ICAN makes Time Magazine!

This has been under lock and key, but I am proud to be able to announce and actually get it off my check that The International Cesarean Awareness Network has a wonderful spread in TIME MAGAZINE this issue!!!!!!

We (the women of ICAN) worked very diligently over the past couple weeks making sure every last hospital in the entire United States that offered maternity services was called and polled about their VBAC policies!
ICAN of Connecticut was able to call hospitals in Connecticut, Wisconsin, and Oklahoma.

Please read, pass along, comment on, and enjoy the article!

http://www.time.com/time/magazine/article/0,9171,1880665-1,00.html

CAM 2009

We are in the home stretch right now before Cesarean Awareness Month here in Connecticut.
Last year our governor denied our request for a proclamation for Cesarean Awareness Month, well this year we are not only requesting our proclamation again, but we are also submitting it with a petition!
We are nearing 200 signatures, so please take a couple minutes and sign it to help out Connecticut moms!

http://www.ipetitions.com/petition/CAM2009/index.html

CAM

Last April I started The International Cesarean Awareness Network of Connecticut (www.icanofconnecticut.webs.com) because of the birth experience I had with my son. I found out that Connecticut has a VERY high c-section rate, of 34.1% (as of 2006) which is the most recently released statistic from the CDC. (CDC.gov)
That puts Connecticut at the 7th highest c-section rate in the nation, higher than both California, and New York, who in some cases are infamous for their "designer births".

Every April across The United States, The International Cesarean Awareness Network celebrates Cesarean Awareness Month. It is important to us, and should be more important to our communities, especially Connecticut with such an alarming Cesarean rate.

(The WHO *World Health Org* recommends a SAFE cesarean rate for the USA to be between 10-15%)

So last April, I, as leader of ICAN of Connecticut sent a proclamation to Governor Jodi Rell's office to have Cesarean Awareness Month recognized across the state. After waiting 3+ weeks for a response, and calling the governors office, I found out that our proclamation was denied because the Governors office felt as though the issue of Cesarean Awareness and more maternity care education in our state was too controversial of an issue for the Governor to be involved with.

Too controversial? Education in health care is too controversial? The safety of women and babies across the state is too controversial?
But issues like Plan B being available for OTC sales, and civil unions, are not too controversial for our governor to be involved with. Hmmmm? Something stinks!

After much research, and meeting with Congressman Christopher Shays, I was given some medicaid statistics. (For those who are not aware of what medicaid is, it is state funded health insurance, meaning free, that the tax payers are paying for) and out of all the c-sections taking place across the nation, our government is paying for a whopping 41% of those! But educating our women on c-sections and helping to learn how to prevent them is too controversial of an issue.

We are fighting for a signature on our proclamation this April 2009 to help educate women across the state and bring light to this growing maternity care crisis.
Please help support ICAN and sign our Cesarean Awareness Month petition!
Lets make our voices heard across the state!

http://www.ipetitions.com/petition/CAM2009/index.html

ABC on Cesarean Births

http://abcnews.go.com/Health/WomensHealth/story?id=6595888&page=1

http://abcnews.go.com/video/playerIndex?id=6596728

C-Section Too Early Risks Baby's Health

Babies Born by Surgical Delivery Before 39 Weeks May Suffer Health Problems

When 37-year-old Alicia Cooney of Cleveland was pregnant with her first child in October 2007, her doctor expressed no concern about scheduling her Caesarian delivery, or C-section, just 38 weeks into the pregnancy.

But when Cooney became pregnant with her second child last April, her doctor was singing a different tune about when to schedule a C-section.

"I did notice a change within the hospital that they really wanted to make sure my C-section wasn't before 39 weeks," Cooney explained.

Cooney said that her doctor expressed concern about the increased risk of wet lung -- or an accumulation of fluid in the newborn's lungs -- in babies delivered by C-section before 39 weeks of gestation.

Cooney's doctor may not be alone in changing his practice in the face of these risks. On Wednesday, a new study published in the New England Journal of Medicine found that C-section delivery before 39 weeks of gestation is, indeed, linked to increased health problems for babies.

According to the National Institutes of Health, a pregnancy of normal gestation lasts about 40 weeks, with "normal" pregnancies ranging from 38 to 42 weeks.

A team of researchers lead by Dr. Alan Tita from the department of obstetrics and gynecology at the University of Alabama at Birmingham examined the results of 13,258 women who had a scheduled, repeat C-section that was planned for no other medical reason than the fact that the woman had previously had a C-section.

The researchers found that, compared to babies delivered by C-section at 39 weeks of gestation, those born at 37 or 38 weeks had a higher rate of breathing problems, blood sugar problems and serious infections. Moreover, those babies were more likely to be admitted to the neonatal intensive care unit.

"Early elected delivery is associated with adverse outcomes for the baby," Tita explained. "And the earlier you deliver, the higher it increases the risk."

These findings are in line with current recommendations by the American College of Obstetricians and Gynecologists (ACOG).

Yet despite the long list of potential complications associated with C-section delivery before 39 weeks, the study also found that a large number of the women studied -- 36 percent -- chose to schedule a C-section delivery before 39 weeks anyway.

"I have seen women induced or have a scheduled C-section because they have family scheduled to be in town, because they want the baby to be born on an anniversary or someone else's birthday, because they want the baby born prior to Jan. 1 for tax purposes, or because they are simply sick and tired of being pregnant," said Dr. Elaine St. John, associate professor of pediatrics in the Division of Neonatology at the University of Alabama at Birmingham.

Other experts say that the increase in C-sections before 39 weeks is due to a lack of understanding of the dangers associated with elective late pre-term birth.

"Most women think the risks to their babies are the same whether the babies are delivered four, three, two or one week before the baby is due," explained Dr. Sessions Cole, director of the Division of Newborn Medicine at the St. Louis Children's Hospital. "This study should help mothers understand that there are significant risks to their babies associated with elective late preterm

Patient Pressure Figures Big

Approximately 30 percent of all babies born in the United States are delivered by C-section. A study published in April 2005 in the journal Obstetrics and Gynecology found that elective C-sections accounted for about 28 percent of all C-sections performed in the U.S. in 2001.

However, many experts report a growing trend toward encouraging women not to schedule an elective C-section before 39 weeks at hospitals all over the country.

"The recommendations for years have been to avoid elective delivery of any kind until after 39 weeks," said Dr. Lisa Jones, a gynecologist at the New Bedford Community Health Center in New Bedford, Mass. "So all this study really does is reinforce what we already knew."

Still, some experts say that the power of maternal insistence in scheduling an early C-section is enough to convince many doctors to go along with their patient's wishes.

"I think the practice of early [C-section delivery] will only end if hospitals ban the practice," Holzman said. "There is little reason for [obstetricians] to stop since they are often pressured by patients."

The study also outlines some of the risks women must consider when opting to deliver by C-section after 39 weeks.

According to Tita, one such risk is having an unexplained stillbirth while waiting for the 39-week-mark to deliver. This risk is very small, but Tita said that it is still best for women to follow ACOG recommendations by waiting the full 39 weeks before delivering by C-section.

Early Surgical Delivery Sometimes Appropriate

There are, however, certain instances in which an early delivery is appropriate.

"If there [are] firm medical indications of risk to the mother's or fetus's ... health [such as] worsening maternal high blood pressure [or] lack of fetal responsiveness ... then delivery is indicated," Cole explained. "However, the risks of these conditions should be weighed against the risks described by this study."

Moreover, Holzman said, "For most of these [conditions], the risks to the fetus in delaying [delivery] are well known and predictable."

Many experts ultimately hope that this study will prove to the public that the risks of early C-section delivery greatly outweigh the benefits in most cases.

"Hopefully articles like this will help educate the general public and fewer babies will be placed at risk in the future," said Dr. Patricia Chess, associate professor of pediatrics at the University of Rochester Medical Center.

Just on a side note, that was mentioned in the news cast itself but not in the text of the article.
36% of all cesarean sections, are elective before 39 weeks.
50% of the cesarean sections before 39 weeks result in NICU care.
70% of the cesarean sections before 39 weeks result in infection in the child.
A child born by cesarean, before 39 weeks is 200% more likely to have respiratory distress.

One Year Post Cesarean

I often thought of asking other mothers to write about this subject, but now I face this subject eye to eye on my son's first birthday. I know that I should be thinking about more pleasant things and how grateful I am for such an amazing and beautiful little boy, but when I think of his "birth" day it often still brings nightmares.

Would I change anything that happened? Of course not because without the birth experience I had, and the first hand experience of how traumatic and devastating a cesarean section can be, I would not have seek for an ICAN chapter in my area only to find out there was not one.

I would not be here helping women in my area and helping to prevent unnecessary and very unwanted cesareans.

I personally know of one I prevented just with one of our meetings, and the feeling it gave me made me cry. Knowing I helped this woman avoid what I went through was the whole reason I started this.

Not many women understand my struggle, and that is ok, because I will always remind myself that "Some people, just don't understand" and I am not going to make anyone try and understand.

I just want to thank everyone who has been accepting, loving, supportive, and informative over the past year, you will never know the true impact that you have made on myself, my soul, and my family.

For that I say Thank you.

2009 Meeting Topic Announcement

We had a great planning meeting this morning! I wish more people would have been able to join us, but I wanted to pass along the monthly meeting topics for 2009!

Drum roll please!!!!

January - Movie Viewing

February - How to choose a provider for your pregnancy

March - How do avoid an unnecessary cesarean

April - Cesarean Awareness Month

May - Birth Story Night (Open forum)

June - Changing providers mid pregnancy

July - Breast feeding after a cesarean section

August - Fathers Night

September - Body Image after Pregnancy & Birth

October - Anger : How to deal with an unexpected birth outcome

November - Interviewing providers

December will be hit or miss depending on the group of women we gather over the year. Hopefully we will have enough to have a small holiday get together.

Also, one of our goals for 2009 is to have 2 ICAN of CT events a month, one being our meeting, and one being other activities, whether they are movie viewing's, discussion groups, pot luck dinners or lunches, planning meetings, ec.

2009 is going to be our year to get out into the community more!! Lets hope we can be successful!

I was under the impression, at first, that this was a article written as a joke, until I learned that this was really written by an OB/GYN currently practicing in the state of Texas.

"How to Guarantee a Failed VBAC" by Dr. Gerald Bullock

Doctors...be noncommittal enough in the early interviews: the issues won't come up again until later in the pregnancy. It is the rare patient indeed who has the presence of mind and strength of conviction to change doctors later in pregnancy.

...During the pregnancy, be sure to add to the mystique of the previous cesarean by ordering several ultrasounds, and suggesting an amniocentesis, so the mother will understand how different and potentially dangerous her situation is. Never mind informing her that the risk of amniocentesis is higher to the baby than the risk of VBAC...

If by chance the mother hears about cesarean prevention classes or VBAC group meetings, tell her they are a bunch of crazy radicals who have only their own crosses to burn and do not have her best interest in mind.

Be sure to spell out whatever criteria you have in considering a VBAC for them. Tell them that the baby must not weight more than whatever is your own limit (never mind that your guess at the weight is often as much as 2 pounds off). Give her your own personal allowances for the amount of time you feel is safe for her to labor. Make sure she understands that she will be laboring against a deadline.

If you are not successful in getting the patient to consent to a repeat cesarean early in labor, do not despair. All is not lost. There are several ways in which you can get her to give up her notion of VBAC. Make sure she remembers what a high risk patient she is, and keep an ever constant vigil for "catastrophe". Don't give in to the frivolous request to ambulate. It is imperative that you know exactly what the contraction pattern is, she must be therefore confined to bed from the time of arrival to the time of delivery. Have the perseverance to insist upon monitoring.. .Be kind and considerate, and apologize for not being able to allow her more flexibility.

..Say things like "of course, your baby's safety is our primary concern"
When the patient arrives early in labor, look at her critically and say something like "Do you really think that you are going to have that big thing from below?" A note from the anesthesiologists: Come in fairly early to do your "routine pre-op history review". If you do it right you can leave the impression that almost all VBAC mothers eventually go ahead with a repeat cesarean. The return to her room frequently to check her progress...Explain what will happen "while" she has the cesarean, not "if" she has it. If you are not trained in conduction anesthesia, explain to her why general anesthesia is safer for her and the baby...Finally (for other staff members standing outside the door) you may say something like "Is that blood ready? get it stat! what if she ruptures?""

-Dr. Gerald Bullock.