Gentle C-section

I thought this Q&A by Michel Odent at Mothering.com might be of interest.

Q: We now find ourselves preparing for a cesarean birth. We are wondering what things would be helpful to keep in mind/plan for/request in order to have the gentlest birth possible considering the circumstances.

A: The best way to deviate as little as possible from the physiological model of birth would be that the medical team is comfortable with the principle of an elective in-labor cesarean. In other words, the medical team would accept to wait until the day when you are in labor to perform an "in-labor non-emergency cesarean." This way it is a guarantee that the baby will have given a signal indicating that his or her lungs are mature. We know today that the baby participates in the initiation of labor. Furthermore, during labor contractions, the baby is exposed to hormones that make more complete the maturation of his or her lungs. This is why, as all pediatricians know, there is an increased risk of respiratory problems during the days following a cesarean performed before labor starts. And—we never know—if you have the possibility to be in labor with nobody around but an experienced, low-profile, and silent midwife, the birth might go faster than what you can imagine. Many women who gave birth by cesarean to their first baby because the pelvis was much too small give birth easily by the vaginal route to their second baby—if they are in a situation of absolute privacy.

~s~

How to handle your hospital's VBAC policy

I found this rather encouraging article at Mothering.com with suggestions on approaching your hospital about having a VBAC if their policy bans or discourages them. Here's an excerpt:

"It is illegal for a doctor or hospital to perform invasive surgery on you against your will. However, until more consumers begin challenging VBAC bans and demanding the right to labor and the right to attempt vaginal delivery, many of these draconian policies will remain in place. Research the studies available on both VBACs and repeat cesarean sections and consider your personal circumstances to determine which birth choice is most appropriate for you."

The article continues to suggest who you might contact and meet with to discuss the research and your wishes. There is also a sample letter.

VBAC stands for vaginal birth after cesarean, and you can read more about VBACs here and here.

I did a little research on the cesarean and VBAC rates of our local Logan Regional Hospital, and actually found some data! According to 2006 numbers, Utah's cesarean rate is only 9.9% overall. The rate of a first time cesarean at Logan Regional Hospital was 7.7%, and the VBAC rate at Logan Regional was 22.1% (which meant that 77.9% of previous cesareans had repeat cesareans). The Health Department webpage the describes these numbers plainly states that repeat cesareans have higher risks than vaginal births, but also recommends that a hospital should not offer VBACs if the facility is not capable of doing emergency cesareans in case the uterus ruptures. It's nice to know what the administration* thinks, that way you can talk to them in their language.

~s~

*edited to change "authorities" to "administration." I knew I didn't quite have the right word! We are our own authorities, right?!