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“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? [...] If primary and secondary cesarean rates continue to rise as they have in recent years, by 2020 the cesarean delivery rate will be 56.2%, and there will be an additional 6236 placenta previas, 4504 placenta accretas, and 130 maternal deaths annually. The rise in these complications will lag behind the rise in cesareans by approximately 6 years. [...] 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 [...] 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 [...] 
Per Silver (2006), “The risks of placenta accreta, cystotomy [surgical incision of the urinary bladder], bowel injury, ureteral [ureters are muscular ducts that propel urine from the kidneys to the urinary bladder] injury, and ileus [disruption of the normal propulsive gastrointestinal motor activity], the need for postoperative ventilation, intensive care unit admission, hysterectomy, and blood transfusion requiring 4 or more units, and the duration of operative time and hospital stay significantly increased with increasing number of cesarean deliveries.” [...] There is this idea that if you don’t VBAC and you schedule a repeat cesarean, that you will be safe from complications. This is because during a “VBAC counsel,” women are often told of the risks of VBAC, namely uterine rupture, but they are rarely told the risks of repeat cesareans in their current and [...] 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 [...] 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 [...] This article published June 19, 2009 demonstrates one hospital’s experience when they changed their oxytocin protocol. Note that they refer to oxytocin, but oxytocin is produced in a woman’s body and causes uterine contractions during labor whereas Pitocin, which is what they are likely referring to, is “synthetic oxytocin sold as medication.” There is a [...] Below are the sources I used for the VBAC Class given on March 20, 2009. More classes are in the works, so keep checking back, subscribe, or become a fan on Facebook. Many of the studies measure multiple items – uterine rupture, VBAC success, etc. – but I categorized them by the topic that I [...] 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 [...] 
I’m a hard number cruncher. But there are major limitations if you are going to rely solely on case controlled studies to decide between home and hospital birth. There are so many variables and nuances that haven’t been “number crunched” to that extent but make a HUGE difference in the how your birth progresses and the ultimate outcome. [...] This is a comprehensive article on adhesions which is a fancy word for scar tissue. I think the most relevant points of this whole discussion are: Adhesions “develop in 93% of people who have undergone pelvic surgery” and “they are especially common after cesarean sections.” You get more adhesions with each cesarean. Adhesions can cause: [...] |
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