Daylight Section

After receiving the email from our mutual friend about her new grand baby's delivery, my friend wrote the following poem, which she has given me permission to share with you...

Daylight section

Your baby is here!

What an awesome blessing!

Congratulations!

Congratulations!

You hear

7 lbs, 3 oz baby girl

Healthy, full head of hair

Your baby is here!

You should be so happy!

Broken water

Ticking time-clock

Fetal monitor, pitocin drop

Doesn’t matter now, be happy!

Rejoice, rejoice, your baby is here!

Happy, healthy, full head of hair.

Tied down, trussed up, starved and drugged

Lied to, terrified, heart tones dropped?

But your baby is here, you should be happy,

Congratulations!

They did their best for you

Congratulations.

Your baby is here.

Prepped for surgery, shaved and scrubbed

Catheters, monitors, gaping wound

Daylight section

Beautiful baby extracted

A good outcome, no distress after all

Congratulations.

…and condolences.

This poem is dedicated to Sofia, Noelle and all the others
who have been cut from their mother’s womb for no good reason

Be Happy! It's a 7lb, 3oz. Baby Girl!

I received this email from a new baby's grandma about week ago. It's the story of millions of American women who don't know whether they should grieve over their surgical birth, or just move on and "be happy" that they have a healthy baby.
After all, what more could they ask for? Their doctor all but promised them a healthy baby.
S/he didn't promise how that baby would arrive, except that it would be in the safest way possible, the best that 21rst century medicine can deliver.

"Noelle" was surgically delivered before noon today

7 lb 3oz.

They say she has a full head of long dark hair and that she is pink and alert when awake, nursing at least every 3 hours.

They sent a picture of her to my cell phone. The picture of Noelle is now my cell wallpaper.

The interventions and subsequent "fetal distress" were horrific. I cried all day long from anxiety over what they did to "Sarah" [daughter in law] and my granddaughter. They tied her, they trussed her, they starved her, they drugged her, they exhausted her and they terrified her.
After that torture, "fetal distress" was inevitable. (Eeek! fetal heart tones dropped to 127!!)
.... It was all conveniently resolved with major abdominal surgery.

In spite of the interventions, Noelle was vigorous upon extraction. Oops, no cord wraps or fetal depression after all, hmmm.... But they got the kid conveniently "delivered" during daylight hours and within the 24 hour deadline from spontaneous rupture of membranes (SROM). Another "good outcome" for their stats.

A good outcome on paper. But was it good for mother and baby?
Did the treatment they received increase their chances of safety, of life, of successful breastfeeding,
of bonding, of happy mothering?

They had a one in three chance of C-section just by choosing hospital birth in the United States.
But 1 to 3 is 100% if you happen to be the ones sectioned.
It's not like my daughter-in-law was only 33% sectioned.

I am grateful that Noelle seems to have weathered the storms of intervention fairly well. But who knows the long term effects? Mommy, on the other hand, is now not only a new mother, but a post operative patient.

There is a place for emergency C-sections. But in this case, the emergency was created by the very system my loved ones blindly trusted to provide "safety".

I was painfully aware of the peril they were entering with their choice of care and helpless to avert the impending tragedy.
I did what I could to provide accurate information and techniques for dealing with a system that is more about avoiding medical liability than supporting the normal process of birth. (And I had prayed that they would "luck out" and end up being blissfully ignorant of the dangers they had avoided.)

I am so angry at the successful "sale" of "services" with which my loved ones got a total "bait and switch".

The reality of grandmotherhood has not really set in. I SO want to be happy.
And I am grateful for the precious child.
But I am heartbroken by the inhumane way she and her mother were treated at such a crucial time in their lives.

Thankfully, Sarah planned to breastfeed which seems to be going fine.

It's tomorrow now. Maybe I have cried myself out and I can get some sleep now.

On Surgeons and Normal Birth

"In [European] countries, obstetricians serve as specialists. They are essential members of the maternity care team, but they play a role only in the 10 to 15 percent of cases where there are serious complications. Most women have babies without ever setting eyes on a doctor.

In the United States, the numbers are reversed. Obstetricians "attend" 90% of births and have a great deal of control, essentially a monopoly, over the maternity care system. Obstetricians are taught to view birth in a medical framework rather than to understand it as a natural process. In a medical model, pregnancy and birth are an illness that requires diagnoses and treatment. It is an obstetrician's job to figure out what is wrong (diagnoses) and do something about it (treatment) - even though, with childbirth, the right thing in most cases is to do nothing.

To put it another way, having an obstetrical surgeon manage a normal birth is like having a pediatric surgeon babysit a normal two-year-old. Both will find medical solutions to normal situations -- drugs to stimulate normal labor and narcotics for a fussy toddler. Its a paradigm that doesn't work."

Marsden Wagner, M.D., M.S.

Born In the USA,
How a Broken Maternity Care System Must Be Fixed
to Put Women and Children First,
University of California Press, 2006

ACOG's lastest grenade tossed at homebirth

It should come as no surprise... homebirth advocates are stirring the water and challenging groups like ACOG to justify their stances on homebirth and midwives with evidence. No new studies in the works, just another statement of their opposition to homebirth...

ACOG NEWS RELEASE

For Release:
February 6, 2008

Contact:
ACOG Office of Communications
(202) 484-3321
communications@acog.org

ACOG Statement on Home Births

Washington, DC -- The American College of Obstetricians and Gynecologists
(ACOG) reiterates its long-standing opposition to home births. While
childbirth is a normal physiologic process that most women experience
without problems, monitoring of both the woman and the fetus during labor
and delivery in a hospital or accredited birthing center is essential
because complications can arise with little or no warning even among women
with low-risk pregnancies.

ACOG acknowledges a woman's right to make informed decisions regarding her> delivery and to have a choice in choosing her health care provider, but
ACOG does not support programs that advocate for, or individuals who provide,
home births. Nor does ACOG support the provision of care by midwives who are
not certified by the American College of Nurse-Midwives (ACNM) or the
American Midwifery Certification Board (AMCB).

Childbirth decisions should not be dictated or influenced by what's
fashionable, trendy, or the latest cause célèbre. Despite the rosy picture
painted by home birth advocates, a seemingly normal labor and delivery can
quickly become life-threatening for both the mother and baby. Attempting a
vaginal birth after cesarean (VBAC) at home is especially dangerous
because if the uterus ruptures during labor, both the mother and baby face an
emergency situation with potentially catastrophic consequences, including
death. Unless a woman is in a hospital, an accredited freestanding
birthing center, or a birthing center within a hospital complex, with physicians
ready to intervene quickly if necessary, she puts herself and her baby's
health and life at unnecessary risk.

Advocates cite the high US cesarean rate as one justification for
promoting home births. The cesarean delivery rate has concerned ACOG for the past
several decades and ACOG remains committed to reducing it, but there is no
scientific way to recommend an 'ideal' national cesarean rate as a target
goal. In 2000, ACOG issued its Task Force Report Evaluation of Cesarean
Delivery to assist physicians and institutions in assessing and reducing,
if necessary, their cesarean delivery rates. Multiple factors are responsible
for the current cesarean rate, but emerging contributors include maternal
choice and the rising tide of high-risk pregnancies due to maternal age,
overweight, obesity and diabetes.

The availability of an obstetrician-gynecologist to provide expertise and
intervention in an emergency during labor and/or delivery may be
life-saving for the mother or newborn and lower the likelihood of a bad outcome. ACOG
believes that the safest setting for labor, delivery, and the immediate
postpartum period is in the hospital, or a birthing center within a
hospital complex, that meets the standards jointly outlined by the American Academy
of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that
meets the standards of the Accreditation Association for Ambulatory Health
Care, The Joint Commission, or the American Association of Birth Centers.

It should be emphasized that studies comparing the safety and outcome of
births in hospitals with those occurring in other settings in the US are
limited and have not been scientifically rigorous. Moreover, lay or other
midwives attending to home births are unable to perform live-saving
emergency cesarean deliveries and other surgical and medical procedures
that would best safeguard the mother and child.

ACOG encourages all pregnant women to get prenatal care and to make a
birth plan. The main goal should be a healthy and safe outcome for both mother
and baby. Choosing to deliver a baby at home, however, is to place the process
of giving birth over the goal of having a healthy baby. For women who
choose a midwife to help deliver their baby, it is critical that they choose only
ACNM-certified or AMCB-certified midwives that collaborate with a
physician to deliver their baby in a hospital, hospital-based birthing center, or
properly accredited freestanding birth center.

The American College of Obstetricians and Gynecologists is the national
medical organization representing over 52,000 members who provide health
care for women

Response to ACOG's recent statement on Home birth

PushNews from The Big Push for Midwives Campaign

CONTACT: Steff Hedenkamp, (816) 506-4630, RedQuill{at}kc.rr.com

FOR IMMEDIATE RELEASE: Thursday, February 7, 2008

ACOG: Out of Touch with Needs of Childbearing Families

Trade Union claims out-of-hospital birth is “trendy;”

tries to play the “bad mother” card

(February 7, 2008) — The American College of Obstetricians and Gynecologists (ACOG), a trade union representing the financial and professional interests of obstetricians, has issued the latest in a series of statements condemning families who choose home birth and calling on policy makers to deny them access to Certified Professional Midwives. CPMs are trained as experts in out-of-hospital delivery and as specialists in risk assessment and preventative care.

“It will certainly come as news to the Amish and other groups in this country who have long chosen home birth that they’re simply being ‘trendy’ or ‘fashionable,’” said Katie Prown, PhD, Campaign Manager of The Big Push for Midwives 2008. “The fact is, families deliver their babies at home for a variety of very valid reasons, either because they’re exercising their religious freedom, following their cultural traditions or because of financial need. These families deserve access to safe, quality and affordable maternity care, just like everyone else.”

Besides referring to home birth as a fashionable “trend” and a “cause célèbre” that families choose out of ignorance, ACOG’s latest statement adds insult to injury by claiming that women delivering outside of the hospital are bad mothers who value the childbirth “experience” over the safety of their babies.

Hundreds of Missouri home birth families in support of midwives fill a Senate Hearing room in 2005

“ACOG has it backwards,” said Steff Hedenkamp, Communications Coordinator of The Big Push and the mother of two children born at home. “I delivered my babies with a trained, skilled professional midwife because I wanted the safest out-of-hospital care possible. If every state were to follow ACOG’s recommendations and outlaw CPMs, families who choose home birth will be left with no care providers at all. I think we can all agree that this is an irresponsible policy that puts mothers and babies at risk.”

The Big Push for Midwives calls on ACOG to abandon these outdated policies and work with CPMs to reduce the cesarean rate and to take meaningful steps towards reducing racial and ethnic disparities in birth outcomes in all regions of the United States. CPMs play a critical role in both cesarean prevention and in the reduction of low-birth weight and pre-term births, the two most preventable causes of neonatal mortality.

Moreover, their training as specialists in out-of-hospital maternity care qualifies CPMs as essential first-responders during disasters in which hospitals become inaccessible or unsafe for laboring mothers. In addition, CPMs work to ensure that all babies born outside of the hospital undergo state-mandated newborn screenings and are provided with legal and secure birth certificates.

Currently, Certified Nurse-Midwives, who work predominantly in hospital settings, are licensed and regulated in all 50 states, while Certified Professional Midwives, who work in out-of-hospital settings, are licensed and regulated in 24 states, with legislation pending in an additional 20 states.

The Big Push for Midwives http://www.TheBigPushforMidwives.org is a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico , and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care.

Media inquiries should be directed to Steff Hedenkamp (816) 506-4630, RedQuill{at}kc.rr.com.

Is It Safer to Have Another Cesarean or Attempt a Vaginal Birth (VBAC)?

And the evidence in favor of vaginal birth over repeated cesareans just keeps piling up!
Check out this most recent study, just published in the journal of
Obstetrics & Gynecology
(2008;111:285- 291).

The study's OBJECTIVE:
To estimate the success rates and risks of anattempted vaginal birth after cesarean delivery (VBAC) according to the number of prior successful VBACs.

METHODS:

From a prospective multicenter registry collected at 19 clinical
centers from 1999 to 2002, we selected women with one or more prior low
transverse cesarean deliveries who attempted a VBAC in the current
pregnancy. Outcomes were compared according to the number of prior VBAC
attempts subsequent to the last cesarean delivery.

RESULTS:

Among 13,532 women meeting eligibility criteria, VBAC success
increased with increasing number of prior VBACs: 63.3%, 87.6%, 90.9%, 90.6%,
and 91.6% for those with 0, 1, 2, 3, and 4 or more prior VBACs, respectively
(P<.001).

The rate of uterine rupture decreased after the first successful VBAC and did not increase thereafter: 0.87%, 0.45%, 0.38%, 0.54%, 0.52%(P=.03) .

The risk of uterine dehiscence and other peripartum complications also declined statistically after the first successful VBAC. No increase in neonatal morbidities was seen with increasing VBAC number thereafter.

CONCLUSION:

Women with prior successful VBAC attempts are at low risk for maternal and neonatal complications during subsequent VBAC attempts. An increasing number of prior VBACs is associated with a greater probability of VBAC success, as well as a lower risk of uterine rupture and perinatal complications in the current pregnancy. Contrast that study with another from Obstetrics & Gynecology (2006;107:1226- 1232) which found that there is maternal morbidity associated with multiple repeat cesareans.

OBJECTIVE:

To estimate the magnitude of increased maternal morbidity associated with increasing number of cesarean deliveries.

METHODS:

Prospective observational cohort of 30,132 women who had cesarean delivery without labor in 19 academic centers over 4 years (1999-2002). RESULTS: There were 6,201 first (primary), 15,808 second, 6,324 third, 1,452 fourth, 258 fifth, and 89 sixth or more cesarean deliveries. The risks of placenta accreta, cystotomy, bowel injury, ureteral injury, and ileus, the need for postoperative ventilation, intensive care unit admission, hysterectomy, and blood transfusion requiring 4 or more units, and the duration of operative time and hospital stay *significantly increased *with increasing number of cesarean deliveries. Placenta accreta was present in 15 (0.24%), 49 (0.31%), 36 (0.57%), 31 (2.13%), 6 (2.33%), and 6 (6.74%) women undergoing their first, second, third, fourth, fifth, and sixth or more cesarean deliveries, respectively. Hysterectomy was required in 40 (0.65%) first, 67 (0.42%) second, 57 (0.90%) third, 35 (2.41%) fourth, 9 (3.49%) fifth, and 8 (8.99%) sixth or more cesarean deliveries. In the 723 women with previa, the risk for placenta accreta was 3%, 11%, 40%, 61%, and 67% for first, second, third, fourth, and fifth or more repeat cesarean deliveries, respectively.

CONCLUSION:

Because serious maternal morbidity increases progressively with increasing number of cesarean deliveries, the number of intended pregnancies should be considered during counseling regarding elective repeat cesarean operation versus a trial of labor and when debating the merits of elective primary cesarean delivery.

Miscarriage... Is There an Answer?

I think so, and I want to write a book about it!

Several years ago, I was contacted by several women who were having repeated miscarriages. They desperately wanted to have a baby. These women found their hopes soaring several times a year when they would find themselves pregnant, only to be harshly crushed a couple of months later when they began spotting... bleeding... cramping.... staying in bed, calling their doctor or midwife.... and then miscarrying.

Some of them would call me sobbing, saying, "All I want is a live baby! Why can't anyone tell me what's wrong with me? Why doesn't my doctor know what to do? I've done every test that modern medicine has invented and they still don't know why this keeps happening!"

I didn't know any more than their doctors did.
All I could say was, "I'm sure there's an answer somewhere. Obviously, something's wrong, and usually when there is something wrong, there is almost always a way to fix it..."

Their agony of miscarriage after miscarriage compelled me to try to find answers. I read books.
I spent days and months online, researching. I waded through big, fat textbooks, and boring Swedish studies on reproductive health. I read fertility books. I talked to mothers and their doctors and midwives.

I began to find bits and pieces here and there... things that sounded reasonable and helpful. I began forwarding articles and information on to my friends who were struggling with miscarriage.

Before long I began receiving calls - I'm four months pregnant and I'm doing fine!"
Mothers would beam, "This baby is our miracle baby!" and then they'd tell me about taking vitamins, drugs, herbs, hormone supplements, additional testing - all kinds of things that I had found info on.

One of those success stories!

I began to see things that were working for some of these women. They were solving their own problems with lots of information in front of them. They started passing my number on to their friends. Soon I found myself besieged with calls from desperate women from across the country who would call me at all hours, apologizing for their call, but explaining that they were spotting or cramping and thought maybe I could help them because their friend had told them about me.

I really couldn't "prescribe" anything to them. I couldn't tell them what to do. I wasn't a medical professional, and I wasn't their caregiver. But I had several big folders, packed with studies, articles, recommendations from both the medical field and alternative healthcare practitioners.
And now, I had personal stories from women who had live, healthy babies, and credited it to what they had done with both modern medicine and things as simple as herbal teas and healthy foods.

I decided to find the best book to recommend to these women... And I began searching for a "miscarriage bible" - an all encompassing book, explaining miscarriage and it's many causes and a whole range of possible solutions. When I realized it didn't exist, I began looking for a book from the medical model, focused on miscarriage and how to prevent it and a book from the holistic perspective as well. I bought most of the books I could find, but none of them seemed to be what these mothers needed.

So, I decided that I would write the book, since no one else has. I have a lot of information. I need to find a lot more. I need to know more of the most puzzling questions about miscarriage and what women want to know about it. My work on this project has been on hold for nearly two years now, as I have had other things to focus on. But, I want to get back to work on it shortly, because I know that every day there are women looking for answers, and I want them to find them somewhere...

If you have any suggestions, or questions about miscarriage that you would like to see answered, or if you have ideas for studies that you wish somebody was doing, or... whatever you think would be most helpful in the arena of miscarriage, I'm looking for more material and questions.

If you know of anyone who is currently researching miscarriage, or who has a special "remedy" or unique information in their practice, I'm anxiously waiting to hear more!

I'm interested in anything and everything that can be done to prevent a miscarriage - drugs, herbs, surgery, vitamin and mineral supplements, hormones, nutrition, family relationships, essential fatty acids....

I'd like to know what testing is most helpful and practical, and what has not be helpful in determining the causes of miscarriage.

I'd also love to include stories of women who have struggled with miscarriage, and of course, some success stories!

Email me at: betterbirth4you {at} gmail {dot} com.

The Struggle to Be Skinny Enough

It was a few weeks ago. I found myself sitting in a little restaurant, the walls covered with retro advertisements and old Coca Cola signs from the 50’s.

I sat there, sipping my drink and waiting on my food, when the thighs of a bright and smiling girl with bouncy curls on a poster on the wall caught my eye. She wore a yellow pleated mini skirt, and was leaning back, holding her Coke. Her thighs were prominent in the picture and they were so … uh, normal sized. She wasn’t fat, or chubby, but her rosy cheeks glowed. She looked healthy and hearty. I couldn’t stop staring at her. It just seemed so weird to see a model about my size, not rail thin, on the wall.

I spent more time starting at the rosy cheeked girl with a huge smile on the Coca Cola poster than I did eating my food. How different from the models that are held up today as the perfection of beauty, I mourned to myself. The models from fifty years ago weighed far more than the stars of today. They weren't fat; they were healthy weights, with some curves, and actual flesh on their bones!

Angelina Jolie, thin limbs, gaunt and hollow face. Our culture has adjusted to thinking this is as good as beauty gets! Every magazine and billboard shouts out that sharp and stark cheek bones are more beautiful than gently rounded cheeks, legs are more beautiful with nothing but bone, and waists are most beautiful when they are impossibly small.

This is what our girls try to be. They starve themselves, live on diet sodas, protein shakes, low-calorie fillers… binge and purge because of the array of food set before them hourly. …Always feeling fat and ugly and hoping to catch a guy’s attention by getting as skinny as their friends. Size 4 jeans have almost become a status symbol.

Growing up in a culture that values an almost starved look (one that most people cannot obtain in a healthy way) carries over into motherhood.

A few months ago, I was visiting with a pregnant doula client and her husband. This beautiful woman who I’ll call Grace [details changed to protect her identity] is slender – 10-20 pounds underweight, and half-way through her pregnancy weighs less than she should as a non-pregnant person.

Grace was talking about her baby’s movement. I asked if I could touch her belly and feel the baby. She smiled and said, “Of course. He’s right here.” As I laid my hand on her nearly flat stomach (yes, she was half way through her second trimester!), she grimaced and said, “Sorry, there’s a huge blob of fat there. You’ll just have to ignore it.” Then she turned away and looked embarrassed.

Of course, I said something positive back to her about her body, but as I left I wondered how many other pregnant mothers feel the same way about their bodies, not because there is any truth to the way they feel, but because our culture makes them feel that way.

How many women feel like Grace? How many women are starving their babies for fear of “getting fat”?

I’m not advocating obesity or being overweight or gaining a huge amount while pregnant, or pigging out, or…

I’m advocating that women feel pressure to be healthy, not skinny!

New York City Midwifery Care - 1931-1961

The Maternity Center Association, New York City ~ 1931-1961

From 1931 the Lobenstine Midwifery Clinic of New York City, in affiliation with the Maternity Center Association (MCA), offered home birth services to help meet the needs of the most economically deprived and needy families of the upper Manhattan tenements. Between 1931 and 1961, 5,766 mothers registered with the clinic, of which 87% gave birth at home, attended by midwives. Their maternal mortalities were less than one third the national rates of the time. Their average neonatal death rates were only 16 per 1,000, while that of New York City as a whole ranged from 28.9 in 1931 to 18.4 in 1961. These results by the MCA midwives are even more remarkable in light of the fact that poor nutrition was prevalent among their clients. 36.4% of them suffered from secondary anemia, 6.3% tested positively for syphilis and 6% were in their tenth pregnancy. The MCA discontinued its home birth services years ago, but retains its legacy of superior outcomes.

~ From Law, M., Report on the Maternity Center Association Clink, NY, 1931-1951, American Journal of Obstetrics and Gynecology, 69:178-184, 195S.

~ Faison, J., The Maternity Center Association Clinic, NY, 1952-1958, American Journal of Obstetrics and Gynecology, 81:395-402, 1961.

These data and additional studies which I will be posting and crediting to Dr. David Stewart's work have been excerpted from his book, The Five Standards for Safe Childbearing, by Dr. David Stewart, Ph.D. Dr. Stewart is a medical statistician with special education in obstetrics and is one of the leading world authorities in the area of midwifery and home birth statistics. He has been an invited lecturer at meetings of the American College of Obstetrics and Gynecologists (ACOG) and the National Perinatal Association (NPA) and numerous other childbirth-related functions throughout North America. He has served on committees of the American Public Health Association (APHA) and the American College of Nurse Midwives (ACNM). Dr. Stewart is the author or co-author of more than 200 publications, including 13 books. He serves as the Executive Director and co-founder of the International Association of Parents and Professionals for Safe Alternatives in Childbirth - NAPSAC International.

For more information, or to purchase The Five Standards for Safe Childbearing, contact:

NAPSAC International

Rt. 4, Box 646

Marble Hill, MO 63764

Phone/Fax: (573) 238-2010 or

(800) 758 - 8629

A Clearly Defined Risk of Cesarean Birth: Hysterectomy

The American College of Obstetricians and Gynecologists’ “Green Journal” contains some enlightening news in the January 2008 issue that every pregnant woman should know. It’s contained in a report about a very recent study titled, “Cesarean Delivery and Peripartum Hysterectomy” -- Obstetrics & Gynecology, Knight et al, 2008; 111:97-105-

Check it out here: http://www.greenjournal.org/cgi/content/abstract/111/1/97

I hope you have a friend with access to the medical journal who can get you a copy of the complete study. It’s a great resource to keep on hand… and to give to anyone who has been told that “cesarean is about equally safe when compared to vaginal birth”!

The study was a population-based, matched case-control study that studied 318 women who underwent peripartum (around the time of birth) hysterectomy between February 2005 and February 2006 and 614 matched control women. The study was done in the United Kingdom, using the United Kingdom Obstetric Surveillance System.

The conclusion of the study was:

Peripartum hysterectomy is strongly associated with previous cesarean delivery, and the risk rises with increasing number of previous cesarean deliveries, maternal age over 35 years, and parity (number of pregnancies carried to over 28 weeks) greater than 3.

Here are a few of the most interesting and relevant findings of the study:

Women who were having their first cesarean delivery were approximately 7.13 times more likely to end up with a hysterectomy (as compared to an equal control group having a vaginal delivery instead) by the time it was all over.

By the time it was the woman’s second or more cesarean delivery, her risk of hysterectomy was over 18 times greater than the woman having a vaginal birth!

~Women undergoing their first vaginal delivery were found to have a
1 in 30,000 chance of having a peripartum hysterectomy

~Women undergoing their first cesarean delivery were found to have a
1,700 chance of having a peripartum hysterectomy.

~Women undergoing their second cesarean delivery were found to have a
1 in 1,300 chance of having a peripartum hysterectomy

~Women undergoing their third or more cesarean delivery were found to have a
1 in 220 chance of peripartum hysterectomy.

ACOG’s journal said it themselves:

“This study has confirmed the significant risk of peripartum hysterectomy associated with prior cesarean delivery. These data provide evidence that cesarean delivery leads to a greater than seven times increase in the odds of having a peripartum hysterectomy to control hemorrhage. A similar risks was noted in a recent U.S. study using the Nationwide Inpatient Sample. We have also been able to identify that the risk also then extends beyond the initial cesarean delivery into subsequent deliveries; women who have more than one previous cesarean delivery have more than double the risk of peripartum hysterectomy in the next pregnancy, and women who have had two or more previous cesarean deliveries have more than eighteen times the risk. This full quantification of these risks provides the evidence needed to comprehensively counsel women about the risks of primary cesarean delivery and to counsel against cesarean delivery without a specific medical indication.”

The article winds up with a statement:

“Although fortunately a rare condition, peripartum hysterectomy nevertheless represents a catastrophic (and sometimes fatal) end to a pregnancy for any woman, regardless of whether she considers her family to be complete.”

Kudos to your obstetrician if s/he brings up this info when informing you of the risk of Cesarean section birth!