Prevention
Power Community Awards - Nomination
September 17, 2004
Nominator's name: Claudia
E. Villeneuve
Nominator's Address: 7604-153
Street Edmonton , AB T5R 1N4
Nominator's Phone number: (780)
444-3041 Evenings (420-8292 Daytime)
Name of
individual, team or organization being nominated: Edmonton
VBAC Support Association/ICAN of Edmonton
Nominee's
address: 736 Johns Road
Edmonton , AB T6L 6P3 Nominee's phone number: Contact
Association leader Shannon Beckett at (780) 450-6263 or by
email at edmontonVBAC
@ yahoo.ca
Name of initiative: VBAC
Is A Safe Option (VBAC is Vaginal Birth After Caesarean) Prevention
Power Community Award Category: Volunteer – This
category recognizes an individual who has devoted time and
energy in support of health promotion or prevention for the
betterment of others on a volunteer basis.
Provide information
about the initiative and the individual, team or organization:
The Initiative
The initiative of VBAC Is A Safe Option by the
Edmonton VBAC Support Association/ICAN of Edmonton performs
an essential service to the community by disseminating information
on healthy alternatives to repeat surgical birth. The increased
popularity of elective caesarean surgery without fully informed
consent of the health risks and alternatives, and the institutional
restrictions on VBAC or vaginal birth after caesarean options,
have made the promotion of VBAC a key priority. There are
many reasons why women and their families may want a VBAC
or vaginal birth after a caesarean, as an alternative to
an automatic repeat caesarean. Some may be medical and some
may be emotional. Others may be financial or in terms of
recovery. When and whether a caesarean delivery is necessary
continues to be a matter of much controversy. "Once
a Caesarean, always a Caesarean" used to be standard
advice, and doctors rarely considered allowing a woman to
go through labor and have a vaginal birth. For the last 20
years, however, obstetricians have been more willing to consider
trying labor, plus the World Health Organization recognizes
that VBAC should be offered as a healthier alternative to
repeat caesarean surgery, whenever possible. The SOGC, Society
of Obstetricians and Gynaecologists of Canada, supports VBAC
as a safe option and updated its VBAC guidelines in July
2004 to reflect that.
The Organization
The Edmonton VBAC Support Association/ICAN
of Edmonton is a non-profit group, founded in February 1986
and formally registered under the Societies Act of Alberta
in May of the same year. In 2004, the Association became
an official chapter of ICAN, International Cesarean Awareness
Network, bringing the experience and support of an international
organization to their own.
The goals of the Association
are:
- To provide information about vaginal birth after cesarean
(VBAC) to women and their families.
- To provide emotional support to women and their partners
who are planning a VBAC.
- To increase public awareness of VBAC as a safe option.
- To represent and promote the interests of VBAC parents,
as health care consumers, to health care professionals
and to various levels of government.
The Association achieves its objectives through the following
activities:
- Monthly public information / discussion / support meeting;
periodic presentation of audio visual material, a lending
library; information from surveys of Edmonton-area obstetricians
and all Alberta hospitals; telephone counseling; distribution
of information packages; information updates.
- Monthly meetings provide and emotionally safe, accepting
and supportive place for women to discuss their feelings
and listen to others; telephone support is also provided
to those unable to attend monthly meetings.
- Displays at health conferences; notices in community
newsletters; articles and letters in local newspapers;
appearances on local radio and television stations.
- Surveys and letters requesting policy changes to Edmonton
area hospitals; in-service presentations to hospital staff;
representation on the Edmonton Area Birth Educators Committee;
written submissions to the Department of Hospitals and
Medical Care, the Alberta Advisory Council on the Status
of Women, the Alberta Health Care Utilization Committee,
the Premier's Commission on Health Care Costs, and the
Alberta Medical Association.
The profile of the Association includes:
- Offer support to women and their families who have recently
had a caesarean, women who are interested in having a VBAC
and women who want to prevent a caesarean. They come together
in an informal gathering to share birth stories, answer
questions and support one another. Periodically they have
guest speakers come and talk on issues relating to pregnancy.
- The Edmonton VBAC Support Association/ICAN of Edmonton
exists for every pregnant woman, even first time mothers.
Guests do not need to have had a caesarean in the past
to participate. The Association believes that avoiding
the first cesarean is crucial to women's future reproductive
health.
Tell us how the initiative
meets the award criteria:
The initiative of VBAC
Is A Safe Option by
the Edmonton VBAC Support Association/ICAN of Edmonton
helps support the Capital Health belief that “health promotion
and injury and disease prevention are key aspects of health
reform.” Capital Health is correct in realizing that “people
-community members- are the most effective ambassadors
of promotion and prevention and the most dynamic forces of
widespread change.” The Association is formed of community
members who have experienced caesareans and VBAC and wish
to support other community members who are going through
the same experiences. The Association is an effective ambassador
for the promotion of VBAC, or vaginal birth after caesarean.
Ever since its inception in 1986, the Association has helped
many women become fully informed of their birth options regarding
caesareans and VBAC.
The Association is working to promote
health by creating awareness that VBAC is a safe option,
and prevent injuries that can occur during caesarean surgery.
By creating awareness of VBAC as a safe option, and reducing
the rates of caesareans, the result is the improved health
of community members, and ultimately, the improved health
of our region. Since caesareans costs about twice as much
as a vaginal birth, the added value of this initiative is
to help sustain our health system by reducing health care
costs. The reduction of caesarean rates, through the initiative
of VBAC Is A Safe Option by
the Edmonton VBAC Support Association/ICAN of Edmonton, is
an example of community members taking positive action to
improve health and prevent injury and disease to our citizens.
Provide details on how the initiative promotes health
or helps prevent injury and disease:
The initiative promotes awareness of VBAC as a safe option. Here are some of
the benefits to the mother and baby by having a vaginal birth, instead of an
elective repeat caesarean (found in http://www.pregnancy-info.net/vaginal_birth.html ):
To mother:
-
Prevention of death from surgery
-
Prevention of lesser complications from surgery
-
Prevention of blood loss
-
Prevention of infection
-
Prevention of injury (bowel, urinary tract, etc.)
-
Prevention of blood clots in the legs
-
Prevention of feelings of guilt or inadequacy that surgery
sometimes causes
-
Breastfeeding is generally easier after a vaginal birth
-
The cost of a vaginal birth is about $3,000 less
To baby:
- Prevention of Iatrogenic Prematurity (meaning surgery
was done, because of an error in guessing a due date)
- Reduction in the cases of Persistent Pulmonary Hypertension
- Labor prepares the baby for extrauterine life
- Prevention of surgery related fetal injuries (lacerations,
broken bones)
- VBAC results in fewer fetal deaths than elective repeat
cesareans
The World Health Organization issued a statement in 1992
explaining that "continued increases in rates of obstetrical
intervention are unlikely to lead to improvements in birth
outcome and may result in a higher incidence of adverse outcome
for mothers and their offspring. The risks associated with
caesarean section include: damage to uterine blood vessels;
accidental extension of the uterine incision; damage to the
urinary bladder; anaesthesia accidents; wound infections;
maternal mortality. Depressed Apgar score; higher rates of
neonatal respiratory distress; shortened mean length gestation;
and higher perinatal mortality in subsequent pregnancies." The
initiative of VBAC Is A Safe Option thus promotes
alternatives to an automatic repeat caesarean, with all of
the risks of typical major abdominal surgery.
Provide other information for the judging panel
when considering this nomination:
More information about the
Edmonton VBAC Support Association/ICAN of Edmonton can be
found at their local website www.edmontonVBAC.netfirms.com ,
and their parent website ICAN International Caesarean Awareness
Network at www.ican-online.org .
The Association also advertises locally through the Support
Network at www.thesupportnetwork.com and
it has collaborated in natural childbirth awareness projects
with the Association for Safe Alternatives in Childbirth
ASAC, at www.asac.ab.ca in
Edmonton. All the members of the Association are devoted
volunteers that strive to balance their regular work and
family life, with their volunteer work, and have themselves
experienced not just one but two, three or more caesareans
of their own. The Association's commitment to creating awareness
of birthing alternatives to repeat surgery has not slowed
since its creation in 1986. The current trends on birth in
Alberta and Canada show that caesarean birth is on the rise,
thus increasing the risk of short term and long-term injuries
to mothers and babies, making the existence of the Edmonton
VBAC Support Association/ICAN of Edmonton, as a PREVENTION power house,
more important than ever before.
ATTACHMENT
Bulletin from the
website of the Society of Obstetricians and Gynaecologists
of Canada SOGC supporting VBAC as a safe option (At http://sogc.medical.org/pub_ed/BringBaby/vaginalBaby_e.shtml ):
PUBLIC EDUCATION – PREGNANCY
AND BIRTH
by: Society of Obstetricians and Gynaecologists of Canada
SOGC
What is a VBAC?
When
people talk about Vee-BACK, it means Vaginal Birth After
Caesarean (VBAC).
What is a Caesarean birth?
It is an operation
that cuts into your belly and uterus (or
womb) to remove your baby. About one of every 6 or 7 births
in Canada is a Caesarean birth.
People
used to believe "once a Caesarean, always a
Caesarean". They thought that a woman who had one baby
by Caesarean would have to have all other babies by Caesarean.
Doctors were worried that if a woman's uterus was cut open
during a Caesarean, then her uterus might not be strong enough
to go through normal labour during the next pregnancy.
Now,
between 70 and 80 per cent of women who had Caesarean births
can give birth vaginally (through the vagina). This is the
usual way to give birth. Even women who have had more than
one Caesarean birth can try to have a vaginal birth the next
time. You need to talk this over with your doctor.
Why
is VBAC better?
- You will have a faster recovery after birth. It usually
takes a few weeks to heal after a Caesarean birth. There
is more pain and you will have to stay in hospital longer
after a Caesarean birth.
- You will have fewer complications. In other words: VBAC
is probably safer than a Caesarean birth.
A Caesarean is an operation ( surgery ).
You have to be frozen from the waist down or put to sleep
(anaesthetic). You might need to have blood during or after
the operation (a blood transfusion). Afterwards, you could
have pain or bleeding or get an infection.
- You and your husband or partner can be more involved
in the birth.
Can everyone have
a VBAC?
If you had a Caesarean birth and would
like to have another baby by VBAC, you and your partner
should:
- talk to your doctor, and/or
- go to VBAC classes to learn more about VBAC.
Two things you will have to think about are:
- the kind of cut ( incision ) that was
used during the Caesarean
- the position of the baby at the time
of birth.
What kinds of cuts
are there?
Doctors use the word incision when
they talk about cuts. You can NOT tell what kind of incision was
done to your uterus by just looking at the scar on your belly.
This is because the scar on your belly is not always in the
same place as the cut to your uterus.
Your doctor will have
to look at your medical records to find out where the incision in
your uterus was made.
If you have a new doctor, you should
get your medical records from your old doctor and give
them to the new one.
Does it matter where the incision
was?
Yes, it does. It matters because the place
where the cut was made on your uterus could tear (or rupture )
during labour. If the old scar ruptures ,
you can have serious bleeding. This could hurt both you and
your baby during birth.
Some incisions rupture more easily than others. There are
4 kinds of incisions:
- The Up-And-Down incision. This kind
of incision is hardly used at all today. It has the highest
risk of rupturing during a vaginal birth. It was made in
the top, rounded part of the uterus. It is also called
a classical, inverted T or high vertical incision.
- The Low, Vertical incision. This kind
of incision is hardly seen today. It is also up-and-down
but was made in the lower, thin part of the uterus. It
is not clear what the chances of rupture are. Talk to your
doctor about this.
- The Transverse incision. This incision
was made ACROSS the low, thin part of the uterus. It is
the most common kind of incision today. It heals strongest
and has less chance of rupture during a vaginal birth.
- An Unknown incision. You may not be
sure what kind of incision you had. Your doctor might not
be able to find out. You may still be able to have a VBAC.
You need to talk to your doctor about it.
When is VBAC not possible?
- If your uterus has ever ruptured .
- If the placenta is covering the opening
to the uterus ( cervix ). [The placenta grows
inside your uterus with the baby and helps to keep the
baby alive].
- If your baby is lying across your uterus (transverse)
instead of with its head down.
- If you decide not to have a VBAC, even after talking
it over with your doctor.
Can I have a VBAC if :
- I'm Carrying Twins? Sometimes it is possible to have
a VBAC with twins. It depends on the position of the babies
at birth.
- The baby is breech ? Breech is when
the baby's feet or bottom are pointing down inside your
uterus. You may still be able to have a VBAC.
- The baby weighs more than 8.8 lbs? You may still be able
to have a VBAC.
Can I have induced
labour with a VBAC?
Doctors have ways to get labour
going if
- labour doesn't start on its own, OR
- labour slows down or stops once it started.
The
doctors and nurses at most hospitals in Canada have rules
about inducing labour for women who are trying VBAC. Talk
to your doctor about the rules at the hospital where you
will give birth. Also, there is a pamphlet called " Inducing
Labour ".
Does VBAC Always Work?
No,
nothing is certain. We do know that 60 to 80 per cent of
women who try to have a VBAC are able to do it. Make sure
the hospital where you will have your baby can do an emergency
Caesarean. Do not try to have a VBAC as part of a home birth.
The
Prevention Power Community Award is a recognition program
created by Capital Health in Edmonton, Alberta. The year
2004 was the first time that the VBAC Association submits
a nomination.
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