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April is Caesarean Awareness Month as proclaimed by the International Cesarean Awareness Network and Governor Frank Murkowski and recognized by the National Institutes of Health.
The Caesarean rate is on the rise. In 2003, the Centers for Disease Control and Prevention reports the national Caesarean rate was 27.6 percent, the highest ever. According to state of Alaska vital statistics, Bartlett Regional Hospital had a 43 percent Caesarean rate that same year. When a Caesarean is necessary, it can be a lifesaving procedure for both mother and baby, but the World Health Organization estimates that nearly half of the Caesareans in this country are unnecessary and states that rates over 15 percent expose women and babies to unnecessary risk.
Some of the risks of Caesarean in the mother are increased risk of hemorrhage and blood transfusion, increased risk of hysterectomy and two to four times the risk of dying than after a vaginal birth along with all the risks of any major surgery such as infection and blood clots. Risks to baby include increased risk of respiratory distress, cuts from the surgeon's scalpel, and iatrogenic prematurity. Each additional Caesarean increases risks of uterine rupture and placental abnormalities in subsequent pregnancies. Medical evidence has shown time and again that vaginal birth after Caesarean is a safe option for most women.
I am saddened to learn of the VBAC ban in Juneau. It is unconscionable that the hospital's bottom line is dictating policy this way. The truth is, if a hospital is not safe for a woman to VBAC in, it is not safe for any woman to give birth in. Women should, and do have the right to accurate information regarding risks and benefits of any procedure and the right also to refuse any procedure.
I urge all women to educate themselves about their options. There are many steps you can take to prevent an unwanted Caesarean, and it starts with education. Take a childbirth class, read books and Web sites which outline the risks and benefits of labor interventions and how to reduce those risks. Birth attendant choke is important too, consider hiring a midwife and using a professional labor assistant, or "doula," both have been shown to reduce your risk of Caesareans. Make a birth plan and discuss it with your care provider prior to labor.