I almost cannot bear to hear these stories about mothers dying in the OR due to placenta accreta caused by multiple cesareans. Everyday women are told 1) That a primary cesarean is necessary to birth her baby for some reason. In many (dare I say, most, cases is just UNTRUE. 2) That attempting a VBAC is dangerous. Which is also just UNTRUE and NOT what is recommended by ACOG. 

These women are left with option to have no more children or put her LIFE at risk to give birth by more cesarean sections. Which isn't usually explained how risky each subsequent pregnancy becomes. If it's explained, it's usually after her second or third cesarean. What kind of choice is that at that point???

And for a doctor, I imagine it is terrible to lose a baby during a delivery. But, a mother? How do they go on? I'm sure they do everything they can and it must be awful to realize you cannot save her. But we need them to STOP doing all of these unnecessary cesareans! Overmedicalizing birth in the first/second pregnancy is the root cause of mother's hemorrhaging on the operating table a few cesareans later.  

Maybe I'm especially emotional hearing of these stories because I lost my mother at age 9. I don't want any other child to endure this kind of loss. And because of my work, I know it can be different. Giving birth doesn't have to be risky. It can be healthy, respected, and trusted in most cases. And, women can be trusted to make their own informed decisions when given the right information based in research and allowing that along with intuition to guide them instead of FEAR...

I don't want to post the stories that have deeply saddened me recently. I know I have other mothers reading, some facing cesareans that have become necessary and possibly complicated and scary pregnancies. Or maybe just like me, a motherless mother who's heart breaks to think of any other mother leaving her children behind. So, instead, if you'd like to read about how another mother managed to survive when facing what became a life threatening pregnancy, read her story included in a previous post below about preventing the primary cesarean.  Below is a great video on VBAC. 

Today I want to say that ICAN is about supporting the first time mom, too, not just those hoping for a VBAC. It is a great resource for preventing that primary cesarean birth. As is the VBAC facts site and Jen Kamels who runs it and teaches a workshop around the country and online.

http://www.ican-online.org
www.vbacfacts.com

Our local ICAN of SEPA:
http://icanofsepa.wordpress.com
https://www.facebook.com/groups/411506922273373/

I'm also linking a story here that offers a great explanation as to why we fight so hard to help mothers avoid their primary (and too often unnecessary) cesareans and to birth vaginally. It details the risks and dangers to mothers of multiple cesareans. This mother is not alone, more and more of these examples are making news because they are becoming more prevalent problems in pregnancies and in the OR. Just to be aware, though, I had tears in my eyes the whole time while reading. She does a great job writing so that the reader can almost feel her fears through what was a very scary experience. To clarify, MOST 1st and even 2nd repeat cesareans will be manageable by most hospitals and with what blood they have on hand for possibility of transfusing...I do not want to scare moms facing a repeat cesarean where they NEED to trust and depend on a doctor to keep them safe, but this story also shows how a mother did her homework to do just that - be in the best place with the best team to make sure she'd be going back home to her kiddos. This was simply the situation she ended up in during her 7th pregnancy. Her placenta became deeply implanted into her uterus and cervix after multiple previous surgeries to her uterus. 

As a doula, I never want my clients to have any good answer to the question, 'what else could I have done to prevent my first cesarean?' This is especially important when moms desire a larger family. I have had friends and family members tell me that their doctors never once mentioned to them before, during, or after their first cesarean that they'd need to consider limiting family size due to having that surgical birth and the increased dangers of multiple pregnancies and cesarean births following. And not just that, but that they'd not been offered a chance to VBAC and instead told that it is dangerous to try, safer to schedule ANOTHER cesarean, and just accept having 2 children or at most 3 if she really really wants to risk it, but no more! Women are being told this AFTER their second cesareans when their options are nearly nil at that point! It's infuriating. And sad. More women need doula support through their first pregnancies and births, good information, supportive care providers, and to visit their local ICAN group before having their first babies if we want to stop this trend from continuing. Women need the truth! They need their options! They want to make informed choices! 

I recently met a nurse who told me there is a doctor on her floor who frequently says all babies should be born by cesarean and has no problem recommending tube tying after the second to all mothers. I seriously hope he is in the extreme minority. But I have a feeling that while we do have docs who truly believe in the safety of and support less medicalized vaginal birth, the number of docs seeing their norm everyday be cesarean deliveries is increasing by the day. This will just continue to have an effect on moms and babies (physically, mentally, emotionally!!!) if we don't advocate for ourselves and surround ourselves with professional support and evidence based information. 

And while I'm thinking of it. Hug another woman today. Love her with that hug, if even for just a few seconds. We don't always know each other's journey. 

Let me start by saying I support my doula sisters who make a few extra bucks by encapsulating placentas. Doulas/Childbirth Educators are always hopefully learning some things from each other, either in real life or this wild world of cyber support via blogs, social media, email forums, etc. We wrap our loving arms around each other in times of need, we offer each other our experiences, suggestions, etc, but we also keep each other in check. We provide accountability for each other. Usually it's done with gentleness and understanding. So I want to be careful because I believe with all my heart that most of us, while we make a little income from our important work with families, truly are in it for the love of supporting moms and babies. I cannot shake this feeling of needing to speak up about something that's been bugging me for a while. I do not mind placenta encapsulators advertising their business, but what I do mind is them stating that there is 'research' supporting the benefits of encapsulation. In particular, regarding the reduction of post partum depression and increase of milk production, though especially the former is really bugging me lately. This is a serious claim, on a serious issue. This can and IS giving moms the impression that there is actually evidence supporting that their dried and crushed placenta taken in pill form can prevent them from getting a PPMD. There is no such evidence that I'm aware of. And I've been told by PE, "YES THERE IS - here's the links! Smiley face" Many times, similar posts show up on these various groups. I've looked at everything they've provided and called 'evidence' before - it was not. It is all based on hypothesis. And I don't think it's an unreasonable one either, I just have a problem with how it's being presented sometimes. I know I'm not the only one thinking it. I know a handful of local doulas, even some who encapsulate or have in the past, who agree with me! I read some of these links and think, "You're kidding, right?" This 'research' says things about women quite possibly lacking iron after the expulsion of the placenta and this is the cause of PPMD. Or similarly, the release of all the hormones in the placenta is the cause of it. But none of these links are studies showing that the consumption of the placenta fixes this hypothetical cause of PPMD, let alone consumption through capsules. Some encapsulators are making a great business out of it, too. Teaching classes to other birth professionals on the how to's - there's one coming to Philly soon. Thank goodness for it, honestly, because initially, women were out there bringing other women's blood products into their own homes with not nearly as much information on safe handling or various processing techniques. What this class is going to cover sounds great. And to be perfectly clear - I support my doula sisters who encapsulate, I refer my clients out for this service if they want it, I have my own encapsulated placenta in my freezer, and I understand the theories and why it makes sense. However, can't we just be more upfront with moms about what this 'research' actually says? When I click through to the educator's beautiful website, I don't see any grandiose claims, but I do notice a some resource links on the left side of her site on 'scientific research' and 'benefits' - however, none of the links open to anything. A recent post on a social media site shows a question from a mom asking if there was any scientific evidence for doing placental encapsulation to prevent PPD. Not to my surprise, again, some PE and maybe some other moms pop in with these links that say nothing of what she's asking. I posted this quote from one of the better articles cited. "Evidence is limited in the areas regarding specific hormones and nutrients a placenta may offer, proposed benefits for nutrition, and prevention of postnatal depression and increased lactation. Interestingly, these are the primary reasons sited to support placentophagy." (Beacock, 2012) - From a British Medical Journal article. Some of these articles, from what I've read of the ones that actually studied something related to placentophagy, seem to say that there are hypotheses and theories based on the components in placenta being able to bridge the gap in terms of hormones lost after expulsion of placenta, however, it is stated more than once that 'evidence is absent'. So, to end, I do not believe there is research that specifically supports placenta ingestion through capsule form being proven to reduce PPD. Anecdotally, amongst my clients and many others I know who've ingested their placenta pills, there are mixed reviews. The reason for that could be many. I just ask that if you are advertising your placenta services, teaching how to encapsulate, or simply commenting on posts like the one mentioned, be very upfront with moms about what research actually says and does not say. Be clear about what is anecdotal, what is theory, what is your opinion, experience, and the limited research there is on anything regarding placental ingestion for treatment or prevention of anything. People will still choose it without having to be led to believe there is scientific evidence supporting it.  ~