vivian shaw

“BAC” to Nature

The high rate of Caesareans in the United States—about 1 in 3 births—is a really big deal, so I’m glad to see that this piece on vaginal births after Caesarean, otherwise known as VBACs, made it to my homepage of the NYTimes.

The article focuses on a hospital run by the Navajo Nation that has been successful with performing a high percentage of VBACs, loosely hinting at some themes of how natural birth has become a sort of battleground for the medical community and women, particularly, marginalized women of color.

As Washington debates health care, this small hospital in a dusty desert town on an Indian reservation, showing its age and struggling to make ends meet, somehow manages to outperform richer, more prestigious institutions when it comes to keeping Caesarean rates down, which saves money and is better for many mothers and infants.

This week, the National Institutes of Health will hold a conference in Bethesda, Md., about the country’s dismal rates of vaginal birth after Caesarean, or VBAC (pronounced VEE-back), which have plummeted since 1996. “I think it’s the purpose of this conference to see if we can turn the clock back,” said Dr. Kimberly D. Gregory, vice chairwoman of women’s health care quality and performance improvement at Cedars-Sinai Medical Center in Los Angeles.

It’s my personal belief that the ever-increasing medicalization of the birthing process should be a primary issue in both feminism and civil rights, but the people who think about this topic most regularly tend to be either pregnant or professionally linked to maternal and child health. I belong to the latter subset, and through involvement with community child birthing classes, have learned about the incredible ways in which women’s bodies change during pregnancy, all the way through labor and delivery, and then even after birth—all to accommodate the natural birth and safety of the child. Our current medical model does not practice confidence in the natural competence of laboring women, and in turn, often creates more problems for both mother and child. For this issue to be highlighted in the media mainstream is a good thing.

Here’s another interesting quote:

Doctors and midwives here earn salaries and are not paid by the procedure, so they have no financial incentive to perform surgery. (Doctors earn $190,000 to $285,000 a year, and midwives $80,000 to $120,000.)