The media circuits are buzzing this week with “news” of the safety of vaginal deliveries after C-sections (VBAC). While this really is not “news” for some, the new guidelines released by the American College of Obstetrics and Gynecologists marks a needed turning point in this country’s perception of a women’s ability to birth. The news the attention, ability and success of such a birth choice.

Candidates for VBACs are those women who have had a Cesarean birth using a horizontal incision low in the uterus (low transverse incision). It is recommended that such candidates undergo counseling in preparation for their VBAC, to encourage, support the women’s emotional and physical concerns.

Between 60 percent and 80 percent of women who attempt VBAC have a successful vaginal delivery, according to the guidelines.

The guidelines which are published in the August issue of Obstetrics and Gynecology, recommend that the following women may also be candidates for a trial of labor after a Cesarean:

• Women who’ve had two previous C-sections using a low transverse incision.
• Women who’ve had a C-section with a low transverse incision who are currently pregnant with twins.
• Women who’ve had a Cesarean delivery but don’t know if they had a low transverse incision.

The ACOG recommends that women who choose a VBAC birth choice should do so only if they’re in a facility that has “staff immediately available to provide emergency care.”

Women who are not eligible for a VBAC consists of:

• Women who’ve had a vertical incision on their uterus
• Women who’ve had/had Serious pregnancy complications such as placenta previa

Welcome back from your holiday weekend! In case you have not heard the wonderful news, the NY State Assembly has cleared the Midwife Modernization Act on July 1st. New York is now one step closer to granting women the right and access to midwifery care and home-births should they chose. With the passing of this act, it will no longer be a requirement for licensed professional midwives to have a “written practice agreement” with a physician or hospital as a prerequisite to practice. After the closing of St. Vincent’s, the only hospital in NYC to sign this agreement for midwives, women where stripped of their option to have a home-birth as the midwives were no longer legally allowed to practice homebirths.

Thanks to New York State Association of Licensed Midwives (NYSALM),Choices in Childbirth, BirthNet, Rochester Area Birth Network (RABN), Buffalo Birth and the various physicians including many OB/GYN physicians for spear heading the rally cry and for the thousands of people who signed petitions and called their legislators to overturn the WPA requirement and support the MMA.

Now, all that is needed for the bill to go into affect is Governor Patterson’s signature and 90 clearing days!

I will keep you all posted

I have read that when a baby appears to be in the transverse position, that this symbolizes the baby’s comfort and desire to be close to their mother’s heart. While this is a sweet notion, when it comes to birth, the transverse position is problematic for a desired vaginal birth.

If after 30 weeks your baby is still presenting itself in a transverse position and your care provider and your self are concerned, it is helpful to incorporate some of these natural ways to encourage the little one to turn:

• Have either your partner or friend speak to the baby, shine a flash light, or place ear phones at your pubic bone area
• Contact a homeopathic doctor to give see if Pulsatilla in 200C potency or higher will work for you
• Pelvic rocking and exercises to strengthen muscle tone.
• Drink plenty of fluids.
• Have a chiropractor perform the Webster technique
• Try an inversion such as the one below:

DO do the inversion if you feel strong enough and it does not cause you discomfort for 2-3 times a day. DON’T do it if you have trouble breathing. As with any exercise, ask your caregiver if there is any medical reason why you shouldn’t do this. DON’T do this inversion if the case is your baby was in a breech position and has already turned head down.

1. Have a helper to brace your shoulders so you don’t come down from the couch too fast.
2. Have your knees on the edge of the couch.
3. Come down slowly.
4. Brace yourself on your forearms.
5. Relax your belly.
6. Relax your neck and head.
7. Hold the pose for 30 seconds for a head down, posterior baby, or a minute for a breech or transverse baby, if you can. Start with shorter times in the pose and work up to 30 seconds.
8. Crawl forward, bringing one knee down to the floor and then the other.
9. Come to your hands and knees.
10. Sit up, on your heels and catch your breath.
Crawl around the room helping the weight of the womb settle forward.

(above directions from Spinning Babies)

At the same time, I found this statement via Birth Naturally

Less than 20% of the babies who are transverse at 37 weeks will remain transverse when labor begins, so another option is to wait for labor to start and attempt to turn the baby or perform a cesarean if it is still necessary.

Speaking from within the context of the statement directly above, your doula and midwife can work with you to suggest various positions during your labor to encourage the turn of your baby. Using gravity and motion can potentially save you from unnecessary internal interventions.

(photos for from Getty)

I sometimes believe that if Einstein were to have developed a scientific equation that revealed the connection between the birth of a baby and the relativity of time, he would have correlated that the gift of a new born child accelerates our perception of time. I awoke up this morning and realized that the little adorable princess that came into this world, it seems like just yesterday, is one month old today. Usually, after I attend births, it takes me a few days to fall out from under the magical joyous spell of wonder and amazement a birth can cast on you. With this last birth I attended on November 13th, I was so moved, touched and inspired, that it has taken me a month to really begin to grasp its positive impact.

Up until last month, I had been given a series of invaluable gifts, the introduction to several amazing women I had never known until I became their doula. Now, I forever am blessed with the gift of knowing their strength and grace as mothers, their families and adorable sons. Ironically enough, all of the births I had attended in my doulahood were for the births of adorable awesome little boys till last month. On November 13th 2009, I experienced the emotionally powered gift of attending the birth of a most cherished friend’s second daughter.
What you may not know is that the birth of this amazing mother goddess’s first daughter was the inspiration behind me finally beginning my doula path. I had been exploring the possibility of starting the path prior but was telling myself, “Oh maybe 5 years from now.” Then, one day during her 37th week, I was taking pictures of the soon to be 1st time mom with daughter still inside her womb in central park for memory sake. 4 hours later, her water broke. The next day I rushed to the hospital to meet the sparkling gem and see her inspiring mother. I had brought prints of the photos I took to the hospital and as we looked through them, we realized that I had captured her daughter descending down from the beginning of the photo session to the end. Though I was not there to attend her birth (I was not yet a doula), I wanted to be.

It was the first time that I had seen a close friend through the stages of her pregnancy and as a new mother. It introduced me to a new aspect of love and care. It inspired be to not delay and begin my doula path. So fast forward nearly three years later and here I am still moved by this woman and her now two daughters. Not only was it an empowering gentle birth experience, but it was my 1st time I watched a girl be born. It is not that I do not greatly appreciate my experiences witnessing the birth of boy angels, but as for me personally being so driven to understand and explore the various aspects of womanhood from being a girl to a wise elder, this was a significant benchmark in my life.

Even though I do not have children yet, I now have a closer sense of the feeling that parents and immediate family feel when they welcome a new member to their world. Babies teach us what love is all about. Pre-existing love through friendship makes the already wondrous emotional experience of childbirth even more intoxicating (even more magnified for the parent/s I am sure). It fuels more oxytocin in the room (Oxytocin is WONDERFUL). For any women reading this post, reconnect to the roots of sisterhood. If you have the opportunity to accompany a cherished friend or relative in childbirth, do so. It is one of the most rewarding gifts for both you and the mother will ever receive.

Happy one month old day Princess Ophir
Pink & Glitter By Tori Amos

Mama Meditation & Shopping Event at EGG Baby
Tuesday, December 8, 2009
6:00pm – 9:00pm
EGG baby pop-up shop in Dumbo, Brooklyn

Join Tender Shoots Wellness Founder, Latham Thomas, for a guided meditation for moms followed by a shopping soire with EGG Baby and Maternity.
RSVP to press@egg-baby.com

The Pregnant New Yorker Series
Wednesday, December 9, 2009
6:30pm – 9:00pm
Renew Physical Therapy
149 Madison Avenue, Suite 903
(Btwn 31st and 32nd)
Register

Cara Muhlhahn, as featured in “The Business of Being Born” will be at this month’s Pregnant New Yorker to answer your questions about midwifery and childbirth. I will be discussing and answering questions about being a doula, and other guest will be discussing how to keep fit throughout your pregnancy and after wards. How physical therapy, chiropractic and massage can help you through your pregnancy and the benefits of having a baby nurse. Get easy and economical ways to green your home in preparation for a baby. Plus come see some great products on everything baby and mommy.

This is very sad story to post. With hardly any warning, the Bellevue Birth Center has officially closed. It is important for me to post this to bring attention to the fact that our resources as women are dwindling in the New York City. A big rally cry and call to action is needed. Though Bellevue was known to accommodate lower economic bracket and those on Medicaid, the services and sacred support that Bellevue offered are the same services and support that every birthing mother should have.

If only the conscienceness of the mainstream was penetrated with the awareness and knowledge of the impact birthing centers have on the birthing mother as opposed to the hospital setting and linear western standards, then they would not be so quick to give a brief sympathetic look over that the “Poor Women’s Haven” (as titled in the NYT’s article) had to close its doors due to low funding and awareness.
Birthing rights and options for all women are in jeopardy. And overall women’s health & educational reform needs to take place. Not just for women from certain demographics, all women, and men who have or plan on having children. That’s basically everyone. How the children of this world are brought/birth into our reality realm is a sacred experience and journey and moment that needs to honored, encouraged and celebrated as opposed to jeopardized, standardized and dehumanized.

Now, there are three remaining natural-birth centers in New York City, The Birthing Center at St. Luke’s Roosevelt Hospital, Manhattan, The Brooklyn Birthing Center, Brooklyn, and the Morris Heights Women’s Health & Birthing Pavilion, Bronx. All of which are stretched in various boroughs with only a certain amount of birthing rooms.

Thankfully the Eli Manning Holistic Birthing Center at St. Vincent’s and the free-standing The New Space for Women’s Health are underway to be developed and build. Both free standing and in hospital Birthing Centers need to be adopted into America’s healthcare system. The idea of the C-section rate nearing 1 in 2 and more and more babies having drugs streamed into their not even day old blood systems as a normal commonality is disturbing.

What do you think are the best outlets for self awareness of the body’s design for birth?

I came across this wonderful and informative flim entitled “The Facts About Waterbirth” over on 5min.com. It’s a great introductional piece for those of you who may be considering a home birth, birth at a birthing center or even tips as how to utilizing the shower in Labor and delivery rooms can help with the progression of labor in a hospital birth. You will also see several discussions with mothers, midwives and doctors in this film. Check it out. If you have any questions about resources that talk about waterbirths further, have a look at some of my previous posts or leave me your questions in the comment field.