Review of Data: Vaginal Birth Still Best

This article appeared in the African newspaper Cape Argus as breaking news (why isn’t it breaking news in America?):

Dr. Brian M. Mercer, of Case Western Reserve University in Cleveland, Ohio, and colleagues studied the impact of prior vaginal birth after cesarean on outcomes of attempted vaginal births in subsequent pregnancies in 13 532 women.

For 9 012 women (67 percent), this was their first vaginal birth after cesarean - what doctors call “VBAC.” Twenty-nine hundred women (21 percent) had a history of one prior VBAC, 1 058 (7,8 percent) had a history of two, 371 (2,7 percent) had a history of three, and 191 (1,4 percent) had a history of four or more VBACs.

Results showed that the frequency of VBAC success rose with increasing number of prior VBACs, from 63 percent with no prior VBACs to 88 percent for women with one and 91 percent for those with two or more prior VBACs.

The corresponding incidence of uterine rupture, a serious complication of labour, declined from 0,87 percent to 0,45 percent and 0,43 percent. The rates of other complications followed similar patterns with increasing number of prior VBACs.

In contrast, the investigators note, repeated cesarean deliveries are associated with higher risks of complications like placenta accreta (when the placenta implants too far into the uterus) and trauma to internal organs in the mother, as well as more frequent hysterectomies and blood transfusions.

“Women planning large families… should be reassured by the increasing success rates and decreasing risks associated with VBAC attempts in successive pregnancies,” Mercer and his associates conclude.

March 31, 2008 | Filed Under Cesarean Birth, VBAC | Leave a Comment 

Breaking news! VBACs at home upheld in Colorado!

Congratulations to the women of Colorado for retaining the right to vaginal birth after cesarean (VBAC) at home attended by Registered Midwives! The Department of Regulatory Agencies has composed the following rules as a result of testimony provided by midwives, physicians, ICAN representatives, and citizens in December 2006. The written rules reflect the self-directed practices already in place by many of the state’s midwives. Read more

May 17, 2007 | Filed Under Home Birth, In the News, Politics, VBAC | 4 Comments 

VBAC at home in Colorado

I thought I should give an update on the recent rulesmaking hearing that was held at the Department of Regulatory Agencies in Denver.  Many experts on birth testified in front of the director, including an obstetrician who likened the choice to VBAC at home to choosing to drive while drunk!  The implication is that women who choose VBAC are irresponsible and reckless.  At any rate it is the consensus of those present that the meeting leaned in favor of women continuing to have the choice to VBAC at home in Colorado.  From the date of December 15, 2006, the Director has 180 days to make her final ruling.

We’ll keep you updated!

January 14, 2007 | Filed Under Home Birth, VBAC | Leave a Comment 

Home VBAC in Colorado

There will be a Rulemaking Hearing at the Department of Regulatory Agencies (DORA) in Denver on December 15, 2006 at 9:00am at  Suite 1380A/B, 1560 Broadway Denver, Colorado.

The purpose of the Rulemaking hearing from the standpoint of the Director of DORA will be to define the guidelines of Registered Midwives attending to vaginal birth after cesarean (VBAC) clients at home.

There are a number of groups, the Colorado Board of Medical Examiners, the Colorado Medical Society, and the Board of Nurses who would rather see the practice of VBACs at home abolished entirely.  These professional groups will be represented at the hearing and we assume they plan to be very aggressive in convincing the Director VBACs at home are unsafe and therefore Registered Midwives should not be allowed to attend them.  The midwives will be presenting appropriate rebuttals to their arguments in support of continuing our record of safe practice for VBACs at home.

If you had a VBAC at home, or know someone who did, please consider writing a letter in support of this very important option.  Consider writing the letter on behalf of yourself, your midwife, your friends and any number of women who are affected by the 30.2% cesarean rate.

The complete notice is here including the proposed rules which the Colorado Midwives Association is in agreement with minor wording changes:  http://www.dora.state.co.us/midwives/rulemaking.htm

Letters should be addressed to:

Midwifery Registration
1560 Broadway, Suite 1340
Denver, CO  80202

Indicate “written testimony only” if you wish the letter to be submitted for the Director’s consideration.

If you wish to speak for three minutes on your own behalf you must apply to do so ONE WEEK prior to the hearing by calling Vana Montgomery at 303-894-7429 or email her at Vana.Montgomery @ dora.state.co.us (remove the spaces) to make sure you have your time at the microphone.

December 2, 2006 | Filed Under Cesarean Birth, Home Birth, In the News, Midwives/Midwifery, Politics, VBAC | 4 Comments 

Wanted: Your Voice.

I saw this on one of the mailing lists to which I subscribe and thought it might be of interest to some of our readers. I took the liberty of modifying it for this forum (rather than an email group).

My name is Jennifer Block. I’m a journalist currently working on a nonfiction book about U.S. maternity care, including the rising cesarean rate and the widespread denial of VBAC. My goal is to document how this climate is impacting women and families in all ways. You can help just by getting in touch–you can email me at writingblogck@gmail.com. I’m especially interested in hearing from women who…

  • were coerced into a cesarean
  • had a traumatic cesarean
  • have/had PTSD or other psych problems following a cesarean
  • have/had physical complications following a cesarean
  • want to have a VBAC but can’t find a hospital/provider
  • VBAC women who arrived at the hospital pushing (or any other strategies to achieve a VBAC in a hostile hospital)
  • VBAC women who had a repeat cesarean they did not consent to
  • women who’ve had to travel to access a VBAC provider
  • women who’ve had to hire midwives to travel to them from far away for a VBAC (or breech, twins, etc.)
  • midwives who travel to women wanting VBACs
  • women who’ve decided to go unassisted to achieve VBAC
  • women who’ve opened up their homes to other women seeking VBAC

If you write, please let me know your location, the year of the cesarean and/or VBAC, and a phone number where I can reach you.

My deepest thanks,
Jennifer

October 28, 2006 | Filed Under Cesarean Birth, VBAC | Leave a Comment 

Next Page →