Category Archives: Natural Birth Advocacy

Denied a VBAC???

Cesarean Section

More and more we are hearing about women being “denied” a VBAC (Vaginal Birth After Cesarean) by their OBs, Midwives, or local hospitals. Here is some information that can help you get the birth you want and deserve:

#1- VBACS ARE NOT ILLEGAL! Anyone who tells you this is lying (or grossly misinformed.) Period.

#2- Any hospital that accepts Medicaid or Medicare that states they have a “VBAC BAN” is in direct violation of federal code 42CFR482.13 which states that any hospital that is federally funded can lose funding if they deny care and can lose all funding if a complaint is received. 

#3- EMTALA, Federal Emergency Medical Treatment and Labor Act, also known as COBRA or the Patient Anti-Dumping Law. EMTALA requires most hospitals to provide an examination and needed stabilizing treatment, without consideration of insurance coverage or ability to pay, when a patient presents to an emergency room for attention.

This means hospitals HAVE to take you if you show up in labor. If you have been denied a VBAC by a hospital or know of a hospital with a ban you can call EMTALA at (404)562-7500 to report them.  You can also contact http://www.medlaw.com if you have been threatened by a hospital for court ordered cesarean, told a hospital has a VBAC ban, or dropped from a providers care within 30 days of your due date or while you were in labor. 

#4-  Check out birthaction.org, specifically your state’s resource page on where you can file other complaints. Also check out  Birth After Cesarean for lots of other specific info on how to get your VBAC.

And last but most importantly!

#5- Contact a local home birth midwife! Even if you think “you could never have a home birth”, or “home birth is too scary!” it can be an eye opening moment when you sit down for a consultation with someone who protects normal, natural birth. It gives you  a chance to ask any and all questions you may have, understand how birth at home works, and provides you with an opportunity to see that not all midwives are long skirted, patchouli smelling, hand-it-to-the-man-ers(although we love those kinds too!!!) and are trained in handling low-risk birth outside of the hospital setting. 

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Filed under Dangers of Hospital Birth, Natural Birth Advocacy, Uncategorized, Vaginal Birth After Cesarean

“It’s not your birth.” by Charlie Rae Young

postpartum    

      “It’s not your birth.” This is a phrase I hear quite frequently from other birth professionals. Whether they are childbirth educators, doulas, or midwives. That statement seems to be an automatic reply in the birth community when a women chooses something that we know, on a professional level, is an unhealthy choice. Whether it be birthing in a hospital, allowing interventions, or choosing not to breastfeed. Are we, as a birth community, standing idly by while mother’s make uneducated choices because it is politically correct?
     As a doula, I feel it is my duty to educate women on the options they have regarding their birth. With my daughter I desperately needed someone to educate me. I needed someone to say that the hospital is not the place for a healthy woman to give birth. Someone to explain that out of hospital births are just as safe, if not safer, as hospital births. I wish someone would have told me my choices were not the best. I wish someone would have been brutally honest with me. Sure, it was MY BIRTH…but doesn’t every mom want what is best for themselves and their babies? Don’t we all as mothers want to give our children the best start possible?
      I understand a natural, intervention free homebirth is not the right choice for every woman. However, shouldn’t we encourage all women to do their research on what is the best birth? Shouldn’t we be providing them with good information and not leaving them at the hands of a Google search? Midwives, you should be shouting about your good outcomes from the rooftops! Doulas, tell every pregnant woman you meet about what you have to offer! Give them the numbers, the facts, book recommendations. Childbirth Educators, give women the truth. They have come to you because they WANT to learn. They need to know what really lies ahead for them at the hospital if they choose to birth there. They need to know that interventions during pregnancy are not always necessary. They need to know what to expect out of a homebirth. Lets teach women that it is their body and their choice to birth however they choose.
     I will say, that if after we all do our jobs to adequately inform parents, that it is ultimately their choice to choose what is their best birth. Like many other things, we take all of the information we have acquired and apply it how we feel is appropriate in our lives. At the end of a woman’s journey into motherhood she should be able to say, “I made the best educated choice for myself and my family, and I do not regret anything about it.”
      We, as a community, need to stop making the excuse of “its not your birth” and start reaching out and sharing valuable information with childbearing women. No, It is not my birth…but it is my job as a fellow human being to stand up for what I believe in, what my quest for information has taught me. It is my job to make sure there is never another woman who crosses my path who will end up with a traumatic birth experience because she simply did not know any better.

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The Perineum, Privacy and Normal Birth by Evelyn Ojeda-Fox

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Birth is an internal process that is easily disturbed by unnecessary interventions. According to midwife Ina May Gaskin, “sphincters are shy”.

A woman’s dilated cervix can easily close in the presence of disruptive people or actions (cervical reversal). In a normal birth, vaginal exams and other handlings of the perineum during labor are interventions that can interfere with the natural birthing process.

At any other time in our lives, our vagina is considered “private”. During birth a woman is told to lay back, open her legs and allow her body to be explored by strangers. A laboring woman loses her dignity, privacy and trust in herself in the hands of the people that she has hired to assist her in this sacred moment.

Gloria Lemay, Canadian birth attendant and birth activist, writes: “Why avoid that eight-centimeter dilation check? First, because it is excruciating for the mother. Second, because it disturbs a delicate point in the birth where the body is doing many fine adjustments to prepare to expel the baby and the woman is accessing the very primitive part of her ancient brain. Third, because it eliminates the performance anxiety/disappointment atmosphere that can muddy the primip (woman having her first baby) birth waters. Birth attendants must extend their patience beyond their known limits in order to be with this delicate time between dilating and pushing.” http://www.glorialemay.com/blog/?p=72

Why Should We Be Concerned?

• Vaginal exams are the traditional clinical method to evaluate progress in labor. According to Freedman’s Curve (a 1955 study of 500 women), a woman should dilate 1 cm per hour after she has reached 4 centimeters of dilation. When women don’t perform to this standard, some birth attendants become frustrated and push for drugs such as Pitocin and other augmentation methods to speed labor to progress “normally” initiating the cascade of interventions.

• A woman may become discouraged by multiple exams and mindless comments such as, “you are only __cm”. Labor then can stall giving way to interventions that often end in cesarean.

• Vaginal exams increase the risk of infection by bringing bacteria towards the cervix, even when done carefully and especially after the release of the membranes.

• Vaginal exams are not a reliable way to predict when labor will begin. Labor normally begins when the baby is ready and a wonderful cocktail of hormones begin to release.

• Vaginal exams are particularly painful during contractions and disrupt a woman’s concentration.

• Perineal massage during labor, besides being intrusive and invasive, according to research does not protect the perineum. http://www.bmj.com/cgi/content/full/322/7297/1277

• There is a higher incidence of perineal tears with the hands-on approach to perineal care during the pushing stage of labor than with the hands-off approach. http://www.ncbi.nlm.nih.gov/pubmed/12092017

• Some practitioners routinely do a stripping of the membranes, with or WITHOUT the woman’s permission. Using their fingers they separate the bag of waters from the cervix. The thought behind this is that it will stimulate the production of prostaglandins to help labor begin and irritate the cervix causing it to contract. This is a painful procedure, can leave you spotting or bleeding and has not proven to be effective for everyone. It could start the cascade of interventions.

• Informed consent means that you need to have all the information to accept or refuse treatment. Do not open your legs unless you understand why and agree with the reason. If you don’t agree, ask for the research.

How To Have A Gentle Birth And Protect The Perineum:

• Hire a midwife who trusts the birth process and will support and encourage you to listen to your body.

• Review your birth plan with your midwife at every prenatal visit during your last trimester. (You are not being “difficult”. It’s your body, your baby.)

• Reprogram your mind by immersing yourself in images of normal gentle birth.

• Prepare your perineal muscles and tissues during your pregnancy by having a healthy diet and regular exercise. Read more.

• Walking, squatting, pelvic rocks, tailor sitting, kegels and swimming are useful exercises to strengthen the pelvic floor.

• Gentle perineal massage during the last weeks of pregnancy could help a first time mom get acquainted with different sensations in the perineum.

• Try different positions to birth your baby. Stay vertical. Listen to your body!

• Labor down/Breathe the Baby Down, this is the opposite of directed pushing or purple pushing which can harm your baby by depriving him/her of oxygen.

• While laboring down, you can support your own perineum to help you stay in control of your body.

• Instead of vaginal exams, the most accurate way to judge progress of normal labor is by noticing the changes in the mother’s behavior. For that you need a birth attendant willing to be present and compassionate.

• Visualize: “I am stretching beautifully,” “There’s lots of room for the baby to come through,” “I’m doing this nice and easy”, “I’m getting huge.”

• Vocalize deep sounds by chanting, moaning, grunting. A loose jaw = a loose perineum.

• Apply warm compresses everywhere on the woman’s body so there is less focus on that one spot (the perineum). The woman relaxes, the midwife relaxes. -Naoli Vinaver, CPM, Mexico

• Refuse an episiotomy.

• Avoid an epidural.

• Hire a doula to be your advocate in the implementation of your birth wishes.

In conclusion: Stay. Away. From. My. Vagina!

Other Resources:
http://www.mothering.com/easing-tension-and-fear-natural-childbirth-understanding-sphincter-law-conversation-ina-may-gaskin

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