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Wednesday, February 26, 2014

First Time Cesarean Rates Decline in 2012

According to this article from, c-section rates declined 2% for first-time mothers from 2009-2012.

"Cesarean delivery rates in 19 states reporting to the U.S. Centers for Disease Control and Prevention averaged 21.9 percent in 2012, the CDC said in a report released Thursday. This represented a return to the rate last recorded for those states in 2006."

Prior to this, cesarean rates had continued to increase every year.

But the reality of this small decrease hits full force in a quote from CDC statistician Michelle Osterman. "Because primary cesareans are starting to decline, the overall cesarean rate will be impacted because there is only a 10 percent chance that a woman who has had a cesarean is going to have a vaginal birth afterward," she said.

Ten percent. That means a full 90% of women who have had a cesarean section go on to have a repeat cesarean for their second birth. What a number. While it is encouraging that first-time cesareans are either stabilizing or declining, we still have a long way to go before cesareans are not an inevitability for a large percentage of women in America.

What do you think of these statistics? Is a 2% decline something to celebrate? How do we decrease repeat cesareans (and convince hospitals that this is the profitable thing to do)? Let us know in the comments.

Saturday, February 22, 2014

Taking off our rose-colored glasses

Our closed Facebook group continues to grow and to be an incredible resource and support for more and more women.  I can hardly keep up with it all and am grateful my fellow board members, especially Katie Champ, have been doing an exceptional job at keeping it safe and relevant. 

I have been thinking about fear tactics, and the effect they have on all of us.  Let me remind you that I am speaking as a mom.  I am not a professional.  It seems to me every time I hear a birth professional in the hospital setting talk about VBAC and homebirth, they all seem to have been part of some horror story that involves the loss of the baby.  As the years have gone by, I have become suspicious of how many actually witnessed this, or if it is just stories passed around.  And they never report any horror stories that occur in the hospital, as though everything is just perfect there.  So I built up resentment over it and distrust. 

(start here if coming in from the Newsletter)

But something happened just recently to remind me, to remind many of us, that there are real people out there who do experience loss, and I don’t ever want to be a part of minimizing this.  I wonder what those families would think if they knew they were being used as horror stories to shame other moms for their birth choices.  It doesn’t seem to honor or respect either family, certainly not the baby, and really just seems to use them to suit their own needs and/or fears. 

So I do not presume to speak for all other women preparing to VBAC, but when I did, I learned a lot about what could go wrong, including that I could lose my baby.  I learned statistics, I learned about drugs, methods, risks, and on and on.  I made educated decisions that were best for me at the time.  With my first VBAC, I needed to be in the hospital.  I felt more secure knowing there was a “safety net.”  I don’t know what that safety net was exactly, in my mind, but it was important for me based on where I was in my journey.  With my HBAC, it was the opposite-I was more afraid to be in the hospital and all the risks that are there. That is where I was then in my journey.  Both were OK choices, and both should be made available to all women because we need to birth where we feel safe and are fully supported. 

This is completely opposite from my first birth-I had never heard of placental abruption, cord prolapse, uterine rupture, placenta accreta, nor had I ever heard of side effects from epidural, risks of Cytotec (I was never even told about Cytotec, even though it was used on me), risks of induction, risks of cesarean, etc.  The only thing I was ever told by my OB was that after 42 weeks there is a higher chance of stillbirth.  So there, that was it.  I was led to believe that everything would be just fine as long as we got the baby out before 42 weeks, and I did everything they told me.  “Thank God for modern medicine that saved my baby’s life,” was something I said regularly until I started preparing for my VBAC and the bombshell was dropped on me.  I was completely unprepared for anything bad happening, and if my baby had died I would have been bewildered, as I really didn’t think things went wrong to the baby when you had good prenatal care and did everything your doctor told you to do.

So with my VBAC’s I knew very well  that sometimes things go wrong, that not everything can be controlled, not everything explained, not every baby saved  no matter what you do, no matter who is attending.  I learned about all the things that can go wrong.  But in learning about it all, I wasn’t any more fearful, just realistic.  I learned that birth is as safe as life gets.  I saw this on a bumper sticker of my midwife, and soon understood what it meant.  So with all that knowledge, I made what I believed were the best decisions for both my baby and me and our health and our lives.  Now had I lost a baby, maybe I would feel differently, and I am grateful to not be in that position, but it would be hard to believe I would feel any differently, since I knew all the risks.  I was prepared and empowered, and it was important to my midwives that I knew all these things, as opposed to my OB who never mentioned one statistic, one negative, one drawback to being induced.

But one thing I never, ever want to do is try to guess what other families may be going through after a loss, other than supporting them and honoring their baby.  Because when we talk about loss, there really is a baby, and a mom, and a family, and the story is theirs to tell.  I think a hospital worker spewing out a horror story at a pregnant woman dishonors both families .  Women have the right to make their own decisions, no matter what others think.  And I believe they have a right to not have people spew horror at them.  I do encourage all women to learn about all the risks, and advantages, so they can make their own best decisions, and then please, let them gestate in peace!