International Cesarean Awareness Network

Education, Support, & Advocacy for Birth Justice & Healing

She Wants a VBAC, But Her Partner's Not So Sure

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ICAN’s Education Director Krista Cornish Scott has published an article on About.com called, “Planning a VBAC When Your Partner’s Isn’t Sure.” Krista provides tips for dealing with this situation such as acknowledging fear, asking your partner to listen to how your cesarean affected you, and approaching your partner with their learning style.

Krista writes, “Getting your partner to understand or at least be supportive of your birthing plans, whatever they are, can reduce a great deal of prenatal stress. Trying these tips can help open the door to better communication as well as a better birth for the entire family.”

Read the full article here and share it with women you know who might need these valuable tips!

Best of the Birth Blogs – Week Ending August 1st

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Your weekly one-stop for highlights from the birth blogosphere. Visit weekly for the latest on childbirth, especially related to cesarean prevention, recovery, and VBAC. To nominate a blog post to be featured here, email me at blog@ican-online.org.

Birthing Beautiful Ideas is on a roll, with another great post this week, this time on the pros and cons of birth plans.

Molly at Citizens for Midwifery shares a thoughtful reflection on why it’s important to care about birth, even if many birthing women don’t seem to.

Kathleen Kendall-Tackett takes on the question of whether telling women not to breastfeed overnight is good advice in combating postpartum depression on Science & Sensibility.

Finally, Patti Ramos posted this beautiful picture of the birth of a father.

Best of the Birth Blogs – Week Ending June 20th

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Your weekly one-stop for highlights from the birth blogosphere. Visit weekly for the latest on childbirth, especially related to cesarean prevention, recovery, and VBAC. To nominate a blog post to be featured here, email me at blog@ican-online.org.

Note: The “best of” blog will be on hiatus next week due to a family vacation without (gasp!) internet access.

Don’t miss the sixth (and final) Healthy Birth Blog Carnival: MotherBaby Edition posted on Giving Birth With Confidence. This carnival focuses on keeping moms and babies together immediately after birth and features several posts that deal with the issue of skin-to-skin contact after cesarean birth.

Given that today is Father’s Day in the U.S., we loved this post from Cesarean Parent’s Blog on dads and birth, which touches on several important topics, including dads in the OR.

Enjoy Birth Blog linked to this story of a doula’s VBA3C.

Finally, ACOG was the focus of much discussion the blogosphere this week, including a post on Our Bodies Ourselves outlining how two articles in the latest issue of Obstetrics and Gynecology, ACOG’s flagship journal,  provide some hope for change in their VBAC guidelines. On the flip-side, several bloggers pointed out ACOG’s attempts to blog access to midwives in New York, including Jennifer Block and Stand and Deliver.

CAM Birth Story #12: Poppy's Breech Birth (Dad's Perspective)

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In honor of Cesarean Awareness Month 2010, we will be filling the blogosphere with stories from real women (and their families) who know first-hand the consequences of a 32% cesarean rate. Each day we will post at least one birth story submitted by these women. Prepare to be moved (hint: grab a box of Kleenex)!

This morning, we posted Poppy’s Mom’s version. Here’s what Dad has to say about her birth:

So Tuesday morning, Julie wakes me with “I think my water broke”. We looked and it was the case. Now, being over three weeks before the due date, we weren’t quite ready. So we all ran around the house packing bags and preparing. An hour later the four of us piled into the car and went to Julie’s OB.

Once there, Julie is examined and her midwife says, “I don’t think that’s a head.” We check and yep, the baby has settled in breech position. Our options are to have an immediate C-section or to drive across town to the one doctor in Atlanta who does inversions and breech births. Back into the car we go at a trot. We drop off the kids with our excellent friend Jody because stuff is about to get REAL.

So we drive over to Dr. Tate, an older OB, Orthodox Jewish as they come, an odd bird at that. I like him right away. We talk to him for a bit and ask (kind of beg) him to take us on. He acquiesces, somewhat (understandably) grudgingly. From here, it’s the hospital with a short detour to pickup Julie’s mom and sister (just arrived) and grab a bite to eat. Julie has a big bowl of mushroom soup – it’s the last food she’ll eat for 28 hours.

We arrive at the (new) hospital and check in. We get a room and hang out for a bit. And then a bit longer. And a bit longer. After a few hours hanging out, Julie calling all her local mamas for support, me trying to be helpful, Dr. Tate comes in and checks up. Julie is not far along in labor, not progressing much at all. We talk options and decide to wait a bit longer. He heads out and I take Julie’s sister Samantha to her car. This is so she can pick up the boys from Jody’s and take them home. Julie figures that her boys not being home is making her worry, thus preventing labor from starting. I come back and a long night starts.

I won’t go into the details too much. Suffice to say that after a few minor interventions (Cytotec(!) and Pitocin, no pain killers) and a brief meconium scare, we arrive at 9:00 in the morning. Julie’s contractions have gotten tighter but she’s “not quite there yet”. Then she get the urge to push and everything happens really fast. The baby goes from “not quite there” to “about to come, fo’ realz” in no time flat. Doc T does not want to deliver breech in the labor room – we need to transfer to an OR, stat! but the baby is coming fast. What to do?

Did you ever see Terminator 2? That scene where the robot is on the hood of the car as it careens madly down the highway? That is what happens next, as Julie is wheeled into the OR, with Doc T kneeling on the end of the bed literally holding the baby in, yarmulke flapping in the breeze. This guy is a hero.

We all arrive in the OR (me newly be-scrubbed), and out pops Poppy, bottom first. Julie then has to deliver the head which takes a second. Poppy is pulled over to a table and is worked on by a NICU team. She then has to go off to the NICU and I, after checking that Julie is OK, follow.

Again, the details are tedious and I won’t go into them. Leave it that Poppy turns out OK. She has just been delivered to our room after a full day in the NICU and we are a family of three. Tomorrow we upgrade to a family of five, as we get to go home around midday. And so, a new adventure begins.

Guest Blogger: Spinning VBAC Babies

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Bringing ICAN’s 25-year-plus tradition of support and education in the mother-to-mother and sister-to-sister model into the internet age, we have invited passionate bloggers to join us around our virtual circle of women. We hope to introduce you to new voices that you have not heard before, and also to respected voices that will already be well-known to you.

This week we welcome our guest blogger Gail Tully (“The Spinning Babies Lady”). Gail is a midwife and doula trainier in Minneapolis, MN. Her website, Spinning Babies, makes the principles of Optimal Foetal Positioning accessible and understandable in order to promote easier labor.

After any birth, a dad may sit and look a little stunned. But the look on Steve’s face lives with me still. There was joy and the flood of relief, an element of wonder, awe and just a bit of indignation ….

His wife, Sara, held their hour-old second child, skin-to-skin, at her breast. A glow of triumph highlighted Sara’s calm satisfaction. Their 2-year-old had been born by cesarean surgery after a long pushing stage with no descent. His asynclitic head was angled into the pelvis as if he’d tipped his head to listen to voices beyond the womb. After 14 hours of active labor, a cesarean was done at 7 cm.

Steve’s daughter, just born at home, also presented with an asynclitic head position. Again, labor seemed to stall. This time we midwives had a suggestion. Sara was willing to try something unusual.

She stood up and faced her midwife with her hands on each of her midwife’s shoulders. When a contraction was anticipated, she put her right foot up on a chair. As the contraction actually began, she continued to look forward at her midwife but also leaned towards her right knee.

Her posture reminded us of its namesake, the Lunge. Popularized in the birthing world by Penny Simkin, author and physical therapist, the Lunge opens the mid pelvis and outlet on the side of the raised knee. The lunge may be able to atone for asymmetry in the opening of the pelvic floor. If the baby’s head doesn’t straighten out, the Lunge may make more room for the tipped head to emerge.

I asked Sara to Lunge through three (3) three consecutive contractions with her right knee raised, and then switch sides and do 3 contractions with her left knee raised. In between contractions, she stood with both feet on the floor and swayed a bit to return good circulation to her legs. Opening the pelvis and letting the head move down past the place of constriction can take 12 contractions for a first time mom, but for Sara it actually took only 5 contractions.

Suddenly, Sara’s voice changed. She felt more comfortable. Some women will then birth quickly. In Sara’s case, she just wanted to rest. A quick check verified a symmetrical (even) head, but a rim of cervix remaining. We suggested she rest without pushing to let the head come down gradually and in this new symmetrical position. Yes, she could have pushed as a second time mother and “reduced” the rim with the pressure, but there may have been a chance the head would again tip as the soft tissues were not used to holding the head evenly yet. She panted away her urge to push until her body insisted beyond her ability to postpone pushing. It seemed to be the right thing for her baby.

An hour later we midwives heard the new sound we were waiting for. Soon, Sara’s daughter was born, imprinted with the triumph of the Lunge.

Steve caught my glance. “Fourteen hours of labor and we got a C-section, and now five lunges and we get a home birth?!”

The asynclitic baby presents unexpected challenges at birth. Recognizing an asynclitic presentation is not as “easy” as recognizing a breech, for instance. For one thing, the baby’s head is supposed to be asynclitic at the start of labor. It isn’t until after 3 cm that the head descends lower than the sacral promontory and straightens out. That is, if the pelvic floor is symmetrical and allows the birth to proceed as nature intended.

Achieving a VBAC may involve addressing any challenges that the soft tissues (muscles, ligaments and fascia) brought to the previous birth. When length of labor or fetal position was one of the factors in a previous cesarean, an asymmetry can be suspected. Come visit at www.SpinningBabies.com for VBAC support through fetal positioning.