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A Woman’s Guide to VBAC: Navigating the NIH Consensus Recommendations

September 7, 2010 By A Woman's Guide to VBAC 1 Comment

In June 2010, a National Institutes of Health (NIH) panel published a Consensus Development Conference Statement on vaginal birth after cesarean (VBAC).

In addition to examining the current evidence related to VBAC and offering recommendations for future research on this topic, the NIH panel concluded that VBAC was a “reasonable option” for most women with a previous cesarean section.

In the context of a current birth climate that can be somewhat hostile toward VBAC, this was an exciting moment for many birth advocates, maternity care providers, and mothers!

But even with all that is included in the NIH Statement on VBAC, it might be difficult for many of us to wade through the information in it and figure out what it means for us and our particular birth options and unique circumstances.

This is where the guide comes into play.

A group of maternity care experts and VBAC advocates came together to address the most common and pressing questions women may have about their birth choices in what could be called the “post-NIH-Consensus-Recommendations Era.” We hope this guide gives you the tools you need to empower yourself to advocate for you, your baby, and your birth choices!

 

The sections of A Woman’s Guide to VBAC

 

The Inspiration for this Project

The concept for this guide was borne out of many things: the timeliness of the NIH panel’s statement on VBAC, the importance of the statement itself, and our personal interest in advocating for women seeking vaginal birth after cesarean.

But we would be remiss if we didn’t acknowledge another source of my inspiration for this project: namely, the heartfelt and heartening consumer participation in the NIH Consensus Development Conference on Vaginal Birth After Cesarean.

As women who were lucky enough to attend the NIH Consensus Conference on VBAC in person (Kristen) or view the entire proceedings in real time by webcast (Amy), we can say with some certainty that consumers – that is, the mothers, doulas, midwives, nurses, doctors, and other birth advocates who traveled from near and far and volunteered their time to attend—played a big role in this conference!

We listened, we read, we talked with one another, we got the word out to women who couldn’t participate in the meeting, and we asked some of the most incisive questions of the entire conference proceedings.

Quite simply, we made a difference.

This guide is dedicated to those consumers—and to all of us who are maternity care consumers, whether we are currently pregnant, have been pregnant, or simply work and advocate on behalf of pregnant women.
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What exactly is a National Institutes of Health Consensus Development Statement?

This statement is the product of an NIH Consensus Development Conference. These two-and-a-half day conferences—which are free and open to the public—are organized by the NIH to address issues in medicine that are both controversial and pertinent to health care providers and the general public.

During the NIH Consensus Development Conference on VBAC, an independent panel listened to presentations given by invited expert speakers. The panel also heard input from members of the general public during Q&A sessions. Finally, drawing upon the conference proceedings and upon a systematic review of the evidence on VBAC, the panel drafted their statement on VBAC.

Like all Consensus Development Statements, the statement on VBAC is not legally binding. It does not create practice guidelines, nor does it establish any health policies. Nonetheless, it is still an exceedingly important document. In fact, because of the high-quality evidence that the NIH panel uses to create consensus development statements, the NIH claims that it is “reasonable to expect that the panel will be able to give clinical guidance” to care providers.

Filed Under A Woman's Guide to VBAC, Birth, Birth plans, Choosing a care provider, Featured Post, Pregnancy, Preparing for VBAC Tagged With A Woman's Guide to VBAC

A First Timer’s Experience with Childbirth Class

September 1, 2010 By Cara Terreri 2 Comments

Today’s post is a guest post interview with Ann Romero, a new mom and staff member at Lamaze International. She shares her experience with taking a Lamaze childbirth education class as a new mom-to-be.

Why did you decide to attend a childbirth education class?

As a first-time mom, I didn’t know what to expect. I wanted to take a class to help prepare my husband and myself. The last thing I wanted to feel was anxious or nervous – I just wanted to be focused on meeting my baby.

Why did you choose a Lamaze class?

The main thing that attracts me to Lamaze is the Healthy Birth Practices; they are so simple and so natural. I did not want to go in to the hospital on birth day and follow blindly whatever a doctor or nurse said just because they are professionals — I wanted to be an informed woman. I have always been like that; my dad always told me that I started asking why to everything as soon as I could talk. To me, Lamaze was all about educating yourself to make the best decisions for you and your baby and that made me feel comfortable. I also did not want to have to learn a technique; I wanted something that would come naturally and relax me.

What was the format of your classes?

I took a class one evening a week for 2.5 hours for a period of 4-5 weeks. I took my class thru the DC chapter of Lamaze.

What were your impressions of the first class?

Our class only had four other couples, so it was very intimate. I didn’t know what to expect, but our instructor involved the dads first. She got them to talk about their fears and expectations. Listening to them talk made me and I’m sure the other moms feel more relaxed and free to voice our feelings as well. Being 7 months pregnant when we took the class, I really liked the relaxation exercises and massages we practiced too!  

Talk about some of the more notable details of your class.

The one thing I noticed is that we were all first time parents. One of the first questions the instructor asked was if anyone was planning to take advantage of the pain relief options at the hospital. She was not judgmental, but rather let the course information present itself to help women make their decision. All of the moms present at the beginning of the course were planning on getting an epidural because of their perception of childbirth. I remember one of our classes had to be rescheduled because our teacher was also a doula. She came to class the next week and told us about her client’s birthing experience. She told us the client was moving around during labor and trying different positions – several of the moms didn’t even know that was possible. At the end of the class, two of the moms decided to find a midwife instead of continuing to see their ob/gyn and one mom decided to find a hospital that would allow a water birth.

How have your emotions and thoughts and the way you feel about childbirth changed after taking the class?

For some reason, when people see that you’re pregnant, they decide to tell you about their labor experience and of course, they are all scary stories of people laboring for days with 4th degree tears! So naturally I was very nervous about giving birth, and I didn’t think I could do it. That fear is what drew me to take a childbirth education class.

During the class, the teacher made it seem like birth wasn’t so bad. That was the first time anyone described birth to me that way. She showed us a video where a woman was laboring at home but was sitting on the floor watching TV with her husband – she was so relaxed! Nothing like the movies! I was starting to feel like, “I can do this!” The class left me wanting to educate myself even more! I searched for more videos, blogs and articles on natural birth and the more I learned, the more natural it seemed. It seemed like the only way to go and made me wonder why people were not exploring this option more. I came across one woman’s blog who had her natural birth with her family and friends present and after the baby was born, they celebrated with champagne. She looked so happy in the pictures, even while she was pushing I didn’t see pain in her face, but rather determination. I knew that was the experience I wanted!

Filed Under Birth, Birth plans, Childbirth education, Choosing a care provider, Featured Post, Healthy Birth Practice, Pregnancy Tagged With childbirth class

Coming Soon on the Blog: A Woman’s Guide to VBAC

August 30, 2010 By Cara Terreri 4 Comments

Even with all of the information that is included in the recent National Institutes of Health (NIH) statement on VBAC, which says that VBAC is a “reasonable option” for most women with a previous cesarean section, it might be difficult for many of us to wade through the information and figure out what it means for us and our particular birth options and unique circumstances.

To address these concerns, Lamaze along with a team of midwives, obstetric research experts, mothers, doulas, lawyers, and healthy birth and maternity care advocates developed A Woman’s Guide to VBAC: Navigating the NIH Consensus Recommendations. The Guide, which will launch next week right here on Giving Birth with Confidence, will cover: 

  • What all of the technical terms in the statement actually mean
  • How to analyze the risks and benefits of VBAC and repeat cesarean delivery
  • Putting the risk of uterine rupture into perspective
  • Contacting your local hospital to find out their VBAC rates and policies
  • Advice on how to discuss the NIH Statement and its recommendations with your care provider
  • Other questions about the NIH Statement on VBAC

A Woman’s Guide to VBAC may be just what you need to empower yourself to be an advocate for you, your baby, and your birth choices!

Filed Under A Woman's Guide to VBAC, Birth, Birth plans, Choosing a care provider, Pregnancy, Preparing for VBAC, Recent Posts Tagged With A Woman's Guide to VBAC, VBAC

Have You Taken The Birth Survey?

August 25, 2010 By Cara Terreri Leave a Comment

Have you heard about The Birth Survey? It’s an ongoing, online maternity care survey that provides a place for women to give feedback about their birth experiences with specific doctors, midwives, hospitals and birth centers. The feedback is then made available in a searchable online database that provides resources to help other women and families to make more informed choices when choosing maternity care providers and birth settings.

 

The main goal behind The Birth Survey is to provide access to information that will help women of childbearing age choose maternity care providers and institutions that are most compatible with their own philosophies and needs. The survey was created by the non-profit organization, the Coalition for Improving Maternity Services (CIMS), a coalition of individuals and national organizations with concern for the care and well-being of mothers, babies, and families. The CIMS mission is to promote a model of maternity care that will improve birth outcomes and substantially reduce costs.

 How great would it be to have access to feedback and information on all of the hospitals, OBs, midwives and otherwise through just a few clicks? The Birth Survey is currently in the building process with its database, which means YOU need to go and take the survey to help make it complete! The survey takes about 30 minutes to complete, and you have the option to save and come back to it later.

Here’s what else you’ll find at The Birth Survey:

  • Survey results in the way of ratings for doctors, midwives, hospitals and birth centers
  • Intervention rates by state for hospitals and birth centers
  • State by State links to info on the health of mothers and babies and access to VBACs
Filed Under Birth, Birth Center, Birth plans, Choosing a care provider, Health and well-being, Healthy Birth Practice, Pregnancy, Recent Posts, Working with a midwife Tagged With The Birth Survey

A Birth Story: Lauren & Baby Naomi

August 23, 2010 By Cara Terreri Leave a Comment

On Monday, June 14, I went to work just to do patient phone calls and desk work. The nurses I work with hadn’t let me hardly touch a patient for days so I knew I could get a few hours at work and not over exert myself. I worked about a half day and then went to the chiropractor for a routine visit. My midwife recommended chiropractic care to help with the baby’s positioning and also for my pelvic/hip alignment. On the way home I felt the urge to do a major grocery shopping trip, so off to Giant I went to stock up on essentials. Over an hour later, I finally got home, only to commence a kitchen overhaul…cleaning out the fridge and reorganizing the cabinets. After my nesting cravings had been satiated I was able to relax with my husband, Adam, until about 10:30 pm when I started to have some Braxton Hicks contractions. Hoping to sleep through these minor contractions, I was asleep by 11:30 pm, but then was up at 2 am due to the discomfort that was coming with each contraction. At this point, it felt mostly like moderate to severe menstrual cramps, not so bad. I was excited and hoping that maybe this was “it” so I started tracking the frequency of each surge. All night my contractions came with some regularity, but they were too inconsistent. On Tuesday morning around 8 am I spoke with my midwife who suggested I try to rest and keep my appointment for that afternoon.

On the birth ball, with Adam supporting my back.

At my appointment around 2 pm, I found out that I was only 1cm dilated which was a little discouraging at the time. Megan (the midwife) was really concerned that I was so exhausted and suggested I try to get some sleep that night because true labor could be weeks away. At her suggestion, I accepted some prescription sleeping pills, knowing that I needed the rest. Unfortunately I had a reaction to the sleeping pills which caused me to be incoherent and in and out of sleep all night. I found myself in the tub around 5:30 am, listening to my iPod and breathing through each surge.

On Wednesday morning, I didn’t feel rested and the contractions were getting stronger. I spoke with my hypnobirthing instructor on the phone and made another appointment with the chiropractor in hopes that she could help “get things moving.” I also made an appointment with an acupuncturist, hoping that maybe stimulating the right pressure points could help get me into active labor. While at home, I just sat on my exercise ball, bouncing around or trying to relax in the tub. I found that my surges were increasing in intensity but I was still able to breathe through each one and stay very relaxed, calm and positive. I’ll take a moment to note that as prepartion for birth, I listened to relaxation exercises and birth affirmations as part of my hypnobirthing class. Because of this, I was able to quickly go into a deep state of relaxation and allow my body to respond to uterine surges with ease. Around 2 pm I checked back in with my midwife requesting to be assessed prior to my acupuncture appointment; my contractions were about every 5 minutes and I was just plain curious to see if things were progressing. 

Meeting Naomi for the first time.

At the birth center, the midwife told me I would not be making my appointment for acupuncture because I was 7 cm dilated and she wanted to admit me! I was relieved to know I really was in labor and excited to have the baby! Adam and I went upstairs and chose our birthing room, a large room with private jacuzzi tub and comfy queen size bed. Adam unpacked the car and brought my exercise ball in for me to use. After a little while I asked my nurse, Ann to get the tub ready so I could relax in there for a bit. I labored in the tub for a couple hours, Adam rubbing my shoulders and my mom massaging my low back during each contraction. My ipod speakers were set up with some relaxing music and the recording of birth affirmations previously mentioned. I was allowed to eat and drink as I wanted and was encouraged to take fluid by mouth since I did not have an IV like at a hospital.

 Around 7 pm, I was presented with the option to have my membranes ruptured. I was really exhausted from not sleeping for 2 nights and really wanted to get things moving so Adam and I decided to go ahead and do it. Afterward, the contractions became increasingly intense and I changed position from the tub to birthing stool. After pushing for about an hour I moved onto the bed so that I could be better supported. At 9:50 pm, Naomi Christine was born after about 1.5 hours of pushing.  My labor was calm and relaxed until I had to push. While I wouldn’t say that it was painful, pushing required every ounce of my being because I had been sleep deprived and unfortunately had not eaten enough that day.

Our first family photo.

While I received some sutures, Adam took off his shirt and held Naomi ”skin-to-skin” with him. Then, she went right to my chest and stayed there for 2 hours. She had absolutely no problems with jaundice, having passed two meconium stools in the first 4 hours of life, and my milk was in at 48 hours. I attribute these things to the uninterrupted skin-to-skin time of bonding and nursing in those first hours of life. I’m thankful that my first birthing experience was what I envisioned. I felt empowered, in control, and had minimal medical interventions.

Filed Under Birth, Birth Center, Birth stories, Coping with pain, Healthy Birth Practice, Labor, Pregnancy, Recent Posts, Working with a midwife Tagged With birth story

Great Expectations: Liz @ 18 Weeks

August 20, 2010 By Liz Abbene 4 Comments

“Feels like a foot!” It’s amazing how four little words can totally change things. Up until a few days ago, I spent a portion of every day worrying about the well-being of this little nugget and fearing that we would lose our baby once again.  As much as I didn’t want to, I couldn’t help it, and it was starting to weigh on my mind. As I’m nearing the half-way point of my pregnancy, I realized that this worry has interfered with me truly being able to enjoy this little one.

Then, at my prenatal visit the other day with my midwife, she was palpating my belly to feel the baby’s position, and said, very casually, “Feels like a foot!” At that moment, I felt like this dark cloud that has been following me for the last several months lifted. I was amazed at the fact that our little nugget is now big enough for her to distinguish body parts–that he or she is growing and thriving inside me, despite my worry, making me realize that I need to fully trust my body and my baby.

We heard the baby’s heartbeat again (no trucker interference this time), strong and clear.  My children continue to relish in the fact that my belly is getting bigger all the time, making it a prime target for hugs and kisses. I called up the photographer who took maternity photos for me with my previous pregnancies (including the one we lost) and had her come over to take the first pictures in what will become a series, ending with new baby shots. All these things, along with the feeling of those tiny little feet squirming around inside me, have given me a whole new outlook on my pregnancy.

Filed Under Great Expectations, Health and well-being, Pregnancy, Recent Posts Tagged With Great Expectations

Lamaze Blogger Attends BlogHer 2010

August 19, 2010 By Danielle Elwood Leave a Comment

Me with Gina from The Feminist Breeder

Thanks to the help of a few gracious sponsors, I was fortunate enough to attend BlogHer 2010. While the event encompassed a variety of experiences related to blogging, there were a couple of great moments that really focused on healthy birth. As a blogger ambassador for Lamaze, I provided a couple of pregnant bloggers with Lamaze Mom-to-Be Skin Care sets and talked about why I work with Lamaze, which was especially exciting after my Passion for Birth training the weekend before!

I also rubbed elbows and exchanged thoughts with some other amazing healthy birth and pregancy bloggers out there, including Gina from The Feminist Breeder and Jenn from Baby Makin(g) Machine.

The one experience I had that really focused on birth was my lunch chat on Saturday, day two of the event. I sat down at a table speaking with two women, neither of whom have children, and the movie Crisis in the Crib came up in the conversation. In overhearing our conversation, another woman who is currently 5 months pregnant sat down and proclaimed, “I don’t know crap about pregnancy, can you help me?” I was floored and excited at the same time! It was a great feeling to know that women looked to me as a resource on healthy birth! The more we spoke, the more I knew that she actually did have a clue as she had already enlisted a midwife for care and was considering a birth doula. She was on the right track! I would have loved to connect with more women on a deeper level — especially those who seemed to be uncomfortable talking about pregnancy or birth. But there’s only so much time!

Overall, BlogHer 2010 was an awesome experience, and I am eternally grateful to Lamaze to providing me with a great foundation for educating women.

Filed Under Birth, Pregnancy, Recent Posts Tagged With BlogHer10, Momotics

Week of Giveaways: Mom-to-Be Skin Care Gift Set from Lamaze

August 13, 2010 By Cara Terreri 14 Comments


This giveaway is now closed.
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Welcome to day five of the Giving Birth with Confidence Week of Giveaways – just one more giveaway day left! Be sure to join us tomorrow for the final giveaway, and if you’re just joining us, visit Monday, Tuesday Wednesday and Thursday’s posts for more chances to win great items!
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Today, we are giving away FIVE mom-to-be skin care gift sets from the Lamaze body care line (a $24.75 value each!). The gift bundle includes all that a mom-to-be (and new mom) would need to soothe and pamper herself — Lamaze Belly Butter, Lamaze Belly Cream, Lamaze Moisturizing Body Cream, Lamaze Cooling Leg and Foot Cream, and Lamaze Anti-Oxidant Bath Powder. I know that when I was pregnant, I used anything and everything to keep my skin moisturized and itch-free! Here’s a little more info about the mom-to-be package:

Lamaze Belly Butter – exceptional for keeping the skin elastic and stretchy during pregnancy, as well as soothing itchy bellies. Key ingredients include organic and natural cocoa butter, and shea butter.

Lamaze Belly Cream – contains a variety of healing and emulsifying ingredients clinically proven to help minimize the appearance of stretch marks and scarring.

Lamaze Moisturizing Body Cream – a luscious alternative to regular lotion with a thick, creamy feel that leaves skin incredibly moist yet won’t leave the skin greasy

Lamaze Cooling Leg and Foot Cream – provides a revitalizing foot and leg massage, cooling and moisturizing with thick, penetrating cream.

Lamaze Sitz Bath Powder – this healing bath powder will foam to a wonderful lather while helping soothe and heal your body after pregnancy.
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FiveGiving Birth with Confidence readers will win a Mom-to-Be Skin Care Gift Set from Lamaze!

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Here’s How to Enter

Everyone has three chances to win — choose one or all three!

1. Visit the Shop Lamaze Amazon Store then come back here and leave a comment to tell us about your favorite “wish-list” item from any product category on the site.

2. Create a login and become a member of the Giving Birth with Confidence online community. It’s FREE and easy. Leave a second comment on this post to let us know that you’re a new member or if you are already a member.

3. Tweet about this giveaway with the following text: Enter to win today’s #giveaway week: Skin Care Gift Set! To enter, post a comment at www.givingbirthwithconfidence.org & RT this message! Be sure to come back here and leave a third comment to tell us that you tweeted.

This giveaway is open to anyone, worldwide. It will end this Sunday, August 15 at 11:59 p.m. EST. Winners will be announced on Monday, August 16. Good luck!

Filed Under Gear, Giveaway, Health and well-being, Pregnancy, Recent Posts Tagged With Week of Giveaways

Week of Giveaways: Maternitique Gift Certificate

August 11, 2010 By Cara Terreri 19 Comments

This giveaway is now closed.

Welcome to day three of the Giving Birth with Confidence Week of Giveaways! We have lots of fun and useful items to give away, so be sure to visit the site each day this week and enter to win. If you’re just joining us, visit Monday and Tuesday’s posts for another chance to win!

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Today’s giveaway is a $25 gift certificate to Maternitique, an online boutique that features natural products for pregnancy, maternity and baby. As a mom who has recently taken a vested interest in choosing safer household and body care products, I am in love with this site’s philosophy toward natural and organic products in pregnancy.

Maternitique’s products reflect what mothers and midwives have always intuitively known, and what modern research is only beginning to prove: that the lifestyle choices we make before, during and after pregnancy—beauty and skin care, diet, exercise, stress management, pain and symptom relief—affect fetal health, childbirth outcomes and newborn development.

Owner Tara Bloom tells us why she founded Maternitique: “I loved being pregnant, giving birth, and becoming a mother, and I want to help other women enjoy the journey to motherhood as much as I have. Women deserve the best throughout pregnancy and they shouldn’t have to worry about what’s safe. That’s why I’ve hand-picked products that pamper moms while protecting babies.”

Maternitique has a site full of awesome products, but probably one of the most unique (that I’ve seen) is their “Lighten My Labor” line, which includes naturally based, non-toxic mists, lotions and gels to encourage calmness and trust throughout labor. The Lift Me Body Mist, developed by an OB/GYN nurse practitioner, is infused with light scents of neroli and lavender oils to refresh and cool during labor transition.

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One Giving Birth with Confidence reader will win a $25 gift certificate to Maternitique!
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Here’s How to Enter

Everyone has three chances to win — choose one or all three!
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1. Visit the Maternitique Web site then come back here and leave a comment on this post telling us about your favorite product that they carry.

2. Create a login and become a member of the Giving Birth with Confidence online community. It’s FREE and easy. Leave a second comment on this post to let us know that you’re a new member or if you are already a member.

3. Tweet about this giveaway with the following text: Enter to win today’s #giveaway week: Mom Gift Certificate! To enter, post a comment at www.givingbirthwithconfidence.org & RT this message! Be sure to come back here and leave a third comment to tell us that you tweeted.

This giveaway is open to anyone, worldwide. It will end this Sunday, August 15 at 11:59 p.m. EST. Winners will be announced on Monday, August 16. Good luck!

Filed Under Birth, Coping with pain, Gear, Giveaway, Labor, Newborn, Parenting, Pregnancy, Recent Posts Tagged With Week of Giveaways

Great Expectations: Liz @ 16 Weeks

August 6, 2010 By Liz Abbene 1 Comment

Throughout pregnancy, women are bombarded with horror stories, tragic tales of loss, and panic-inducing accounts of unexpected outcomes.  Being exposed to these negative images causes women to fear the process of birth, which ultimately can impact their birth experience, possibly leading to greater discomfort, difficult labor, and unnecessary interventions. In my line of work, I am privileged to be a part of the amazing, beautiful, and awe-inspiring elements of pregnancy and birth. However, sometimes these not-so-perfect things creep in as well, and I’d be lying if I said that it doesn’t affect me too.

So, what is a mama to do?  I am definitely trying to keep negative birth images free from my life as much as possible. That means no dramatic, worse-case scenario birth TV shows, since apparently normal birth doesn’t make for good programming.  It means seeking out positive birth stories, whether it be in person, books, magazines, or on the web. READ:  Keep in mind that positive doesn’t have to mean easy, short, unmedicated, vaginal, orgasmic, etc. It means taking time every day to focus on this baby and connect with him or her, whether it be a few minutes before bed at night, during yoga class, or in the shower, as is often the only quiet “me-time” during the day.  As I begin to really feel pregnant, it means truly embracing the changes–the aches and twinges of my growing belly, the road map of veins that has taken over my legs, the breasts that are on the verge of letters that I’ve never reached before in a cup size–rather than dwelling on the discomfort.  I feel that by doing these things, I can overshadow any negativity that sneaks in, and ultimately I am preparing myself for a fabulous birth, no matter what.

Filed Under Birth, Birth stories, Great Expectations, Health and well-being, Pregnancy, Recent Posts
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