VBACs are more likely successful if you call the midwife

A new study shows that VBACs (Vaginal Birth After Cesarean) are more likely to be successful if a midwife provides the care instead of an obstetrician. 

You can read a portion of the abstract of the study here, and an excerpt is below:

Background

Research is yet to identify effective and safe interventions to increase the vaginal birth after cesarean (VBAC) rate. This research aimed to compare intended and actual VBAC rates before and after implementation of midwife-led antenatal care for women with one previous cesarean birth and no other risk factors in a large, tertiary maternity hospital in England.

Conclusions

Implementation of midwife-led antenatal care for women with one previous cesarean offers a safe and effective alternative to traditional obstetrician-led antenatal care, and is associated with increased rates of intended and actual VBAC.

US C-Sections Rate: Too High

If you've been or are pregnant in NYC,  probably one of the first things you did was to figure out who your doctor would be and where you would give birth. You may have spent hours googling something like "NYC OB low cesarean rate," or "NYC hospital low c-section rate." And you may or may not have found the answers you were looking for. Consumer Reports just released an article reviewing the current state of cesarean births and rates by hospitals around the country. Many of the hospitals in NYC that my clients have given birth in do not release their statistics. Considering that your biggest Cesarean risk might be the hospital that you give birth in, withholding c-section rates by hospital (and even by practice or doctor) just doesn't seem ethical.

You can read the full article here: http://www.consumerreports.org/doctors-hospitals/your-biggest-c-section-risk-may-be-your-hospital/

Seeding the Microbiome

This is a relatively new phenomena that has come up in the birth world as more and more research on the significance of gut health and our microbiomes has emerged. In birth, this applies in particular to a vaginal vs. Cesarean birth. During a vaginal birth, the baby is colonized, or "seeded" with bacteria from the mother's vagina, which leads to long term health benefits; in a Cesarean birth, the baby does not have the same bacterial colonization opportunity. It is because of this that some women are looking to simulate this process at the time of a Cesarean.

We are just now beginning to understand that many modern day health conditions, such as colon cancer, Autism, and mental health (just to name a few) are likely affected by the balance, or lack of balance, in good and bad bacteria in our bodies. Think of the recent surge in the understanding and promotion of probiotics, our understanding of antibiotics, and the fermented food movement. 

The recent documentary "Microbirth" focuses on bacterial health in birth, as well as some recent articles below. You can also check them out to understand how some women are choosing to take vaginal seeding into their own hands in the event of a Cesarean.

https://www.scienceandsensibility.org/p/bl/et/blogid=2&blogaid=825

http://www.positivebirthmovement.org/pbm-blog/category/gauze-seeding

http://www.mostlymicrobes.com/vaginal-seeding/

Using a Mother’s Microbes to Protect Cesarean Babies

"The first germs to colonize a newborn delivered vaginally come almost exclusively from its mother. But the first to reach an infant born by cesarean section come mostly from the environment — particularly bacteria from inaccessible or less-scrubbed areas like lamps and walls, and skin cells from everyone else in the delivery room.

That difference, some experts believe, could influence a child’s lifelong health. Now, in the first study of its kind, researchers on Monday confirmed that a mother’s beneficial microbes can be transferred, at least partially, from her vagina to her baby after a C-section."

Read the full article from the NYT Well Blog here.