Impactful Tweets (pt 2) from ICAN Conference

Looks like @DeepSouthDoula is the winner of cool tweets, part 2.  I’ll have to tell her the amazing news, LoL!  Looks like there will have to be a part 3 tonight.  Henci Goer has already made some great points, and she’s only just gotten started!  w00t!!  Here’s the link to part 1 if you missed that post.

DeepSouthDoula Abdominal scars can change your overall body mechanics for the worse. #ICAN2011
Interesting how people don’t consider what happens to the muscles and especially the connective tissue as a result of this major abdominal surgery.  I’m a professional opera singer and rely on the entire abdominal complex to support my sound.  This includes the pelvic floor.  This entire structure has been permanently altered.  Have you considered how your cesarean might (will) affect you physically?

poderyparto Herrera: People should see a c/s. Once they ser it they’ll start asking more questions. #ICAN2011
This is an interesting statement.  I just don’t imagine your average woman would be interested or even willing to watch a cesarean surgery.  And really, it’s different being in the room when one is happening versus seeing it on TV or YouTube.

Preparing4Birth: #ICAN2011 @ICANtweets Insurance company should not mandate how doc works. Write congressman. A state issue
This is HUGE.  I was aggravated to learn from my OB that his malpractice insurance doesn’t cover vaginal breech delivery.  He’s an older doctor, so of course, he knows how to do it.  I think it is incredibly unfair that my second birth was dictated by someone else’s friggin’ insurance!!!

Ethologicmom #ICAN2011 amazing that dice didn’t realize that women choose or are forced into hbacmom by bans and lack of support!
Dice?  I have no idea.  But yes, women increasingly choose homebirth and unassisted birth because they ultimately feel unsupported by some (or all) careproviders.  A woman who feels forced into homebirth or unassisted birth are not ideal candidates for those settings.  A woman should have access to the care she desires.  We’re the ones paying for it!!!

DeepSouthDoula The only true way to know if you will have a successful VBAC is to try. #ICAN2011
I just can’t imagine not trying . . . even though people would try to scare me out of it.  Fearmongering is not the way to go, folks . . . studying the evidence is!

drpoppyBHRT How do we “grow” supportive providers? #VBAC @BirthingKristin #ICAN2011 #NIHVBAC
I imagine that since newer docs are typically less willing to recommend VBAC (based on NIH VBAC consensus report), that now that the ACOG recommendation has been revised, perhaps the new generation of OBs will be less resistant.  This doesn’t mean we shouldn’t be doing everything we can to positively affect our local birth culture!

DeepSouthDoula Any person pregnant or not has the right to refuse medical treatment – even in an emergency. Goes for refusing CS. #ICAN2011
One of my friends is having her 3rd VBAC after cesarean.  We were performing out of town, and she thought the local hospital didn’t allow VBACs.  She was relieved to learn (from me . . . yay me!) that she did NOT have to consent to a cesarean if she had the misfortune of going into labor in that town.  On the other hand, it would have been an opportunity for us to ‘educate’ that particular hospital on the rights of childbearing women! ;)

DeepSouthDoula Have the NIH & ACOG statements ready & use them to our advantage. #ICAN2011
Great advice!  I’m on Spring Break right now, and honestly, I’m just now getting around to reading the NIH VBAC Consensus report.  Eye opening, really.  I’ve “clipped” out the conclusion summary and points within the detailed section of the statement that directly apply to my situation or to issues that seem most critical to me.  I will be bringing some of this information with me as I interview an OB regarding VBA2C.

DeepSouthDoula SHARE – ORGANIZE – PROMOTE – CHANGE. Make connections through social media. #ICAN2011
Following the #ICAN2011 channel has shown me that a lot of birthies are now quite active on twitter.  I guess I’ll pay more attention to twitter . . . at least for a while.  Birthies and moms are welcome to request to follow me – @labortrials.


Impactful Tweets (pt 1) from ICAN 2011 Conference

I’m taking a break from my “Emotional Clutter” post that I’ve been working on.  Ahhh, nice to take a breather from that topic.  My friend, L, pointed me to http://twitterfall.com as the best hashtag (#) reader out there.  And well, she would know!

So, I’ve been reading the #ICAN2011 channel and want to share some of the tweets that I’ve seen that should make an impact on VBACtivists as we do our important work!  (Since I’m pulling this content from a public channel, I am not asking permission to repost.  I will remove tweets if the OP requests.)

@DeepSouthDoula: [Macones] Be patient and keep working on us (OBs). Things will get better but it will take time. #ICAN2011
This is encouraging to read.  Other tweets indicate that consumers should be addressing hospital administrators.  However, from personal experience I can tell you that our hospital’s CEO said he can’t make the OBs change.  It’s easy for folks to displace and deflect in this business.

@Preparing4Birth: VBAC candidacy – low vertical incision 98% are this type. 1 or 2 prior ces should have access. Birthweight not a predictor. #ICAN2011
I read another tweet that indicated he supports VBA2+C but that it takes the right patient with the right provider in the right hospital.  I’ve also read that the steepest increase in rupture rates is between 1 (.5%) and 2 (1%) cesareans and then begins to level out.

@Unnecesarean: Macones: We’ve all focused so long on uterine rupture but need to also focus on the consequences of multiple cesareans #ICAN2011

@babydickey: We are underestimating the risks of multiple c-sections. #ICAN2011
A great site for weighing the risks of VBAC and repeat cesarean is Childbirth Connection.  Also have a look at the NIH VBAC Consensus.

@ShannonMitchell: When vbac rates CAN be 60-80% Don’t ask me to wait for ten years for a 20% rate #ican2011 #birthaction
I love me some Shannon.  She’s absolutely right, so we all need to get off of our duffs and DO SOMETHING!  Or do MORE!!

@ Unnecesarean: Macones: If hospitals can’t respond to emergencies, they probably don’t have any business doing obstetrics. (attributed to Landon) #ICAN2011
This is a very important point and should be addressed any time a facility with a maternity ward imposes a VBAC ban.  People who live in towns with VBAC bans in place should write letters to the paper, picket the hospital, and set up an on-line petition at the very least.  The average family doesn’t know that a facility that can’t handle a VBAC is unsafe for childbirth.

@ShannonMitchell: From 30 to 32% is 40,000 cesareans #ican2011 #birthaction
Wow, 30-32% is not nearly as offensive as knowing that 40,000 more women were cut open . . . many (most?) unnecessarily!  And other tweets indicate that the 40K cuts refer to the increase from 32-32.9% (our current national cesarean rate).  If that’s the case, how is that not perceived as a national crisis????

@tiffrobyn: Dr Macones: ECV, CVS testing, carry 1-2% risk, greater than vbac. #ICAN2011
Tests and procedures (including cesareans) that OBs may offer are sometimes riskier than what they refuse to do (attend VBAC).  I will say that I’ve never been offered an amnio, ECV, or CVS even at my advanced maternal age. ;)

More later, I am certain . . .

Cesarean Awareness Month 2011

© Amy Swagman, 2010 -www.themandalajourney.com

© Amy Swagman, 2010 -www.themandalajourney.com

So another year has passed, and I’m back to wondering where we are with our cesarean awareness ‘campain.’  I’m somewhat ‘skirting’ the loop (not really inside or outside of it, just around), so I’m not your most up to date source.  For truly outstanding resources related to cesarean awareness, read Unnecessarean and VBAC facts for starters!

A couple of things that have my attention lately:

  • Our national cesarean rate is staggering, and some predict that by 2020, 1/2 of our births will be done by cesarean.  We must be vigilant!
  • Montana needs a Friends of Montana Midwives group
  • Montana’s cesarean rate is 29% just below the national average.  However, some counties in MT have super high cesarean rates.  Why is that? (Carter County had a 65.4% c/s rate 2005-08 according to the March of Dimes!!!!)
  • Birth activist are working so hard – it’s just awesome!  Thank you to all who are gettin’ it done!!
  • According to Childbirth Connection, “A high-quality, high-value maternity care system is within reach, and childbearing women are the most important stakeholders to drive system change.”  Have a look and see what you can do!
  • Also, through Childbirth Connection, I’ve learned about relevant legislation that has been introduced.  This legislation needs our support!!
  • ICAN is getting ready for the 2011 conference – wish I could be there . . .

Because I’m pregnant I’m in a great position to find out even more about what is being done locally and what still needs work.  I have found – contrary to what my OB told me – that a few OBs will consider VBA2C on a case by case basis.  I have discovered that our only independent birth center, run by a fantastic CNM, does VBACs (even primary!) but not VBAmC.  I have lots of friends who are pregnant these days and have learned a lot about local practices.

Because I’m pregnant with #4 and work a full time job (one that often has me out of town on weekends in the Spring and has me out at night), I haven’t had the time & energy to get more aggressive.  This too shall change, and when it does – LOOK OUT!  ;)

In the meantime . . . what can you do?

Cesarean Recovery, v.1

I am annoyed by my cesarean recovery.  I am more than 5 months post partum and still have pain and tenderness on the left side of my abdomen.  I’m sure I must have a number of adhesions that need to be broken down.  I did attend ICAN’s webinar about scar care and have been doing some massage.  I use a few drops of Young Living’s lavender oil – I recommend a therapeutic/medicinal grade essential oil – and massage it into my skin.  I have to massage all along the left side of the top layer of abdominal muscles (rectus abdominus), and it’s tender from pelvis to ribs.  Not good.

I am also annoyed that so many people are resigned to putting themselves, their babies, and their patients through this major abdominal surgery without a really really good reason.  Fetal distress, small pelvis, cephalo-pelvic disproportion, maternal demand, and previous cesarean are the usual suspects and are not necessarily indication for a cesarean.  <sigh>  I recovered easily enough from my first cesarean, but this time around it’s a different story.

I’ll end v.1 here.  To recap, I am not pleased with my recovery because I still have significant tenderness and pain more than 5 months after my surgery.  Does that sound like fun to you?

Positive Thoughts On the Cesarean Section

One of my ICAN friends posted this on Facebook today:

BirthCut Calling all C/S mothers! I am looking for positive cesarean birth stories! I am also looking for any tips about the actual surgery and/or recovery you may have for cesarean mothers. And, well, anything else you may have — art, videos, etc etc. Thanks!

Interesting thought.  Do I have anything positive to say about my cesareans?  Actually, I think I do:

DECEMBER 2004

I was exhausted from the flu – vomiting and pooping everywhere.  The illness forced my body into labor before we were ready.  Although I arrived at the hospital at 9cm dilated, my baby quickly got stuck.  I don’t know if I could have pushed her out.  I was so utterly exhausted.  I pushed with everything I had and it still wasn’t enough.  By the time I had the cesarean I was incredibly thankful for the “convenience” of modern medicine.

I did recover quickly physically.  I don’t recall feeling poorly for long.  And I still felt like superwoman . . . for a while, anyway.

AUGUST 2009

Pregnant with twins which meant that I was “risked out” of homebirth and birth center birth.  By 37 weeks both twins were breech.  When my Baby A broke her water in the middle of the night, I knew she did it with her feet.  I was so disappointed because the LAST THING I WANTED was to go through major abdominal surgery again.  I had learned so much about my body . . . I learned that my miscarriages were likely influenced by the presence of adenomyosis (caused by the first cesarean in 2004) . . . I knew that if I were to get pregnant again that a VBAC after 2 cesareans would be nearly impossible unless I wanted to try it alone . . . I know that these abdominal surgeries are risky in my line of work (I’m an opera singer).

I had considered bucking the system since breech is a variation of normal, depending on who you ask.  I thank God for guiding me elsewhere, because my precious Baby A would not have likely survived a vaginal birth.  She was entangled in her cord, and the cord was wrapped around her legs.  Both girls presented double footling breech.

Although I am still in pain 5 months later, and have yet another scar, and have yet another saggy somewhat sensation-less flap of skin above my scar, and have found my singing to be anything but stellar due to my weakened core, I am thankful that a cesarean was available to me.

I don’t recommend a cesarean unless it is really REALLY necessary . . . sad that probably half of the cesareans that are performed in the United States are likely not necessary.  A cesarean is considered a morbidity because of its seriousness – it’s a MAJOR abdominal surgery.  However, there are situations where a cesarean may be prudent or necessary.  When the technology is used appropriately, it is indeed a blessing.  To learn more about c-sections, visit Childbirth Connection and ICAN.

Cesarean Scar Care Webinar

I just attended the Cesarean Scar Care Webinar with Isa Herrera via the International Cesarean Awareness Network (ICAN).  What a terrific benefit for subscribers (it was free), a great introduction to ICAN for folks who aren’t subs, and a great cost ($15) for non subscribers.

Herrera is the author of Ending Female Pain and performs physical therapy in New York City.  I was excited to attend this webinar because 5 months post cesarean, I still have a LOT of pain and tenderness, especially on the left side.  I imagine this has a lot to do with E’s position in utero.  Herrera said that an uncomfortable lie can cause more adhesions, so obviously I have a lot of work to do to break up those adhesions and get to healing!

Herrera states:

“Women coming to me are often not getting the tools and advice they need . . .” to recover from cesareans.

Sad but not surprising.

Something I previously misunderstood:  according to Herrera the abdominal muscles (the recti) are not cut during surgery.  Instead, they are pushed to the side.

Something else I didn’t know:  during a cesarean 8 layers of fascia and connective tissue are cut.  From what I previously learned, it’s the damage to the fascia and connective tissues that compromise the uterus the most.

Something of which I am skeptical:  Herrera hypothesizes that regularizing and rehabilitating the scar tissue and adhesions may reduce the risk of uterine rupture in future pregnancies and labors.  The reason that I am skeptical is that from what I know about scar formation and healing, scar tissue NEVER approximates undamaged tissue.  Scar tissue organizes differently from undamaged tissue.  On the other hand, it is possible that with Body Talk or acupuncture or other healing modalities that damaged tissue can be restored.  And it’s not like my arm splits open every time I use it, and I have a large gnarly scar on it!

Herrera talked us through a number of exercises and stretches that should help break up adhesions and encourage healing.  The ones that I plan to start using immediately are “long strokes,” “longitudinal stretches,” and kegels while drawing in my abs.  I’ve also started using my Wii Fit and have found that the exercises there have woken up my core a bit.  I am also massaging lavender oil, purchased from Young Living because of the medicinal-grade quality, into the “damaged” areas.

For more information on cesarean scar care, purchase Herrera’s book.  Also, check out the websites http://www.apta.org and http://www.pelvicrehab.com.

April is Cesarean Awareness Month

For those of you who do not know, April is Cesarean Awareness Month. Did you know that our national cesarean rate continues to increase every year? Over 31% of births take place surgically via cesarean section. Consumer Reports has named cesarean surgery one of the top overused procedures in the United States. Even though the US tends to deal with pregnancy and childbirth from a medical perspective, our country’s maternal/fetal outcomes are among the WORST in the industrialized world. I hope you will take some time this month to learn about cesarean surgery, why women in your communities may not consider cesarean-born babies to have been birthed, why women are having more trouble post-cesarean with becoming or staying pregnant, why women may have less access to birthing options following a cesarean, and why women should be searching for less medically-interventive options for pregnancy and childbirth. Talk to people in your community about preventing unnecessary cesareans (keeping in mind that cesareans are appropriate for some emergent situations and in case of emergency), midwifery care (nurse-midwifery and professional midwifery), birth venue choices, and how to help someone recover from a cesarean. For more information on Cesarean Awareness Month, visit http://www.ican-online.org and also search for a local chapter. Together we can make a difference, one birth at a time.