Will VBACs make a comeback?
The New York Times wrote a fascinating story looking at the rise and fall of VBACs — or vaginal births after Caesarean section — and how the government would like to bring them back into practice more frequently. It examined the successes at a Navajo hospital in Arizona, where they have lowered their number of Cesareans and increased their number of VBACs, even though the national numbers are just the opposite.
Here is the gist of The New York Time’s very long, but very interesting, story:
In the beginning there used to be a saying “once a Caesarean, always a Caesarean.”
Doctors feared the Caesarean scars on the uterus could rupture during subsequent labors so women were always forced to have Caesareans after their first one.
However in 1980 a panel declared it was safe for many women to deliver vaginally after having a C-section and the VBAC became very popular.
By 1996 VBACs reached their high of 28.3 percent.
Then there were some problems. Ruptures, deaths and of course lawsuits lead to stricter guidelines to perform VBACs and the rate has now dropped to below 10 percent.
So why is that bad? Here’s what the New York Times’ article explains:
“The national Caesarean rate, 31.8 percent, has been rising steadily for the last 11 years and is fed by repeat patients. Critics say that doctors are performing too many Caesareans, needlessly exposing women and infants to surgical risks and running up several billion dollars a year in excess bills, precisely the kind of overuse that a health care overhaul is supposed to address.”
“Even the American College of Obstetricians and Gynecologists has acknowledged that the operation is overused. Though there is no consensus on what the rate should be, government health agencies and the World Health Organization have suggested 15 percent as a goal in low-risk women.”
“ ‘VBAC’ has become a battle cry, with fierce advocates on both sides—women who insist that they should not be forced into surgery versus doctors and hospitals who insist on repeat Caesareans, citing the risks of labor and concerns about liability and insurance. ”
With that background information, then the article looks at the Tuba City Regional Health Care Corporation. It’s a hospital run by the Navajo Nation in Arizona and many believe is a model of what obstetric care should be like across the nation.
The hospital’s overall Cesarean rate is 13.5 percent which is less than half the national rate of 31.8 percent in 2007.
And last year the hospital had 32 percent of women who previously had Cesareans deliver vaginally. (Remember the national average is below 10 percent.)
Nurse-midwives deliver most of the babies born vaginally. It is believed that the C-section rate is lower because the midwives are trained to coach women through labor and will wait longer to recommend a C-section. Also the midwives are less likely to induce before due dates which can also lead to a C-Section.
(For comparison sake, midwives attend to only 10 percent of vaginal births nationally.)
Besides just the midwives, changes in insurance practices could also help increase VBACs, according to the article.
“Changes in malpractice insurance would also help, so that obstetricians would feel less pressure to perform Caesareans. (The hospital and doctors in Tuba City are insured by the federal government, and therefore insurance companies cannot threaten to increase their premiums or withdraw coverage if they allow vaginal births after Caesarean.) Patients, too, would have to adjust their attitudes about birth and medical care during pregnancy and labor.”
So what do you think? Did you have a VBAC? Would you have chosen a VBAC if you could? Did you feel pressured to have a C-section from your doctor or insurance company?
Do you think it is an important goal to reduce the number of C-section and increase VBACs? Would you be afraid to deliver vaginally after a C-section?
Would this story help you want to have a midwife attend your birth? Would it increase your confidence in asking for a VBAC?
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243 comments Add your comment
Gigi
March 12th, 2010
12:27 am
Just trying to follow the argument that is going on….birth is an involuntary action…one does not have to think,,,automatically the muscles ( like the heart) work to push the baby out….that is effective in almost every case and a woman CAN even do it alone….imagine if one thought all the time their heart will fail them. Of course if something does go wrong, it is better to be near a professional, but again a TRUE professional…one that will understand when he/she should jump in and not people that with non-medical inductions and unecessary cesarians have messed up human birth to the extend that 30% of women have to have major abdominal surgeries!
This is a crisis situation that should make all think- we need to get out of it.
irisheyes
March 12th, 2010
7:04 am
Yes, Gigi, it is an involuntary action. However, giving birth does not come without some MAJOR risks. I am a c-section baby, and I would be dead if not for a c-section. My first and third sons would be dead if not for c-sections. Are they used too much? Probably. Are they always unnecessary? Definitely not. Like I said before, if I get a healthy baby in the end, I’m happy. I didn’t have the whole vaginal birth pushing the baby out experience. Guess what? I really don’t care. I have three wonderful, beautiful kids. Isn’t that the goal?
I just love...
March 12th, 2010
7:42 am
…how all these moms who advocate anything tell others not to trust what their MD tells them but to research it, or better yet, just listen to what I say cause, oh, by the way, I did NOT go to med school but I know much more than the MD who DID go to med school and who has delivered at least 1 more infant than any of them…but hey, we read in a magazine that everything a MD says has not factual basis, so just adhere to what I write since I read it somewhere…
Michelle Frank
March 12th, 2010
7:42 am
Irisheyes, NO one is contesting whether the goal is a healthy baby. I think that’s a rhetorical point that you, and others, keep making, and it has nothing to do what many of us others are saying. Women deserve the opportunity to labor and deliver their babies as their bodies were meant to do, and in today’s birth climate, both here in Atlanta and nationwide, that is not happening.
I have heard time and again women say ‘my c-section baby would be dead if it weren’t for my c-section,’ and you know what, some of them are probably 100% correct. But a vast majority of them believe that that is true because their OB told them so, and once they seek out what really happened prior to them landing in the OR, they discover differently.
How many women have an “emergency c-section for fetal distress” these days? Countless. How many of those women’s labors were augmented with pitocin, etc.? Countless…
Michelle Frank
March 12th, 2010
7:47 am
And another comment to motherjanegoose: I think it’s horribly sad that for seventeen years you’ve been blaming yourself for your daughter’s Erb’s Palsey. Is that what all of your doctors have been telling you for all these years, that because you chose to VBAC you nearly paralyzed your daughter? I have never seen anything in a medical article or journal, or even on a website rather, that shows a direct correlation between a VBAC and Erb’s Palsey.
first time poster
March 12th, 2010
8:22 am
When I had my child 12 years ago, I went into delivery with zero expectations of how I would reach the end goal of a healthy baby. I didn’t plan on anything, though I did consider what could happen. If it was too painful, I knew I’d ask for an epi, if I or my baby were in danger/distress I would have a c-section, if everything went “perfect” so much the better. But as life is want to do, stuff happened. My labor was fast (4 – 8 cm in 30 mins), baby was “sunny side up” had depended, but I wouldn’t get past 8 cm, and baby would not turn over despite some fairly limber movements on my part considering the pain and my girth! End result was a healthy mom and a healthy baby delivered by c-section. Bottom line, you can plan, you can research and still the unexpected can happen. Be informed, no doubt, but also be prepared that the unexpected can and will happen so be open minded and willing to do what you have to for a good outcome.
Frankly, Michelle Frank...
March 12th, 2010
8:40 am
…you have totally missed motherjanes’ point regarding her difficult delivery – she is not blaming herself, she is blaming the OB who would not listen to her desire to end the labor and to proceed with the c-section! Hence, all of you rants as to how bad NS Hospital is and how much you have read has lost all credence since you were unable to comprehend what motherjane was relating as HER experience.
Yeah, Michelle Frank...
March 12th, 2010
8:42 am
…are you a MD/OB, or did you just stay at the Holiday Inn Express last night?
Christine
March 12th, 2010
8:45 am
“I just love… how all these moms who advocate anything tell others not to trust what their MD tells them but to research it, or better yet, just listen to what I say cause, oh, by the way, I did NOT go to med school but I know much more than the MD who DID go to med school and who has delivered at least 1 more infant than any of them…but hey, we read in a magazine that everything a MD says has not factual basis, so just adhere to what I write since I read it somewhere…”
I just love… how you are too incompetent a debater (really, you are just a troll, but I’ll try to be nice) to actually present any facts that back up YOUR opinions.
No one is saying ‘believe me, I know more than your OB’. No one here is getting their info from a magazine. We are talking about *evidence-based medicine*. Studies performed by physicians that include thousands of cases. Levels of evidence. Something you clearly know nothing about.
If you had bothered to read the link I posted from the NATIONAL INSTITUTE OF HEALTH, you would see that physicians all over the country are working to solve this problem.
I suggest you familiarize yourself with studies so that when you eventually decide that giant stick removed from your rear-end, you can find the least invasive option to do so.
Wow
March 12th, 2010
8:52 am
New Stepmom, you say you are not knocking the choices of others, yet you seem to dismiss the goals of those who strive for a more natural birth as being selfish trend-followers. Where is the “honey” in that? You also say that the process is not about you. Does that mean you won’t be getting the epidural, then?
Nurse&Mother has not backed up anything she says with any stats. Her words are not facts, they are opinions. It doesn’t mean she’s 100% wrong – but it also doesn’t mean she knows all just because her handle on this blog says she is a nurse.
What’s with all the challenges based on what someone does for a living, anyway? How do you know someone who is a stay at home mom isn’t also a nurse, physician, biologist, statistician? Or just knows how to read?? Someone is either and MD, or… what? A homeless person staying in a hotel?
momto5+1
March 12th, 2010
8:55 am
I just love…..clearly all mothers are ignorant and all dr’s are right. That is your point, no? That all medical professionals in fact do make it a priority to keep up with new medical research and always provide the highest level of evidence based care? That there are no dr’s practicing fear based medicine, looking out for their own best interests instead of their patients? A dr’s dream you are! Well, until something bad happens then you become a nightmare because you have no personal responsibility.
What article is it that you reference? The one in the original blog? I’m pretty sure what was linked was from the National Institute Health, The March of Dimes, etc. Not exactly the authors of Parenting magazine.
And as just a “mom” which I find to be a huge assumption that I choose not to qualify, I have a vested interest in birth outcomes. Subjecting my children to unnecessary and often harmful interventions is not something I would ever choose. I believe the whole point many posters made, and quite well, is that it is not only your right but your responsibility to ask questions and make informed decisions. But I’m a “mom,” how could I possibly be capable of reading and understanding medical research?!?!?
Becky
March 12th, 2010
9:03 am
New Stepmom..I hope all goes well with the birth of your first baby..My nephew and his wife had a very bad experience with Northside when their first baby was born, so no one in our family will ever go back there..Again, good luck and best wishes..
Yep, there go Christine and Momto5...
March 12th, 2010
9:31 am
…continuing to attack someone who has the audacity to challenge their “do as we say” mentality… and then, it seems that momto5 thinks that just because she has 5 + 1 (whatever that means) she know way more than ALL MDs, whether good or bad – she knows that ALL MDs do NOT read journals and the other medical periodicals in order to keep up with cutting edge medicine – She and Christine both know that what THEY read is gospel and the only truth out there. yeah, they know it all, because they done birthed babies!
And, Becky, I will agree that Northside may not be opportune, but no hospital is – I have been malpracticed on at Northside, St. Joseph’s, Piedmont, GA Baptist/Atlanta Medical Center(when I was born – see I am brain damaged – thought I would get that out there before one of you decides for yourself), Presbyterian Hospital in Charlotte, NC, and in numerous MD offices here in the Atlanta area.
So, yes, though you may think, Christine, that I am “A dr’s dream you are! Well, until something bad happens then you become a nightmare because you have no personal responsibility” I have taken personal responsibility, and that is why I think I know more about some of these issues than most of you advocates.
So, please, try to stay civil and leave the unknown accusations out of the discussion – you sound much more knowledgeable when you stick to the facts, and not supposition of “because I read it and believe it as Gospel”.
Every good accountant will tell you that you can get statistics to say whatever it is you want them to say – just ask AIG!?!?!??!?!
momto5+1
March 12th, 2010
9:43 am
Reading not your thing huh? I never said that ALL dr’s do not read medical journals. I was in fact pointing out your insinuation that moms were ignorant and dr’s were all knowing was ludicrous. Still is.
And right, because my screen name is momto5+1, it means that I have more knowledge than ALL dr’s. Assume much? I don’t have to qualify my educational background for you or anyone else, but I have worked with pregnant and laboring women for 10 years so yeah clearly my own personal experiences is all I have to go on.
I didn’t regurgitate any info, simply referred to links posted. I’m sure the NIH has a vested interest in whether or not women birth via major abdominal surgery or vaginally. That makes perfect sense…..right! You may want to look into how scientific studies are conducted before you start spouting off about how statistics are “fixed.” The AIG books and VBAC studies are not even similar. Nice try though.
Lastly, VBAC’s are not “cutting edge medicine.” They aren’t some trendy new birth practice. Dr’s are choosing not to practice evidence based medicine when it comes to VBAC’s (and so much more), regardless of what the medical journals have to say.
There you go again Momto5...
March 12th, 2010
9:57 am
Spouting off that you know more than a current practice L & D nurse (who has your “experience beat by at least 2 years), while characterizing “Dr’s are choosing not to practice evidence based medicine when it comes to VBAC’s (and so much more), regardless of what the medical journals have to say”. Yeah, just go by what the book says, practical experience has nothing to do with doctoring – oh yeah, that is why it is called THE PRACTICE OF MEDICINE.
Obviously, it is you who does not know ANYTHING about statistics and how they can be misconstrued in ANY application.
Actually, the AIG books were not ‘fixed’ – the powers in charge just did not tell the whole truth about what the stats meant; once they were looked at in depth is when you and I became stockholders in the company!
momto5+1
March 12th, 2010
10:03 am
And a nurse and a dr are exactly the same. Practical experience is the problem. They have NO experience with VBAC’s when they choose not to allow them.
I can only assume that ignorance must be bliss or so many wouldn’t choose it.
And your profession is what? Troll?!?!
Jamie
March 12th, 2010
10:19 am
The whole argument is not just about statistics it is about evidence based medicine as well as recommendations made by the National Institute of Health and The World Health Organization but I guess Nurse and Mom probably knows more than them as well. These practices are currently in place in many countries that do not have the 2nd highest newborn death rate in the modern world (as the US does).
There you go again Momto5...
March 12th, 2010
10:22 am
…with the name calling – and I did not mean to infer that VBAC’s were cutting edge medicine – I was referring to Christine’s catch-all phrase that MD’s do not keep up with the ways of the world re: the current state of the various medical fields. But, you wrote ” I don’t have to qualify my educational background for you or anyone else, but I have worked with pregnant and laboring women for 10 years so yeah clearly my own personal experiences is all I have to go on”. So, because you have worked with pregnant women you know more than those who, as I said before, actually WENT to medical school, thus having a whole lot more than 10 years of “working with” – try hands on working on pregnant women – but in you mine, you still know more!
And, as I first said yesterday, I am not a troll, but a 30+ year med mal person, with graduate degrees and industry certifications and all that stuff, so I do write with more than a little interest and knowledge in this field, as I am required to keep up to date in many field of medicine, not just OB, though I am by no means proficient in any field of medicine – I leave that to the folks who actually went to med school and I ask their advice when I need info on any particular medical topic.
And your expertise, other than “mom” and 10 years of “working with” pregnant women?
Elaine
March 12th, 2010
10:25 am
I can assure you, most private practice doctors in this area are far too busy to keep up with the current literature on VBAC. They have already made up their mind they are not going to do VBAC due to liability issues (NOT because VBAC isn’t a reasonable choice), and therefore they don’t care to keep current with VBAC issues. That *is* the fact. In my effort to locate as many VBAC-friendly careproviders in the Atlanta area for the VBAC advocacy organization I donate my time to (ICAN), I have called many OB practices in the metro Atlanta area to discuss their VBAC policies over the last 5 years. The summary is that those who do not support VBACs are not supporting them because they are afraid of getting sued if something goes wrong. Pure and simple. Fear.
The risk of uterine rupture in a VBAC is quoted to be around 0.5%-0.8%. The risk of ANY childbirth emergency happening to any birthing mother is around 1%. Why just single out the VBACs?
Geez, Jamie...
March 12th, 2010
10:25 am
..what do you think “evidence based medicine” is, other than statistical analysis of what is reported around the world? And, I would not put too much stock The World Health Organization, unless you are one of those who believes the United Nations has everyone’s best interest as their primary agenda…
Christine
March 12th, 2010
10:27 am
Please stop attributing things to me that I did not say. You have done it twice now. Check the post you are quoting. I would expect a 30 + year med mal “person” (not lawyer, eh? paralegal? admin assistant? which “person” is that exactly?) to be a stickler for details.
Anyway, there’s little credibility in posting “what you do for a living” on here. I could say that I am the head of the World Health Organization, or an OB who has been practicing for 30 years. No one ever lies on the internet ;)
Geez, Elaine...
March 12th, 2010
10:29 am
“I can assure you, most private practice doctors in this area are far too busy to keep up with the current literature on VBAC. They have already made up their mind they are not going to do VBAC due to liability issues (NOT because VBAC isn’t a reasonable choice)”
And you know this because you called “most private practices in the Atlanta area”? You admit you only called “many”, yet you painted with the “most” brush…
Elaine
March 12th, 2010
10:35 am
And by the way, how many VBACs have you actually seen? Our organization supports over 70 VBACing women a year, with an overall success rate of 83%. Compare that to the average OB who sees either no VBACs because he refuses to handle them, or a handful at most because he doesn’t actively encourage them either. Experience does matter, and when it comes to VBAC, surround yourself with people who actually see and do them all the time.
momto5+1
March 12th, 2010
10:36 am
Medical school is not nursing school. Don’t be confused.
Jamie
March 12th, 2010
10:38 am
Ok so how do we do medicine besides based on evidence?? What is your solution? I guess we all listen to nurse and mother. And ok so if the United Nations does not have our best interest in mind should we not be trying to do something about having the 2nd highest newborn death rate in the modern world? The only thing we are looking for is a healthy baby right? Apparently there is an issue somewhere.
My bad, Christine, ...
March 12th, 2010
10:38 am
…I apologize for attributing statements to you that you clearly did not say.
And, I was only replying to momto5’s request for my background – and, why would I lie – no I am not a lawyer (but I have worked closely with them for over 30 years); no, I am not a paralegal, nor an administrative assistant – just a working person who comes to work everyday at 6am, does my job, and goes home, just like most working folks. I just happen to work in the insurance field of medical liability claim management, so I have more than a little interest in this, and all topics on this site, that involve medical issues.
Momto5, who is confusing ...
March 12th, 2010
10:39 am
…medical school with nursing school? That is the 2nd time you mentioned that…
Elaine
March 12th, 2010
10:40 am
Dear geez,
A calling campaign is nothing to deride. It is a very good method of learning about the policies of area practices.
In fact, our national organization called every hospital in the United States to determine the VBAC status of hospitals that had maternity services and news services often refer to our work when discussing the VBAC ban issue.
See here: http://www.ican-online.org/vbac-ban-map?filter0=**ALL**&op1=5&filter1
Yes, we picked up a phone and called.
Becky
March 12th, 2010
10:42 am
@Yep..I haven’t called anyone a bad name on here, so not sure why you said that to me..All I stated was that my family had a very bed experience with Northside..If you were a regular on here, you would know that I don’t have any children (and the reason), so I can’t offer anything on the “right” or “wrong” way to give birth, other that I would hope that a woman’s Dr. would know enough about her to allow her to give birth in a way that is best for her and the child..
Good statistic, Elaine ...
March 12th, 2010
10:43 am
…83% of the VBC’s with your group was associated were successful – what about the “other” 17%?
Sorry, Becky ...
March 12th, 2010
10:48 am
…I was not referring to you after the paragraph that began “and Becky” – the rest of the paragraphs were directed at Christine.
And I am regular and know that you care for your niece and nephew, that you are 45 years old, that you live west of Atlanta (near I20) and that your husband takes “45 minutes and is just getting started”…
Christine
March 12th, 2010
10:51 am
And that was one of the mis-attributed quotes.
“…83% of the VBC’s with your group was associated were successful – what about the “other” 17%?”
unless you know of a third way that a baby exits a mom, it would make sense that the other 17% were CBACs.
Elaine
March 12th, 2010
10:53 am
The 83% success rate means that 83% of the women had their sought-after VBAC, and 17% ended up with a repeat cesarean.
Grateful VBACer
March 12th, 2010
10:56 am
My first two were born via c-section – the first because my doctor (that I blindly trusted) wanted to induce and my body wasn’t ready. The second because my labor did not move fast enough for doctor’s liking. They were awful experiences. My babies were sleepy from the drugs, I was separated from them for a distressing amount of time, my breast milk took forever to come in, I was in awful pain (because I did not want to further drug my babies or impair my already limited caring abilities) from using minimal drugs.
When I became pregnant with my third, my doctors (at one of Atlanta’s top hospitals) told me a VBAC was not an option because of the risk of uterine rupture. I was crushed. It wasn’t until I started researching that I discovered facts that told me that my baby and I were at much more statistically significant risks with each additional c-section than with a VBAC. I learned that even first time vaginal birthers can have a uterine rupture. I got in contact with a number of well-educated people and read a lot of scientific articles and determined it was a “risk” I was eager to take.
I found a doctor with ample experience in delivering VBAMCs, multiples, breech, etc and asked about his experiences and outcomes and methods. He in no way promised me a VBAC but he set my mind at ease that I would get and honest shot at it, and that he was capable of dealing with any issues that could arise, including diving into an emergency c-section.
My labor and delivery was carefully monitored and I had a successful and uneventful VBA2C. I did it completely naturally with the help of my husband and doula, because I wanted an unmedicated baby and a ready milk supply. I’m particularly grateful for the outcome because shortly after birth, we discovered my baby has a rare illness and I was able to immediately, and relatively painlessly tend to him in the NICU – something I could not have done after a c-section.
Becky
March 12th, 2010
10:58 am
@Yep..OK. I just wasn’t sure if I was reading it wrong..The rest you pretty much got right..The 45 minutes..Wow, not even sure how long ago that topic was, but I meant that in a joking manner or wishful thinking..Hope everyone has a wonderful day and a great weekend..:) ((( ))).
Michelle
March 12th, 2010
11:09 am
New Stepmom, try not to be too nervous. Once the process starts, just try to enjoy it as much as you can!! I can guarantee that for every hospital in every city in the county, you will find folks who say they would NEVER go there, so take some of the opinions with a grain of salt! One of your reasons for going to Northside (if I read your post correctly) is that is where your physician delivers. You are picking the MD, not necessarily the hospital. It is the MD who decides if/when a delivery is progessing as it should, etc. Try to enjoy the rest of your pregnancy, even if it is being spent in bed! Once he’s born, you won’t have to worry about that any more! :o)
As for all of you spouting statistics, etc., what about real life experience on a day in/day out basis? Does that not account for anything in your mind?
I don’t believe N&M has advocated one way or the other. She has stated that yes, vaginal births are optimal, but not always acheivable. She has even stated that VBAC’s are OK too under many circumstances!
It’s definitely your decision to try for VBAC, and you should find a physician who is willing to try with you.
You can all talk about and show every statistic out there. Think of it this way though…what if YOU or YOUR child were a statistic on the negative side? How would you advocate from that point forward?
Something you should take into account from N&M’s perspective is this, she actually SEES this stuff every day! She deals with the good and the bad EVERY day. She isn’t just spouting statistics that are out there. She is basing her opinion on what she sees and knows! Does she encompass the entire country and world? No!
And to the converse, Christine and her company have seen many of the “good” things. I’d like to know what happens when their VBAC’s go bad? What kind of statistics do they keep for that?!
Until you have to fight for the life of the mother &/or child, I don’t think you can fully appreciate exactly what happens!
Jamie
March 12th, 2010
11:25 am
I think this is where you guys are loosing me so if someone gives a statistic about uterine rupture thats valid but statistics about successful VBACs or the dangers of c-sections are not. One person (Nurse midwife) seeing birth happen everyday is more valid that another person (a doula) who sees births happen everyday. One persons anecdotal evidence of a bad outcome is superior than anothers about a good outcome. I wholeheartedly agree that personal experience will color ones opinion but I do not think that this is grounds for a blanket recommendation for major surgery. I think (actually as nurse mother said) that there are lots of gray areas but many are simply pointing out the fact that the current birthing environment is making very blanket recommendations.
Elaine
March 12th, 2010
12:06 pm
In the 5 years that ICAN of Atlanta has been serving women seeking VBAC in the area, we have aided close to 700 women either through phone support, referrals, in-person support groups, and a very active message board community. In that time, we have not had any maternal or infant deaths or neonatal birth injuries directly related to a mom’s VBAC status. A very rare event, like uterine rupture is, is seen…. very rarely!!! It is something that most doctors see once or twice in their career. Even our most VBAC-friendly OB, who is a member of our organization, who does over 100 VBACs per year, has only seen 4 uterine ruptures in his entire 30 yr career, having supported over 1000+ VBAC mothers and delivered over 5000+ babies. And of those 4 uterine ruptures, one was in a mother with no history of prior cesarean! And in those cases, no babies or mothers were compromised. Immediate medical action ensured mom and baby survived. A uterine rupture is a medical emergency, but it does not mean automatic death for the baby if prompt action is taken and there have been no reported cases in the medical literature of a mother dying from a uterine rupture either…. however, each year mothers die from complications from their cesareans, usually due to hemorrhages or embolisms or thromboses. In fact the maternal death rate in the US is on the rise and part of it is attributed to the ever-increasing cesarean rate. And the more cesareans a woman has, the riskier each additional surgery is for her.
Elaine
March 12th, 2010
12:19 pm
I also want to point out that not everyone who contacts us chooses to VBAC. And we can help her plan a more family-friendly cesarean and help her in her recovery from her surgery. Our scope is beyond just those moms who choose to VBAC. We basically serve to fill in the information gaps that busy OBs don’t have the time to disseminate. We have had a mother choose to have an elective repeat cesarean stay around as a member of our community because she still cares about making sure a woman can make a truly informed decision and can have the least traumatic surgical experience possible. Some women just contact us for careprovider referrals. Some for just an informational pamphlet. Everyone can agree that a healthy reduction in the overall number of cesareans that are performed is good for the health of both mothers and babies.
My bad ...
March 12th, 2010
12:49 pm
…ladies, regarding the 83% success rate for VBACs – obviously I interpreted the ’success rate’ to mean that of the 100% who tried it, 83% were successful. Thanks for clarifying…
Maybe I do need to take a reading comprehension course; nah, being as old as I am I’m probably just starting in the first stages of dementia…
Patricia
March 12th, 2010
1:03 pm
How is what you just said – “of the 100% who tried it, 83% were successful” – different from what Christine and Elaine said?
Because ...
March 12th, 2010
1:25 pm
… I was not very clear in my statement. What I should have said was that of all their clients (100%) only 83% of their actually tried the VBAC. They then clarified that the other 17% did not try the VBAC for whatever reason.
SLYGSAYSISOI
March 12th, 2010
1:34 pm
All I know is that you shouldn’t be pushing so many babies out of your vagina if you want to keep it firm and tight. A c section will keep your labia from becoming like sliced roast beef.
Patricia
March 12th, 2010
1:44 pm
No, they said that 100% tried, 83% had VBACs, and 17% ended up having repeat C-sections.
Elaine
March 12th, 2010
1:59 pm
I’ll further clarify… not everyone who turns to our organization chooses VBAC. Of those who chose to go for VBAC, 83% actually had a VBAC, and the other 17% ended up with a repeat cesarean after a trial of labor for whatever reason (failure to progress, malposition, fetal distress for example).
SLYGSAYSISOI
March 12th, 2010
2:01 pm
What % of women who have had multiple vaginal births keep a youthful apppearance to their vaginas?
This information I would think would have an impact on decision making.
momto5+1
March 12th, 2010
2:10 pm
“What % of women who have had multiple vaginal births keep a youthful apppearance to their vaginas?
This information I would think would have an impact on decision making.”
It would. For a guy not getting any.
And don’t you know? After 2 babies you don’t push them out, they just get up and walk out on their own.
SLYGSAYSISOI
March 12th, 2010
2:19 pm
No, I don’t know. And you make jokes, but it stands to reason that the appearance would change. Things would get stretched and what-have-you.
I am merely curious as to the changes one can expect.
momto5+1
March 12th, 2010
2:26 pm
None. It doesn’t get stretched. It is made to expand and contract. Obviously not immediately after birth, but within months. As for how it actually looks? Look it up, I’m certain there are plenty of pics online. But like all things, it will change with age regardless of childbirth.
Just a Reminder...
March 12th, 2010
2:54 pm
Half of all doctors finish in the bottom of their class.