risky” – Mona Lydon-Rochelle MD, March 2010. “In terms of VBAC, “your risk is really, really quite low” – George Macones MD, March 2010. Both Drs. Macones and Lyndon-Rochelle are obstetricians and researchers who made these statements at the 2010 NIH [National Institutes of Health] VBAC Conference. Now you may think, “Wait a sec. Everything I’ve heard from my family, friends, and medical provider is how risky VBAC is and how cesareans are the conservative, prudent, and safest choice.” Why the discrepancy between the statements of these two doctor researchers and the conventional wisdom prevalent in America? [...]

Confusing fact: Only 6% of uterine ruptures are catastrophic

questionmarkwoman

How many times have you heard “Only 6% of uterine ruptures are catastrophic” or “Uterine rupture not only happens less that one percent of the time, but the vast majority of ruptures are non-catastrophic?” But what does that mean? Does that mean only 6% of uterine ruptures are “complete” ruptures? Result in maternal death? Infant death? Serious injury to mom or baby? This article will explain to you the difference between uterine rupture and uterine dehiscence as well as explain the source and meaning of the 6% statistic. [...]

Confusing math misleads women on uterine rupture and mortality risk

VBAC Facts reviews a blog post that shares a study on VBAC along with statistics the blogger calculates, many of which misrepresents the risk of uterine rupture and infant mortality during a VBAC attempt demonstrating why it is important to not only know the source of the statistics, but also know that the blogger can do simple math. [...]

Cesarean Section Consent Form

From Another VBAC Consult Misinforms:

[My OB] did not mention risks to repeat c-sections.  When I brought it up he said there aren’t any except the obvious risks that come with any surgery.

It’s because some OBs continue to mislead their patients about the risks of cesareans that I share this excellent cesarean section consent [...]

The Risks of Cesarean Section

We all know the primary risk of VBAC – uterine rupture.  And when your typical VBACing mom meets with an OB, she must sign a “VBAC consent form” acknowledging that she understands this risk.  However, I find it ironic that women signing up for a repeat cesarean are not required by their OB to sign [...]

41 countries have fewer babies dying around the time of birth than the USA

As I promised at the VBAC class today, here is Birth by the Numbers, by Eugene R. Declercq, PhD, Professor of Maternal and Child Health, Boston University School of Public Health, where he presents the sobering statistics of birth in the United States today.

I had the privilege of hearing Dr. Declercq speak at the [...]

Umbilical cord around baby’s neck rarely causes complications

Parents often have a visceral and fearful response when they see a cord wrapped around their baby’s neck which is called a nuchal cord. Even though umbilical cords around the neck and body are common and occur 25% – 35% of the time, they very rarely result in the death of a baby. [...]

Perinatal Death Low with Home Births

perinatal = “occurring during the period around birth (5 months before and 1 month after)” (wordnetweb.princeton.edu/perl/webwn)

Perinatal Death Low with Home Births

By Nancy Walsh, Contributing Writer, MedPage Today Published: August 31, 2009 Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, RN, BC-ADM, CDE, [...]

ACOG makes plea for bad out-of-hospital stories password protected

It’s interesting that ACOG is only interested in collecting stories of out-of-hospital births with poor outcomes… what about all the women who give birth in hospitals who otherwise would have had a completely normal labor and delivery but for the hospital procedures, unsupportive staff, and resulting stress?  There are wonderful OBs and great hospitals, but [...]

“Pit to Distress” – A significant risk of hospital birth

There are two things women generally believe about OBs:

1. Their OB would never do anything to put them or their baby in harm’s way,

2. If their OB gives them a drug, or recommends a procedure, that’s only because the benefits outweigh the risks.

Unfortunately, both of those things are not always true.

Women [...]

“Pit to Distress”: Your Ticket to an “Emergency” Cesarean?

Last week I wrote about a hospital reduced it’s use of Pitocin and found that their emergency cesarean rate decreased.

Then today I run across this new term “Pit to Distress” at unnecesarean.com:

“Pitocin is used like candy in the OB world, and that’s one of the reasons for medical and legal risk,” says Carla [...]

Cesarean section changes DNA of newborns

Fascinating, but we don’t know what it means.  I’ll be watching for future research.

The emphasis below is mine.

29. jun 2009 kl. 12:12

Caeserian section changes DNA of newborns

Swedish research shows that a Caesarian birth section changes a newly-born’s DNA.

Af  Julian Isherwood

Children who are born by Caesarian section may have an [...]

Hospital’s Oxytocin Protocol Change Sharply Reduces Emergency C-Section Deliveries

This article published June 19, 2009 demonstrates one hospital’s experience when they changed their oxytocin (Pitocin) protocol.

I’ve included the entire article below and have emphasized what I consider to be the most interesting parts.

Hospital’s Oxytocin Protocol Change Sharply Reduces Emergency C-Section Deliveries By Betsy Bates Elsevier Global Medical News Conferences in Depth

CHICAGO [...]

The Role of Interpretation – ACOG Refines Fetal Heart Rate Monitoring Guidelines

“Since 1980, the use of EFM has grown dramatically, from being used on 45% of pregnant women in labor to 85% in 2002,” says George A. Macones, MD, who headed the development of the ACOG document. “Although EFM is the most common obstetric procedure today, unfortunately it hasn’t reduced perinatal mortality or the risk of cerebral palsy. In fact, the rate of cerebral palsy has essentially remained the same since World War II despite fetal monitoring and all of our advancements in treatments and interventions.” [...]