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.
“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!”
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.
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.
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.
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.