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Before or During a Cesarean VAGINAL BIRTH AFTER CESAREAN FOR WOMEN OF SIZE If you have had a prior cesarean, must you always have cesareans? 15 Steps You Can Take To Reduce Your Risk of a Hospital Infection, accessed at February 6, 2008. Many doctors today strongly discourage women of size from trying for a Vaginal Birth After Cesarean (VBAC), and this plays a very significant role in the high cesarean rate in obese women. “Incision Choice for Cesarean Delivery in Obese Patients: Experience in a University Hospital.” 2000 May;38(5):415-26. Most articles about pregnancy in obese women, and even many childbirth providers, assume two things: that being fat interferes with a woman’s ability to give birth vaginally; and that the sky high cesarean rate among women of size is the logical outcome of obesity.Women of size do have very high cesarean rates today. Or is some of the increase caused by misguided assumptions about obesity and by unneeded interventions and protocols commonly used with women of size?(For more information, see Vaginal Birth After Cesarean (VBAC) or Repeat Cesarean Section? Gyte, Continuous Cardiotocography (CTG) as a Form of Electronic Fetal Monitoring (EFM) for Fetal Assessment During Labour, 2001;2-6. ) Remember, every cesarean puts a woman at more risk for future birth complications.

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This is not an indication of a security issue such as a virus or attack.As the number of cesareans increases for a woman, the risk of complications in future pregnancies also increases. Obese women who have surgical births have higher rates of anesthesia problems, severe bleeding, wound problems, and infections than non-obese women who have surgical births.Babies born via cesarean section also face more risks than babies born vaginally: they are more likely to have respiratory problems in the newborn period, more likely to have difficulties establish breastfeeding, and more likely to experience asthma in childhood and adulthood.They can benefit from using a less-interventive model of care and from choosing their care provider and birthplace wisely. They must recognize that modern practice patterns and biases may have raised the cesarean rates much more than obesity itself. “Population-based assessment of the risk of primary cesarean delivery due to excess prepregnancy weight among nulliparous women delivering term infants.” 2002 (July);25(6): E1-9. Sandall J, Soltani H, Gates S, Shennan A, Devane D. They must stop inducing labor at such high rates, they must stop intervening for big babies, they must stop pressuring women of size into having unnecessary and debatable tests and procedures, and they must become more vigorous in their promotion of spontaneous natural labor for women of size. Midwife-led continuity models versus other models of care for childbearing women.

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