Heard national guidelines don't support VBAC? Well you heard wrong. Join us for a deep dive into ACOG's VBAC guidelines. In this episode of The VBAC Facts® Podcast, VBAC Facts® Founder Jen Kamel explains the significance of these guidelines for anyone birthing in the U.S. or working in healthcare. Jen clears up common misconceptions, highlights the difference between uterine rupture and dehiscence, and stresses the importance of informed decision-making. Tune in to learn more about VBAC's risks, benefits, and the role of different factors, such as BMI and induction, in VBAC outcomes.

If you have a question or comment for the podcast, have something positive that has happened in your world relative to VBAC that you'd like us to share on the podcast, or you have a suggestion for an episode topic or a specific person you'd like us to feature on the podcast, click here and let us know!

00:21 Understanding ACOG and Its Influence

01:43 Decoding ACOG's VBAC Guidelines

02:10 Alternative Language for TOLAC

04:47 Assessing VBAC Candidacy

06:35 Levels of Evidence in ACOG Guidelines

09:11 Risks & Benefits of VBAC & Elective Repeat Cesarean

11:48 Understanding Uterine Rupture and Uterine Dehiscence

14:11 Evaluating Medical Research on VBAC

25:31 VBAC Calculators and Prediction Models

34:13 Who is Not a VBAC Candidate?

51:35 Induction and Augmentation After Cesarean

VBAC Facts® resources

• Article: How to qualify medical studies: “Three times the risk?:” What the large Canadian VBAC study really says
• Article: New study reveals surprising truths about the VBAC calculator
• Article: Vaginal birth after two cesareans (VBA2C): An overview of the evidence
• Article: Vaginal birth after three or more cesareans (VBA3C/VBAMC): An overview of the evidence

VBAC Facts® trainings

• VBAC Facts® professional membership: where we house a library of continuing education trainings including The Truth About VBAC™ for Professionals, Plus Size VBAC: Odds, Risks, and Realities, The Truth About VBA2C: Risk, Rates, & Outcomes, The Limited Evidence on VBA3+C: Decision Making in the Midst of Uncertainty

Other resources

• American College of Obstetricians and Gynecologists. (2019). ACOG Practice Bulletin No. 205. Vaginal birth after cesarean delivery. Obstetrics & Gynecology, 133(2), e110-e127.
• American College of Obstetricians and Gynecologists. (2016). Refusal of medically recommended treatment during pregnancy. Committee Opinion No. 664. Obstetrics & Gynecology, 127, e175-82.

Studies mentioned

• 50 percent did not meet the criteria for FTP: Zhang, 2010
• BMI provider bias: Bernstein, 2012 & Metz, 2013
• "80% of people with one prior cesarean schedule an elective repeat cesarean:" Curtin, 2015
• Less than 3% actually labor after two cesareans: Dombrowski, 2020

Music produced by (Analogue)/(prod. Analogue).

Instagram: @prod.analogue

Join VBAC Facts® Founder Jen Kamel as she continues "Esther's" harrowing story of avoiding a court ordered cesarean. "Esther" navigates an unassisted birth after four prior cesareans amidst intense scrutiny from social and emergency services. Follow her journey through legal battles, hiding from authorities, and ultimately obtaining a landmark ruling from the Israeli Supreme Court that upholds the right to decline a cesarean. Discover the intricate ethical and legal dilemmas surrounding birth autonomy and the resilience required to make one's own medical decisions.

00:00 Welcome Back for Part 2

00:56 Seeking Refuge and Medical Concerns

02:04 Engaging with Social Services

02:42 "They Are Asking for a Psychiatric Evaluation"

05:59 Legal Battle and Court Hearings

13:57 Physician Testifies: "Suicide Mission"

17:40 What Jen Would Tell the Court

21:40 Tracking Her Through Her Phone

23:56 Hiding from Authorities

25:21 A Glimmer of Safety

26:10 Navigating Work and Legal Challenges

26:53 Courtroom Battles and Contractions

28:36 Police Encounters and Relocation

32:22 The Birth Amidst Chaos

36:36 No Appearance, No Compensation

38:39 Creating Legal Precedents and Reflections

40:48 The Aftermath and Moving Forward

41:47 Decision Making With Higher Clinical Risk

42:54 How She Feels About the Decision

43:54 Deciding to Have Unassisted Births

45:59 Why Women Go "Underground" to Birth

47:28 Feelings about Legal Precedent

48:24 Conviction to Move Forward

51:40 Conclusion

• The Israeli Supreme Court Ruling, dated August 25, 2024
• Is VBAC illegal? Is homebirth illegal? - VBAC Facts® Article
• Vaginal birth after two cesareans (VBA2C): An overview of the evidence - VBAC Facts® Article
• Vaginal birth after three or more cesareans (VBA3C/VBAMC): An overview of the evidence - VBAC Facts® Article
• Single vs Double Layer Suturing: Is One Method Superior? - VBAC Facts® Continuing Education Training
• The Truth About VBA2C: Risk, Rates, & Outcomes - VBAC Facts® Continuing Education Training
• The Limited Evidence on VBA3+C: Decision Making in the Midst of Uncertainty - VBAC Facts® Continuing Education Training

Music produced by (Analogue)/(prod. Analogue).

Instagram: @prod.analogue

In this episode of the VBAC Facts® podcast, CEO and founder Jen Kamel delves into a gripping discussion with "Esther" and her experience with the Israeli Supreme Court ruling favoring her choice against a compelled repeat cesarean. The conversation with "Esther" and her attorney Tamir explores deep-seated issues of medical coercion, informed consent, and the ethical dilemmas within the healthcare system. "Esther" shares her personal journey through multiple pregnancies, miscarriages, and her fight for autonomy over her birthing choices. She recounts her traumatic experiences and the impact they had on her approach to healthcare, highlighting the crucial need for accurate information and respect for patient choice in medical practice.

00:00 Introduction and Content Warning

00:24 Meet Esther and Her Story

04:40 Esther's First Pregnancy and Miscarriage

06:32 The Birth of Twins and First C-Section

08:10 It's a Gentle Cesarean

10:09 Planning for a VBAC and Second C-Section

14:55 Never Asked About Intended Family Size

16:15 Uterine Window Noted During Second Cesarean

16:58 Single vs Double Layer Sutures

18:14 Fourth Pregnancy and Emergency C-Section

21:05 Uterine Thickness Conversation

24:01 "The Insurance Company Won't Event Let Us"

29:02 Starts Considering Unassisted Birth

31:44 Sixth Pregnancy After Three Cesareans

32:31 Struggles with Medical Care

35:10 Confrontation with Paramedics

35:43 Threatened to "Call Her Psychiatric"

37:03 Forcibly Sedated Her

37:15 Hospital Trauma of Fourth Cesarean and Aftermath

38:47 No Heartbeat, but Still Cesarean?

40:36 Three Doctors to Sign Off

41:26 What Evidence Based Medicine Means

45:28 Reflections on Stillbirth and Loss

46:08 Not feeling safe in her own home

46:49 The Journey to Trust God Again

48:36 Mistreatment Impacts How People Engage with Health Care

49:52 Staying Private About Pregnancy After Four Cesareans

53:57 Community Interference and Fear

56:24 Conclusion

• The Israeli Supreme Court Ruling, dated August 25, 2024
• Is VBAC illegal? Is homebirth illegal? - VBAC Facts® Article
• Vaginal birth after two cesareans (VBA2C): An overview of the evidence - VBAC Facts® Article
• Vaginal birth after three or more cesareans (VBA3C/VBAMC): An overview of the evidence - VBAC Facts® Article
• Single vs Double Layer Suturing: Is One Method Superior? - VBAC Facts® Continuing Education Training
• The Truth About VBA2C: Risk, Rates, & Outcomes - VBAC Facts® Continuing Education Training
• The Limited Evidence on VBA3+C: Decision Making in the Midst of Uncertainty - VBAC Facts® Continuing Education Training

Music produced by (Analogue)/(prod. Analogue).

Instagram: @prod.analogue