ICAN of Southern Nevada

Promoting Cesarean Awareness



Mothering Magazine Articles
Here are some GREAT articles on cesareans and VBAC (vaginal birth after cesarean):


C-Section Birth Raises Risk of Asthma in Newborns by 79 Percent

C-Section Birth Raises Risk of Asthma in Newborns by 79 Percent


(NaturalNews) Children delivered by cesarean section (c-section) are significantly more likely to develop asthma and allergies later in life than children delivered through natural, vaginal birth, according to a study conducted by researchers from National Institute for Public Health and the Environment in Bilthoven, the Netherlands.

A c-section is a procedure in which a child is surgically removed through a mother's abdomen, rather than emerging naturally through the vaginal opening. It is medically recommended only in cases where vaginal delivery would seriously endanger the life of infant or mother, but is becoming more common as many women's preferred method of childbirth.

Researchers compared the rates of asthma and allergies among 2,917 eight-year-olds, comparing the rates between those who had been delivered vaginally and those who had been delivered by c-section. They found that the risk of asthma was 79 percent higher in those delivered by c-section compared with those delivered vaginally. The correlation between c-section and asthma risk was even higher among children born to one or more parents with allergies.

"Our results emphasize the importance of gene-environment interactions on the development of asthma in children," the researchers wrote. "The increased rate of cesarean section is partly due to maternal demand without medical reason. In this situation, the mother should be informed of the risk of asthma for her child, especially when the parents have a history of allergy or asthma."

C-section is already known to raise a child's risk of diabetes by 20 percent, compared with vaginal delivery. In spite of this known health risk, rates of the procedure have been steadily rising in the United States over the last 25 years, increasing by 46 percent since 1985 to a current level of more than 30 percent of all births.

Childhood asthma rates have also been on the rise, particularly among urban populations, with rates increasing by two to four times in the last 30 years in some countries.

Sources for this story include: www.reuters.com.

The new "natural" Caesarean

From The Times

April 4, 2009

The new "natural" Caesarean

With more babies being born by Caesarean section, a new movement is
campaigning to make the event a more "natural" experience

Charlotte Edwardes

The lights of the operating theatre are dimmed and there is a mood of calm among the hospital staff. A midwife softly narrates a continuing procedure to a patient who is squeezing her husband's hand. The surgeon gives the nod: it's time. The drape across the patient's abdomen is lowered and her head is raised. Her eyes widen as she and her husband watch their baby, tiny and pink with a mop of black hair, being gently delivered from her. There is a moment of collective awe before the newborn's cry fills the air. "It's a boy!" his mother gasps, before enveloping him in a warm hug.

This mother has just had a "natural Caesarean", a revolutionary technique that attempts to turn one of the world's most common operations into an experience closer to vaginal birth. The idea was conceived by Professor Nicholas Fisk, formerly a consultant obstetrician at Queen Charlotte's Hospital in London, in response to the rising numbers of Caesareans in the UK. Caesarean deliveries account for 24 per cent of all births. More than half are emergency C-sections rather than planned, and maternal age is a factor; according to the National Sentinel Caesarean Section Audit, mothers under the age of 20 have a C-section rate of just 13 per cent, compared with 33 per cent for mothers aged between 40 and 50.

There's no doubt that a Caesarean is major surgery. It is also the joyous moment of arrival for parents and this is what Professor Fisk, and two colleagues - Dr Felicity Plaat, consultant anaesthetist, and Jenny Smith, a senior midwife and author (see panel) - set out to emphasise.

"It struck me that all the effort was going into changing normal childbirth but that Caesarean section was still steeped in old surgical rituals," says Fisk. "In some cases I was horrified; the baby would be dragged out like a tumour and passed to several medical staff before the mother. It was ripe for reform."

His team concentrated on three areas. First, parental involvement: this meant dropping the drape that "divorced" the mother from her abdomen, to allow her to see her baby's head emerge; the baby itself blocks the mother's view of the operation.

The second point was physiological: Fisk showed that when a Caesarean is performed slowly the baby is able to "autoresuscitate" - start breathing unaided - while still attached to the placenta, as in normal birth. The baby is "half-delivered" and a combination of the naturally contracting uterus and the baby's vigorous wriggles allow the lungs to expel fluid in a similar way to a vaginal birth. This reduces the risk of the baby needing help to breathe; a common occurrence after a Caesarean.

Finally, Fisk wanted to see newborns handed immediately to their mother for skin-to-skin bonding. "There are now official standards for skin-to-skin bonding in childbirth, but these are almost never met with Caesareans," he says. One obstruction is that the monitoring equipment needed for patients in surgery is routinely attached to the mother's chest. "In a natural Caesarean we attach the ECG wires to the back of the chest so that the baby can be placed on the mother after birth," Plaat says. The anaesthetic dose is lowered so that there is no "heaviness in the arms" to prevent holding the baby, and a clip that measures oxygen in the blood is attached to the toe.

Plaat knows from experience how important it is for a mother to be given her child as quickly as possible: "My son was passed around, measured, weighed, dressed and even had his hair washed before being given to me. A crucial player, therefore, is the midwife . She has to be enthusiastic and involved. It's not just 'dumping baby on mum' and writing up notes; it's making sure that the baby is safe, is not going to slip off, and is warm. We put towels over the baby and even bubble-wrap - the kind you buy in big rolls in Ryman."

Smith, whose book Your Baby, Your Body, Your Birth advocates a softer general approach to birth, adds: "And while keeping both mother and baby safe, we focus on the fact that this is a birth. We bring in the elements of normal birth: the mother can see her baby's sex at the same time as the operating team. The father can perform a second 'cutting of the cord' and the midwife can show him where to clamp it. It is entirely different from the experience parents have had before."

While plans to audit the effects of the natural Caesarean on mother and baby are in the pipeline, women who have heard of the technique want it now. The procedure is unsuitable for babies who are in the breech position, or when the baby or mother, or both, are in danger, or for premature babies whose lungs are not mature. But Ruwan Wimalasundera, consultant obstetrician at Queen Charlotte's, says that 90 per cent of his patients ask for the natural Caesarean and more than 100 have been performed in the past 18 months. "Parents love it," he says. "The benefits are obvious: mothers bond with their baby earlier."

Those who have had a natural Caesarean could not be more effusive. Camilla Fisher had one last summer, after an emergency Caesarean two years before. "It was the most relaxing environment: calm and reassuring," she recalls. "The staff and my husband were all in green surgical gowns, but it didn't feel like an operation. When you've had a natural Caesarean you wonder why it was ever different. I've never felt that I was deprived of a 'natural birth'."

Discuss your views on birth styles at timesonline. co.uk/alphamummy

How to have a 'natural' C-section

Jenny Smith, a leading midwife and author of Your Body, Your Baby, Your Birth (Rodale UK, £14.99), gives these tips:

Ask if the surgical team will play music and if your partner can take photographs.

Ask for an epidural dose that won't make your arms "heavy".

Ask for the screen to be dropped so that you can see your baby being delivered.

You can ask to call the sex of your baby yourself.

Ask the midwife to pass your baby directly to you so that you can enjoy skin-to- skin bonding immediately.

Ask that the father may perform the second "cutting of the cord" while the baby is in your arms.

Secondary Cesarean Sections Pose Risk Factors

Secondary Cesarean Sections Pose Risk Factors

Wednesday, March 18, 2009 by: Jen Patterson, citizen journalist

(NaturalNews) Doctors warn most expectant mothers with a previous Cesarean section about the risks of vaginal birth following a Cesarean (VBAC) but not about the risks of multiple Cesarean sections both to mother or her baby. The primary cause for concern during VBAC is uterine rupture, which could lead to the deaths of mother and baby. When told of that possibility, and often under pressure from her doctor, many women opt for a scheduled repeat Cesarean section.

That a Cesarean section is major surgery is often downplayed. Yet, risks to the mother include increased risk of emergent hysterectomy, hemorrhage, organ damage, infection with increased risks of rehospitalization, and cardiopulmonary and thromboembolic conditions. Surgical wound complications such as adhesions can cause bowel obstruction and chronic pain; pain at the incision site often persists beyond six months. Risk of maternal death is 4 times higher with Cesarean section than with vaginal birth, although this risk is small in both cases.

Babies born by Cesarean section have an increased risk of respiratory distress syndrome and a five-fold increase in persistent pulmonary hypertension over those born vaginally. Problems with future reproduction associated with previous Cesarean sections include infertility and numerous placenta problems. Placental abruption, where the placental lining separates from the uterus, rises from a risk of 1 in 1500 to 1 in 300 after just one Cesarean section; 20-40% of placental abruptions result in neonatal death. Placenta previa occurs when the placenta adheres to the uterus dangerously close to or covering the cervix and has a 5 times higher frequency after a Cesarean section. This risk increases with number of previous Cesarean surgeries: after 4 or more, placenta previa is 9 times more likely. Risk of ectopic pregnancy (those that develop outside the uterus or within the Cesarean scar) is slightly increased as well, with the likelihood about 1.3 times higher.

The occurrences of negative outcomes listed above are likely to increase as the rate of Cesarean section increases. As measured in 2005, the rate of Cesarean sections in the US was 30.2%. This excessive rate is due in part to the low incidence of VBAC which is in part due to maternal 'choice' and in part due to lack of VBAC support by hospitals and doctors. In his recent Naturalnews article, 'Early Repeat C-Sections Linked to Health Complications in Newborns' Reuben Chow states "...It is also likely that many women are opting for C-sections with the hope that it would be the easier choice of delivery. And the thing about C-sections is that, once a woman has had it once, she is very likely to use the same method for subsequent pregnancies." This statement reflects a common theme portrayed by the media that women choose Cesarean sections over vaginal births. However, the 2005 'Listening to Mothers' survey found only 1 woman out of 1500 who requested a primary Cesarean section (for a first birth that is). Choice of primary C-section is virtually non-existent. As for the choice of subsequent Cesarean section, VBAC is often not an option; many US hospitals officially ban VBAC, while others have 'de facto' bans where no doctor on staff will support one.

This risk that women are advised of, that of uterine rupture while attempting a VBAC, is about 6 in 1000 or 0.6%. During a primary vaginal birth uterine rupture can still occur and does at a rate of about 2 in 1000 or 0.2%. Additionally, because an obstetrician is required to be present in any hospital were a VBAC is underway, the risk of death to mother and baby during an actual uterine rupture is very low. With a skewed assessment of this risk and little, if any, assessment of the risk of secondary Cesarean, the ability of women to make informed decisions is badly compromised.

Birth is a natural process that can be very empowering for a woman. A Cesarean section is often the antithesis of birth empowerment and can be emotionally traumatic for many women. The International Cesarean Awareness Network (ICAN) has more information including local support groups (http://www.ican-online.org).

Hemminki, E. and J. Merilinen 1996. Long-term effects of cesarean sections: ectopic pregnancies and placental problems. American journal of obstetrics and gynecology 174: 1569-1574
Zelop, C. and L.J. Heffner 2004. The downside of cesarean delivery: short-and long-term complications. Clinical Obstetrics and Gynecology 47: 386-93.
Fang, Y.M. and C.M. Zelop 2006. Vaginal birth after cesarean: assessing maternal and perinatal risks--contemporary management. Clinical Obstetrics and Gynecology 49: 147-153.
Lamaze International: http://www.medicalnewstoday.com/art...<http://www.medicalnewstoday.com/articles/\40783.php>
Block, J. 2007. Pushed The Painful Truth About Childbirth and ModernMaternity Care, Da Capo Press, Cambridge, MA.

"The Trouble With Repeat Cesareans"
by Pamela Paul
February 19, 2009


"For many pregnant women in America, it is easier today to walk into a hospital and request major abdominal surgery than it is to give birth as nature intended. Jessica Barton knows this all too well. At 33, the curriculum developer in Santa Barbara, Calif., is expecting her second child in June. But since her first child ended up being delivered by cesarean section, she can't find an obstetrician in her county who will let her even try to push this go-round. And she could locate only one doctor in nearby Ventura County who allows the option of vaginal birth after cesarean (VBAC). But what if he's not on call the day she goes into labor? That's why, in order to give birth the old-fashioned way, Barton is planning to go to UCLA Medical Center in Los Angeles. "One of my biggest worries is the 100-mile drive to the hospital," she says. "It can take from 2 to 3 1/2 hours. I know it will be uncomfortable, and I worry about waiting too long and giving birth in the car."

Much ado has been made recently of women who choose to have cesareans, but little attention has been paid to the vast number of moms who are forced to have them. More than 9 out of 10 births following a C-section are now surgical deliveries, proving that "once a cesarean, always a cesarean"--an axiom thought to be outmoded in the 1990s--is alive and kicking. Indeed, the International Cesarean Awareness Network (ICAN), a grass-roots group, recently called 2,850 hospitals that have labor and delivery wards and found that 28% of them don't allow VBACs, up from 10% in its previous survey, in 2004. ICAN's latest findings note that another 21% of hospitals have what it calls "de facto bans," i.e., the hospitals have no official policies against VBAC, but no obstetricians will perform them. (Read "The Year in Medicine 2008: From A to Z.")

Why the VBAC-lash? Not so long ago, doctors were actually encouraging women to have VBACs, which cost less than cesareans and allow mothers to heal more quickly..."

Deaths of two NJ women

May 11, 2007

The women of the International Cesarean Awareness Network offer their deepest sympathies to the families of Melissa Farah and Valerie Scythes, two New Jersey women who died after undergoing cesarean surgery. This tragedy affects not just these new families; it is a tremendous loss to the community.

While any birth poses small but measurable risks to mothers and babies, it is well-established that cesareans increase the risk of a mother dying by 3-4 times.  Common causes of maternal death by cesarean include: hemorrhage, infection, post-operative blood clots, and adverse reactions to anesthesia.

Read the entire statement...

New Statistics

February 09, 2007

The 2004 and 2005 numbers, straight from the CDC.

The final state by state data for the US cesarean rates have been released for 2004 and 2005's preliminary dates are included. The CDC expects to post final data for 2005 in late spring 2007.

Breaking News

November 21, 2006

ICAN Names Top 15 Studies That Should Keep Mothers Out of the OR

As the number of cesarean sections in the U.S. continues to mount, so does the research showing that mothers and babies may be paying a high price for this surgery.  Research published just in the last year has highlighted the short-term and long-term risks of undergoing a cesarean, for both mother and baby.  Other research has called into question the assumed safety advantage of cesarean section over vaginal birth in various situations including vaginal birth after multiple cesareans and breech deliveries.

“Everything we know and continue to learn about cesareans supports more judicious use of the surgery,” says Tonya Jamois “but it is clear that the procedure is being overused.”

Major pieces of research released in 2006 showed that women who undergo cesareans versus women experiencing a vaginal birth have a higher risk of dying in childbirth, have a higher chance of suffering from potentially fatal placental problems in subsequent pregnancies, and their babies have a higher chance of being injured during surgery.  The list of 15 studies that ICAN collected also shows that vaginal birth after cesarean, including multiple cesareans, continues to be a reasonably safe birthing choice for mothers.  Read Entire Press Release

What is ICAN?
The International Cesarean Awareness Network, Inc. (ICAN) is a non-profit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC).

The Southern Nevada Chapter of ICAN supports the community by offering free monthly meetings on topics related to pregnancy and birth, with an emphasis on cesarean prevention, recovery and VBAC.  In addition to the meetings we offer telephone and email support, a lending library and community referrals as needed.

Statement of Beliefs

We, the International Cesarean Awareness Network, Inc., believe that:

1. The cesarean section rate remains at an alarmingly higher rate than the 15% average recommended by the World Heath Organization (WHO). WHO estimates that half (50%) of all cesarean sections performed in the United States are unnecessary.

2. When a cesarean is necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. With half the cesareans being performed deemed unnecessary by WHO, the risks these mothers and babies are exposed to are avoidable and costly.

3. In most cases VBAC is safe for both mother and infant. A repeat cesarean should never be considered routine- it is major abdominal surgery with many risks.

4. Birth is a normal physiological process. Given sincere emotional support, real education, and an honest opportunity, 90-95% of women can deliver vaginally, joyfully, as nature intended.

5. Women have the right to accurate information regarding nutrition and risks of drugs during pregnancy and labor. Poor nutrition, smoking, alcohol, and medications taken during pregnancy and labor often affect the infant's well-being and contribute to unnecessary cesareans.

6. Women have the right to the information necessary for using medical technology and procedures judiciously. The misuse of technology has fostered the high cesarean rate. Women have the right to know what tests are being performed, the side effects of such tests, the right to decline any procedures. Informed consent is not a privilege, it is a right of all birthing women.

7. Women must be allowed to express all their birth related feelings in a safe and supportive environment. The emotions of a pregnant and birthing woman have profound effects on the birth outcome.

8. Patient-choice cesareans are unethical and immoral on the part of physician. Women are not being fully informed of the risks of this option in childbirth, and therefore make decisions based on cultural myth and fear surrounding childbirth.

9. We as women must now assume more responsibility for our own bodies and births. At stake are our babies, our bodies, and our futures.

banner courtesy of ICAN Alaska

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