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 | 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 | Oct 19, 2015 | Hospital birth, Inductions, Using statistics, VBAC
A reader recently asked, “I wonder however if there are studies that compare the method of induction. My Doula said that the increase rates of uterine/ scar rupture was due to using high dosages of Pitocin, but now the induction uses lower dosages and administered at longer intervals. Do you know something about this?”
by Jen Kamel | Feb 12, 2013 | Birth myths, Inductions, VBAC
It’s important to use clear, specific language when we talk about birth because there is a lot of confusion among moms, advocates, doulas, and health care providers about VBAC and induction. When I point out the lack of clarity many people have on the topic to “anti-induction advocates” (for the lack of a better term), they respond with the fact that their focus is warning moms about elective inductions, which is absolutely needed. And they genuinely believe that people are aware of the distinction between elective and medically-indicated inductions. However, that has not been my experience, in fact it’s been quite the opposite. There are many people who don’t understand the why, when, and how of inducing VBACs and that is impacting the abilities of women to make informed decisions and exercise their right of patient autonomy.
by Jen Kamel | May 27, 2012 | Birth myths, Inductions, Large/macrosomic babies, Planning your vbac, Uterine Rupture, VBAC
Spontaneous labor is always preferable to induced or augmented labor but there are medical conditions that can necessitate the immediate birth of a baby. It’s nice for those women for whom vaginal birth is still an option to have a choice: gentle induction/ augmentation or repeat cesarean. Of course, informed consent reviewing the risks and benefits of their options is essential. Some women might be more comfortable scheduling a cesarean whereas others might want to give a gentle Pitocin and/or Foley catheter induction a go.
by Jen Kamel | Jan 16, 2012 | Birth myths, Inductions, Using statistics, Uterine Rupture, VBAC
It was interesting to note that among women with a prior cesarean, 72% of ruptures occurred during spontaneous labor. The scar itself, that prior cesarean surgery, is what increases the risk of uterine rupture the most.