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Forum: VBAC: Vaginal Birth After a Caesarean

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  #1  
December 16th, 2010, 01:03 PM
rubyredslipperz's Avatar Mega Super Mommy
Join Date: Jun 2009
Location: Needles, CA
Posts: 3,231
Hi ladies! I used to be a member and host this board earlier this year, but due to some family issues I needed to step down. I saw this pop up on my FB page this afternoon and just felt the need to share it for your inspiration. I know going for a VBAC in this day in age is brutal and we could all use a mood booster.

Mom defies doctor, has baby her way - CNN.com

(CNN) -- On Thursday, December 2, as Aneka sat at home nine months pregnant, the phone rang.

It was her obstetrician wanting to know where the heck she was. Did Aneka forget that today was the day for her cesarean section? How could she have forgotten?

No, Aneka hadn't forgotten. She hadn't shown up intentionally.

"She told me, 'You're being irresponsible. Your baby could die. You could die,'" Aneka recalls. Then the doctor hung up.

Aneka (she doesn't want her last name used) had already resolved to not have a C-section, even though the doctor told her it was absolutely necessary. She wasn't going to be opened up surgically, no matter what her doctor said, no matter what any doctor said.

In some online communities, Aneka is a hero who defied the obstetrical establishment and gave birth her way. To many doctors, however, she's a risk-taker who put her and her baby in peril by giving birth at home.

'No, no, no, you can't do this'

Aneka's story begins nine years ago with the birth of her first daughter, Nya. After 10 hours of labor, her doctor told her she wasn't progressing quickly enough, and she needed a C-section.

"I didn't know any better, so I said OK," Aneka says.

In a postpartum visit six weeks later, the doctor told her she'd needed the surgery because her hips were too small to pass the baby.

"I thought to myself, what's she talking about, I don't have small hips," Aneka remembers.

Four years later, doctors told Aneka she couldn't deliver her second child vaginally, since Nya had been delivered by C-section. Studies show when a woman gives birth vaginally after having had a previous C-section, there's a higher chance her uterus will rupture since she's pushing against scar tissue.

Then again, when Aneka was pregnant with her third child, son Adasjan, she had a C-section for the same reason.

When she became pregnant with her fourth child, a boy named Annan Ni'em, she expected to have a fourth C-section. But about seven months into her pregnancy, Aneka started to read more about childbirth online, and noticed a documentary by actress Ricki Lake called "The Business of Being Born," a film released in 2008 that questions the way American women have babies.
Aneka made a controversial health decision by giving birth vaginally to her fourth child after three previous C-sections.
Aneka made a controversial health decision by giving birth vaginally to her fourth child after three previous C-sections.

"I was a little bit angry after watching documentary," she said. "It made me realize I'd been robbed of the birthing experience. If possible, all women should be allowed to birth naturally."

"I asked my doctor if I could try delivering vaginally, and she said no," Aneka says. "I called the hospital and they said they wouldn't allow it, and I called three other hospitals and they wouldn't let me deliver vaginally, either."

The closest hospital that would let her try to deliver vaginally was in Manassas, Virginia, about 90 minutes from her Maryland home. She and her husband, Al, decided that was too far.

So just seven weeks away from her December 1 due date, Aneka contacted the International Cesarean Awareness Network, an advocacy group that promotes vaginal births after cesareans, or VBACs.

"She asked me if I could find someone who would deliver her vaginally," remembers Bobbie Humphrey, who works with ICAN. "She started to cry because she'd heard 'no, no, no you can't do this' so many times."

But Humphrey told her yes, that she knew of a midwife who would be willing to deliver her baby at home.

An article in Midwifery Today, written by Barbara Stratton, the National VBAC ban chair for ICAN, lists several approaches women have used to protest a VBAC denial.

On December 5, three days after the C-section that never took place, Annan Ni'em was born at home. He weighed 9 pounds, 6 ounces and was delivered after 20 hours of labor, and, she says, just four minutes of pushing. He was completely healthy.

"We were all crying at the delivery," says Humphrey, a doula who assisted the midwife at the birth. "It was very emotional. I was just so proud of Aneka."

Soon, word spread on e-mail lists and chat rooms about the healthy delivery.

"People were e-mailing Aneka saying 'congratulations, you're a role model," Humphrey says.

"Potential for catastrophe"

Vaginal births after cesarean sections pose some risk, but so does having another cesarean. After weighing the risks of each, the American College of Obstetricians and Gynecologists came out with a statement earlier this year saying it's reasonable to consider allowing women who've had two C-sections to try to have a vaginal delivery.

The group added that there's limited data about what should happen with women, like Aneka, who've had more than one previous cesarean.

Despite the ACOG statement, many doctors and hospitals refuse to do VBACs because of the risk. Women who try to deliver vaginally after cesarean have between a 0.5 percent and a 0.9 percent chance of having a uterine rupture -- a potentially deadly complication for both mother and baby, according to the American College of Obstetricians and Gynecologists.

Women with two previous C-sections have a 1 percent to 3.7 percent risk of a uterine rupture, according to ACOG.

Studies show the risk for a uterine rupture goes up if the woman's labor is induced. Aneka's was not.

Dr. Jeffrey Ecker, a spokesman for ACOG and director of obstetrical clinical research and quality assurance at Massachusetts General Hospital, warns against reaching too many conclusions from Aneka's successful VBAC at home.

"Anecdote is no way for folks to make plans," he says. "Just because something turned out well for one patient doesn't mean there are no risks and it will turn out well for you."

He says there's a reason that uterine rupture is more likely when a woman's had a C-section.

"You cut into the muscle of the uterus during a cesarean, and it heals with a scar that is often weaker than the muscle that was there before surgery," he says. "The scar can be weak enough that the contractions cause it to separate."

In that case, blood flow to the placenta can be interrupted, and the baby doesn't get enough oxygen.

In its latest position paper, ACOG recommended that VBACs be attempted "in facilities with staff immediately available to provide emergency care."

"There is potential for catastrophe if [a uterine rupture] happens in a home environment," says Dr. William Grobman, an ACOG spokesman and associate professor in the Department of Obstetrics and Gynecology at the Feinberg School of Medicine at Northwestern University.

Grobman says he understands Aneka's desire not to have another C-section.

"This was a last resort. This was a choice because she had no other options," he says.

But Aneka says if she has another child, she'll give birth at home.

"Once you have that experience there's no other way to go, being in the comfort of your home without any unnec
essary interventions and feeling like you're in charge," she says.


....................


"Anecdote is no way for folks to make plans," he says. "Just because something turned out well for one patient doesn't mean there are no risks and it will turn out well for you."


I kind of laughed at that, I know it has truth to it but I just kind of said "And it doesn't mean it won't turn out well either."


Hope you ladies are having lots of luck! I'll be back when baby #3 comes around
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Raean, 27 - single mom to Chloe (1.31.03) & Savanna (8.26.05)

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  #2  
December 16th, 2010, 07:06 PM
Mega Super Mommy
Join Date: May 2010
Location: Omaha, NE
Posts: 1,106
I just read that story on CNN.com too. I recently had a c-section for my first pregnancy and am hoping for a VBAC the next time if we are blessed to conceive again. I'm so glad this story had a happy ending for her and her baby.
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  #3  
January 1st, 2011, 12:22 AM
Karine119's Avatar SAHM of 3 Drama Queens!
Join Date: Sep 2006
Location: Boston, Ma
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I know I just read this and it gives me great hope! I know my regular midwives may or may not let me attempt a VBA3C after my attempt at a VBA2C, but she suggested that maybe a repeat might be best for our next. If we are not given a VBA3C as an option when we decide for #4 I will be looking into a HBA3C. I feel that a another repeat for me could result in....

A) Too much scar tissue and being told no more children after #4
B) An emergency arises on the table and I have to have a hysterectomy
C) We decide to go for #5 and I rupture during that pregnancy as a result of having 4 c-sections.

IMO it is our decision as a couple or my body's decision on when we are done having children, not my body being forced into the decision due to repeat c-sections.
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  #4  
January 4th, 2011, 07:31 PM
Super Mommy
Join Date: Oct 2010
Posts: 787
I think it was too risky. I'm glad everything was fine, but I wouldn't take that chance.
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