Posts Tagged ‘NIH’

August 3rd, 2010

New VBAC Guidelines

After being so involved in the National Institute of Health’s VBAC consensus earlier in the year, I, as well as so many others were really anticipating the new ACOG VBAC Guidelines. The decline in VBAC began when they changed their guidelines suggesting only certain women, and certain hospitals were candidates for a Trial of Labor after a previous Cesarean delivery.  We saw a peak in the VBAC numbers in 1996, then a drop consistently there after.

ACOG included in their release something new that previously had been unthinkable in the medical community as a valid option for most women, and that is a trail of labor after two previous cesarean sections. Studies show that it is a safe and valid option for women who wish to attempt a VBA2C, which I have been saying all along.  But maybe now because a huge medical organization with MD after their names says it, people will understand it truly is a safe choice for mothers to make.

Also included in these guidelines are women pregnant with twins, with a prior cesarean delivery, and an unknown uterine scar, which in the past have meant automatic repeat cesarean deliveries.

Just some numbers to include into this also.

In 1970, the cesarean delivery rate was 5%, in 2007 it increased to over 31% of all deliveries with very little improvement to maternal and neonatal outcomes. VBAC was at about 5% which increased all the way up to 28% in 1996. Then the decline started, in 2006 the VBAC rate dropped down to a little over 8%.  Which is horrible for our women here in the U.S.

While I stand by women being informed on making their own choices regarding their care, as a mother who has had two cesarean deliveries, researched, learned the numbers, the risks, and everything involved in VBAC vs. ERCD (Elective Repeat Cesarean Delivery) the risks for a repeat c-section are much higher than a trial of labor after a previous cesarean. You are more likely to have long term complications, be re-hospitalized, need a type of blood product, and all the risks that go along with major surgery when opting for a cesarean over a trial of labor.

The risk for a uterine rupture is between 0.6-0.8% with one previous cesarean delivery, and the most recent studies and numbers has not shown a neonatal death from uterine rupture. I am not sure the amount of years it has been, but per the information from the NIH VBAC consensus, it has been at least 10 years since they have documented a case.

Maternal mortality rates are higher with elective repeat cesarean deliveries over VBAC also. When comparing ERCD to VBAC, per 100,000 births, there are 9 less maternal deaths with VBAC than elective repeat cesarean delivery. Hence showing that VBAC is safer, despite all the discussion of risks.  Those are 9 mothers, sisters, daughters that can and should be saved!

I think that these new VBAC guidelines are certainly a step in the right direction, while the change may not take place overnight, we are seeing that it is something now being addressed on a large public forum as the backlash of high cesarean rates are starting to take their toll on our women and babies.

March 14th, 2010

This Week’s Round Up

There are a ton of things that have gone on this week, starting with the National Institute of Health’s Vaginal Birth after Cesarean conference in Bethesda Maryland.  Lots of activists, professionals, and reporters descended on Maryland in hopes of a huge change in the maternity care system in our country, and it looks as though it worked!
A couple, or should I say, a ton of articles from this week…

United States urged to confront shocking maternal mortality rates
Too Many Women Dying in US While Having Babies
Doctors Debate C-Section Options
Deadly Delivery by Amnesty International
Women Struggle to Avoid C-Sections
Panel Urges more Choice in Birth after Cesareans
Too Many Preventable Deaths Among New Moms
Group Urges New Rules for Vaginal Birth after Cesarean
Panel Urges new Look at Cesarean Guidelines
NIH Panel : End Bans on Vaginal Birth After Cesarean
Vaginal Birth After Cesarean Underused
Panel : Vaginal Birth after Cesarean not too common
Panel : Women Need a Chance to avoid repeat C-section
Are C-Sections too common?

On to my favorite blogs for the week, from babywearing to ICAN :

Slings & Safety by Doula-la-la
The illusion of Choice
Once a Cesarean, Rarely a Choice
WSJ talking crap about Breastfeeding
New Moms at Risk, and a Wake Up Call to Nurses

I am extending my giveaway another two weeks because of the lack of people who signed up for it. So if you are interested in winning a beautiful nursing reminder, sign up!

Wednesday night wrapping up The NIH Conference, I had Joy Szabo on my radio show also.
Check that out too!

There wasn’t much blog talk this week that didn’t center around the NIH VBAC Conference, but if you have something you wrote, or even loved someone else’s post, please link it up here!

March 13th, 2010

2011 ICAN Conference Chair

Well, as many of you already know, I am heavily involved in ICAN, better known as the International Cesarean Awareness Network, and I have been since shortly after the birth of my first child. I started my own chapter in my local area, and then I moved on around the time that I was ready to give birth to my second child to become the Northeast Regional Coordinator also. Because I am so passionate about ICAN and what they do, I have been always willing to go above and beyond to help.

So when the opportunity came up to be on the 2011 ICAN Conference Committee, I of course applied. Knowing that this conference, I will not be too pregnant to travel, heck, I won’t be pregnant at all! LOL So I knew there would be nothing holding me back this time. I desperately wanted to go in 2009, but Ben decided to join us just 3 short weeks after the conference in Atlanta, so had I gone, who knows what would have happened!

I originally applied to be the 2011 Speaker Chair, with a second option as the Registration Chair. I thought the speaker chair would not only be fun, but because of the awesome connections I have made in recent months, would be perfect. (Not only that but I am starting an ICAN movement towards a “Silver Fox” panel for the conference which would include Marsden Wagner, Eugene Declerq, and Sutart Fischbein) and the registration chair was simply a second pick.

Yesterday, Maureen, the woman who is the head for the conference in 2011 contacted me with a favor and of course, like I always do, I took on the challenge. Which was to accept the National Promotions and Publicity Chair instead of what I had applied for because of the lack of interest in the chair position. I was truly surprised at that because with all the social media today, I would have assumed that people would have jumped on something so easy!

Of course I told Maureen, like I normally tell any ICAN Board member, I would help where ever they needed me to, and then she told me to consider myself the official 2011 ICAN Conference National Publicity and Promotions Chair. Score!  While I was pretty confident that I would obtain a position on the conference board, I did not think it would be anything as important.

So what exactly am I supposed to do with this title right?  Sounds like it is pretty broad?  Well some of my duties include what I already do on a pretty much daily basis with social media connections.
Some others include :

• Advertising the Conference to ICAN members, and other National Organizations that would be interested.
• Develop advertisement for the conference.
• Communicate with National Publications (which I have already been doing heavily with the recent media on c-sections, maternal mortality, and the NIH VBAC Conference).
• Networking… Facebook, Twitter, Blogs, etc.. (So if you want to blog about the conference as it gets closer, I am your woman!)
• Work with the Local Publicity and Promotions director to write press releases

So many more things, it seems to be like a great position, and like I said before, I am in the habit of really doing most of anything they ask of me. One example is a video I made earlier in the year for ICAN. I obtained the music from a friend of mine (Rob Taylor) who is a local musician in my area, and all the pictures came from ICAN chapters and members Nationally.

I hope you enjoy!
I had a really great time making it, and I am super excited in my new future at ICAN, at least until it is over in April of 2011!

March 12th, 2010

Wrapping up NIH VBAC Coverage

So much came from this conference this week, so I wanted to share a ton of links that may be helpful for those who were not able to participate.

If you were not able to watch the coverage, you can use these links for viewing of what took place.
Day One of the National Institute of Health’s VBAC Conference
Day Two of the National Institute of Health’s VBAC Conference
Day Three of the National Institute of Health’s VBAC Conference

All three links are video feeds.

The Original Draft Statement
Current Statement after Revising
The final statement should be out within a week or so, until then I will leave the slot for this blank.

The Conference Abstract

In the aftermath of this conference, there are an incredible amount of articles not only addressing the rising cesarean rates, increasing maternal mortality rates, and lack of VBAC access, but human rights issues that the panel at NIH did not address in their statement.
So, because I have been a media junkie the past couple days, I started tracking all the links.

United States urged to confront shocking maternal mortality rates
Too Many Women Dying in US While Having Babies
Doctors Debate C-Section Options
Deadly Delivery by Amnesty International
Women Struggle to Avoid C-Sections
Panel Urges more Choice in Birth after Cesareans
Too Many Preventable Deaths Among New Moms
Group Urges New Rules for Vaginal Birth after Cesarean
Panel Urges new Look at Cesarean Guidelines
NIH Panel : End Bans on Vaginal Birth After Cesarean
Vaginal Birth After Cesarean Underused
Panel : Vaginal Birth after Cesarean not too common
Panel : Women Need a Chance to avoid repeat C-section
Are C-Sections too common?

As more stories come out, I will continue to include the links!

March 11th, 2010

Joy Szabo, NIH, & What Wasn’t Addressed

Last night I was lucky enough to have a 45 minute slot with Joy Szabo on my radio show. I was certain people would call in with questions to ask her about her experience, but it seemed as though the National Institute of Health VBAC Conference has really been overshadowing the whole week, especially in the birth and activism community who happen to be the main readers of my blog!
So half way through the show, when I realized that no one was calling in with questions for Joy, after talking about her story, feelings, and experience, we turned the table over to the final draft letter from the NIH panel.

That is when the show started to pick up, because people are MAD!  No matter how many times the same topic was brought up, it was left out not only in the draft letter, but in essentially their revised draft. While we do not know if it will make it into the final statement, most of us are not optimistic.
The topic?  Women being able to make their own choices, and say NO to their provider, repeat surgery, and NOT have to go through any type of legal recourse or court ordered intervention like we are we are slowly starting to see in our country.

It was brought up yesterday morning during the time in where the audience was able to make comments, suggestions, and ask questions, but again brought up during the Press Conference by Susan Jenkin’s from The Big Push for Midwives.  During the press conference panel members continued to dodge the question, and comments once again.

Now most of us went into this whole week not expecting much from the conference because many of us have been down this road, and knew that change is often not something that comes about, but after the first couple speakers, slides which included pictures of the ICAN logo and the banner from The Unnecesaean, many of us were smiling ear to ear hoping, and praying this would really be the step we needed. By day 3 it turned clear that it would not be what many of us would have liked to happen.

The one positive I find that came from this was the final suggestion for ACOG to revisit and revise their statement including immediate terminology, to something that is much more realistic in our medical community today.

We got a little carried away in the show last night, and went over our time limit, but I wanted to again thank those who did come on the show, speak, and bring a great discussion. Joy Szabo for bringing the issue of VBAC Bans into the mainstream media, Traci Perg for being so passionate, outspoken, and bringing up amazing points about modern day feminists, as well as pro choice supporters, Lauren Cooper, current Chapter Director for ICAN and her reflections on the conference. Lauren is a good friend of mine, as well as a great mentor, and she will be coming back on in April for one of the radio shows focusing on Cesarean Awareness Month, and last but certainly not least, Sarah from Salisbury Connecticut, a local doula, friend and advocate in my community.

Tell everyone what you think about the panel’s statement and leave a comment!

PS!  Please, please please!  If you have had a cesarean section, take our Post Cesarean Feelings Survey, it will ONLY be available till Monday March 15th, and we are trying to hit between 1000 and 1500 mothers!  Pass it along on Facebook, to your friend, family, or clients!
Post Cesarean Feelings

March 10th, 2010

Tackling the Draft Statement

I saw down and listened, read, and watched the question and answer session for the draft statement by the panelist who read it, as well as the audience who was able to add their input. One surprise I found was the President of ACOG who had been at the conference all along finally got up to make a comment, of course only after ACOG was called out in this statement’s conclusion.

I am glad that on several occasions through the document they discuss the NON medical factors that are influencing VBAC today.
I would also like to point out that I enjoy their final statement in the end which includes asking ACOG to reconsider their recommendation of VBAC and the “immediate” wording.

I really wanted to pick this all apart much more, but I am going to wait for the final draft for that.

I encourage everyone to read the draft, and submit comments in the next short couple hours to have your voice heard and suggestions looked at!

March 10th, 2010

The Draft Statement is Available!

The National Institute of Health’s VBAC Draft statement is now available to the public.
You can read it at
http://consensus-nih.org/omar-public/PublicComments/VBAC/PublicComments.aspx?AspxAutoDetectCookieSupport=1

Please read, and leave comments, they will only be taking comments for a short period of time today!

March 9th, 2010

NIH VBAC Day 2 Coverage

While the day was much shorter, I found it had a much more personal level of it as speaker Rita Rubin took on the stories of women around the country who have been victims of VBAC bans, lack of evidence based medicine surrounding VBAC, and women being forced to take matters into their own hands with out of hospital and sometimes unassisted births.
It certainly gave the speakers a much more personal feel and put names and faces to women struggling with this.

But I will get to that later in my post.

The day started with information on epidural anesthesia, as well as the lack of available anesthesiologists nationally to fill the need of the “immediate emergency care/delivery” guideline. I learned a lot about the national crisis surrounding available anesthesiologists.

1. Epidurals do not cause, or mask symptoms of a uterine rupture, if anything they allow for other options other than general anesthesia in the case of a rupture of need for emergent delivery.
2. When the speaker asked ACOG what they mean by immediate in their recommendation, their answer was “Immediate means immediate” kinda like banging your head against the wall?
3. Rural hospitals, and hospitals in rural areas have lower number of anesthesiologists, meaning lower access to an anesthesiologist in an emergent situation.
4. Currently in The United States, there are less than 30,000 current practicing anesthesiologists.
5. 55% of those anesthesiologists are over the age of 55 meaning they will be retiring in the next roughly 10 years.
6. There is an increase in Woman anesthesiologists, but women are more likely to work part time, or less likely to take on over night shifts, or shifts in Obstetric anesthesiology because of the schedule.
7. 4% of hospitals with in house anesthesiologists have 500 or more deliveries a year.

All in all, having in house anesthesia specifically, and only for Obstetrics, or VBAC is completely unrealistic. Not only that, but one thing that caught my attention of this speaker was the comment that “We need to remove lawyers and insurance companies from this choice” meaning the choice of VBAC vs. elective repeat cesarean delivery.
There was a suggestion at one point that VBAC only be “allowed” at hospitals that have at least 1500 births per year, but unfortunately like the 24 hour anesthesiologist coverage just for VBAC it is simply unrealistic. There are areas of our country that women have a 3 hour drive, or even longer to a hospital of that kind of caliber.
In the end, ACOG blames the OB’s, the OB’s blame the hospitals, the hospitals blame the women… and it is a giant blame game.
We need to stop playing the blame game, and we need to make this an available option for all women, while using the real evidence on its safety!

Moving on to some more things I learned…

1. Placental Abruption & Cord Prolapse are more common than Uterine Rupture.
2. Trial of Labor has much lower rate of perinatal death in women with previous cesareans as opposed to elective repeat cesarean deliveries.
3. In a study, 20% of OB/GYN’s say they reduced their exposure to lawsuits by no longer offering VBAC.
4. The risk of fetal death in a first time mother, is the same as, a mother VBAC’ing.

The last thing there shows a statistical analysis that shows us no difference between a mother VBAC’ing her second child, and a first time mother giving birth to her first child. The fetal death rates are the same. This shows one thing to me, and many others who were also live tweeting during this, women are not being truly informed about all of the risks and benefits of VBAC.  Women are not being given accurate, and real information.

There were several comments about women and their providers needing to be the ones making the decision regarding the mothers choice to VBAC or have an elective repeat cesarean, and some may not agree with me, but in my opinion it shouldn’t have to do with her provider at all. It should be the patients decision, period.

Another part of the survey that made me giggle was one of the reasons cited for women opting for elective cesareans instead of VBAC was to avoid the pain of labor which I have been through twice, also ending both times in a cesarean delivery. Avoid pain? Who are you trying to fool because cesareans certainly are not avoiding pain by any means!

More bits and pieces I learned :

1. 49% of ACOG Fellows in one survey said they do more cesarean sections for fear of litigation.
2. There is more and more clear evidence that women want VBAC but are being denied these services by providers, as well as hospitals.

Then came the discussion of woman’s stories, and what has taken place all over the country to women searching for VBAC as an option. Several ICAN women were quoted, as well as featured which I loved!
Gina also known as The Feminist Breeder was featured, and her struggle to have a VBAC.
Joy Szabo of Arizona who had to drive 350 miles, leave her husband and 3 children behind because of her hospitals choice to ban VBAC after she had already had a VBAC at this facility!  (Joy will be on my radio show tomorrow night at 10pmEST)
The number of women, and their stories were touching, and made the whole experience and conference real it made the panel members, and audience members realize these are real women we are talking about and essentially deciding the future of their childbearing.

In many cases, the question and answer sessions were my favorite part. Although there were a few audience members who continued to get up with their long winded comments sometimes going no where, or no relevance to VBAC at all. Which bothered me because there was a clear line of providers and activists who had short, to the point, and important comments and questions.

Couple comments from the question and answer session which stood out to me :

1. “No one should be brought to the OR against their will or without their consent”
2. “I feel like I am committing a crime when I take a knife to a woman I know has a high VBAC success rate” – VBAC supportive OB working in a hospital with a VBAC Ban

(I promise, I am starting to get to the end)

One of my issues was the discussion on ethics when it comes to VBAC and elective repeat cesarean deliveries. There is such a gray line that is being crossed continually in this country. Women who have Child Protective Services called on them for being a “difficult patient” and that is something we should not be seeing at all. Being a difficult patient, and being an informed consumer should not be something women fear having their children taken because of.
We should not be seeing women rolled into the OR with Sheriffs or court orders.
We should not be seeing women charged with Murder over a stillbirth when a cesarean is declined.
These are real stories!

One last thing that really got me also!
A panel member said something about protecting the rights of patients AND providers… well ya know what.. the rights of the providers are the ones being protected, by these bans, the defensive medicine, women are the MOST venerable ones involved, and that should not be it!

I could sit on my soapbox for hours, so I will stop there.
I hope that the NIH takes this chance to really form a informed and evidence based guidelines and recommendation for this.

We will see tomorrow when they release it at noon!

March 9th, 2010

NIH VBAC Day 1

While I wanted to be the first Blogger to have my live coverage up from the National Institute of Health VBAC Conference today, between a toddler and 9 month old, dinner, cleaning, and working on moving furniture out of the house for our delivery tomorrow, I can’t say I will be the first. Oh well, housework happens right?  I neglected it enough today.

While I originally planned to have live and continuous coverage all day, again, life happens, and I did not realize how hard it would be to “live blog” with the time limits, as well as fast moving speakers. While the panel and speakers were on a strict time limit, things move quite quickly.

I was able to “tweet” live and I am going to use all the things I tweeted today to basically write my run down, as well as share some of the many things I learned today. I think after this conference I should have VBAC after my name just for all I know about it. I THOUGHT I knew a lot before this.

1. My day started off tweeting with Amy Romano from Science and Sensibility about the amazing amount of talk regarding evidence based medicine, practice and guidelines for this consensus.
   
2. Another awesome point at the start of the consensus, was the fact that one of the presenters started to discuss the blogging community, She used a screen for her presentation which I believe The Feminist Breeder caught a picture of, and surprised all of us. Yup, you see it right, on the top of the screen is the logo of the popular birth and cesarean section website, The Unnecesarean! I almost peed myself! Along with that is the ICAN logo, and other various PRO VBAC websites.
3. Discussion of placental problems after previous cesarean sections, and the increased risk of more serious and more dangerous placental complications with each cesarean birth.  We have seen in the past 20 years a large increase in things like placenta previa, placenta acretta, and other life threatening placental issues.
4. The risk of hysterectomy also increases, which is rarely discussed. The risk of having a hysterectomy with the 4th cesarean section is 2.5%
5. A quote from one of the speakers included “repeat cesarean section does not eliminate the risk of fetal injury” Which is a huge common misconception of women who are opting for elective repeat cesarean deliveries, also refereed to as ERCD’s.
6. Privately insured patients have higher repeat cesarean rates, and women who have medicaid coverage have higher VBAC rates.
7. 45% of providers stopped providing VBAC services completely due to the ACOG recommendations on VBAC.
   

   Kinda blurry, but my toddler and I watching the conference online

8. White women, are more likely to have a VBAC although African American women have lower risk of uterine rupture or adverse reactions to VBAC.
9. Rural hospitals have lower trial of labor after cesarean section rates, as well as lower VBAC rates, and higher VBAC ban rates. Which is something we all pretty much knew before hand.
10. Induced VBAC success rates are 63%, lower than the over all VBAC success rate of 73%.
11. There was a lot of talk about VBAC outcome prediction tools, which I am not sure how I really feel about them, on top of this, my child decided to start acting up around this point which took me away from the computer for a little bit.
12. Another quote “trying to give women the information they need to make an informed decision” which is what the VBACtivist community has really been saying all along.
13. Countries that use the Midwifery Model of Care have high VBAC success rates. Someone from the audience chimes in “Does that mean we need to move?” LOL!  No, that means we need to get our OB’s to practice like midwives. Ya think we will be able to wrestle the knives out of their hands?
14. Then the first audience question came. And I fell in love with my second, much older husband. Only second to Marsden Wagner. Dr. Suart Fischbein got up, and spoke about liability, VBAC bans, and posed several amazing questions. My heart melted!  I am so glad to have him coming on my radio show in a couple weeks!
15. A friend of mine, Stacey Gregg of New Jersey also spoke, asking questions about racisim in VBAC and medical care, and the panel was very quick to dismiss her, but the worst part was, she had very valid concerns, comments, and questions.
16. Then came my favorite part of the whole day… One of the panel members made a statement about home birth data, and how there really isn’t any, or at least any accurate data and the WHOLE ROOM ERUPTED!  “YES THERE IS!!!!”  Maybe they missed that CDC release last week?
17. When comparing ERCD to VBAC, per 100,000 births, there are 9 less maternal deaths with VBAC than elective repeat cesarean delivery. Hence showing that VBAC is safer, despite all the discussion of risks.  Those are 9 mothers, sisters, daughters that can and should be saved!
18. Now, on to something I was not aware of today… cesarean ectopic pregnancies. Meaning, ectopic pregnancies IN or ATTACHED to the cesarean scar which are deadly!   Something again not spoken of in the risks of cesarean delivery. This happens in 1 out of 200 pregnancies after a cesarean. I wish I had a picture of it as it was fascinating.
19. Another thing I never knew was the increased risk of stillbirth after cesarean sections, and each elective cesarean after!
20. Factors that affect uterine rupture… hmm… right on the slide it said INDUCTION and OXYTOCIN!
21. There was a great discussion on using ultrasounds to look at the thickness of uterine scars and access the risk for a uterine rupture in the weeks before labor.
22. Another great Birth Advocate Shannon Mitchell was able to get up and ask a question.
23. Got to see The Feminist Breeder ask an awesome question about post cesarean emotional impacts.  The panel agreed that there certainly should be more research on the topic itself.
24. Jen from VBAC Facts was able to get up and question VBAC bans and the hospitals that say they are not “equipped” for VBAC. Basically covering and having the panel agree with her about hospitals not being properly equipped is an excuse.
25. You should have seen the look on the faces of the panel when a mother got up and introduced the baby on her hip as a breech HBAC birth meaning, vaginal breech birth at home, after a cesarean.  GASP!
26. Then moved onto the Trial of Labor and the impact on the infants, and again my children started raising hell, so I only got bits and pieces, but I will share what I did get.
27. 2007 marked the 11th year of constant increases in the cesarean rate in The United States.
28. There looks to be a direct connection between the rise in cesarean section rates, and women in the US putting off having children till their later childbearing years. (Interesting graph I will have when they publish the full report)
29. The risk of uterine rupture is 0.8% and the risk for fetal death out of that small percent is only 6%!
30. 1 out of every 3 elective repeat cesarean deliveries takes place BEFORE 39 weeks gestation, when the recommendation is NO elective deliveries before 39 weeks. Showing that providers are picking and choosing which guidelines they want to practice.
31. NICU admission rates in the above babies are higher.
32. Increased risk of Type 1 diabetes in children born via cesarean section.
33. One speaker called ACOG’s current VBAC guidelines “overkill”
34. The same speaker also said home births are not something women should be doing for VBAC’s. Which causes a problem, at least for me. What this speaker/provider does not understand is under the current VBAClash in the country, the ONLY option for many mothers interested in VBAC is out of hospital births, or even UNASSISTED births.
35. Desirre Andrews, the current ICAN President was able to stand up and address the amount of hospitals nationally with VBAC Bans, De facto bans and why women are being forced into alternative birthing options because of these guidelines. She shined like a star!

Now, I would like to add a short disclaimer that all of the above information is NOT information of mine. This belongs to the National Institute of Health’s VBAC Consensus presenters today. These are all studies THEY brought to the table, these are all numbers they they cited, and if you would like further information on ANY of this, you can pre order the full presentation and consensus report on the NIH Website.

These are FACTS that have come from medical professionals, scientific medical studies, and major universities.

March 8th, 2010

Afternoon update

I thought that I would be able to update live with everything going on, unfortunately I underestimated my children for the morning session. In reality with the vast amount of information being given, it is near impossible to really keep up.
I was able to tweet live on twitter, as well as watch the live twitter feed for the #NIHVBAC hashtag which is the current tag suggested for the conference itself. I am going to share some information I got off of there as well as some highlights from this morning.

The first thing I want to get out there is a CNM brought up in the question session was home birth, especially for VBAC mothers also known as Home Birth after Cesarean, or HBAC. The moderator promptly made a comment about how there are no accurate statistics for home birth. The room ERUPTED in YES THERE IS!!! And many people continued to speak out about it.

Other great highlights were Dr. Stuart Fischbein being the first person up to the question stand to talk about hospitals who have VBAC bans, hospital policy, and the lack of TRUE informed consent taking place nationally.  He is my hero, and I am so excited to have him coming up on my radio show in April.   Can I add him to the list of men I would like to marry?

Lots of other stuff included the difference in maternal death between VBAC and ERCD’s which out of 100,000 deliveries with previous cesarean sections, 9 out of 100,000 women will die from routine elective cesareans.  Nor are we talking about the serious risks to future pregnancies including life threatening conditions, placental problems, future infertility, etc.

They also tackled the issues surrounding informed consent and how many women are not being given accurate information regarding VBAC Vs. ERCD and the risks involved. Whether for monetary or liability reasons.

There is so much, but once the conference is over tonight, and my husband is home from class, I will be blogging in full.

P.S. The Unnecesarean logo ended up on one of the presenter’s slides!  I was so excited to see that, as well as the ICAN logo right next to it!

March 8th, 2010

Dr. Caroline Signore

• Low risk women have a 23.6% risk for a cesarean with their first child.
• With their second child they have a 90% chance of having a second cesarean
• Lack of VBAC coverage by insurance, and hospitals.
• Between of hospitals 17-58% do not allow VBAC
• In tough economic times cesarean deliveries are a more costly procedure when compared to vaginal birth.
• The rates of adverse outcomes from VBAC are as low as SIDS.

March 8th, 2010

Part 1

To start off, at the end of the next couple of days, when the consensus is over, you can obtain the report at http://www.ahrq.gov/ which is the agency that got the contract.

I am starting to watch, and blog and I am trying to get as much onto my blog as I can while following this myself.
I guess it is going to be harder than I though.

First thing I would like to point out is all the women on the panel, as well as all the different backgrounds of the panelists. Nurse midwives, OB’s, etc… A lot of my posts will e bullet points of statements from the conference.

Some appreciations to get familiar with for the next coupe days :
TOL = Trial of Labor
APC = After Prior Cesarean
VBAC = Vaginal Birth after Cesarean
ERCD = Elective Repeat Cesarean Delivery

• VBAC Access is certainly restricted
• Panel is going to look into why the VBAC numbers are decreasing as well as to if these reasons are VALID reasons.
• Lots of emphasis on EVIDENCE based medicine, practice, and research.

March 8th, 2010

Hospitals not “equipped” for VBAC

Since the NIH VBAC Conference is starting today, I wanted to touch on this subject. We often head hospitals with active VBAC (Vaginal Birth after Cesarean) bans in place use the excuse that they are not “equipped” for an emergency that could come from a VBAC in the case of something like a uterine rupture, etc. I have pondered about this thought over and over, and realized that if these hospitals are truly not equipped for an emergency that would or could come from a VBAC, then maybe they should not be operating a Labor & Delivery unit…. period.

Emergency situations can happen in any kind of childbirth, previous cesarean or not, and there have even been cases of uterine rupture without any type of a previous cesarean section. So because of this I feel as though this excuse on many levels is simply that, and excuse.

Why not just come out and say we are

• lazy
• scared of getting sued
• misogynistic
• anti reproductive choices

We don’t want women to use their own vagina to birth their babies, we want the big bucks from the repeat cesareans!

Here’s to hoping NIH’s VBAC conference will help turning around all the National VBAC Ban’s and help the VBAC rate rise again!