Dear Andrea Can you give me a reference for this Wollongong research by Alison Shorten re lack of good information for women?? Denise Hynd ----- Original Message ----- From: "Andrea Robertson" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, February 05, 2004 4:03 PM Subject: [ozmidwifery] A positive VBAC article
> This was in today's Sydney Morning Herald: > > ------------------------ > > > When push comes to shove > > By Liz Keen > February 5, 2004 > <http://www.smh.com.au/cgi-bin/common/popupPrintArticle.pl?path=/articles/20 04/02/05/1075853973714.html>Print > this article > <http://www.smh.com.au/cgi-bin/common/popupEmailArticle.pl?path=/articles/20 04/02/05/1075853973714.html>Email > to a friend > > Jennie Freedman had her first child delivered by emergency caesarean at the > Royal Hospital for Women (RHW) in Randwick in 2001. > > She had wanted a natural labour because she felt it would be safer for her > baby but the baby was posteria (meaning the baby's spine was facing her > mother's back) which often results in a long labour. > > Freedman passed through the first stage of labour and pushed for three > hours in the second stage before the midwives at the RHW birth centre > suggested she would need forceps or an emergency caesarean section. Her > baby daughter, Tianah, needed to get out and arrived eventually by > caesarean section. > > The experience made Freedman even more determined to attempt a natural > birth when she became pregnant again in 2002. > > "I wanted to know what it felt like to give birth," she says. But to her > surprise, several obstetricians she consulted pressured her to have another > caesarean, assuring her it would be safer for both her and her baby. > > Statistics recorded in the NSW Department of Health's Mother and Babies > Report showed that 29,000 women gave birth by caesarean section in NSW in > 2002 and many were now facing Freedman's choice of a repeat elective > caesarean or attempting a vaginal birth after caesarean (VBAC). > > Allison Shorten, a senior lecturer in midwifery at the University of > Wollongong, has conducted research that shows women are receiving varying > support in making this decision. "Many women appear to have very little > information about their options for birth," she says. "They are accessing > their information through the internet, friends, books or the hospital." > > This lack of information inspired Shorten to create a booklet to help women > in that position to make informed decisions. > > Shorten says her research shows that hospital policy and the views of > individual practitioners heavily influence the decisions of women - which > is reflected in the varied number of attempted VBACs at hospitals. In some, > the rate of attempted VBACs is 80 per cent while at others, it is about 20 > per cent. > > According to statistics gathered by the Royal Hospital for Women, 30 per > cent of women facing this decision attempted a VBAC during 2002. > > At present, RHW does not have a policy on discussing options with a woman > making this decision although the director of obstetrics at RHW, Dr Rob > Buist, says that a leaflet explaining options will be available soon. > > The issue that concerns most women when making a decision between a VBAC > and a repeat caesarean, is the risk of a uterine rupture. > > If a rupture occurs, there can be bleeding, and it almost always means the > baby is in distress. The most likely outcome is an emergency caesarean and > rapid stitching of scar tissue from the previous caesarean. In extreme > cases, there is a risk the baby will die, or the mother will need a > hysterectomy. > > Buist says that 50 per cent of women attempting a VBAC at RHW in 2002 ended > up having an emergency caesarean section. > > But Buist says that the risk of hysterectomy in uterine rupture equals the > risk of hysterectomy in repeat elective caesareans. > > He also says the risk of the baby dying after a uterine rupture "is low > enough that it is approximately the same risk as a baby dying in a first > labour. So the risk of a baby dying is the main reason that women do not > attempt a VBAC." > > However, Buist says an elective caesarean is more risky: "The most > significant risk is that with every caesarean section, the risk of [having > to have] future caesareans increases." > > But Freedman was more concerned about a posteria labour than a uterine rupture. > > After researching the issue on the internet, Freedman chose to attempt a VBAC. > > "Once I had researched and processed the risk of uterine rupture, I had to > move on and let it go," she says. " Although I did decide to have a Doula > [professional birth support] in case that fear [of uterine rupture] came up > in labour. I was more scared an obstetrician would drop in and pull me in > for an emergency caesarean at the drop of a hat." > > All went well and her son, Nathan, was born in a straightforward vaginal > birth last year. > > Shorten says although women attempting a VBAC face a greater risk of > emergency caesareans and complications - some still prefer to try it. > > "Some women are happy having an experience of labour even when they then > have an emergency caesarean because attempting vaginal birth is something > they value," she says. > > Freedman says if she has another child, she will definitely choose to give > birth vaginally. > > ------------------------ > > Makes a change! > > > ----- > Andrea Robertson > Birth International * ACE Graphics * Associates in Childbirth Education > > e-mail: [EMAIL PROTECTED] > web: www.birthinternational.com > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. 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