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Tuesday, July 9, 2013

Review: VBAC Facts Class with Jennifer Kamel

This weekend I had the pleasure of attending Jen Kamel's VBAC class "The Truth About VBAC: History, Politics and Stats" in Buffalo, NY. She is amazing - traveling the lecture circuit to present loads of information to both laypeople and birth workers alike.

I've already had a VBAC and I'm "just" a birth advocate, but I highly recommend the class if you can either attend in person or check out the webinar version. Why spend money on a class when I'm not even a birth professional? For philosophical reasons, this was as inspiring as it was educational.

What an opportunity it was to network with local doulas, midwives, advocates and birth professionals! I met new friends, heard and shared stories and exchanged information that not only could I use but pass on to others as well. The presentation was heavy on graphs and charts (Jen's favorite LOL) which is a good thing - putting it all into perspective is important. Without that perspective and information, women are potentially making a life-changing decision with less data and fewer facts, perpetuating the idea that "VBAC is dangerous!" and that it's selfish, foolish or risky to even consider it.

Some important take-away messages that I left that night with:
• Studies are important, as long as you're looking at the big picture. For instance, rupture rates are key, sure; but if the study you're reading doesn't tell you the number of women who had labor induced or augmented, then it's not going to give you all the facts. That is very important information to have - because it can increase the overall risk of rupture. Without it, it can definitely skew your impression of whether it's safe or not. Is your doctor quoting these same studies, that might present data the way he wants it to? Perhaps.

• Ultimately it all comes down to the level of risk that you are willing to accept. One is perceived as inherently safer, or more dangerous, than the other. Why is this? Because one is performed much more frequently than the other, to the point where risks and disadvantages are glossed over and minimized. I've always thought that it's just a shuffling game: you're trading one set of risks for another. You put off the more immediate risks of a VBAC and trade them for the more long-term, cumulative risks of repeat cesarean. If you're not looking at the long-term picture, you may not have all the best information at the time.

Why does a rare but well-publicized uterine rupture (which is not always catastrophic) send up more warning flags than surgical complications after four cesareans? Why are we more afraid of the risk of rupture - which may not even be realized - than we are about cesarean complications, that are becoming increasingly more common as more women have more cesareans?

Jen's presentation may be just the thing to give a VBAC mom the edge when it comes to studies and statistics - and it's downright sad that you even have to walk into a doctor's office defensively posturing yourself with a ream of studies to back up your birth plan. Don't expect your doctor to know all the facts and figures - or to even come close. Jen's information is nothing that you can't already find on your own, it's just painstakingly put together from the same medical journals and articles your doctor has access to - conveniently all in one place. The benefit to you is that the legwork has already been done - which is a big plus when it comes to the virtual sea of data that can be very overwhelming. Kudos to Jen for her hard work and determination!

For a list of upcoming classes and webinars, visit