VBAC Video: This Woman's Work

"... a three year journey that took this couple from their unexpected hospital cesarean birth to birthing their second baby at home in water - condensed into a mere 6-minute video. You, the viewer, become a witness to their very heartfelt, personal sacrifice and transformation."

I first saw this on The Beginning of Motherhood

The Natural Cesarean

The natural cesarean: a woman-centred technique

What do you think?

Prevent Cesarean Surgery

Information about the risks of c-sections to both mother and baby.

Including quotes from women who have had both cesarean and vaginal birth.

Favorite Recent Pregnancy/Birth Links

I post a lot of web links on my Mamas and Babies facebook fan page, but I often forget to pass the information on here. I think it's important to share as much information as possible, so I'm bringing you some of my recent favorite web links related to pregnancy and birth.

These are in no particular order:

• The Unnecesarean: U.S. Cesaren Rate Reaches Record High, Rises for 13th Consecutive Year - The Cesarean rate for 2009 was 32.9%, up from 32.3% in 2008. The rate continues to climb despite cesarean birth carrying greater risks to mothers and babies in comparison to vaginal birth.
• As early elective births increase so do health risks for mother, child - Babies are being born earlier than they were 10 years ago, thanks to elective inductions and scheduled c-sections. This carries multiple serious risks to mothers and babies. Do you know what the risks of delivering even a week early could be?
• Motherhood: Induced and Seduced: The Dangers of Cytotec - A drug commonly used for labor induction which hasn't even been approved for such use by the FDA, and it carries great risks with it. Why is it used so often? It's cheap.
• C-sections up, overall births down in 2008 - As the cesarean rate increases, the overall birth rate drops? Why do you think this is?
• Pre-Holiday Induction of Labor Without Medical Indication - Some striking statistics about labor patterns through the major holidays of the year. Some food for thought when your doctor or midwife suggests scheduling your child's birth.
• Early skin-to-skin contact after birth: the more the better - A post from Stand and Deliver covering a recent study proving the increased effectiveness of early skin-to-skin contact within the first 3 hours of birth. The more contact, the better the results. 
• A proactive approach to breastfeeding - Another post from Stand and Deliver, about approaching breastfeeding prepared. Taking a proactive stance rather than reactive. Especially good information for first-time mothers or those planning to breastfeed for the first time.
• Everything you ever wondered about breastfeeding during pregnancy, but didn't want to ask... - A straight-forward FAQ style blog post about breastfeeding while pregnant and tandem nursing, from a mom who's been doing it for years.

Happy surfing!

Cesarean and VBAC Resources and Links

I've got a few links to share on the topic of c-sections and vaginal birth after cesarean (VBAC).  I'm not going to comment much, because I'd like you to read them and decide what you think.  Please feel free to post your opinions or questions in the comments below.  Here goes:

• Prepare Mothers and Fathers for Cesarean Birth: Should cesarean education be a part of all prenatal education?
• Unnecessary C-sections on the Rise
• Rate of C-sections in the US is 'Undeniably High,' Doctor Says
• Cesarean Rates in Women of Size:  Are heavier women more likely to have a c-section?
• Special Scars - Special Women:  For women who have had a cesarean.  The creator also has a facebook page and Yahoo group for the same purpose.
• Labor Deemed Good for Women
• VBAC or Repeat C-section:  I found this through Jill on The Unnecesarean.  She said it's her favorite resource on the topic.
• A Woman's Guide to VBAC: Putting Uterine Rupture Into Perspective:  Comparing the risk of uterine rupture alongside other potential birth risks.
• A Woman's Guide to VBAC: Navigating the NIH Consensus Recommendations
• VBAC After 2 Cesareans: Distorted Risk Perception: Are doctors making this out to be more dangerous than it actually is?
• Bill Gates and Robot Cesareans: Are c-sections routine enough to be performed by robots?
• Every Bit as Magical:  The "natural c-section".  Can cesarean birth rival vaginal birth and be just as beautiful?  Should we try to make it that way?

Why So Many C-sections?

Often when I talk with people about the dangers of c-sections they ask me:


"If c-sections are so bad, then why are they so common?"


My response is simple:


If something goes wrong with a vaginal birth and it goes to court, the doctor will be asked "Why didn't you do a c-section?"


If something goes wrong with a cesarean birth, the doctor can say to the court "We did everything we medically could."


It's called liability, and often referred to as "Defensive Medicine".

Obesity and Cesarean Section

A recent blog post on The Unnecesarean sheds some light on the connection between obesity and cesarean section:

Obesity Causes a Rise in... Articles about the Cesarean Rate

The post is partly in response to a New York Times article:

Growing Obesity Increases Perils of Childbearing

The Unnecesarean post also cites a really good blog post on The Well-Rounded Mama:

Exaggerating the Risks Again

For a nice overview of the topic, read the post on The Unncesarean, and if you want more info, read the other two as well.

In a nutshell, this is what I learned:

• Obese women are more likely to have a cesarean because of the increased risk of pregnancy complications like Gestational Diabetes and Pregnancy Induced Hypertension (AKA Preeclampsia).  How much?
• According to The Well-Rounded Mama, 90% of obese women will NOT experience GD or PIH.  The risk for GD in morbidly obese women (BMI over 35) is 9.5%, compared to 2.3% in women with a BMI less than 30.  The risk for PIH in morbidly obese women is 6.3% compared to 2.1%.

Jill from The Unncesarean also points out that these aren't the only reasons obese women are more likely to have a c-section compared to other women, and that journalists should write about the reasons and heart of the matter rather than simply sensationalizing the trends.


I personally have a hard time seeing how these complication risks can warrant the current US overall cesarean rate of 33%.  Something to think about.

Cesarean vs. VBAC Video

One mother's journey through 2 c-sections and a Home Birth After 2 Cesareans (HBA2C)

What are some of the differences you notice?

Cesarean vs. VBAC:  A Dramatic Difference from Alexandra Orchard on Vimeo.

ACOG Issues Less Restrictive VBAC Guidelines

This has just been released by ACOG this week. It's far from perfect, but definitely a step in the right direction!

This is huge. Very important information for women and their care givers regarding vaginal birth after cesarean. Due to copyright issues I'm not including any direct quotes from the article. Please read the article here:

Ob-Gyns Issue Less Restrictive VBAC Guidelines

For information on the impact of the new guidelines, click here.

The Dangers of C-section and Benefits of VBAC

I've recently come across quite a few articles and blog posts about c-sections and VBAC's, and I want to share them with you.

Dangerous delivery shows peril of multiple C-sections - This article may be a bit shocking, but I appreciate the candor about the risks of multiple c-sections. The old adage that "once a c-section, always a c-section" is not necessarily true, although many doctors and women still act like it is. The truth is that the more c-sections a woman has the more dangerous it is for her, and vaginal birth after a cesarean can be a viable option.

"The case points out a fundamental truth about surgical delivery: a first cesarean for most women leads to a cesarean with every pregnancy. And while a first section is quick, easy to perform, and rarely complicated, each repeat surgery carries greater risk."

Does Electronic Fetal Monitoring Increase the Rate of Unnecessary Cesareans? - This blog post on The Unnecesarean outlines something that I've read about in other books and articles: Electronic Fetal Monitoring is unreliable and leads to unnecessary c-sections. You know those belts and monitors that are strapped on a laboring woman in the hospital? One of those is the EFM monitor, and that's the culprit we're talking about. If you haven't heard about this risk before please, PLEASE read this post.

"There are numerous reasons that one of three U.S. births now is by cesarean, but Dr. Alex Friedman blames some on an imprecise monitor strapped to laboring women. Too often, he has sliced open a mother’s abdomen fearing the worst, only to pull out a pink, screaming bundle."

"'Everyone knows it’s a bad test,' said Friedman of the Hospital of the University of Pennsylvania. 'You haven’t done the patient a big service by doing an unnecessary surgery.'”

A Doula’s Journey to Vaginal Birth after Three C-Sections - This is a really cool post written by a doula who had a successful VBAC (Vaginal Birth After Cesarean) after 3 prior c-sections. She tells her story, her journey, and how she came to experience what she has supported other women in experiencing in her years as a doula. It's a really beautiful story

Dr. Poppy Daniels Surprise VBAC - Dr. Poppy Daniels had scheduled her third c-section and ended up with a surprise VBAC on the same day her surgery was scheduled to happen! I love her perspective as a doctor who is supportive and trusting of women's bodies to birth babies without intervention. She also explains her journey and how she came to have a beautiful surprise vaginal birth.

International Cesarean Awareness Network - For more than just anecdotal evidence, go here for VBAC information and support. ICAN has local support groups everywhere to help women meet and support each other.

Skin to Skin Contact in the OR: Speaking Up and Making it Happen

I've found more really good information on this subject:

Skin to Skin Minutes After C/S in the OR… Speaking Up and Making it Happen

This blog post by a Labor and Delivery nurse gives some excellent advice on how to speak up and ask for skin to skin contact immediately after a cesarean birth. This can be done while the mother's incision is still being closed, and it provides an important bonding time between mom and baby to establish breastfeeding and a healthier, happier newborn.

Here is a wonderful video that shows an example of skin to skin in the operating room:

Breastfeeding and Skin to Skin in the Operating Room

"With a Cesarean birth the baby can be brought to mom's chest and feed even as the incision is being closed."

Skin to Skin in the OR

The routine is generally to whisk the baby away for weighing, drying, and doing newborn checks while the doctors close the incision and the mother lies on the operating table. As long as the newborn is in stable condition, it can be brought to the mother and held skin to skin just as many would after a vaginal birth.

There are other things that can be done differently to make a cesarean section birth more meaningful. A friend of mine had a positive experience with her cesarean birth. Her midwife gave some really good suggestions to them before going in for surgery. One of those suggestions was for the father to hold the baby and not let the nurses have him back. When the nurses wanted to put the baby in the bassinet to take him to the nursery, the father gently refused and told them he would hold his son. Even after they told him he wasn't allowed to do that, he held tight to his newborn and insisted on carrying him to the nursery himself. He stayed with the baby when the mother couldn't be there.

There are options other than the normal routine, but you must ask for them. You need to know your rights and how to ensure you get them. Do you have any suggestions for expectant parents on what they can do in the event of a cesarean section?

Risk to Baby Rises With Repeat C-Sections

This study appears in the June issue of Obstetrics and Gynecology, which all Obstetrician's should be acquainted with.

Click here for the article as it appeared on Yahoo News on May 21, 2009

Here are some highlights from the article:

"Babies delivered by elective, repeat cesarean section delivery are nearly twice as likely to be admitted to the neonatal intensive care unit (NICU) than those born vaginally after the mother has previously had a c-section, a new study finds.

"Nationwide, the c-section delivery rate keeps rising. According to the study authors, by 2006, 31.1 percent of deliveries in the United States were done this way. "'The decision to have your first c-section is very important," [Dr. Alan Fleischman] said.

"There should be a clear medical indication [because] your first may dictate subsequent [delivery methods].'

"Women also need to know that vaginal delivery is possible for many women who have already undergone a c-section, Fleischman said. Some hospitals do not allow vaginal delivery after a prior c-section, however, so he suggested that any woman who is planning on one find out early on what her hospital's policy is."

Study: Elective C-section babies born before 39th week face risks

You learn something new every day. At least, I do, and I like it that way.

I just learned today that babies born via Cesarean Section are more likely to have respiratory problems compared to babies born vaginally. A recent study tracked more than 24,000 women who had repeat c-sections performed at 37 weeks or later. Of those women, 13,258 had elective c-sections, meaning it was simply by choice with no medical basis for the surgery. Some of the main points of the study are:

• Over one-third of women are having elective repeat Cesareans. This is a significant number.
  
• Delivery just 3 or 4 days before 39 weeks led to increased complications.
• Respiratory problems are more likely with repeat c-sections, as well as other complications, particularly when the surgery is done before 39 weeks or after 40 weeks gestation.
• Parents and Doctors should wait until the 39th week to deliver via repeat elective c-section, and no later than the 40th week.

If you'd like to read the article yourself, please click on the link in the top paragraph. I found this article through another blog.