Volume 46 ~*~ December 2007

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• Women happier when babies delivered by midwives: Statscan survey

  The majority of new Canadian mothers are happy with their labour and the birth of their child, suggests new data released Tuesday by Statistics Canada, though midwife deliveries are seen in a more positive light.

• After C-sections, obstacles to vaginal birth go up

  Jackie Haverdink suggests the birth of her fifth child merits at least a footnote in an obstetrics journal. After Haverdink delivered four babies via Caesarean section, her fifth came into the world through the birth canal. That may not sound remarkable, but in some medical circles, Haverdink is a birth-giving rarity.

• Induced births concern some

  "A lot of these secondary C-sections are scheduled at 39 weeks or 37 weeks, due to problems with dating," Keefe said. "It can pose serious consequences to a baby's health."

• Evidence does not support the routine breaking the waters for women in spontaneous labour

  The aim of breaking the waters (also known as artificial rupture of the membranes, ARM, or amniotomy), is to speed up and strengthen contractions, and thus shorten the length of labour. The membranes are punctured with a crochet-like long-handled hook during a vaginal examination, and the amniotic fluid floods out. Rupturing the membranes is thought to release chemicals and hormones that stimulate contractions. Amniotomy has been standard practice in recent years in many countries around the world. In some centers it is advocated and performed routinely in all women, and in many centers it is used for women whose labours have become prolonged. However, there is little evidence that a shorter labour has benefits for the mother or the baby. There are a number of potential important but rare risks associated with amniotomy, including problems with the umbilical cord or the baby's heart rate.

• Estimation of Fetal Weight

  In the case of macrosomic fetuses, attempts to predict birth weight from fetal measurements on ultrasonography have been unsuccessful in improving clinical outcomes. Many researchers have concluded that ultrasonographic fetal biometric assessments are no more predictive of fetal macrosomia than clinical assessments of fetal size by means of simple external abdominal palpation.

• Updated Care Practice Papers from the Lamaze Institute for Normal Birth

To encourage positive birth outcomes, the Lamaze Institute for Normal Birth has identified and updated six care practices, adapted from the World Health Organization, that promote, support and protect normal birth. When adopted, these care practices can have a profound effect—instilling confidence in the mother, and facilitating a process that results in an active, healthy baby.

An Angry Email

ICAN member Michelle Webb writes it from the heart, about the state of birth for the woman whose baby is determined to be breech.

So I am going back through the c-section stuff, and it relates to a lot of the abuse from my childhood and it seems to have to deal with one I have to deal with another.

I have written a lot of platitudes and I have been at times very much at peace with my c-section, but having dealt with some shit in the past few weeks and after reading the e-mail from the midwifery student about her research paper and having read for years about the inability of womyn to sue for their unwanted c-sections and other personal stuff that has happened today and this week... I needed to write something ANGRY... because I am really stinking angry.

STATE SACTIONED RAPE

I have a beautiful little girl. She is beautiful.... and the day she was born my body was ripped apart. The day she was born I was denied a womyn's right to labour and she was denied a baby's right to choose her birth date. The day she was born the great country I live in failed to meet the promises it makes in its own Charter of Rights.... The day she was born a crime was committed against both of us. And the day she was born was just another day in the medical world of birth.

In Canada, the SOGC (the society of ob's and gynecologists of Canada) recommends c-sections at 38 weeks for babies presenting breech. Their recommendation impacts the ability of doctors to get insurance providers if they offer womyn the opportunity to labour with their babies. Thus, even those doctors who dislike the invasive and risky c-section above normal labour and birth are inclined not to offer womyn an option to birth. Thus few doctors are able to have and maintain the skills to catch breech babies... THUS, a non-elected group of people, representing an elite class has essentially denied the rights of womyn to labour and birth their breech babies with a skilled attendant.

The recommendation was made based on a study called the Term Breech Trial. The TBT was released in 2002 and received criticisms from care providers skilled in breech delivery for its dangerous and ill-defined protocols. Good candidates for breech did not enter the study to avoid being randomized into the 'surgical' category. Other care providers self identified as having 'breech skills' without any definition being set out within the study. And the results were catastrophic... but a recommendation was made, and in Canada and around the world it has been adhered to.

Brave souls spoke out against the TBT. The dangerous protocols, the arrogance of the study's authors... the lack of raw data released.

The very authors revoked their recommendations after the TBT's 2 year follow up. The decision to revoke was not even based on the poor protocols of the original study, but on the long term lack of benefit for babies and mothers.

BUT THE RECOMMENDATION STILL REMAINS IN THE SOGC GUIDELINES.

State sanctioned rape.

Sure, one could search out a homebirth midwife skilled in vaginal breech delivery, beg her to take you on in the last weeks of your pregnancy, find a place to stay within her catchment area... yes, every gestating womyn has the energy to battle like that for her birth.... NOT

I was cut after hunting the province for a doctor who would offer me a trial of labour. My midwife lied, she implied that it was illegal for midwives to attend breech.

I was cut and bleed energy out of my incision site for years following my birth.

I was cut and raped and my very photos show that part of me died that day.

My daughter's birth date was decided by a rotation schedule.

All of this was done with respect only because I fought the OB who told me I was irresponsible and inconsiderate to not schedule my section at her convenience.

STATE SANCTIONED RAPE

No, womyn are not able to attain legal restitution for the damages their bodies and souls suffer after a c-section. Because like all rape, the damage is hard to prove, and like with all rape, the burden of proof seems to fall on the victim, who is just trying to put the pieces of their lives back together.

STATE SANCTIONED RAPE

Yes, this is angry... And maybe even unbalanced. I am not writing it as a piece of literature, I am not writing an editorial, I am not writing a testament. I am writing as part of healing and sometimes that is ugly and angry and BIG and LOUD.

It is what it is. I am not planning to start a debate about what rape is and isn't. I am letting go of rage in a place where I have come to expect support and empathy.

http://web.mac.com/breechbirth/iWeb/Site/Welcome.html for more information on the Breech Coalition.

From the Chairperson of Mental Health

Those of you who attended the Silver Anniversary Conference in Syracuse likely heard Sharon Storton speak on emotional trauma following cesareans.  Out of her talk, a collaboration was formed. She and I have teamed up and are developing a training for mental health professionals called "Traumatic Birth Awareness Training" (TBAT).

Research has shown that as many as 25-33% of women perceive their births to be traumatic.  Yet many of us have encountered therapists who at best do not understand the impact of birth trauma, or worse, minimize women's' pain with such sentiments as "well at least you have a healthy baby."

In March, we will be presenting on traumatic birth at the CIMS Forum. We will cover: Issues which affect women's perceptions of birth, risk factors for developing PTSD after childbirth, and manifestations of trauma symptoms in the perinatal period and how they differ from traumatic stress in other life phases.  We will also discuss how the MFCI (Mother-Friendly Childbirth Initiative) can provide an adjunct diagnostic tool for clinicians, approaches to treating the epidemic of trauma following childbirth and ways in which the CIMS (The Coalition for Improving Maternity Services) GAC (Grassroots Advocates Committee) Transparency Project, ICAN's Traumatic Birth Awareness Training (TBAT), SOLACE (Support to Overcome Labor and Childbearing Experiences) can support women suffering from traumatic birth experiences and aid in the prevention of trauma responses in future birthing women.

We are confident that TBAT is an essential step in educating mental health and birth professionals about the impact of traumatic birth.

Christie Craigie-Carter
Chairperson of Mental Health, ICAN

From the Chapter Director -- Help Wanted!

Attention Volunteers-in-Waiting! ICAN is growing again! Do you live in CA, NV, UT, or AZ (SouthWest), PA, NJ, MD, DC, VA, WV, KY, TN (MidAtlantic) or MS, AL, GA, FL, SC, NC (SouthEast) ?

We are looking for Regional Co-ordinators to support and co-ordinate our chapters in these regions. A qualified candidate would enjoy getting to know multiple chapter leaders, motivating others in ICAN's mission, and working independently to further the goals of ICAN in your region. You do not need to have been a part of a local chapter, but familiarity with ICAN is a must. Please contact the Chapter Director ASAP at chapters@ican-online.org to receive the full job description and application.

From the Chapter Director -- Please welcome TWO new Regional Co-ordinators

As most of you know, Gretchen Humphries has served ICAN as RC for the MidWest but in April joined the Board of Directors as our Advocacy Director.  These are both big jobs and she graciously has helped us transition these last few months until our exciting announcement...

Due to amazing growth and a growing talented pool of applicants in our ICAN community, we have split the MidWest region and welcome TWO new Regional Co-ordinators to our team!

Tami Groth
MidWest Regional Co-ordinator
midwestrc@ican-online.org
serving ND, SD, NE, MN, IA and WI

Rebecca Hoogstraten
MidLakes Regional Co-ordinator
midlakesrc@ican-online.org
serving IL, IN, MI and OH

We are thrilled to have both of these long-time ICAN'ers join the RC team and look for good things from both of these newly-drawn regions.

Yahoo Answers as a Medium for Advocacy

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ICAN's mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC). This newsletter is for informational purposes only and does not replace the advice of a qualified birth professional.

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