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Volume 45 ~*~ 15 October 2007


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In The News

  • You Can Have Your VBAC: If You Do It During the Daytime

    This Hedgesville, W.Va. mom was told she could VBAC -- during the hours of 7 a.m. to 3 p.m.  A bizarre fallout from the "immediately available" caveat in ACOG's recommendation?  Or maybe not.  The hospital turned around and set the record straight.

  • Stop Eating For Two: Obese Moms-to-be Should Gain Less Weight

    In a study published in Obstetrics and Gynecology this month, researchers are recommending that obese women who gain fewer than 15 pounds are less likely to develop preeclampsia, less likely to need a cesarean, and more likely to have a baby of normal weight.

  • Rupture Risk Rare After Previous Cesarean

    Also in this month's Obstetrics and Gynecology journal, a new report on the risk of uterine rupture after a previous cesarean. The conclusion? The study reports an overall rupture risk of .32 percent, including women who elect a repeat cesarean.  The risk reported by the article for women undergoing a trial of labor is .74 percent.  

  • Health Advocates Alarmed by the Increasing Cesarean Rate

    In this article out of Florida, the author seeks to uncover some of the driving factors behind the alarmingly high Cesarean rate.
     

In The Research

  • Hit 'Em Where it Matters: Homebirthers Enjoy More Postpartum Sex

    Trying to convince your husband that homebirth is the way to go?  The promise of sex might change his mind.  In this study, "Attachment or Loss within Marriage: The effect of the Medical Model of Birthing on the Marital Bond," a significant differences between homebirthers and hospital birth couples were found at 4 and 12 months postpartum, with the nod going toward the homebirthers.

  • Understanding the Research on VBAC

    This article carefully looks at the 2006 Landon study, making logical sense of the statistics presented.  Its conclusion? With no statistical difference in the rate of uterine rupture between VBAC and VBAmC, the "perceived" higher risk is just that: fiction.

From the Women of ICAN

How I Got Lara Ecker's Firing at 38 Weeks on the News

ICAN of Baltimore's Barbara Stratton tells us how she scored a big one for VBAC rights publicity.

Its all about the pitch. 

That’s what I learned from ICAN’s resident PR expert Berna Diehl.  Have a pitch ready that you can deliver in only a sentence or two and make it catchy.  For television news, call the station in the early morning before their daily planning meeting and ask for “the planning desk.”  Newspaper reporters start their days a bit later.  Try them mid-morning and since they are always on deadline start with the question, “Is now a good time to talk or are you on deadline?”  Berna, by the way, is working on a media guide for chapters and is always willing to help folks who want to pitch stories to their local outlets.

Lara’s firing was actually part of a three part pitch.  I lead the only ICAN chapter in Maryland and had started hearing in late April that the hospital in Washington County – the county where Lara lives - was telling women that they could now only VBAC if they did so between the hours of 7 a.m. and 3 p.m.  Oh how I couldn't wait to tell THAT to a reporter but I sat on my hands while I got everything ready.

I started to search for women who were affected by the ban and would be willing to speak to the media.  I posted on the Maryland page of mothering.com and emailed the Washington County La Leche leader (found her using a search on La Leche International’s website).  I posted on the yahoo list for the birth circle in that area and asked everyone to forward my request around.  Eventually I had five women willing to speak out.  Three were currently pregnant and two had VBAC’d at that hospital just before the ban took effect and wanted the option to remain open in the future.  I gave them some tips for talking with reporters (thanks again to Berna) and asked them to be as available as possible by telephone once I contacted the reporters.  Meanwhile, I asked my state delegate to request an opinion from the Maryland Attorney General’s Office as to whether it is legal to section a woman against her will.

Right in the middle of putting together my media list Lara was fired by her OB for refusing to schedule an automatic, repeat cesarean.  Soon after, the Maryland Attorney General’s Office issued an opinion that “generally” it is illegal to section a woman against her will.  Lara was very angry about her firing and so when I offered to try to get the media involved she jumped at the idea.

I called the Washington County newspaper first.  My pitch was something like, “There is a woman in Washington County who was just fired by her OB at 38 weeks pregnant for refusing to schedule a repeat cesarean.  To complicate things, the county hospital is telling women with previous cesareans that they can only have vaginal births between 7 a.m. and 3 p.m.  Would you be interested in covering this story?”  The news editor asked me to email them more information and so I sent her a brief paragraph including the tidbit about the attorney general’s office.  They bit.

I then called the Washington County TV news station and, unfortunately, they immediately asked me to email the story to them rather than pitch it by phone.  I hate when that happens because I’m never convinced that TV stations actually read their emails but I didn’t have a choice.  I wanted to only wet their appetites and so sent them just a brief paragraph as well.  They bit too.

In the end, the TV reporter interviewed Lara about her firing and myself and another woman about the ban.  When she put the hospital on camera however, they completely denied that the ban ever existed so she nixed that part of the story.  Instead, the station ran Lara’s piece by itself (it was the headlining story of that broadcast) and the newspaper covered the ban (which is now a ban reversal) a few weeks later.   

~*~*~*~*~*~

Why I Want a VBAC After My CBAC

I am making this post for myself and for those of you who are afraid of having a CBAC and even a VBAC. Maybe it will help, maybe not.

My first C/S was due to a breech baby discovered after 5 hours of labor w/ ruptured membranes. I had had two prior vaginal births and the difference between the two was so disturbing to me, I didn't know what to do with myself. It was a recovery complicated by both subdermal and uterine infections, and an absolute disbelief at how he came into this world. I NEVER once considered he would arrive via C/S.

When I went for my first VBAC, my greatest fear was that my uterus would rupture and my baby would die. That didn't happen. I was induced at 38W5D. 14 hours later I was dilated to six and my doctor already had one foot out the door. I was sectioned, unnecessarily,because my doctor put me on the clock and didn't like how long I take to labor. He had somewhere else to be. For him, it was as simple as that. For me, it was one of the most defeating moments of my life.

At the beginning of my current pregnancy, I was told I would not be allowed a TOL. I thought I was okay with that, as some have said, there is something oddly comforting about knowing how its all going to turn out. However, the closer I got to delivery, the more the idea of  a ERCS bothered me. I just couldn't help but think, I DON'T WANT THIS!!! I fired that OB today. He obviously doesn't believe in my ability to birth.

I had to ask myself why I'd want to risk going through another labor and maybe have it end in a C/S anyway? It was then that I realized, not only did I think that wasn't going to happen, I believe that knowing I tried to VBAC was my saving grace through a disappointingly painful recovery. I may not have tried a VBAC the "right way" the first time, but I did try. When I had my CBAC, one of my worst fears was realized. I remember crying my eyes out in the hospital a few days after she was born. The nurse thought I was in physical pain, but I was crying because I'd had yet another surgical birth. I was angry, scarred and wounded but I survived and even though it took me a while to realize it, I am not broken.

Trying for a VBAC after CBAC isn't just about me. My daughter deserves the chance to be birthed, not just cut out of me in a cold OR, only to see me for a few moments. She deserves the chance to be pushed through the birth canal, have the amniotic fluid squeezed out of her lungs naturally and know the sure comfort of her mother's arms in the first moments of her life. I have shared this view with some who don't understand it, with the belief that she'd never remember the difference anyway. I'd challenge them to prove it.

When my first son was born vaginally, he began screaming so hard about all you could see was the inside of his mouth. The moment he heard my voice, he stopped completely and was instantly comforted. It is a moment that is etched in my heart forever and made me realize just how important the familiar comfort of "mom" is to a newborn.

I'm attempting a VBAC(again) for myself and for my daughter, because we both deserve this chance.

Get Active

Job Opening!

Do you love communicating? Do you write well? Are you familiar with the sound deadlines make as they whiz past you? Then you might well be just the person to be the future editor of ICAN's flagship newsletter, the Clarion. We're looking for someone with the ability to manage a process, encourage submissions, explore new technologies, and retain an appropriate sense of perspective in the face of provocation. Please send your resume/vitae, statement of interest, and samples if you have them, to publications@ican-online.org.

International Center for Traditional Childbirth Hosts a Doula Training

Back by popular demand, the ICTC is offering a Full Circle Doula Training, October 25th-28th, 2007.  Find details at www.blackmidwives.org/doula.

Talk It Up

Come together the second Monday of every month to chat with fellow ICANers.  In a "chat room" set up on MommyChats, talk with fellow ICANers about birth, VBAC, cesarean healing, and whatever other topics that come up.  Ask questions, share stories...it's all there on ICAN's MommyChat.  The next chat will be Monday, November 12th.  "See" you there! 

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ICAN's mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC). This newsletter is for informational purposes only and does not replace the advice of a qualified birth professional.

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