Archive by Author

Coping with the Pain of Labor

6 Nov

Many mothers considering a VBAC, especially if their prior cesarean was scheduled, are concerned about how they will cope with the pain of labor. Some fear that having an epidural will complicate labor and lead to additional interventions that will lower their odds for having a vaginal birth. The VBAC Education Project

Non-drug methods of pain relief including continuous emotional support from a doula are beneficial for mothers and babies and do not cause harm.

  • What options for pain relief are you considering?
  • Try to use non-drug methods of pain relief and comfort measures before using drugs for pain relief.
  • You may want to use music, aromatherapy, visualisation, rhythmic breathing and relaxation, yoga or hypnobirthing techniques.
  • Find out about touch therapy, massage, a water birth, acupressure or acupuncture, water injections, and TENS (electrical stimulation).

If you want an epidural:

  • Try to wait until your cervix is dilated to 4-5 centimeters before it is given to you.
  • To help the baby move through your pelvis and rotate for birth, try changing positions slowly while in bed every 20 to 30 minutes during labor. You may need some help.
  • When you are fully dilated, you may need to wait an hour or more before you feel you’re ready for active pushing.
  • You may want to rest or sleep until you feel rectal pressure strong enough to push on your own.
  • You may want to wait until the numbness of the epidural wears off before pushing. With an epidural you may need up to three hours to push your baby out.

Find out more about coping with the pain of labor from Module 7 of  Deciding if VBAC Is Right for You: A Parent’s Guide.

Additional Resources

National Health Service, UK

Choices In Childbirth


In Celebration of Midwives

4 Oct

In celebration of National Midwifery Week, let’s look at the exemplary service that midwives provide for expectant mothers.ž

Evidence shows that with the midwifery model of care mothers have: NMW2015-Logo-WEB-250px

  • ž More prenatal education and counseling time;
  • žMore freedom of movement in labor and birth;
  • žMore access to food and drink in labor;
  • ž Fewer labor interventions;
  • žMore access to non-drug methods of pain relief;
  • žFewer complications of birth;
  • ž Fewer cesareans;
  • ž More VBACs;
  • ž Higher breastfeeding rates;
  • ž Excellent maternal and perinatal outcomes.

A study in the journal, The Lancet, defined midwifery as, “skilled, knowledgeable and compassionate care for childbearing women, newborn infants and families across the continuum throughout pre-pregnancy, birth, postpartum and the early weeks of life…respecting women’s individual circumstances, and views, and working in partnership with women to strengthen women’s own capabilities to care for themselves and their families.”


American College of Nurse Midwives

Watch a video about midwives in hospitals.

Our Moment of Truth

Share With Women

Find a Midwife

Big Push for Midwives

Citizens for Midwifery

Midwives Model of Care

Midwives Alliance of North America (MANA)

About Midwives

Mothers Naturally

National Association of Certified Professional Midwives

Normal Healthy Childbirth for Women and Families: What You Need to Know

The Mama Sherpas

A documentary by Brigid Maher about the benefits of nurse-midwife and physician collaboration.



Birth Professionals Are Eager to Increase Awareness About VBAC

21 Sep

Maternity care professionals have many suggestions for increasing awareness about the safety of VBAC and supporting mothers who want to labor after a prior cesarean. They only need an opportunity to make that happen. Intro.key

On Saturday, September 19, I had the honor of speaking about VBAC and the VBAC Education Project to a room full of dedicated maternity care professionals at the Lamaze/ICEA Joint Conference in Las Vegas, Nevada. I spoke about the need to educate parents and professionals about bringing back the choice to labor for a VBAC which was widely available till the late nineties when nearly 1 in three U.S. mothers with a prior cesarean had a vaginal birth. I asked the audience if they could think of one strategy they could use to increase awareness of the safety of VBAC in their community or one change they could make in their hospital policies and procedures to help mothers who wanted to labor after a prior cesarean. I was inspired by the suggestions they made.


Update On The Safety of Home Birth After a Cesarean (HBAC)

17 Sep

A recently published study on planned home VBAC in the United States, the largest to date, may shed a little more light on the safety of home birth after a cesarean for parents who may be considering that option. The study is the second one on planned home births based on the MANA Stats 2.0 data set.

More and more women in the U.S. are faced with the denial of hospital-based maternity care for VBAC. According to a report by the Centers for Disease Control and Prevention, planned home VBACs have been increasing at the same time that hospital VBACs have been decreasing. Some women are choosing a home VBAC rather than having an unnecessary repeat cesarean or repeating a previously traumatic surgical birth. Mothers need as much information as possible to make an informed decision about where and with whom they want to give birth.        20111225_Jess_6743_2000

Researchers compared outcomes for 1,052 women with a prior cesarean who planned a home birth with 12,092 women without a prior cesarean. All women were cared for by midwives. Here is what the study found: