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The First Three Steps: How White Perinatal Professionals Can Support BIPOC Birthing People

The First Three Steps: How White Perinatal Professionals Can Support BIPOC Birthing People

by | Sep 3, 2020 | Racism, VBAC

It is virtually impossible for anyone who was raised in a white colonialist country – like the United States – to come into adulthood without racism in their heart and mind. This is where implicit bias comes from. So if you have heard people say things like, “All white people are racist,” that’s what they are referring to. It’s not using the N-word or going to a KKK rally. It’s not listening to Black women when they report pain in the hospital and missing a potentially deadly complication as a result. That is one way implicit bias presents. So what can white birth professionals do about it? How can they identify and face the implicit bias in their own heart, and systemic racism within the health care system, so racial disparities can improve?

Does VBAC after more than one prior cesarean pose an increased risk? YES.

Does VBAC after more than one prior cesarean pose an increased risk? YES.

by | Aug 31, 2020 | Birth myths, Evidence based medicine, Maternal Outcomes, Planning your vbac, Using statistics, Uterine Rupture, VBAC, VBAC after multiple cesareans

An advocate claims that the American College of Obstetricians & Gynecologists (ACOG) said VBAC after more than one prior cesarean (VBAMC) doesn’t pose an increased risk. A reader contacted me asking if this was correct. It is not. ACOG does not say that because it’s not true.

New study reveals surprising truths behind the top three VBAC calculators

New study reveals surprising truths behind the top three VBAC calculators

by | 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 the Rinat Dray forced cesarean lawsuit stands right now

Where the Rinat Dray forced cesarean lawsuit stands right now

by | 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?

Accreta spectrum disorder tied to increased risk of PTSD

Accreta spectrum disorder tied to increased risk of PTSD

by | Aug 5, 2019 | Cesarean section, Maternal Outcomes, Traumatic birth, VBAC

We often think of the physical risks and benefits when talking about VBAC versus repeat cesarean section, but what about the toll on mental health? The stress of having a complication like placenta accreta is often not addressed and parents are left on their own trying to figure out how to cope with this serious diagnosis. So I was thrilled to come across a study finally addressing this issue and to include it in our monthly Grand Rounds for VBAC Facts Professional Members. Join me for this Grand Rounds excerpt where we review Tol 2019, a study looking at the connection between abnormally invasive placenta and post traumatic stress disorder.

Uterine rupture survival story teaches two lessons

Uterine rupture survival story teaches two lessons

by | 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.

Free Handout Debunks...

There is a bit of myth and mystery surrounding what the American College of OB/GYNs (ACOG) says about VBAC, so let’s get to the facts, straight from the mouth of ACOG via their latest VBAC guidelines.

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