Reflecting on NIH VBAC conference

As I wrote shortly after attending the first day of the NIH conference on Vaginal Birth After Cesarean (VBAC) a few weeks ago, the experience was tiring. The panelists might have been trying to convey the message the uterine rupture is really rare — less than 1% — and that it does not deserve to be weighted more than a whole lot of other issues, including complications and risks of cesarean delivery. But honestly, it did not help this hopeful VBAC mom to see a bunch of photographs of uterine rupture!

I admired the birth activists who spoke out, women who have been working hard on this issue while I’ve been comparatively on the sidelines, not regularly attending ICAN meetings (in part because I didn’t believe I would ever regain my fertility or get pregnant). But here I am, four and a half months along, and ignoring this issue is not an option. I’ve chosen to work with a midwife at home, and I hope that my baby’s cord is long enough this time and that other factors go in my favor for a successful HBAC (homebirth after Cesarean).

No matter what kind of care I’d chosen, it’s important that I understand the climate surrounding this issue as well as the facts. Indeed, the whole point is that the climate has dictated which facts get to “count,” which in turn reinforces the tenor of the climate. Everything goes in a circle! But the way it spins has been heavily influenced by medical articles and the publicity surrounding them, and, most significnatly, by pronouncements by the American College of OB/Gyns (ACOG). Although the NIH statement is not perfect, it does call on ACOG to rethink its position about surgical facilities and anesthesia needing to be “immediately available” anywhere a VBAC is attempted.

It was powerful to follow the rest of the conference and the coverage by birth activists and then to write this news bulletin at Mothering.Com: “National Institutes of Health Conference Calls Vaginal Birth After Cesarean a “Reasonable Option.”

Check it out for more background on the issue and responses to the conference.