Vaginal Birth a Safe Option After Multiple C-Sections

“'This was the first large study of VBAC in which certain outcomes, such as uterine rupture, were studied prospectively,' notes Landon, who serves as vice chairman of obstetrics and gynecology at the Ohio State University Medical Center.

"'The study has confirmed that the majority of women with multiple prior cesarean deliveries undergoing trial of labor can expect to achieve a successful vaginal birth,' says Landon, whose findings were published recently in the journal Obstetrics and Gynecology.

"The benefits of VBAC include a faster recovery time and avoidance of the operative risks of cesarean section, which is a major operation.

"'Beyond these obvious benefits, there seems to be a component that is not completely tangible,' notes Landon. 'It goes along with the experience of vaginal childbirth, which certain women value, and there is probably not a price that you could put on that for a certain subgroup of women.'

"Landon advises that women should carefully research the topic of VBAC, looking for a physician who is willing to share data in an unbiased manner, who supports the concept of VBAC provided that a woman is an appropriate candidate, and who is willing to evaluate each case individually."

Click here for the full article

Amazing VBAC Success Story

This amazing woman has posted her VBAC birth story on her blog. Please take the time to read through it. It's a bit long, but definitely worth reading.

VBAC (Vaginal Birth After Cesarean) is becoming less and less available for women than it was in the past. In the 1980's VBAC's were encouraged and doctors did what they could to help women achieve them. Today, with cesarean sections becoming increasingly common and convenient (for the doctors and hospitals, not for the mothers) women are finding that they have to advocate for themselves if they really want to birth vaginally after a c-section.

This woman knew what she wanted. She did her research and prepared herself as well as she could for a successful VBAC. She knew what she needed to do, and she knew her legal rights. In her amazing birth story she describes in detail how she and her husband had to fight for what they wanted, and they were wonderfully successful. She birthed her second baby vaginally, after 38 hours of labor, and the mother and baby are both doing exceptionally well.

Make sure you read all the way to the end. I really like the feelings she expresses in the last few paragraphs.

Birth Documentary Film Festival in American Fork, Utah

***I'm sorry to inform everyone that this event had to be canceled. Please watch for future film screenings and other exciting birth events!***

I've mentioned this before, but as it gets closer to the event day I'd like to bring it to everyone's attention. Please feel free to share this information with everyone, and reserve your ticket today!

• Date: June 13, 2009
• Location: Towne Cinema Theaters in American Fork, UT
• Cost: $25
• What: Screening of Orgasmic Birth, Pregnant in America, The Business of Being Born, Special Guest Speaker, Debra Pascali-Bonaro, producer/director of Orgasmic Birth, seen on ABC's 20/20
• Email: moviescreening@rawmelissa.com if you have questions

All registrants are entered in drawings to win free DVD's, Books, and Chocolate from Raw Melissa!

To register: Paypal $25 to moviescreening@rawmelissa.com, Send Check to Birth Movie Screening, P.O. Box 721 Springville UT 84663, or call (801) 759-5124 to pay with Credit Card

My Thoughts on "Your Best Birth" by Ricki Lake & Abby Epstein

For a while I was reading everything I could get my hands on about pregnancy and childbirth, and soaking up every bit of it. I got to the point of saturation a few months back, feeling like everything I was reading was a rehash of what I had already read. I guess that's good, because I was retaining the information I was reading.

The publishing of Ricki Lake and Abby Epstein's new book Your Best Birth was a really good excuse to start reading again, and they have not disappointed me. Your Best Birth is written with the intention of giving women a book that is easy to read and provides them with the information they need to make informed choices for their own childbirth. I feel the authors have definitely achieved that.

The beginning of the book includes Ricki and Abby's personal childbirth stories and explains the purpose of the book. Very quickly, however, they dig right in with the important information, and there's a lot of it. Interspersed with the information, are stories from other women and their experiences.

I enjoy reading birth stories of all kinds, and this book is full of them, as well as the educational material that everyone should know about childbirth. I would recommend this book to everyone, male or female, whether they are expecting a child or not. Compared to many other books I've read on the subject it's an easy read, and a relatively short book.

For more information about the book: Your Best Birth

For more information about the new pregnancy and childbirth online community: My Best Birth

For more information about the documentary film that sparked the interest in bringing us this wonderful new book: The Business of Being Born

Ricki Lake's Push for Safe, Empowered Birth

Ricki Lake and Abby Epstein were interviewed by Maria Iorillo, CPM of Mindful Mama:

Ricki Lake's Push for Safe, Empowered Birth

"Ricki Lake never set out to be a childbirth activist, but since the release of her film The Business of Being Born in 2008, she has become the face of a growing movement toward informed and empowered birth choices. And now with her newly released book, Your Best Birth , Lake and her friend, producer, and coauthor, Abby Epstein seek to help even more women understand their options and, in their words, "take back the birth experience." Mindful Mama recently sat down with Lake and Epstein to talk about their lives in the spotlight, and what's next."

I discovered this interview through the new online pregnancy/birth community: My Best Birth

Artwork Honors Mothers Lost in Childbirth

Click here to access the White Ribbon Alliance Collection

"Stories of Mothers Lost is a stunning collection of fabric panels created by men and women to honor the lives of loved ones needlessly lost in 20 countries, from Afghanistan to Uganda and Bangladesh to Burkina Faso, India and Tanzania. Created by the WRA, with support from the United Nations Population Fund, and on display for the first time in October 2007 in London, this traveling exhibition shines a global spotlight on the changes necessary to ensure every woman's birthright - to live through pregnancy and childbirth, ready to nurture children and contribute to the vitality of her community and nation."

I discovered this through my friend and trainer Melissa

Intrahepatic Cholestasis of Pregnancy

What is obstetric cholestasis (intrahepatic cholestasis of pregnancy – ICP)?


Obstetric cholestasis (sometimes called "cholestasis of pregnancy", "OC", "intrahepatic cholestasis of pregnancy", "ICP") affects the liver, which in some women seems to be oversensitive to pregnancy hormones. Bile is produced in the liver and normally it flows down the bile ducts into the intestines where it helps with the digestion of food. If you have OC, the flow of bile into the intestines is reduced and so bile salts build up in your blood.


What are the symptoms of Cholestasis of pregnancy?

• Itching, particularly on the hands and feet (often is the only symptom noticed)
• Dark urine color
• Light coloring of bowel movements
• Fatigue or exhaustion
• Loss of appetite
• Depression

Less common symptoms include:

• Jaundice (yellow coloring of skin, eyes, and mucous membranes)
• Upper-Right Quadrant Pain
• Nausea

Who is at risk for Cholestasis of pregnancy?
1 to 2 pregnancies in 1000 are affected by cholestasis. The following women have a higher risk of getting cholestasis during pregnancy:

• Women carrying multiples
• Women who have previous liver damage
• Women whose mother or sisters had Cholestasis

How is OC identified?
A diagnosis of cholestasis can be made by doing a complete medical history, physical examination, and blood tests that evaluate liver function, bile acids, and bilirubin.


Will OC harm my baby?
The risk of having a stillborn baby is 15 per cent greater for women who have OC than for other women. Nobody is quite sure why. The baby may die because of the bile acids, which are known to cross the placenta, or as a result of being suddenly deprived of oxygen, perhaps because of placental problems.


ICP/OC has been reported to be associated with an increased risk of spontaneous premature birth, fetal distress and stillbirth. With active management (which usually means treatment and choosing to deliver early) the risk of stillbirth in an ICP/OC pregnancy is believed to be the same as that for a normal pregnancy (1%). Most hospitals chose to monitor women with ICP/OC more closely and to deliver the babies early in order to minimize any risk to your baby.


How is OC managed?
The treatment goals for cholestasis of pregnancy are to relieve itching. Some treatment options include:

• Topical anti-itch medications or medication with corticosteroids
• Medication to decrease the concentration of bile acids such as ursodeoxycholic acid
• Cold baths and ice water slow down the flow of blood in the body by decreasing it’s temperature
• Dexamethansone is a steroid that increases the maturity of the baby’s lungs
• Vitamin K supplements administered to the mother before delivery and again once the baby is born to prevent intracranial hemorrhaging
• Dandelion Root and Milk Thistle are natural substances that are beneficial to the liver
• Bi-weekly non-stress tests which involve fetal heart monitoring and contraction recordings
• Regular blood tests monitoring both bile serum levels and liver function

Treatment for cholestasis of pregnancy needs to be determined by your physician who will take the following criteria into consideration:

• Your pregnancy, overall health, and medical history
• The extent of the disease
• Your tolerance of specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

Treatments that should not be used for Cholestasis include:

• Antihistamines
• Aveeno and Oatmeal Bath

*There are conflicting views on using the medication Cholestyramine for treatment of cholestasis. In the past, this medication was readily used to treat this condition, but some studies have shown that Cholestyramine may not be as effective as other treatments and potentially has some adverse side effects such as blocking essential vitamins like Vitamin K (a vitamin that is already deficient in women with cholestasis).


Will the itching go away after delivery?
ICP is believed to be a condition caused by a gene mutation resulting in the liver's inability to cope with high levels of estrogen present in the body. However, ICP is sometimes a result of an underlying liver disorder. It is normal for patients to continue itching for some time after delivery, particularly with cases that have been prolonged or in cases where a patient has had several pregnancies in a short time frame, but special attention should be given to patients whose itching intensifies after delivery or does not go away at all. Postpartum Serum Bile Acid testing and Liver Function testing are suggested for ICP patients to ensure overall health. A differential diagnosis may include Primary Bilary Cirrhosis, Hepatitis, AIDS, anemia, Benign Recurrent Intra-hepatic Cholestasis, and bile duct obstruction.

I found this information posted by Full Circle Doulas on Facebook and americanpregnancy.org.

Upright Position Shortens Birth Canal by 1/3

Did you know that being in an upright position for the third stage of labor (pushing stage) can shorten the birth canal by one-third?

As a simple example: if the birth canal is 3 inches long in a lying-down position, when you are upright it will only be 2 inches long. That's 1 inch less the baby has to go through!

Being upright also provides a straight downward pathway for your baby to come through. Lying down on your back actually creates more work for you and your baby, because the position of the tailbone creates an upward slope that the baby must pass through.

Suggestions for upright positions for pushing your baby out:

• Squatting on the bed, holding onto a squat bar (many hospitals have a bar that attaches to the bed, but you have to ask for it).
• Squatting on the floor, supported by your birth partner or other birth attendants. The birth partner can stand or squat behind the mother and support her by holding her under the arms and allowing her to lean back into him/her. Or one person can be on each side of the mother to support her.
• Squatting on a birth stool (such as the one pictured). Click here for more information about birth stools.
• Upright in a tub. You can lean against the back or side of the tub and allow your body to rest against it. The water also helps reduce some of the pressure and weight of your body, and can provide a soothing effect. Check with your care giver and/or hospital about their policy on water birth and what your options are.
• Any upright position that is most comfortable to you in the moment. You may choose to lean forward against a person, bed, or other piece of furniture or birthing ball while squatting, or whatever feels most comfortable to you.
  
• Toilet sitting. Naturally, you wouldn't want to birth your baby on the toilet, but sitting on the toilet during labor can provide comfort and help move labor along in the second stage (transition).

In general, being in an upright position during childbirth at any point is helpful. During the first stage it can help labor progress more quickly, as in the second stage as well. Movement and changing position throughout the labor process is highly recommended for comfort and progress. Any upright position is particularly helpful in shortening the birth canal in the third stage of labor to help shorten the passage the baby must go though.

Web Chat with Ricki & Abby on My Best Birth

Ricki Lake and Abby Epstein are all over the place lately, as they do a media blitz to promote their new book and website. I just received an email about a web chat with them, and thought I would pass it along:

"Tomorrow, May 13, at 7pm EST and again at 7pm PST, Ricki & Abby will be hosting a video web chat discussion about "Your Best Birth." You can watch it right on mybestbirth.com and email questions which they can then respond to live."

For more information about the web chat, please click here.

TV Show "The Doctors" Hosts Discussions on Childbirth With Ricki Lake & Abby Epstein

I happened to be flipping through TV channels one afternoon and noticed a show called The Doctors on one of my local stations. It drew my interest because the description said they would have Ricki Lake on the show. It was already about 20 minutes into the episode, but it immediately caught my attention because they were discussing VBAC's (Vaginal Birth After Cesarean) and went on to discuss other childbirth issues as well.

The show features a panel of doctors who weigh in on various health topics. I'd like to share with you the specific childbirth topics that they covered in this particular episode:

Your Best Birth
Ricki Lake and Abby Epstein spoke about their documentary film The Business of Being Born
and their new book Your Best Birth. I've blogged about both of these in previous posts. I've seen the film twice and love it, and I'm anxious to get a copy of the book to read.

and their new book “Becoming a mother is an amazing rite of passage,” Ricki says. “What a gift … it’s also an opportunity for women to be empowered and to be transformed in a positive way. Birth is a natural process, and it doesn’t have to be scary or an emergency situation waiting to happen.”

For information about The Business of Being Born airing on Showtime, click here.

For information about entering to win a copy of the book Your Best Birth, click here.

Are Home Births Safe?
Ricki and Dr. Lisa went head-to-head in a debate about the safety of home birth. It was a really interesting discussion.

You can watch the debate in 2 sections: Part I and Part II

VBAC - Vaginal Birth After Cesarean
"Is it safe to have a vaginal birth after a C-section (VBAC)?
Jillian is 6-months pregnant with her second child. Her first birth was a C-section because her daughter was breach, but she’d like to deliver her second baby vaginally.

Dr. Lisa says the risk Jillian faces is uterine rupture, which is a serious risk. Although the chances of that happening are one percent, most hospitals will not perform a VBAC for fear of uterine rupture. Dr. Lisa narrates an animation of a typical C-section."

Natural Birth
"Pain management during labor:
• Dulas, or birth coaches, can help reduce pain
• Immersion in water can decrease pain
• Pain management techniques
• Pre-natal classes
• Acupuncture
• Breathing techniques"

Click here for a complete synopsis of the episode

"My Best Birth" Website for Expectant Parents by Ricki Lake & Abby Epstein

The creators of The Business of Being Born have launched a new interactive website for expectant parents and anyone interested in pregnancy and childbirth. The website is:

www.mybestbirth.com

I'm amazed at the multitude of information they have, including a personal page for each member with blog posts, photos, video clips, and more!

Please take some time to check it out, sign up and get involved in the conversations, watch the videos and participate with the upcoming events, contests and discussions.

Childbirth Film Advocates Birth Education

A few months ago I blogged about an Educational Childbirth Video Contest by a non-profit group called Birth Matters Virginia.

I'm happy to share with you the short educational film: Educated Birth. It's an entry in the video contest, and I encourage you to watch it and rate it on YouTube. If you'd like, please let me know of your thoughts and feelings about it.

The purpose of the film is to promote childbirth education for expectant parents. This is something I feel strongly about, and a big part of why I do what I do.

Breast Milk Contains Stem Cells!

Admittedly, I don't know a lot about stem cell research. I know that stem cells could eventually provide vital support in treatments for serious diseases. I also know that stem cell harvesting has been a controversial subject because of the practice of harvesting stem cells from embryos, and I have stayed out of that debate as much as possible.

More research has found that breast milk contains stem cells, and this is a ground-breaking discovery. Dr. Mark Cregan has made some amazing revelations about the properties of breast milk:

“We already know how breast milk provides for the baby’s nutritional needs, but we are only just beginning to understand that it probably performs many other functions,”

"He says that, in essence, a new mother’s mammary glands take over from the placenta to provide the development guidance to ensure a baby’s genetic destiny is fulfilled."

“We already know that babies who are breast fed have an IQ advantage and that there’s a raft of other health benefits. Researchers also believe that the protective effects of being breast fed continue well into adult life."

The discovery of stem cells in breast milk could provide a whole new array of options in harvesting stem cells and using them to treat serious illness.

To read the whole news article, please click here: Breast Milk Contains Stem Cells

I found this article through a fellow childbirth blogger: Doula Surround

American College of Nurse-Midwives Position Statement on Home Birth

ACNM website

Because I'm planning a home birth for the first time, I'm reading everything I can find on the subject. I recently came across the American College of Nurse-Midwives Position Statement on Home Birth, and I thought I would share it with my readers.

American College of Nurse-Midwives Position Statement on Home Birth

One thing I find interesting in the statement is that the ACNM stresses the importance of properly categorizing planned home birth and using it as a basis for clinical studies.

"The safety of birth in any setting is of utmost priority and has been the focus of home birth research. Investigators have defined “planned home birth” as the care of selected pregnant women by qualified providers within a system that provides for hospitalization when necessary. Recently, high quality controlled trials and descriptive studies have established that planned home births achieve excellent perinatal outcomes. Home birth is also credited with the reduced use of medical interventions that are associated with perinatal morbidity." (italics added)

"Unfortunately, studies which have not differentiated between planned and unplanned home birth or attendance by qualified versus unqualified attendants, and/or that do not clearly define appropriate inclusion criteria, have been used to discredit all home birth. The evidence indicates that appropriate client selection, attendance by a qualified provider, sound clinical judgment, and transfer to a receptive environment when necessary, promote safe outcomes."

I appreciate the position of the ACNM. They have established criteria for planned home births and encourage expectant parents to be properly informed so they can make the best decision for them and their babies.

Ricki Lake Shares Her Birth Stories in Her New Book "Your Best Birth"

Ricki Lake has become a prominent advocate of childbirth education and options. Along with Abby Epstein, she created the documentary film The Business of Being Born, which is an excellent resource for anyone who wants to learn more about birth options in the United States.

On May 1, 2009, Ricki and Abby were interviewed by Meredith Viera on the Today Show about their book:

Visit msnbc.com for Breaking News, World News, and News about the Economy

"Actress and former talk show host Ricki Lake shares her birth experiences in the new book, "Your Best Birth." Written along with Abby Epstein, the book is a guide packed with advice from medical professionals about the different options expecting mothers have."

Click below to read an excerpt from the book:
Ricki Lake on giving birth without meds.