“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? […]
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. […]
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 (EGMN) – The modification of the oxytocin infusion protocol at a large university-affiliated community hospital nearly halved the number of emergency cesarean deliveries over a 3-year period, reported Dr. Gary Ventolini.
As oxytocin utilization declined from 93.3% to 78.9%, emergency cesarean deliveries decreased from 10.9% […]
“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.” […]
This is a great piece for deciding between VBAC and repeat cesarean. Those who wish to VBAC, but have husbands, family, and/or friends who don’t understand why, might find this document very useful. I have found that people who are anti-VBAC really seem impressed by what doctors and medical organizations have to say, so I’m thinking they will find this document compelling. Plus, VBAC has this reputation of being “risky” and repeat cesareans are thought of as the “conservative approach,” and this document challenges both lines of thinking. Why not write a sweet little note like, “I know you are […]