Day 2 Pt 1 Impactful ICAN Conference Tweets

The working subtitle of this post is . . . you can lead an OB to the table, but can you keep him/her from cutting??

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Here are some of my favorite tweets from the Saturday morning sessions.  (And as I look at the 300+ conference tweets paused in twitterfall this morning, the day after, I realize there may not be a part 2 . . . kind of like History of the World!)

Disclaimer: Since I collated these posts from a public feed reader, I have not asked permission to repost them.  OPs may request their tweets be removed and are welcomed to clarify their tweets in the comments section.)

Regarding breech:

BirthingKristen “Women should have the right, the support, and the resources to choose their own set of risks.” #vaginalbreech #ICAN2011
I do believe this, but gee, it’s hard to achieve especially when you involve birth attendants, regulations, insurance, hospitals, even birth centers, etc.  I’m afraid to say that the fact is that women will never fully have the right to choose their own set of risks unless they birth on their own.

DeepSouthDoula Vaginal breech birth is in our reach but it’s up to the parents to make it happen. Like the parents who walked out 1 hour prior. #ICAN2011
Again, somewhat idealistic.  In my case, I knew I’d be trying to fight my provider’s malpractice insurance . . . me . . . alone.  I’m not saying there aren’t things we can’t and shouldn’t do, but realistically many, if not most, families are not going to fight the system one hour before giving birth.  And they shouldn’t be made to feel like failures because they didn’t fight this overwhelming machine.

ShannonMitchell GT: breech birth is a part of the traditions midwifery #ican2011 #breech
Yes it is.  Isn’t it a shame that it’s often not in the current scope of practice for traditional midwifery?

DoulaMari: “Mama loves you enough to have you at home even though you were breech!” #ican2011
This just hurts my feelings.  I know the statement had nothing to do with me or my choice to consent to a CBAC for double footling breech twins and that it’s excerpted from an emotionally powerful experience, but it still cuts like a knife.  Actually, it feels like a repetitive cut to the same wound that refuses to heal.

drpoppyBHRT When docs tell midwives, “you can’t do that” is it really because THEY can’t do that? #vaginalbreech #normalbirthignorance #ICAN2011
Nice.  Yes, I think a lot of the time it does mean that.  They haven’t been trained to trust the body’s wisdom; they’ve been trained to search for pathology and treat that pathology.  Even the NIH VBAC consensus report indicates that younger doctors may be more resistant to VBACs because they were trained during a time when VBAC was (is) so highly contentious.

heathertom Tully: the question may be Is the attendant safe? #ICAN2011 #vaginalbreech
Absolutely.  I personally would be more afraid to show up at the hospital pushing out a breech baby if I didn’t know that the doctor on the receiving end was experienced with breech.  In fact, I’m of the opinion that in my community it may be irresponsible to show up at my hospital with a vaginal breech.  It hasn’t been part of the local practice – obstetrics or midwifery – for more than 10 years.

poderyparto Breech: 80% no intervention needed at all, 20% need maneuvering. #CAM2011 #ICAN2011
In other words . . . HANDS OFF THE BREECH!

drpoppyBHRT OBs in Germany and Israel are working to unite midwives and OBs to increase vaginal breech birth. I love that! #kneechest #ICAN2011
This is wonderful to know.  We should be pointing to these case studies every chance we get.  This will help us as we advocate for evidence-based care.

Other awesome tweets: (before I fell off the wagon)

drpoppyBHRT: Midwives told to stop doing #VBACs, they responded “when you stop doing cesareans.” Gail Tully #ICAN2011
AWE.SOME.

MamaBear1326 Why am I lucky enough to live where I achieved a vba2c and some people dont have that option #breaksmyheart #ican2011
Many women don’t feel they have the option to birth their babies.  This is so sad.  The fact is that women have fundamental rights.  No one can force you to consent to a surgery.  And even ACOG’s 2005 committee opinion supports protecting these rights:

Efforts to use the legal system to protect the fetus by constraining pregnant women’s decision making or punishing them erode a woman’s basic rights to privacy and bodily integrity and are not justified.”  (via birthaftercesarean)

Unnecesarean Dr. Poppy Daniels: “Women who really want a vaginal birth can go to extremes to get it.” (No kidding) #ICAN2011
And we will.

ICANofAtlanta How many ob-gyns have not read the latest ACOG practice bulletin on VBAC, not to mention the NIH consensus? #ican2011 #hcsm @drpoppybhrt
. . . and won’t acknowledge that local practice should change to reflect the bulletin and NIH findings.  This is why I’m sending letters to all local OBs.  I’m done with their fear mongering and lies.

RobinPregnancy T-shirt spotted: Keep your politics out of my vagina on @shannonmitchell #ican2011
Nearly snorted my coffee when I read this.  And I want one.

mollytoba I keep hearing about better integration of midwifery and OBGYN care. Who is actually doing this? Any successful models? #ICAN2011
Someone did respond to this, but I can’t find the tweet.  She mentioned some place in LA (which I can’t remember if refers to Louisiana or Los Angeles!).  But that was the only ‘successful model’ response I read.

DeepSouthDoula Exploring birth trauma in mamas AND with birth professionals. What we witness can be traumatic for us too. #ICAN2011
I may have to dedicate a post to this.  Birth professionals who experience trauma need to be treated!!!  Please refrain from bringing your trauma into future births.

babydickey “I’m not a uterus walking into an operating room.” I’m a pregnant woman with a family. #ICAN2011
<le sigh>

blairlovesjason Glad @drpoppybhrt discusses the harm in shows like Deliver Me, A Baby Story, etc. Means a lot coming from a professional. #ican2011
Totally!  I didn’t know any better and was watching these shows in 2004 when I was pregnant with DD1.  It made me afraid of the cesarean, but it didn’t do anything to help me (or encourage) me to prevent it.  It was like watching a car wreck in progress, over and over and over again.  Dammit, and then I wrecked my ‘car.’

ShannonMitchell Acnm says they are working on revised vbac statement addressing “immediately available” #birthaction #ican2011
Very good news.  The ACNM needs to step up and not hide behind ‘big brother.’

babydickey Midwives Alliance of North America (MANA) has a c-section rate of 5.03%. YEA! #ICAN2011
I trust this to be true, but it would be so helpful if MANA would release the data.  People want to see it.  I want to see it.  MANA hold plenty of statistics that to my knowledge are not publicly accessible.  It’s a shame.

mollytoba Ida Darreagh of NARM: the safest place for a woman to give birth is where she feels strong, supported and capable. #ICAN2011
Absolutely.  This is why I try to be super careful when talking with mamas who have different ideas about where to birth.  Everyone should feel safe giving birth.  It doesn’t ensure a perfect outcome, but it’s still important to respect one another’s decisions.

DeepSouthDoula Don’t feed the trolls! Seriously not worth it. As @unmarketing says – you are not the jackass whisperer. #ICAN2011 AND seeKJtweet Ok who said Beetlejuice? #ICAN2011
Oh my.  There is a persistent non-practicing OB with too much time on her hands who just hates natural birth advocacy.  She has quite a cult following.  I used to go to her blogs thinking there was something possibly to learn there . . . but it’s just so polemic that I realized I was wasting my time and scaring myself in the process.

RobinPregnancy Every state needs to look at the safe transport bill for home births. #ican2011
And where do I go to find that?  Over to Google.  Searched [“home birth” “safe transport” legislation] which didn’t come up with much.  But I did find that a bill is working its way through the Illinois General Assembly.  Have a look!  I found this as a result of reading this action alert from the Chicago-area homebirth meet-up group.

Impactful Tweets (pt 3) ICAN 2011 Conference

I tried to catch as much of the Henci Goer chatter on twitter as I could tonight.  We have a full house tonight (our 3 plus 2 neighbor kids spending the night, oy!) so I’m playing with less than a full deck.  Ha!

Disclaimer: Since I read these tweets on a public hashtag channel, I’m not asking permission to repost.  If anyone wants their tweet removed or wants to clarify a tweet, please let me know.

anderzoid #ICAN2011 henci goer: how much we have over medicalized birth? IV drip- not allowed to eat or drink – induction- cord clamping- etc
I assume this was a slide of the topics used to justify the point that birth is over medicalized.  My previous research leads me to concur that these are some of the ‘biggies.’

poderyparto Ineffective & harmful practices: sonograms to estimate fetal weight, planned cesarean for breech,not supported by research. #ICAN2011
Ultrasound is such a poor diagnostic tool for assessing fetal weight in the 3rd trimester.  I can’t recall exactly ‘when’ ultrasound is more accurate for predicting due ‘dates,’ but it’s very early on – I’m thinking 8-12 weeks gestation, but don’t quote me on that.  Only one mom out of the many I know personally that were told they were going to have a big baby actually did have a big baby.  Friends and family members who have had 3rd trimester estimates done with specialists have birthed babies 2 pounds lighter than predicted!!!!  Regarding the no-questions-asked cesarean for breech – a flawed Canadian study is what dictates current US practice.  Thank goodness Canada is taking the lead to restore breech as a version of normal.

bbybirthingmama Scheduling a section for breech, twins, “big baby” and slow labor are not supported by research! #ICAN2011
I was sad to discover that 75% of twins in Montana are born by cesarean.  I imagine all breeches are born by cesarean except for the rare surprise breech or unattended breech births.  Many docs aren’t ‘allowed’ by their insurance companies to deliver breeches naturally – how convenient for them.  Slow labor – yeah!  Most women just DON’T dilate 1cm/hr.  I REPEAT – MOST WOMEN AREN’T GONNA DILATE ACCORDING TO FRIEDMAN’S CURVE.

tconsciousdoula The way to get a VBAC? Tell the Dr you are planning on having 10 children! #ican2011
Now that’s a good one.  I’ll have to add that one to my list!

babydickey: Perinatal death from csec scar uterine rupture is 6 in 10,000. But did you know pregnancy loss from amniocentesis is 60 in 10,000? #ICAN2011 AND Unnecesarean 6% of scar ruptures—> perinatal death (3 per 10,000). Compare to excess risk of pregnancy loss from amniocentesis… 60 per 10,000. #ICAN2011
Here’s what was stated in the NIH VBAC Report: “Approximately 6 percent of uterine ruptures will result in perinatal death. This is an overall risk of intrapartum fetal death of 20 per 100,000 women undergoing trial of labor. For term pregnancies, the reported risk of fetal death with uterine rupture is less than 3 percent.”

tconsciousdoula planned VBAC should be the norm (87%) actual rate is 9% (2007) #ican2011
Add this information to your notebooks in case you need to make the case for VBAC to a doctor, a nurse, a hospital administrator, or a friend.

tiffrobyn A 41 week pregnancy is not only normal, it is AVERAGE! #ICAN2011
Like . . . duh.  Why have care providers forgotten that?  Well, statistically that may not be the exact average for all childbearing groups (i.e. primip vs. multip), but it’s absolutely ridiculous to pressure a woman into inducing at 41 weeks.  Some providers will start pressuring you at 39 weeks, especially if you let them anywhere near your cervix!

bbybirthingmama WHO Recommends no more than 10% induction rate. I didn’t know that. #ICAN2011 BUT poderyparto US induction rate 2005: 47% (babydickey tweeted 41%) of women planning vaginal birth! #ICAN2011 #CAM2011

shedenka So hospitals and docs tell ALL women “you can’t eat/drink” during labor. Total CYA: aspiration risk is 3.2 women out of 10 million #ICAN2011

nashvillebirth Henci Goer makes my head hurt in a good way. She always melts my face off. #ICAN2011
*Giggle*  This really made me smile.  I love having my brain hurt in a good way.  It’s invigorating!!

bbybirthingmama Early Cord Clamping can take up to 40% of newborns blood volume! #ICAN2011
I had no idea!  All of my babies have had their cords clamped immediately.  I will definitely add this to my notebook – I had decided a while back that I wanted delayed cord clamping.  I know it’s not really a strange thing to ask of a CPM but may be strange for an OB.

anderzoid Henci Goer still on ineffective & HARMFUL practices: Care by an OB for LOW-risk & MODERATE-risk women #ican2011
This point was made by a NYC OB in “The Business of Being Born.”  It’s overkill, and generally speaking, normal birth just isn’t exciting enough for them.  Plus, most of them have never seen a normal birth – especially the younger OBs.

anderzoid: #ICAN2011 #ppdchat Henci Goer: it’s hard to get #PTSD on radar bc TRAUMA is centered in Institution. DEPRESSION is centered in women.
This is a very interesting statement and one that I’d like to have fleshed out for me.  I can almost grasp it but not quite.  I will say that people seem to be aware of PPD and acknowledge it but are less able to grasp PTSD as it relates to childbirth (or pregnancy loss).

Want to read more conference hi-lights?  Here is part 2 and part 1 of my Impactful Tweets “coverage.”

DH & I have a big to do list for the weekend, so I don’t know how thorough future posts will be.  Enjoy the weekend!

EDITED to add “Birthing Beautiful Ideas’s” wrap-up of the day’s presentations at the ICAN 2011 Conference.  Have a look!

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 . . .