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VBAC: Is it for you?

Cranbrook VBACAre you faced with the decision of attempting a vaginal birth after cesarean (VBAC) or a repeat c-section? I know you want to do what is best and safest for baby and yourself. I want you to make the right choice for you! So I decided to gather some of my favorite resources and post them all here so you can read through them and make your informed choice!  -Darla

 

 

 

VBAC: making a mountain out of a molehill

I really love this article even though it is based out of Australia, she does a fabulous job of explaining the risk of uterine rupture and describing the numbers and what they really mean. She gives suggestions on how to prepare during pregnancy and what to expect while you’re in labour! I highly recommend this read!

To be honest, as a midwife uterine rupture is the least of my worries when caring for a woman having a VBAC. I actually think the mountain that has been built out of the risk-molehill requires more energy and attention. These women do need special treatment, but not in the form of disempowering fear-based counselling or practice. They have often had a previous traumatic birth experience and are dealing with fear from family, friends, and the medical system, in addition to their own worries. They have been labelled ‘high risk’ and are constantly reminded of the potential disaster waiting to occur. They also risk ‘failing’ if they encounter any complications or end up having a repeat c-section. This impacts on their ability to trust their body, follow their intuition and allow the physiology of birth to unfold. Often these women need more nurturing, reassurance and support from those involved in their birth.”

VBAC Facts!

This is the place to go to get great info, myth busting at it’s finest!

“Many women believe that the only safe choice after a cesarean is another cesarean. Social pressure plays a huge role in a woman’s decision making process and the prevailing American conventional wisdom is greatly influenced by persistent and pervasive myths about vaginal birth after cesarean (VBAC). The result is a 86% repeat cesarean rate in America among women with one prior cesarean (1) despite the fact that most women are candidates for VBAC and most VBACs are successful.  Let’s draw a clear line between myth and fact.”

 

VBAC or Repeat C-Section

So much great information, it’s very thorough in answering questions many women face.

What is the bottom line?

If you do not have a clear and compelling need for a cesarean in the present pregnancy, having a VBAC rather than a repeat c-section is likely to be:

  • safer for you in this pregnancy
  • far safer for you and your babies in any future pregnancies

When thinking about the health and safety of your baby in the present pregnancy, there are trade-offs to consider: VBAC has some advantages, and a repeat c-section has others.

 

ACOG VBAC Guidelines

This is the gist of the guidelines put out by the American College of Obstetricians and Gynecologists, if you want to read the full in depth report you can find it here.

“Attempting a VBAC is a safe and appropriate choice for most women who have had a prior cesarean delivery including for some women who have had two previous cesareans.”

 

BC VBAC Guidelines

Here you can find the benefits and risks laid out for you as well as answers to some of the more frequently asked questions!

My last thought is to take into consideration your birth team. Having your care provider on board with your hopes of a VBAC put you on the path to a good birth experience. Consider hiring a doula to help your prepare prenatally through working out any fears or doubts you have, and releasing your previous birth story. The extra support during labour can be a game changer!
I hope these resources help you and your family make the right choice for YOU!

 

Photo Credit: MabyCakes via Compfight cc

Soulful & Holistic Prenatal Classes coming to Cranbrook, BC

This is very exciting news to finally share! Mandala Birth will begin offering prenatal classes in the new year! My Soulful & Holistic Prenatal class is a 7 week series covering all the major topics to prepare you for labour and birth. Being a holistic class I cover the physiological aspect of labour and birth, while also bringing in the emotions and soul through relaxation and mindfulness techniques.

 

Cranbrook Prenatal Class

The class will be hosted in the yoga studio of the Kootenay Therapy Center, their gorgeous space is perfect to come together as a group to learn, enjoy and make new connections with other expecting couples.

Benefits of Skin to Skin Contact

Sometimes as a doula seeing so many healthy babies born and placed on moms bare skin I forget the researched benefits of immediate skin to skin contact. It is astounding now rereading the facts, that any hospital would continue to routinely separate mother and newborn.

What & Why practice skin to skin?

Skin to skin contact; often referred to as kangaroo care, is the practice of placing dried, newborn, naked baby on mothers bare skin.

Aside from the fact that you have just worked incredibly hard to bring your sweet baby earthside and now with every fiber in your body, you will most likely want to snuggle this new being into your bosom, get to know them, exclaim over the perfectness of their nose, the softness of their skin and kiss the top of their head. There is a huge benefit to baby and mother scientifically for immediate and prolonged skin to skin contact after birth. The World Health Organization quotes evidence from 34 randomized trials involving 2177 women and their babies and recommends kangaroo care for the first hour following birth.

skin to skin in new borns

Benefits for baby:

  • Mothers bare chest is babies happy place
  • Babies are calmer and less stressed
  • Babies tend to cry less
  • Babies maintain their temperature, they are more stable and regulated then when placed in an incubator
  • Heart rate stays within normal range
  • Oxygenation levels are maintained as heart rate is regulated
  • Babies blood sugar levels are increased
  • Improves sleep organization
  • Immunity is increased as baby is colonized by the same bacteria as the mother
  • Breastfeeding is more likely to occur easily
  • A good latch is more likely to occur

Prolonged skin to skin is beneficial for babies and older bubs too, for many of the same reasons.

Benefits for mother:

  • Immediate bonding
  • Learning early cues of hunger
  • Reduces postpartum depression
  • Increases milk production
  • Speeds recovery time (often because mom is staying in bed with baby)
  • Improves emotional well being

Are there risks?

The researchers found NO risks related to skin-to-skin care—only benefits. Importantly, the researchers found multiple risks to routinely separating moms from babies after birth. Separating a healthy baby from a healthy mom after birth decreases the chance of successful breastfeeding and raises the risk of the mother’s breast engorgement and anxiety, and instability of the infant’s heart rate, respiration, temperature, and blood sugar. Babies who are separated from their moms and swaddled are 12 times more likely to cry.”

If you want to continue offering your babies these fabulous benefits the best thing you can do is to stayed cuddled up in bed for the first few weeks of their life. The holding, nuzzling and breastfeeding your baby on demand all give mom a rush of oxytocin, the hormone that helped you give birth but which now helps your uterus shrink and return to non-pregnancy size. That flood of oxytocin you receive is also helping your response mechanism; you relax, and have a sense of well being while, it creates nurturing and affectionate behaviour in you towards baby.

skin to skin nuroo topIf you are a mom of toddlers or older children staying in bed may be more challenging, but it isn’t necessary to deprive your new born of skin to skin, Nuroo Baby is a company that has developed a carrier shirt allowing mom more mobility while offering baby the warmth and the comfort of skin to skin. I have personally been able to try out these tops, they are lovely, providing baby a perfect cocoon.

Life Saving

Kangaroo care is a low technology, high touch approach to new born care and it is saving lives!

“In developing countries, Kangaroo Care for low-birthweight infants has been shown to reduce mortality, severe illness, infection and length of hospital stay” -Canadian pediatric society

 

 

The power of skin to skin is so powerful that babies have returned to life after Doctors pronounce them dead.

 

Want to read more?

The Journal of Perinatal education says,

“Nature prepares you and your baby to need and seek each other from the moment of birth. Oxytocin, the hormone that causes your uterus to contract, will stimulate “mothering” feelings after birth as you touch, gaze at, and breastfeed your baby. More oxytocin will be released as you hold your baby skin-to-skin. Your brain will release endorphins, narcotic-like hormones that enhance these mothering feelings. These hormones help you feel calm and responsive and cause the temperature of your breasts to rise, keeping your baby warm. Because of the normal “adrenaline rush” babies have right after birth, your baby will be bright, alert, and ready to nurse soon after birth. During the hours and days following birth, you will learn to understand your baby’s cues and unique way of communicating with you.”

The International Breastfeeding Center states,

“Studies have shown that even premature babies, as small as 1200 g (2 lb 10 oz) are more stable metabolically (including the level of their blood sugars) and breathe better if they are skin to skin immediately after birth. Skin to skin contact is quite compatible with other measures taken to keep the baby healthy. Of course, if the baby is quite sick, the baby’s health must not be compromised, but any premature baby who is not suffering from respiratory distress syndrome can be skin to skin with the mother immediately after birth. Indeed, in the premature baby, as in the full term baby, skin to skin contact may decrease rapid breathing into the normal range.”

Haiti Skin to Skin

Beautiful Haitian woman wearing her sisters twins

Kangaroo Mother Care says, “Skin-to-skin contact should ideally start at birth, but is helpful at any time. It should ideally be continuous day and night, but even shorter periods are still helpful.”

Pub Med reports that, “Behaviorally based measures of sleep have shown increased quiet sleep (QS) and decreased active sleep (AS) during skin-to-skin contact (SSC) with the mother”

If you are involved in hospital care for newborns and new mothers and want to provide more training for your staff on the benefits check out this link for a dvd training!

Photo credit: b/w photo by Sharalee Prang, Haitian woman image from The Burning Bra on Instagram