a birth worth fighting for

Great article from The Wall Street Journal about VBAC

while many health care professionals are working to reduce caesarean births, 

majority of women are still having  the repeat procedure even if they are eligible for a vaginal birth after caesarean. Although this article is US based, we see similar results here in Canada. In fact, caesarean section is the most frequent surgery performed on Canadian women. For more info pertaining to c-sections in Canada check out this article by The Star. 

Caesareans and VBAC are definitely hot topics. C-sections can be a life saving procedure for mom and baby without question. There will always be a need them and I feel fortunate to live in a country where we have access to medical professionals who perform them. However with the rise in number of women giving birth by caesarean compared to just 10 years ago, many are questioning why? 

In Canada, many family physicians refer pregnant women to obstetricians regardless of whether they are high risk or not. It's important to know that maternity care providers are not interchangeable, Midwives, family physicians and Obstetricians each deliver babies with a very different approach. Obstetricians are trained to manage high risk pregnancies and birth that often requires intervention, however they have been left to fill the gap- by default not design. Meaning having Obstetricians  attend more women with low risk pregnancies can result in higher intervention rates that are perhaps less needed, less effective and less evidence based. Many see this mismatch approach for low risk mothers as a cause for the rising rate in Caesarean birth. 

Unfortunately Canada is a nation that has very few midwife attended births, they represent 10% of births nationally. A far cry from countries like the Netherlands where midwives attend 80% of the births and the UK where midwives attend all births and are primarily care providers for most. Midwives are trained to manage low risk pregnancy and birth in a community based way, resulting in few interventions and according to the Cochrane Review- provide safety and efficacy as an option that should be available to all women. In Ontario, midwifery care has proven lower intervention rates, fewer re-admissions to hospital and shorter hospital stays. 

I encourage women and their families to research their birth options by talking with their doula, family physician, midwife or obstetrician. The key to an empowered birth is knowledge and finding the right healthcare provider for you!