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.
Thursday, March 11, 2010
Saturday, March 6, 2010
Why Is VBAC a Vital Option?
Why is VBAC a vital option? by Heather Deatrick and Jess B.
*This post is the combined thoughts of Heather, ICAN Twin Cities member; and myself, Jess, ICAN Twin Cities member. Written for the ICAN Blog Carnival and for all birthing women out there.
Jess: How do we even start this post? Why is VBAC a vital option – I have reams and reams of information in my head – and I know that there is evidence upon evidence to support why I think and know that VBAC is a vital option. I am a perfectionist and like to wait until things are perfect before I submit them. But, in order for me to meet the deadline for this post – I am afraid that I will not be addressing every issue – besides the fact that I think this would turn into a doctoral thesis if I did!
Heather: To me it is obvious. The c-section rate is climbing. The rate it is going, followed by subsequent c-sections, means women are facing surgical birth as the norm. This defies logic as women have been giving birth for thousands and thousands of years and we have been a very successful species. The most successful actually, and hand washing to prevent disease only started in the last 100 years! To suddenly, in a matter of two decades, have birth become something that women cannot do without the help of a surgeon is arrogant and dangerous.
Jess: Let me start by stating that I had a successful VBAC in 2009. My c-section was in 2006 after an induction for pre-eclampsia at 36w5d. A nurse talked me into an epidural at 3cm (easy to do when the mom is in a fog due to Magnesium Sulfate running through her veins) even though I wasn’t feeling any pain. Shortly thereafter, my bp dropped significantly and my son responded by giving a bunch of whopping late heart decelerations. Hence my “emergency c-section” under general anesthesia. I knew before I even left the hospital that my next birth was going to be a VBAC. I even had nurses telling me, without me even mentioning my desire to VBAC, that I will never be able to have a vaginal birth as there would be too much risk for me and the baby. I must admit that my initial decision to VBAC was highly emotionally driven. I mourned the lack of initial bonding with my baby and the fact that he was given bottles by the nurses right away, thus ruining our breastfeeding relationship. But, hey, in no particular order of one reason being the best or that type of thing, there is reason number one why VBAC is a vital option – for the emotional health of the mother. Honestly – I’m tired of people who brush aside the emotional importance or significance of a vaginal birth – these factors are also important – so let’s start supporting mothers in that quest.
Heather: We know that while childbirth certainly has been dangerous in the past, this did really change with the advent of washing hands, and the ability to stop hemorrhages. Though while it was dangerous, it certainly wasn’t 30%, the way the c-section rate is now. I think it is abundantly clear that the rising c-section rate has to do with other things-technology, fears of litigation, time constraints for the doctors.
So why is VBAC vital? With every c-section comes a woman’s higher chance of death, comes a babies higher chance of breathing problems and asthma and who knows what else. We know that nature does everything for a reason, and vaginal birth is no different. The only way we are going to stop the runaway rising c-section rate is to start making VBAC the norm. When that happens, the provider will start to view vaginal birth as the norm again. It seems to me that vaginal birth is viewed as abnormal and a woman is “lucky” these days to have one.
Jess: I want to point out what some of our resources show. The Mayo Clinic states that the cons to C-section are: Your hospital stay will probably be longer than if you'd had a VBAC, Pain and fatigue linger longer after a C-section, you may wait longer to bond with your baby and begin breast-feeding , A repeat C-section makes it riskier to attempt VBAC for your next baby. C-section poses rare — but real — risks to your baby, such as premature birth and breathing problems. The risk of needing a hysterectomy to stop bleeding after delivery increases with the number of repeat C-sections. A C-section costs more than a successful VBAC does.
I once heard the quote “A C-section is a controlled rupture of the uterus.” I’ve had so many people throw uterine rupture in my face during my VBAC pursuit, a real risk no-doubt, but maybe I should have countered with the controlled rupture line.
Generally, if you have a low-transverse scar on your uterus, your risk of rupture is less than 1%. This article helps put VBAC and uterine rupture in perspective.
Heather: I have a feminist slant too as to why VBAC is vital. To me it seems that this a way to take away the controls from women that used to be 100% ours. Once, women gave birth out of our vaginas and women, midwives, throughout cultures and throughout time, caught them. This was one part of a woman’s life that was sacred and males were not a big part of, but certainly were in awe of. After all, to have a baby is almost god-like—to create and birth life is incredible. My own father told me when I was girl how lucky I was, and what an honor it was. While it is wonderful to have men part of this now, I would never change that, it is no longer a woman who does it. It is a monitor, a fetal scope, a suction, an epidural to sleep, a scalpel, a doctor delivering. It is our body totally controlled by an institution the minute we walk into a hospital. It is the ultimate handing over of our body to another.
To me, a c-section should really be only life saving. A woman today should be able to really say “thank goodness for modern technology that saved my baby and me.” While maybe a lot of women ARE saying that (even I did!), it isn’t the truth and really, modern technology has actually killed many. In this day and age there is no excuse or valid reason for a rising maternal mortality rate. I truly believe that changing the tide on VBACs is the answer.
*This post is the combined thoughts of Heather, ICAN Twin Cities member; and myself, Jess, ICAN Twin Cities member. Written for the ICAN Blog Carnival and for all birthing women out there.
Jess: How do we even start this post? Why is VBAC a vital option – I have reams and reams of information in my head – and I know that there is evidence upon evidence to support why I think and know that VBAC is a vital option. I am a perfectionist and like to wait until things are perfect before I submit them. But, in order for me to meet the deadline for this post – I am afraid that I will not be addressing every issue – besides the fact that I think this would turn into a doctoral thesis if I did!
Heather: To me it is obvious. The c-section rate is climbing. The rate it is going, followed by subsequent c-sections, means women are facing surgical birth as the norm. This defies logic as women have been giving birth for thousands and thousands of years and we have been a very successful species. The most successful actually, and hand washing to prevent disease only started in the last 100 years! To suddenly, in a matter of two decades, have birth become something that women cannot do without the help of a surgeon is arrogant and dangerous.
Jess: Let me start by stating that I had a successful VBAC in 2009. My c-section was in 2006 after an induction for pre-eclampsia at 36w5d. A nurse talked me into an epidural at 3cm (easy to do when the mom is in a fog due to Magnesium Sulfate running through her veins) even though I wasn’t feeling any pain. Shortly thereafter, my bp dropped significantly and my son responded by giving a bunch of whopping late heart decelerations. Hence my “emergency c-section” under general anesthesia. I knew before I even left the hospital that my next birth was going to be a VBAC. I even had nurses telling me, without me even mentioning my desire to VBAC, that I will never be able to have a vaginal birth as there would be too much risk for me and the baby. I must admit that my initial decision to VBAC was highly emotionally driven. I mourned the lack of initial bonding with my baby and the fact that he was given bottles by the nurses right away, thus ruining our breastfeeding relationship. But, hey, in no particular order of one reason being the best or that type of thing, there is reason number one why VBAC is a vital option – for the emotional health of the mother. Honestly – I’m tired of people who brush aside the emotional importance or significance of a vaginal birth – these factors are also important – so let’s start supporting mothers in that quest.
Heather: We know that while childbirth certainly has been dangerous in the past, this did really change with the advent of washing hands, and the ability to stop hemorrhages. Though while it was dangerous, it certainly wasn’t 30%, the way the c-section rate is now. I think it is abundantly clear that the rising c-section rate has to do with other things-technology, fears of litigation, time constraints for the doctors.
So why is VBAC vital? With every c-section comes a woman’s higher chance of death, comes a babies higher chance of breathing problems and asthma and who knows what else. We know that nature does everything for a reason, and vaginal birth is no different. The only way we are going to stop the runaway rising c-section rate is to start making VBAC the norm. When that happens, the provider will start to view vaginal birth as the norm again. It seems to me that vaginal birth is viewed as abnormal and a woman is “lucky” these days to have one.
Jess: I want to point out what some of our resources show. The Mayo Clinic states that the cons to C-section are: Your hospital stay will probably be longer than if you'd had a VBAC, Pain and fatigue linger longer after a C-section, you may wait longer to bond with your baby and begin breast-feeding , A repeat C-section makes it riskier to attempt VBAC for your next baby. C-section poses rare — but real — risks to your baby, such as premature birth and breathing problems. The risk of needing a hysterectomy to stop bleeding after delivery increases with the number of repeat C-sections. A C-section costs more than a successful VBAC does.
I once heard the quote “A C-section is a controlled rupture of the uterus.” I’ve had so many people throw uterine rupture in my face during my VBAC pursuit, a real risk no-doubt, but maybe I should have countered with the controlled rupture line.
Generally, if you have a low-transverse scar on your uterus, your risk of rupture is less than 1%. This article helps put VBAC and uterine rupture in perspective.
Heather: I have a feminist slant too as to why VBAC is vital. To me it seems that this a way to take away the controls from women that used to be 100% ours. Once, women gave birth out of our vaginas and women, midwives, throughout cultures and throughout time, caught them. This was one part of a woman’s life that was sacred and males were not a big part of, but certainly were in awe of. After all, to have a baby is almost god-like—to create and birth life is incredible. My own father told me when I was girl how lucky I was, and what an honor it was. While it is wonderful to have men part of this now, I would never change that, it is no longer a woman who does it. It is a monitor, a fetal scope, a suction, an epidural to sleep, a scalpel, a doctor delivering. It is our body totally controlled by an institution the minute we walk into a hospital. It is the ultimate handing over of our body to another.
To me, a c-section should really be only life saving. A woman today should be able to really say “thank goodness for modern technology that saved my baby and me.” While maybe a lot of women ARE saying that (even I did!), it isn’t the truth and really, modern technology has actually killed many. In this day and age there is no excuse or valid reason for a rising maternal mortality rate. I truly believe that changing the tide on VBACs is the answer.
Wednesday, February 24, 2010
Three Birth Centers Opening in the Twin Cities!
Wow - three birth centers are opening/have opened in the Twin Cities. I am so excited about the increase in options for women here. These are exciting times!
This article at Twin Cities.com talks about the birth center opening in St. Paul. Midwife, Amy Johnson-Grass is opening up this one and it is called Health Foundations. It also touches on Morningstar Birth Center as well, which is connected with the Menomonie birth center in WI.
This article discusses Health Foundations Birth Center, the Morningstar Birth Center that will open in St. Louis Park, and a Minneapolis Birth Center that will be in the vicinity Abbott and Children's hospital.
One of the quotes I really like is the one that talks about how birth centers fit with the "cultural norm" of going somewhere else to birth, but are a low-intervention option for birth that is similar to homebirth.
Take some time to look over these articles. Like I said - exciting stuff for the metro area. More options for women. Let me or other ICAN members know if you have questions about the birth centers. I'll try to stay on top of all of the new developments, births, and etc. in relation to these exciting new developments!
This article at Twin Cities.com talks about the birth center opening in St. Paul. Midwife, Amy Johnson-Grass is opening up this one and it is called Health Foundations. It also touches on Morningstar Birth Center as well, which is connected with the Menomonie birth center in WI.
This article discusses Health Foundations Birth Center, the Morningstar Birth Center that will open in St. Louis Park, and a Minneapolis Birth Center that will be in the vicinity Abbott and Children's hospital.
One of the quotes I really like is the one that talks about how birth centers fit with the "cultural norm" of going somewhere else to birth, but are a low-intervention option for birth that is similar to homebirth.
Take some time to look over these articles. Like I said - exciting stuff for the metro area. More options for women. Let me or other ICAN members know if you have questions about the birth centers. I'll try to stay on top of all of the new developments, births, and etc. in relation to these exciting new developments!
Thursday, February 18, 2010
Save the Date: "Laboring Under an Illusion"
ICAN of the Twin Cities is proud to announce a film screening of "Laboring Under An Illusion: Mass Media Childbirth vs. The Real Thing" to celebrate April's Cesarean Awareness Month. Please save the date and time on your calendar!
Saturday, April 24th, 3:00pm
Washburn Library, Minneapolis
Donations will be accepted for admission. Refreshments will be served!
A brief description of the film:
"Breathe! Push! Hurry! Give me drugs! Oh no! I love you! I hate you! Help! Are we bonding yet? There are more pregnant women watching TV birth scenes than attending childbirth classes. So when labor starts, they may be surprised by the real thing. A new documentary film, “Laboring Under An Illusion: Mass Media Childbirth vs.The Real Thing,” contrasts actual birth footage with the fictionalized commercial version. In
over 100 video clips, anthropologist Vicki Elson explores media-generated myths about childbirth."
More information here.
Saturday, April 24th, 3:00pm
Washburn Library, Minneapolis
Donations will be accepted for admission. Refreshments will be served!
A brief description of the film:
"Breathe! Push! Hurry! Give me drugs! Oh no! I love you! I hate you! Help! Are we bonding yet? There are more pregnant women watching TV birth scenes than attending childbirth classes. So when labor starts, they may be surprised by the real thing. A new documentary film, “Laboring Under An Illusion: Mass Media Childbirth vs.The Real Thing,” contrasts actual birth footage with the fictionalized commercial version. In
over 100 video clips, anthropologist Vicki Elson explores media-generated myths about childbirth."
More information here.
Sunday, February 14, 2010
More Hope for VBAmC
VBAmC - that stands for Vaginal Birth After Multiple Cesareans. I ran across this article the other day and appreciated the hopeful information that it had for women seeking a VBAmC. I know of women who had a repeat cesarean after their first cesarean just based on information from their doctor telling them that a subsequent c-section would be in their best interests. It's not until after that repeat c-section that they discover that maybe they can still deliver vaginally. Or there is the woman who attempted a VBAC and for whatever reason it ended in a c-section and she may be wondering about the safety of VBAC for her - or better yet (in my opinion) - how she is going to convince a care provider that it is safe. I believe that one of the biggest issues for VBAmC is finding care provider support - especially if it is a woman's preference to deliver in the hospital setting. One may have the best luck finding support with home-birth midwives or birth centers - but what about those who need to/want to deliver in the hospital setting?
In short summary this article highlights the fact that of the 89 women who attempted a vaginal delivery out of 860 - all of who had 3 prior c-sections or more - none of those women experienced a uterine rupture. The article notes that it is a small sample size as it is difficult for women to try or "be allowed" to try a VBAmC.
Overall - there is a positive tone and it appears that VBAmC is being looked at more closely. I hope that this conference in March will provide fair, insightful, and continued overall positive change towards the VBAC movement.
Let me just conclude this by saying that I believe if the mother has looked at her options, knows her risks vs. benefits and believe that a VBAmC is for her, then by all means, she should pursue it and believe in herself. Like I stated above, the challenge for her is finding a supportive care provider willing to stand alongside her.
In short summary this article highlights the fact that of the 89 women who attempted a vaginal delivery out of 860 - all of who had 3 prior c-sections or more - none of those women experienced a uterine rupture. The article notes that it is a small sample size as it is difficult for women to try or "be allowed" to try a VBAmC.
Overall - there is a positive tone and it appears that VBAmC is being looked at more closely. I hope that this conference in March will provide fair, insightful, and continued overall positive change towards the VBAC movement.
Let me just conclude this by saying that I believe if the mother has looked at her options, knows her risks vs. benefits and believe that a VBAmC is for her, then by all means, she should pursue it and believe in herself. Like I stated above, the challenge for her is finding a supportive care provider willing to stand alongside her.
Sunday, January 31, 2010
Being prepared matters
Just over a week ago I got a text message from a friend asking for prayers. His wife was being induced at 35 weeks due to low amniotic fluid.
My first thought?
Oh crap. She's gonna end up with a c-section. Yet another friend to "welcome" into the Sisterhood of the Scar.
Turns out, I was wrong. Even though she was induced at the hospital with the 3rd highest cesarean rate in the Twin Cities (30%), she escaped a surgical birth.
How did this happen?
I bumped into her at church this morning. She told me that she was freaked out when she knew she was headed for induction. She had the same thought I did, that she was probably going to end up with a cesarean. The chances were certainly good - a high risk situation, induction, a preemie on the way...
I think it was her preparation (and no doubt support of her husband and others) that made a huge difference. This was her second birth. Her first had been at the same hospital, but they were well-prepared the first time, too. They had taken Bradley classes and stayed home as long as possible during labor. She had a drug-free birth the first time around. That same mindset and preparation helped her avoid more interventions during her induction this time. She told me, "The only bummer was that I had to be in the bed the whole time [for monitoring, Pitocin, etc]. But I used having to go to the bathroom a lot as my excuse to get up often. So, I got the drug-free birth I wanted. Well, except for the Pitocin...."
My friend was prepared to meet the challenges of an unexpected, stressful birth because she knew from experience as well as from childbirth eduction that sometimes you have to work with what you've got. She knew that moving around is so important in labor. So, she used a little trick to work the system and get up as much as she could. It wasn't a completely ideal situation, but she worked for the birth she wanted even despite the odds.
My first thought?
Oh crap. She's gonna end up with a c-section. Yet another friend to "welcome" into the Sisterhood of the Scar.
Turns out, I was wrong. Even though she was induced at the hospital with the 3rd highest cesarean rate in the Twin Cities (30%), she escaped a surgical birth.
How did this happen?
I bumped into her at church this morning. She told me that she was freaked out when she knew she was headed for induction. She had the same thought I did, that she was probably going to end up with a cesarean. The chances were certainly good - a high risk situation, induction, a preemie on the way...
I think it was her preparation (and no doubt support of her husband and others) that made a huge difference. This was her second birth. Her first had been at the same hospital, but they were well-prepared the first time, too. They had taken Bradley classes and stayed home as long as possible during labor. She had a drug-free birth the first time around. That same mindset and preparation helped her avoid more interventions during her induction this time. She told me, "The only bummer was that I had to be in the bed the whole time [for monitoring, Pitocin, etc]. But I used having to go to the bathroom a lot as my excuse to get up often. So, I got the drug-free birth I wanted. Well, except for the Pitocin...."
My friend was prepared to meet the challenges of an unexpected, stressful birth because she knew from experience as well as from childbirth eduction that sometimes you have to work with what you've got. She knew that moving around is so important in labor. So, she used a little trick to work the system and get up as much as she could. It wasn't a completely ideal situation, but she worked for the birth she wanted even despite the odds.
Sunday, January 24, 2010
What to Say, How to Say It
I just wanted to ponder the issue that a lot of us at ICAN have run into. And that is -how to present/give birth advice in a way that people will listen, not be offended, not go in the wrong direction, and again - actually listen and take in what you have to say.
Let's face it - most of us are a part of ICAN because we have been affected by birth in one way or another. (If you just happen upon this blog or are passing by - welcome!). I also think that most of us find opportunities all of the time to inform others about birth. Some people ask for suggestions, and there are others who are just talking about their pregnancy or birth and we can't seem to keep our mouths shut - I mean - it would be a sin to withhold all of the information we have.
I ponder this topic because the last thing I want to do is turn someone off so much that they won't even listen to what I have to say. And I must say, my approach has changed a lot over the past couple of years. There was a time when I would just jump in and say things when my advice wasn't asked - ie) "Don't induce 1 week past your due date - inductions are horrible - let your baby stay in ." - to a 2nd time mom that had a vaginal birth her first time.
I'm still struggling with the right balance. Just recently I made it known, subtly, to someone I have to see daily, that I don't exactly agree with weekly cervical checks from 36 weeks on out. I'm kind of wishing I would have just kept my mouth shut. Yet, I know I've slowed down more, listened more, and have gotten better at trying to put information out there in a factual, somewhat non-biased sounding way. I really try to affirm actions and decisions that seem informed by mothers. I seek to encourage and uplift all mothers regardless of whether or not I agree with them. I have to remember that the last thing that I want any mother to feel is put down by what I say - because that is the opposite of what we are trying to do. Sometimes my passion for wanting the best for all mothers and babies is without inhibitions.
So, tell me - what is your best approach with pregnant mothers and birth advice? Or perhaps, share an instance that you regret and wish you could have approached differently. I'd love to hear people's tactics for giving information in a sensitive way - yet with the mission towards better birth in mind.
Let's face it - most of us are a part of ICAN because we have been affected by birth in one way or another. (If you just happen upon this blog or are passing by - welcome!). I also think that most of us find opportunities all of the time to inform others about birth. Some people ask for suggestions, and there are others who are just talking about their pregnancy or birth and we can't seem to keep our mouths shut - I mean - it would be a sin to withhold all of the information we have.
I ponder this topic because the last thing I want to do is turn someone off so much that they won't even listen to what I have to say. And I must say, my approach has changed a lot over the past couple of years. There was a time when I would just jump in and say things when my advice wasn't asked - ie) "Don't induce 1 week past your due date - inductions are horrible - let your baby stay in ." - to a 2nd time mom that had a vaginal birth her first time.
I'm still struggling with the right balance. Just recently I made it known, subtly, to someone I have to see daily, that I don't exactly agree with weekly cervical checks from 36 weeks on out. I'm kind of wishing I would have just kept my mouth shut. Yet, I know I've slowed down more, listened more, and have gotten better at trying to put information out there in a factual, somewhat non-biased sounding way. I really try to affirm actions and decisions that seem informed by mothers. I seek to encourage and uplift all mothers regardless of whether or not I agree with them. I have to remember that the last thing that I want any mother to feel is put down by what I say - because that is the opposite of what we are trying to do. Sometimes my passion for wanting the best for all mothers and babies is without inhibitions.
So, tell me - what is your best approach with pregnant mothers and birth advice? Or perhaps, share an instance that you regret and wish you could have approached differently. I'd love to hear people's tactics for giving information in a sensitive way - yet with the mission towards better birth in mind.
Saturday, January 9, 2010
Jamie's Breech Birth Story
On April 1, 2008, I found out that Baby (gender at the time was unknown) was breech. Approaching 33 weeks pregnant, I was unafraid because I knew there was plenty of time for Baby to turn around. For curiosity's sake, I posed a question in an online community, asking what typically happens if a woman goes into a hospital in labor with a breech presenting baby. The answers I received were, to say the very least, shocking, eye-opening and frightening. I had women point me in the direction of "Pushed" by Jennifer Block in which there is at least one story of a woman forced by court order to have a c-section against her wishes because her doctor thought it best for her particular situation. The general reply I received from the women in their replies was that to refuse a c-section would be unwise since most all doctors nowadays are not taught the art of breech vaginal delivery. Many were helpful, offering links to Gail Tully's "Spinning Babies" website, as well as ICAN. I was told about the various techniques to help coax a breech baby to turn. To be honest, I didn't follow any of the advice or techniques yet, Baby was once again head-down by April 7, 2008.
I didn't worry about it and, in fact, I went to that same online community and did a little online happy-dance and bragged that Baby had resumed a vertex position. If I'd only known...Toward the end of my 37th week of pregnancy, May 5, 2008, I went in for my weekly appointment with my midwives at a large hospital in Minneapolis. She laid hands on me and got a strange look on her face and said something about breech presentation. She left the room and returned with a portable ultrasound machine. I held my breath as the midwife spread the lovely goop on my belly. BAM! There was a little head pushing into my ribcage where there was supposed to be an ass. I was not amused. My midwife was going to schedule an external cephalic version (ECV) but by the time we were finished with my appointment, the scheduling office was closed. She spent a lot of time with me showing me various positions to get in to to coax Baby to turn and gave me other tips as well; much along the same lines as what can be found on the Spinning Babies website. She also made an appointment for me to have a moxibustion session later that week. Moxibustion is a traditional Chinese medical practice that involves the burning of herbs to stimulate acupuncture points. In pregnancy, the herbs are burned near the pinkie toe on the woman's foot. When I finally did get in to have a session, it was just for the woman to show me how to do it myself at home. I went to my mother's house and had her do it for me and it was quite surreal. It certainly did get Baby moving around a whole lot but all that movement was a whole lot of nothing and Baby still remained breech. The session did make for a neat video to add to the story! I swear, it was like something out of the "Aliens" movie! I wasn't able to get the supplies needed for the moxibustion until what turned out to be 2 days before I gave birth. The session had been scheduled for the middle of my 38th week of pregnancy but the night before I was supposed to go in, I got a call from my surgeon's office saying a surgery I'd previously been turned down for due to my late stage of pregnancy, was back on. So the moxibustion was canceled and instead I spent the better part of the day on an operating table getting my right hand sliced open for the second time during my pregnancy in order to repair a tendon injury. Because of this surgery, I was unable to do the water therapy I'd wanted to try to get Baby to turn. I did go to the pool on Mother's Day (I even got in for free!) but I had a splint on my hand and could not go underwater so it was all but pointless, at least from the point of view of someone attempting to get a breech baby to turn.
I had 2 versions performed during the last week and a half of my pregnancy. The first one was at the hospital. I went in early in the morning and was placed in a triage area of the maternity ward surrounded by other women in various stages of pregnancy. I laid in the bed hooked up to an IV for fluids and a fetal heart rate monitor for about an hour and a half before they brought me into the ultrasound room with the OB who attempted the version. The lights were kept low as a technician stood by and checked periodically with the goop-covered transducer to see if any progress was being made on Baby's position. Let me tell you, if you think having a human kicking its way around in your uterus is a strange feeling, try having someone on the outside attempt to get that tiny human to move in a direction it does NOT want to go. I walked around for days afterward feeling as though I'd been punched repeatedly in the stomach. I left that day feeling sad and defeated.
That weekend I networked in a way I never had before. I called my aunt who gave me the number to my other aunt who gave me the number to a home birth midwife that she had met through some group or other. I called the midwife and left a voicemail, practically in tears, and let her know of my situation. She called me back the next day and we talked some things over. She said that she would gladly have me come to her house and she would make another attempt at a version. It was a Monday morning when my boyfriend and I drove to her home in St. Paul. I ran into a friend of mine in the lobby of her building and he got a kick out of my story behind being there in his building! The midwife buzzed us in and when we walked into her apartment, I felt very welcomed. Her kids were running around playing and were very respectful of the fact that Mommy was with a client. They just kind of played off to the side while the midwife and her assistant laid hands on me while I was laying on a mat on her carpet. She was very gentle and despite still feeling bruised from the hospital's attempted ECV, I didn't feel any pain. The assistant listened with the fetoscope while the midwife worked. She must have had her hands on me for 10-15 minutes before she finally gave up and let me know that this baby was wasn't going to turn. She told me she was not going to charge me anything for the attempt, which was a welcomed silver lining amidst a sea of mucky grey.
She then offered to attend my birth at home. The thought hadn't occurred to me, though I had been told that was about the only way to accomplish a vaginal breech delivery. If I knew then what I know now, I would have jumped at the chance. To be honest, that little voice in my head told me to have my birth with her and I really did want to despite knowing virtually nothing about home birth, especially considering my first birth was a stereotypical hospital birth with an epidural and a midwife I'd never before laid eyes on. But I really knew I could trust this midwife. However, after discussing it with my boyfriend and my mother (I'd be giving birth at her house if that's the route we took), they were not comfortable with the idea therefore the midwife was not comfortable since they were my support persons.
So there I was, 9 months pregnant and knowing I was going to have a c-section despite the fact that women have been birthing babies who present in all forms of presentations since the dawn of time. It sounds extreme but it was like a death sentence for me, the c-section, I mean. I had done everything I could think of to get Baby to turn. I spent so much time inverted hanging off the end of my couch that upside-down began to look like right-side-up to me. I talked to Baby so often that I thought for sure it would be born so sick of my voice that it would cry whenever I spoke. I played music via headphones between my legs while holding a cold pack on baby's head near my rib cage. I tried a heat pack in place of the head phones. My best girlfriend had brought me her Ab Lounger that allowed me to get into an even better inverted position than I was able to accomplish on my couch. I watched a lot of TV upside down with a cold pack on my ribs and a heat pack and headphones down below while I sang little songs to Baby about how it needed to go toward the sound and flip around for Mommy.
At 39 weeks exactly, I had my last midwife appointment. My favorite midwife was there that day and she had no choice but to send in an OB who told me all of the scary stories about why my wanting to have a vaginal delivery could very well kill me and my baby. She brought in copies of statistics and studies (I know now that this was excerpts from the Hannah Term Breech Trial that has since been proven to be so full of holes that it's almost laughable that a medical professional was showing them to me) and I read through them while listening to her and this little voice in my head was telling me to run very very far away. But at that point, I didn't have a choice. I'd called all the area hospitals and no one would accept me for a vaginal breech delivery. A nurse at one hospital I called went so far as to lay into me about how unwise of a choice I was making by trying to have a vaginal breech delivery. I think I simply hung up on her. In general, I got the same tone from every place I called.
I didn't give up trying to call to find a provider but I had no luck. Finally I was at a coffee shop near my house writing up a new c-section birth plan when my favorite midwife from my hospital called me. She said she'd just left a conference and met a perinatologist from a different hospital who wanted to meet me for a consult the following day. She got his office on the phone via 3 way and I went to the consult the next day.
During the consult, I was told that in the practice of 15 doctors, 12 would be open and welcoming for my vaginal delivery, but that 3 would push strongly for a c-section. He basically said that, while those 3 would push for the surgery, they were ALL more than trained and competent enough to do a vaginal delivery. He made sure I knew the risks but made it clear that he felt those risks only really applied to women with larger babies and who had not given birth before. He didn't warn me in a frightening way that the choice I was making was going to harm me or my baby. He did say there was a risk, but also said there were many risks to c-sections and said that if there was such a thing, I was a perfect candidate for a breech vaginal delivery. He did a quick ultrasound which showed Baby was 6 pounds even and he told me what to do when I was in labor.
I laugh now when I think of the conversation I had with him that day. He said just in case I came in in labor to one of the 3 doctors that would push for surgery, to labor at home as long as possible and to only come in when I felt I was very far into labor. Overall, he made me feel really calm. Well, that was the calm before the storm I suppose, but I'll get to that later.
My labor had kind of started that Monday, when I was 39 weeks along. Contractions were regular but they were 15-19 minutes apart, though slowly getting closer together. I knew I wasn't going to make it to the end of the week. I drank a few glasses of wine over the course of those few days before I had my consult with the perinatologist because even though I'd accepted that I had to have surgery, I almost knew I wasn't going to have to; the same little voice that told me a c-section was not the "right" thing for me also told me to have faith. No sooner did I get home from the consult than my contractions started to pick up. By 9pm that night they were 7 minutes apart and getting closer. I got no sleep that night. I'm not comfortable sharing the story of my labor that night because it's pretty much littered with personal drama, for lack of a better way to put it. My boyfriend never really saw me in labor with our first daughter, not TRULY in labor. With her, my water broke, we went to the hospital, got the epidural when contractions started and I pushed her out in 47 minutes, there was no primal woman in labor going on as there was with my breech baby. With my breech baby, it was a lot more primal, I was listening to my body, I was having contractions to signify I was really in labor and labored at home as opposed to having waters break and immediately going to the hospital. I was a lot more in touch with myself as a mom, and as a pregnant woman and I think I must have been like a complete stranger to him and he was not there for me in any sense.
By around 2pm the next day, I'd been up all night walking the sidewalk in front of my place. Mike's mom came over that morning and had spent a good portion of the night talking to me on the phone. I was living next door to my mom's house so my mom was there as well as my best friend. Mike was at home right next door but I don't think I saw him until hours later when we were all getting ready to go to the hospital and, to be honest, I didn't care. I was deliriously in love with being in labor; I can't think of a better way to describe it. It was beautiful; everything I'd read about in Ina May Gaskin's books. I felt so empowered and beautiful and I laughed through the (quite painful) contractions as I dropped to my knees to moo like a cow or blow raspberries. During a late lunch, my mom and Mike's mom realized that my contractions were barely over a minute apart and they convinced me it was time to go to the hospital. I agreed about half an hour after that; it was around 3 in the afternoon.
I don't remember a whole lot about the ride to the hospital aside from arguing with my mom for going over bumps in the road because it made my contractions unbearable. Since I'd just switched practices the day before, I didn't have any idea where to go once I got to the hospital. I tried calling 411 to get the number to the hospital but a woman in active labor strapped behind a seat belt, mooing like a cow and arguing with her mother does not lead to a successful phone call. We just parked in the ER parking lot and were directed to the maternity ward. The walk down the hallway and the ride in the elevator is a complete blur to me of leaning against walls and I think I may even have sat on the floor once or twice. I was still laughing. I feel like the perinatologist who did my consult really set my mind at ease and despite the fact that I was going to be giving birth in a hospital again, I felt at peace because I knew I was going to get the safe, vaginal breech birth I knew I and my baby deserved.
Of course, I wound up with a doctor who wanted to do a c-section. I had a huge fight with the doctor and kicked him out of my room and said if he wouldn't do it, to find someone who would. He left and came back 45 minutes later with what I love to call the "waiver of baby death" and said that while he was uncomfortable doing it, he was probably one of the most trained for breech delivery, having been in practice since the mid 70's when breech delivery was a normal thing. During that 45 minutes that he was out of the room (and I was in the sterile maternity intake room hooked up to monitors laying flat on my back, of course), my labor all but stopped. Mike was nowhere to be found because he'd found other more important things to tend to like locking his keys in the car outside the hospital. My contractions became unbearably painful and according to my mom and Mike's mom, I was losing it completely; hyperventilating, crying, shaking, angry. While I calmed down after he agreed to "allow" me my vaginal delivery (gee, how generous of him, right?), I never did regain that sense of peace and calm I'd had when laboring at home. I think that's why I finally broke down at 7pm or so and got the epidural. It wasn't really for the pain, which I was managing quite well again at that point. I was more than afraid the doctor would find a "reason" to do the surgery and I did not want to risk there not being enough time and my having to use general anesthesia.
I basically gave up. I don't blame myself for it, but I know I gave up. I let him break my waters and I let him administer Pitocin. I did have a LONG conversation with him about not wanting to have him perform an episiotomy during the pushing stage, that I knew my body could push Baby out without one and that if it came down to it, I'd rather tear along the path of least resistance. Just shy of 2am, I felt that burning feeling and I knew from my previous birth that I was ready to push. That's when it got crazy...I was wheeled in to the OR (I already knew I'd be giving birth in there, which was kind of frightening) and there I was, Mike was the only person allowed in the room, covered head to toe in a gown and mask, holding the video camera. I don't remember exactly how many people were in the room but they had the doctor's surgical team and the NICU team in there with us. I don't remember exactly how long it took to push her out but I know it had to have been less than 10 minutes because I had her out with the 3rd contraction. After the 2nd contraction, he asked the nurse for the tool so he could do an episiotomy and I screamed out NOOOOOO. He told me her heart rate was dropping and that he needed to get her out RIGHT AWAY. Of course I went with it. She was born at 2:04am on May 16th 2008. Six pounds 3 ounces of perfection. I was able to hold her immediately while he stitched me.
I left after she was 12 hours old, much against medical advice. I knew I wasn't going to stay as long as they wanted me to but I left so soon because the pediatrician came in when she was around 10 hours old or so and before asking me how I or she was doing, he said he'd taken a look at my chart and saw that I was still nursing my 19 month old and that I should probably stop now that I had the new baby. I barked at him about how the WHO recommends nursing for 2 years and as long as is mutually desired thereafter and that if I wanted parenting advice from him, I would have asked. He checked her from head to toe and quickly left the room!
Fast forward to this past February, I got a copy of her medical records and mine as well. I got her records to be able to get her social security card (she didn't get one in the hospital because she didn't have a name when we left). I got my records just for curiosity's sake. In both of our records, there is no mention of her ever having a problem with her heart rate and the only mention with the episiotomy is that tearing was likely. In her records, it very clearly states that her fetal heart tones were reassuring throughout. Her heart rate was never a problem, there was no need for the episiotomy, he gained my consent through lying to me before cutting me from my vagina down toward my anus.
All in all, I'm VERY happy that I was able to have my vaginal delivery. But I very much feel as though my entire birth experience was a form of emotional, and at times, physical rape. I can't watch a video of a woman giving birth, be it in a hospital or at home, without longing to be in labor with her again, to be able to have a do-over. I cry a lot when I think about it. I have a copy of "The Business of Being Born" from Netflix that's been in my possession for several months now that I've not been able to force myself to watch. I'm afraid of everything flooding back to me again. My little breechling is now 19 months old. I wasn't able to begin facing my birth experience with her until about 4 months ago. Sure, I've been "bragging" about it since I gave birth, but it wasn't until recently that I really allowed myself to feel the emotions.
Mike videotaped the birth. I watched it for the first time a month or so ago and I was a crying mess just by halfway through it. I got to the part where he cut the episiotomy and I heard the loud cry I made and it was like being on that hospital bed all over again. He didn't wait long enough for the numbing medication to set in before he took the tool to me and I FELT my flesh being cut open. I had blocked that out of my mind. The time on the video after she was born, I look like someone else. I don't see myself when I watch the video. I was shaking from the epidural and perhaps the adrenaline pumping through my body. I was completely detached from the entire situation. Mike was off near the table where they'd brought her to weigh her and clean her off and I was listening to all the conversations around me and adding babbling sentences to other people's conversations. I think the most telling part of the entire video and the entire story is that I didn't cry when she was born. When they placed her in my arms it was like I was holding A baby but not MY baby. I had no attachment to her whatsoever. I continued to feel like that for the first month or so of her life. I had this baby with her mouth on my nipple and I was changing her diapers and she was like this strange little alien that had just dropped from the sky and I was expected to take care of her.
Around the time she was able to start smiling and became more interactive with others around her, that's when I felt a bond and I *knew* she was mine and I felt that surge of love hormones. Before that time, I was just going through the motions. I knew she needed to eat so I offered my breast. I changed her diapers and her clothes, I bathed her, she slept next to me at night and I did all of the other things a mother does for her child and that I did for my first daughter but for that first period, I didn't feel as though I was doing these things for my own child. Knowing what I know now, I was in a state of shock after giving birth to her. I don't see myself in the video or in pictures because the self I've come to know and love after 20-some years on this planet was not really present. That "me" took a hike the moment the doctor came into the room and barked at me about how he would never take the kind of risk I was taking with his own child and he didn't understand why I would take it with mine. While I am very much bonded with my daughter now, and have been since she was around 2 months old, I feel as though now that I'm finally facing my birth experience head on, ugliness and all, I'm finally getting to know myself again, the self that ran away and hid when I got to the hospital that day.
In September of 2009, I made a choice to finally go to college, having graduated from high school in 2000. I think the reason I waited so long to go back to school is that I didn't know what I wanted to be when I grew up. Now I know I want to be a midwife. As of January 11, 2010, I will be attending classes to gain the general education credits necessary to enroll in the nursing program. The next step after becoming a nurse is to complete the training to become a certified nurse midwife. Through personal experience, I have found that there is a frighteningly MASSIVE amount of incorrect information out there for women who are pregnant, about to give birth, nursing a baby, a toddler and raising children in general. There are blanket statements passed around to women who, through no fault of their own, just don't know any better and believe that doctors (OBs and pediatricians specifically) are infallible. For a long time, I was one of those people. I felt that doctors were bound by their oath to "do no harm" and that if they'd gone to school for so long for their specific field, obviously they must be right. My experiences over the years have taught me otherwise. And I am grateful for those experiences and both of my daughters for the parts they have played.
Friday, January 8, 2010
Washington Post article on breech birth
The woman featured in this article who had two cesareans for breech and then went on to have a breech VBAC is an ICAN chapter leader!
Breech is near and dear to me since a young woman contacted our chapter a year and half ago desperate for help with finding an OB to deliver her breech baby. I was at a loss. I knew of none at that time, except for homebirth midwives, who would or could. To tell this woman I couldn’t help her prevent this cesarean was devastating and I will never forget it. Fortunately, she went on to deliver vaginally in a hospital.
When I heard Canada was reversing its policy on breech it gave me hope. If other countries are changing their policies on birth, we may someday too. Every woman should be prepared. Breech is not abnormal, it is just another way for a baby to come out. So because of this, I do have hope that the US will practice more evidence-based medicine with birth in the hospitals. That one day the VBAC rate will be over 50% and the c-section rate well under 20%. We will see healthier moms and healthier babies, we all know that. It starts with us, trusting our bodies and choosing a professional who does as well, and who is skilled in more than just the knife.
Next post: Jamie's Breech Birth story!
Thursday, January 7, 2010
Emergency Childbirth, or common sense?
This was forwarded to me by another midwife - advice for impromptu birth attendants, straight from the DOD. It would be wonderful if medical practitioners routinely followed this commonsense advice for safe birth! Notice there is no mention of checking for a Cesarean scar first...
Emergency Childbirth Reference Guide Posted at 01:18 AM on January 06, 2010
U.S. Department of Defense
Emergency Childbirth
A Reference Guide for Students
Medical Self-Help Training
Course Lesson No. 11
Emergency Childbirth: What To Do
1. Let nature be your best helper. Childbirth is a very natural act.
2. At first signs of labor assign the best qualified person to remain with mother.
3. Be calm; reassure mother.
4. Place mother and attendant in the most protected place in the shelter.
5. Keep children and others away.
6. Keep hands as clean as possible
7. Keep hands away from birth canal
8. See the baby breathes well.
9. Place the baby face down across the mother's abdomen.
10. Keep baby warm.
11. Wrap afterbirth with baby.
12. Keep baby with mother constantly.
13. Make mother as comfortable as possible.
14. Identify baby.
What Not To Do
1. DO NOT hurry.
2. DO NOT pull on baby, let baby be born naturally.
3. DO NOT pull on the cord, let the placenta (afterbirth) come naturally.
4. DO NOT cut and tie the cord until the baby AND the afterbirth have been delivered.
5. DO NOT give medication.
DO NOT HURRY - LET NATURE TAKE HER COURSE.
{emphasis is not mine - I copied this exactly as written}
This is how I approach attending VBAC as a traditional midwife and it works quite well - just ask the mothers!
Emergency Childbirth Reference Guide Posted at 01:18 AM on January 06, 2010
U.S. Department of Defense
Emergency Childbirth
A Reference Guide for Students
Medical Self-Help Training
Course Lesson No. 11
Emergency Childbirth: What To Do
1. Let nature be your best helper. Childbirth is a very natural act.
2. At first signs of labor assign the best qualified person to remain with mother.
3. Be calm; reassure mother.
4. Place mother and attendant in the most protected place in the shelter.
5. Keep children and others away.
6. Keep hands as clean as possible
7. Keep hands away from birth canal
8. See the baby breathes well.
9. Place the baby face down across the mother's abdomen.
10. Keep baby warm.
11. Wrap afterbirth with baby.
12. Keep baby with mother constantly.
13. Make mother as comfortable as possible.
14. Identify baby.
What Not To Do
1. DO NOT hurry.
2. DO NOT pull on baby, let baby be born naturally.
3. DO NOT pull on the cord, let the placenta (afterbirth) come naturally.
4. DO NOT cut and tie the cord until the baby AND the afterbirth have been delivered.
5. DO NOT give medication.
DO NOT HURRY - LET NATURE TAKE HER COURSE.
{emphasis is not mine - I copied this exactly as written}
This is how I approach attending VBAC as a traditional midwife and it works quite well - just ask the mothers!
Tuesday, January 5, 2010
Twin Cities Metro Cesarean/Vaginal Birth Rates
One of the latest things going around our birth advocacy community is the 2008 cesarean and vaginal birth rates for the Twin Cities metro hospitals. As many of us in ICAN have learned - it's important to consider these rates when giving birth. Just as it's important to consider your provider's individual numbers as well. I was kind of saddened to learn that Unity's c-section rate (where I had my cesarean) was on the low end. I guess I still kind of wish that my induction for pre-eclampsia would have worked out.
Those of us who have had a VBAC or are preparing for a VBAC are considering where to give birth. For those of us who decide that it will be hospital, these rates should be very helpful in deciding where to give birth. A friend of mine just became pregnant for the first time and who did she call right away? Me - and believe me, I do feel honored. She called me because ever since my baby #1 came I've been very vocal about birth - go figure. In just one night I got her thinking about midwifery care, and then after emailing her some information, I got her focused on the East Metro hospitals (minus United) instead of Abbott. All this before this handy little spreadsheet came out:
When looking at these numbers - it's important to consider the cesarean vs. vaginal birth rates. Obviously the higher the c-section rate - the more likely your chances are of having one. That is why it is important to know your provider's c-section rates, vaginal birth rates, VBAC success rates. The World Health Organization recommends a c-section rate no higher than 10-15% to keep the surgeries from doing more harm than good. Only one of our hospitals actually measures up to that - so that's a whole other post, but consider these rates and may you use it to ask questions of your providers, do research before deciding where you are going to birth. I had my VBAC at U of M Fairview, Riverside. They are on the higher end for the metro c-section rates, however, my midwife group had an 85-90% success rate for VBAC deliveries. That number was definitely a factor in helping me choose those particular providers. It all goes back to making an informed decision. Hopefully this will be another piece towards helping women make informed decisions.
Monday, January 4, 2010
Childbirth turns tragic, then joyful—a Christmas Miracle! or The Dangers of Epidurals?
Alarm bells went off when I read this amazing story of a mom and her baby miraculously coming back to life after “mysteriously” dying during childbirth. I knew there had be some reason her heart stopped (like all the drugs?!) I couldn’t find it though—the doctor kept on reiterating what a mystery it all was.Well, turns out she was induced and had an epidural. So why wasn’t any of this mentioned in the media or by the doctors involved? Have these things become such a common part of birth that no one even thinks of them as unnatural? I am totally baffled and appalled.
Henci Goer explained how epidurals can cause cardiac arrest in a blog post this week:
Her Survival Was a “Christmas Miracle,” but the Disaster Was Man-Made
Every woman needs to know all the facts. When I voiced my concerns for the epidural to my OB, he patted my knee and said “of course you will have it!” The same way he patted my knee and said I would have a repeat c-section instead of a VBAC for any subsequent births……
My point to this is not that epidurals are across the board wrong or bad. They can be very helpful when someone is at their breaking point, too tired, too scared, or in my case pumped full or Cytotec and Pitocin and totally unable to handle the pain. Everyone should be able to decide if it is time. But we need to know the risks! We have a right to know the risks. We deserve to know that it isn’t a miracle cure that will make childbirth a piece of cake.
And maybe we should be really alarmed that a doctor made no mention of this when she said her patient's death was a mystery.
I am glad she and the baby survived, but as a birth activist, a VBACtivist, the end does not justify the means. Our experiences matter.
Thursday, December 31, 2009
Maple Grove's Opening Act? A C-Section
The first hospital to be built in the metro area in 10 years opened it's doors to business today. It's first act? A scheduled cesarean.
WCCO reports:
The hospital is opening in stages, due at least in part to the current recession. It's current focus in on labor and delivery, and it's marketing campaign to attract patients appears to be working. The hospital website heralds its facility as the "region's premier birth center" and boasts of labor and delivery suites that help you feel "at home."
According to the Star Tribune (emphasis added):
Hmmmm. The birth center AND surgical area? Since when do these two things go together? I guess the state's 26% cesarean rate might tell us something about that.
While Maple Grove Hospital may be selling itself as the best maternity care around, evidence from scientific research suggests other standards. The Milbank Report on Evidence-Based Maternity Care: What it is and What it Can Achieve, based on a rigorous analysis of the best scientific studies of childbirth available, states (emphasis added):
Unless the care providers at Maple Grove Hospital (or any birth place, for that matter) support this kind of evidence-based care, expectant mothers and families in the Twin Cities might want to think twice before signing up for this "premier" birth center.
WCCO reports:
Melissa Bistodeau, had a scheduled C-Section in the afternoon. She, along with her husband Joe Bistodeau, and son Cole, got the royal treatment.
Nurses and doctors gave them a standing ovation as they made their way to their room.
The hospital is opening in stages, due at least in part to the current recession. It's current focus in on labor and delivery, and it's marketing campaign to attract patients appears to be working. The hospital website heralds its facility as the "region's premier birth center" and boasts of labor and delivery suites that help you feel "at home."
According to the Star Tribune (emphasis added):
On Saturday, nearly 6,000 visitors showed up for an open house at the new facility. People milled around the lobby clutching gift bags and chatting with Cochrane as the Maple Grove High School jazz band played. Kids got their faces painted. Outside, families posed for photos in front of a North Memorial helicopter.
Todd and Christine Nelson of Ramsey were in a long line waiting to tour the birth center and surgical area. Christine is expecting her first baby in April. She says she changed obstetricians so she could deliver at Maple Grove.
Hmmmm. The birth center AND surgical area? Since when do these two things go together? I guess the state's 26% cesarean rate might tell us something about that.
While Maple Grove Hospital may be selling itself as the best maternity care around, evidence from scientific research suggests other standards. The Milbank Report on Evidence-Based Maternity Care: What it is and What it Can Achieve, based on a rigorous analysis of the best scientific studies of childbirth available, states (emphasis added):
Although most childbearing women and newborns in the United States are healthy and at low risk for complications, national surveys reveal that essentially all women who give birth in U.S. hospitals experience high rates of interventions with risks of adverse effects. Optimal care avoids when possible interventions with increased risk for harm. This can be accomplished by supporting physiologic childbirth and the innate, hormonally driven processes that developed through human evolution to facilitate the period from the onset of labor through birth of the baby, the establishment of breastfeeding, and the development of attachment. With appropriate support and protection from interference, for example, laboring women can experience high levels of the endogenous pain-relieving opiate beta-endorphin and of endogenous oxytocin, which facilitates labor progress, initiates a pushing reflex, inhibits postpartum hemorrhage, and confers loving feelings. Large national prospective studies report that women receiving this type of care are much less likely to rely on pain medications, labor augmentation, forceps/vacuum extraction, episiotomy, cesarean section, and other interventions than similar women receiving usual care. Such physiologic care is also much less costly and thus provides outstanding value for those who pay for it. Burgeoning research on the developmental origins of health and disease clarifies that some early environmental and medical exposures are associated with adverse effects in childhood and in adulthood. Recognition of known harms and the possibility that many harms have not yet been clarified further underscores the importance of fostering optimal physiologic effects and limiting use of interventions whenever possible.
Unless the care providers at Maple Grove Hospital (or any birth place, for that matter) support this kind of evidence-based care, expectant mothers and families in the Twin Cities might want to think twice before signing up for this "premier" birth center.
Tuesday, December 15, 2009
Dads get post partum depression, too
The great discussion at last night's support meeting ("Healing From Traumatic Birth") reminded me of this recent article from the New York Times on fathers and post partum depression.
According to the article:
I guess it really shouldn't be surprising. Childbirth certainly transforms life for a woman who becomes a mother, but men go through a significant change as well, often bringing up new worries about the health and well-being of their partners and children, as well as increased financial and other strain. In the case of men whose partners have had traumatic birth experiences, the rate of post partum depression might be even higher.
So, why don't we know more about this? Again, from the article:
Well, duh. I guess we could have guess at the whole men-don't-express-their-emotions well. But the biological links are not something that I had ever thought about.
So, what can we women, their wives and partners, do about it? One thing is to get help for our own depression. The reason is this:
There are lots of resources in the Twin Cities community for support in healing from depression and other difficult emotions after birth. Whether you had a traumatic experience or the most wonderful birth imaginable, post partum depression can be a serious, but not insurmountable, issue - not only for moms, but for dads too.
Click here for a list of local resources.
According to the article:
Up to 80 percent of women experience minor sadness — the so-called baby blues — after giving birth, and about 10 percent plummet into severe postpartum depression. But it turns out that men can also have postpartum depression, and its effects can be every bit as disruptive — not just on the father but on mother and child.
We don’t know the exact prevalence of male postpartum depression; studies have used different methods and diagnostic criteria. Dr. Paul G. Ramchandani, a psychiatrist at the University of Oxford in England who did a study based on 26,000 parents, reported in The Lancet in 2005 that 4 percent of fathers had clinically significant depressive symptoms within eight weeks of the birth of their children. But one thing is clear: It isn’t something most people, including physicians, have ever heard of.
I guess it really shouldn't be surprising. Childbirth certainly transforms life for a woman who becomes a mother, but men go through a significant change as well, often bringing up new worries about the health and well-being of their partners and children, as well as increased financial and other strain. In the case of men whose partners have had traumatic birth experiences, the rate of post partum depression might be even higher.
So, why don't we know more about this? Again, from the article:
Unlike women, men are not generally brought up to express their emotions or ask for help. This can be especially problematic for new fathers, since the prospect of parenthood carries all kinds of insecurities: What kind of father will I be? Can I support my family? Is this the end of my freedom?
And there is probably more to male postpartum depression than just social or psychological stress; like motherhood, fatherhood has its own biology, and it may actually change the brain.
A 2006 study on marmoset monkeys, published in the journal Nature Neuroscience, reported that new fathers experienced a rapid increase in receptors for the hormone vasopressin in the brain’s prefrontal cortex. Along with other hormones, vasopressin is involved in parental behavior in animals, and it is known that the same brain area in humans is activated when parents are shown pictures of their children.
There is also some evidence that testosterone levels tend to drop in men during their partner’s pregnancy, perhaps to make expectant fathers less aggressive and more likely to bond with their newborns. Given the known association between depression and low testosterone in middle-aged men, it is possible that this might also put some men at risk of postpartum depression.
Well, duh. I guess we could have guess at the whole men-don't-express-their-emotions well. But the biological links are not something that I had ever thought about.
So, what can we women, their wives and partners, do about it? One thing is to get help for our own depression. The reason is this:
By far the strongest predictor of paternal postpartum depression is having a depressed partner. In one study, fathers whose partners were also depressed were at nearly two and a half times the normal risk for depression. That was a critical finding, for clinicians tend to assume that men can easily step up to the plate and help fill in for a depressed mother. In fact, they too may be stressed and vulnerable to depression.
There are lots of resources in the Twin Cities community for support in healing from depression and other difficult emotions after birth. Whether you had a traumatic experience or the most wonderful birth imaginable, post partum depression can be a serious, but not insurmountable, issue - not only for moms, but for dads too.
Click here for a list of local resources.
Tuesday, November 24, 2009
Welcome new bloggers!
We welcome three new mamas to our roster of contributors:
..
- Jessie Bridgeford - mother of two, most recently to Alex by VBAC
- Chandra Fischer - mother of two, our fearless chapter librarian and founder of the chapter in 2005
- Vanessa Coldwater - midwife, mama and "tub lady". Vanessa plans a regular "ask the midwife" column
..
Tuesday, November 17, 2009
Post-partum Depression Study
Opportunity to Participate in a Research Study on Postpartum Depression
A study investigating women’s experiences of pregnancy after recovering from Postpartum Depression is being conducted. Candidates for participation are women who have been diagnosed with moderate to severe Postpartum Depression by a mental health or medical professional and then had a child after recovering from that depressive episode. All participants must have given birth between nine and twenty-four months ago (i.e. their most recent child is between nine months and two years old) and be free from symptoms of Major Depression at the time of participation.
This study is comprised of a short, 10-15 minute phone interview consisting of some demographic questions (e.g. age, ethnicity, date of initial diagnosis, current psychological functioning). Additionally, some women may be asked to participate in two 1-2 hour audiotaped interviews to take place in a private, convenient location of their choice. The first interview will consist of questions aimed at gathering information on the experience of pregnancy after recovering from Postpartum Depression. The follow-up interview will be used to clarify ideas that arise from the first interview and will provide a chance to gain new information that may have been left out in the first interview. Women who participate in the 1-2 hour interviews will be compensated with a $5.00 Target gift card after each interview. Additional benefits of the study include informing mental health professionals about the process of preparing for another child as well as another potential episode of Postpartum Depression. In this way, professionals can be better informed of what women find helpful, what is not helpful, and what they wish they would have done differently. This information has the potential to enable professionals to aid other women who are in similar situations. Your participation in this research is completely voluntary and confidential. You may choose to withdraw from the study at any time.
If you are interested in participating in this study, please contact Amanda Delsman, Doctoral Candidate at the American School of Professional Psychology/Argosy University, Twin Cities, via email at adelsman@msp.stu.argosy.edu or via telephone at 651-492-3572.
A study investigating women’s experiences of pregnancy after recovering from Postpartum Depression is being conducted. Candidates for participation are women who have been diagnosed with moderate to severe Postpartum Depression by a mental health or medical professional and then had a child after recovering from that depressive episode. All participants must have given birth between nine and twenty-four months ago (i.e. their most recent child is between nine months and two years old) and be free from symptoms of Major Depression at the time of participation.
This study is comprised of a short, 10-15 minute phone interview consisting of some demographic questions (e.g. age, ethnicity, date of initial diagnosis, current psychological functioning). Additionally, some women may be asked to participate in two 1-2 hour audiotaped interviews to take place in a private, convenient location of their choice. The first interview will consist of questions aimed at gathering information on the experience of pregnancy after recovering from Postpartum Depression. The follow-up interview will be used to clarify ideas that arise from the first interview and will provide a chance to gain new information that may have been left out in the first interview. Women who participate in the 1-2 hour interviews will be compensated with a $5.00 Target gift card after each interview. Additional benefits of the study include informing mental health professionals about the process of preparing for another child as well as another potential episode of Postpartum Depression. In this way, professionals can be better informed of what women find helpful, what is not helpful, and what they wish they would have done differently. This information has the potential to enable professionals to aid other women who are in similar situations. Your participation in this research is completely voluntary and confidential. You may choose to withdraw from the study at any time.
If you are interested in participating in this study, please contact Amanda Delsman, Doctoral Candidate at the American School of Professional Psychology/Argosy University, Twin Cities, via email at adelsman@msp.stu.argosy.edu or via telephone at 651-492-3572.
Monday, November 9, 2009
ICAN Webinars: Home Birth After Cesarean
Join the women of ICAN at this month's online events! Online webinars offer you the opportunity to learn and interact in an exciting format. All you need to participate is a computer with internet access and speakers or a headset.
Educational webinars are free to ICAN subscribers. If you are not a current subscriber, you may subscribe or renew through the ICAN Bookstore or through your local chapter, or pay the applicable webinar fee.
Online support meetings are always free for everyone.
http://ican-online.org/webinars
NOVEMBER
Online Support Meeting: Homebirth After Cesarean
Tuesday, November 17, 10:00 pm EST
Free for everyone
Join the women of ICAN in a live online support meeting. The topic for this meeting is "Homebirth After Cesarean." Share your story, your fears, your dreams…and support other women in their journeys.
http://ican-online.org/online-support-meetings
* * *
Homebirth After Cesarean: What the Research Does and Doesn't Say
Sunday, November 22, 3:00 pm EST
Free for ICAN subscribers - subscribe now: http://ican-online.org/store
CEUs available for childbirth professionals
Is homebirth after cesarean (HBAC) as safe as in-hospital VBAC? What elements make it risky? With no studies are available on HBAC, Amy Haas, BCCE takes on the difficult task of applying the available studies on VBAC to the domain of homebirth to give a general idea on its safety.
http://ican-online.org/webinars/homebirth-after-cesarean
To unsubscribe from these announcements, login to the forum and uncheck "Receive forum announcements and important notifications by email." in your profile.
You can view the full announcement by following this link:
http://ican-online.org/forum/index.php?topic=1945.0
Educational webinars are free to ICAN subscribers. If you are not a current subscriber, you may subscribe or renew through the ICAN Bookstore or through your local chapter, or pay the applicable webinar fee.
Online support meetings are always free for everyone.
http://ican-online.org/webinars
NOVEMBER
Online Support Meeting: Homebirth After Cesarean
Tuesday, November 17, 10:00 pm EST
Free for everyone
Join the women of ICAN in a live online support meeting. The topic for this meeting is "Homebirth After Cesarean." Share your story, your fears, your dreams…and support other women in their journeys.
http://ican-online.org/online-support-meetings
* * *
Homebirth After Cesarean: What the Research Does and Doesn't Say
Sunday, November 22, 3:00 pm EST
Free for ICAN subscribers - subscribe now: http://ican-online.org/store
CEUs available for childbirth professionals
Is homebirth after cesarean (HBAC) as safe as in-hospital VBAC? What elements make it risky? With no studies are available on HBAC, Amy Haas, BCCE takes on the difficult task of applying the available studies on VBAC to the domain of homebirth to give a general idea on its safety.
http://ican-online.org/webinars/homebirth-after-cesarean
To unsubscribe from these announcements, login to the forum and uncheck "Receive forum announcements and important notifications by email." in your profile.
You can view the full announcement by following this link:
http://ican-online.org/forum/index.php?topic=1945.0
Wednesday, November 4, 2009
Planning a VBAC
Join us for our monthly support meeting next Monday, November 9th, from 6:30-8:30pm. Our topic will be planning a VBAC. We will discuss reasons to consider VBAC for your next birth as well as resources and things you can do to prepare. Our own Heather Deatrick will be leading our discussion.
Childcare is available for a $5 donation. Please RSVP to icantwincities@gmail.com
Meeting location:
Holy Cross Lutheran Church
720 E Minnehaha Pkwy, Minneapolis, 55407
Friday, October 9, 2009
Birth & Baby Expo TOMORROW!
Twin Cities Birth & Baby Expo
Tomorrow, 10:00am to 5:00pm
Midtown Global Market
Over 50 Exhibitors (see below)
Door prizes
Goodie bags
"Meet the doulas and midwives" event @ 11:00am
Resources, products, services for healthy birth & parenting!
Presented by: ICAN of the Twin Cities
Sponsored by: Blooma Yoga & Wellness, the Childbirth Collective, Family Times Inc., Health Foundations Family Health & Birth Center, Helping Hands Birth Services, Lake Pointe Chiropractic & Wellness, Morningstar Women's Health and Birth Center, Peapods Natural Toys & Baby Care
Exhibitors:
- 3 Bears Chiropractic & Wellness and Bodywork by Liv
- American College of Nurse Midwives, Chapter 11 Region
- Americare Chiropractic Wellness Center
- Awesome Nannies
- Bellies to Babies
- Bliss Yoga Studios/Veronica Jacobsen, CD(DONA), LCCB, CLC
- Blooma Yoga & Wellness
- Brelle Co. LLC/Child's Health Journal
- Chamindika Wanduragala (unique, artist-designed baby clothes)
- Child & Family Chiropractic Center
- Cindy Miller, Farmers Insurance
- Cultural Care Au Pair
- Diaper Free Baby
- Discovery Toys (Marlene Zoller)
- Do Good Diapers
- Earth Mother Midwife
- E. Dahl Photography
- EMERGE - MSP
- Everyday Miracles
- Family Tree Clinic
- Health Foundations Family Health & Birth Center
- Helping Hands Birth Services/Nickie's Naturals
- Hennepin County Medical Center, Nurse Midwife Service
- Intentional Environment
- International Cesaren Awareness Network of the Twin Cities
- It Works Marketing
- Joeys by Dar
- Lake Pointe Chiropractic & Wellness
- Mama Luna Doulas
- Minnesota Better Birth Coalition
- Minnesota Council of Certified Professional Midwives (MCCPM)
- Minnesota Families for Midwifery
- Minnesota International Center for Trad. Childbearing
- Morningstar Women's Health & Birth Center
- Optimal Health Zone
- Parenting Oasis
- Pregnancy & Postpartum Support of Minnesota
- Revolution Wellness Center
- Sally Kirwin, RN
- Soft Bums
- Spellbound Jungle Photography
- St. Croix Valley Doulas
- Swami Baby
- Sweet Pickles, LLC
- Ten Moons Rising
- The Bradley Method of Natural Childbirth
- The Childbirth Collective
- Victoria Welch (henna, natural baby items)
- Vida Baby Boutique
- Wildtree Herbs
- Wonderment
- Young Living Essential Oils
Tuesday, October 6, 2009
A Boring Birth?!? The UC of Isaiah Gideon
by Martha BashamI just don’t know if there are words to do justice to the way my baby boy came into this world. To put it simply and maybe best, it was a little piece of heaven. I’ve never been closer to God or my family as I was in the moments he was born and after.
Even now, 2 weeks to the day after he was born, I have a hard time believing how amazing his birth was. I feel like I dreamed it all. While I was pregnant I only hoped, dreamed, that it would be what it was. I would live and relive those moments over and over again if I could and will draw on that experience any time in my life that I need strength or courage. Because of his birth I know myself better. His birth was about responsibility from the start. During pregnancy I was responsible for taking the best care of myself that I ever have in my life. During the 2 years prior to his birth I took responsibility for preparing and educating myself about birth and every possible path that birth could take. I surrounded myself with people who were also educated about birth. But ultimately in my mind, my soul, I had a perfect picture of what this birth would be and it was.
What it wasn’t was dramatic. Or scary. Or painful. It wasn’t anything that people typically envision in a birth. And it was nothing like you see on t.v. By all means, Isaiah’s entrance into this world would probably be classified by some, as boring.
A boring birth.
But really, I would not call it boring. Sure, it wouldn’t make for good t.v. but I wouldn’t call it boring. I would call it peaceful. Joyous. Beautiful. Calm. Relaxing. Even triumphant.
On July 22nd at 3:00 pm my family who had just visited prior to leaving for their trip to Hawaii for my brother’s wedding was getting ready to say goodbye. My husband worked the night shift that night and he woke up as they were leaving to see them off. At 3:30 he was getting ready to go to work and I sat down on the couch to relax after a long day. My 3 girls, 5, 3, and 1 were playing. They had woken early that morning and my 1 year old was getting very tired after a long day with no nap. We had spent the day shopping and having ‘girl’ time together as I knew that things would get busy when the baby arrived.
When I sat down on the couch I felt the baby drop. It happened very quickly and noticeably. Shortly after that I had this feeling that labor would be starting soon. By 4:00 Nick was ready to go to work. I wasn’t having regular contractions, just the same Braxton hicks/ prodromal labor that I had experienced for weeks prior. Instinctually I knew that it was going to happen that night. I just knew. I let him know this but told him to go to work anyway ’just in case it wasn’t’. We all said goodbye and he was off to work. It took him about an hour to get to work and would take him another hour to get home. By 5:00 I was still not having regular contractions. They were still the same and still barely noticeable. I cleaned my house, helped my girls get ready for bed, washed all the laundry and took care of anything that I knew I wouldn‘t want to worry about once the baby did arrive. I was doing these things instinctually and that instinct was telling me that baby would be on the way very soon. I took a bath because I was tired and just wanted to relax. I sang along to my Ipod and could hear my older girls singing along from in their room while they were playing with their toys. I called Nick at work. He called back just after 5:00 and I told him he should come home or he might miss the birth. He was home by 6:00 and I was playing barbies with our girls. Our 1 year old had fallen asleep and it was just my oldest 2 still awake. When Nick got home he thought maybe my call was a false alarm. I was calm, relaxed, and not in pain. I did ask him to rub my back because it was tired after a long day. I was still keeping busy and my girls helped me switch the clothes from the washer to the dryer. It was almost 7:00 and I decided to lay down and rest a little. Still no regular or painful contractions. I went to the bathroom and half expected some signs of labor but nothing.
I went to go back to our room and lay down when my dh said, something along the lines of ‘so, we’ll have the baby tomorrow maybe?’ He was thinking he could go to sleep. I said, ‘no, baby will be here soon’. It was after 7:00 (7:15? I’m not sure…time is fuzzy at this point) I couldn’t sit still. I needed to be moving, pacing, walking, and I walked down our hall, into our living room, and then back into the bathroom. That was transition. It lasted about 5 minutes from the time I told Nick baby would be here soon and it never hurt. It was also the only time I had a regular contraction pattern or contractions that felt slightly more noticeable than Braxton hicks. My body then started to bear down. I wanted to be in the tub at first and the feeling of the water from the shower was very relaxing and soothing. Nick checked in on me and I think he finally believed that baby was going to be born soon. I reached down and felt the bag of water bulging. I told him that it was very close. Then I wanted to be out of the tub. I got out and Nick gave me towels to dry off. I made my way to our room and onto our bed.
Once I got on the bed I reached down again and felt a hairy head and shortly after that I knew I needed to slowly breathe him out. Nick and my girls were there with me, they were just watching and waiting quietly and patiently. When baby’s head came out I heard my older daughter say “I see the baby’s head!” I had my hand on baby’s head as it crowned and in the same contraction as the head was born the shoulders turned and baby’s body slid gently out into my hands onto the bed. He cried right away and was immediately pink. He looked around and then gave another good cry. I was so busy looking at him that I didn’t even think to look and see if he was a boy or a girl. We didn’t find out because we opted not to have an ultrasound. Nick asked and when I looked I half expected him to be a girl. I said “it’s a boy!!”
Within 15 minutes of his birth he was breastfeeding and the placenta came out. He ate for a half hour nearly every hour for the first 12 hours of his life, my milk came in the 2nd day, and has been a great eater! I’ve even kept up with the demands of cloth diapering a newborn (this is the biggest surprise for me!). He weighed in at 9lb 2oz on the fish scale Nick bought for his birth...our “catch of the day” as he called him :)
Isaiah Gideon was born exactly how I hoped he would be. He had a peaceful entrance into this world. I was able to listen to my body and my instincts and do everything I needed to so he could have a safe and peaceful birth. I knew myself enough to know exactly what I needed for his birth and I know birth enough to know exactly what I needed to bring him safely into this world. I had hoped I would “know” I was “in labor” sooner this time (last time I didn’t know until an hour before she was born!) and I did. Even though my labors aren’t ’traditional’, instinctually I *just knew*. I had hoped I would enjoy it and soak it all up and I did. I had hoped my husband and my girls would be able to witness it and they did. I had hoped for the birth that was perfect for me and our baby and it was. I am so thrilled that my girls were able to see a baby, their brother, brought into this world in such a way, that they too may someday birth without pain or fear and it might be a joyous and beautiful event for them too. I feel so incredibly blessed!
Friday, October 2, 2009
Mother-Sized Activism for VBAC!
Click over to the official International Cesarean Awareness Network's blog to learn about our new feature: "Mother-sized Activism" where we break down the big issues (like VBAC bans) into mother-sized bits.When we all do our little (but significant!) part, we can make a big difference for birthing women!
Photo credit: Birgit Amadori
Saturday, September 19, 2009
Expo Exhibitors as of 9/17
We have the following confirmed exhibitors for the Expo on October 10th: Blooma Yoga & Wellness, Morningstar Women's Health & Birth Center, Helping Hands Birth Services/Nickie's Naturals, Lake Pointe Chiropractic & Wellness, Health Foundations Family Health & Birth Center, The Childbirth Collective,International Cesaren Awareness Network of the Twin Cities, Family Tree Clinic, The Bradley Method of Natural Childbirth, Cultural Care Au Pair, Optimal Health Zone, Awesome Nannies, St. Croix Valley Doulas, Do Good Diapers, Child & Family Chiropractic Center, Cynthia Miller - Farmers Insurance, Brelle Co. LLC, Wonderment, MN Families for ...Midwifery, MN International Center for Trad. Childbearing,Ten Moons Rising, Parenting Oasis, Bellies to Babies, Swami Baby, Soft Bums, MN Better Birth Coalition. There's still room for you - email us for more information to exhibit: twincitiesbaby@gmail.com
Thursday, September 10, 2009
Celebrate healthy birth & parenting!
The first-ever Twin Cities Birth & Baby Expo will take place on Saturday, October 10th from 10:00 to 5:00 at the Midtown Global Market (920 E. Lake St, Minneapolis).
What the Expo is all about:
This exciting event is presented by our ICAN chapter and sponsored by eight awesome Twin Cities organizations and businesses: Blooma, Childbirth Collective, Family Times, Inc., Health Foundations, Helping Hands Birth Services, Lake Pointe Chiropractic and Wellness, Morningstar Birth Center, and Peapods.
The purpose of the Expo is to showcase the phenomenal and diverse resources in our community that promote and celebrate healthy birth and parenting. Exhibitors will include doulas, midwives, childbirth educators, wellness service providers, natural products, support groups and more!
The event will also feature door prizes, goodie bags for the first 350 guests, and special times to "Meet the Doulas" and "Meet the Midwives."
What you can do:
* Attend and bring friends! It's FREE!
* Encourage a business or organization you love to exhibit at the Expo. Visit our website for info on exhibiting.
* Promote the Expo. Become a fan on Facebook. Contact us for fliers or postcards to distribute.
* Volunteer to help with spreading the word, setting up, or cleaning up. Email us to find out how to help
Saturday, August 22, 2009
Informative Birth Videos
Cross-post from ICAN-Blog:
Three new, thought-provoking videos related to childbirth are available online.
This video compares the cesarean experience with VBAC for both mom and baby:
The video below discusses infant mortality, especially among communities of color, and highlights the role of reducing unnecessary obstetrical interventions in improving outcomes.
Finally, this video shows an economist elaborating on the cost savings of increasing out-of-hospital birth:
Three new, thought-provoking videos related to childbirth are available online.
This video compares the cesarean experience with VBAC for both mom and baby:
Cesarean vs. VBAC: A Dramatic Difference from Alexandra Orchard on Vimeo.
The video below discusses infant mortality, especially among communities of color, and highlights the role of reducing unnecessary obstetrical interventions in improving outcomes.
Reducing Infant Mortality from Debby Takikawa on Vimeo.
Finally, this video shows an economist elaborating on the cost savings of increasing out-of-hospital birth:
Less Cesareans with Induction of Labor? Read the Fine Print!
Cross-post from ICAN-Blog:
Media reports this past week have hyped a recent study claiming that induction of labor may actually reduce the need for cesarean. These findings appear to contradict previous research and generally held opinion.
However, these reports have underplayed and underreported the substantial caveats offered by the researchers about their findings. Although the authors do report a 22% reduction in cesareans in women who had elective inductions after 41 weeks, they temper their findings with the following:
1) These findings may not translate to many, if any, hospitals in the U.S. because of how obstetricians tend to practice in reality. According to the press release, “Prior research has indicated that doctors often tend to proceed from starting an induction to cesarean fairly quickly.” Thus, in order for these findings to be relevant, doctors must have patience to allow inductions to work. (Which begs the question: Why not just wait for spontaneous labor to occur?)
2) Induction of labor, on the whole, remains vastly understudied and further analysis is needed. As one of the lead researchers on the study states, "It’s pretty surprising that something obstetricians do all the time hasn’t been studied all that well."
With these substantial caveats in mind, it’s far too soon to rush to the conclusion that induction of labor is “safer” than spontaneous labor, even in post-dates pregnancies. The fact remains that women must be aware of the risks associated with any obstetrical intervention and have the freedom to make choices that they believe are best for themselves and their babies, not doctors’ protocols and hospital time clocks.
Friday, August 21, 2009
Twin Cities Birth & Baby Expo - October 10th
Only seven weeks to go until October 10th!
Twin Cities Birth & Baby Expo
Saturday, October 10th
10am-5pm
Midtown Global Market
Minneapolis, MN
The mission of the Twin Cities Birth and Baby Expo is to connect local families with empowering, multicultural resources and education that promote healthy birth and parenting and to celebrate the transformative experience of becoming parents.
The Expo will showcase local businesses and organizations that operate in line with this mission. We aim to connect parents and families in the Twin Cities with businesses and organizations that offer products or services promoting healthy birth and parenting from diverse perspectives.
Sponsors: We have collected an amazing line-up of sponsors for the Expo and our heartfelt thanks go out to them: Blooma, Childbirth Collective, Family Times magazine, Health Foundations, Helping Hands Birth Services, Lake Pointe Chiropractic and Wellness, Morningstar birth center, and Peapods.
Advertising: We will be offering reusable welcome bags with goodies and informational inserts to the first 350 visitors to the Expo. For $25, you can have your organization's or business' inserts included in the bags. If your organization or business would like to donate goodies forthe bags, let us know (e.g. product sample, promotional pen/magnet/waterbottle/etc). We will also be doing door prizes. If you would like to donate an item for the door prizes, please contact me.
Exhibiting: Prices for exhibitor tables are: $75 for a for-profit business, $50 for a non-profit. If you feel that the prices are out of reach for your organization, we encourage you to join up with someone else to share a table or contact us to discuss. The deadline for applications is September 25th.
Volunteering: We are also looking for volunteers to help out the evening before, during, and after the Expo. Email me if you think you might be available to help with set-up, clean-up, or during the Expo.
Saturday, August 15, 2009
VBAC Webinar
Presented by VBAC Facts, “The Truth About VBAC” answers all your questions about vaginal birth after cesarean giving you the information you need to make an informed decision.Why is this Webinar Important?
We live in a time where 50% of American hospitals have formal or de facto VBAC bans, where women are told VBAC is illegal, and where the practice of “pit to distress” is common.
Women who schedule their repeat cesarean do so believing that VBAC is not an option while others fight during labor to avoid unnecessary surgery after unknowingly hiring unsupportive medical professionals.
Women are not told that the risk decreases with each VBAC and yet increases with each cesarean. Women are not told that there is an approximately 99.6% chance they will not rupture and a 99.95% chance that their baby will be born alive and without permanent injury.* In short, women are led to believe that VBACs are risky, cesareans are safe and they believe it.
* Risk of uterine rupture during a spontaneous labor after one prior low horizontal cesarean is 0.4% or 1 in 250. Risk of infant death or brain damage is 0.05% or 1 in 2000. (Landon 2004)
Objectives
The goal of the webinar is to make information available and digestible for people to make their own decisions, never to convince anyone to have a VBAC or homebirth. Although women are more likely to have a successful VBAC in the out-of-hospital environment, many women prefer hospitals and are looking for ways to increase their likelihood of VBAC success. The webinar provides women with fully cited, research based information as well as specific, practical tools to plan their VBACs in either location through a comprehensive review of the latest VBAC research.
Content
Over the course of two 90-minute sessions, “The Truth About VBAC” provides women with a extensive analysis of their options as well as the encouragement they need to successfully VBAC:
Part 1: Sunday, September 27 9:00 pm EDT (6:00 pm PDT):
* Why do VBACs have a bad reputation?
* Cesarean Section: Immediate & long term risks to mom
* Cesarean Section: Risks to newborn
* Cesarean Section: Risks to future pregnancies
* Benefits of cesarean section
* Case study of a hospital VBAC ban
* VBAC success factors
* The marketing of "risk"
Part 2: Sunday, October 4 9:00 pm EDT (6:00 pm PDT):
* Uterine Rupture: An overview
* VBAC: Risks to baby
* VBAC: Risks to mom
* Benefits of spontaneous vaginal birth
* The risks & benefits of hospital vs. home vbac
* How to select a truly supportive care provider
* Coping with unsupportive friends & family
* Reading list & learning more
The fee for this 2-part webinar is only $30. Click here to register.
Click here for more information.
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