Taking off our rose-colored glasses

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

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

(start here if coming in from the Newsletter)

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

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

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

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

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

Twin Cities Hospital Cesarean Rates, 2010

Jill at The Unnecesarean recently posted a listing of Minnesota cesarean rates by hospital for 2010. This list is long, so below are the rates just for Twin Cities metro area hospitals.

Abbott: 37.1%
United: 34.9%
Fairview Southdale: 33%
Fairview University: 32.1%
Fairview Ridges: 31.5%
Maple Grove: 27.6%
Mercy: 27.2%
Unity: 25.4%
Woodwinds: 24.9%
St. Francis: 24.0%
Methodist: 24.0%
Regions: 23.5%
HCMC: 21.9%
North Memorial: 21.6%
St. John's: 20.9%
St. Joseph's: 13%

As these numbers show, only one hospital in the metro area has a cesarean rate that is within the World Health Organization's recommended safe range of 10-15% - St. Joseph's in St. Paul.  All other metro hospitals are well above that range.There are no real surprises in the hospitals that rank highest in cesarean births. Abbott, United, and Fairview Southdale have long vied with each other for the top three spots.

Evidence shows that choice of birthplace is a key factor in determining the kind of maternity care you get. These numbers should give you one piece of information to weigh when considering where you would choose to give birth in the metro, which should also shape who you choose as a care provider. For more information on choosing a birthplace, see ICAN's excellent white paper on the topic.

Also important to consider is whether or not the hospital(s) in your area support VBAC. Go to our local chapter's website for information on hospital VBAC policies in Minnesota.

VBA2C twins-in the hospital!

It always makes my day when I run across a Birth Warrior in an unexpected environment. This one came via my son’s preschool teacher. I love amazing birth stories, and then VBAC birth stories are really fun to hear, but TWIN VBA2C? And she didn’t go through ICAN? I was beside myself.

I will share the link to her blog at the end of this post, but want to say that what I find amazing about us women is we all come in different shapes and sizes and wear different armor. Meaning this is one of those women who just did it, she just did it! She wanted it and it happened. There are women like that, and there are women like me who share and talk and preach and then put up photos and would even post a video. There are those who are so quiet, and those that are loud. Those that do it all alone, and those that are surrounded by people. What matters is that we do it the way we feel the safest and most supported, no matter where that is, and who is there. And that everyone around us believes in us.

This is how it should be here in the US. It isn’t though, without alot of fighting, demanding and preparing. In the meantime, we will keep working, and of course women will keep having babies.

So enjoy this birth story-and if you are a mama out there wanting a VBAC, or vaginal birth of twins or a breech baby, or don't want to end in cesarean unless truly necessary, it can happen!

Jessica's amazing birth story:

http://followart.blogspot.com/2011/10/buzz-that-never-fades.html

~Heather

WHAT TO EXPECT when you are a good little patient.....

Babble has a nice little "10 things every expecting woman should know" post, and the first one was to throw out your What to Expect book. I know I don’t need to say the whole name of the book because I am sure every one of you have it, probably from a baby shower, or coworker, or sister in law or whatever. It is like the Baby-Book-Bible. In fact, I received two copies-one from my sister and one from a free new-baby care package through my insurance company!

Looking back, it is no wonder I walked into my medicalized birth that ended in a failed induction/c-section and never questioned it. It was, after all, all in The Book! Nowhere in that book does it say to get away from your OB and see midwife, do not get induced unless absolutely necessary (and what absolutely necessary even is or how to find out), question your OB, say no, believe in your body, and so on. Right? Or did I miss that? Maybe there were little things like explaining what a midwife is (thought I cannot remember reading this), or even avoiding an unnecessary induction. Maybe. But they didn’t tell me that the OB would order an unnecessary induction. They did not tell me that my body could birth and intervention should only be rarely used. They never, ever said to question any medical protocol at all, so it never occurred to me. They never mentioned any sort of difference between the medical model and midwifery model. If they did and I missed it, my apologies, but I certainly do not remember any. That book helped to support my basic unquestioning belief that there was one right way to have a baby-in a hospital with lots of machines and ORs, and that birth is scary and dangerous and thank goodness for modern medicine!! The only good thing I can say about it was there was a little paragraph about childbirth prep classes and they mentioned Bradley. I ended up buying a Bradley book in my ninth month (too late), and then took a Bradley class for my next birth, my VBAC.

So anyway, Babble has a funny post about the book, and also the 10 tips for first time moms. The tips are good, though I would also add DO NOT WATCH A BABY STORY or any of those TV shows, and to take a long, comprehensive birth class like Lamaze or Bradley. And to ask someone from ICAN if they were to do it all over again, who would they have catch their first baby…..

The Babble posts:

Pregnancy Tips for First-Time Moms

10 things every expecting woman should know

Reason #482 Why You Should Throw “What To Expect When You’re Expecting” Out The Window

This title is my favorite and sums it all up perfectly:

What To Expect When You’re Expecting AKA Call The Doctor, Your Whole Family Is Dying

I always tell people to throw that book out too, and get one or all of the many other fabulous books out there—Ina Mays Guide to Childbirth, Henci Goer’s The Thinking Woman’s Guide to a Better Birth, and so on. I have often complained to the bookstore when I see their huge section devoted to the What to Expect franchise and really nothing of any quality otherwise (they look at me like I am insane). Helping women to have an empowered birth is still a steep uphill battle, but well-worth the fight!

Large malpractice settlement following c-section!

I first heard about this as a teaser for the upcoming 10:00 news. They only said ‘large malpractice lawsuit settlement nets 4.6 million after mom dies after giving birth’, or some variation of that. I said to my husband “c-section!” Of course while he is used to the c-section talk and takes it very seriously, he really wanted to know why I was so sure. I said because women in the US don’t die from vaginal births anymore-that is so rare. They die from c-sections-they die from bleeding to death or from a blood clot (my statement wasn’t too scientific, so now that I look up the numbers, I see that hemorrhage is number one, though I can’t find it directly tied to c-sections).


When I watched it on the news they made no mention to the c-section. They only said she bled to death after the birth. I went to find it online and the Strib had a much more in depth article. Honestly, I was so shocked to hear that it was much more than a woman bleeding to death after a c-section. I was so shocked to read that a hospital would actually perform one when they didn’t even think they had blood on hand! In my mind, I immediately assumed it was because they view c-sections as so common and ordinary that they didn’t think they would need it?! I don’t know, I am at a loss. It is bad enough—the risks with having one’s labor induced, the risks of having a c-section, but honestly I never feared personally that there wouldn’t be blood on hand. I thought it was common knowledge that the blood loss from surgery is high, and the potential for blood loss postpartum, whether vaginal or surgical was high as well! Stunning. What a tragedy.


Unfortunately, the culture of c-sections is so accepted that there is no question of being induced at 41 weeks. Now, I am not saying I know everything—maybe she was showing signs of preeclampsia or the baby was stressed and the c-section was necessary, but I was induced at 41 weeks just for “post-dates,” and how many of us are there were induced at 40 or 41 weeks for no reason, or “post-dates?” This is so common that no one bats an eye at it. This woman did not have to die and the hospital certainly was negligent and deserves to pay that settlement, even more. But the fact is, we live in c-section culture and these death will continue to happen until the rate comes down. The fact is, this hospital was not safe to have a baby. How many others out there? Or is the medicalization of birth that is at fault?

I will end with talking about my own birth journey. With my first, I thought having a fancy OB would keep my baby and me safe. It never entered my mind that he has a different list of priorities than I. I was naïve, I know, but I really believed that I was safer with a trained OB and delivering in the biggest private maternity hospital in the state. It just didn’t dawn on me that overused technology is not a good thing in the case of normal, low risk birth. This boggled my brain. When I went to Bradley classes with my VBAC hopes when pregnant with my 2nd, I knew I needed to switch to a midwife (in a hospital setting), but still wasn’t sure about my body. I also was shocked but interested to learn that my instructor “caught babies” at home! Wow—I remember thinking how could this women know what to do in case something goes wrong? At home? This is nuts. Now fast forward to baby #3, and we are having him at home. And you know what? I feel safest there. I know that my midwives are better trained and have higher skills in vaginal birth and all its potentials for problems than most OB’s (who, in my opinion are one trick ponies as skilled surgeons). I know that should something catastrophic happen I am a few minutes from a hospital that can handle an emergency c-section (and I know I could get there in the same time they would prep me in the hospital), and I know that if I stall and just can’t finish at home we are blessed to have an OB here who believes in birth and will let me finish my labor without shame. This is the way it should be. Birth is as safe as life gets and midwives are incredibly skilled. I am so lucky to be able to have a baby where I feel safe, and know that if I need a c-section, it will be truly necessary. When I heard this story about this poor family, I thought, “and they say homebirth isn’t safe!” Hospitals have a whole set of problems that need to be fixed before they can start pointing fingers at homebirth. Finally, I will end with saying women matter! Our birth matters! The end does not justify the means, and often the means is killing us women. This needs to be talked about.


Heather
Mom to two boys-one by c-section due to failed induction and one by hospital VBAC.

Boy #3 due in January, planned homebirth



*******************************

From the Star Tribune:
Malpractice lawsuit nets $4.6 million award
A woman bled to death after giving birth at a hospital in Wright County.
By SARAH LEMAGIE, Star Tribune


The family of a woman who bled to death after delivering her first child was awarded $4.6 million Thursday by a Wright County jury in a malpractice and wrongful-death suit brought against the hospital where she gave birth.


Claudia Calcagno of Albertville began hemorrhaging and died hours after her son was born on Jan. 18, 2008, at Monticello-Big Lake Community Hospital, now New River Medical Center. Her doctors were unable to perform surgery that could have saved her life because the hospital failed to provide enough blood for transfusion in time, even though it was "sitting right in their refrigerator," an attorney for Calcagno's family argued.


"Her doctors needed blood to save her life. It was as simple as that," said attorney Kathleen Flynn Peterson.


The jury's award isn't the largest ever seen in a Minnesota malpractice case, but multimillion-dollar verdicts against health-care providers are unusual, said Flynn Peterson.
In a statement issued Friday, the hospital declined to release expert-witness documents supporting its position, saying they contained private medical data. "Our thoughts and sympathy go out to the Calcagno family," the statement said. The hospital is considering an appeal.


Flynn Peterson said the hospital argued in court that Calcagno's doctors were negligent, and should have gone ahead with the surgery. On Friday, the hospital said that "clinical staff members can only act under the direction of a physician, and we believe [hospital] staff members acted according to the orders of the attending physicians."


Two doctors were named in the suit along with the hospital, but Flynn Peterson said it became clear to her before trial that they were not at fault.


The jury found that neither doctor was negligent. The award includes compensation to Claudia Calcagno's family for past and future economic loss, as well as the loss of her companionship.
For Claudia's husband, Bob, "not a day goes by I don't think about her," he said in an e-mail Friday. "To put it simply, I miss my wife."


Claudia was as an executive assistant for Catholic Health Initiatives, Flynn Peterson said. She and Bob met on the job in 1999: He worked for a company that installed furniture for her office. They began dating, and married in 2004.


"The day we found out we were pregnant I cried like a baby," Bob Calcagno said.
As Claudia's pregnancy developed, their excitement grew. She got the house ready for a baby, and "you just knew she was going to knock this whole mothering thing out of the park," he said.
Calcagno, 36, was 41 weeks pregnant when admitted to Monticello-Big Lake Community Hospital on Jan. 17, 2008, to have labor induced. Her labor stretched into the next day, and after she had pushed for two hours, her obstetrician ordered a caesarean section. At 6:50 p.m., she gave birth to a healthy son, Vico.


But mistakes that contributed to her death had already been made, Flynn Peterson argued. Court documents say that a routine order to type and screen Calcagno's blood put in before her C-section wasn't done until hours later. And following its own policy, the hospital did not stock blood of her type -- A negative -- falling short of accepted standards of practice, Flynn Peterson said.
At 8:50 p.m., nurses checking on Calcagno found that she was bleeding heavily. Her doctors were called, and a surgery team was paged.


A doctor who examined Calcagno ordered blood for her. The hospital lab sent the O negative blood, traditionally the universal donor type, it had in stock. A 911 call was also made to get blood from a hospital 12 miles away, but it's unclear when it arrived.
Calcagno could have received A or O positive blood that the hospital had in stock, but her doctors said they were never told it was available, Flynn Peterson said.
She was taken to the operating room for an exam under anesthesia and possible treatment, including surgery to remove her uterus. But her doctors decided against that.
According to documents, they were concerned that, given the hospital's resources, they wouldn't be able to control potential bleeding problems if they went ahead with surgery. They also felt they had stabilized Calcagno. So instead, they decided to transfer her to North Memorial Medical Center in Robbinsdale. As a medical crew from North Memorial wheeled her to a helicopter, two more units of blood arrived and were sent with her.


During the postpartum hemorrhage, Calcagno lost at least 4,000 milliliters of blood. By the time she reached North Memorial, she was in critical condition, with dangerously low blood pressure. Despite treatment, including a blood transfusion, her heart stopped beating shortly after she arrived at the hospital. Doctors started an emergency hysterectomy, but despite efforts to revive her during surgery, she died.


With help from Vico's grandparents, Bob Calcagno is staying at home for his son's early childhood. The couple had planned to have one parent stay home for their son's first five years, and "he wants to keep that pledge to Claudia," Flynn Peterson said.
Bob Calcagno said Friday that no amount of money will bring his wife back, "but I take comfort knowing that our futures, especially Vico's, are financially secured."
Sarah Lemagie • 952-882-9016

Star Tribune Features Low-tech Birth & Midwives in MN

The Star Tribune recently published two stories highlighting one Minnesota woman's journey to VBAC despite many roadblocks and St. Joe's Hospital's extraordinarily low cesarean rate. Both articles are valuable in what they have to say about birth in our area.

The first article by Josephine Marcotty tells Danette Lund's search for a care provider to support her desire for VBAC.

Because she had delivered her first child by Caesarean section, a hospital birth would almost certainly mean surgery again. Home birth? Her midwife refused, saying it was too risky. A birth center outside a hospital? She'd have to shell out $7,000 because her insurance wouldn't cover it.

"I felt like I had no options," said Lund, 36, who lives near Waconia. "I was so frustrated."

Lund and other women have discovered that birth in America is rarely the natural event they long to experience.

The article goes on to highlight the overuse of cesareans, the risks involved, and the barriers that so many of us face to having a safe, healthy birth. Marcotty uses Lund's story to illustrate how, despite what media stories and even doctors sometimes say, women are fighting to avoid unnecessary interventions in childbirth. Lund's story will sound familiar to many of us:

"There is nobody advocating for lower C-section rates," Peaceman said. "It's not insurance companies. Not doctors and not women."

Except, perhaps, for women like Lund.

Last year, when she became pregnant for the second time, she knew she was likely to have a C-section again. The surgery has become standard for women like her because there is a small chance that a prior C-section scar will rupture during contractions....

Lund's hospital, Ridgeview in Waconia, will consider a vaginal birth after a C-section. Many hospitals won't because of stringent national medical guidelines for the procedure...

After weighing her options, Lund asked a midwife to deliver her baby at home, but the midwife said it was too risky. She called a St. Louis Park birthing center run by midwives. Although such centers are common in some states, they are new to Minnesota, and Lund's health plan wouldn't pay.

By that point she was 30 weeks pregnant and out of options, she said.

Lund, an attorney and trained litigator, is the first to admit she is not typical of most pregnant women. She's comfortable with confrontation and decided to take matters into her own hands.

Three months ago her labor started at 1:30 a.m. She and her husband waited. And waited. They counted the minutes between contractions, then waited some more. Finally, when she was far enough, she hoped, that it would be too late for a C-section, she went to the hospital.

As soon as she arrived, her water broke. Her cervix was 9 1/2 centimeters dilated. She was ready to deliver her daughter.

"I said: 'Yay, there is nothing they can do to me now,'" Lund said.

The second article by Chen May Yee profiles St. Joe's Hospital in St. Paul, which boasts an incredibly low cesarean rate of around 12%, far lower than Minnesota's 26% rate and the nation's 32.3% rate.  The story tells of St. Joe's long history of supporting natural childbirth, especially with its emphasis on midwifery care.

Kara Sime, 38, a first-time mother from St. Paul, arrived one recent Thursday morning, her contractions five minutes apart. By Friday morning, her labor still wasn't progressing. Exhausted, Sime asked for an epidural, a powerful painkiller, and got one. She also got Pitocin, a synthetic hormone to induce labor.

But there was a problem. Her baby was facing backward, increasing the diameter of the head going through the pelvis. Such cases usually require a C-section or a vacuum.

Instead, the midwife and nurse helped Sime onto all fours -- no small feat since her legs were numb from the epidural. With Sime's belly hanging down, the baby turned.

Three pushes later, Catherine Julia was born at 6 pounds 10 ounces.

"I don't have surgical skills," said the midwife, Melissa Hasler. "I'm motivated to get the baby out vaginally."

Gail Tully, on her Spinning Babies Blog, also shared her own experience with the care providers at St. Joes:

A long time ago, I was at a posterior birth with Deb Monson in which the mom was working hard but staying at 7 cm for 3 hours. Deb's simple trick of 3 pushes against her fingers as they created a false pelvic floor quickly turned the baby and let the labor proceed. Doctors at St. Joe's (I don't know if the Midwives do this) will also occasionally reach in and manually rotate the posterior baby's head to anterior so the birth can finish vaginally. Not all posterior births need any of these interventions, but some do and I believe these skills are a big part of why St. Joe's has a low rate of cesarean section. Plus, the community midwives and doulas have long referred to St. Joe's for their quiet, kind nurses, and mother-centered birthing practices. 

With such a low cesarean rate and a practice culture that supports non-interventive birth, St. Joe's may be the best hospital in the Twin Cities for women hoping to avoid a cesarean. Sadly, however, St. Joe's is the only hospital in the Twin Cities metro area that does not allow VBACs.

This means that St. Joe's rich tradition and practice culture described by Yee and Gail are not available to women like Danette Lund who, for whatever reason, did not avoid that first cut. In a conversation I once had with a representative from St. Joe's administration, I was told that this is because HealthEast "cannot afford" the medical malpractice insurance fees involved in supporting VBAC. This stands in stark contrast to St. Joe's reputation for supporting evidence-based childbirth. And, unfortunately, it shuts out women seeking VBAC who could perhaps most benefit from the kind of support and quality care that St. Joe's provides.

Many thanks to Marcotty, Yee and the Star Tribune for writing and publishing these stories on a very important topic for birthing women in Minnesota.

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:

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.

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:

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:

Respectful Cesarean?

"Yeah, right."

At least, that was my response when I first saw the title of Joni Nichol's talk at ICAN's International Birth Conference in Atlanta last April. But after a few minutes of listening to Joni's descriptions of cesarean births with soft music playing in the OR and parents talking to their babies as they are born, I was warming up to the idea.

Joni is a midwife practicing in Guadalajara, Mexico. Her description of respectful cesareans included the following elements: cesarean is used only as an absolute last recourse, it is preceded by spontaneous labor whenever possible, the place of birth changes but not the philosophy of care, and the experience is made personal, positive, and memorable. Joni's talk left me dreaming of what changed attitudes in our medical community could do for women who truly need cesareans but who still want a peaceful, beautiful birth experience.

You can read about a respectful cesarean here on Joni's website.

VBAC Policies in Minnesota

According to a survey conducted by ICAN of the Twin Cities in 2008, 39 out of 101 hospitals (38%) with labor and delivery services in the State of Minnesota have formal policies prohibiting vaginal birth after cesarean (VBAC). Particularly in rural areas of the state, this means that women must either "choose" unnecessary, repeat cesarean surgery or travel extensively to receive maternity care. An additional 30 hopstials (30%) have policies leaving access to VBAC up to individual doctors' discretion. In total, this means that two-thirds of all hospitals with labor and delivery services in Minnesota have formal or de facto policies that severely limit birthing women's access to choice in childbirth. For more information, please contact ICAN of the Twin Cities: icantwincities@gmail.com.




Download PDF here. Key for hospital #s here.


Click here for a PDF of Twin Cities metro VBAC Map