Silent Knife: Cesarean Prevention and Vaginal Birth after Cesarean (VBAC)

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The bible of cesarean prevention. Wall Street Journal A landmark event, which will change the course of obstetric care by giving parents the informtion they need to make the decisions that are best for their own families. Comprehensive, highly readable, sensitive . . . should be read by everyone who cares about someone. Marian Tompson Director, Alternative Birth Crisis Coalition American Academy of Medicine Required reading for all childbirth professionals and prospective ...

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The bible of cesarean prevention. Wall Street Journal A landmark event, which will change the course of obstetric care by giving parents the informtion they need to make the decisions that are best for their own families. Comprehensive, highly readable, sensitive . . . should be read by everyone who cares about someone. Marian Tompson Director, Alternative Birth Crisis Coalition American Academy of Medicine Required reading for all childbirth professionals and prospective parents. Journal of Gynecological Nursing

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Product Details

  • ISBN-13: 9780897890274
  • Publisher: ABC-CLIO, Incorporated
  • Publication date: 4/25/1983
  • Edition description: New Edition
  • Pages: 466
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.94 (d)

Meet the Author

NANCY WAINER COHEN co-founded C/SEC, Inc., the first and now the largest cesarean organization in the country, in 1973 and is a consultant and advisor to the Cesarean Prevention Movement. She is a leading authority on VBAC and has counseled thousands of women on the subject since 1972. Her many articles have dealt with VBAC, cesarean prevention, and positive birthing.

LOIS J. ESTNER, formerly an English teacher, is a VBAC mother, La Leche League leader, and counselor on the topics of breastfeeding, childbirth, and cesarean prevention.

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Table of Contents

Foreword xi
Preface xiii
Acknowledgments xix
Chapter 1 Introduction 1
Chapter 2 The Knife Unsheathed: Cesarean Section in the United States 7
The State of the (Obstetric) Union 7
A Brief History of Cesarean Section 10
Factors in the Rising Cesarean Rate 11
Indications for Cesarean Section 15
Absolute Indications 15
"Gray Area" Indications 16
Relative Indications 16
The Cesarean Population 24
Risks of Cesarean Section to the Mother 26
Major Abdominal Childbirth 26
Maternal Death 29
Maternal Illness and Disability 30
Psychological Complications 33
Risks of Cesarean Section to the Infant 34
Risks of Cesarean Section to the Mother/Infant Relationship 37
Costs of Cesarean Section 39
Conclusions 39
Chapter 3 Voices of the Victims (Letters from Cesarean Mothers) 41
Chapter 4 Grieving ... and Healing 59
Grieving? For What? 62
Factors Affecting Grieving 64
Cesarean Sections: Decisions of Love 65
Grieving Responses 66
Fathers' Grief 67
Identifying the Symptoms ... 68
... And Working Our Way Through ... 69
... To Healing 70
Conclusion 74
Chapter 5 Of Sound Mind and Belly: Uterine Dependability 75
The Uterus and the Cervix 78
Uterine Incisions 79
Popularization of Repeat Cesarean Section 80
The Transverse-Incision Revolution 81
The Specter of Uterine "Rupture" 83
Iatrogenic Causes of Uterine Instability 85
Signs of "Rupture"? 85
When Instability Does Occur--Sterilization or Repair? 86
Scare Tactics 89
Growing Support for VBAC: The Studies 92
The 1940s 92
The 1950s 92
The 1960s 93
The 1970s 94
The 1980s 95
"The Experts" Speak Up ... Sort of 96
VBAC: Getting Down to Specifics 97
"What If My Pelvis Is Too Small?" 97
Failure To Progress 99
More than One Cesarean 99
VBAC after a Previous Uterine Infection 100
Breech VBAC 101
VBAC Twins 101
A Time Limit for VBAC Labor? 101
How Many VBACs? 102
How Long between Pregnancies? 102
Is It Ever Too Late To Decide on a VBAC? 103
If at First You Don't "Succeed" ... 103
Forceps 103
"Your Uterus Is Paper-Thin!" 104
What about Hysterography? 104
Fibroids 105
"Management" of VBAC Labors 105
Manual Exploration of the Uterus 106
VBAC with a Vertical Incision 107
Inverted-T Incision 109
Hysterotomy 110
Our Statistics 110
Out of 105 Women ... 111
... And out of 105 Labors ... 112
... Came More than 105 Babies! 112
Healed and Healthy 113
Chapter 6 The Fallacy of Natural Childbirth 117
How Natural Is Natural Childbirth? 117
Purebirth 119
Chapter 7 Increasing Your Potential for Normal Birth: Nutrition and Exercise 123
Father's Nutritive Role 126
A Few Nutritious Tips 127
Exercise during Pregnancy 131
Reaping the Rewards 134
Chapter 8 Diagnostic Time Bombs? 135
Pregnancy as Pathology 135
Informed Consent? 135
Women as Lab Rats 138
Tests during Pregnancy: Help or Hindrance? 139
Estriol Testing 140
Ultrasound 140
Amniocentesis 144
Oxytocin Challenge Test 146
Non-Stress Test 147
X-Rays 147
"Don't Worry Your Pretty Little Head!" 150
Ignorance Is Bliss? 150
Chapter 9 Birth Interventions and Their Consequences 153
When To Go to the Hospital 154
Upon Your Arrival ... 155
"Just a Little Ride" 155
Admissions Procedures 155
In the Labor Room 156
Maternal Position during Labor 158
The "Prep" 160
Enemas 160
I.V.s vs Food during Labor 162
Amniotomy and Infection 168
Vaginal Exams 173
A Breath of Fresh Alternatives 175
... Back to the Labor Room 176
Induction of Labor 176
Electronic Monitoring Devices 180
Drugs 183
Second Stage 187
In the Delivery Room 189
Anesthesia 189
Forceps 190
Episiotomy 192
Stirrups 196
Birthing the Placenta 196
Cord Clamping 196
"Welcome to the World, Dear Child": Baby's Own Interventions 198
Silver Nitrate 200
Vitamin K, Circumcision, and Jaundice 202
Going Home ("Hate To Eat and Run ...") 205
A Note about Breastfeeding 205
Judicious Use of Medical Interventions 206
Why Reinvent the Wheel? 207
Chapter 10 Paternal Perspectives 211
Paul's Story 211
Martin's Story 218
Chapter 11 Labor Support 223
"The Climb" 223
The Climb--with Help 225
"No Drugs--Just Hugs!" 226
Why Not the Hospital Staff? 228
Mates as Labor Assistants? 229
Supporting the Laboring Woman 233
Choosing a Labor Assistant 235
Labor Support: "Where Can I Find It?!" 235
Additional Support 236
Labor Assistants Are Not Magicians! 236
Consumer Power 238
Siblings at the Birth 239
Preparing Children for the Birth of a New Sibling 240
Friend (or Foe?) 242
Beyond Labor Assistants 243
Chapter 12 Mindscapes 249
The Body and the Mind 250
The Power of Beliefs 251
Our Beliefs Influence Our Births 256
Identifying Beliefs 259
Feeling Safe 260
The Pressure To Perform 266
Birth, Death, and Pain 267
Birth as a Sexual Experience 268
Territorial Primacy 272
From Daughters to Mothers 274
Opening the Heart 276
Love: Birth's Most Precious Assistant 276
Creating a Cesarean 282
"Why Me?" 284
"But I'm Due on Tuesday!" 285
Chapter 13 Planning Your Birth 287
Childbirth Preparation 288
Traditional Course Content 290
Finding the Right Instructor 295
Choosing Your Birthplace 299
For Those Who Choose a Hospital Birth 299
What about Homebirth? 307
Roadblocked? 309
Breech Presentation 309
Herpes 314
When Purebirth "Fails" 316
Choosing a Physician 317
Interviewing an Obstetrician 324
Changing Physicians 333
Doctors Who Care 333
Medical Records 334
Reclaiming Responsibility 336
Chapter 14 In Case a Cesarean Is Necessary 339
Prenatal Planning 340
Delivery 341
Postpartum Planning 343
Your Newborn 344
Chapter 15 Voices of VBAC (Letters from VBAC Mothers) 347
Chapter 16 Cesarean Deliverance 381
Appendices 383
A Labor Chart 384
B Preventing Unnecessary Cesareans 386
C VBAC Classes: Questions for Private Discussion 392
D VBAC Classes: Questions for Open Discussion 393
E Resource Groups 394
F Sample Affirmations 396
References 397
About the Contributors 427
Index 429
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Customer Reviews

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  • Anonymous

    Posted January 12, 2001

    Our Bodies Heal

    The hospital in the rural community in which I live has recently decided to no longer allow VBAC deliveries. When I delivered my last two children they had yet to allow VBAC deliveries, so I chose to travel an hour to the nearest hospital thoughtful enough to provide this service. In 1986 and 1988 I delivered two wonderfully healthy children vaginally, after having had a previous C-Section. 'Silent Knife' inspired me to do so, as the basic message was simply that our bodies heal -- that's what they were made to do. When an indication for surgery exists, then certainly the medical professionals must present the option and inform the prospective parents of the risks and benefits. To completely deprive pregnant women of the opportunity to deliver vaginally after a C-Section, simply on the basis that she has previously delivered a child via C-Section, without any other indication for surgery, is wrong. The authors of 'Silent Knife' wish simply to inform women of their right to choose the manner in which they give birth.

    1 out of 1 people found this review helpful.

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  • Anonymous

    Posted October 20, 2000

    Great Expectations -- Very Disappointed

    Of all the book descriptions I read everyone of them made wonderfull acclaimations toward this book. So when I bought it and started reading it I was very surprised. It is very opinionated, one-sided, disapproving of all medical physicians, exaggerated, and very often the case completely untrue. In just the first two chapters I have found quite a few wrongfull accusations, in appropriately emphasized quotes, and exaggerated statistics. Not only that, but the statistics that were used were from the 1970's! There is no up to date information in this book and I am very disappointed. Please... if you want to buy a book to get to understand VBAC and Cesarean Section better, use any book but this one. This is more of a windy editorial than an actual representation of what to expect for a VBAC and to prevent a Cesarean. After reading this book I was mortified to the point of tears at how the authors made me feel I was such a failure as a woman because I had a C-Section and how my doctor was waiting by my bed the whole labor for the moment when he could pounce and rip my belly open. This is a HORRID HORRID book!

    1 out of 1 people found this review helpful.

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  • Posted March 23, 2013

    .My first pregnancy was a Cesarean birth in 1982. In 1985, I was

    .My first pregnancy was a Cesarean birth in 1982. In 1985, I was pregnant with twins and wanted a chance to have a vaginal birth.  There were plenty of books about C-Sections.  Back in those days it was taboo to have a VBAC especially since my second pregnancy was twins.  I actually called the author and she adequately answered my tough questions. I waited till I was 36 weeks pregnant and left for Indianapolis, IN where they had done many VBAC deliveries successfully.  The delivery of my twins was no exception.  It was joyous to have had the opportunity to have a vaginal birth.  This book was my bible in a day and age when it was accepted and expected to have a second C-section.  Thank goodness this book was around in 1985 for me!  The book has many inspirational chapters.  My favorite addressed laboring and pain which I have used to assist in control of pain to this very day.  Today I am a nurse who is able to see through the “scare tactics” that the “Horrid” reviewer stated she experienced with her read.  I sat in on my daughter’s second pregnancy with the Obstetrician using her repertoire of scare tactics of why she should have a second C-Section.   What is scary to me is to not have a knowledge base of both sides to make the right decision for yourself.  

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  • Anonymous

    Posted October 4, 2005

    Wonderful and healing book!

    Don't let Miranda's sadness over her own c/section put you off this marvelous book! I feel sorry for Miranda and hope she comes to terms with her pain. This book is incredible and a real help. It is timeless and accurate and a must read for any pregnant woman who wants to avoid teh knife to give birth. our bodies were degisned by God to give birth, so get this book for your own empowerment.

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  • Anonymous

    Posted January 15, 2001


    I believe any woman who has had a cesarean knows that she has been robbed. Unless needed in case of an emergency, many cesarean sections are unnecessary. One in four women in America give birth by c-section. I have a hard time believing that so many women are incapable of giving birth naturally. This is a beautiful book that gives hope to those women out there that have been told they 'can't'. Vaginal birth after cesarean is possible and very empowering for mothers. Excellent read!!!

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