by Jen Kamel | Oct 29, 2018 | Birth stories, Infant Outcomes, Maternal Outcomes, Uterine Rupture, VBAC
Having a prior uterine surgery increases the risk of uterine rupture. The relative risk is still low, but it’s there. Other factors can push that risk higher (such as induction.) But sometimes there is no “reason” for a uterine rupture other than a prior cesarean. Uterine rupture stories illustrate that even though the risk is ~ 0.4% (among those with one prior low transverse cesarean in a spontaneously laboring VBAC), that small number impacts real parents & babies.
by Jen Kamel | May 7, 2018 | Cesarean section, Hospital birth, Inductions, Infant Outcomes, Maternal Outcomes, Using statistics, Uterine Rupture, VBAC
A VBAC study out of Canada reported, “Absolute rates of severe maternal morbidity and mortality were low but significantly higher after attempted vaginal birth after cesarean delivery compared with elective repeat cesarean delivery.” After reading the abstract, and full text, I could quickly see how this study will be misinterpreted by many, so let me walk you through it.
by Jen Kamel | Apr 25, 2018 | Hospital birth
I came across this story from a nurse and I wanted to share with you. First because it’s an amazing story illustrating how nurses can help birthing parents avoid a primary cesarean. And second, because we can all use some good news.
by Jen Kamel | Jan 4, 2018 | Hospital birth, VBAC
“I need to ask a favor from anyone who 1) had a vaginal breech birth in the hospital, 2) had one at home because that was your only option, or 3) was pressured into a cesarean because it was not an option due to hospital policy or lack of experience of attendant. I am getting a lot of pressure to stop attending breech and despite my best efforts to get privileges at a tertiary care hospital with neonatology, it is not happening. Please send your impassioned pleas and experiences to Sutter Davis Hospital 2000 Sutter Pl Davis CA 95616 Thanks!”
by Jen Kamel | Oct 31, 2017 | Home birth, Hospital birth, VBAC
Last week, I shared the eleven things that I love about ACOG’s latest VBAC guidelines. And with good reason. There’s some excellent new language as well as reiterations of positions that they presented back in 2010. But there are a few places where ACOG misses the mark and these are the three areas that gave me the most concern.
by Jen Kamel | Oct 25, 2017 | Hospital birth, Inductions, Informed consent, Language, Large/macrosomic babies, Planning your vbac, Resources for unsupportive family members, Using statistics, VBAC, VBAC after multiple cesareans, VBAC Bans, VBAC Consults
When I found out that ACOG released their new guidelines yesterday, I couldn’t wait to devour them. This morning, I had an opportunity to cuddle up with the new recommendations and I’m quite pleased. As always, there are things to like and areas where I think ACOG missed the mark. But here are the eleven good things about ACOG’s 2017 VBAC guidelines.
by Jen Kamel | Sep 12, 2017 | Racism, VBAC
Recently, I had a great extended conversation on racism in birth work at a VBAC Facts training for professionals in Covington, LA. And I wanted to share it with you. One doula shared that we simply needed to treat all clients the same regardless of race. What she was saying is that we should be colorblind. Now, I felt the good intentions in her heart. I knew what she was trying to say. Because there was a time that I believed the same thing. I was so glad she spoke up because it kicked off a tough conversation that needed to be had.
by Jen Kamel | Aug 8, 2017 | Infant Outcomes, Maternal Outcomes, Traumatic birth, Using statistics, Uterine Rupture, VBAC
So what matters more: Our personal experience? Or the conclusions of medical evidence? I suspect that most of my readers would say, the evidence. Hands down. And that is what most people believe… until they experience a bad outcome. That’s when things become more complicated. That single event can override all their knowledge. Everything they believed to be true. Suddenly all those statistics from the research come flying off the page. They are no longer just a number. They are now associated with a face… a baby… a parent.
by Jen Kamel | Aug 19, 2016 | Legislation, VBAC
I have thought about AB 1306 for so many hours since I initially opposed it last Friday and I’m feeling really conflicted about it. Let me share with you why. Removing physician supervision will improve the ability of CNMs to practice autonomously including offering VBAC in the hospital setting (where hospital policy permits) and in birth centers (provided the CNM opts to offer VBAC). This could be a good thing for VBAC families and a great thing for all the other people CNMs serve. And so it’s really tough because it could negatively impact the small number of women who plan home VBACs by requiring them to have a VBAC consult with an OB. So, what is the right decision?
by Jen Kamel | Jul 6, 2016 | Cesarean section
A woman who had four cesareans, after planning VBACs and home births, recently contacted me. She didn’t know where she fit into the birth community. My heart went out to her because there have been periods in my life when I have felt isolated and alone. And it’s a crappy feeling. I replied to her, “A vaginal delivery is not required to participate in the birth community. There are many cesarean moms just like you who are seeking compassion, connection, and understanding. You could be a soft place for other women to land as they mourn (or celebrate!) their cesarean deliveries.”
by Jen Kamel | Apr 22, 2016 | Birth stories, Infant Outcomes, Uterine Rupture
Women who have had uterine ruptures and lost their babies have endured some of our greatest fears. But they are part of our community as well. When the VBAC Facts Community, a Facebook group, was opened to the public, we welcomed and embraced the parents who joined us after their loss. Often they felt like they were no longer part of the birth community. They didn’t know where they fit in. They felt isolated and yet they wanted to share their story. We had many loss moms as members and many parents who were planning VBACs who wanted to hear their stories.
by Jen Kamel | Feb 17, 2016 | Home birth, Hospital birth, Informed consent, Planning your vbac, VBAC, VBAC Bans
I’m in an online group for labor & delivery nurses where the discussion of vaginal birth after cesarean (VBAC) at home came up. While some understood the massive VBAC barriers many women face, others simply said, “Find a hospital that supports VBAC.” I left a late-night comment stating that “finding another hospital that supports VBAC” is just not a reality in many areas of the country. It’s literally not possible. Not even in the highly populated state of California. I also suggested rather than calling women stupid or debating the validity of the decision to have a home VBAC , we should consider why women make this decision.
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