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

Every once in a while I come across one of those books that I can absolutely not put down. To be quite frank, in the past, those books have been in the likes of historical fiction or Harry Potter (my literary guilty pleasure). Though I have come across several books about birth which I have found very informative, I had never felt the extreme urge to carry such a book with me everywhere I went till I finished its 300 pages in one weekend. That changed this weekend.

Author Randi Hutter Epstein, M.D. has unknowingly recruited me as her new enthusiastic fan. In her new book, Get Me Out: A History of Childbirth From the Garden of Eden to the Sperm Bank, Epstein weaves together a collection of well researched historical facts, fads, and tales into a very eye opening chronological history of Western birthing and women’s health care. I am often asked, “If the Midwifery Model is the ideal model, why are hospital births so popular? Didn’t obstetricians help make birthing easier at the turn of the century?”. This book answers those such questions and more in a shear way that neither left, right or middle wing can deny. This is not a book that dives into the history of midwifery. It is a definite eye opener bound to captivate its reader on the history of obstetrics and the unfortunate altered perception of “mainstream” birth today. I even believe that the male audience will find this book just as enjoyable/shocking as Jared Diamond’s Guns, Germs, and Steel. There are a lot of interesting parallels between the two books (I coincidentally started reading Guns, Germs, and Steel first till I saw this book in B&N on Thursday night) . It will be clear after reading this we must fight harder for better birth choices ones based on respect and time based models such as midwifery. The case is undeniable. Why continue to let the legacy of characters like the J.P. Morgan and James Marion Sims reign (read their back stories in this book) over the ancient wisdom and traditions of woman’s past when it comes to our most cherish power and gift as women? Why continue with the sabotage?

This is definitely not a how to book or what to expect book, it is a full on historical book. But unlike our society, Epstein does not leave the important facts out ( no matter how hard they are to swallow). She puts them front and center. I do feel that this book should be read by women and men alike to fully understand the foundation in which women’s health care (under the Western Model) was constructed under. This book will empower you to ask questions that you may have never even thought to ask and answer some questions that have been lingering for generations.

Epstein, a medical journalist for the New York Times, Washington Post, and more, has a refreshing talent for conveying weighty facts in a humorous digestible manner. She will also leave you with your jaw on the floor as a side effect of disbelief. Next time you walk by the Who Knew Section at Barnes and Nobles or are browsing on Amazon.com, pick up this compelling, powerful thought provoking must read.

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?

blend images

Usually, the common scenario goes that most women with prelabor rupture of membranes (their water breaking) go into labor naturally within 24 hours of the break. But twice in one week, I have heard several stories of women who have experienced a leak of a clear liquid substance but not having subsequent contractions. The obvious and valid concern tends to be that labor has begun but the absence of contractions accompanied by rupture membranes propose several risks such as possible bacterial infection. In both of these cases though, both women were told that their membranes weren’t ruptured (their water did not break)

Now, the end results for these women were different. In one case, the one mother was induced for her doctor was concerned that labor was not progressing and that the baby could be at risk for a bacterial infection. Though the medical staff did not believe it was her membranes leaking they wanted to take precaution. In the second scenario, the mother was told that her membranes were in tact, thus her baby was safe and that everything was fine. She could go home and let the labor begin on its own accord.

I had to investigate what could possibly be the clear liquid substance I had been hearing about. I came across an article posted by Circle of Life Midwifery in Salem, OR . I found it fascinating and thought it provided a possible explanation. Pamela Hines-Powell, CPM, LM, explains that there are two layers of the membranes, the amnion (the inner) and the chorion (outer) layers. According to her article:

Some membranes rupture high up in the uterus. This is called a “hind leak”. Typically, water will come out slowly, perhaps gush once and trickle here and there. Hind leaks may be caused from baby’s foot breaking the bag, or a positional change. As there are two layers of the membranes (the amnion and the chorion), sometimes leaking may be caused from the outer layer of the bag (the chorion) breaking. In both cases with a hind leak and a leak from the chorion breaking, there is a good chance of the bag “resealing” itself with cessation of any sort of leak.

ONLY YOUR MEDICAL PROVIDER can determine if this is the case. Not myself, nor any doula, nor your partner or a hand mirror. There is no other way to know. There are definitely several precautions to take till you are able be checked out by your doctor or midwife. Here are a few recommendations from Pamela Hines-Powell, CPM, LM:
• Absolutely, positively, NOTHING in the vagina. No fingers, tampons, penis, oral-genital contact, etc.
• Drink plenty of water to help replenish amniotic fluid – at least 64oz of water a day
• Wear something loose-fitting with no panties when you can
• If you are leaking and need something for sitting, use clean towels fresh out of a hot dryer
• Take your temperature every 4 hours while you are awake (record on a sheet of paper).
• Take 250mg Vitamin C every 3-4 hours while you are awake
• Eat foods that are non-constipating and easy to digest

Check out more suggestions or read more of the article here or visit her website.

The Pregnant New Yorker has put together the best practitioners, products and services in one room for one day. Join in on November 14th!

It’s an opportunity to get expert advice and talk one on one to a variety of practitioners in all aspect relating to pregnancy and babies.

There will be demos, classes, mini consultations, samples, and more. Register today and be eligible to win some amazing raffles!

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.

Denise Spatafora, creator of the BornClear childbirth preparation course, has just released a wonderful book entitled Better Birth: The Ultimate Guide to Childbirth from Home Births to Hospitals.

The book is based on her Born Clear method which is structured around the intuitive mind-body connection of expectant parents. The BornClear method aims to dispel the fears and mystery around birth.

This book educates the reader as to how the mind affects the body and how our thoughts can release “the medicines/pain relievers” during labor. She goes over several relaxation techniques and visualizations which help women tap into their own hormonal toolbox to aide them throughout labor.

THIS IS TRULY A REMARKABLE MUST READ for expectant parents. There are definitely plenty of linear text-books written books out there about pregnancy, but I have not come across many that dive into the depths of the mind-body connection, sacredness and the humanity essence aspect of pregnancy and birth as this book does.

Here is a segment that features Spatafora on the Today show speaking to her BornClear method.

And another clip honoring the book: