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Thursday, March 11, 2010

Headed in a Better Direction?

If you are at all involved in the birth world or consider yourself somewhat of a VBACtivist I'm sure you've heard of the National Institutes of Health consensus conference where they discussed VBACs in light of the decline of VBACs in the last 15 years and the increasing cesarean rate. I won't get into the whole conference on this post - because there is SO much to blog about in regards to that. But I must say that my following of this has almost led to a renewed explosion and passion in my heart for better birth in America.

What I really want to talk about is this particular article that stems as a result of the conference: Base VBAC Decision on Evidence NIH Panel urges. That title just gives me chills. There were many OBs, midwives, PhDs, etc in attendance at this conference. Along with some birth activists just like you or me. This article sums up the conference for you. There are six questions that the conference was asked to look at and answer after conference discussion. The first link I posted has all of the questions and the long answers. It also provides many statistics and evidence to support the answers.

Not only from these articles, but from the bits and pieces I've picked up from Facebook, twitter, etc - it is my impression that the conference was very positive in that VBAC is seen as a vital option and that true informed consent should be given to women (not just a speech about all of the dangers of VBACing and uterine rupture and no mention of the RCS risks). However, I am cautiously optimistic, as it is one thing to urge providers to use evidence when helping women choose VBAC or RCS, it is another thing for providers to put it into practice. But, hey - one step at a time, right?

One item that really sticks out was this mention by ACOG's president:

"The report in general is very good," ACOG president Gerald F. Joseph, Jr., MD, said during public discussion of the draft report. His only suggestion was to strengthen the report's comments on liability issues.

It was found that liability is a prime reason that some OBs won't support VBAC, or are quick to abandon the VBAC attempt. If that is where the true inhibition lies for OBs, we must make a difference somewhere in order to take that liability away from OBs. If that's what we need to do to give women a fair chance, we need to fix that, however, that in itself is a whole other discussion.

I hope with all of my heart that this conference is the start of an upswing in our country. So that women actually have a CHOICE in how they birth and that they are presented with true informed consent of the risks on both VBAC and Repeat C-sections.

To read ICAN's official statement on the VBAC statement, click here.

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