Tuesday, December 25, 2007

VBAC homebirth



This is a wonderful story of a woman who had two previous hospital births resulting in caesarean birth who chose to birth at home for her third child. She tells her story very eloquently in this video. She understands that she needed to be upright and mobile and to have faith in her own bodies ability and in the care and support of her midwife. This is the story of her personal journey.

If you are considering a VBAC it is important that you understand why you needed a caesarean previously. You need to be well informed of the risks of all your birth options before you decide what is best for you and your baby. You might need to talk to more than one care giver before you can truly make an informed decision. Check out the Childbirth Connections information about the risks associated with various birth options.

5 comments:

Carolyn McIntosh said...

The things that particularly struck home with me about this birth were;
The supportive loving presence and acceptance of the woman's husband.
First caesarean she attributes to a posterior lie and the fact that she was immobile on the bed.
Second caesarean was elective because she was overdue.
The medical staff were saying this is a big baby, i.e. justifying that they believed the caesarean was inevitable and necessary.
Third time around was the first time the women was really empowered , informed, knowing of her ability and possible limits.
What do you think? Any more comments about this?

athina said...

Hi Carolyn,
I m very interested in this subject and I have read some relative sources.Although the validity in predicting successful vaginal birth after caesarean delivery is still on under discussion, midwife’s support and sound advice remains an important precondition in patient selection for a trial of labour. Autonomous midwives, who are aware of the emergency recourses to attend VBAC, reflect in their actions and offer a continuity of care to the women achieve to build up a trusting relationship with them. If all these qualification are adopted into clinical practice, trial of labour will undoubtedly become safer for both mothers and babies, regardless of the setting. As it is claimed by Rinehart (2001) the positive future of midwifery in all around the world lies in midwives being accountable for enhanced outcomes for mothers and babies while encouraging the gentlest birth possible for any clinical situation.
Some more details.
Rinehart (2001) in an article concerning ‘VBAC and technical issues for Midwives’ includes recommendations to midwives doing home VBAC. Firstly, he notices that midwives should be aware of the physical and psychological differences in a woman with a previous caesarean. Secondly, he considers essential the development of a VBAC practice protocol reflecting the midwife’s knowledge as well as access to emergency. Detailed informed consent with the client is also considered necessary while an ultrasound should be performed early in the third trimester for placenta location. Finally, according to the author midwives should take into consideration if their VBAC protocol is negotiable or not.
In the same article VBAC is considered one of these clinical circumstances with increased risks for mothers and babies which requires knowledge and resources for constantly good outcomes. As it is claimed by the author pregnant women after a previous caesarean section have unique needs and worries. Consequently, women in a subsequent pregnancy need to be supported in their choice of VBAC or elective caesarean and midwife’s role is to explain the risks and benefits of each.
I liked the video about VBAC homebirth so much..

Carolyn McIntosh said...

Thanks for your comment here Athina. I have found the article you mention here from Midwifery today magazine http://www.midwiferytoday.com/articles/vbacprimer.asp
It has a good discussion of risks associated with VBAC. Another excellent source for information on this topic is VBAC.com. This is also an American site with American data, however it is relevant to us all.
http://www.vbac.com/index.html

In order to help and support women we need to keep up to date ourselves with the latest evidence for practice. We also need to be able to direct women to useful information which will help them to make informed decisions about their own care.

vbacqueen said...

That was beautiful....
Never blindly accept that we have no choice when it comes to birthing our babies. We DO have a choice and who knows what we're capable of unless we try?
Tina, UK
VBA3C 2006

Carolyn McIntosh said...

It is a lovely, honest video isn't it. The world health oraganisation has made to comment that no state can justify a caesarean rate of more that 15%. As many countries now have a caesarean rate of 30% or more this means that many unnecessary caesareans are being performed. Caesarean's can however be a life saving operation when they are truly required. As you say, you will never know what you are capable of if you do not try.

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