birth

The research is clear: Vaginal birth after c-section is safer and better

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Highlighting something that we all already knew, the research is finally starting to come down in our favor on this issue of vaginal births after c-section (VBAC). Despite the frightening number of hospitals entirely banning VBACs, and an alarming number of providers refusing to do them, the research is showing that VBACs are the safer, better option for most moms and babies.

From the LA Times:

The first paper summarizes the findings of a government consensus conference that took place in March at the National Institutes of Health. Researchers concluded that vaginal birth after cesarean is “a reasonable choice for the majority of women.” The paper is based on a large database of births and finds that although both elective repeat cesarean section and VBAC are highly safe, maternal death was higher for elective repeat Cesarean sections (0.013% versus 0.004% for a trial of labor). The rates of hysterectomy, hemorrhage and transfusions did not differ between the two groups. Uterine rupture — the complication that is usually given for discouraging VBACs — was rare but higher in the trial of labor group (0.47% compared with 0.03% in the repeat C-section group). Infant death was higher in the trial of labor group (0.13% compared with 0.05% in the repeat C-section group).

How long do we think it will take medical practice to catch up to the research?

Where’s my midwife?

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Sylvia from a new organization, Where’s my midwife? sent me this video. It chronicles the response to a Wilmington, NC ob-gyn practice that one day decided to fire all their midwives. The physicians told them that they didn’t want to “wait around for the midwifery patients to give birth.” This is unfortunately not a new or unique story. It’s happening all around the country. Midwives need autonomy from doctors who can control their ability to practice.

I got chills multiple times while watching.

It’s a success story, as their grassroots organizing resulted in a reversal of the antiquated hospital policy that required an OB to be present when a woman was giving birth with a midwife. Doesn’t look like the midwives got rehired though.

This movement is growing, that’s for sure. In just the three years I’ve been writing this blog, the activism and activity around this issue has exploded. There are so many more doulas, midwives, parent advocates. Things are getting worse in the world of birth, and it’s getting people activated.

Where’s My Midwife is continuing their activism beyond this one instance, and working to open a Birth and Wellness Center in Wilmington NC in May 2015.

On Radio Bilingue this afternoon, 3:30 pm EST, talking about maternal health

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I’ll be a guest on Radio Bilingue this afternoon, talking about maternal health and the situation for childbirth in the United States.

You can listen to the program here. It will be in Spanish! I’ll post the link to the interview after the show.

Update: You can listen to the recording from the program here.

Video and update about NYC midwives

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Rachel, a doula from New Jersey, sent me this video she made about what she fears the birth future will be like.

So the situation with the NYC homebirth midwives has not been resolved, despite amazing advocacy and action on all your parts. The Department of Health told Choices in Childbirth they got more calls about this issue than any other, ever.

I’ll keep folks posted if I hear anything else about the situation in NYC.

UPDATE: Lauren at Birth and Bloom has an account of the press conference that happened on Friday.

At midnight tonight, half of NYC’s homebirth midwives will be illegal

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St. Vincent’s is closing. It’s a bad situation for many involved, the women who gave birth there, the other patients who received care there. No attempts at saving the hospital have worked.

Another result of the closure is that the NYC home birth midwives no longer have a back-up hospital or WPA (written practice agreement). They need this WPA, signed by a doctor, in order to practice in NY, even though those doctors have little to no involvement in their practice. St. Vincent’s was one of the only supportive hospitals in the city.

About half of the homebirth midwives in NYC have found other people to back them up–but the other half are stuck. At midnight tonight, they can no longer practice legally, despite the fact that they are licensed practitioners.

It’s a mess, and the NY government is not considering this an emergency because their patients can “just give birth in a hospital.”

We all know why this is unacceptable.

You can help. Take action today to put pressure on the NY State Department of Health:

YOU MUST ACT NOW to save the home birth option for New York Women:
Call:
  • 311
  • Wendy Saunders, Executive Deputy Commissioner for the NY State Department of Health, appointed by Governor Paterson. 518-474-8390
  • Larry Mokhiber, the Secretary of the Board of Midwifery (518-474-3817, extension 130)
And say….

With the closing of St. Vincent’s Hospital, half of the licensed, highly trained home birth midwives serving NYC have lost their Written Practice Agreement (WPA).   St Vincent’s was the only Hospital in the city supportive of a woman’s right to choose a home birth and willing to sign a WPA.  In the weeks since it’s announced closure, these midwives have reached out to hospitals and obstetricians all across the city looking for support, with no success.  Please help us to save the homebirth option in New York.

Access to homebirth in NYC put at risk by closing of St. Vincent’s hospital

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For a few months now, news has been circulating that St. Vincent’s, a Catholic hospital in NYC’s Lower East Side West Village was facing closure due to crippling debt.

It’s a Catholic hospital, which means no abortion procedures, no emergency contraception, and probably some other shitty anti-choice practices as well.

But it’s also one of the best hospitals for birth in NYC. Not only has St. Vincent’s been the back up hospital for most NYC home birth midwives, it’s also done a lot over the last year and a half to reduce c-sections and improve conditions. Doulas, midwives and VBACs were supported by the labor and delivery ward there.

Well now it seems the closing is definite.

It’s not just NYC that facing this kind of problem–in Miami, Jackson Memorial Hospital is also facing potential closure. It’s a hospital that serves many un and under-insured patients in the Miami area, and also has relationships with midwives.

For a movement that wants to get birth out of the hospital, you’d think we’d be happy to have hospitals closing. But we need hospitals as back-ups for home and birthing center births. Also why is it always the birth friendly hospitals and centers that get shut down? I wonder if not doing enough c-sections is bad for the profit margins.

Sigh.

If you want to take action in NYC, check out Choices in Childbirth for petitions and actions.

“This baby will never fit in your pelvis” and other absurd statements by providers

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Just found this site called My OB said WHAT?!? with alternately sad/funny/appalling things that OBs have told their patients about birth. Despite the title, it’s not just OBs, but also nurses and midwives as well. It’s a testament to the fact that no provider is perfect, all of them are human, and many of them are pushing some really problematic ideas about birth.

A few choice ones:

“Oh, honey, it’s too late for that!” – L&D nurse handing the mother a bedpan when the mother asked if she could go to to the bathroom.  The mother was 5 cm dilated at the time.

“You’re much too small. This baby will never fit in your pelvis. I can’t believe someone told you you’d be able to birth a baby vaginally.” -OB to a mother, upon meeting her for the first time, without an exam or medical history.

“Listen, if you don’t trust me to make decisions, you need to find another Doctor.”- OB to patient when asked about flexibility around options for delivery.

“Oh come on, stop that. Suck it up!” – midwife to a mother shivering from the cold and epidural while being strapped to the bed, shaved, and prepped for an emergency c-section.

About the site:

The purpose of this site is to capture the crazy but true comments said to birthing women by doctors, midwives, doulas, lactation consultants, and childbirth educators when they are having their babies! Got a “My OB Said WHAT?!?” to share?? Send them to submissions@myobsaidwhat.com. And watch this site for more unbelievable but true comments said to women as they birth their babies!

Check it out here.

Birth blog round-up

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This 50 Best Blogs for Midwives round-up includes Radical Doula in the “Doulas” section, but it’s seems to be a pretty good survey of all sorts of birth blogs around the web.

Check it out here.

Maternal mortality and c-sections on the rise

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Cross-posted from Feministing.com

This is a post I wrote for Feministing that I wanted to cross-post here. It’s a bit broader (and less political!) than what I write for Radical Doula because of the audience there.

Birth has been making national news lately because of the release of recent data indicating continuing upward trends in maternal mortality and c-section rates.

Jessica mentioned the recent California report that exposed the rise in maternal morality in the state. But this problem isn’t just in CA, it’s national.

The New York Times reported this week that the US c-section rate has reached an all-time high of 32%. That’s more than 1 in 3 women giving birth via surgery. C-section has been the most common surgical procedure in US hospitals for a while now, and the increases don’t seem to be slowing down.

I often get flack for being anti-doctor when I write about birth politics here, but pretty much everyone can get behind a concern about this rate of surgical birth.

The increases — documented in a report published Tuesday — have caused debate and concern for years. When needed, a Caesarean can save the mother and her child from injury or death, but most experts doubt that one in three women need surgery to give birth. Critics say the operation is being performed too often, needlessly exposing women and babies to the risks of major surgery. The ideal rate is not known, but the World Health Organization and health agencies in the United States have suggested 15 percent.

The risks to c-sections are numerous. It’s major abdominal surgery, with it’s resulting possibilities for complications. It presents problems for subsequent pregnancies, and it can be really difficult to find a hospital that will allow you to try a vaginal birth after a c-section (VBAC), meaning once a c-section, always a c-section.

Amnesty International recently released a report entitled Deadly Delivery: The Maternal Health Care Crisis in the US. Amnesty, an organization often focused on highlighting the stark situation of countries around the world, found itself examining what is a crisis among maternal health in the US.

The report exposes the fact that the risk of dying during childbirth is greater here than in 40 other countries, putting us at the bottom of the developing world when it comes to maternal mortality.

Continue reading →

Video: The Prison Doula Project

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I found this awesome video at Birth and Bloom.

I heart the Birth Attendants, who run this Prison Doula Project. I also love this video because it shares the stories of these doulas and the women they work with–but it protects their anonymity using this cool form of animation. That’s a big piece of telling the stories of these incarcerated folks–you also want to respect their desire for privacy.

For more about The Birth Attendants, check out their website.