United Brachial Plexus Network, Inc.

Hi Karleen - what I wrote them is that no matter what birth they chose to have the most important aspect is the practitioner they choose. And that if they have a birth that may be deemed high risk - shoulder dystocia in the last birth, etc. - and they want a vaginal birth - that if they are deadset on a vbac then to find the best expert to help them birth - someone who can really handle an SD birth. Just like if they were to have a C-sec to find an expert who has success there as well. The other thing I tried to explain to them was they really have to take a good hard look at WHY they needed a c-section in the first place - and have a very HONEST talk with their practitioner about the reality on both sides of the coin. I never tried to push anyone into just doing a c-sec - it IS risky - however if they are informed about the big picture - they will be able to make informed choices and also choose the right practitioner to help them birth any way. I really was trying to stay balanced in the conversation but the only risk they think to a VBAC birth is uterine rupture and that's just not true. But they weren't willing to hear about shoulder dystocia.

I just wanted to add one more quick thing...because this subject has been staying on my mind.

we are the sum of our experiences to date...that along with education are what will guide women to their decisions. I had a horrible experience vaginally and a wonderful c-section experience, so of course I have a bias...for what I would do. Of course I share my experience, but since others do not share the same experiences they don't make the same decisions. Had I not had such a horrible experience, and more importantly such lasting consequences from that experience, I would probably be inclined to try a VBAC. I know several people who changed to c-section during the course of a delivery and had great outcomes, "perfectly born" children. Looking back one could think that maybe they were those "unneccessary" c-sections. Since there was no "real" consequence in the end a VBAC would naturally be something to consider. While there are risks in both types, statisically there are less with vaginal, so why not go for it?

Another off the wall philisophical thought came to me...I have always been humbled by the thought that had this been another time or another place many moons ago, me and my daughter would have died during the delivery. A scary thought...but I think I might compensate my opinions by the fact that there is this thought that in the "survival of the fittest" mindframe, I was not meant to survive. (And I thought I was pretty fit going into labor...ha ah) But I did survive, and there must be a reason. Is it to save someone else? Is that why I feel the need to speak up when I know people don't want to hear it? Just thinking out loud here.

Okay... I'm getting a bit out there so I'll shut up!!!!

Lisa D - don't ever shut up. The world needs you to speak and so do we!

There certainly ARE risks with both - BUT there are so many doctors out there that CAN deliver a successful shoulder dystocia birth without injuring a baby and there are so many doctors that CAN do a c-section without consequences to the mother or child. That is why I believe the crux of the whole matter is to find the very best practitioner there is that can handle your personal situation.

The biggest problem is how do you find this person? You can search the court systems - if you know where the doctor practiced (could have moved around to avoid consequences) and you also have to know all the corporate names they hide behind. I guess what I'm asking for is a medical big brother or maybe just a little honesty. Wouldn't that be something! There's so much slime out there it is just sickening. Reminds me of ghostbusters (I didn't mean it in a funny way - the more I learn the more nauseated I become - I keep envisioning that sea of slime underneath the museum).

As I've read through the this thread, three things stand out:

1) There is so much ignorance out there among practitioners and parents about shoulder dystocia, BPI, how to evaluate the risks and make a birthing decision, and how to handle shoulder dystocia safely if it happens. It is just astounding to me. Shortly after my son's birth, I talked to my cousin, a recently certified midwife who'd been through a prestigious nursing-midwifery program in New York. She said, "Don't most of those injuries resolve in the first year?"

2) Amen to the person who pointed out that no one is counting so no one really knows what the risk is.

3) To the doctors who are quitting their practice because of the high cost of malpractice insurance, YOU MIGHT WANT TO CONSIDER REDUCING THE SOURCE OF SOME OF THE CLAIMS! Considering that BPI accounts for such a high percentage of OB malpractice claims, you would think that alone would be motivation to have a serious education and training effort for those who deliver babies! I don't get it.

There has got to be a way to get some national media attention for this problem. I know that when I talk to people, I do get the feeling that they think I am an alarmist.

Julie

This isnt really an answer to your question but a slightly different focus I am offering, just ignore it if you dont like it-
In my opinion many of the dystocias I have heard about, guessing over 50%, could have been avoided with good labouring positions, healthier diets and proper dystocia management during the birth,
Altho a C section would have avoided injury in these cases, so would proper management of pregnancy labour and birth, so
I choose to focus on educating birth care attendants regarding diet red flags and nutritional counseling, healthy labour positions, and proper management of dystocias if and when they occur, having an experienced doula present, or consulting a qualified homebirth midwife would certainly help- homebirth midwives are trained to weed out potential at risk clients with a passion, and an experienced homebirth midwife is more likely to catch red flags simply because the amount of time spends with clients is aprox an hour a visit (as opposed to 7 minutes average OB visit) -
so when I come accross a mum posting who I think might be at risk I strongly urge her to visit a homebirth midwife who is well known in the community,
Bright Blessings for you Francine to shine upon all your good deeds...

I just skimmed some of the answers and saw you made a post about your baby possibly wpuld have died if delieverd at home. I want to say that I am sure that I believe you if you say that, while that truth holds true for you, I can say with absolute assuredness that had my baby been born in a hospital I am absolutely positive his injuries would have been much more far reaching, and that they would have whisked him away to give him oxygen and put him on moniters and so forth(liability stuff) he wopuld have been tested for things that I was able to avoid, (phrenic nerve involvement which was causing him to puke, sugar)and I thank my higher power that I was able to have him at home,
I totally would stand by your right to choose a C section, and respect your opinions as valid and honerable, this is NOT an attack, or really even a disagreement, just an addition to the opinions being offered, also you might want to notice the statistics of homebirthed babies on this board...how many babies are here that have been homebirthed?
I am an advocate (duh ) of homebirth which is why I am so passionately speaking up- and I will admit its not for everyone, and there are TRULY times when a mum should be sectioned or at the very least deliver in the hospital, many many, and Im not saying all homebirth midwives are saints, there are crappy ones too-
but I do wish to bring light on the fact that C sections are not the only way to avoid injury due to dystocia...
OTOH, I would stand behind any woman who wanted to be sectioned after a dystocia regardless of injury,
Let us stay united, and disagree only so that it benefits our common knowledge and mentality, I completely respect all opposing opinions on this topic-
blessings, mary

Francine,
I commend you for trying. My focus this year is also awareness. I am working on a press release kit with my sister. We were both communications/PR majors. Our goal is to have it ready 1 month prior to awareness week. Closer to that time, I will be asking people to help out with various contacts. My long term goal is to take this to the top. I'm thinking 48 hours, CNN, maybe Oprah (if she decides to do a show on something relevant)
We need to find a way to target the masses. We need to make our voices louder.

Allison - contact Kim West- she is UBPN's Communications person...she can help you with all that you need and can tell you what they are working on currently, what's been done so far, etc. kim@ubpn.org
good luck!
-francine

Wise words, Karleen. Too true, Marymom-and how many babies here had a vaginal labour without any form of intervention or induction? These are the things that make vaginal birth dangerous. At least on the VBAC board Francine could post with her name and email, I DON'T feel comfortable doing that here if I am going against the flow, and that's sad.