By Lisa Keyser, ICAN of Northern Virginia Co-leader in waiting
On Sunday, February 23, ICAN of Northern Virginia co-leaders Jen Whitaker and I were grateful to be able to attend a VBAC Facts Workshop with Jen Kamel, founder of The class, called "Truth About VBAC: History, Politics & Stats," took place in Reston VA and was sponsored by Monica Maruesceac of NoVA Birth Network. We were joined by local childbirth advocates, doulas, midwives, nurses, and expectant moms (plus one dad!).
The mission of VBAC Facts is to close the gap between what the medical organizations say and what the people believe. There is a pervasive and insistent belief that VBACs are not safe, and that any mother who considers one is being selfish, or is holding her birth experience as more important than her baby's health. That was not always in the case, as in the late 80s and early 90s VBACs were highly encouraged, and even required in some places. 
The American College of Obstetricians and Gynecologists (ACOG) has acknowledged past paternalistic practices in obstetric care. Pregnant women were served by mostly male OBs who told them how they were going to deliver. Though the obstetric playing field has evened out greatly in recent years, which more women answering the call, overall the doctor-patient relationship remains much unchanged. Women discussing birth or VBACs tend to talk in terms of being "allowed" and "permitted" to have choices, while for any other major medical event the doctor provides true informed consent, and the patient makes the ultimate decision.
For post-cesarean birth, mothers have two options. Repeat C-section or VBAC. As Jen joking added, "They have yet to beam the baby out Star Trek-style."
Local Midwife Claudia Booker had some choice comments on the term "informed consent."
"It should be called informed CHOICE instead of informed consent. Consent implies that the doctor, not the patient, is making the decisions."
The VBAC Facts class was full of - you guessed it - facts. Jen compiled data from a huge number of studies and provided it in easy-to-understand charts and graphs. When mothers consider having a VBAC, they are usually warned about the risks of Uterine Rupture (UR). However, very infrequently are mothers ever warned about the risks of Elective Repeat Cesarean Sections (ERCS) such as placenta accreta. Jen was able to highlight and pull out the numbers for both outcomes, which allowed the workshop attendees to make a comparison and draw our own determinations.
The DC workshop was full of great questions, banter, and some excellent back-and-forth on statistics and what could be done in our immediate area. At the end of the day, we were all exhausted yet excited - full of new numbers and knowledge that will help further the cause of patients' rights. It comes down to a simple conclusion - mothers must be able to make the decision themselves, and in order to do so they must be armed with the real facts and statistics available. Thanks to work by Jen Kamel and others like her, many more mothers will be able to do just that.

About ICAN

The International Cesarean Awareness Network, Inc. (ICAN) is a nonprofit organization whose mission is to improve maternal-child health by reducing preventable cesareans through education, supporting cesarean recovery, and advocating for vaginal birth after cesarean (VBAC). Learn More About ICAN