http://ican-online.org/community/users/ican-blog/blog/ican-responds-coalition-childbirth-autonomys-statement-cesarean-rate

ICAN Responds to the Coalition for Childbirth Autonomy's Statement on the Cesarean Rate

The Coalition for Childbirth Autonomy (CCA) released a statement today questioning the World Health Organization’s recommended cesarean rate of 10 - 15%. CCA suggests that a woman should be able to request a cesarean without medical indication. While ICAN supports both updated research on this topic and an increase in patient education and autonomy, we maintain that many women who are choosing a cesarean are making that decision without full informed consent.

Research shows that cesareans introduce additional risk in dozens of areas when compared to a vaginal birth. For the mother, these increased risks include death, hysterectomy, bood clots, increased pain & recovery time, infection, and post-partum depression(1). For the infant, additional risks include respiratory problems, breastfeeding problems, asthma in childhood(1), and type 1 diabetes(2). In addition, there are increased risks in future pregnancies, such as infertility, ectopic pregnancy, placenta abnormality, uterine rupture, preterm birth, and stillbirth(1).

ICAN does not believe that cesarean should be the typical solution for fear of childbirth. With appropriate counseling, most women who fear childbirth are comfortable attempting a vaginal birth (3, 4). Most show long-term satisfaction with their decision to change modes of delivery (4), and with intensive therapy, labor times were shorter (3).

ICAN will continue to work to improve maternal-child health and to protect a woman’s right to ethical and evidence-based care during pregnancy and childbirth.

(1) Maternity Center Association. 2004. What Every Pregnant Woman Needs to Know about Cesarean Section. New York: MCA. www.maternitywise.org.

(2) Cardwell, CR et al. Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia. 2008 May;51(5):726-35.

(3) Saisto, T et al. A randomized controlled trial of intervention in fear of childbirth. Obstet Gynecol. 2001 Nov;98(5 Pt 1):820-6.

(4) Nerum, H et al. Maternal request for cesarean section due to fear of birth: can it be changed through crisis-oriented counseling? Birth. 2006 Sep;33(3):221-8.

Childbirth Education : How does it meet the need?

International Cesarean Awareness Network of Connecticut's monthly meeting is coming up! Last month, it was just me and one other person.
LOL
I am trying to get a few more people to come because we have an exciting special guest speaker!
The meeting topic this month is "Childbirth Education : How it meets the need"
I really think it will be beneficial to everyone.
VBAC moms, repeat c-section moms, doula's, and mothers in general!

Our meeting will be Monday October 20th, 2008 at 7:00pm
At Dr.
Jason Jenkin's office
97 Gulf Street Milford, CT.
06460

For more information, please contact us.

ICANConnecticut@aol.com
www. icanofconnecticut. webs. com

Thanks ICAN of the Twin Cities...

I am just not sure where to put this.... This is a Thank you of sorts. Praise for ICAN. Praise for the women who power ICAN.
I am so happy to say that if it had not been for ICAN meetings, the website and the email list and the support of them my life would be, well, not the same.
My birth, my amazing VBAC with Violet would not have ever happened the way it did. Violet may have never even been born.

My ICAN story starts with a desperate google search of "normal birth after a cesarean."
I found Chandra, the chapter leader of ICAN of the Twin Cities. She and ICAN helped me find my way. I remember that Chandra even gave me the resource information for unassisted birth.
ICAN really opened a door, no, not a door, a gate- I could see the path before that but I could never quite get to it- then with that little push- the gate slammed open. The information I found through ICAN and my ICAN contacts stepped into my mind, like a forgotten memory, like an impulse I'd deeply suppressed. With that information came power. It was like I suddenly had other senses- all the worlds within the world and above and beyond it unfolded all around me. I was still me but I was more than me- my body was mine, to do with as I wished.
I want you to know how much I value you all for that. We, the women on this forum, the women on the email list the women who are leaders at ICAN make ICAN what it is. Without us, there is nothing. There is despair and loneliness. I thank you, the women of ICAN with all my heart.

Our ICAN chapter leaders are so important- next time you see a CL, give her a big fat kiss. They do SUCH an important work. It is not an easy job, it is work, it takes real dedication.

So- What does ICAN mean to you? What has ICAN done to help you? aaaaannnnnddddd... What have you done for ICAN???

Connecticut Post

ICAN of Connecticut was in today's Connecticut Post newspaper.
The International Cesarean Awareness Network of Connecticut, Chapter Leader, Danielle Elwood, wrote a letter to the editor over 2 months ago, and today the letter was featured in the paper!
Congratulations to Danielle, and ICAN of Connecticut!

1 in 3 Connecticut Doctors unhappy

I think this may be a key to the high c-section rates in the state, as well as the way other doctors among the state react to their patients.

A new report released by Connecticut Medicine details that out of 1,100 doctors in CT surveyed said that they are not happy as a provider in Connecticut. "The University of Connecticut Heath Center's Institute for Public Health Research surveyed nearly 1,100 practicing physicians in Connecticut. The results were published Wednesday in Connecticut Medicine, a journal of the Connecticut State Medical Society."
"The doctors complained that malpractice insurance costs too much, managed care is imposing too many restrictions and the cost of living and doing business in Connecticut is too high. They're also not happy with the longer hours they're working."

ICAN Forums!

ICAN of CT has finally launched their message boards!
Please join us!

http://www.icanofconnecticut.yuku.com

Letter from the President

I wanted to share this with everyone, because I feel like this was a very important letter from the President in this quarter's Clarion.

Spring was busy. I gave two presentations over and hour long. One was about doulas encouraging VBAC to an audience of doulas. The other was on the personal impact of cesareans on families to a more mixed audience of doulas, childbirth educators, and nurses. While both went well, the one on the impact of cesareans has mixed reactions from the audience.

I am a mom. I gave the mother's point of view on cesareans. I spoke from my experience. I am also ICAN's president, and I spoke on behalf of many women. There is a wide continuum of experiences regarding cesareans. I acknowledge them but do not speak for them all - there are enough obstetricians wearing rose tinted glasses romanticizing cesareans - I speak for the women who have scars on their heart as well as their abdomen.

I want to be clear : We are seeing only the tip of the iceberg in regard to the impact of cesareans on women and their families. The reality is that the impact is far larger and deeper than we know. As the cesarean rate increases, so does our glimpse into the reality of the immense proportions of the epidemic and its impact on our lives. Cesarean surgeries impact the health of both mother and baby. Cesareans impact the workplace, as the time mother - and fathers - need off is lengthened. ICAN has recently been tracking a trend among health insurance companies to deny coverage or charge higher premiums to women who have had prior cesareans. The sill have both a financial and a health impact on families. Cesareans impact the woman's image of herself. Cesareans impact relationships between ever family member

The session covered these and other ways cesareans impact the family - everything from breastfeeding and bonding to the reaction of husbands. It was quickly apparent, from the first question after the presentation, that the real impact on families was not acknowledged. A nurse asked, "What about smaller hospitals who can't provide VBAC's?" "What about them?" I asked. I continued that that was an excuse -- that doctors, hospitals, and insurance companies are all pointing fingers at each other as the reason they can't provider VBAC for moms, meanwhile women are being left without a place to go birth or with coerced cesareans.

The nurse said that we are sending women into an adversarial situation. I got a little upset. I replied that we encourage women to interview care providers carefully to find someone supportive, that if a hospital has a ban, we suggest meeting with administrators to clarify our rights. We have moms who are still denied a VBAC, so we encourage them to look at all options, including changing hospitals, and interviewing homebirth midwives. Sometimes that doesn't work, and moms labor in the parking lot to avoid cesareans. She said that didn't make any sense -- that we need to look at the informed consent angle. I laughed out loud. "I'm ICAN's president. Do you think we don't understand what patients rights are about? Why do you think we are upset that they are violated everyday? Everyday we have women who contact ICAN --saying that they are being denied a VBAC, that there is a VBAC ban -- that they want to know their rights, their options"

She argued with me, saying that wasn't true. Someone else yelled out that if that were true, we could sue. "We have tried" I said, "and no lawyer will take the case -- that there aren't any 'sue-able damaged.'" I told the story of a woman in Michigan who has a horrible story of abuse and coercion and was interrupted several times -- people not believing the story. I finished the story, though I barely got through it. Women were shaking their heads and muttering "that can't happen."

It was very tense and frustrating to me. The undeniable looking the other way by professionals to what is really happening is discouraging and disappointing. It confirmed to me we have to continue speaking the truth. After the conference, a woman approached me and said, "Thank you. The emotion you showed touched me. I can tell you hold man women's stories. Thank you for carrying them and for sharing them."

Let me share my personal mission statement : I will know I have achieved my goals when, while being introduced, when I tell women what I do, I get a beautiful peaceful birth story back, instead of the painful, traumatic stories I do now.

May that day come soon.

- Pamela Udy