Informed consent Archives

New study reveals surprising truths about the VBAC calculator

by Jen Kamel | Feb 24, 2020 | Evidence based medicine, Informed consent, Language, Racism, Using statistics, VBAC, VBAC Consults

VBAC calculators have been embraced with open arms by some providers, whereas others reject them altogether. Who’s right? Trying to predict who will have a VBAC is tricky. We know some individual factors, such as having a prior vaginal delivery, are associated with higher or lower VBAC rates. By combining various factors, VBAC calculators generate a percentage that represents the best guess for an individual’s odds of having a vaginal birth after cesarean. But VBAC calculators, also called VBAC success calculators, are not always accurate and can create emotional baggage.

Where Rinat Dray’s forced cesarean lawsuit stands and what every birth professional should know

by Jen Kamel | Aug 15, 2019 | Hospital birth, Informed consent, Legal Issues, Traumatic birth, VBAC, VBAC after multiple cesareans

In 2011 a woman with two prior cesareans named Rinat Dray was forced to have a cesarean at Staten Island University Hospital in New York. She sued the hospital and two physicians for ‘improperly substituting their judgement for that of the mother’ and ‘pressuring and threatening her.’ During the course of her lawsuit, it was revealed that this hospital had a secret forced cesarean policy. When I learned about this policy, I was shocked. Yes, forced cesareans happen. They are woven into the culture of some hospitals as are other forms of obstetric violence. But to have a formal, written policy saying that it was OK?

Eleven things to love about ACOG’s 2017 VBAC Guidelines

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.

Calling women who plan home VBACs “stupid” misses the point

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.

VBAC bans, exercising your rights, and when to contact an attorney

by Jen Kamel | Aug 24, 2012 | Hospital birth, Informed consent, Legal Issues, Planning your vbac, VBAC, VBAC Bans

“Does the hospital have the right to stop contractions and section the patient? This is what I’m hearing in my birthing community and I really cannot believe a hospital would/could do that.”

Confusing fact: Only 6% of uterine ruptures are catastrophic

by Jen Kamel | Apr 3, 2012 | Birth myths, Home birth, Hospital birth, Infant Outcomes, Informed consent, Language, Maternal Outcomes, Planning your vbac, Using statistics, Uterine Rupture, VBAC

The statistic “Only 6% of uterine ruptures are catastrophic” is from the Evidence Report (Guise 2010) which was the basis of the 2010 NIH VBAC Conference and it refers to the rate of infant death due to uterine rupture.

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