Home waterbirth of VBAC twins.... Days apart!!

This is one of the most incredible birth stories I've ever read!!  It's a wonderful testament to the power of patience and faith in our bodies to birth our babies when and where they wish to come!!  If you read just one Birth Story this month, this definitely should be it!

This is the story of the birth of Hellena's twins.  Hellena is the 7th child of a 7th child awaiting the birth of her 6th & 7th children in Australia.  With the support of her community and her wonderful midwife Lisa Barrett, she describes the fears of a VBAC mama and the impact these fears have on the birth of her second twin when labour stops after the birth of her first twin.  Her story is an amazing insight into the strength of women and the powerful impact that our surroundings and inner thoughts and fears can play during birth.

I hope you all enjoy these incredible 2 chapters that follows the  amazing birth of these beautiful twins!!!

Natural birthing of twins

By Lisa Barrett on November 22, 2010

Here is a great birth story reproduced from Hellena Posts blog

My last birth taught me a lot. Not least being a deep respect for fear, and a respect for the experiences of many many women in our culture who experience medical births. I found that almost every week, another layer of my most recent caesarean birth experience peeled away to be closer examined, worked through, and cleared, to make way for my upcoming birth of twins. And I had 4 other natural birthing experiences to call on! What courage must women have, who have had a caesarean as their first birthing experience, and go on to face their fear and strive for a natural birth afterwards!?!? I was more nervous coming up to this birth than I’d ever been before, and more aware of all the things that could go wrong. The normal birthing fears (will they be stillborn? Disabled? Need intervention?) seemed magnified, not to mention a big fear that my body wouldn’t be able to travel birth’s path gracefully, and that my fear would disable my ability to cope with what happened. I was also well aware that I was entering the twilight zone, with a whole heap of wierd seven things going on…..  Being the seventh child of two seventh children, about to have my sixth and seventh children, and almost a pure Friesian, Currawong part Friesian, a country with a flag that has 7 blue and red stripes with 7 red love hearts…..  And the biggest thing that messed with my head was how I’d ‘positive thought’ my way through my previous pregnancy – focusing on an ECO or Easy Comfortable Orgasmic birth, sure I was having a girl, and we’d already named her too – Faye Wildcat. Needless to say, I got it wrong on all points, and have come to realize for myself that our thoughts really do create our reality……except for the random factor, where things happen that maybe you need rather than want. Apart from my head wounds, my body was capably and beautifully carrying twins, and I astounded my alternative health practitioners with how healthy, robust, and well my body was operating. The twins spent the entire pregnancy in Yin and Yang position – one with it’s head down, and one in breech position. From the different heart rates, Lisa predicted that one would be a boy and one a girl, which was a prediction that many people, us included, favoured. She also predicted that the baby in breech position would nicely turn over to be head down once the first twin was out. Lisa came to visit regularly, and proved a wise midwife indeed, as nearly every time she came she offered me a different way to approach my fears, or a nugget of information that helped my journey.

Late pregnancy was heavy, ponderous, and intensely inward, and a heavy case of thrush came in the last weeks making life itchy and sore. Coming up to 38 weeks I was in that weird inbetween place, where I was hoping for it to happen soon, but really glad that it wasn’t yet, all at the same time. Had a bit of a false start where I thought it was happening, and surprised myself at how well I coped when it came to it, which helped me feel better about the fears that had been plaguing me. And then came the night of the 20th, where we were both feeling ready as we could be, and I even felt well enough to indulge in some love making. Currawong reckons he knew exactly what we were doing that night, and what would be the result, but I didn’t have the same premonition. At 3am in the morning, I woke to my waters breaking, (which had never happened to me before…), got up and panicked for a minute, and then started shaking for an hour or so. Rang Lisa first thing and asked her to come straight away – I’d been worried that this birth would happen so quick that she wouldn’t have time to get here – as it was, she probably could have stayed home a bit longer…..

Currawong got the birthing pool happening, and Mum and Jess got here, and we gently labored till morning.

The kids all woke up and hung out in the birthing space, and some fellow community members were dropping in and out and keeping an eye on what was happening, and some older members even dropped in, as it was the community meeting day.

At 9.25, to chanting and humming and sounding, a baby boy was born, and he shot out like a cannon towards the side of the pool.

He was quickly passed to me and was quite blue and not making any noise, and Lisa told me to breathe in his face, which I did, and he spluttered and gave a cry.

First thing the name ‘Maxamillion’ came into my head, with the thought that having a million in your name must be a good omen. I said the name, and then Currawong said ‘Hercules’…..Lisa said “Maxamillion Hercules, what a great name!” and thus he was named.

 The rest of Chapter one can be read on Lisa Barretts blog HERE

Twins…. the story continues

By Lisa Barrett on January 1, 2011

So. A brief recap. We’d all got a bit stressed about the lateness of the second twin, then decided to sleep on it for a bit. I couldn’t sleep, and lay in bed listening to the sounds of Currawong clearing out the birthing pool, clearing the energy of the first birth, and making way for the second….

By the time I realized that no sleep was going to happen, I came out to a cleared and cleaned space, and a Currawong with a mission. He set about making food and starting to deal with the kids that were waking up. “Is there another baby yet?”…..”No, not yet”. Everyone slowly woke and we all hung out on the lounges chatting about what to do now. It’s amazing how a little bit of sleep can turn a desperate situation into one more manageable. Lisa decided to go off and do a bit of research on twin births and ring some old and trusted midwife friends, and we decided to give Russell Smith the Ayurvedic masseur a ring and see if he could help.

I consider myself extremely honoured to call Russell and Alison friends, he drums with Currawong and they inspire the hell out of each other, and is what I call a real healer. He swears, doesn’t read, smokes cigarettes, and doesn’t pull any of the ‘my shit don’t stink’ crap that so many ‘healers’ and ‘gurus’ I’ve known in my past push. He’s real, and honest, and calls a spade a spade, and has people come to him from all over the world, cause what he does really works. Alison is one of those women who makes you just wanna crawl into her lap and get lashings of mother love. She creates beautiful spaces and foods and moods, and giggles and laughs all the while. A more generous couple are hard to find. And bless their hearts, and may love and beauty rain on their heads forever more, within half an hour they were here. They just came. Russell straight away got to work on me, and Alison lay next to me chatting, spreading ease of mind like a balm. Russell started reading my body and telling me what was going on. It turns out my body had decided that it’s job was done! That was birth wasn’t it? Push one baby out and it’s over! My womb had blockages, and my uterus hadn’t contracted down, so even though baby number 2 was head down and ready to go, there was no punch from my uterus to help him out. A whole stack of fear had also locked itself in with the blocked womb, and it was all just stuck. He was massaging my feet and it HURT! And then he did all sorts of other work on my legs and by the time he got back to the bit that had hurt, it didn’t hurt anymore.

Meanwhile Lisa had come back from her research trip, Alison was pottering around cleaning the house, doing dishes and the like, and Russell got Currawong down to give him a work over too. We were all gobsmacked when Lisa reported that she’d found a statistic about the average amount of days between twins being born as 47 days….. It seems that many twins are born prematurely, and when one comes out early, they do their best to keep the second one in for as long as possible. She’d also bounced what was happening off some trusted advisors, and they all agreed that while I was healthy, and the baby  inside was healthy, there was no ‘normal’ time for twins to be born. In fact, in the days before hospital births became the norm, it was not uncommon at all for twins to be born days or even weeks apart. It’s only since birth has entered the treadmill of a hospital schedule that the second twin has only been allowed half an hour to make their own entry, before the birthing woman is induced to bring them on.

Peri-natal psychologists and midwives I’ve talked to have all found that quite often babies who are dragged into life by their legs and arms as in the case of caesareans, or induced to be born at more convenient times, set up life patterns of feeling like they’re being dragged through life against their will. Like they’re never on time to do the right thing, and that people around them are always overshadowing them and making decisions for them against their will. It seems quite stunning to me in the light of such logical conclusions about how birth sets us up for life, that we do anything apart from gentle welcomes to the world, with the mother, baby and family all being respectfully honoured in their journey.

But back to the story. I reckon I’m fortunate to be one of the few women in a western world at this point in our history, to experience the reality of having just given birth to a baby, but needing to put that baby to the side with other people holding it in the hours following the birth, because I had another baby inside me that needed to be birthed as well. I kept looking at Max and realizing that if he was a ‘singleton’ (a rather dubious term in my opinion((sounds to me like ‘simpleton’)), coined by mothers of ‘multiples’, to describe single baby’s…), I’d be holding him and staring at him and RESTING!! But it wasn’t to be. During the time that Currawong was getting a massage, my uterus started contracting. It was like the after pains you get after birthing that get more intense the more babies you have. I thought it was birthing contractions at first, till I tried moving like I did with contractions and it hurt more….I had to stay completely still for uterine contractions it seemed. Before Russell left he told me that “it would go like a bullet now..” I liked his metaphor. We were all relieved and felt like the whole experience was a lot more ‘normal’. We told Lisa she should head home and get some supplies and have a rest…none of us had expected it would be going this long! Not long after the blessed couple left, Lisa headed home for a while too. We all agreed that we were part of 2 separate births, and all was totally normal and fine.....

....And then at 4.05 in the morning of Monday the 23rd of August, 49 hours after my waters broke to begin the entry of Maxamillion, a little baby was born in the sac. Which burst just before coming out. It was like opening the most amazingly soft, velvety present I’ve ever been given, pulling the membranes from the head and trying to work out which gender we’d been gifted with. Like I said before, all the odds were on a girl baby being the second one out of my womb. Through the birth I’d been mentioning fairly solidly how my ‘little witch girl’ was on her way, and wondering what she’d look like, and telling ‘her’ to hurry up………..the first thing I said was, “It’s not a boy is it!?!?!”......

 

To read all of Chapter 2   Please Click HERE

More Cesareans Than Even Before.

The CDC has just released the  report on births for the US, and yet again the cesarean section rate has risen. The National C/Section rate went up 2 % from 2008, hitting 32.9% for 2009!!!

Not surprisingly to any natural childbirth advocates, the national birth rate fell by 3 percent less than 2008  with a birth rate of 4,247,694 in 2009, compared with 4,131,019 in 2008.  Is it any wonder that it fell?!  It is a fact that many women are actually choosing to forgo having another baby due to the fear of having a repeat Cesarean Section.  Add to that fact that many women who do decide to have another baby after  a C/Section suddenly discover that they are incapable of getting pregnant again naturally, because the surgical scar can cause infertility problems.  When as many as 1 in 3 women suffer from fertility problems after a C/Section is it any wonder that the American National Birth rate is falling?

Last February  it was announced   that having a VBAC birth (Vaginal Birth after Cesarean Section) was actually safer than they originally thought, especially for women with multiple uterine scars. BJOG  ( an International Journal of Obstetrics and Gynaecology), found that women with 3 previous Caesarean Sections have similar outcome rates of success as women with only one previous Caesarean section in a study of 25000 women attempting a vaginal birth after a Ceasarean section. The study shows that not only did the women with 3 previous C/Section uterine scars have a very similar rates of success in having a VBAC birth, but that the rates of morbidity were also very similar between the women that had a VBA3C and those that chose to be delivered by elective repeat caesarean.  A few month later ACOG made an official announcement that:

ACOG states that VBAC is a safe and reasonable option for most women, including some women with multiple previous cesareans, twins and unknown uterine scars.  ACOG also states that respect for patient autonomy requires that even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced nor can care be denied if a woman declines a repeat cesarean during labor.

Shall we gather here again at this time next year to see if the new official party line has had any effect at all on the rising Cesarean Section rate?  Are you holding your breath?  Me neither.

ACOG can make all the grand pronouncements they want, but if the hospitals and Doctors and Midwives don't listen and change their policies accordingly, then it's all just a  waste of the paper that the studies were printed on.

After I wrote: "New ACOG guidlines for VBAC births"- I sat at the computer and once the initial high of elation had worn off, I had a bit of a sad.  I stared at the words on the screen and thought to myself "how many women out there are reading this news with a sense of unbearable sadness for the births they didn't have.  Couldn't have.  Because last week these people and their grand pronouncements said they couldn't."  Five months ago I fought tooth and nail, and had to signed a stack of waivers pretty much as tall as my eldest son, to have a VBAC birth.  And I live in Canada and have the good fortune to have a Charter of Rights that gives me the legal Right to refuse a surgeons knife, I can't imagine  how my American sisters feel.

We, the women and mothers, have been  telling them for years. We have been in a ridiculous battle against the "powers that be" to be able to birth our babies OUR way.  To follow our intuition and allow ourselves the  dignity of choosing where, when and how we will give birth. It has ALWAYS been OUR births. We shouldn't of needed a big green light from a commercially motivated "association" (just another word for "corporation") to tell us this- to allow this to be denied to hundreds of thousands, if not millions, of mothers!!

Mama Birth said it so well in her article "ACOG Still Sucks"

Thousands of women have fought, bled and died for this change to come about. They have gone through the stigma of birthing at home in order to have a birth that they chose. They have been attended by supportive midwives. Some of them have birthed unassisted. Some of them have had hospital births in hostile environments where they were disrespected but in the process have shown hospital staff that VBAC is possible.
These are the women who deserve the praise for this recent statement.

Not ACOG. To ACOG I want to say this:

What can you do for all of those women who were denied VBAC because of you? Can you remove their scars? Can you remove their fears? Can you give them their births back? Can you change what you have already done?

You can do none of these things. Thousands if not hundreds of thousands of women have already suffered at your hands. Many more will because of the refusal of many OB's within your community to even acknowledge these new recommendations. You can not fix the pain that you have caused.

Thank you ACOG for changing your policy.

Shame on you for all of the bad births, scars, pain, depression and death that have come at your hands because of your unwillingness to do this sooner.

So will the leopard change it's spots?  Will the American national   Cesarean Section rate fall for this year?  Maybe next year?  Yea, I'm definitely not holding my breath on this one.

"When Birthing Becomes a "Fetish""

I read this article and wanted to cry and rage.  Cry, because it's so true.  Rage, because it's so true. When will women stand up and realize that this is all just another way that women are subjugated, manipulated and repressed?
In North America women like to think of ourselves as "Feminists" (although many of us hate that particular term due to the mass misuse of it), as women who fight for equality, who stand up for ourselves and our Rights. If someone decided that women had to stand on the bus and let all the menfolk have the seats, you can bet there'd be a mass uprising across our continent that would make WWII look like a dinner party.  Yet these same women who would stomp on anyone who tried to take away their Equal Rights cower and prostrate themselves before the almighty Medical machine that tells them to shut up and birth their babies like good little girls, drugged to the nines, feet up in the stirrups, push on command and then lay quietly while their babies are manhandled, slapped, poked, prodded, stuck with needles, blinded by bright lights and eye drops, weighed & measured, & washed, and finally delivered into their mothers care bundled up like a neat package delivered by the post man.
And then when women stand up for themselves and try to take back their births, try to normalize natural birth as it was intended to be, Idiots like this write letters to the editor of the NY Times saying:

"Under new medical guidelines “natural birth” fetishists can more easily choose vaginal birth after a Caesarean, which results in what your article describes as “quite low” rates of uterine rupture (.7 to .9 percent).
Low? How many severely injured women and brain-damaged babies with multimillion-dollar medical and education bills do those “low” rates yield? And for what benefit?
How many physician hours and medical malpractice insurance dollars are to be expended on the inevitable lawsuits brought by the angry parents who regret their choice?"

HERE to read the original comments 


But Guggie Daly's article  "When Birthing Becomes a Fetish" says it all:

"If mamas who want a VBAC are called natural birth fetishists, then men who exercise, change their diet and take medications after heart surgery must be artery fetishists. And people who do physical therapy after spinal surgery are spine fetishists. People commend and praise those who are recovering from non-birth surgery. Someone who wants his body to work normally is applauded and encouraged. But for women who want normal birth? Clearly, nothing but surgery is good for those pregnant women. Hack it open, pull it out and pay those surgeons! Your body is evil and useless! Or so society tells them.

Why is normal birth attacked in our society? The lustful sexualisation of a woman's body influences the way our culture handles this situation. Just as nursing a child draws criticism and restrictions, so does pushing a child through our birth canal. For in a lustful culture, women are merely objectified, non-person beings present for the satisfaction of males. Therefore, their duality cannot be tolerated. Female breasts are for sexual foreplay only and a female vagina is for sexual intercourse only. A woman who wants to wear provocative clothing is praised. A woman who wants to nurse her child in public is condemned. A woman who goes in for surgery to remove her child is making the "safe choice" while a woman who tries to birth vaginally is a "fetishist." Notice the projection?

Because of this inequality, each person within the family unit is turned in violence towards the other, with both the mother and father turned against the child. The child, once seen as a symbol of the couple's unity and love, is instead looked upon as a thief, one who steals the woman's body from the man and one who ruins the woman's body so that she cannot appease the man to his standard."

 HERE to read the original article



Yep, tears of sorrow and anger.

And the saddest part of this is that so many many women will actually buy into this.  They'll point their fingers at the VBAC'ing, Homebirthing, Midwife Using women and call us "Abnormal"  because WE are standing up for our Rights and the Rights of our babies. Because WE are taking back the births that were taken away from us by the medical machine and the Good Ol' Boys Club.

We Fight because we HAVE to. We speak out because we HAVE to.

The wonderful Gloria Lemay posted this on her blog and I think it is extremely relevant to this conversation:

When Good Women Remain Silent

“First they came for the breech birthers, and I did not speak out–because I was not a breech birther;
Then they came for the twins, and I did not speak out–because I was not carrying twins;
Then they came for the high risk women, and I did not speak out-because I was not a high risk woman;
Then they came for the VBACs, and I did not speak out– because I was not a VBAC;
Then they came for me– and there was no one left to speak out for me.”

Taken from a talk by Laureen Hudson of California at the Trust Birth Conference (March 2010). 

What they cant' give back

After writing my previous Blog- "New ACOG guidlines for VBAC births"- I sat at the computer and once the initial high of elation had worn off, I had a bit of a sad.  I stared at the words on the screen and thought to myself "how many women out there are reading this news with a sense of unbearable sadness for the births they didn't have.  Couldn't have.  Because last week these people and their grand pronouncements said they couldn't."  Five months ago I fought tooth and nail, and had to signed a stack of waivers pretty much as tall as my eldest son, to have a VBAC birth.  And I live in Canada and have the good fortune to have a Charter of Rights that gives me the legal Right to refuse a surgeons knife, I can't imagine  how my American sisters feel.

We, the women and mothers, have been  telling them for years. We have been in a ridiculous battle against the "powers that be" to be able to birth our babies OUR way.  To follow our intuition and allow ourselves the  dignity of choosing where, when and how we will give birth. It has ALWAYS been OUR births. We shouldn't of needed a big green light from a commercially motivated "association" (just another word for "corporation") to tell us this- to allow this to be denied to hundreds of thousands, if not millions, of mothers!!

Sad.  It really is.

Then I read Mama Births article on the topic, and she sums it all up soooooo well:

Wednesday, July 21, 2010

ACOG Still Sucks

The road to hell is lined with the heads of card carrying members of ACOG. Step softly, they often carry knifes.

They think they know what is best for you, and because they are doctors, they are used to being listened too.

I am happy today to hear the news that ACOG has made a new statement about VBAC. You can read the statement here. I know I sound negative about something that is actually WONDERFUL news for the VBACing natural childbirth community. It is just fantastic that ACOG is coming out in support of the relative safety of VBAC.

Despite how great this news is I simply can not bring myself to praise ACOG. I am glad that they are finally admitting what many women have known for years now, that having a vaginal birth after a Cesarean birth is possible, doable and SAFE.
So I am glad that ACOG has had a change of heart, that they recognize that the c-section rate is too high and that VBAC rates are too low. I am glad they are finally loosening their restrictions so that hopefully VBAC is more doable. But I don't really think they deserve any credit....

...Who deserves the credit for this change? VBACing women do.

Instead of praising ACOG for realizing that despite all the gobs of money they can make off of c-sections, their anti-evidence approach to VBAC is hurting them in the long run, I would like to praise all of the women out there who have fought for VBAC.

Thousands of women have fought, bled and died for this change to come about. They have gone through the stigma of birthing at home in order to have a birth that they chose. They have been attended by supportive midwives. Some of them have birthed unassisted. Some of them have had hospital births in hostile environments where they were disrespected but in the process have shown hospital staff that VBAC is possible.

These are the women who deserve the praise for this recent statement.

Not ACOG. To ACOG I want to say this:

What can you do for all of those women who were denied VBAC because of you? Can you remove their scars? Can you remove their fears? Can you give them their births back? Can you change what you have already done?

You can do none of these things. Thousands if not hundreds of thousands of women have already suffered at your hands. Many more will because of the refusal of many OB's within your community to even acknowledge these new recommendations. You can not fix the pain that you have caused.

Thank you ACOG for changing your policy.

Shame on you for all of the bad births, scars, pain, depression and death that have come at your hands because of your unwillingness to do this sooner.

 HERE to read the entire article on Mama Birth

Yes, Shame on ACOG (and SOGC) for their tyrannical disregard of women and babies. The mothers have won this battle... but not the war.  Oh yes, as I said in my earlier post, this war has only just begun.  Now the battle to get hospitals and doctors to FOLLOW these recommendations is about to begin....

New ACOG guidlines for VBAC births

*doin' the happy dance, doin' the happy dance*

This is so amazing that I'm literally grinning from ear to ear!!! Yesterday ACOG (The American College of Obstetricians and Gynecologists... also known as "the Black Hats"...usually!) released a new set of Guidelines for VBAC births. And the news is Hip Hip Horay Goooooooood!!!

For Release:

July 21, 2010

Ob-Gyns Issue Less Restrictive VBAC Guidelines

Washington, DC -- Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans, according to guidelines released today by The American College of Obstetricians and Gynecologists.
The cesarean delivery rate in the US increased dramatically over the past four decades, from 5% in 1970 to over 31% in 2007. Before 1970, the standard practice was to perform a repeat cesarean after a prior cesarean birth. During the 1970s, as women achieved successful VBACs, it became viewed as a reasonable option for some women. Over time, the VBAC rate increased from just over 5% in 1985 to 28% by 1996, but then began a steady decline. By 2006, the VBAC rate fell to 8.5%, a decrease that reflects the restrictions that some hospitals and insurers placed on trial of labor after cesarean (TOLAC) as well as decisions by patients when presented with the risks and benefits.
"The current cesarean rate is undeniably high and absolutely concerns us as ob-gyns," said Richard N. Waldman, MD, president of The College. "These VBAC guidelines emphasize the need for thorough counseling of benefits and risks, shared patient-doctor decision making, and the importance of patient autonomy. Moving forward, we need to work collaboratively with our patients and our colleagues, hospitals, and insurers to swing the pendulum back to fewer cesareans and a more reasonable VBAC rate."
In keeping with past recommendations, most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered a TOLAC. In addition, "The College guidelines now clearly say that women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a TOLAC," said Jeffrey L. Ecker, MD, from Massachusetts General Hospital in Boston and immediate past vice chair of the Committee on Practice Bulletins-Obstetrics who co-wrote the document with William A. Grobman, MD, from Northwestern University in Chicago.
VBAC Counseling on Benefits and Risks
"In making plans for delivery, physicians and patients should consider a woman's chance of a successful VBAC as well as the risk of complications from a trial of labor, all viewed in the context of her future reproductive plans," said Dr. Ecker. Approximately 60-80% of appropriate candidates who attempt VBAC will be successful. A VBAC avoids major abdominal surgery, lowers a woman's risk of hemorrhage and infection, and shortens postpartum recovery. It may also help women avoid the possible future risks of having multiple cesareans such as hysterectomy, bowel and bladder injury, transfusion, infection, and abnormal placenta conditions (placenta previa and placenta accreta).
Both repeat cesarean and a TOLAC carry risks including maternal hemorrhage, infection, operative injury, blood clots, hysterectomy, and death. Most maternal injury that occurs during a TOLAC happens when a repeat cesarean becomes necessary after the TOLAC fails. A successful VBAC has fewer complications than an elective repeat cesarean while a failed TOLAC has more complications than an elective repeat cesarean.
Uterine Rupture
The risk of uterine rupture during a TOLAC is low—between 0.5% and 0.9%—but if it occurs, it is an emergency situation. A uterine rupture can cause serious injury to a mother and her baby. The College maintains that a TOLAC is most safely undertaken where staff can immediately provide an emergency cesarean, but recognizes that such resources may not be universally available.
"Given the onerous medical liability climate for ob-gyns, interpretation of The College's earlier guidelines led many hospitals to refuse allowing VBACs altogether," said Dr. Waldman. "Our primary goal is to promote the safest environment for labor and delivery, not to restrict women's access to VBAC."
Women and their physicians may still make a plan for a TOLAC in situations where there may not be "immediately available" staff to handle emergencies, but it requires a thorough discussion of the local health care system, the available resources, and the potential for incremental risk. "It is absolutely critical that a woman and her physician discuss VBAC early in the prenatal care period so that logistical plans can be made well in advance," said Dr. Grobman. And those hospitals that lack "immediately available" staff should develop a clear process for gathering them quickly and all hospitals should have a plan in place for managing emergency uterine ruptures, however rarely they may occur, Dr. Grobman added.
The College says that restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will if, for example, a woman in labor presents for care and declines a repeat cesarean delivery at a center that does not support TOLAC. On the other hand, if, during prenatal care, a physician is uncomfortable with a patient's desire to undergo VBAC, it is appropriate to refer her to another physician or center.
Practice Bulletin #115, "Vaginal Birth after Previous Cesarean Delivery," is published in the August 2010 issue of Obstetrics & Gynecology.

 HERE to go to the original Release by ACOG


What does this mean for women birthing in America with a previous Caesarean section scar?   ICAN (International Cesarean Awareness Network..also known as "the White Hats")  breaks it down this way:

ACOG states that VBAC is a safe and reasonable option for most women, including some women with multiple previous cesareans, twins and unknown uterine scars.  ACOG also states that respect for patient autonomy requires that even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced nor can care be denied if a woman declines a repeat cesarean during labor.

“ACOG’s updated recommendations for VBAC are much more in line with the published medical research and echo what ICAN has stated for years .” says Desirre Andrews, President of ICAN.  “The benefits of VBAC cannot be overstated and if ACOG is truly ‘serving as a strong advocate for quality health care for women’ then this is a long overdue action on their part.”

ICAN hopes ACOG’s new VBAC guidelines will enable women to find the support and evidence-based care that they need and deserve.  Every woman must understand the capabilities and limitations of the  care provider and facility she chooses.  Less restrictive access to VBAC will lead to lower risks to mothers and babies from accumulating cesareans.  However, more than a revision of the VBAC Practice Bulletin is required to reverse the over a decade long trend of increasing cesarean rates and decreasing VBAC rates.  ICAN challenges ACOG to take an active role in educating both women and practitioners about healthy childbirth practices; practices that not only encourage VBAC but discourage the overuse of primary cesareans....

 HERE to read the entire ICAN statement

And what does this mean for Canadians (and possibly citizens of other countries like Canada)?  Well seeing as the Canadian medical associations seem to live in the back pockets of similar American organizations, I'm strongly suspecting that the trickle method will apply here, and soon Canada's SOGC (Society of Obstetritians and Gynaecologists of Canada...also known as the "black hats"), will respond with their own version of VBAC guidlines that will help to unfetter women and give at least some power back to make their own decisions on when, where, and how they will birth!!!

But, while I'd like to bask in the knowledge that a step has been taken in the right direction, this is no time for birth advocates to sit back and take a vacation.  We still need to have these "recommendations" enforced, and turn the tide to save women from being cut in the first place.   There is no rest for the advocate and the actvist.

A glorious HBAC birth story from Gloria Lemay

I read this post on Gloria's blog this morning while drinking my coffee in the peace of a sleeping house...and it brought tears to my eyes.  Gloria's article is written by a mother who had two terrible Caesarean Section birth with her first two children- both born prematurely due to doctors being convinced by ultra sounds that they were full term when they were NOT.  This woman's story is a powerful victory over fear and the medical machine. One that should enlighten, empower and encourage women every where to take back their births.

Third births: finally getting it right

This came in as a comment on my blog post “What’s a Poor Midwife to Do?” but I think it should have it’s own blog space. Gloria
Gloria, this jumped off the page for me: “Something to notice is that for many women, it takes two screwed up births to get the third birth somewhat acceptable.”
This is me. I had two coerced c/s without labour and thereby two premature babies, the first of which was so premature that his skull would mold to my hands while I breastfed him and from sleeping so that I spent weeks gently re-forming his skull manually. He had breathing problems until 6 months pp, and his skin was so soft that I couldn’t even feel it under my fingertips.
I look at pictures of him now and see how obviously premature he was. He was my first and a c/s because otherwise, “if I [went] into labour, he could [have] die[d]” from his frank breech position. His brother was also a no-labour c/s for the very same positioning ‘reason.’
For my third baby, I saw an OB in my 1st trimester (midwives wouldn’t even talk to me seriously- I’d had ’shared care’ for the first two pregnancies after breech was indicated in the 3rd trimester) but left his office and never returned.
I freebirthed the next baby with my first labour- at 46+3, a 9 hour painless birth. It was GLORIOUS! He was 10lbs 3oz, strong and beautiful.
I then freebirthed another boy at 42+3 at the tail end of a flu that my whole family had. It was a precipitous labour- 3 minutes long, and he was 10lbs 8oz. Also beautifully formed and strong.
Now I am 45 weeks tomorrow with our fifth baby....

HERE to read the entire Blog on Gloria Lemay's site

VBAC- Finding a Midwife

I have had several people over the past few months asking me about finding a care provider to support their decision to have a VBAC (Vaginal Birth After Caesarean).


Each pregnancy after the Caesarean birth of my eldest son, was a struggle to search for a midwife.   Why a midwife?  Because I KNEW without a shadow of a doubt that if I had chosen a Doctor in a hospital setting I would fail.  I knew that I wanted to labour and birth at home and that going with  a midwife was my only option.  And of course there is the fact that the model of midwifery care was so much more appealing to me:  Being with the same two care providers for the entire pregnancy, knowing that THEY would be there for the birth and that I wouldn't be subjected to the laws of chance with what doctor I would have when labour started.  Not to mention the fact that midwives have much lower statistics for Caesarean Sections and unnecessary medical interventions.

With each of my pregnancies I had to search for a midwifery group to take me on- and the searches became far more involved and difficult after each C/Section. What finally won out in each case was perseverance!   (That and the fact that many of my emails to Groups said things like "I'm having a home birth regardless of whether or not I can find a midwife!"...)

The following is a copy of the letter that I sent out to just about every Midwifery Group in SW Ontario.  Feel free to use it as a basis to write your own!!

Good morning,

I would like to introduce myself...and then beg for your help.

My name is Danielle Arnold, I am a breastfeeding and natural childbirth activist and co administrator of Natural Mothering. I'm also a mother of 4 and due mid February with baby #5.  My family and I have recently returned from Africa, from the Democratic Republic of the Congo.  Since arriving back in Canada in Sept. I have moved and settle my family in Brantford ON, and I am now trying to find a maternity care provider.

I realize that this is very short notice, but I am desperate to find a midwife or obstetrician to support my need to have a VBAC birth.

Let me give you a brief synopsis of my birthing history.

My eldest son, 1991- born at 38 weeks after my water was "accidentally" broken, failed induction followed by, of course, a caesarean section.

When I became pregnant with my eldest daughter in 2002 I knew I did not want to repeat my experience in a hospital birth. We found a midwife and had a  natural home birth.  10 hours of active labour and 35 minutes of pushing.

When I was pregnant with our youngest daughter (2005) we moved across the country  to Kamloops BC, and I made the shocking discovery that there were no midwives within a 3 hour drive of our city.  Back to the hospital, and another OB and another very negative experience. I ended up with a slow posterior labour. Tsking OB's telling me that I'm endangering my baby..... exhaustion and no support, I gave in and allowed them to do a C/S.  As far as C/S's go it was very easy and the recovery was quick and relatively painless.

Then came my pregnancy with my youngest son in 2007.  We had moved back to the Toronto area and I spent 4 months trying to find a midwife who would take me on for a home birth.  Finally I found a lovely midwife in east Toronto.  We found an OB to consult with at Toronto East General, and he agreed to my TOL.  By 41wk5days I'd been in and out of prodromal labour for over a week, at 3-4 cm and fully effaced.  When I called my midwife, while in early labour  she was uncomfortable with our home birth plan and advised  that we transport. The OB on duty (NOT our consulting OB), was a completely obnoxious man who screamed at me and my husband, told us that we were trying to kill our baby, alluding that we were horrible parents etc.....and yet again I ended up agreeing to another C/S- though this agreement was completely made under duress:  I was left feeling that I had no support and no say in the decision.

This is where the main difference comes from my previous C/S births.

First of all the spinal block  did not take on my upper right quadrant,  no one would listen to me when they started the surgery.... when I started screaming at them "I can feel that", the student anaesthesiologist (yes, it was a student who placed the spinal block....again, against my wishes) pumped me full of Ketamine- Instantly I was out of my mind.  I couldn't see or hear anything... but I could feel everything.  By the end of the surgery I had managed to get control of myself again and was at least verbal and aware.   They took us to the recovery room and left us there.  I managed to nurse my son with a lot of help from my husband, and when the nurse came in I asked for painkillers. (as the spinal block hadn't taken in the upper right abdominal area, neither did the painkillers)  She said that she would find a doctor to get the "OK", and that I would be moved to my room in the next 1/2 hour ........ 3 hours later I was still in the recovery room, hadn't seen a single medical staff member and still had no painkillers.  My husband finally stormed out to the nurses station and demanded that someone come look after me and get me moved to my room (the previous nurse had forgotten to tell anyone that I was there.)  2 days later I went home and 2 days after that I returned because I KNEW that something was wrong- that I wasn't getting better.  It turns out that the surgeon had stitched an abdominal nerve into my internal stitches.  Solution: NONE.  I was told that I just had to wait till the internals dissolved...in 8-10 weeks.  So I spent the next 8wk5 days hunched over , unable to walk straight, unable to carry my new born baby. Because of the huge amount of drugs for pain they had me on (they had to keep changing them because of the reactions I had- such as ulcers...), I have almost no memories of my son's first 9 weeks of life.

Needless to say I do NOT wish to have a repeat Caesarean Section.

As I said at the beginning of this long winded letter, I am a Natural Childbirth advocate.  I have done more research on the topics of VBAC births and C/S's, medical interventions and the statistics involved than most maternity care providers.  I am VERY well aware of the risks of uterine rupture  during a TOL VBA3C, probably more so than most medical professionals.  I am also VERY well aware of the risks of having a 4th C/S, to both my self and my baby. I am not an unreasonable woman, I am not someone looking for that miraculous all empowering feminine experience who wants to have a Home water unassisted lotus birth in the back yard in a teepee... so that I can say that I did.  What I am is a well researched, knowledgeable mother that wants what is best for myself and my baby.  Which is NOT a scheduled caesarean section.

I do not expect any midwives to agree to allowing me a TOL HBA3C... as much as I detest the necessity, I realize that Ontario midwives are bound by the rules of the Ontario Midwives Association and the "guidelines' of the hospitals that they have privileges in.  But I need someone to support me in my wishes to have a vaginal birth in a hospital.  I NEED someone to go to bat for me with the hospital administrators and obstetricians , to say "this woman knows her situation and knows the information and knows the statistics and knows the risks involved and wants to have a Vaginal birth."  Someone who will guide me in my quest to make this a reality.

Because the truth is this:  This is my body, this is my baby, this is my birth.  I am the only one that should have the ability to say how and where I will birth my child.  I should have the right to say "NO" to a scheduled caesarean section.  I am aware of the legalities and I know that a hospital can not force me into a medical procedure that I do not allow.  But I also know enough to know when a C/S is necessary and am willing to work within those parameters.

So please:  I need your help.  I do not care how far I have to travel to have my baby.  I just want to find someone who will support my informed decisions and will stand by me.

I am looking forward to speaking with you further, and hope to have the opportunity to convince you that I DO understand all that is involved in my decisions.

Regards,
Danielle Arnold

Canada's Rising Caesarean Section Rate

 A brilliant article that comes clean about Canada's rising Caesarean Section rates.  It doesn't white wash the statistics, it doesn't hide the TRUTH:  Caesarean sections cause more Caesarean sections!!!  And every medical intervention in labour and delivery causes an increased risk of "having to have" a C/Section. 

While the Society of Obstetricians and Gynecologists of Canadais finally realizing that the soaring rates of medical interventions- such as inductions, epidurals, and C/Sections- are having a detrimental effect of the health of our women and children, they have yet to address the worst problem:

The Doctors and the Hospitals themselves.

 The Society of Obstetricians and Gynecologists of Canada has made comments that the C/Section rate is too high, that inductions shouldn't be done so often, that Vaginal  breech births are healthier than C/section deliveries, and that VBAC births should be encouraged.... but that's all just whistling in the wind if the doctors and hospitals are adamantly turning their backs with their fingers in their ears singing "Lalalalalalala..."

It's all very wonderful that they are making these recommendations and statements, but that's not helping the mothers who are out there searching for a birthing attendant who will allow them to have a VBAC or to deliver their breech baby naturally/vaginally. 

And don't just blame the doctors- finding a supportive midwife can be equally difficult.  When I was pregnant with my second child back in 2002, I had three different Toronto midwifery groups turn me down point blank because I had had a previous Caesarean section.  The fact that it happened 10 years previously didn't matter even slightly.  When I was pregnant with my 4th child- having had 2 C/S's and one natural  HBAC (homebirth after C/S)- I had to search for MONTHS and had to beg and cajole to find a midwife to support my wishes to have another HBAC birth.  ...and my 5th child? after THREE Caesarean sections?!?  I was SHOCKED to hell and back when one lone midwifery group in a 100 km radius actually accepted me as a client.  But even then, while they took me on, they did so with a lot of trepidation and scepticism.

If I hadn't been so damn stubborn, (and knowledgable), I probably would of given up on trying to have a vaginal birth years ago and would now be sporting 5 uterine scars.

NOT a Healthy situation.

So yet again, as with just about everything worth having in life, we need to fight to achieve and support our Rights.  If women do not demand that hospitals/doctors/midwives accept their wishes to have a VBAC birth, then change will not happen, no matter how many "recommendations" the Society of Obstetricians and Gynecologists of Canada wants to make.

Worries surround Canada's rising C-section rate

 

 

By Sharon Kirkey, Canwest News Service

 

Dr. Jan Christilaw was in the operating room the day a routine incision was made into a young mother's abdomen to deliver her baby.
What happened next, Christilaw says, "is something we never want to see."
Normally, the placenta separates from the wall of the uterus after birth. It's lacy almost, and not like solid tissue. "You can take your hands and sort of scoop it up, it's like breaking cobwebs as you go," says Christilaw, an obstetrician and president of B.C. Women's Hospital and Health Centre in Vancouver.
But the placenta had eroded through the wall of the uterus, a condition known as placenta accreta. As soon as they stretched the opening of the uterus to deliver the baby, "the placenta started bleeding everywhere," Christilaw says.
They couldn't get the bleeding to stop. The woman was losing two cups of blood every 30 seconds.
"You get into this place where you think, OK, this is what I'm trained to do, I know exactly how to do this," Christilaw, who was a senior resident at the time, says. "You don't panic, but you're calling in everybody you can possibly get into the room." People had to squeeze the bags of blood, because the pump could not put it in fast enough.
The only way to stop the bleeding was an emergency hysterectomy. The woman was in the operating room for eight hours, and lost 15 litres of blood.
It used to be that obstetricians might only ever see one or two cases of placenta accreta in their practice lifetime. Although still rare, obstetricians across Canada say one of the most feared complications of pregnancy is increasing as a direct consequence of the nation's rising caesarean-section rate.
Virtually all placenta accretas occur in women who have had a previous C-section, and the risk increases with each additional surgical delivery. The placenta attaches to the old C-section scar. Scars don't have a proper blood supply to feed a placenta, so the it keeps burrowing into the uterus until it finds one, sometimes pushing through the uterus completely and into the bladder or other organs.
The condition can be detected by ultrasound, but not always. "You almost never see it in a woman who has not had a C-section," Christilaw says.
Today, about 28 per cent of babies born in Canada are delivered by caesarean. In 1969, Canada's rate was five per cent.
More than 78,000 caesarean sections were performed in Canada last year, making it the single most frequently performed surgery on Canadian women.
Ellen Hodnett wonders how so many C-sections could be justified.
"Women have stopped being able to give birth vaginally, in such numbers?" says the professor and Heather M. Reisman Chair in perinatal nursing research at the University of Toronto's Bloomberg Faculty of Nursing.
The World Health Organization says no more than 15 per cent of deliveries should be done by C-section.
"We don't know what the ideal rate is," says Dr. Mark Walker, a high-risk obstetrician at the Ottawa Hospital and senior scientist with the Ottawa Hospital Research Institute. "I think it's fair to assume it's lower than where we are now."
Walker says changing demographics — older first-time mothers, more multiple births from fertility treatments, more mothers with hypertension, diabetes, obesity and other health problems — are not enough to explain an almost doubling in the C-section rate since the early 1990s.
Neither is there evidence to support the idea that women are seeking C-sections on demand. Studies from Ontario suggest less than one per cent of caesareans are for "maternal request."
The Society of Obstetricians and Gynaecologists of Canada says the vast majority of caesareans are done for medically valid reasons. But there are concerns that too many are being ordered because labour isn't progressing quickly enough, and that thousands of "routine" interventions are now being done that increase the odds of a woman needing a surgical birth.
What's more, the number of women who give birth vaginally after a previous C-section is dropping dramatically, meaning more and more women are having repeat C-sections.
"The percentage of caesareans we're doing for repeats because we didn't do a trial of labour, those are the ones we need to be asking ourselves about," Walker says.
Dr. Michael Klein calls it the industrialization of childbirth, where, in today's risk-averse society, women in labour are being treated "as an accident waiting to happen" and where doing something is always better than doing nothing.
"Physicians and society have helped women basically believe that childbirth is no longer a natural phenomenon, but an opportunity for things to go wrong," says Klein, emeritus professor in the departments of family practice and pediatrics at the University of British Columbia.
"But the fundamental issue is, we aren't improving outcomes by doing more C-sections. For the first time in Canada, we are seeing the key indicators for mothers and babies going in the wrong direction."
Risks to babies range from accidental lacerations when the surgeon cuts into the uterus, to neonatal respiratory distress. Research suggests two times as many babies born via C-section will end up in an incubator with water on their lungs, or with serious respiratory problems compared to babies delivered vaginally, because a C-section interferes with the normal hormonal and physiological changes associated with labour that prepare a baby to take its first breath.
Risks to women include higher risks of hemorrhage requiring a hysterectomy, major infections including blood infections, wound infections and bladder infections, and blood clots in the lungs — and every C-section increases the risk for another.
"If you have a caesarean section for the first birth, the probability of having one the second time around is huge, because of the difficulty women have in getting a doctor to look after them once they have a uterine scar," Klein says.
The worry is that the scar will pull apart during labour, causing a uterine rupture.
"If you have a catastrophic rupture, you can get into big trouble," Christilaw says. "You can have a negative outcome for mom or baby. In severe situations, the baby can die or become damaged — but that's a very rare outcome."
Her hospital is encouraging more VBACs — vaginal births after caesarean — in carefully selected women. "In those women who attempt a VBAC, our success rate is well over 80 per cent."
But less than one in five women in Canada with a previous C-section delivered vaginally in 2007-08. Eighty-two per cent had a subsequent C-section.
Christilaw says the only thing preventing Canada from seeing "horrific" complication rates from C-sections is the fact women are not having as many babies as they once did.
"A C-section can be a life-saving manoeuvre for a mother or baby. Nobody is saying differently," she says. "What we're trying to say to people is, a C-section is not a benign thing. If you need one, that's different. But you should not be doing this unless you absolutely have to."
C-sections are frequently the end result of a cascade of interventions that often starts with inductions.
Tens of thousands of women in Canada have their labours artificially induced every year, often via intravenous infusion of artificial oxytocin. Oxytocin is naturally produced by the human body. It's what creates contractions in labour. Today in Canada, one in five women who gives birth in hospital is induced.
What doctors fear are stillbirths. But alarmed by the rising rates of inductions, the Society of Obstetricians and Gynecologists of Canada recently urged doctors not to consider an induction until a woman is at least one week past her due date.
Claudia Villeneuve says that women are getting induced "if they're two, three, four days overdue."
"Inductions are rampant," says Villeneuve, president of the International Cesarean Awareness Network of Canada. "You have a perfectly normal mom who comes in with a perfectly normal baby, and now you put these powerful drugs into her system to force labour to start."
The "humane" thing is to offer an epidural, she says. With an epidural, a woman can't feel pain in the lower half of her body. But epidurals slow labour, sometimes so much that labour stops. "Now you have to get this baby out," Villeneuve says. Two-thirds of first-time C-sections are done for "failure to progress."
Klein says epidurals are too often given before active labour is established.
"The majority of women today get their epidurals in the parking lot."
So the cascade continues: epidurals increase the use of electronic fetal monitoring, where electrodes are strapped to the woman's belly to monitor her baby's heart rate.
"It's hard to change positions when you have a fetal monitor on, and an epidural with its little things taped to your back, and an IV in your arm," Hodnett says. "Why would labour progress normally, if you're stuck in a labour bed with all this machinery on you?"
What's more, EFM is an imperfect technology. It detects subtle changes that can't be picked up by just listening to the baby's heartbeat after contractions, "and those subtle changes are often false positives," Klein says. "In other words, the fetus is OK, you just think it isn't OK."
Kayla Soares had been in mild labour at home for 24 hours when her contractions suddenly stopped. Doctors told the Edmonton mother she would have to be induced. She was three centimetres dilated when they started the oxytocin drip.
"It was the worst pain I've ever felt in the world," she remembers. "I wasn't having contractions at all and then they put me on the oxytocin and every half-hour they would boost it up, so the contractions were coming every minute, pretty much. It was like going from nothing to being in crazy, absolute labour, and in so much pain." Eleven hours later, she was still just three centimetres dilated. "That's when they said it was enough, and they were doing a C-section.
"I didn't want to do it. I was asking, could we just have more time?"
Three weeks later, she still couldn't get out of bed without help. Her incision had become infected. "It felt like I was ripping apart every time I moved. It was a pretty brutal recovery."
Soares had her second baby in June. "I was dead set on having a VBAC," a vaginal delivery after caesarean. "It was a fight, an uphill battle the whole time with doctors." One obstetrician asked her her shoe size. "She said that because I was a size five and smaller framed that I definitely was going to have another caesarean and that a VBAC wouldn't happen. She said that because I was a 'failure to progress' the first time I'll be a 'failure to progress again.'"
Two weeks before her daughter was born, Soares started going in and out of labour. "They had me convinced it was causing stress to the baby even though the tests said everything was fine. They had me convinced it was enough, because I was overdue and they said my incision was going to rupture," she says.
"They just kind of scared me into having another C-section."
skirkey@canwest.com

HERE to read the original article
 

"Unnecessareans"

Women were not born with zippers.  We did not ask to have them installed at puberty, nor when we decided to have our babies.  Yet hospitals and most doctors seem to think that pulling a baby out of a woman's cut open abdomen is as easy and as painless and as harmless as opening a zipper.  Hell most of them would probably install zippers after every C/Section they did, just to make the next one that much easier. 

"Don't worry about going through the pain of labour and delivery... we'll just book you in on a day that's convenient for you, unzip you and  wham bam  it'll all be done!"

Gloria Lemay's Blog

Unnecessareans

Unnecessareans {365/34}, originally uploaded by Trader Photography.

I think this image is startling and perfect to remind us that a cesarean surgery is for life. One obstetrician made the following observation about the risk: of this operation:
“’If one went to the extreme of giving the patient the full details of mortality and morbidity related to cesarean section, most of them would get
up and go out and have their baby under a tree,’ [Dr. McDonald] said.”
[Neel J. Medicolegal pressure, MDs’ lack of patience cited in cesarean
‘epidemic.’ Ob.Gyn. News Vol 22 No 10]

"The Rule of 10"

Oh this is such a great article from Midwifery Today Magazine!! I've read it before a couple of years ago when it was originally published, but I so wish I had had a chance to read it again before going into labour myself 2 weeks ago!!!

In this article by Lydi Owen "The Rule of 10- versus women's primal wisdom" She talks about the history of the golden 10 centimetres that the Obstetrical community worships. Yet another example of ridiculous rules and absolute "Truths" that the medical machine invented way back in the 50's when they thought their doctors were omnipotent and could completely control childbirth. One of the many "Rules of Birthing" that they invented that still haunts most obstetrical wards to this day: That a woman MUST be fully dilated to 10 cm's before being allowed to push, other wise there will be horrifying outcomes.....

There is a rule of labor that forbids a woman to push with contractions until her cervix is completely dilated to 10 cm. Women are warned that to push before this doorway is completely open and out of the way will result in a swollen and/or torn cervix.

What will supposedly happen if the cervix swells?

Doctors, nurses, midwives, doulas and childbirth educators all warn that a swollen cervix will impede labor and increase the chances of tearing the cervix, thus causing hemorrhage. They have been taught that a swollen cervix is easily broken or pulverized. If this is indeed the truth, then why do most women during labor have an irresistible urge to begin bearing down before dilation is complete?

Could it be that the instinctual wisdom of our bodies has become our enemy? Is Spirit trying to destroy us instead of guiding us? Why would we feel the need to begin bearing down at 5–6 cm (or sooner) if it would shatter the gateway to the baby’s outer world? ...

...How did this “Rule of Ten” come about?

In 1951 doctors Greenhill and DeLee wrote “During the first stage of labor no abdominal pushing is allowed because the cervix will tear.”(2)

We can safely assume that the women being studied by Greenhill and DeLee were under the influence of drugs, because in the mid-20th century the orgy of drug interference during labor and birth was at its height of glory. Almost no women were informed enough to withstand the onslaught of drugs given to them during birth in the hospital. Unfortunately, the situation has not changed in the sixty years since.

Therefore, these doctors were scientifically incorrect in concluding that the “Rule of Ten” was valid, without simultaneously observing a control group of drug-free laboring women in the upright position (as opposed to being drugged and lying down in beds).

HERE to read the entire article from Midwifery Today

Just two weeks ago when I was labouring to birth my youngest son Kael, I encountered this "Rule of 10", and had to struggle through it alone, as no one would listen to my plea's of "I have to push!!". I was at 8 cm and getting Tsk Tsk Tsk from the on call Obstetrician - after being lectured about my inflamed cervix and the fears of my uterus rupturing, and being told NOT to push no matter what my him, the nurses and my midwives.... well, you listen, right? They are the professionals, right? So I went against my instinctual urge and panted and did what ever I could to NOT push.... But when the urge became a primal force that could not be ignored, I was incapable of NOT pushing...

...and low and behold, my son's head descended through my "inflamed and swollen" cervix with no trouble what so ever.

I managed to beat the odds and have my VBA3C birth. I managed to do this without the whole hearted support of the medical personnel who were present at Kael's birth. BUT..... how much easier would his birth have been if they had allowed me the freedom to push as my body instinctually wanted, if they had allowed me to be the guide to my birthing, trusting that as the birthing mother I KNEW what to do- that my body knew exactly what to do. If they had allowed me that logical freedom, I wouldn't have had the epidural that almost ruined everything. I would have pushed how I wanted, when I wanted, and I would have been the one in control, instead of the one being controlled.

...If Wishes were Fishes, right?

Please read the article- please tell everyone you know about it- talk to your midwives and doctors about it!! It is only when women take back control of their bodies and their births that we can make permanent changes to how the field of Obstetrics treats women, and make hospitals set up their policies to enable women, instead of disabling them.

You are woman. Let them hear you roar!

A Mothers Victory: My VBA3C Birth Story

“Boobalumba has arrived!”

After three Caesarean sections, I knew I wanted a natural birth for my fifth child. I had written a detailed birth plan describing how I was to be involved and treated during my labour and birth at the hospital, with as little intervention as possible. My plan notwithstanding, this is my story of the very difficult labour and birth of my son on February 8, 2010.

by Danielle Arnold-McKenny


It all started with a week of annoying, stop and start prodromal labour. There really is nothing quite so frustrating as playing the guessing game every time the contractions start. Is this it…this time?! But after a week of lots of contractions and various other questionable symptoms, early evening on Saturday (February 6, 2010) I was pretty certain that we were onto the countdown.

Contractions continued during the night for the first time. Although they slowed right down and became erratic, they kept getting stronger. Sunday morning they slowed to a halt for about three or four hours. When they started up again, it was like being back at square one.

So I kicked my husband Nick and the kids out of the house to go to a friend’s to watch the Super Bowl. Then I set out to do some serious relaxing: filled the living room with candles, put some of my favourite aromatherapy oils in a burner, put on soothing music, got settled into my super comfy rocking chair, and just…R E L A X E D.

Soon enough the contractions became steady at about 8–10 minutes apart. Nick brought the kids home and tucked them into bed late that night, and we called my best friend Lynda over to be with us.

By 3 AM I was definitely in labour. While still only about 6–8 minutes apart, the contractions were strong enough for me to need to support myself and focus on breathing through them—rocking and swaying. We called our midwife, to put her on alert that the party was definitely on. By 5 AM the contractions were still 6 minutes apart but very strong. I had to decide what to do next.

I knew that the kids would be waking up soon and really didn’t think I could deal with my labour and them. So I made the decision for us to head off to the hospital. It was too early—I knew it was—but I was so tired, having not really slept in two nights. I just wanted to know where I was in my labour, to know how far/fast I was progressing.

I think that this is one of the worst things that most labouring women do—worry about the numbers: how many minutes apart, how many centimetres dilated, how many hours of labour…This turns so easily into a downward spiral.

When we arrived at the hospital, we were met by one of our midwives—and so started that downward spiral. She checked me at 6:30 AM. I was only 3 centimetres…3? Just 3 centimetres?!? Oh gods!!! Immediately I became depressed, completely despondent. Three centimetres was exactly where I’d been when I’d gone to the hospital in labour with my youngest daughter Keira, and exactly where I stayed with that labour, which this one had so far exactly mirrored. Keira’s birth ended up being a Caesarean section…

On my midwife’s advice, Nick and I started walking the hospital hallways, to try to “ramp up the contractions,” as she was convinced that I wasn’t in active labour yet—another very disappointing announcement that brought me down even further. How was I supposed to continue like this? In my opinion, my contractions were damn strong, as strong as they were when I was close to transition with Quinlin, my home-birth, vaginal-birth-after-one-Caesarean (VBA1C) baby.

So we walked the halls, stopping to lean on whatever I had available during contractions. We talked and I cried. I was so despondent, and after two nights of almost no sleep, I was completely exhausted. How was I going to make it through this if the contractions were already this strong and I wasn’t even in “active labour”!?!

Nick was a huge support both physically and emotionally. While we walked, we talked: about my fears, about the “options,” both of us knowing what the “option” was…We returned to our room and talked to our midwife about the jumble of emotions, about the labour and my fears. We decided that we would talk to the obstetrician on call. Even then I knew that we were taking the first step down the road to another Caesarean. But I was so caught up in my anxiety and despondency that I had lost hope.

When the doctor arrived finally at around 9 AM, I was desperate for some relief from the contractions. Luckily I had an OB who wasn’t a pusher. Oh, he definitely wanted me to have the C/S, to remove the “risks” of my trial of labour, and to save the staff from the obvious stress of having a VBA3C on their labour & delivery floor. But he suggested that he see how far along in my labour I was before we made the final decision. For this alone, I have much respect for the man, because at that moment I was so vulnerable that he could have pushed me right down to the operating room himself and knocked me out. I wouldn’t have uttered a peep. But instead he checked me over.

I was 8 centimetres!!!!

From down in the valley of emotional despair so dark and heavy that I could barely breathe, I flew up to the top of the tallest mountain of elation!! 8 centimetres?!? I could do this!!!! Nick’s face lit up in what I knew was a mirror expression of my own. Eight centimetres were unimaginable.

“What do you want to do?” the OB asked. “I want to continue to labour!!!” I almost shouted in excitement.

He then started on the litany of risks, and rules I “had to” follow. He suggested that we break my water to help get things moving along. I readily agreed. Hell, if he’d suggested cartwheels while holding a bottle of nitroglycerine, I’d have eagerly agreed with him!

So he quickly broke my membranes. With a huge rush of lovely, clear amniotic fluid, I instantly felt Baby Boobalumba (as we had nick-named him) drop down a bit farther. Continuing with his sermon, the OB warned me that he’d give me one hour to show some progress, and that we would discuss “the options” when he returned.

For 20 minutes or so, the contractions eased off in severity, while coming closer together. I was laughing between contractions and joking with Nick and my midwife. That break was short-lived, though. Very soon transition fell on me like a lead curtain.

Oh, it was bad.

After an hour, the doctor returned and checked me again. Still 8 centimetres. “Tsk tsk tsk” is what I got, and again he started listing the risks and lecturing me on the dangers of having a uterine rupture if I didn’t hurry up and progress. I argued that Boobalumba moving lower was progress. I immediately lost my high regard for him when he began shushing me and telling me off like a naughty child.

Have I mentioned that I don’t take lightly to someone treating me as an inferior being? Hackles were raised, and Nick quickly set about to calm me down. We were given another hour.

Oh gods!!! Contractions were now never-ending waves that carried away any semblance of humanity I had left. The logical Dani was left behind by the primal Dani, who ruled unchecked over the writhing body that had been human just a few hours before.

Occasionally the logical Dani had flashes of insight that penetrated the haze of transition: thoughts of caged mountain lions screaming in rage at their captors; the lone wolf caught in a trap that gnaws its own leg off to try to escape…for I was the trapped animal, trapped by the hospital staff, policies, doctors, and my midwives. I was hooked up to a fetal monitor that inhibited my ability to move. I was suppressed by people telling me where to go and how to position myself, and reminding me of the clock that continued to tick towards the “deadline.”

Some of what happened that I’m about to relay, I learned later from Nick. At this point my chronological memory that was recording the events as they happened became seriously erratic (resulting in gaping holes big enough to drive a truck through).

At some point during my transition to a blubbering mess, my friend Lynda showed up after taking my kids to her parents’ house. Between Lynda and Nick, I had a small bit of calm to cling to. They took turns talking to me, feeding me sips of water, rubbing my back, and helping me be as comfortable as possible.

Then my second hour was up. The OB arrived and announced that I was still just 8 centimetres and my cervix was inflamed.

I begged for relief. The last piece of human Dani was ready to admit defeat. But I managed to beat back the primal contractions and somewhat coherently tell the doctor that if I could just relax for a minute, just have a moment’s respite to regain control of myself…If I’m heading down the hallway to the operating room anyways, then give me the epidural so that we can try just one last time to finish this dilation thingy that you’re all so hyper about!!

Then the human spark slipped away, having said its final piece, and the primal Dani took over again. Nick discussed it all with the doctor. They arranged to get me an epidural, and Nick bargained a further half hour to see if we could achieve the final 2 centimetres that they wanted.

Immediately the room seemed to fill with people. Two maternity nurses bustled in to set up an IV…I remember biting the head off one for even thinking about putting the IV into the back of my hand…my second midwife was there.…the noise levels rose substantially and I felt like I was in a stadium surrounded by overwhelming crowds. I vaguely recollect my midwife checking me again and saying that she thought the cervical lip could be moved…and she did something down there that wasn’t pleasant.

Then they all decided that I needed to be lying down right now. “Take the pressure off the cervix”…“let the swelling go down”…snippets of directions, with me arguing that I didn’t want to lie down. I can’t lie down, I won’t lie down…yet somehow they had me down flat on the bed, taking away the last vestige of control that I had over this three-ring circus.

More people flooded into the room. The anaesthesiologist came with cartloads of paraphernalia. At some point they kicked Lynda out of the room on some flimsy excuse, leaving me with one fewer island of support to cling to.

At this point I remember feeling “the push.” I told “them” that I needed to push, that I felt that pressure, that I needed to poop…and I remember “them” telling me not to push, that it was too early, that I wasn’t fully dilated to the golden 10. They rolled me to my side to get ready for the epidural, hands on me everywhere, voices ordering me to do this and do that, curl into a ball, hold still, don’t move…I tried to follow orders. The small inner voice of logic screamed at the primal me to listen: “Don’t move, you idiot!! That’s a needle in your spine!!!”

All of a sudden my primal self was engulfed by an all-consuming command to push…Out of the confusion of the moment, standing out from the roaring crowds came the scream: “I have to push!!! I have to push!!!!!”

The crowds yelled back at me: “Don’t move!!” “Don’t push!!!”…

What came next is a moment of clarity that I will remember to my last breath. It came so clearly and so powerfully that it is permanently etched into my brain. I pushed. With every fibre of my being. Every muscle, every tendon, every vital organ. I pushed once, then again. And I felt Baby Boobalumba burst through some invisible barrier and move down into my vagina. I felt every contour, every millimetre of his descent.

A primal growling scream rose out of me that was pure energy. I was filled with a sense of exhilaration as endorphins flooded my system. I CAN DO THIS!!!! I CAN BIRTH MY BABY!!!—only to be cut off by grabbing hands and barking orders from the madding and maddening crowds…“Stop!! Don’t push!! Don’t move!!”

Voices tumbled overtop each other. “Is the baby coming?” “Can you see the head?” “I can see the head!” “Turn her around!” “Lie on your back!” Voices bellowing at me…

The human Dani fought with the primal Dani to take back control. The human Dani knew logically what she needed to do. Knew that she needed to retake control of her body, not just from the primal Dani, but from all of these people who were trying to control her.

I needed to get up. I needed to get off my back and upright. I needed to find my voice and make these people all shut up and listen to me.

Another contraction and another push. This time my midwife cheered me on: “Push!!!!!” and I did, feeling the baby’s head start to crown, the burning that brought with it that all-encompassing need to keep pushing—only to have it all come to a crashing halt. The epidural kicked in, to block all sensation of the contractions.

The voices yelled at me to push, but the urge was simply gone. Along with the realization that my guide had disappeared came the awareness that I couldn’t breathe. “They” kept yelling at me to push, to lie back and grab my legs and pull them back…but I couldn’t find my centre, couldn’t breathe in the air deeply enough to get a full breath, couldn’t feel the contractions to cue me to push…I needed to get up. I had to get up, I tried to tell them to let me up…but they just kept pushing me back down and telling me to grab my legs…

“Tsk tsk tsk we missed another contraction.” “Dani, you have to push, the baby’s head is half way out!!! You have to push!!!”

HELLO?! I’m perfectly aware of exactly where the baby’s head is, thank you very much!!!!

I tried again to tell them that I couldn’t feel the contractions, that I couldn’t breathe…but the crowds drowned me out with their incessant commands and annoying nattering verbal diarrhea.

I reached down and felt the top of my baby’s head, and ran my fingers through the masses of soggy hair. Someone pushed my hand away and forced me to grab the back of my thigh. The human Dani sighed in resignation. They couldn’t hear me, they wouldn’t listen. I had no choice but to do it “their” way. So ignoring the roaring of the masses surrounding me, I breathed in as deeply as I could and P U S H E D.

The relief of his head coming fully out is one that every woman who has given birth can no doubt relate to. Again I reached down. I wanted to birth my baby. I wanted to grasp his slippery body as it came out of me, as we started our journey as two separate beings. I wanted to be the first to hold him. Then someone pushed my hands away again and forced them back to my legs. And so again I pushed as “they” ordered, and Baby Boobalumba was born.

Strange, but as soon as he was delivered onto my belly, the human Dani completely took over. I immediately reminded my midwife not to clamp the umbilical cord, and asked for a warmed blanket to put over both of us.

Once the cord was cut a few minutes later, my midwife asked me to push to deliver the placenta. At that point one of the nurses made a motion to press on my belly. I immediately slapped her hand away and told her No, then told my midwife that I did not want any cord traction applied. As the epidural was now firmly in place and I had no feeling at all, I concentrated on muscle memory and pushed…hard, delivering the placenta in one quick swoosh.

When one of the nurses tried to rub Boobalumba down with a towel, I pushed her away again. After that, no one interfered with me and the baby; no one tried to weigh him or measure him or clean him. They left me alone to be with my baby.

Now that clarity had returned, I could concentrate on him and interact with the people around me as a rational being again. I immediately started asking Nick for details and found out only then that Lynda had been kicked out of the room and he had run out into the hallway as soon as Boobalumba was born to grab her and bring her back in. He also told me that the nurses wouldn’t allow him to take a picture as our son was crowning. That made me so angry.

Oh, I was mad, really mad!!!

But on the surface I was able to enjoy the victory for what it meant to me personally: a validation that I was not broken. Though the birth had not gone even remotely as I had wished, and my birth plan was basically trampled on by galloping hordes, I did it.

Writing this down now, a little over a week later, I am able to verbalize many things that at the moment were just notes stored away for later analysis. The basic need for understanding and support for the VBAC mother. Support and care that are different from what other birthing mothers need.

My personal story is one of vindication of a VBA3C mom. We are not broken. We are perfectly capable of birthing our babies without the surgeon’s knife. My story will, I hope, inspire those that were there—the OB doctor, the labour & delivery nurses, my midwives—to realize that it is possible if only women are given the choice.

I wasn’t given the “choice.” I demanded that they allow it. I didn’t have their support or their understanding. I had to rely solely upon myself and my husband, knowing that if we wavered even for a moment, as we came so close to doing several times, we would be engulfed by the medical machine and processed as yet another number.

Sure, our birth is a number, but a very different and more important one: the first VBA3C in Cambridge Memorial Hospital (Cambridge, Ontario, Canada) and by the Cambridge Midwives Group. I hope that through my experience they will open doors to more VBAC mothers. I hope that my story inspires others to make choices for themselves and to learn from my mistakes and my victories. We can do it. But we have to fight for our rights and continue to fight to make changes so that other women will not have to fight the battle I did.