Cesarean Awareness Month: Why is it so hard to get a vaginal birth?

April is Cesarean Awareness Month. You may wonder why an entire month needs to be devoted for raising awareness about c-sections. Here’s why. The c-section rate in the United States is on the rise at an alarming rate. It’s estimated that in 2008 over 1.3 million babies in the US were born by c-section, accounting for 32.3% of all births. It also marks the 12th consecutive year the Cesarean birth rate has risen, despite a number of medical organizations — including The World Health Organization (WHO) and American Congress of Obstetricians and Gynecologists (ACOG) — urging medical care providers to work on lowering the Cesarean birth rates and increase access to Vaginal Birth after Cesarean (VBAC).

Cesarean Awareness Month - April

My Gentle Birthing Blog discusses that while VBAC is often suggested as an option to a woman who has had a c-section, in reality, VBACs are hard to come by due to the fact that many hospitals no longer allow them.

According to the National Center for Health Statistics, the C-section rate in the United States has risen 53% since 1996. Cesarean birth is being overused, and VBAC (Vaginal Birth After Cesarean) is being grossly underused, at about 8%, because many hospitals are outlawing VBACs. Because of bans on VBACs, women have been denied access in over 40% of hospitals in the United States. The National Institutes of Health has found that VBACs are reasonably safe for women who had a previous cesarean birth and are low risk for uterine rupture.

Andrea Owen says, “Fighting for my own VBAC has changed my life. I don’t use that term very often, only when I truly mean it. It opened my eyes up to the world of American obstetrics, and how far we’ve come away from birth as a natural process. In my opinion, we’ve shoved a big, fat middle finger in Mother Nature’s face.”

And in the sometimes the truth is stranger than fiction category, the Keyboard Revolutionary wants to know how it is that “a woman can waltz in off the street, say she’s pregnant and wants a Cesarean, and everyone leaps to her command….yet a woman who IS pregnant has to jump through hoops and fight tooth and nail just to give birth vaginally?” Yep, in 2008 in Fayetteville, NC, a woman who was NOT even pregnant was given a c-section.

So how can a woman avoid a c-section in the first place? Knowledge is power. Here is a list of Five Essential Questions to ask your care provider. My Gentle Birthing Blog also has a list of the risks with cesarean birth as well as a list that might help you avoid having your first c-section.

On Live Your Ideal Life guest blogger Pamela Candelaria who writes over at Natural Birth for Normal Women discusses the risks of a c-section as described on a typical consent form and says, “what isn’t on the form may be surprising.”

Heather of A Mama’s Blog provides a lot of information about The Reality of C-sections.

And Breastfeeding Moms Unite posted What to Expect of Your Body after a C-section.

Bellies and Babies has a great round up of posts in honor of Cesarean Awareness Month.

There is one victory worth celebrating regarding Cesarean birth and women’s health in general. Thanks to the Health Care Reform, c-sections, giving birth and domestic violence can no longer be considered pre-existing conditions and used to deny insurance coverage. It’s a step in the right direction, but so much more needs to be done to lower the c-section rates and allow women access to VBACs, so that they don’t have to travel 350 miles just to have a vaginal birth. And that’s why an entire month is needed to raise awareness about cesarean sections.

Additional resources:

Photo credit: Flickr – Grendellion

Cross-posted on BlogHer

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Got breast milk to spare? Denver milk bank is in desperate need.

The freezers are nearly empty at a Denver milk bank, which is experiencing its lowest supply ever in the bank’s 25-year history. The Mother’s Milk Bank at Presbyterian St. Luke’s hospital is one of only 10 milk banks in the country that collects breast milk from mothers across the country and delivers it to sick and premature babies. The shortage has been due in part to a rough flu season and an increased need from hospitals and parents seeking breast milk.

If you are wondering in this day and age, with formula readily available, why milk banks are so important, there’s information in this Breastfeeding.com article, Banking on Breast milk. The majority of milk from the milk banks goes to babies who are sick or need milk because of medical conditions such as formula intolerance or feeding issues related to prematurity. Unlike formula, breast milk contains immunologic properties to help fight infection and illness.

Milk banks exist because many babies will not thrive without human milk. Infants with failure to thrive (FTT), formula intolerance, allergies and certain other medical conditions may require real human milk for health and even for survival.

A typical candidate for donor breast milk might be a formula-fed infant that exhibits prolonged episodes of inconsolable crying, ongoing vomiting and classic allergy signs such as purple or black circles under the eyes, pallor, skin inflammation, lethargy and frequent or bloody stools. Another typical candidate might be a premature infant whose mother cannot (or cannot yet) supply breast milk.

All donors to Human Milk Banking Association of North America (HMBANA) member milk banks undergo a screening process that begins with a short phone interview. Donor mothers are women who are currently lactating and have surplus milk. Donor mothers must be:

  • In good general health
  • Willing to undergo a blood test (at the milk bank’s expense)
  • Not regularly using medication or herbal supplements (with the exception of progestin-only birth control pills or injections, Synthroid, insulin, pre-natal vitamins; for other exceptions, please contact a milk bank for more information)
  • Willing to donate at least 100 ounces of milk; some banks have a higher minimum

The Denver milk bank welcomes donors both local and out of state
For donating mothers who don’t live near Denver, the milk bank ships supplies and a box with dry ice to mail the milk. Mothers are not paid for donating. Also, the HMBANA milk banks will often loan pumps to donor moms if they don’t have one of their own.

I donated milk to the Denver milk bank when my son Julian was a baby and had previously donated to a local mom directly when Ava was a baby. I’ve been blessed with a plentiful supply and was happy to do what I could to help others. Although I wasn’t able to collect as much as I had hoped, it all adds up.

Brandie also pumped her milk for the Iowa milk bank. She describes the process she went through when she donated nearly 400 oz.(!!) to the milk bank in 2003. As she packed up the cooler to mail her milk in, she couldn’t help but get emotional.

I was sending a piece of myself off in that cooler. Lots of hours of pumping (or at least what felt like lots of hours). I cried. As silly as that sounds, I did. I thought about how that milk might go to feed another baby and help another family – who for whatever reasons needed breast milk for their baby and couldn’t provide it themselves. I thought about how when so many around me thought breastfeeding your own baby was gross, disgusting, something only to be done behind closed doors where no one would have to actually see it, there were people out there who so firmly believed in it that they would use my milk to feed their babies.

Jodi, Milk Donor Mama, and Cate Nelson have all been milk donors too.

Emily from Et Cetera recently found herself with a surplus of pumped milk. As her freezer stash grew, she began to get concerned that it would expire before it was consumed. That’s when she learned about breast milk banking. She’s signed up to be a donor and encourages others to as well. “Why let your extra breast milk go to waste? Share it with a baby who desperately needs it. And even if you can’t donate, you can get involved. The more people know about milk banks, the more babies will thrive.”

A doctor’s prescription is required to receive breast milk from a HMBANA milk bank.

Deanne Walker of Colorado Springs received donor milk from Mother’s Milk Bank at Presbyterian St. Luke’s hospital for her twin boys who were born 10 weeks premature. In addition to the babies being born early, Deanne had several infections which dramatically affected her milk supply. I spoke with Deanne via email where she pointed out the importance of breast milk for preemie babies.

When babies are born prematurely the mother’s milk is different – it’s called super preemie milk loaded with even more protein, antibodies and dense nutrition than regular breast milk. Preemies need the extra nutrition because their digestive tracts are not fully developed, they are so small and need to grow more rapidly, and also because they are so much more prone to infections in those early weeks. Formula just cannot deliver the nutrition and antibodies provided by nature.

Deanne is thankful for the donor milk her now thriving 3 1/2 year old sons received until her supply was established enough to provide full feedings for them, but wishes it was covered by her insurance like formula was. (Note: Medical insurance sometimes covers the cost of donor milk when there is a demonstrated medical need for the milk on the part of the infant.) She and her husband had to cash in their retirement account to pay for the milk. The cost of breast milk from the Denver milk bank is currently $3.50 per ounce (which covers the donor screening, processing of the milk, etc.), which adds up very quickly especially when feeding more than one baby.

Please see the information below if you have breast milk to spare and would like to help babies in need. Or if you are looking for a worthy place for your tax-deductible donation, please consider making a donation to a milk bank. The HMBANA milk banks are non-profit organizations and depend on community and private donations to keep the doors open.

Information on donating or receiving breast milk:

Edited on 1/26/10 to add:
This morning the United States Breastfeeding Committee released a statement and urgent call for human breast milk for premature infants in Haiti. The first shipment is getting ready to go out to the U.S. Navy ship Comfort. You can read the entire statement and find out how you can donate by reading Give Them Roots blog about it: URGENT: Milk Donations for Haiti Infants. Thank you!

Cross-posted on BlogHer.

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Birth plan? Doula? Natural birth? Not here you don’t.

A sign posted at the Aspen OB/GYN Women’s Center in Provo, Utah has many women up in arms. What’s so offensive? Read for yourself.

The sign reads as follows:

Because the Physicians at Aspen Women’s Center care about the quality of their patient’s deliveries and are very concerned about the welfare and health of your unborn child, we will not participate in a “Birth Contract”, a Doulah Assisted, or a Bradley Method delivery. For those patients who are interested in such methods, please notify the nurse so we may arrange transfer of your care.

I first learned of this sign from Naomi, the Denver Doula, who posted it on Facebook. Being a doula (which is misspelled on the sign) herself, she took a particular interest in it. When she called the Center and inquired with the receptionist as to why the sign was posted she was told, “in case there is an emergency we don’t want anyone to get in the way of the doctor doing what he has to do.”

Annie from PhD in Parenting was inspired by the sign to write How Not To Have a Natural Birth and believes the center might as well have said:

Because Physicians at Aspen Women’s Center care only about doing things their own way and making as much money as possible from unnecessary birth interventions, even if it poses greater risks to the welfare and health your baby, we will not participate in a “Birth Contract”, a doula-assisted, or a Bradley Method delivery. For all patients who have done any research into having the safest birth possible, please notify the nurse so that we can transfer you to a facility that cares less about control and money.

Annie added, “I guess we can at least credit them with warning women in advance. Many hospitals with the same attitude don’t have a sign hanging out front.”

Amber responded, “I always thought the big ‘trust birth’ poster in my midwives office was a little cheesy. Now that I’ve seen the alternative, I think it’s truly marvelous. Really.”

Miriam Zoila Pérez of Radical Doula wrote a post called Signs You Don’t Want to See at Your OB-GYN’s Office. She believes the sign could be translated to say:

We don’t care at all what you want as a parent, or a person in labor. We want a patient who will sit quiet and do what we say–no matter what. Oh and if you have a partner you want involved, tough. Your desires don’t matter.

Miriam adds, “They should change the name of the center to the ‘Unborn Children Center’ since they don’t seem to care too much about the women involved.”

A commenter named Janna responded saying, “That’s what bothered me most about this hateful little sign–not once is the “welfare and health” of the MOTHER mentioned, just the “welfare and health” of the “unborn child” and the “quality” of the “deliveries.” Who would want to give birth in a place where they’re the lowest priority on their caregiver’s list? I hope women in this area have other options and the opportunity to have safe, healthy, supportive births.”

Does no doula, Bradley Method birth or birth “contract” equal no women’s rights?

Summer who writes at Wired for Noise says signs like this one and stories like the lack of choice with regard to our reproductive health and doctors’ personal “birth plans” make her sometimes think Doctors Hate Women.

What does it say when women have to escape, have to run away in order to do something as normal as give birth? What does it say when women are treated like children, talked down to, insulted, lied to, and handed letters telling them what the god-head doctor will allow or not allow. When all you want to do is give birth and you’re doctor is more concerned with telling you to sit down and shut up, what is that if not hatred?

I have to agree with Annie that at least some doctors are upfront with what they will and won’t “allow” as part of their practice. Kudos to them for being honest. Hopefully that will allow women to look for another care provider while she’s still early in her pregnancy.

Rest assured if the OB/GYN I had at my daughter’s birth would have given me a piece of paper with her “rules” or had a sign posted like that at the Aspen Women’s Clinic, I would have found another care provider pronto. Instead, however, she paid me lip service and acted like she cared about my birth plan (though she didn’t act very well and that should have been a big clue for me) and said we could “try” Hypnobirthing, etc. However, when push came to shove (no pun intended), it was her way or the highway. I had my healthy baby girl at the end of it and for that I am truly thankful, but I also got a lot more than I bargained for (and not in a good way). Then again it was that experience lead me to pursue a home birth for my second child and become a home birth advocate.

Although I admire the Aspen Women’s Center’s honesty, I find it truly offensive that they imply that if a woman wants a doula, natural birth, or has a birth plan, she is not concerned with the welfare and health of her baby (so much more personal than “unborn child” don’t you think?) or is even putting her baby’s life at risk. Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily. And how exactly is choosing a Bradley birth not good for the health or welfare of the baby? “Bradley® classes teach families how to have natural births. The techniques are simple and effective. They are based on information about how the human body works during labor. Couples are taught how they can work with their bodies to reduce pain and make their labors more efficient.” What about a birth plan or “contract?” Is that harmful to the “unborn child?” The American Pregnancy Association suggests, “Creating a birth plan can help you have a more positive birth experience.”

There are other things I find offensive as well, like Janna mentioned above, the mother does not seem to be included in the equation at all. Is there any concern for her “welfare and health?”

Who’s time money welfare are they really concerned with? I’ll let you draw your own conclusions. I’ve obviously already drawn mine.

Cross-posted on BlogHer.

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The event that changed my life forever

Five years ago today my life experienced a dramatic change – for the better. It was five years ago today, with the birth of my daughter Ava, that I became a mother.

It’s amazing to me how something like becoming a mother can be such a profound experience, but I really feel that I wasn’t able to fully discover who I was until that life-changing event. That’s not to say that the moment my daughter was born a lightbulb went off over my head and I knew my purpose in life, but being a mother has caused me to experience life and think about things in ways I don’t think I would have been able to otherwise.

The past five years have been enlightening, maddening, exciting, challenging, amazing, frightening, hilarious, beautiful, heart-wrenching, and joyful – sometimes all at once! Motherhood is unlike any other experience I’ve ever had and I am so thankful I am able to be a part of it.

A couple days ago I was rereading a journal I kept before Ava was conceived. There are only a few entries in it, but this one in particular, from Aug. 31, 2003, stood out. I don’t know if I’ve mentioned this on my blog before or not, but Jody and I did not have an easy time conceiving her and actually had to have a little help via the IUI (intrauterine insemination) route. I wrote about my sadness and wanting so badly to be pregnant, to have that experience of being a mother.

“I am so looking forward to nurturing, teaching and sharing our lives and the world with our child(ren). I am looking forward to that first smile, the first laugh, the first step, the first words, hearing “I love you, Mom” and absolutely everything else that goes along with it.

I know I will never take my child for granted.”

Rereading that journal entry was a good reminder for me of how hard we fought to get Ava in our lives in the first place. And even though being a mother can be very challenging at times, it is also so rewarding and something I wouldn’t trade for the world.

I feel so fortunate that I have been able to experience all of those “firsts” not once, but twice with both Ava and Julian. Motherhood is an incredible gift and I feel so blessed to get to experience it.

Thank you, Ava, for making me a mom and getting me started on a path of self-discovery I may have missed out on otherwise. I am a better person because of you. I hope your birthday and year are filled with as much magic and wonder as you bring to my life every day. I love you.