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Know the facts about vaginal birth after cesarean.

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    I hear a lot, "What's the big deal about cesareans? What difference does it really make if you have a cesarean?" Of course, if a cesarean is medically necessary, then the benefits outweigh the risks. But in the absence of a medical reason, the risks of cesareans must be carefully considered.

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    I hear all the time how induction in VBAC is contraindicated. This is false. This is the kind of misinformation that materializes when we demonize all induction rather than specifying that elective inductions are not worth the increased risks. It’s important to use clear, specific language when we talk about birth because there is a […]

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    A dear woman contacted me.  15 months after her cesarean, it was still hard for her to read my posts without crying.  This simply broke my heart.  She is not alone.  There are many women who carry the grief and pain of their traumatic vaginal or cesarean births or the loss of their baby.  Every. […]

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    Trying to find a VBAC supportive health care provider can be (very, very) difficult process. Understandably, some women choose to call various providers rather than meet with them face to face. This woman's experience illustrates the pitfalls of this method.

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    “I have just seen so many women who have husbands who aren’t supportive because they don’t understand. My husband would love to help more men understand.” A couple recently shared their VBA2C (vaginal birth after two cesareans) journey with me.  It touched my heart.  My the time I was done reading it, I had tears […]

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    There has been a lot of confusion regarding AB1308, the legislation that went through at the beginning of this year in the state of California. It said that LMs were no longer allowed to attend home births some situations (such as breech, beyond 42 weeks gestation, etc) and other situations required a physician to sign off […]

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    My intention in attending this meeting was to amplify the voice of the consumer. I think sometimes it's difficult for OBs who attend VBACs, or for those who live in communities where they have access to hospitals that allow VBAC, to understand that not everyone lives in that world.

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    Over the last five years Dr. Stuart Fischbein, a Southern California obstetrician, has attended 135 home births. These deliveries included VBACs, vaginal breech and vaginal twin deliveries. A summary of these births has been recently published. Here are some highlights along with a few additional resources I compiled where you can learn more. On patient selection: “This model was not […]

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    Isabel recently asked over on Uterine rupture rates after 40 weeks: “I wonder however if there are studies that compare the method of induction. My Doula said that the increase rates of uterine/ scar rupture was due to using high dosages of Pitocin, but now the induction uses lower dosages and administered at longer intervals. […]

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    I’ve written before about the symptoms of uterine rupture as well as how having an epidural does not interfere with the diagnosis of uterine rupture. The focus of this Quick Fact is how shoulder pain can be a symptom of uterine rupture. How can an uterine rupture cause shoulder pain? Internal bleeding from uterine rupture can […]

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    Update: Since this article was originally published, it has been updated with several new resources (listed at the bottom) as well as a video.     “No one can force you to have a cesarean.” I see this all the time in message boards. Don’t worry about … the VBAC ban …your unsupportive provider … […]

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    In 2010, I was sitting next to an OB/GYN during a lunch break at the National Institutes of Health VBAC Conference. She was telling me about how she had worked at a rural hospital, without 24/7 anesthesia, that offered vaginal birth after cesarean (VBAC). I asked her what they did in the event of an […]

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    I’m in an online group for labor & delivery nurses where the discussion of vaginal birth after cesarean (VBAC) at home came up. While some understood the massive VBAC barriers many women face, others simply said, “Find a hospital that supports VBAC.” I left a late-night comment stating that “finding another hospital that supports VBAC” […]

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    Women who have had uterine ruptures and lost their babies have endured some of our greatest fears. But they are part of our community as well. When the VBAC Facts Community, a Facebook group, was open to the public, we welcomed and embraced the parents who joined us after their loss. Often they felt like they were no longer part of the birth community. They didn't know where they fit in. They felt isolated and yet they wanted to share their story. We had many loss moms as members and many parents who were planning VBACs wanted to hear their stories.

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    A woman who had four cesareans, after planning VBACs and home births, recently contacted me. She didn’t know where she fit into the birth community. My heart went out to her because there have been periods in my life when I have felt isolated and alone. And it’s a crappy feeling. I replied to her: A vaginal […]

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    Update August 25, 2016 1:32pm This bill has been postponed until Monday. Update August 25, 2016 9:57am For those of you watching this issue closely, this bill will be up for a Senate floor vote today. You can watch the California Senate live here. Update August 24, 2016 10:06pm The Senate floor vote for AB […]

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    My intention in attending this meeting was to amplify the voice of the consumer. I think sometimes it's difficult for OBs who attend VBACs, or for those who live in communities where they have access to hospitals that allow VBAC, to understand that not everyone lives in that world.

    The post What I told the California Medical Board about home VBAC appeared first on VBAC Facts.


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    “Home birth is not for everyone but informed choice is. The patronizing statement, “home delivery is for pizza”, is unprofessional and has no place in the legitimate discussion. Some suggest making hospital birth more homelike.

    The post New Research on Home Birth with an Obstetrician appeared first on VBAC Facts.


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    A reader recently asked, “I wonder however if there are studies that compare the method of induction. My Doula said that the increase rates of uterine/ scar rupture was due to using high dosages of Pitocin, but now the induction uses lower dosages and administered at longer intervals. Do you know something about this?"

    The post Applying medical research to clinical realities appeared first on VBAC Facts.


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    Internal bleeding from uterine rupture can cause referred pain through the phrenic nerve which can present in the shoulder. Shoulder pain is sometimes not included in lists of uterine rupture symptoms, but I have seen it cited multiple places (see below) and have had conversations with OBs, nurses, and anesthesiologists who have experienced uterine ruptures with shoulder pain. I’m also aware of two cases where the uterine rupture diagnosis was delayed because staff was not familiar with the incidence of referred pain.

    The post Shoulder pain is a symptom of uterine rupture appeared first on VBAC Facts.


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