7 VBAC TRUTHS

Let’s be real; there can be a lot of myths, misconceptions and out-right misinformation about the risks of Vaginal Birth After Ceasarean (VBAC). Educating yourself and finding a care provider who informs their practice with the latest research and references is key to planning the safest birth for you and your baby. Here are some things to keep in mind as you ponder and plan.

1. Your uterus is strong and it will heal well

Good research continues to show that the risk of uterine rupture for a VBAC is very low and is comparable to other risks faced by birthing mothers without a history of ceasarean. Avoiding induction or augmentation is an easy way to reduce your risk of having a uterine rupture.

2. VBACs are healthy for babies

Vaginal birth is the biologically appropriate way for babies to be born and as the norm for our species, carries with it many elements that are important for a lifetime of health. Exposure to mom’s natural bacteria gets baby’s immune system started the right way, and all that good squeezing during the birth means fewer trips to the NICU or worries about breathing issues both at birth and beyond.

3. VBACs are healthy for moms

There is no question that a vaginal birth is safer than major abdominal surgery. Some studies have shown that mothers face at least twice the risk of death if they have a ceasarean due to complications from the surgery like blood clots, infection and embolism. And forget those myths about ‘protecting’ your vagina with a ceasarean: a study of nuns showed incontinence and prolapse occuring similarly to their child-bearing counterparts of the same age.

4. A VBAC is a good choice even if you’ve had more than one ceasarean

Dr. Mark Landon et al found in a large and well-designed study that VBAmC (m = multiple) mothers were not substantially at higher risk than VBAC moms, and that vaginal birth should be a reasonable option presented to them should they desire a trial of labour. (http://www.scfmresidency.com/SCFM_Curriculum/Journal_Club/10-19-06_Journal_Club/Uterine_Rupture_Article.pdf)

5. VBAC labours come in all shapes and sizes

Patient care providers recognize that sometimes the real reason a mother had a ceasarean previously was because she wasn’t supported through a labour that might have been a bit different than average. Having patience, avoiding induction or augmentation, and having a birth team equipped with a variety of ways to keep mom focused and supported through her unique labour can make all the difference for a successful VBAC.

6. VBAC moms come in all shapes and sizes

Many moms have been told they are ‘too small’ to have a baby vaginally or that they are ‘too overweight’ to do the same. However, we know from experience (and supported by research) that if you have a supportive care provider, all sizes of women can be great candidates for a VBAC. For an inspiring video of women who were all told they were too small to give birth but then subsequently birthed a bigger baby via VBAC, go to www.ican-online.org/questioncpd

7. VBAC is your choice, not your doctor’s

You are the one that ultimately gets to decide what your birth will be. VBAC is not a special procedure nor should it be treated as such. A doctor may have concerns about a VBAC versus a ceasarean, but they are not the ones that will bear the risk of either choice for the rest of their lives. A good care provider will offer solid research and resources to a mother making a decision, and then remind her that in the end, it is her decision to make.

Krista Cornish Scott is the Education Director with the International Cesarean Awareness Network (ICAN).

Magic of Labour and Birth

WHAT YOU NEED TO KNOW

Having a baby is the true "change of life." Women who go through labour and birth fully supported often emerge from the experience changed forever. One of my patients who had her two children at home told me: "My births were absolute peak experiences of ecstasy and spiritual fulfillment. Nothing I’ve ever experienced before or since has come anywhere close. As a result of my experiences, I now trust my body implicitly."

SPIRITUAL AND HOLISTIC OPTIONS

In order to experience the transformational power of birth, women need to know the following: 

1. Labour proceeds on its own schedule. The delicate timing that is a result of the delicate interaction between a baby and her mother needs to be respected. (Risky labour inductions for "convenience" and all the complications associated with them [e.g., increased risk of pre maturity, C-section, and maternal death] are now on the rise all over the country.) 
2. Childbirth is designed by nature to be a peak experience that is joyous, ecstatic, and loving. The body of the laboring woman is flooded with natural morphine-like substances called endorphins as well as oxytocin, the bonding hormone.
3. Birth is sexual. This makes sense—after all, the baby is moving down the vaginal canal and stimulating the G-spot and all the nerves connected with sexual feeling. As midwife Ina May Gaskin says, "The energy that got the baby in is what gets the baby out. Many women experience the most intense orgasm of their lives when they birth in environments in which they are loved, adored, and fully supported." 
4. How you do it is what you get. Because of the heightened emotional and neurological receptivity of both mother and baby, the birth experience deeply imprints both mother and baby and impacts their relationship for a lifetime. 
5. Natural birth is safe. Studies have repeatedly shown that in healthy mothers with no risk factors, home birth is as safe as hospital birth. Perhaps safer. 
6. There are many choices for how to have your baby. In fact, there are more childbirth choices now than ever before—everything from high-tech hospital birth to water birth at home.

Article courtesy of Christiane Northrup.

LEARN MORE | RECOMMENDED READING OR RESOURCES

• Ina May Gaskin is one of the best-known pioneers of midwifery. Learn more about her work at www.inamay.com.
• Coalition for Improving Maternity Service (CIMS) is a collaborative effort of numerous individuals and more than 50 organizations representing over 90,000 members. CIMS aims to promote a wellness model of maternity care. 
• Doulas of North America (DONA) is an international association of more than 4,000 doulas nationwide who are trained to provide the highest quality emotional, physical, and educational support to women and their families during childbirth and postpartum.
• Childbirth.org, founded by doula Robin Elise Weiss, is a source of comprehensive information on pregnancy and childbirth.
• Birthworks believes in empowering women by developing their self-confidence, trust, and faith in their ability to give birth.
• Mother-Daughter Wisdom, by Christiane Northrup, M.D., Chapter 4, "Pregnancy: Trusting the Process of Life" and Chapter 5, "Labor and Birth: Accessing Your Feminine Power"
• The Wisdom of Menopause, by Christiane Northrup, M.D., Chapter 12, "Pregnancy and Birthing"
• Birth As We Know It, a movie by Elena Tonetti-Vladimirova shows the beauty of natural birth in water 
• Journey into Motherhood: Inspiring Stories of Natural Birth, by Sheri Menelli

Birth: Perfection in Action

Article courtesy of Christiane Northrup.

I’ve often said that if you want to know where a woman’s true power lies, look to those primal experiences we’ve been taught to fear—not coincidentally the very same experiences the culture has taught us to distance ourselves from as much as possible, often by medicalizing them so that we are barely conscious of them anymore. Labour and birth rank right up there as experiences that put women in touch with their feminine power, along with the menstrual cycle and menopause. But imagine what would happen if our culture believed that we required medical help to have our monthly periods. 

What if all women went to medical centers for menstrual "anesthetics," to help them avoid feeling the passage of menstrual blood, or for a procedure to extract menstrual blood quickly and painlessly, so they wouldn’t have to go through this monthly "nuisance." If, when reading this, you notice that the idea of menstrual extraction appeals to you, you will probably also be drawn to birth interventions. This is simply a sign that you’ve been talked out of some of your feminine power.

At no other time than in the act of giving birth does your body serve so directly as a channel for the life force—if you do not interfere with that life force. And at no other time can you see Nature’s wisdom so palpably in action—if you are willing to allow Nature to do what Nature does best.

The process of birth is one of Nature’s highest achievements. Nature in all her wisdom has designed it so that the experience teaches a woman about her inner resources and how to access them. If participated in consciously and fully, labour will also cement the relationship between mother and child, and, if the mother’s mate is present, among all three of them.

The teaching is embodied in the rhythms of labour, which entrain the body and brain of the mother with strength, flexibility, and resilience. You experience contractions, which force you to find the resources to deal with the discomfort and to go deep within. And then you have a period of rest and relaxation, during which you can change positions, get more support, drink some water, and prepare yourself for the next contraction. You learn to go with a situation you cannot control, which may involve pressure and pain. And you learn to trust that the process will give you the time and strength you need to ready yourself for the next wave of contractions.

The bonding occurs thanks to the extraordinary biochemistry of labour, which primes the body and brain of both mother and child with high levels of two potent neurotransmitters, oxytocin (which causes uterine contractions as well as intense feelings of love) and beta-endorphins (the body’s natural opiates, which cause euphoria and numbing of pain). Together these hormones create a biological imprint in the bonding circuits.

All of these processes occur naturally, and most women do not need any of the numerous interventions, mechanical and drug-mediated, that make childbirth in this country resemble a medical emergency rather than a normal physiological event. But pregnant women tend to go along with this overmedicalized approach unthinkingly, assuming that their doctors know best. If, however, you understood that birth interventions such as IVs, electronic fetal monitoring, episiotomy, epidural anesthesia, labour induction, vacuum extractor and forceps deliveries, and cesarean sections might have adverse consequences for yourself and/or your baby, would you still participate in them under circumstances when they’re not medically necessary—which in most cases they aren’t? Birth interventions that bypass the normal processes of labour and birth are the equivalent of clamping the umbilical cord before the baby has had a chance to adjust to breathing on her own—another medical procedure that is all too common in the rushed environment of today’s delivery rooms.

No one speaks more clearly about the perfection of the design of the female body for giving birth naturally than Ina May Gaskin, a professional midwife who is the founder and guiding spirit of the Farm Midwifery Center and who has been delivering babies for over thirty years. From their birthing center in a rural community in Tennessee, Gaskin and the other midwives at the Farm have overseen the prenatal care and attended the births of more than 2,200 babies, most of them born in their parents’ homes or at the Farm. They have a safety record for mother and child that would be the envy of any medical center anywhere, despite (or probably because of!) the fact that fewer than 2 percent of their births were cesareans, fewer than 1 percent were assisted by forceps or vacuum extractors, and none of their births were drug assisted, except in cases of medical emergencies.

"Remember," Ina May says, "your body is not a lemon. You are not a machine. The Creator is not a careless mechanic."

(a lemon in American terms means that something is not working).

LEARN MORE | RECOMMENDED READING OR RESOURCES

• Ina May Gaskin is one of the best-known pioneers of midwifery. Learn more about her work at www.inamay.com.
• Mother-Daughter Wisdom, by Christiane Northrup, M.D., Chapter 4, "Pregnancy: Trusting the Process of Life" and Chapter 5, "Labor and Birth: Accessing Your Feminine Power"
• The Wisdom of Menopause, by Christiane Northrup, M.D., Chapter 12, "Pregnancy and Birthing"
• Ina May’s Guide to Childbirth, by renowned midwife Ina May Gaskin

Article courtesy of http://www.drnorthrup.com/womenshealth/healthcenter/topic_details.php?topic_id=136