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21/2/2002 00:56
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Ilana Shemesh, natural midwife
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מאת:
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תשובה לכרמית בקשר לvbac
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כותרת:
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Hi Carmit,
I personally don't accept VBAC clients for homebirths. It is more a political reason than a medical reason. It is one of the "grey areas" in midwifery. Some VBACs are much more suitable for homebirth than others, like if the reason for the Cesarian was due to fetal distress or high blood pressure, or due to breech, these are not reasons that should necessitate another Cesarian. However, if it was due to lack of progress, or a high head, or a very large baby, then this is a mechanical problem which could happen again. Although it is often true that the Cesarian was done for a "so-called mechanical problem--small pelvis) but it was due to lack of patience or bad positioning etc. Since homebirth is still so taboo and I am a midwife feel so threatened I really cannot risk more mental pressure and problems with the establishment than I already have. If I needed to transfer a woman in labor attempting a homebirth after a Cesarian, I think that the doctors and midwives would absolutely freak and it would jeopardize my license and the entire future of homebirth. In Israel all VBAC's are considered high risk, and therefore I can't do them at home. There is also some very slight risk of the placenta implanting on the scar and causing problems after the birth with posssible bleeding. You should have an ultrasound to make sure placenta is not near scar. However, there are some homebirth midwives in Israel, who are very good, that do do VBAC homebirth. There is also a very skilled obstetrician in Jerusalem who does VBAC homebirths. You can call me when the time is right and I will give you info. Best of luck
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