tag:blogger.com,1999:blog-2196849136035027484.post3702076513422264635..comments2011-06-01T12:45:47.938-07:00Comments on The Itinerant Laborer: Why the ACOG's new VBAC guidelines don't matter. There. I said it.The Itinerant Laborerhttp://www.blogger.com/profile/16483248275277911345noreply@blogger.comBlogger22125tag:blogger.com,1999:blog-2196849136035027484.post-36868203982112454122010-10-17T17:21:01.596-07:002010-10-17T17:21:01.596-07:00Thank you for this important post...of course I wa...Thank you for this important post...of course I was excited to see the new Bulletin, but instantly thought "Yeah, but going into labor before 39 weeks, having babies that are perfectly 7lbs, laboring with every single piece of technology the hospital owns strapped to you, and in the *right* amount of time will only end up *proving* that VBACing is a miserable failure!" This new bulletin will probably change things for highly motivated momma's who won't take NO for an answer...but many others will be scared by the consent form, discouraged by care-providers, and not-so-subtly sabotaged by the "system"...we MUST be teaching natural, normal childbirthing philosophy to every family!Justinehttps://www.blogger.com/profile/10970876946208148837noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-40538741113062803842010-08-03T05:13:48.342-07:002010-08-03T05:13:48.342-07:00Thank you for your courageous and clear words. Yo...Thank you for your courageous and clear words. You are right on. ACOG changed some of the words in their policy in response to pressure from birth advocates. That's right. Amazing individuals, some representing organizations, some just plain folks, went to Washington DC and sat in on a committee to review VBAC and Cesarean section (I think it was the NIH who sponsored this). Mostly women. They spoke truth to power. They asked blazing follow up questions. They blogged, fb, tweeted, etc. I agree that the changes they made won't make any difference for most obstetricians or hospitals. BUT, they were pressed and they changed. I can't remember a time when WOMEN asked ACOG to change and ACOG did anything but ignore them. I think the changes are placating and patronizing, but at least they are changes and in the correct direction. Let's keep up the pressure and see where we go! Elizabeth Allemann, MD, Missouri USAAnonymoushttps://www.blogger.com/profile/02809029063872897402noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-61765973087622890632010-07-29T04:38:27.198-07:002010-07-29T04:38:27.198-07:00I am a mom of 4 with a successful VBA2C of twins f...I am a mom of 4 with a successful VBA2C of twins from Canada. When the new guidelines came out my OB read them and said the exact same thing as you did. Saying it doesn't make you cynical - it makes you a realist. Until women stop fearing birth, start listening to their bodies and TALKING to each other about ALL parts of pregnancy and labour and postpartum it isn't going to change. Not knowing causes fear and right now there are a lot of women that just don't know what they don't know. Keep talking - I am now a follower of your blog and hopefully the more we talk the more people will start to listen.Anonymoushttps://www.blogger.com/profile/15853855510169004588noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-75048901561313996522010-07-28T21:58:05.577-07:002010-07-28T21:58:05.577-07:00ACOG issued new recommendations because the CDC (a...ACOG issued new recommendations because the CDC (amazingly, for once) actually was honest about the results of their own research and basically told ACOG to quit refusing women VBAC's & get the C-section rate under control. That's the long and the short of the new recommendations. And the OB's will pull out ALL the stops to avoid actually allowing women to VBAC--but maybe this will give us a few more informed Mama's who will insist loudly and get their way.Heatherhttps://www.blogger.com/profile/07067701162901440088noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-76183473327907258632010-07-28T20:58:30.650-07:002010-07-28T20:58:30.650-07:00So interesting. It's great to hear your persp...So interesting. It's great to hear your perspective on this -- it makes so much sense.Leighhttps://www.blogger.com/profile/10809794785758161710noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-74357359583991345402010-07-28T18:13:36.415-07:002010-07-28T18:13:36.415-07:00Thank you all for reading my blog and for posting ...Thank you all for reading my blog and for posting your thoughts about this issue. I am seeing people say things online like "ACOG is finally on our side!" I just don't know what to say about that. I wish I could be so enthusiastic but I don't believe this change in official position is going to trickle down very quickly, if at all, to change the way care is delivered to women who are laboring in hospitals. The system serves itself and the attitudes of even the youngest physicians coming into practice clearly reflect that control and fear still dominate practice. I agree that OB's are a godsend when a woman has medical issues that preclude normal pregnancy and delivery. Those that are really good at what they do should be doing it in cases where their exepertise is required, not in the case of every woman who walks through the door and happens to be pregnant.The Itinerant Laborerhttps://www.blogger.com/profile/16483248275277911345noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-57712125348590936392010-07-28T13:20:09.182-07:002010-07-28T13:20:09.182-07:00Excellent post. Almost every day I hear from women...Excellent post. Almost every day I hear from women, in the park, at the store, in mom's groups, about their cesareans that saved their babies. It is exhausting.<br /><br />We need more hospital workers to step up and voice their stories in the birth change movement. Yes, fear and control --and money and power-- are overarching attributes of hospital birth and we won't get anywhere until the dominant model is overturned and OBs are reinstated as surgical specialists responsible for high-risk moms and babies and not attendants of normal, low-risk births.erinmidwifehttps://www.blogger.com/profile/10712890030355346264noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-33014854770419949752010-07-28T09:13:57.794-07:002010-07-28T09:13:57.794-07:00That is exactly why I switched OBs when I got preg...That is exactly why I switched OBs when I got pregnant with #2. I LOVED having my unmedicated VBAC and would definitely do it again....although I think I might labor a little longer at home than I did.Triciahttps://www.blogger.com/profile/13454118921493155305noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-7516519736435614062010-07-28T08:50:09.508-07:002010-07-28T08:50:09.508-07:00This is exactly how I felt when I read the ACOG VB...This is exactly how I felt when I read the ACOG VBAC statement! Most OB's don't follow ACOG's guidelines anyway unless it suits their agenda. <br />As someone who has been there when VBAC's were preferred to seeing the changes first hand over the years, I knew this didn't mean squat!<br />Thank you for writing this!RevelationMidwifehttps://www.blogger.com/profile/09766758094558729867noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-78358787528103556332010-07-28T04:14:44.424-07:002010-07-28T04:14:44.424-07:00Amazing post! So great to hear that perspective. I...Amazing post! So great to hear that perspective. I hope that the attitude does change.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-3201944737612061952010-07-27T23:18:08.847-07:002010-07-27T23:18:08.847-07:00I never thought of it this way, but you know what?...I never thought of it this way, but you know what? Those are some serious bombs you're dropping. Thanks for sharing your point of view on this. It makes a lot of sense this way. (Unfortunately.)Erinhttps://www.blogger.com/profile/01378921984835830938noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-37074229368617912942010-07-27T22:54:17.258-07:002010-07-27T22:54:17.258-07:00it is true that their goal is probably not to incr...it is true that their goal is probably not to increase the rate of VBAC. Nor are they suddenly comfortable with it. But, whilst it may not mean any much change for you guys in the states... It helps us, in other countries. countries where VBAC is already pretty normal, and where having the ACOG relax their stance, allows or even forces OUR equivalent organisations to relax their a little further. I am not recieving as much opposition to assisting VBAC mama's to saty home longer and the like since these guidelines. I hope that eventually, "everywhere else in the world" will be providing statistics that FORCE the ACOG to give up a little bit of that control. Cause thanks to t'interweb, we are now an international community, and butterfly theory really can happen, even in birth. old the hope ladies, we are trying to change it for you.Anonymoushttps://www.blogger.com/profile/16206369647666989763noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-24326294047055765892010-07-27T22:32:48.511-07:002010-07-27T22:32:48.511-07:00Fabulous post, fabulous blog, insta-follow. Brava ...Fabulous post, fabulous blog, insta-follow. Brava and nice to meet you.Annehttps://www.blogger.com/profile/01019907275666753543noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-67004455961968805142010-07-27T21:15:08.679-07:002010-07-27T21:15:08.679-07:00Thank you for this post. I have been a doula in t...Thank you for this post. I have been a doula in the States for 10 years and I keep telling other people over and over again that these new guidelines everyone is so happy about just aren't going to change a darn thing! I still have clients in some hospitals confined to ice chips because they don't have a dedicated L&D anesthesia team so they have to follow THEIR protocol (nothing p.o., bicitrate before an epidural) it is madness. Doctors have lost the art of birth. They have no idea how to handle a breech vaginally or women who do not want medications or families that ask questions. The ACOG can publish until they are blue in the face but nothing is going to change.Carnevil #9https://www.blogger.com/profile/16231443094916090856noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-46213799188609838372010-07-27T21:05:41.091-07:002010-07-27T21:05:41.091-07:00Babylady, I am writing from a state where HBAC wit...Babylady, I am writing from a state where HBAC with a LM has been banned, so I sincerely hope you are right. However the Bulletin has this little recommendation about TOLAC occurring in "facilities capable of emergency deliveries." I hate to be cynical but I agree that this probably won't affect current practice. There are too many entrenched beliefs and systems that would need to change. We the Sheeple smile, nod, and sign on the dotted line.Birthkeeperhttps://www.blogger.com/profile/10587080230094191030noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-91960135027482376612010-07-27T20:27:37.844-07:002010-07-27T20:27:37.844-07:00Well said, sista! The bottom line is that Obstetri...Well said, sista! The bottom line is that Obstetricians are surgeons who LOVE to do what they know best .... surgery! They may be generally nice people and extremely competent surgeons, but don't expect them to sit around, twiddle their thumbs & wait patiently for someting they can't "control," when, in the end, surgery is so much simpler. <br />... here' to squatting!Anonymoushttps://www.blogger.com/profile/01849474056015523141noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-51012854998829217582010-07-27T19:39:30.594-07:002010-07-27T19:39:30.594-07:00This was my first thought when I saw the new guide...This was my first thought when I saw the new guidelines. It's great and all, but it takes a whole lot more than a short statement from the ACOG to convince medical professionals to change what they're used to doing and what they're comfortable with.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-11005208328089153792010-07-27T18:58:29.565-07:002010-07-27T18:58:29.565-07:00Kayce you probably havent read it because Im reall...Kayce you probably havent read it because Im really really horrible about writing on it. I am trying very hard to write regularly now. It is online that I have finally met like-minded people with whom I can discuss these important issues openly. Thank you for reading my blog and for sharing it. We CAN enact change. <br />Babylady - you are right. I guess because the midwife I work with already does HBAC I never thought of it that way.The Itinerant Laborerhttps://www.blogger.com/profile/16483248275277911345noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-70122518650534746452010-07-27T18:48:54.397-07:002010-07-27T18:48:54.397-07:00This is the same feeling I've had about the ne...This is the same feeling I've had about the new VBAC guidelines and I don't even work in a hospital. Thank you for adding your perspective. I think ACOG changed their guidelines so fewer women would opt to birth in birth centers or at home in their attempts to VBAC. I don't have any proof, of course, but why suddenly is it an issue after ten years? Why is OHSU filing complaints about midwives here in Oregon who are legally attending VBACs, twins and breeches? They have caused enough troubles that the midwives have filed a class action suit against them. I hope the midwives win. ACOG is no different. They are still trying to control the entire childbirth field.Tonihttps://www.blogger.com/profile/11914793731374784005noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-18203593495538372312010-07-27T18:45:20.581-07:002010-07-27T18:45:20.581-07:00you have some great points and for the most part I...you have some great points and for the most part I agree with you. The one thing I think the new guidelines may be able to do is lift the VBAC ban for midwives. In many states where midwifery is regulated VBACs are not allowed under any circumstance. These guidelines give an argument for midwifery boards to allow TOLAC at home with a midwife.Babyladyhttps://www.blogger.com/profile/01349241964143390008noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-20705424147227298512010-07-27T18:40:32.892-07:002010-07-27T18:40:32.892-07:00OMG I LOVE YOU!! My friend posted the link to this...OMG I LOVE YOU!! My friend posted the link to this on facebook, I can't believe I hadn't ever been to your blog before.<br /><br />You have said EVERYTHING I have been thinking. The guidelines don't matter. Sure they are out there, but it all comes down to your OB, your midwife, your providers. And the giant majority of them will cut you faster than anything I have ever seen.<br /><br />Incredible post! I am sharing this with EVERYONE!Kaycehttps://www.blogger.com/profile/04656467879424134893noreply@blogger.comtag:blogger.com,1999:blog-2196849136035027484.post-11945949633467496792010-07-27T17:09:08.345-07:002010-07-27T17:09:08.345-07:00"And no, you can't squat, either. It'..."And no, you can't squat, either. It's not safe." Hahaha. <br /><br />Heather, this is an awesome post. I love it.Maggiehttps://www.blogger.com/profile/17601103760591682505noreply@blogger.com