This week, Lisa Malley, Executive Director of Choices in Childbirth (CIC), discusses the importance of knowing your childbirth choices — and fighting for the one you feel is right. This is especially true with VBAC (vaginal birth after cesarean), one of the most misunderstood birthing practices of today — it’s critical for mothers to be correctly informed.
When my friend Julie called to share the news that she was 12-weeks pregnant, I was delighted. Two weeks later, Julie called me on the brink of tears. She told me she was “fighting the world to have a VBAC” (vaginal birth after cesarean). This would be her second child, and unfortunately her first had been born via cesarean section. I listened as she vented her frustrations. Her doctor would “not allow” her to attempt a vaginal birth after a cesarean, her in-laws insisted that she was crazy to “put herself and her baby at risk,” and her husband was concerned and confused.
Julie had been diagnosed with placenta previa in her first pregnancy the year prior, thus causing her doctors to deliver her daughter via c-section. Despite the complications, she knew unwaveringly that she would have more children — she is one of 11 kids herself and has always dreamed of having a big family.
By the time Julie had called me, she was well-informed and knew the risks of repeat cesarean delivery, including:
- Higher risk of infection, adhesions, intestinal obstruction, chronic pain, ectopic pregnancy and placental problems —compared to mothers who have a successful VBAC
- Increased risk for hemorrhage severe enough to require a blood transfusion due to placental problems from accumulating cesareans
- Higher likelihood of being re-hospitalized for complications related to the surgery
- Decreased fertility and increased risk of miscarriage in future pregnancies
- Greater likelihood of difficulty with mother-infant attachment and breastfeeding
- Elevated risk for prematurity and serious neonatal respiratory problems in baby
Julie bravely decided that she would not give up. With the support of a birth doula and a new (and carefully selected) medical team, she quieted those voices, listened to herself, trusted her body and her instincts, and had a beautiful, natural vaginal delivery. Six months ago, Julie gave birth her third child — a baby boy born at home, assisted by her trusted midwife and doula, and surrounded by the love of her husband and two beautiful daughters.
Luckily for mothers like Julie, there have been some recent and significant shifts in policy around VBAC that are breaking down the surrounding barriers and misconceptions. In March 2010, the National Institutes for Health organized a conference and convened a panel of experts to discuss the current evidence related to VBAC. The panel drafted a statement based on scientific evidence presented in open forum and on published scientific literature. The American College of Obstetricians and Gynecologists (ACOG) recently released newly revised practice guidelines that encourage expanded access to VBAC, and confirm a woman’s right to labor after a prior cesarean.
Julie is just one of the many women who have fought for their right to a VBAC, and thankfully the efforts of these women have not gone unnoticed. The ACOG’s revised guidelines — along with continued education about VBAC, are a few steps in the right direction for mothers everywhere. These advances can only give us hope that the future holds a new and optimistic outlook on childbirth, free of the fears we carry today.
Choices in Childbirth (CIC) is a nonprofit organization that strives to improve maternity care by helping women make informed decisions about where, how and with whom to birth. Through education, outreach and advocacy, they provide information to the public about women’s rights and options in birth. Choices in Childbirth is excited to announce the launch of their Guide to a Healthy Birth Online Provider Network. The goal of the Provider Network is to connect parents with providers who share a similar philosophy of birth, and who will respect and support a woman and her family during pregnancy, birth and postpartum. By simply entering a zip code on the Web site, parents can instantly find all the participating Mother-Friendly care providers in their area.
Lisa Malley, executive director, joined Choices in Childbirth in October 2009. With nearly ten years of nonprofit experience, Lisa brings extensive fundraising background to the position and a strong dedication to women’s health. Her professional experience ranges from reproductive health and rights organizations — including Planned Parenthood Federation of American and the Alan Guttmacher Institute — to university fundraising at Columbia Law School. She has a B.A. from Indiana University, and received a Master’s degree in nonprofit management from Milano Graduate School at the New School University. Lisa lives in Cobble Hill, Brooklyn with her husband, Adam.
Mother’s Advocate wants to know what your opinions are about the guidelines surrounding VBAC — leave a comment below telling us what you think!