Jo, My name is Kathy, I am working in the Know Your Midwife Scheme in Hobart. Our KYM team is very supportive of VBAC women. The only information I can provide you is from one woman's birth experiences of her two VBAC babies. While caring for this woman who had sucessfully achieved a VBAC, but unfortunately sustained a 3rd degree tear in an all 4's position due to compound presentation. The compound arm was directly under the perineum and as soon as I touched the baby's hand to slowly control the arm, the baby responded by flicking her elbow and arm through the perineum. This woman was encouraged to have a caesarean next time, but fortunately, the woman wanted another vaginal birth rather than c/s. This woman was also fortunate enough not to have any sexual dysfunction or incontinence. With the birth of the 2nd VBAC baby, I encouraged the woman to take her time pushing, to take it gently and I suggested letting the baby and uterus do the work (although she followed her instincts to push). I suggested that she use a birth position where I could actually see the perineum as I find the perineum disappears when in a supine position. The woman chose all 4's position, when the perineum began to tear I helped to slow the head to minimise damage, once the head was born I checked for a compounded presentation which was present, but not under the perineum. The woman sustained a 2nd degree tear this time. Perineal massage, a mirror and hot packs on the perinuem when pushing can be helpful. What models of midwifery care are available to this woman? Know your Midwife or Birth Centre that support VBAC women. If not you could suggest an independent midwife once again. What about Jackie at birthrites? Kathy ----- Original Message ----- From: "Jo & Dean Bainbridge" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, May 29, 2003 11:07 AM Subject: [ozmidwifery] vaginal wall tearing
I know there has been discussion in the past about this but I am in a hurry to get some information for a woman whom had a positive vaginal birth that turned ugly when she "tore badly inside and out" (in quotes because that is what she said and I have no further knowledge of what sort of tearing it was.) She has had incontinence problems and sexual dysfunction for the last 16 months. Her first OB said to have a cs (of course) and then yesterday she was told that she should not have a cs and that a vag birth would be the best option. She is now very confused and scarred as hubby wants her to have cs and her fear is that a vag birth will increase problems they already have. She is willing to have a vag birth if she can optimise her chance of reducing the damage if a tear happens again. Can anyone offer midwifery woman focused care and positions etc that she could use during a vag birth? She would have a home birth but she can not afford it. I suggested an independent mw to take with her to hospital but that was dismissed without reason. She is an intelligent woman and if she can read evidence to support the chance of her not having further damage caused then she will opt for a vag birth I think. She wants to make her choice in three weeks so I would appreciate some help in gaining information and not waste time surfing around cheers wonderful women! Hope you can help me help a woman avoid putting herself and her baby through a cs. Jo Bainbridge founding member CARES SA www.cares-sa.org.au [EMAIL PROTECTED] phone: 08 8388 6918 birth with trust, faith & love... -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
