Anita Hedditch: The Oxford breech service
4 days ago
International Cesarean Awareness Network (ICAN), a grass-roots group, recently called 2,850 hospitals that have labor and delivery wards and found that 28% of them don't allow VBACs, up from 10% in its previous survey, in 2004. ICAN's latest findings note that another 21% of hospitals have what it calls "de facto bans," i.e., the hospitals have no official policies against VBAC, but no obstetricians will perform them.
With each repeat cesarean, a mother's risk of heavy bleeding, infection and infertility, among other complications, goes up. Perhaps most alarming, repeat C-sections increase a woman's chances of developing life-threatening placental abnormalities that can cause hemorrhaging during childbirth. The rate of placenta accreta--in which the placenta attaches abnormally to the uterine wall--has increased thirtyfold in the past 30 years. "The problem is only beginning to mushroom," says ACOG's Zelop.
Dr. Stuart Fischbein, an ob-gyn whose Camarillo, Calif., hospital won't allow the procedure, is concerned that women are getting "skewed" information about the risks of a VBAC "that leads them down the path that the doctor or hospital wants them to follow, as opposed to medical information that helps them make the best decision." According to a nationwide survey by Childbirth Connection, a 91-year-old maternal-care advocacy group based in New York City, 57% of C-section veterans who gave birth in 2005 were interested in a VBAC but were denied the option of having one.
[Zelop] says, "I don't know whether we can get back to a higher number of VBACs, because doctors are afraid and hospitals are afraid." So how to reverse the trend? For one thing, patients and doctors need to be as aware of the risks of multiple cesareans as they are of those of VBACs. That is certain to be on the agenda when the NIH holds its first conference on VBACs next year. But Zelop fears that the obstetrical C-change may come too late: "When the problems with multiple C-sections start to mount, we're going to look back and say, 'Oh, does anyone still know how to do VBAC?'"
I fondly remember clothes shopping with my friend, Carla, during my first pregnancy--laughing over soup and sandwiches at Mimi's Cafe and picking out maternity bras and jumpers at Motherhood Maternity. She also found some lovely pieces for me on Ebay and, much to my delight, sneakily shipped a box to my doorstep and another package to my place of work one day (I wore these probably more than most of what I purchased).
I also remember the shirt I wore home from the hospital (my first baby). It was one my mother loved as it reminded her of my great grandmother, Sarah (Sadie) Jane (whom my daughter, Brayla Jane, happened to be named after). In the hospital, like many moms who birth in hospitals, I recall having difficulty getting my daughter to nurse on one side (my left). The lactation consultants were pushing and prodding and threatening to use formula. But as soon as we got home, I unbuttoned this particular shirt and she latched right on--she just needed some privacy. I can't help but run my hands over the beautifully-stitched flowers whenever I see it and recall the fullness of those sweet early days as a brand new mommy--watching my own mother delight in her first grand baby.
A number of items that I wore daily were once Kori's, a childhood friend of mine. We were BFFs (remember that?) in Jr. High School and lost touch in late High School and College. At the age of 30 we surprisingly discovered that we lived just two miles from each other--THREE hours away from where we went to school together. We were both pregnant with our daughters at that time (her 3rd, my 1st) which was SO much fun. Since she gave birth 5 months before me, I inherited her entire stash of maternity wear. And BOY did I wear it out during my first three pregnancies!
Another outfit I was sentimental over was from the year I was still teaching, while pregnant. During the final days of that school year, we had a pie throwing contest at Lone Star Elementary School. I was covered from head to toe with whipped-cream while standing on stage for all to see. Under the thick, sticky white, I was sporting my comfy purple shirt and black denim pants. It took forever to get the whipped cream out of that shirt. I just almost gave up. Heehee! (By the way, thanks Dirk, Garrett, Cooper and everyone else who were part of that surprising event!).