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Old 05-30-2008, 12:53 PM
 
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If by "legitimate" you mean information that you agree with and that ACOG endorses, you will probably be disappointed.
Yes, this. Everyone has their own take on how to handle stuff. I don't seek in any way to convince you, Ima, or anyone else, that the way I do things is the right way for you. Hell, I don't even need to convince anyone that they're the right way for me. I'm just going to to what is best for me, based on thirty real time years of being here, living this particular frame of reference.

My own very limited background in liberal arts, in addition to just being a living human, show me that life isn't full of guarantees and 'Insert Tab A into Slot Bs'

For me, what the dominant culture calls prenatal 'care', is what I call 'scare', and it would not benefit me and my family to seek it. Do you have ultrasounds performed on your spleen? On your intestines? How often? After all, the fact that you are functioning, digesting, surely isn't adequate insurance that there isn't something wrong, is it? (Read heavy sarcasm on last sentence).

Why treat your uterus differently? In my mind, it's misogyny that has got us treating our womanly parts as ticking time bombs, and personally, I just don't sign up for misogyny. There's enough of it out there without me seeking it and paying for it, yipes!
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Old 05-30-2008, 01:16 PM
 
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Originally Posted by ima-06 View Post
why do you think anesthesiologists cannot give general anesthesia to get a baby out during a crash c-section? what makes you think it takes 30 minutes to do a crash c-section in a hospital?
The thing is, the anesthesiologists are not just hanging around the laboring woman waiting for a cesarean, they are usually working elsewhere in the hospital. They have to finish up what they are doing and get to the woman which can take longer than five minutes. In a small town they may have only one anesthesiologist and it can take a while for them to get on the scene.
Even if an anesthesiologist was available immediately it would still take time.

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Old 05-30-2008, 01:18 PM - Thread Starter
 
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what a random series of assumptions. the reason to do a vba3c or a vba2c in a hospital (in an OR, in my opinion) is that there IS an anesthesiologt hanging out there. when your risk goes up, attention goes up.
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Old 05-30-2008, 01:35 PM
 
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Why do you bring your questions to the UC forum? You're not interested in having a UC and it seems like you're more interested in learning about home birth.

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Old 05-30-2008, 02:10 PM
 
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Originally Posted by ima-06 View Post
what a random series of assumptions. the reason to do a vba3c or a vba2c in a hospital (in an OR, in my opinion) is that there IS an anesthesiologt hanging out there. when your risk goes up, attention goes up.
This is an absolutely ridiculous suggestion. There is a less than 1% chance of UR. Catastrophic rupture, even less. There are other emergencies that are more frequent than catastrophic rupture, but we don't send every woman to birth in an OR "just in case" Heck, lets give them all sections just to ward off any emergencies

OT, Greenlee, i have been an admirer of your jewelry since i first started posting on MDC. What gorgeous work!

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ribboncesarean.gif vbac.gifhomebirth.jpg I have given birth a variety of ways and I am thankful for what each one has taught me.

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Old 05-30-2008, 02:16 PM
 
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why do you think anesthesiologists cannot give general anesthesia to get a baby out during a crash c-section? what makes you think it takes 30 minutes to do a crash c-section in a hospital?
No what I said is OB's are not permited to use anas. Also I said it can take up to 30 minutes. I also said (wondering if my post was read all the way) that in a catastrophic rupture they have roughly 5 or less minutes to get baby out.

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Old 05-30-2008, 02:23 PM - Thread Starter
 
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it's a good question about why i posted in a UC forum rather than a home birth forum. it's because i assume (perhaps incorrectly) that i know the answers to my original risk questions if i posed them to a hb midwife, for example, who would guide/advise an attended hb. it's the UCers who are operating in a really different "space" that i wanted to hear from.

there is a "less than 1%" chance of uterine rupture in a vba1c. now, a vba2c or a vba3c is a different story. you got stats on that one? i don't.
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Old 05-30-2008, 02:32 PM
 
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There was a statement a few months ago that vbamc is statistically just as safe as vba1c.

http://www.usatoday.com/news/health/2006-06-29-vbac_x.htm

And who knows if that includes inductions, which would drop the numbers more.

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ribboncesarean.gif vbac.gifhomebirth.jpg I have given birth a variety of ways and I am thankful for what each one has taught me.

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Old 05-30-2008, 02:36 PM
 
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Originally Posted by ima-06 View Post
what a random series of assumptions. the reason to do a vba3c or a vba2c in a hospital (in an OR, in my opinion) is that there IS an anesthesiologt hanging out there. when your risk goes up, attention goes up.
Ok well first they arn't assumptions. And second in a VBAC attempt at the hospital yes they do have a anasth. in house. But where in house will determine how long it would take them to get there. They don't just sit outside of the laboring moms room. They are off doing other things, consults ect. For 3 if you think the the risk of uterine rupture should require VBAC moms to deliver in the OR then ALL moms should have to. The risk of uterine rupture is LOWER then cord prolapse and that can happen to any momma at any time.

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Old 05-30-2008, 02:38 PM
 
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Yes, check out A Guide to Effective Care in Pregnancy and Childbirth (Murray Enkin, et. al.)

"Data on the results of trials of labor in women who have had more than one previous cesarean section tend to be buried in studies of vaginal birth after previous cesarean as a whole. Now that vaginal birth after one cesarean section has received widespread acceptance, reports specifically about series of trials of labor in women who have had two or more cesareans are appearing in the literature. The available data show that among these women the overall vaginal birth rate is little different from that seen in women who have had only one previous cesarean section. Successful trials of labor have been carried out on women who have had three or more previous cesarean sections.

The rate of uterine dehiscence in women who have had more than one previous cesarean section is slightly higher than the dehiscence rate in women with only one previous cesarean, but dehiscences in the reported series tend to be asymptomatic and without serious sequelae. No data have been reported on other maternal or infant morbidity specifically associated with previous cesarean sections.

While the number of cases reported is still small, the available evidence does not suggest that a woman who has had more than one previous cesarean section should be treated any differently from the woman who has had only one cesarean section." That is on page 364, for those of you curious.
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Old 05-30-2008, 02:39 PM
 
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Originally Posted by ima-06 View Post

there is a "less than 1%" chance of uterine rupture in a vba1c. now, a vba2c or a vba3c is a different story. you got stats on that one? i don't.
http://www.greenjournal.org/cgi/cont...tract/108/1/12
Now according to the newest research that was done just a few years ago this shows that in VBAMC (Vaginal Birth after multiple cesareans is still LESS then 1% at .9%

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Old 05-30-2008, 03:15 PM
 
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Originally Posted by ima-06 View Post
what a random series of assumptions. the reason to do a vba3c or a vba2c in a hospital (in an OR, in my opinion) is that there IS an anesthesiologt hanging out there. when your risk goes up, attention goes up.
Not at our local hospital. If I were to VBAC at a hospital (and hell will freeze over before that occurs) an anethesiologist would be on campus, but NOT in the labor/delivery room. The VBACs do not occur in an OR, but in the regular labor/delivery suites.

In the interest of disclosure I've had both an HBAC and an UBAC and had a much easier labor and birth being alone. I chose the positions in relation to communication from my baby/body and I had less trauma to my baby and my body as a result.

No one, no matter how well "trained" he or she is, can ever know my body or my babies (in utero) better than I can. They lack the internal communication and knowledge.
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Old 05-30-2008, 04:17 PM
 
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Most hospitals won't even do VBACs anymore. At our local hospital, even the OBs (who are relatively conservative) protested this, because they're at least smart enough to know that routine c-section is not the safest option for all women. Enforcing scheduled c-secs for all women who have had previous cesareans is not evidence-based care.

The reason for this? Money. ACOG has deemed VBACs especially at risk for rupture (based solely on the fact that induced VBACs are slightly more at risk for rupture, 'cause you never know when you are going to need that pitocin, right? ) so that an anesthesiologist must be available at all times during the labor. Well, most hospitals are not interested in the cost of having an anesthesiologist right there throughout the entire labor, rather than just on-call. Our local hospital certainly isn't. When my son had to have an operation in the middle of the night, they had to call the anesthesiologist at home, wake her up, and have her come in.

Even if I believed that all VBACs are inherently slightly more risky than non-VBACs, if my only option was a non-medically-indicated surgical delivery, you bet I'd be looking at homebirth.
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Old 05-30-2008, 04:46 PM
 
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I am closing this thread, based on the UC Forum Guidelines. I am, however, leaving it up due to all the excellent information presented here. Please take a moment to review those guidelines and the MDC User Agreement.

If there are any questions or concerns, please PM me. Due to technical issues, I am not receiving reports at the moment.
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