Hablamos Espanol, pero despacio!

The VBAC (Vaginal Birth After Cesarean) page!

• a way to shorten labor,
• a way to
• a way to schedule more births for the 9 to 5 daytime hours,
and
• a more convenient (you can pick your baby's birthday to suit your schedule) way to "give birth".
but what they don't say is:
• because the interventions the staff used backfired
• a way to make more money for the hospital/stockholders (if you don't believe me, look at any hospital's annual report, and find out what part of the income comes from cesareans. Also seeHospital Economics.

Someone answer me a question- if a cesarean (which can be a live-saving operation at times) is so wonderful, why aren't we born with Zip-Locs in our bellies? Or, put another way, why do most women refer to the operation as "they took the baby" , as if it was stolen? Or wasn't it? Or, what WAS stolen?

I think most women in thier hearts know they can birth fine on thier own, but our current medical culture is trained (and they therefore train thier clients to expect) to think that they cannot give birth without some sort of medical interventions. And, given some of the fearful training American medical people go thru, it is no wonder the current climate has so many OB's retiring because they can't afford medical malpractice insurance. The answer?

and utilize them as the primary care givers for ALL pregnant and well-woman care, and if a woman needs to see an OB for truly high-risk care (I'm not talking about twins or breech here either- many of those can be caught by midwives as well- they do it in Europe all the time) then she can go and know that she is getting the care she as an individual needs. There are many reasons why a cesarean is done, but only a few that are truly needful.

Generally, these reasons are NOT ones to do a major abdominal operation:

• Previous cesarean operation
• Breech or twins after 36 weeks (and I would question before then also- who gets the greater trauma?)
• previous section less than two years before
• small frame( as long as the pelvis is ok, by doing pelvimetry, and a trial of labor(preferably at home with no timeframe) Leave the lady to her own comfort!)
• mother's height less than 5 feet tall (how did so many of us get here if our mothers and grandmothers were under 5 feet?- 50 years ago the average height of a woman was only 5'4". )
• Mother considered by the staff to be "obese"(this can be as little as 25-30 lbs over some insurance company's tables!)

Questions to ask your doctor or midwife(in the case of ones working with OBs)

Here are some questions to ask your OB, and the answers will give you an idea of what to expect for this birth.(These questions are from the book "Unnecessary Cesarean Sections: Halting a National Epidemic, by Ingrid VanTuinen and Sidney M. Wolfe, MD. published by the Public Citizen's Health Research Group. This is an excellent resource material. Also check with your local ICAN chapter. Links below.)

1) What is your cesarean section rate?(Ideally, doctors with high-risk practices should have rates of no more than 17% and doctors with low-risk practices should have rates under 10% (many in Holland and Sweden are below 5% and they have the lowest infant/maternal mortality rates!)(Italics mine)If possible, try to avoid doctors with cesarean rates above the national average of about 25%.

2) Do you offer a "trial of labor" to women who have had a previous cesarean? (Ideally, approximately 80-90% of women with a prior cesarean should be encouraged to undergo a trial of labor( with a doula's assistance) and about 60-90% of those women should be able to birth vaginally. This includes twins and breeches.)

3) Do you consider an independent second opinion for elective c-sections good medical practice? ( If your doctor gets angry or defensive when you ask questions, including this one, consider changing doctors- better yet, get a midwife!)

4) How do you monitor labor of low-risk clients? of high-risk clients?(ps, if he/she is still calling them patients, be careful, consider that a red flag, or at least a pink one) Do you routinely use electronic fetal monitoring(EFM) to monitor certain groups of clients? Do you use fetal blood sampling or fetal stimulation tests(non-invasive) to confirm fetal distress indicatied by EFM? ( Routine use of EFM may only be useful for high-risk clients, and even then is subject to quite a margin of error).At least of of the other tests should be used to confirm fetal distress unless a serious emergency is noted. Position changes of the mother can also alleviate fetal distress, and not breaking the bag of waters in early labor can almost always avoid this complication.

5) If a client presents with a baby in breech position, do you show the lady how to turn the baby around using Optimal Fetal Positioning or use external cephalic version(turning the baby to head down position) after 37 weeks?

6) Are you concerned about the high section rate in this country/state/hospital? Do you follow procedures using evidence-based care (Coalition to Improve Maternity Services(CIMS) guidelines? If the doctor has never heard of CIMS, offer to give him some literature, and share some with the director of Obstetrics, if appropriate. Many OBs really aren't trained in PREVENTIVE care, so we have to teach as we go.

Not all of these questions may pertain to your situation, but you have a right to ask your OB these and any other question you wish. Effective communication is an important part of the doctor/client relationship, especially if you intend to negotiate for limitaition of obstetrical interventions, including cesarean section.(another excellent reason to hire a doula, they help you with information you need to negotiate).

There is a website, under the heading of Virginia Department of Health, that has statistics similar to what is in this book. However, the information is over 5 years old, and that is an eternity in health care, especially midwifery advocacy. You might want to check the site, or go around and ask your local hospital administrators, for this information, or where it might be found. You should be able to get stats for the previous 2 or 3 years.( As I get time, I will try to update that info for certain counties. I am in the midst of other things right at the moment).

Some links for Breech Birth at home:

• Reasons why people say you can't home birth- but they were wrong
• homebirth breech
• Breech birth at home and birth center
• Breech pictures
• Breech position and home treatment
• Unassisted Footling Breech birth :)

Some links for Twins at home (some unassisted! :) )

Yes, you can have twins at home. You do need to be prepared and both babies, or at least the first one, should be head down, and usually are. The second will probably turn after the first is born.It is wise to have a couple of experienced midwives present, as an extra pair of hands is often necessary. Remember, the Dionne quintuplets were born to a Canadian mom, at home, with only a midwife for help, and no incubator. They were also the 7-11th children of a farmer and his wife. The midwife used an oven door, opened up, and had a basket with blankets in it to receive the babies and keep them warm.

• Owen and Clara's Home Birth, by thier Mom, the moderator of Pregnancy @about.com(pictures, too!)
• Benjamin and Montana's home birth
• Unassisted birth of Unexpected Twins( I have met this lady personally, and she is awesome!)
• Twin Waterbirth- UC
• Unassisted Twin birth, one vertex in water,the other breech on land, and many pictures and a great story. From a nurse/doula's perspective(the mom)

There are tons more sites and stories of breech, and twin births at home to look up. I would just do a google search. Don't settle for an operation if there is any way out of it. Life is too short and precious!

Reading list for preparing for a VBAC

• Silent Knife, by Nancy Wainer Cohen(website here)
• Open Season, by Nancy Wainer Cohen(website here)
• The VBAC companion by Diana Korte(website here)
• Unnecessary Cesareans,Ways to Avoid them, by Diony Young(website here)
• Natural Childbirth After Cesarean, by Karis Crawford and Johanne Walters(website here)
• Active Birth, by Janet Balaskas(website here)
• Complete Book of Pregnancy and Childbirth , by Sheila Kitzinger(website here)
• Creating a Joyful Birth Experience, by Lucia Capacchione and Sandra Bardsley (website here)
• Mind Over Labor, by Carl Jones(website here)
• Transformation Through Birth, by Claudia Panuthos(who also wrote Ended Beginnings with Catherine Romeo) (website here)
• Rebounding From Childbirth, by Lynn Madsen(website here)
• Obstetric Myths Vs. Research Realities, by Henci Goer (website here)
• Understanding and Teaching Optimal Foetal Positioning, by Jean Sutton and Pauline Scott(website here)
• The Birth Partner, by Penny Simpkin(website here)
• The VBAC Experience, by (website here)
• Trust Your Body, Trust your Baby, by Andrea Frank Henkart (website here)
• An Easier Childbirth by Gayle Peterson PhD(website here)
• Birthing from Within, by Pam England and Rob Horowitz(website here)
• The Thinking Woman's Guide to a Better Birth, by Henci Goer(website here)
• The Birth Book, by William,(MD) and Martha (RN) Sears(website here)
• Spiritual Midwifery, by Ina May Gaskin(website here)
• Ina May's Guide to Childbirth, by Ina May Gaskin(website here)
• Immaculate Deception II, by Suzanne Arms(website here)
• Gentle Birth Choices, by Barbara Harper(website here)
• The American Way of Birth, by Jessica Mitford(website here)
• Birth As an American Rite of Passage, by Dr. Robbie Davis Floyd(website here)
• The Labor Progress Handbook, by Penny Simpkin and Ruth Anchetta(website here)
• Mothering the Mother, by Marshall H. Klaus MD,John H, Kennell MD and Phyllis H Klaus(website here)

Videos and other Resources

• Birth Reborn, by Michel Odent(website here)
• Birth into Being; The Russian Waterbirth Experiment (Video), by Global Maternal/Child Health Association(website here)
• Plus size Pregnancy site

Under construction, Keep checking back!

Sign my Guestbook! View my Guestbook! Email Me Return to Home