Family Wellness First
The E-newsletter for Parents to make Informed Health Care Choices
Issue 8: Avoiding the Rise and Risks of Operative Delivery
Vaginal Delivery After Prior Cesarean Delivery May Have Low Absolute Risk
Dec. 16, 2004 — Vaginal delivery after prior cesarean delivery is of low absolute risk, but this risk was greater than with elective repeated cesarean delivery without labor, according to the results of a prospective trial published in the Dec. 16 issue of the New England Journal of Medicine.
Examining the risks associated with Vaginal Births After Cesarean (VBAC) and repeated c-sections this study concludes: "Some people will consider the estimated 588 cesarean deliveries needed to prevent a severe adverse perinatal outcome to be a reasonable number, whereas others will consider the perinatal risks associated with a trial of labor small and well worth taking for the benefit of a vaginal delivery," Dr. Greene writes. "Ultimately, risk, like beauty, is in the eye of the beholder."N Engl J Med. 2004;351:2581-2589, 2647-2649
Taking Action to Maintain VBAC Rights
The following petition is an example of the increase in hospital policy to refuse women the rights to VBACS:http://www.petitiononline.com/fmhvbac/petition.htmlYou may choose to support this cause, and you may use this letter as a sample in your own community if there are hospitals violating your ability to choose.
Avoiding the C-section
Of course the best solution is to avoid the c-section in the first place. In a previous Family Wellness First newsletter, we addressed the rising c-section issue and offered solutions for prevention:http://www.icpa4kids.org/wellness/0003.htm It is imperative that women become informed of their birth options prior to birth. This includes choosing providers consistent with your expectations of birth and reading about the many modes of intervention that interfere with natural birthing.
Ask your Doctor of Chiropractic for birth care providers an support groups in your community who support the natural process of birth and offer the facts, not fears about natural birthing.
Visit our web site:http://www.icpa4kids.org/research/wellness.htm for numerous articles on pregnancy and birth to make informed decisions.
Visit our links page for additional associations that support the natural process of birth: http://www.icpa4kids.org/links/birth.htm
Choosing a Provider of Like Mind:
There are numerous interventions that change the course of a natural birth into an operative delivery. Restricted movement during labor and limited positions in birth, induction, drug use, electronic fetal monitoring, are just some of the usual procedures performed in birth that can drastically alter birth outcome. The following article: "Moving around during labor " by Carolyn Rafferty, RN, BSN gives great insight into the use of routine procedures leading to an operative delivery. Carolyn Rafferty also emphasizes the importance of becoming informed prior to labor. "In health care you always have the right to refuse treatment but it is important that you are informed so that you can be confident you are making good decisions for you and your baby. "
She also states that it is imperative that the mothers-to-be choose their birth care provider according to their own wishes for birth. "It is very important that you discuss these types of possible limitations on your labor choices prior to going into labor. It is crucial that you find out your health care provider's philosophy of "normal birth" and remain informed and "on the same page" with him/her throughout your prenatal and childbirth care. If you find you are not "on the same page" with your provider, you always have the right to find a new one. This is your baby, your body and your birth. Be wise, informed, and your own advocate."
The following web site offers vital tips on choosing a birth care provider of like mind: http://www.motherfriendly.org/resources/10Q/ As Carolyn says, if your birth care provider is not of like mind--you have the right to find a new one.
This Family Wellness First Issue is co-sponsored by Mothering Magazine. Receive a discount to Mothering subscriptions here:http://www.mothering.com/sections/subscribe/affiliates/icpa.html
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