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VBAC.com - This website provides childbearing women and maternity care professionals access to research-based information, resources, continuing education and support for VBAC* (vaginal birth after cesarean).
Vaginal Delivery Can Be Safe After Multiple Cesareans
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By David Douglas
NEW YORK (Reuters Health) Jul 11 - In women attempting vaginal birth after multiple previous cesarean deliveries, the risk of uterine rupture is no greater than in women who have had only one previous cesarean delivery, researchers report in the July issue of Obstetrics and Gynecology.
The author of an accompanying editorial, Dr. Vern L. Katz, from the Center for Genetics and Maternal-Fetal Medicine in Eugene, Oregon, told Reuters Health that this "is exactly the type of evaluation we need to help advise women on the relative safety and relative risks of both repeat cesarean delivery and trials of labor after cesarean. Each woman's situation is specific and advice should be individualized for those specifics."
In the study, Dr. Mark B. Landon of Ohio State University College of Medicine and Public Health, Columbus, and colleagues prospectively examined data for women attempting vaginal birth after a single or multiple cesareans.
Uterine rupture occurred in 9 of 975 women who had had multiple prior cesareans (0.9%) and in 115 of 16,915 women with a single previous cesarean (0.7%), a nonsignificant difference.
However, the rates of hysterectomy were significantly increased in the multiple cesarean group (0.6% versus 0.2%), as were transfusion rates (3.2% versus 1.6%).
Similarly, a composite of maternal morbidity, including endometritis and operative injury, was significantly increased in women who had had multiple cesareans.
Despite this increased risk of complications, the absolute risk is small, the researchers conclude, and "vaginal birth after multiple cesarean deliveries should remain an option."
Dr. Katz added that there is a "shifting paradigm of cesarean, not as an adverse outcome -- a complication -- but as one tool towards achieving the goal of a healthy mother and baby."
"Thus," he concluded, "the studies that we need, like Mark Landon's, help provide guidelines in the best use of the tool."
[URL="http://www.trilightherbs.com/templates/frm...p;subFolderID=1"]Natural ways to ready your body and induce or encourage labor to start
Red raspberry leaf tea
This can be started during beginning of the third trimester , some start it sooner then that but there are some who think it can possibly be linked to m/c if used in the first trimester , so please read further on this before starting that soon . What this does is helps to tone your uterus and help regulate your braxton hicks contractions so that they are more effective once in labor and in their preparing your body for labor , it also helps your uterus shrink back to it's pre pregnancy size faster after birth . It is not believed to actually induce labor but to help ready your body for labor , you can read some about this option HERE .
EPO ( evening primrose oil )
You can get this in capsule form and use it orally or vaginally or both , to use vaginally you can insert desired amount into your vagina preferably at bed time and let them dissolve over night getting them as close to you cervix as you can , some women prick them with a clean pin first so they leak faster as they dissolve . Orally you just swallow with a glass of water of course . What this does is it helps to soften and ready your cervix for dilation , it dose not cause you to dilate but the softer your cervix is the faster and easier it may dilate on it's own , the reason it works like this is that EPO is a
source of gammalinolenic acid which is a precursor to prostaglandin production , in other words it can help your body be more effective in producing it's own prostaglandins which is what does the ripening and thinning of the cervix . You can read more about it HERE .
This is the art of applying pressure to specific points of the body using your fingers and thumbs , what it does is stimulates contractions, helps your cervix to dilate and gets your baby to descend , this is found to be safe for mother and baby and can be done at home after being thoroughly researched . It is found to be very effective , it is said that 83% of mommas who do this or have it done by professionals have been put into labor as soon as 30 minutes or 48 hours after , for this reason it should not be attempted until you have reached or passed your due date to avoid a baby being born too early ! You can read more about this HERE and HERE .
Stimulating the nipples can help to bring on contractions or help ongoing contractions to become stronger and more effective . How it works , our bodies create a hormone called oxytocin , this is what causes contractions , when the nipples are stimulated in the right way it signals the release of oxytocin and thus contractions . You can read more about it HERE .
Sex works in two ways , first do you remember the prostaglandins the EPO can help your body produce ? Well male semen contains prostaglandins as well , and though it's in smaller amounts done frequently it can help to soften your cervix as well , it may be helpful when doing this to prop a pillow or two under your bottom for a lil while after sex , this will help the semen to pool closer to your cervix . The other way sex may work is that when a women reaches orgasm it signals the release of the hormone oxytocin just like nipple stimulation , this in turn can cause contractions . You can read more about this HERE .
That's right , sometimes the best way to get things going is to stop trying and relax , It has been shown that stress and anxiety can lead to the release of hormones that inhibit labor , so if your stressing out you could be keeping labor from starting altogether . The best thing about relaxation is that it's easy , all you have to do is turn off all the lil voices in your head and do something you love to do , light some candles get in a warm bath and listen to your favorite music , go get a message ( from someone with experience in prenatal massage ) , get your hair and nails done , try some aromatherapy , ( clary sage is known to be good in this situation ) or anything else that has always been relaxing to you , I personally love getting my hair washed , odd I know . You can find some nice pregnancy relaxation techniques HERE .
Baby being in a good position for labor and birth is very important , not only can it help things get moving but it also may help shorten your labor as well as reduce labor pains and can reduce your chance of a c-section . There are plenty of things that you can do to encourage baby to get into position so I will give you a link to spinningbabies.com , this site can help with many aspects of babies , their positions and ways to encourage change in them . Definitely check this site out , it's worth it !
A birthing ball is pretty much the same thing as an exercise ball or physical therapy ball , the only difference most of the time is that some ( but not all ) birthing balls come in more of an egg shape then just round , this is for stability for pregnant women but if you were to buy a simple exercise ball at any retail store it would work just the same . The ball allows for a soft yet sturdy place for momma to sit , when done with legs hip width apart it still allows for pelvic movement which helps the baby to find the best position to travel down through the pelvis and down the birth canal , you can also sway while sitting on it , do figure eights or even imagine writing the alphabet on the floor under you . When babies descends into the birth canal they put allot of pressure on your pelvis and that helps relax the joints and open the pelvic bones , something that will allow a baby to pass through your pelvis easier , this pressure will also help in dilation . Also the ball is good to use for encouraging a posterior baby to turn anterior , this is good because while you can labor and birth with a posterior baby it is harder , tends to bring painful back labor and can make labor take much longer , to get baby to turn you would get on your knees , hip width apart and lean the from half of your body on the ball , this also helps with back pain !
this particular blend is what i have been recommended by a midwife friend of mine, and will update with how well i think it worked for me.
you can buy it in 4oz, 8oz, or 32oz. i added it up: if you take 1/2 tsp 2xday (equalling 1 tsp total a day) for the last 5 weeks of pregnancy (35-40 weeks) then the 8 ounces will be perfect! and the site says that is the one most purchased.
you can find evening primrose oil and red raspberry leaf tea in your local GNC
Wendy, Mom to
Kyron, Porter, Donovan, & Jocelyn