We are a small community hospital with 500 birth per year, 3 OB docs, level
one nursery and we still do VBACS. No doc In house after hours and no 24
hour anesthesia in house either!
A good friend of mine delivered her first baby about 2 years ago, was 2
weeks overdue, was induced, pain got out of control, got epidural, was told
by doc that she has CPD so her 7 pound baby was born by section, her NINE
pounds baby was born at home a few weeks ago with a CPM --- ;-) 

Cindy Curtis RNC IBCLC CCE
http://www.breastfeedingonline.com
mailto:[log in to unmask]

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Sam Doak
Sent: Tuesday, February 12, 2008 9:30 AM
To: [log in to unmask]
Subject: Re: [LACTNET] ACOG statement

That's because the ONLY place ACOG will "permit" VBACS to take place are in
tertiary care hospitals with a level III nursery.

In my opinion the act of naming a woman "high risk" due to previous surgery
creates a risk in the mother's head. She is more likely to experience
complications because she believes she is in danger by her birth choice
alone. She is more likely to bleed profusely because she does not believe
her body has the power to stop it. She is more likely to have postpartal
issues because she is now a victim, instead of the strong woman she was
prior to birth.

Evidence shows that the act of induction (especially with cytotec) is what
increases the risk of uterine rupture. Further, the induction rate (95% in
our area) is linked to prematurity levels and the rise in cesarean section
for primips. Since you can no longer have a VBAC at your "local hospital,"
this accounts for part of the ever increasing cesarean rates.

Unfortunately, what ACOG is not seeing is the brutality the women feel after
cesarean birth. I have met very few women who have accepted their cesarean
births with open arms and a welcoming thought. I have, instead, met many
women who feel vicitimized, out of control and so sad.

The fear in ACOGs statement (as well as the unreferenced ignorance) shows
the wisdom of birth is rising. Women are sick of what is happening to them,
and are starting to realize there is something they can do about it. We need
to watch this process carefully, because there is tremendous wisdom we can
gain in fighting the formula dragons.

Best wishes,
Sam Doak

<<
Lest anyone think that hospitals within the USA only give "lip service" to
women who request VBAC, I would like to set the story straight. I work in a
regional tertiary care hospital with a level 111 ICN. We have
Perinatologists who care for the most high risk and extremely sick women. We
could hardly be more "high tech" and yet we have a number of practicing
midwives who offer women the other end of the spectrum. Some of our OB's
continue to perform VBACs. I was not able to open the ACOG statement but
from the comments on Lactnet I can tell I would disagree. Surely I don't
work at the only US hospital where VBACs are still performed. Oh, to tie
this to breastfeeding, we have a 75%-85% breastfeeding rate. We have not
achieved BFHI designation but continue to work on it and are very close. no
surprise, step #6 is the major hurdle. 

Mary Grace Lanese, RN, BSN, IBCLC

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