ACOG Articles Highlighting a Potential Change in Perspective

In this recent post on Our Bodies Our Blog, two recent articles regarding the American Congress of Obstetricians and Gynecologists and their take on the recent forums and studies on VBAC and the rising cesarean rate.

The first is an article from Obstetrics and Gynecology. It highlights the fact that the current VBAC policy of ACOG limits, if not outright denies, the option of vaginal birth after cesarean for most women. It also touches on the subject of informed consent.

The second article is a synopsis from an address given to the ACOG annual meeting. The physician giving the commentary discusses the need to tone down and reassess the current use of induction and cesarean surgery. His tone is encouraging to those who hope to see current trends in maternal care reversed and women given the opportunity to have a say in their own care.

Women Deliver Conference 2010

Often as we work towards lowering the cesarean rate and improving maternal care in DC, we forget that there is another side to the coin. There are places in the world with poor outcomes where a higher cesarean rate would be a blessing. To shed some light on the plight of women and girls throughout the world Women Deliver is holding a conference in the DC area in June 2010.

From their website:

Women Deliver 2010, a global conference, will be held in Washington DC on June 7-9, 2010. The theme of the conference is: "Delivering solutions for girls and women," and we plan to focus on political, economic, social/cultural, and technological solutions. This global meeting will expand on Women Deliver's hallmark of inclusivity, reaching out to new partners and new communities. With all these partners in one room, we will further prove that maternal and reproductive health is a global priority. Women Deliver 2010 will move the dialogue to the global arena with two strong messages:

•The MDGs will not be achieved without investing in women.
•There is just enough time, if the world commits funding now, to achieve MDG5 — additional US$10 billion annually by 2010 and US$20 billion by 2015.

For more information or to register to attend the conference, please visit their website.

VBAC Petition: Please sign!

VBAC Access Petition

Please sign this petition to the American Congress of Obstetricians and Gynecologists (ACOG). The authors of the petition and those who sign it are asking that ACOG look at the recent position statement from the National Institute of Health on vaginal birth after cesarean (VBAC). ACOG has stated a rather strict (and some say hardly feasible) set of guidelines for choosing a candidate for trial of labor (TOL). According to the NIH statement, they should rethink their position on VBAC access and include the mothers themselves in the decision making process.

ICAN of DC is Looking for Birth Pictures/Stories

In April, we would like to hold a multimedia presentation called "Positive Birth: Images to Inspire". But for this even to be a success, we need your birth pictures and stories. We are looking for your pictures and the accompanying stories of your empowering home/birth center/hospital birth, we would really appreciate it. Please know that this will be part of a presentation that will be shown to the public. Thank you for your support of ICAN of DC.


(If you would like to donate please email me.)

Upcoming Midwifery Booth at NBC Health Fair

There will be a health fair at the Washington DC Convention Center sponsored by NBC 4next weekend (January 16-17, 2010). At this health fair will be a booth sponsored by the Citizens for Midwifery. They are looking for women willing to speak to others about their positive experiences with midwifery care and/or homebirth. If you are interested in volunteering an hour, please contact:

Cynthia Warren watershedrangers@gmail.com

This is an excellent opportunity to reach an audience that may not normally have much exposure to the midwifery model of care and/or homebirth.

Recent Washington Post Article on Breech

Today in the Washington Post there was an article about the safety and prevalence of vaginal breech births. Breech is a common reason for primary cesarean sections; something that some mothers and obstetricians are beginning to question. In the article it talks about a flawed study in 2000 that resulted in the thought that across the board cesarean section was indicated for all breech presentations. However since then this article has been questioned as many of the providers who performed the breech extractions/births were not skilled enough in breech birth to attend the women. This provided the authors of the study with inadequate data regarding the true safety of breech.

Recently in Canada the breech protocols were changed and doctors were encouraged to support vaginal breech deliveries under a limited set of criteria. This is promising as vaginal delivery of a breech baby would limit the need for many primary and secondary cesareans. Of course, fear of litigation is a driving factor as not all breech births (or births in general) have a necessarily desired outcome. But that should not limit the ability of other mothers to try. True, individualized care is what is appropriate for women, not fear-based protocols.

And also accepting that not every breech presentation is appropriate for vaginal delivery is another important factor to changing the mindset. It is almost universally accepted that footling breech and transverse presentations are not a good candidate for vaginal birth. That is not to say women have not successfully delivered this way, it is just not optimum for success. For more information about breech and breech vaginal deliveries please click here for the ICAN article on breech.

Upcoming NIH Conference on VBAC

In March the National Institute of Health (NIH) will be hosting a conference on vaginal birth after cesarean (VBAC) nearby in Bethesda, MD. This conference will be free and open to the public. If you cannot attend the conference, it will be broadcast live via webcam.

This will be an interesting event. Many of the speakers lined up and the topics seem to point to a resistance towards positive outcomes for women looking for vaginal birth after cesarean. I think it is important to have some represenation of mothers who have had successful and empowering VBACs to attend, especially for the Public Discussion on the 10th. It will be interesting to see what the outcome of this conference is. Hopefully not more of the same with a smattering of lip service played to women who are looking for true choice for their maternity care and birth options.