Vaginal Birth After Cesarean

Provides guidance for women wondering about giving birth naturally afteraving a cesarean section, from coping with the inevitable negative opinionsbout VBAC to choosing the right caregiver.

The bible of cesarean prevention. Wall Street Journal A landmark event, which will change the course of obstetric care by giving parents the informtion they need to make the decisions that are best for their own families. Comprehensive, highly readable, sensitive . . . should be read by everyone who cares about someone. Marian Tompson Director, Alternative Birth Crisis Coalition American Academy of Medicine Required reading for all childbirth professionals and prospective parents. Journal of Gynecological Nursing

This book provides easy to follow guidance on how to manage emergency situations and common problems in obstetric anesthesia. The book provides different anesthetic recipes for obstetric procedures and describes challenges that will be encountered on a day-to-day basis. There are trouble-shooting chapters and ‘what to do lists’ for frequent dilemmas. The book covers obstetric-specific resuscitation and medical emergencies seen on the labor ward. Antenatal and postpartum complications relating to anesthesia are covered as well as issues that may arise during follow up of patients who have had neuraxial anesthesia during delivery. Quick Hits in Obstetric Anesthesia should be used as a cognitive aid for emergency cases and as a decision-making tool for urgent management plans. It is a guide to common problems and provides core knowledge to facilitate anesthesia care on labor wards for all grades of anesthetist.

The Cesarean Rate is finally dropping in the United States, primarily because women who have had this operation are saying no to a repeat cesarean. They are doing so because vaginal birth after cesarean, or VBAC, is generally safer than the alternative. For most women, though, VBAC is still a scary prospect. In The VBAC Companion, Diana Korte explains the risks and benefits of both VBACs and repeat cesareans. She tells how to work on overcoming fears about labor, how to find a VBAC-friendly doctor (or midwife) and hospital (or birth center), and how to get extra support, from a labor assistant, childbirth educator, or VBAC support group. Korte also describes pain-relieving techniques for labor, and routine hospital procedures to avoid. Throughout the book are VBAC success stories, told in the mothers’ own words, for inspiration on the path to a safe and joyful birth.

This book investigates why women choose ‘birth outside the system’ and makes connections between women’s right to choose where they birth and violations of human rights within maternity care systems. Choosing to birth at home can force women out of mainstream maternity care, despite research supporting the safety of this option for low-risk women attended by midwives. When homebirth is not supported as a birthplace option, women will defy mainstream medical advice, and if a midwife is not available, choose either an unregulated careprovider or birth without assistance. This book examines the circumstances and drivers behind why women nevertheless choose homebirth by bringing legal and ethical perspectives together with the latest research on high-risk homebirth (breech and twin births), freebirth, birth with unregulated careproviders and the oppression of midwives who support unorthodox choices. Stories from women who have pursued alternatives in Australia, Europe, Russia, the UK, the US, Canada, the Middle East and India are woven through the research. Insight and practical strategies are shared by doctors, midwives, lawyers, anthropologists, sociologists and psychologists on how to manage the tension between professional obligations and women’s right to bodily autonomy. This book, the first of its kind, is an important contribution to considerations of place of birth and human rights in childbirth.

Whether you offer comprehensive pregnancy care in your primary care facility, or provide prenatal and postpartum care, this book delivers the guidance you need to optimize health for both mothers and their babies. It covers all aspects of birth care, from preconception counseling and prenatal care, through labor and delivery (both low-risk and complicated), to postpartum care and the first month of life. The completely revised third edition includes the most up-to- date, evidence-based standards of care. It offers information that is patient centered, prevention oriented, educational, and sensitive to the care of the whole woman and her family. Features a reader-friendly outline/narrative format for ease of use in daily clinical practice. Describes how to care for patients with a wide range of medical conditions during pregnancy as well as pregnancy-related conditions. Takes a whole-family approach to maternity care, with discussions of maternal and paternal adjustment, marital adjustment, sibling adjustment, single-parent families, and return-to-work issues. Provides patient and family education materials on a full range of topics, from nutrition in pregnancy to breastfeeding. Features a section on alternative medicine in maternity care. Provides detailed instruction for a wide array of procedures, including cesarean delivery, perineal repair of simple and complex lacerations, circumcision, assisted deliveries, and amnioinfusion. A continued strong emphasis on evidence-based medicine includes an ongoing summary of Level A recommendations throughout the text. A new chapter summarizes practical applications of how to incorporate continuous quality improvement and enhanced medical safety into the maternity care setting. A new section details which immunizations can be used safely during pregnancy. A section on "Centering Pregnancy" discusses this new model of care and how it incorporates longitudinal group.

This report provides a framework for comparing the harms and benefits of delivery options for women with prior cesarean delivery (CD). The information is designed to help consumers, providers, payers, and policymakers in decision making about repeat cesarean or trial of labor (TOL). In 2000, 22.9 percent of all births in the United States occurred by CD. This rate is the highest total CD rate reported since data collection began in 1989. The vaginal birth after cesarean (VBAC) rate, defined as the proportion of women with a prior CD who delivered vaginally, steadily increased from 1989 to 1996. As allowing TOL became more common, practice variation became a larger concern, e.g., expanding criteria for eligibility and medical induction, and for augmentation of labor. In parallel with this liberalization of criteria and management, highly publicized articles suggested that maternal and fetal risks were perceived to be increasing. Subsequently, the VBAC rate has decreased 27 percent from 1996 to 2000. Currently, a crisis in malpractice rates is decreasing the availability of maternity care providers and raising concerns that patients may have limited options, less access to care, and perhaps be at increased risk for complications. Two types of key questions were addressed. The first group (Questions 1- 7) compares the outcomes of a TOL and an ERCD: 1. What is the frequency of vaginal delivery in women who undergo a TOL (spontaneous onset, induced, and augmented) after prior low transverse cesarean or unknown scar? 2. How accurate are risk assessment tools for identifying patients who will have a vaginal delivery after a TOL? 3. What are the relative harms associated with a TOL (spontaneous onset, induced, and augmented) and repeat cesarean? 4. What is the incidence of uterine rupture, and are there methods for preventing major morbidity and mortality due to uterine rupture? 5. What are the health status and health-related quality of life for VBAC and repeat cesarean patients? 6. Regarding VBAC and repeat cesarean, what factors influence patient satisfaction/dissatisfaction with their childbirth experience? 7. How are economic outcomes related to VBAC, repeat CD, and their respective complications? The second group (Questions 8-10) address factors influencing the decision to have a TOL: 8. What individual factors influence route of delivery? 9. What factors influence a patient's decision making regarding VBAC or ERCD? 10. How do legislation, policy, guidelines, provider characteristics, insurance type, and access to care affect health outcomes for VBAC candidates?

Book discusses VBAC (vaginal birth after caesarean).