Links, Safety of VBAC & Other Medical Information
Should women choose a C-section over a vaginal birth? Should women request a VBAC, vaginal birth after a c-section or many c-sectioned babies? by Donna Young
To Quote the cost factors of drugged vaginal births verse a c-section:
"While cost was once an impediment to elective Caesareans, Dr. Harer said they were now no more expensive, and sometimes cost less than vaginal deliveries that involve epidural anesthesia and labor-stimulating drugs."
My comments, as to the article quoted below, as a volunteer birth educator
with four years research, that a major operation is
that. It has major risks, and some women's bodies have ruptured when not even pregnant after a
c-section. If for a medical
reason a woman has to have a c-section, I think it is better to do that, then to use drugs in a vaginal
birth and trials of labor. True
emergency c-sections for the pioneer ladies were at 3 to 5 percent of all births. I doubt true
justification of over 25 increase in c-sections is fair to the medical services, with the USA fees,
annually, for child birth now reaching $20 billion dollars. The increase
of autistic children and other internal disorders seems we are not getting quality children from that
expense.
The drugged vaginal births often then lead to distress to the mother and the
child, and resulting in a c-section anyway...but both
mother and child have had a variety of drugs. Those drugs during a trial labor are now topped
up with more in a c-section. Is it
any wonder these children are impaired and compromised. It may be a factor that drugged children
in the womb will become
more prone to drug abuse, once they take drugs, later, in experimental trials, as some children do this,
by the influence of their
peer group.
I would recommend natural birth (no drugs during labor or the birth of
the child, or after the baby is born). Mothers have a right
to contract for a natural birth rather than a drugged vaginal birth or a major operation of a c-section. Some women have
experienced the flesh eating disease after a c-section. Any cutting of the body can lead to serious
infections. I would rather not
see any injections, at all, into the birthing mother's body or that of the child.
I would prefer to see the child's umbilical cord not clamped or cut at the hospital. Rather, the child has the cord cosmetically
removed at the home of the child, by using an sanitary Umbicut tool. This removal of the cord
and placenta, is of course, is
merely cosmetic and not a medical need. It is the choice of the parents. However, all parents
should be informed of the right of
no tying or cutting of the umbilical cord, and the benefits to the child to go natural delay. The
pioneers simply put the placenta in a
diaper, and it fell off in a day or two's time. No cord infections. No hernias. The
baby was assured of all his immunities and
nutrients in the blood and stem cells. The pioneer method is now called the Lotusbirth. The
cut umbilical cord risks infections
from 5 to 15 days, whereas, the Lotusbirth, the cord and placenta falls off naturally, no cord infections.
Again, the bonus is that the
child gets all its blood. This method is by far, better and more natural and less painful to the
child. Some say the baby does not
experience pain to clamp and cut the cord. Not so, if it is done on a pulsating cord. The
baby screams in pain of the stopping of
the volume and pressure of oxygenated blood that was en route to the expanding lungs. The baby
can go weak, limp and have a
heart attack. Why allow the doctor to rush the clamping of the cord for his/her own time convenience,
followed by the harvesting
for profit of the baby's stem cells and other components of the blood?
The other shared opinions are as follows:
PERSONAL HEALTH
With Childbirth, Now It's What the Mother Orders
By JANE E. BRODY
Published: December 9, 2003
http://www.nytimes.com/2003/12/09/health/09BROD.html
"When my twin sons were born 34 years ago, the goal of every woman I knew, myself included, was
a vaginal delivery.
Alas, for me, that was not to be: the babies were just too big to make it through my narrow pelvis,
and after a nightlong labor they
had to be delivered surgically by Caesarean section."
"Such so-called emergency Caesareans will always be with us, the result of labors that fail to progress, fetuses that are too big or in the wrong position, multiple fetuses, placentas that block the uterine opening, infections, severe hypertension or other complications in the mother and health- or life-threatening problems in the fetus.
If surgical births occurred only for such reasons, the Caesarean rate would be about 10 percent of live
births, 15 percent at most.
But the rate in the United States now exceeds 25 percent, in part because a growing number of
women are requesting
"elective Caesareans" — planned surgical deliveries. The rise in elective Caesareans has created
a controversy in obstetrics,
with some physicians strongly in favor of letting informed women choose their mode of childbirth and
other physicians and nurse-midwives just as strongly opposed when no clear-cut medical reason arises.
The controversy, long brewing behind the scenes, went public three years ago.
Dr. W. Benson Harer, then president of the American College of Obstetricians and Gynecologists, declared,
"Perhaps the time
has come when risks, benefits and costs are so balanced between Caesarean and vaginal delivery that
the deciding factor
should simply be the mother's preference for how her baby is to be delivered."
While cost was once an impediment to elective Caesareans, Dr. Harer said they were now no more expensive,
and sometimes
cost less than vaginal deliveries that involve epidural anesthesia and labor-stimulating drugs.
On the other hand, an expert committee of the college this fall took a more conservative stance: "In
the absence of significant
data on the risks and benefits of Caesarean delivery, the burden of proof should fall on those who advocate
for a change in policy
in support of elective Caesarean delivery."
Why Choose a Caesarean?
With the passing of paternalism in obstetrics, women have had an ever-increasing voice in how their
bodies are treated by the
medical profession. This has had both good and bad consequences.
The good is obvious: every conscious, rational patient should be well informed about treatment options
and able to participate in
treatment decisions. The bad is less obvious: doctors at risk of devastating malpractice suits, should
things not go as well as
expected, are often afraid to go against a patient's choice even if they consider it ill-advised.
There are a number of reasons women may request elective Caesareans. One is convenience — the ability
to fit childbirth into
their work schedules, plan for the care of their other children, or have spouses, parents or both present
at the birth.
Another is fear for the baby's safety. With so many women delaying childbirth and struggling with infertility,
concerns are rising
over vaginal births and possible harmful complications to hard-won babies.
A third factor involves possible pelvic injury that can result in urinary or fecal incontinence, complications
that are more likely to
follow a vaginal delivery. And, of course, there are always some women who are so afraid of the pain
of labor and delivery that
they prefer the major surgery of a Caesarean, which nowadays is nearly always done under regional anesthesia,
allowing the
woman to remain awake and able to hold her baby immediately after the birth.
The doctor, too, may benefit from a birth that can be scheduled outside of office hours and apart from
vacations, and when the
doctor and staff members are well-rested.
A Look at the Facts
The most important question — which method of delivery is safer for an otherwise healthy woman with
an uncomplicated
pregnancy? — cannot be fully answered at this time.
(Page 2 of 2)
The data elaborating the risks of Caesareans include those performed in emergencies — after labor has
begun and medical
problems have developed. These emergency Caesareans still make up a majority, and they are much more
likely to result in
complications, like infections or hemorrhage, than elective Caesareans.
As with any operation, there is a very small risk of a postoperative pulmonary embolism, but this complication
can also occur
after a vaginal delivery.
Of course, a planned Caesarean would obviate the need for a far riskier emergency Caesarean should a problem arise during labor.
In decades past, the main drawback of Caesareans was a higher mortality rate. But recent data from Britain
and Israel reveal a
lower death rate from scheduled Caesareans than from vaginal deliveries.
Although incontinence problems are more common soon after vaginal delivery, years later the method of
childbirth seems to
make little or no difference in the incidence of these disorders.
Women who are concerned about pain should be told that various safe procedures are now available to
relieve the pain of labor.
And while the birth itself will probably be painful, the process of delivery is quite brief.
Once a woman has a Caesarean, chances are all later births will also be Caesarean. Although about 16
percent of women
deliver their next babies vaginally, they risk uterine rupture, which can prove fatal to the baby and
force the mother to have a
hysterectomy.
And, Caesareans can increase the risk of placental abnormalities in future pregnancies.
As for the welfare of the baby, planned Caesareans bring benefits and risks. The risk of stillbirth
rises, albeit slightly, when
pregnancies go beyond 39 weeks. The risk of birth-related cerebral palsy, also very low, is greater
with vaginal deliveries. And
vaginal births that require instruments (forceps or vacuum extraction) are more likely to result in
injuries to the baby, including
bleeding, fractures and nerve injuries.
When mothers are carriers of infectious agents like H.I.V., hepatitis B or C virus or human papillomavirus,
Caesarean delivery
can prevent transmission to the baby.
On the other hand, if there is any uncertainty about the mother's due date, an elective Caesarean can
result in the birth of a
premature baby. Also, there is often a delay in the onset of lactation when babies are born before labor
begins, although no ill
effects on breast-feeding or mother-infant bonding have been demonstrated.
In an analysis published in March in The New England Journal of Medicine, Dr. Howard Minkoff, an obstetrician
at Maimonides
Medical Center in Brooklyn, and Dr. Frank A. Chervenak, an obstetrician at New York-Presbyterian Hospital
in Manhattan,
concluded that "although the evidence does not support the routine recommendation of elective Caesarean
delivery, we believe
that it does support a physician's decision to accede to an informed patient's request for such a delivery."
Any woman considering an elective Caesarean should discuss the benefits and risks fully with her physician
early in the
pregnancy. If the doctor opposes her choice, referral to another physician may be the wisest course.
http://www.nytimes.com/2003/12/09/health/09BROD.html?pagewanted=2
________________________
THE OTHER CHOICES AND OPTIONS BY ELECTIVE CHOICE OF THE WOMAN:
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Vaginal Birth After Cesarean Section (VBAC) Trustworthy Information
Medifocus Guidebook:
Vaginal Birth After Cesarean Section (VBAC)
Guidebook Updated: 05/19/2003
Comprehensive overview of
Vaginal Birth After Cesarean Section (VBAC)
Explore your treatment options
Learn about new developments
Read medical journal abstracts
Find doctors, hospitals, research centers
More Information
Introduction
For decades, it was thought that women who had a previous cesarean delivery (CD) had to deliver subsequent
babies by CD
because of the risk of complications such as rupture of the old abdominal and uterine incision sites
during contractions and the
birthing process.
The old medical adage, "Once a cesarean, always a cesarean" is no longer accepted as a general
standard. VBAC is now
considered a safe, and even preferable, alternative for most women, including women who have undergone
more than one CD in
the past. In fact, it is thought that 80-90% of women are candidates for VBAC which are successful in
60-80% of cases.
Vaginal Birth After Cesarean Section (VBAC) Guidebook Preview
This preview is intended to provide you with a detailed summary of the format and content of the complete
MediFocus
Guidebook on Vaginal Birth After Cesarean Section (VBAC) so that you can decide if this concise and
trustworthy information
may help you or a loved one who is suffering from this medical condition. "
Medifocus Guidebook Preview
Vaginal Birth After Cesarean Section (VBAC)
Updated: 05/19/2003
This preview is intended to provide you with a detailed summary of the format and content of the complete
MediFocus
Guidebook on Vaginal Birth After Cesarean Section (VBAC) so that you can decide if this concise and
trustworthy information
may help you or a loved one who is suffering from this medical condition. We can save you hours of searching
all over the web for
trustworthy, credible health information.
The complete Guidebook consists of the following four major topical areas:
THE INTELLIGENT PATIENT OVERVIEW
This Guidebook begins by providing you a detailed overview of Vaginal Birth After Cesarean Section (VBAC)
including
important information about:
the causes of this condition
common signs and symptoms
medical tests that are used to establish the diagnosis
standard treatments
available treatment options
promising new developments
quality of life issues
questions to ask your doctor
GUIDE TO THE MEDICAL LITERATURE
This section contains a comprehensive selection of references to important articles recently published
about Vaginal Birth After
Cesarean Section (VBAC) in trustworthy medical journals. It also includes electronic hyperlinks to the
Medline™ abstracts of
these articles. Medline™ is the U. S. National Library of Medicine's database collection of references
and abstracts covering
approximately 4,500 medical and scientific journals published worldwide.
This is the same type of professional-level information that is used by physicians and other health-care
professionals to keep
abreast of the latest clinical developments and advances in research on Vaginal Birth After Cesarean
Section (VBAC). A typical
MediFocus Guidebook contains approximately 50 to 75 journal article references with hyperlinks to most
of the article abstracts.
Here are a few examples of some of the medical journal abstracts that are referenced in this section
of the Guidebook:
Vaginal birth after cesarean: what's new in the new millennium?
Curr Opin Obstet Gynecol 2002 Dec;14(6):595-9. 2002
Uterine rupture: what family physicians need to know.
Am Fam Physician 2002 Sep 1;66(5):823-8. 2002
Uterine rupture.
Best Pract Res Clin Obstet Gynaecol 2002 Feb;16(1):69-79. 2002
The case against elective cesarean section.
J Perinat Neonatal Nurs 2001 Dec;15(3):23-38; quiz 89. 2001
Risk factors for uterine rupture during a trial of labor after cesarean.
Clinical Obstetrics & Gynecology. 2001
CENTERS OF EXCELLENCE
State-by-state, country-by-country, we've compiled a unique directory of doctors, researchers, hospitals,
medical centers, and
research institutions that have specialized research interest and, in many cases, clinical expertise
in the management of Vaginal
Birth After Cesarean Section (VBAC). The Centers of Excellence directory is a valuable resource for
quickly identifying and
locating leading medical authorities and medical institutions that are considered to be at the forefront
in clinical research and
treatment of Vaginal Birth After Cesarean Section (VBAC).
RESOURCES AND ORGANIZATIONS
The last section of the Guidebook is a select listing of resources, organizations, and support groups
where you can turn to obtain
additional information about Vaginal Birth After Cesarean Section (VBAC). For each listing, we provide
a brief description of the
organization and their services, as well as important contact information including address, phone/fax
numbers, E-mail, and web-site URL address, when available.
Medifocus Guidebook on
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