ACOG Issues Less Restrictive VBAC Guidelines

July 23, 2010 By Leave a Comment

I’ve been sitting on this for a couple of days.  Not quite sure what to make of it.  I see it praised on the internet as a giant step in the right direction, but could it just be another attempt for ACOG to win back women who otherwise have been making more independent and empowering choices?

Go ahead and google:  ACOG VBAC 2010 for the ACOG announcement and other – more insightful – blogs on this topic.  After so many years dedicated to this issue, I’m finding myself not really caring what the obstetricians of ACOG think.

Women have always had the ability to choose Vaginal Birth After Cesarean.  The question is, whose permission (other than their own) have they been seeking?

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VBAC Petition

March 21, 2010 By 8 Comments

To: American College of Obstetricians and Gynecologists (ACOG)

The purpose of this petition is to let ACOG know that women desire greater access to VBAC, or vaginal birth after Cesarean. The recent NIH VBAC consensus conference has stated “Given the available evidence, TOL (trial of labor) is a reasonable option for many pregnant women with a prior low transverse uterine incision.  When both TOL and ERCD are medically equivalent options, a shared decision making process should be adopted and, whenever possible, the woman’s preference should be honored.

We are concerned about the barriers that women face in accessing clinicians and facilities that are able and willing to offer TOL. Given the level of evidence for the requirement for “immediately available” surgical and anesthesia personnel in current guidelines, we recommend that the American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists reassess this requirement relative to other obstetrical complications of comparable risk, risk stratification, and in light of limited physician and nursing resources.” We, the undersigned feel that VBAC is unreasonably and unfairly restricted because of the current ACOG recommendation that a surgeon and anesthesiologist be ‘immediately available’ during a TOLAC (trail of labor after Cesarean). Far too many women are undergoing unwanted and probably unnecessary Cesarean surgery because of this.

We would like to note that the likelihood of the baby dying during a TOLAC is the same as the likelihood of the baby dying during a nulliparous (first time moms) labor, however ACOG doesn’t recommend a surgeon and anesthesiologist be ‘immediately available’ for first time moms going through labor. We find this discriminatory, inconsistent and unfair. We plead for ACOG to change the recommendations so that ALL low risk VBAC mothers across America can have the chance to give birth to their babies in a normal, safe, healthy way (VBAC).

Sincerely,

CLICK HERE TO SIGN PETITION

This was just sent to my inbox (although I just took the liberty of correcting some spelling mistakes), and there were only 481 signatures when I got on it.  This will need THOUSANDS to be effective.   Let’s go!

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H1N1 Vaccine and Pregnancy

November 29, 2009 By Leave a Comment

U.S. health authorities have made pregnant women one of the highest priority groups for getting the H1N1 swine flu vaccine, but is it actually safe for pregnant women and their babies? Well, the truth is that miscarriage reports from pregnant women who have taken the H1N1 swine flu vaccine are starting to pour in from all over the nation. Vaccines and pregnancy simply do not mix safely. In fact, the package inserts for the swine flu vaccines actually say that the safety of these vaccines for pregnant women has not been established.  Read more…

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New Documentary

July 13, 2009 By 1 Comment

One of the producers of this documentary asked for me to help spread the word – sounds like a fabulous piece:

Turly Pictures is making a full-feature documentary film on Millennium Development Goal 5- to reduce maternal mortality, specifically in Bangladesh, Tanzania, Guatemala, and the United States. Many people in the US will find it shocking to know that the US is ranked 41 in safe motherhood. Our goal with this film is to raise awareness of the issue of preventable maternal deaths. We are currently seeking out stories that would best tell this story of maternal mortality in the US, and welcome any personal stories and insight you or someone you know may have that relates to this issue. Please send all emails to info@turlyinc.com.

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Homebirth in Israel

June 25, 2009 By 1 Comment

Laura Shanley just sent me a pretty good article about unassisted childbirth in Israel.  Well written, balanced, and fair portrayal of the reasons some women choose to birth alone.  As for the doctor’s comments, it looks like the same old garbage is going on all over the world (why am I not surprised).

And what is this about midwives not permitted to attend to VBACs there?  What kind of nonsense is that?  Don’t they realize that the risk of being killed by a crazy Israeli driver on the way to the hospital is FAR greater than the risk of uterine rupture? (no offense intended, my mother is a crazy Israeli driver).

Check out the article at http://www.haaretz.com/hasen/spages/1095684.html.

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Hospital’s Oxytocin Protocol Change Sharply Reduces Emergency C-Section Deliveries

June 22, 2009 By Leave a Comment

I’m not much into research studies.  Not one of them has ever convinced me of anything, but I’ll get into the reasons for that another time.  Here’s a hilarious one, though.  Hilarious because it demonstrates how far we’ve gone into needing evidence-based studies to verify for us what should be common sense:

Hospital’s Oxytocin Protocol Change Sharply Reduces Emergency C-Section Deliveries

By Betsy Bates
Elsevier Global Medical News
Conferences in Depth
June 22, 2009

CHICAGO (EGMN) – The modification of the oxytocin infusion protocol at a large university-affiliated community hospital nearly halved the number of emergency cesarean deliveries over a 3-year period, reported Dr. Gary Ventolini.

As oxytocin utilization declined from 93.3% to 78.9%, emergency cesarean deliveries decreased from 10.9% to 5.7%, Dr. Ventolini said at the annual meeting of the American College of Obstetricians and Gynecologists.

Other birth outcomes improved as well at an 848-bed community hospital that serves as the primary teaching hospital of the Boonshoft School of Medicine at Wright State University in Dayton, Ohio.

These included significant declines in emergency vacuum and forceps deliveries and a sharp reduction in neonatal ICU team mobilization for signs of fetal distress (P = .0001 in year 3 compared with year 1).

“More and more data are showing us that we are using too much oxytocin too often,” Dr. Ventolini, professor and chair of obstetrics and gynecology at the university, said in an interview.
“Our pivotal change was to modify the oxytocin infusion from 2 by 2 units every 20 minutes to 1 by 1 unit every 30 minutes. And we see the results,” he said.

Outcomes of 14,184 births from 2005, 2006, and 2007 were retrospectively analyzed to determine any impact of the change in an oxytocin protocol implemented in 2005. Patient characteristics were similar in all three calendar years.

The most profound changes were in emergency deliveries, including caesarean deliveries, vacuum deliveries (which dropped from 9.1% to 8.5%), and forceps deliveries (which fell from 4% to 2.3%).

The overall cesarean section rate remained unchanged, as did the rates of cord prolapse, preeclampsia, and abruption.

Dr. Ventolini cited a recent article in the American Journal of Obstetrics and Gynecology that suggests guidelines for oxytocin use, including avoidance of dose increases at intervals shorter than 30 minutes in most situations (Am. J. Obstet. Gynecol. 2009;200:35.e1-.e6).

Dr. Ventolini and his associates reported no financial conflicts of interest relevant to the study.

Here is the actual link to the story: http://egmn.idsk.com/stories_global/35_ds_7863805.jsp

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Perinatal: A Symposium on Birth Practices and Reproductive Rights

May 7, 2009 By Leave a Comment

Brava to Jessica Clements for organizing the following interdisciplinary symposium.  I hope to see many new names and/or topics presented there – it’s time for a little freshness and variety in our birthing gatherings!

CALL FOR PAPERS
Submission Deadline: July 13, 2009

PERINATAL
A Symposium on Birth Practices and Reproductive Rights

Wednesday 7th October 2009 (tentative) at George Mason University, Fairfax, Virginia

Forty years ago, the feminist movement advocated for reproductive rights.  Over the years, childbirth was dropped from the agenda. Why? What has this meant for women? How are women organizing for change?

We welcome submissions from scholars, students, activists, artists, mothers and others who work or research in this area. Comparative and interdisciplinary work is encouraged. Feminist inquiries are explicitly sought, although all submissions will be considered. We encourage a variety of types of submissions including academic papers from all disciplines, workshops, creative submissions, performances, storytelling, visual arts, and other alternative formats.

This symposium is interdisciplinary.  Possible topics include:

  • Cultural myths and expectations around birth (written, verbal, or visual
    culture)
  • Rethinking maternal-fetal conflict
  • The psychological impact of contemporary birth practices
  • Developments in midwifery, homebirth, and unassisted birth
  • The symbolic significance of birth practices as socialization
  • The evolution of contemporary birth practices and taboos
  • Maternal resistance to birth practices
  • The feminist movement and birth

If you are interested in being a presenter, please send a 250-500 word abstract and a 50 word bio by July 13, 2009 to: Jessica Clements (jmooreq@gmu.edu). Late abstracts will be considered and accepted if possible.

Please send the abstract as an attachment, not in the body of an email, in either PDF or Word DOC format. Include Title, Abstract (250-500 words), Name, Institutional Affiliation, Address, Phone, Email Address, Brief Bio (50 words).

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Lawyer in Maryland Offering Free Legal Help To Women Facing VBAC Bans

April 15, 2009 By Leave a Comment

I just received word that there is a lawyer in Maryland offering free legal help to women in that state facing VBAC bans.  I haven’t had a chance to follow up on this, but here is the email I received.  I don’t quite understand why the lawyer’s name and email is not included, and it’s not quite clear whether inquiries should be sent to the email in this announcement (I’m not on that list, it was forwarded to my email).

Please comment if you have anything to add (and/or clarify!):

“I am excited to announce that we now have a lawyer right here in Maryland who is offering free legal help to women facing VBAC hospital VBAC bans. Her availability to do this work is between now and the end of the summer so it is important that we find a woman as soon as possible who is currently pregnant and facing one of the VBAC bans in our state. Maryland currently has bans in place in Cecil County, Garrett County, and in Easton. Please email any Maryland lists you are on and ask people to help spread the word so that we don’t miss the opportunity to possibly be the first state in the country to take this kind of legal action. Feel free to include my email address ICANofBaltimore@ comcast.net on all postings. Thanks.

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Six Years

January 14, 2009 By Leave a Comment

Six years ago today, at this very minute, I was on an operating table having what I referred to for many years as an “unnecessarean.”  My daughter Amelia, who is joyously celebrating her sixth birthday today, was extracted from my body in a most degrading manner after a series of unnecessary medical interventions.  More than 20 people “handled” my body during that pregnancy, labor and delivery, and I left the hospital a physical and emotional wreck.

There is no more “sting” in my recollection of the cesarean.  A little grief at what was lost (for both of us) is all that remains.  Today, I am the proud mother of three amazing children.  I have had two VBACs (vaginal births after cesarean), the most recent one at home just three weeks ago.

More pervasive in my memory now is the respectful and supportive way that I was treated by the two people present at my recent homebirth; that is what will remain ingrained in my memory, in the cells of my body, as what childbirth was for me.  The rest is history.

Happy Birthday my dear Amelia.  I can now rejoice in the celebration of your birth and I thank you for being the catalyst for all I am today.

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Introduction to What Would Mammals Do?

January 13, 2009 By 1 Comment

Introduction to the What Would Mammals Do? Archive

Purchase access to the full 90-minute program with Diane Wiessinger by clicking here.

 

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