VBAC is an incredibly political topic in the birth world.  Doctors in the United States are telling women who have previously had ceasarean section births that baby number two will have to be born the same way.  The driving factor in this situation is medical  malpractice insurance companies, who are faced with a growing number of  lawsuits from people claiming that an emergency ceasarean was not available quickly enough.

  One of the effects of the rise in malpractice suits, is that these insurance companies are targeting a procedure that research shows is reasonable and safe.  Many insurance companies are instituting strict standards of procedure for planned VBAC births, which can cost hospitals thousands more dollars to provide.  Many companies are excluding coverage altogether for doctors to allow women with a history of C-Section to attempt a Trial of Labor (TOL). If the doctors and hospital have no insurance coverage, they will not allow the procedure.

What are the risks of a ceasarean section?

Risks of this major abdominal surgery include hemorrhage, bowel obstruction, pain, infection, and tissue scarring and adhesions.  Bonding and nursing are challenged, and babies are more likely to be cut, born early, have breathing problems or weigh less.

What are the risks of VBAC?

Research shows that less than 1% of VBAC births result in uterine rupture  (1.6 per thousand.)  These studies have  included women whose labors were induced.  Pitocin and cytotec, labor induction and augmentation drugs,  create artificially strong contractions, so it is likely that  a study done with women experiencing spontaneous labor would have even lower chances of uterine rupture occuring.   Cytotec is not used any longer in cases of previous ceasarean, and pitocin is monitered closely to keep the dose under control. The risks  of the scar giving way were also greater when incisions were made vertically and higher, but the way the incision is made now, low and vertical, has much better results. 

Vaginal birth itself has a greater risk of continuing perineal pain or incontinence, and a greater risk of baby suffering nerve damage in the shoulder area.

This is a topic that women need to continue doing their research about, as doctors may just tell them that a repeat ceasarean is the best option.  Ceasarean section can be a life saving operation, if necessary, but the c-section rate in America is almost 30%.   Many healthy women are facing unnecessary risks from this major abdominal surgery.  90% of women who have had previous ceasareans are having repeat surgeries.  It is clear that ceasarean section has complications and risks, and the research leans toward those risks outweighing the risk of VBAC.

more online resources:

http://childbirthconnection.org/article.asp?ck=10166#systematic
VBAC research statistics

http://pregnancychildbirth.suite101.com/article.cfm/vbac_controversy
risks of c-section

http://www.mayoclinic.com/health/vbac/VB99999/PAGE=VB00009
The Mayo Clinic reports that VBAC is safer

http://findarticles.com/p/articles/mi_m0CYD/is_3_40/ai_n11832004/
insurance companies set standards for VBAC procedures

http://pregnancy.about.com/od/vbac/a/deniedvbac.htm
What to do if you are denied access to medical care for a VBAC

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      At the Ashland Community Hospital's Birth Center, doula care is provided for any laboring woman who requests support, and the service is at no extra cost.  A doula is a woman, experienced with birth, who provides constant physical and emotional support for a laboring woman.   She can be there as a main support person, if the woman has no family or partner with her, or she can be there to assist the husband or mother.   She will make suggestions about position changes, offer massage, and share her knowledge of the birthing process. She is there as a guide, and her main purpose is to help the woman feel safe and relaxed, so that her body can drop into a rhythm and give birth.   The nurses at the Ashland Hospital provide excellent labor support, but are also responsible for taking blood pressure, checking cervical dilation, keeping records, and caring for other patients.   Since they  cannot always provide constant support,  they have  hired a team of skilled and compassionate women to stay present with their patients.  It is an incredible gift to women, and unique for a hospital to provide this service.

     This Oregon hospital's progressive program began in 1995, as a way to support Spanish speaking women.  Originally, the doulas were fluent Spanish speakers and were there to translate, in addition to offering labor support.  A couple of years ago, the program expanded to include support for all women, and now there are doulas on call 24 hours a day, seven days a week.   Many of the current doulas speak Spanish, but not all are fluent. 

      Having a doula present greatly reduces the need for medical interventions and greatly increases the chances of a woman remembering her birth as a life transforming accomplishment.   You can see photos and read a little about the doulas, including myself,  on the Ashland Community Hospital website: http://www.ashlandhospital.org/Page.asp?NavID=175    

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by Chantia Smith 

As a midwife I have a special admiration for placentas, having been fascinated by them ever since I learned about their great healing benefits in my early studies of Chinese medicine. Traditionally, the placenta has been used to augment the chi and nourish the blood, support new mothers, women in menopause, and people who are suffering from adrenal exhaustion and chronic fatigue.
It wasn't until my sister gave birth five years ago that I began my journey of making placentas into capsules. Since then I have been privileged to process about 100 placentas. Each placenta that I work with is awe-inspiring. This unique organ portrays a beautiful image of the tree of life illustrating it's integral role in the health of a baby. The placenta gives oxygen and nourishes a little one during its' time in the womb.
Not many know that postpartum the placenta can continue to benefit the mother and her baby.  I have seen it help mothers with recovery after birth, postpartum blues, increasing milk supply, restoring energy, as support in subsequent pregnancies, and menopause. It can also be given to infants in very small doses during times of growth to remember their connection to their original nourishment.
I practice universal precautions when working with placentas. I consider it a sacred process and spend much of the time in meditation. It is a great honor to transform the placenta into a nourishing supplement for both momma and baby.
Here are a couple of reports from clients who benefited from placenta capsules:
"The capsules are wonderful. I can't tell you how lucky I feel to have them. How amazing that so few women choose to eat their placentas. I'm definitely telling everyone to do it." -- P. G., postpartum mother, July 2007
 " Thank you so much!! Amy is noticing an immediate beneficial effect, and they [mom and baby] had the best afternoon of their life yesterday." --P.F., new father, September 2008.

For more information about placenta encapsulating you can contact me at chantiajoy@gmail.com or 510-432-8181.
 

About me: I am a new arrival to Ashland from the Bay Area. I am a homebirth midwife trained in herbalism, acupressure, craniosacral therapy, birth trauma resolution and re-patterning, and yoga and movement. With loving presence I support families and individuals in their journey through pregnancy, birth, and postpartum.   

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This evening, I returned from a fourteen hour day at the hospital newly inspired by the dear friend of the woman I was there to help.  "A"  had been in labor all night, after being induced by cytotec at 42 and a half weeks pregnant.  Her dear friend "S," who happens to be a yoga student of mine was with her all night, and in the morning, when things were getting tough, they requested a doula, and hoped that I would be available.  It worked out well for us all that I was on call today, and picked up the phone right away.

"S" remained by her friend's side all night and all day, whispering words of encouragement, demanding her focus when she lost hope, soothing her, holding her, and simply being there with her for the entire experience of labor and birth.  I was able to support them both in many ways, but in the truest sense of the word "doula,"  "S" was there for her friend, and I was inspired and touched to experience this woman's devotion.  At a particularly difficult moment, she got on the bed right in "A's" face and told her, "I have a plan for us now.  You close your eyes and rest, and I'll sit right here the whole time.  If things get hard, open your eyes and look right here at me, and we'll breathe together, one breath at a time.  We'll get through this together."

Every woman deserves a doula who can breath with her and help to carry her through this most difficult trial of her life.

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