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. […]
“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? […]
I thought that I would take the data from the Silver (2006) that I’ve previously discussed and share it in a different way that would be helpful to women with multiple prior cesareans. (You might find it worthwhile to read this article specifically, where you can view the data below in graphs, as well as other articles on placental abnormalities first.) Remember that accreta is when the placenta abnormality deeply attaches into the uterus requiring surgical removal. There is a 7% maternal mortality rate with accreta as well as a high rate of hemorrhage and hysterectomy. One of the […]
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. […]
PushNews from The Big Push for Midwives Campaign CONTACT: Katherine Prown, (414) 550-8025, firstname.lastname@example.org FOR IMMEDIATE RELEASE: August 15, 2011 Study: Two-Thirds of OB-GYN Clinical Guidelines Have No Basis in Science Majority of ACOG Recommendations for Patient Care Found to Be Based on Opinion and Inconsistent Evidence WASHINGTON, D.C. (August 15, 2011)—A study published this month in Obstetrics & Gynecology, the journal of the American College of Obstetricians and Gynecologists, found that barely one-third of the organization’s clinical guidelines for OB/GYN practice meet the Level A standard of “good and consistent scientific evidence.” The authors of the study found […]
Removing the “immediately available” standard while supporting VBAC with twins, after two prior cesareans, and with unknown scars is a huge step in the right direction. It seems that the option of VBAC is now available to hundreds of thousands of women, many of whom, up to this point, were left with no choice at all. […]
In an effort to bring the consumer perspective to the 2010 NIH VBAC Conference, Jennifer Kamel, Founder of VBAC Facts, asked women across America, “Why is the option of VBAC important to you?” This is what they said. […]
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 future pregnancies.
Abnormal placental implantation is one risk of cesareans that only present themselves when you get pregnant again.
Women who expect to only have two children, and thus opt for a repeat cesarean, might think that not VBACing is the safer, and more controlled […]
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% […]
While there are care providers who may mislead you about your risks, benefits, and options, this article is written assuming that you are meeting with an ethical care provider who supports the option of VBAC. Read more on how to find a providers like this.
If you are a good candidate for VBAC, the single most important decision you can make that will have the greatest impact on your chances of VBAC success is who you hire to attend your birth. This is why it’s important to interview several care providers and ask specific questions.
You will often […]
This is great! A hospital reversing their VBAC ban! I really wish articles like this would talk less about "the experience" and more about the life-long benefits of vaginal birth for mom and baby.
May 28, 2009
Natural birth after c-section possible at NMC again
By Leslie Griffy email@example.com
Monterey County women who’ve had a c-section don’t have to leave the county to give birth naturally anymore.
Natividad Medical Center announced Wednesday that so-called VBACs vaginal birth after cesarean are back.
Like hospitals throughout the country, those in the county […]
This is a question that I’ve heard a lot.
Here is the three second answer: VBACs got a bad rap in the 1990s before we understood the increased risk of rupture during an induced VBAC labor, especially with Cytotec. Even if your OB is supportive, s/he may be under pressure from hospital administrators, or other OBs in their practice, who feel differently. Finally, your OB might have experienced a recent lawsuit, uterine rupture, or other bad outcome that influences the way they counsel you.
In the 90s, babies and moms were unnecessarily injured and died when VBAC labors were induced […]