Kathy wrote: "It seems to me that women success rate of VBAC increase with the woman's determination, partners and midwifery support." Oh if only we could have some research proof for this! WE know it is true but those who are determined to compare vbac with repeat cs and only factor in the medically managed vbacs with little to no support just don't seem to want to look at it. I am trying to combat the impending ACTOBAC trial by bringing about some awareness of vbac and the support needed. The more we hear about the institutions who do a vbac supportive model of care the better. The hospitals in Adelaide are resistant to separating vbac from the norm...but as I keep telling them we are not considered normal anyway....so why not let us be separated but in a positive way. The critics claim that by having this sort of vbac focus it is setting women up to fail. I thought the focus could be a "Welcome BAC" (welcome to Birth After Caesarean and also the fact that she has birthed before and this is a welcome back to the hospital...) Therefore the focus is not on a vaginal birth but offers the support most women need to get one. There could be a element of the care that addresses the need for a repeat cs and therefore combat the negativity that can be associated with failing (although we know there is no such thing as failure in birthing...)
The women receive a VBAC package in your care....LOVE to see one? Any chance of having one slipped out of the building and into the post????? CARES are working on a vbac information package and what you have done sounds like something we are strongly recommending the hospitals implement. By encouraging them to do something like this we are actually getting them to look at the way they currently treat vbac. Sorry, but I am going to have to cut it short there...I am so tired and I have to work tomorrow so I will talk again soon. Please email me off list if you like; but I do know that if you keep posting details of what you are doing them others on the list will benefit too. cheers Jo Bainbridge founding member CARES SA www.cares-sa.org.au [EMAIL PROTECTED] phone: 08 8388 6918 birth with trust, faith & love... ----- Original Message ----- From: "Kathy McCarthy-Bushby" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Saturday, May 31, 2003 12:32 PM Subject: Re: [ozmidwifery] Reply to Kathy > Dear Jo, > Our KYM scheme was set up 10 years ago for low risk women. The increase in > VBAC women has increased over recent years, so women strongly wanting a VBAC > have been included in our inclusion criteria to KYM. So if women want an > elective caesarean we are unable to offer care to them. Since 1999 to date > 33 women have planned VBAC. 10 women required repeat emergency caesareans. > 23 achieved their VBAC. 19 of those women had spontaneous vaginal births, > while the other 4 had assisted vaginal births associated with epidural use > or fetal distress. We have a 2nd KYM team that also has success with VBAC, > but I am not aware of their statistics. > > The KYM midwives in my team often refer VBAC women for appointments to see > me. At the first visit we look at what happened last time to see the > contributing factors that lead to the caesarean and focus on trying to avoid > those happening again. The most common reason by far is the posterior > position of the baby in labour. We look at the woman's chances of success > depending on the contributing factors. The primary focus is on cephalic > optimal position, so if the last baby was breech, I proivde appropriate > information (Maggie Banks Breech Birth Woman Wise has a great chapter on how > to encourage turning a breech baby) and encourage the woman to focus on the > position of the baby. The focus on optimal fetal position is important for > women who have had previous posterior baby antenatally and while in > labour.It seems to me that women success rate of VBAC increase with the > woman's determination, partners and midwifery support. > > The women receive a VBAC package with information regarding sucess rate for > VBAC, how to improve their chances of VBAC, the chances of uterine rupture, > hep lock, fetal monitoring, eating and drinking, post dates, natural and > medical induction, active birthing, epidural use and VBAC (increases chances > of another c/s or instrumental birth), moving on from anger, prelabour and > labour signs, comfort strategies, posterior labour, what if I need another > c/s and planning a dual birth plan. W e suggest women read books and provide > appropriate websites (eg. birthrites). I ask women if they would like to met > a woman who has achieved a VBAC, interestingly enough, most women have > already met someone who has had a VBAC. We focus on issues as they arise for > indivivdual women. I encourage that they inform support people of their > plans. The women know that they can come make an appointment to chat to me > as they need, but they also need to meet the other midwives of the team too. > I hope this helps Jo. If you would like to know more just let me know. > kathy > ----- Original Message ----- > From: "Jo & Dean Bainbridge" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Friday, May 30, 2003 6:37 PM > Subject: [ozmidwifery] Reply to Kathy > > > > Thanks for your reply Kathy, > > I am VERY interested in the KYM VBAC care and would love for you to share > > with me as many details about how it was set up; what you do and the > > outcomes!!! We desperately need this sort of care up and happening > > especially in the shadow of the ACTOBAC trial. > > In regards to the woman with the vaginal wall tearing: she is not actually > a > > VBAC. She birth vaginally the first time and tore badly and has suffered > > since and now she is pregnant again and is thinking a cs would be better > > than making the damage worse. > > 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. > > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
