VBAC(Vaginal Birth After Caesarean)I am regularly asked questions about VBAC (Vaginal Birth After Caesarean) and from what I can gather there is a lot of fear and mis-information around the traps about it. The Canberra women I have spoken to have been advised to have an elective Caesarean section for their future children. It appears that these women have been told that it is too risky to attempt a vaginal birth for their subsequent children (please note, I am working only on personal observation from people who contact me for advice and my observations are not to be construed as fact). This puts an a lot of unnecessary stress on the woman and may influence her decision whether to have more children in the future, if she wishes to avoid having surgery. So, why are some Canberra women being told that a VBAC is too risky when studies show that it is not? If the mother in question doesn't do her due diligence about the benefits and risks of having subsequent Caesarean sections, then she may never know that for most healthy and low-risk women with healthy and low-risk babies an attempt at VBAC birth is the preferred option as stated by the World Health Organisation (WHO). (The WHO recommends that baby-friendly hospitals encourage a 60% rate of VBAC attempt with a goal of 75%. P.54, WHO Baby Friendly Hospital Initiative, 2006).
Sidenote: In Thailand, the rate of Caesarean section is increasing at an alarming rate, and it has much to do with Private hospital care (click here to read more). What this report suggests is that if you can afford a private doctor or a private hospital in Thailand, then you have more than a 75% chance of ending up with a Caesarean section. This is not just happening in Thailand. With the previous Liberal Government pushing private health care membership to the Australian public by penalising people with higher Medicare levies if they don't have private cover, (and similarly private health care insurers charging higher levies if the customer does not take private cover by the age of 30) more Australian citizens now have private health cover which ultimately leads to a higher use of private hospitals and private doctors.
What Can You Do About It?1) In a nutshell, do your due diligence.2) Check that you are attending a "Baby Friendly Hospital". (This is a WHO initiative) 3) Check the Caesarean section rate at your chosen hospital or birthing centre. A general rule of thumb is that you will see a lower rate of caesarean section at a public facility than at a private one. If your birthing facility has a low rate of caesarean section (and the WHO recommends a preferred caesarean section rate of 10% or less for community hospitals and 15% or less for "high risk" hospitals, as at 2010) then you can feel confident that you will not be pushed into an unnecessary caesarean section. 4) Be aware that if you are attempting a VBAC, that induction of labour is contraindicated (that means it's not advised) due to the increased chance of your caesarean scar rupturing. I'd recommend that you talk to your doctor to ensure that he/she will not induce your labour unless it is medically indicated. Just because you may have gone overdue is not a valid medical indication to induce your labour unless you or your baby are also unwell. Many pregnancies go "overdue" - it is rare for a pregnant women to spontaneously go into labour on their estimated due date. 5) It is worth questioning your doctor to find out where he or she stands on the issue of VBAC. Sometimes, it is the fear of litigation which drives your doctor's opinion towards surgery over attempting a VBAC. Your doctor will take your previous birthing history into account when advising you of your options. If you have had previous pregnancy illnesses or are currently a "high risk" pregnant woman, then following your doctors advice is crucial. 6) Remember that you have the right and responsibility to change health care providers at any time if you do not feel supported by them, or if you feel intimidated by them. You are not bound to your health care provider. It is worth seeking a second or third opinion, especially if it seems that your doctor's advice is just their personal preference rather than their professional opinion. Ultimately the responsibility is upon you when you are making your birthing preferences and choosing your doctor and birthing facility. If you are informed, have done your own due diligence, have asked all the questions you need and have understood the responses, then you will be in the best position to make the right decision for you and to enjoy your birthing outcome, whatever it may be. A Caesarean section is not a walk in the park. It is major surgery and the recovery can be hard when you have a newborn baby to attend to. The drugs used can and do affect your breast milk, the baby's ability to breastfeed, and can have an effect on the baby's respiration. Studies have shown that Caesarean birth is associated with the alarming rate of asthma in childhood and increases the risk of hospital care in childhood for gastroenteritis. In addition, caesarean section has been studied for the risk of allergic disorders in childhood - allergic reactions which can cause anaphylaxis (suffocation). Just look at the number of schools which now ban certain foods because they have become deadly to children with allergies. 30 years ago when caesarean sections were performed primarily for emergency situations only, such allergies were rare. For the mother, a Caesarean section also increases the risks of maternal death, the need for blood transfusion and the risk of postpartum infection. A VBAC is an amazing experience and if you are well, you're baby is well and you are a low-risk candidate, then the WHO recommends that you prepare yourself for a vaginal birth. Doing childbirth education classes which promote a relaxed, calm birthing such as HypnoBirthing will greatly help you to birth your baby without exertion, and this in turn has the effect of reducing the risk of scar rupture and allowing birth to unfold naturally and as comfortably as possible. If you are unwell or baby is unwell, use your commonsense to decide your birthing outcome. Further reading about VBAC.A fantastic non-HypnoBirth Canberra VBAC story from Anne Bodorkos, Canberra mum of two.The International Cesarean Awareness Network - VBAC Page *Disclaimer* This information is not to be used as medical advice. Always seek the professional opinion of your health care provider and ensure that you properly understand their recommendation before making any decision which could affect your birthing outcome or the health of you or your baby.
Canberra Natural Birth
|
