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Saturday
Jan122008

VBAC Study Worth Seeing

Effect of Hospital Volume on Maternal Outcomes in Women with Prior Cesarean Delivery Undergoing Trial of Labor states in part:

The authors did not find evidence of an association between hospital VBAC volume and the likelihood of adverse outcomes in VBAC after adjustment for patient mix. Other risk factors consistent with prior research were identified, including induction of labor, 2+ prior cesarean deliveries, preeclampsia, diabetes mellitus, and high birth weight. Prior vaginal delivery was protective against adverse VBAC outcomes. The risk of an adverse VBAC outcome in low-volume hospitals was comparable to that in high-volume hospitals.

(end quote)

I wonder why they did a study about hospital volume in the first place? Was there a belief that hospitals that had a large number of patients also had worse outcomes of VBACs? I'm actually quite shocked that anyone even did a study on VBAC success!

I think the risk factors are really important for women wanting a VBAC. You don't fall into those categories? That bodes very well for your upcoming birth.

I also believe that women who are meticulous with their diets (including my earlier recommendations for organic beef and dairy, no dairy products the last 6 weeks of pregnancy and no juices) can go far to curb or eliminate the GDM and large babies. A great diet can also help avoid PIH/pre-eclampsia, as well. There are never guarantees, but every bit helps.

Reader Comments (8)

Was there a belief that hospitals that had a large number of patients also had worse outcomes of VBACs?

I think the idea was that hospitals with LESSER numbers of VBACs might have worse outcomes due to inexperience.

As for diet and preeclampsia, current thinking on pre-e is that it's the result of a failure of the placenta to implant properly in the very earliest stages of gestation, in which case diet won't do much to help.

January 12, 2008 | Unregistered CommenterEmma B.

Dear Navelgazer,as a mom whose babies just keep getting bigger, and who is currently pregnant with #5, I would love a link to "the best diet ever". Not that I dont have some good solid knowledge about this and a midwife who is helping me every step of the way, but the more good advice the better, and since you brought it up...:)

Baby 1: vaginal 9 lbs
Baby 2: c section 9 lbs
Baby 3: homebirth (HBAC) 11 lbs
Baby 4: c section 12 lbs

I dont have GD but I know that that whole thing is tricky. I am willing to do anything, eat fish and sprouts and water all day if that will help. I am six foot one and over 200lbs but twelve pounds is really outrageous, I know.

anyways, any advice will help.I am going for another VBAC, hopefully HBAC. I am past the 1st trimester where I ate whatever I could to survive and now will go to any legnths to keep this baby a good healthy size. I do not expect you to make some giant diagnosis, just would love an elaboration or a link to what you really think might be the very best foods to go for/avoid.

thank you,
HouseFairy 17 weeks preg.

January 12, 2008 | Unregistered CommenterHousefairy

great blog - wonderful pics!

January 12, 2008 | Unregistered CommenterBronxBoysBabyMomma

Thank for posting all the facts to inform everyone about VBAC. There is a lot of myth and a lot of misformation coming from sources we're supposed to be able to trust.

January 13, 2008 | Unregistered CommenterKate

As a VBAC'r I seek out facilities that do a lot of VBAC's. This doesn't always correlate with being a large volume hospital though, though sometimes it does. Maybe they were looking at it because low volume hospitals are less likely to meet ACOG standards for VBAC therefore possibly raising risk or poor outcome?
Demographics and outcomes are always interesting to me.

Interesting study. Once again I WISH I still had the ability to read these studies online for free!
I am curious why you mention no dairy in the last 6 weeks. What about raw milk (http://www.realmilk.com/)?

January 14, 2008 | Unregistered CommenterKat

I'm also curious about what it is about not eating dairy that helps with large babies. I'm 37+weeks pregnant with Baby #2 and my first was 9 pounds even. The only time I usually drink milk is either on cereal or to help alleviate heartburn.

January 20, 2008 | Unregistered CommenterRebekah

Dairy, looking at it from a sustenance perspective, isn't necessary for humans. As LLL is wont to say, humans are the only mammals that drink milk past weaning... and it isn't even our own species' milk!

If women use milk as a condiment and not as a primary food, it isn't the worst thing in pregnancy. I still highly encourage eating/drinking organic because of the growth hormones our cows get throughout their lives. The last thing a woman needs in her body is growth hormones!

The Glycemic Index of milk isn't bad (30/32 out of 100), but many diabetics know milk can drag glucoses up - especially if you add chocolate or eat it as ice cream.

I find most folks eat either very little/no milk products or eat a LOT of them... enough women tell me they crave it and *have* to have it that I know quitting it during the last 6 weeks can make a huge difference in a baby's weight.

January 20, 2008 | Unregistered CommenterNavelgazing Midwife

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