Just a little flash from the past. I was an assistant at this birth.
Despite medical cautions, mom ‘trusts her own body’
JESSICA YORK, Staff Writer
Friday, February 24 SHAFTSBURY — Hers were the first hands to touch Jennabel Emma’s newborn head as she emerged into the world three months ago.
As the national trend spirals downward for natural births after a previous Cesarean section, Barbara Snyder not only had a natural birth after three previous Cesareans, but is encouraging others to trust their own bodies.
“I just had this feeling that I could do it and that I could be healthy,” said Snyder, who is a licensed nursing assistant. “If I hadn’t been as healthy, I don’t think I would have been a good candidate for it. In my opinion, it was a good option for me. But it’s not for everyone.”
Cesarean repeat rates increased from 69.8 to 88.7 per 100 births to low-risk women from 1996 to 2003, according to the Centers for Disease Control and Prevention. Increases in repeat Cesarean numbers corresponded with a decrease in vaginal births after a Cesarean (VBAC), from 30.2 percent in 1996 to 11.3 percent in 2003 for low-risk women, the CDC reported in 2005.
Dr. Mark Novotny, chief medical officer for Southwestern Vermont Medical Center, said he is seeing VBACs increase locally. Novotny said there is a balance between women who have natural births and women who have surgically assisted births.
But just because the numbers are going up for VBACs, Novotny and the hospital aren’t convinced that they’re the way to go. People in the medical profession are now aware that the risks associated with VBACs are higher than had been previously believed, Novotny said. Emergency surgeries that are needed in the case of a failed VBAC are always higher risk, said Novotny.
“Once things go wrong in obstetrics, they tend to go wrong rapidly,” said Novotny. “You’ve got to be able to act quickly to get the baby out quickly.”
SVMC is among thousands of hospitals nationwide no longer offering obstetric patients the option of a VBAC, according to Dianne Cutillo, SVMC marketing and public relations manager. The decision to do so was made after much consideration last fall, she said.
“It was not an easy decision, because caregivers in the childbirth center at SVMC value offering women the ability to have the kinds of birth experiences they choose,” Cutillo said.
Snyder, 27, runs a twice-monthly support group called “Trust Birth” for women who want to learn more about the birthing process – the natural, intervention-free birth process, according to Snyder’s Web site.
“It’s to find out more about trusting their bodies and learning that they can birth babies,” Snyder said.
After having her third child by Cesarean and a lot of research, Snyder said she decided that she would have a fourth child vaginally and at home, without assistance.
In November, after a false alarm two weeks earlier, Snyder was adequately prepared for the big push. After 14 hours of labor, some time on a birthing ball and a final rest in a birthing pool with friends and her husband gathered around, Snyder gave birth to her fourth child. Her husband was able to leave a little bit of umbilical cord for their oldest child to cut later on, Snyder said.
“She came out in the water – they swim right up,” Snyder said of the birth. “When the placenta’s still attached, they’re getting oxygen from the umbilical cord. But you get them up quickly, because the placenta detaches pretty soon.”
The American College of Obstetricians and Gynecologists has suggested that serious complications may occur more quickly during VBAC than during other labor, according to Cutillo. Because of this, the group’s guidelines suggest that the delivering physician and an anesthesiologist, as well as a standby surgical team, be on the hospital premises during labor when a woman is attempting a VBAC.
“Given those guidelines and the resulting impact on resources, fewer and fewer community hospitals perform VBACs,” Cutillo wrote in an e-mail. “As a rural community hospital, SVMC is among them.”
Novotny said patients have the right to choose what they want for health care, but it is important that they understand the consequences.
Snyder said if at any time during her pregnancy or birth she had noticed any problems, she would immediately have gone to the hospital. For Snyder, a natural home birth was the way to go. She said she was happy to be able to avoid the bright lights, fear and commotion of a hospital setting of her previous births, which did not take place at SVMC.
“They got me scared, thinking something was going to happen,” said Snyder. “It was different in that I was more relaxed. I think I was very well prepared. … Ask me three years ago, and I would have said, ‘No way, I’m not birthing at home.’ But I learned so much during my pregnancy. I did so much research, and I just met wonderful people.”