The International Cesarean Awareness Network, Inc. (ICAN) Newsletter

In This Issue

1 Preterm Labor

2 ICAN Board & Mission

2 President's Letter

3 In the News

3 Give Support

4 Bradley InstructorEncourages Supportof ICAN

5 Best-Selling AuthorRoanna Rosewood

6 First-Time MomFinds ICAN

6 Fall Book Review

8 Preterm LaborStudies

9 An EmpoweredBirth

10 FeaturedPhotography

11 ICAN inPhoenix

12 ICANFeatureMember

13 MemberThanks

Volume 30

Issue 3

Fall 2013

Preterm Labor

EmpoweredBirth Scenarios:

By Krystyna Bowman, AAHCC

There is already an elevated sense of pre-caution when you decide to have a VBAC.You will get questions from your family, yourfriends, maybe even your care provider. Youknow why you want a VBAC, but what doesthe evidence show about cesareans andpreterm birth?

If I have preterm labor along my VBACjourney…§ What do I need to know if I had a preemie

via cesarean last time, and I want to havea VBAC this time?

§ What do I need to know if I had a termcesarean last time, and I go into pretermlabor this time around as I prepare for aVBAC?

There is limited literature out there thatspecifically addresses VBACs and pretermbirth. What you can find are a lot of studiesabout the outcomes of vaginal versus cesar-ean deliveries of preterm infants.

What You Need To KnowThe concerns about preterm delivery remainthe same whether the baby is deliveredvaginally or surgically. The question is: areoutcomes improved with mode of delivery;do vaginally-born or surgically-born babieshave better quality of life?

feature continued on page 7

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President’s LetterAs I return from an ICAN planning retreat I am moreenergized than ever about the future of ICAN. I amexcited to take our organization to the next level tobecome a true advocacy organization. While wethrive on the mother to mother support, it is my hopethat ICAN can make a real change in the world bymaking our voices heard. Our mother-to-mothersupport is the cornerstone of ICAN. It always hasbeen and always will be. Without that mother-to-mother support, I am not sure I would be here as yourpresident and I certainly would never have had anHBA2C. When I first walked into an ICAN meetingmany years ago I remember thinking, Homebirth?What? That's fine for you, but it will never be for me.I came full circle after my CBAC and embraced all theeducation and support that ICAN provided to me. Iwent on to have a beautiful HBA2C that I would neverhave had if it was not for the women of ICAN.

I hope we can take that third component of ICAN,advocacy, and further our reach by spreading ourmessage to those that make the legal decisions

which impact the mothers we serve. I have beenreaching out and collaborating with other birth

organizations this year. By working together,we raise our voices collectively and togetherwe can make a larger impact changing thefuture of the birthing climate, for all futuremothers. Together, we CAN reach andpositively impact the lives of so many!

I hope you have enjoyed your summer!

Christa BillingsICAN President

ICAN’sBoardPresidentChrista BillingsPresident@ican-online.org

SecretaryMelody ThompsonTreasurer@ican-online.org

TreasurerRuthie DickenTreasurer@ican-online.org

www.ican-online.org

International CesareanAwareness Network, Inc.P.O. Box 31423St. Louis, MO 63131

The information in this news-letter is intended for generalconsumer understanding andeducation and is not providedas a substitute for profes-sional advice. ICAN encour-ages women to discuss theseissues with a trusted healthcare provider. Opinionsexpressed by the contentand advertising inThe Clarion arenot neces-sarily theviews ofICAN, Inc.

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MissionThe International

Cesarean

Awareness Network

(ICAN) is a non-profit

organization whose

mission is to

improve maternal-

child health by

preventing

unnecessary

cesareans through

education, providing

support for cesarean

recovery and

promoting vaginal

birth after cesarean

(VBAC).

ICAN was founded in

1982 by Esther Zorn.

The Clarion is

published by

ICAN, Inc.

3volume 30 issue 3

By Sarah Lopata

In a June 27, 2013article by MikeStobbe, USA

Today reported onrecent government

findings that morecesareans are being

scheduled closer towomen’s due dates. Whilethe overall rate held steadyfrom 2010 through 2011,rates dropped in week 38 ofgestation and rose in week39. More hospitals and careproviders are successfullylimiting access to electivecesareans prior to 39 weeks;this new guideline is due to animproved understandingabout risks from the surgeryas well as important fetaldevelopment that occurs inthe final weeks of pregnancy.

The shift in cesarean rates,reflecting cesareansperformed at a later

gestational age, indicates thatcare providers and pregnantwomen are responding to thisinformation. Stobbe notesthat the long-term goal is tolower the overall cesareanrate to 15 percent. This couldinvolve more cesareans beingdone closer to 39+ weeksgestation, or even a decline inelective cesareans in general.This change will hopefullyassist in an overall decline asaccurate information reachesmore people.

The current US population’sgeneral understanding ofsurgical risks and fetaldevelopment is limited, oftenconsidering cesareans asroutine and misunderstandingthe very real risks of majorabdominal surgery. Widelyavailable education isessential to encourageinformed decision-making andto improve perinatal health.

The USA Today article canhelp to further raiseawareness that early electivecesareans present higherrates of complications,potentially leading to a trendof mainstream mediareporting more accurateinformation about birthissues. There is a great dealof work left to be done in thearea of cesarean awareness,but even small steps remainsteps towards change.

Stobbe, Mike. “More C-sections arenow done closer to due date.” USAToday, June 27, 2013.http://www.usatoday.com/story/news/nation/2013/06/27/c-sections-due-date/2461771/

Osterman MJK, Martin JA. Changesin cesarean delivery rates bygestational age: United States, 1996 2011. NCHS data brief, no 124.Hyattsville, MD: National Center forHealth Statistics. 2013.http://www.cdc.gov/nchs/data/databriefs/db124.pdf

Mainstream Media Spreads the Word AboutRisks of Elective Cesareans Before 39 Weeks

in the news

Give Support. Inspire Change.Exciting things are happening at ICAN International. Your support allows

these ideas to take form, like our new interactive website, set to be released

early in 2014. Please consider a donation to an organization that is

changing women’s lives. ICAN needs your donations. Every bit counts.

4volume 30 issue 3

stories, the leader opened up thediscussion to possibilities for thenext pregnancy. What were theydoing to deal with their sorrow andloss? What had they learned fromtheir experience? What would theydo differently for their nextpregnancy?

I was hooked. I wanted to keephearing these stories and the learn-ing curve that these courageouswomen were on. Every story gaveme one more clue on how I couldbecome a better educator aboutbirth and the decision points in la-bor. My intention as I became a“regular” was to spare future stu-dents from an “unnecesarean” asthey are called: cesareans that area result of a cascade of interven-tions and circumstances instead ofbeing medically necessary.

I could see the valuable serviceprovided to the women and supportpeople who came. Women, andsometimes their partners, came toheal, learn and grow, some veryliterally! Whether their labors hadvaginal or cesarean outcomes,most of these families came awaywith the sense that this time it wasdifferent. VBAC or CBAC, this birthwas their choice and they were em-powered by their outcomes and thechoices they made.

These giving, generous, andcommitted ICAN leaders whofacilitate the meetings with all thissupport and healing are volunteers.I could not sit by and keep taking, soI decided that the least I could dowas to become a professional sub-scriber. As an educator, I can standbehind ICAN because it is a reputa-ble organization interested in edu-cating and empowering people tolearn more so that they can do dif-ferently.

I discovered ICAN earlyin my career as a childbirtheducator. One of our studentshad a cesarean and she was

really struggling as she came toterms with her birth story. She haddone everything right as a student:she was the picture of health, sheate well, she did all her exercisesand more; she glowed in her preg-nancy. She had the mindset favor-able for natural birth: she knewwhat she wanted, and she is thetype of person who followsthrough once she sets her goal.

She wondered why she had notbeen able to birth vaginally, and sodid I. (I did not share this with her,of course!) I ran across a meetingnotice for our local ICAN chapter,and I invited her to go with me to“check it out.”

I was not sure what to expectoutside of a sharing-type birthcircle. I felt like the elephant in theroom because I have never had acesarean birth. All of ours havebeen pretty uncomplicated vaginalbirths. Some women were in tearsover their birth experience.Whether they cried or not, I couldfeel their sense of loss, of the guiltover their sorrow when they hadhealthy babies. And then there was

the ray of light    the mama who had come to

ICAN in sorrowand had just

celebratedthe triumphof anempowered birth.This wasthemomentofgrowing   after

sharing the

How does the chapter use itsresources? The leadership teamevaluates the needs of the groupand plans meetings accordingly sothat they are informing and empow-ering mamas on their pregnancyand birth journey. I see the leaderspresent their topics with care; theyare mindful that their work is impor-tant. They are empowering a newset of women every season. Thereis a growing lending library for ma-mas to access free of charge. Re-source lists are growing. All thetools a mother and partner need foran empowered birth are there forthe taking, as a gift.

Selfishly, I want to ensurethat it is available as a resource toour students that have cesareans.Even when they are medically nec-essary, there is often a grieving pro-cess for the birth they did not have.I also want to keep learning andgrowing as a professional. It madesense for us to continue giving aswe can, and to keep our profession-al subscription current to support thelocal chapter and ICAN International.

Thank you ICAN for providing aspace and a place for families toheal, learn, and grow. No matterthe outcome of subsequent births,all families are provided a networkof support to celebrate empoweredbirth choices. That is something tosupport at each and every opportunity.

Krystyna Bowman, AAHCC, and herhusband are proud parents to fourchildren and are Bradley Method®childbirth educators. She writesabout pregnancy, childbirth andbreastfeeding at Sweet Pea Births(www.sweetpeabirths.com), and youcan catch a glimpse of unplugged“real” life at Sweet Pea Families(www.sweetpeafamilies.com).

A Bradley Method InstructorEncourages Professional Support of ICAN

Photo credit: Krystyna Bowman

volume 30 issue 3

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healthybaby thanthewomanwho will-inglyputs hervery lifeon theline inordertobringhim intothe world.

This is why I love ICAN. It’s morethan a place to share stories andreceive the support needed to facewhat Amnesty International hasdeclared to be a “human rights cri-sis” (our maternity care system).ICAN is a place where birth leadersare born. ICAN recognizes yourauthority in childbirth, not in spiteof the fact that you are a mother,but because of it. Every time youdonate to ICAN, every time yourefer someone to ICAN, come to ameeting, or share their Facebookposts, you become part of the solu-tion. Because of you, our daughterswill not be forced to submit tounnecessary cesareans.

Roanna Rosewood is a VBA2C motherand coach. She is the co-founder ofBirthPlan Radio, the vice director ofHuman Rights in Childbirth, and thebestselling author of “Cut, Stapled, &Mended: When One WomanReclaimed Her Body and Gave Birthon Her Own Terms.”You can connect with her atwww.RoannaRosewood.com.

“ obody will buy a birth mem-oir written by a mother," theagent told me. The problem

wasn't my manuscript. She gushedover that. It was the market. “Theywant to buy birth books written byexperts, not moms.” Her tone wasgentle and kind, just as theobstetrician’s had been, the onewho told me that I “couldn’t” givebirth. It seemed as if she thoughtshe was doing me a favor by“helping” me to come to terms withreality. Who was I to question her?Agents are publishing experts.Obstetricians are birth experts. Asfor me, well, I’m “just a mom.”

But they were both wrong! I gavebirth naturally, not because myvagina has super powers, butbecause every vagina has superpowers. (Yes, even the ones who,for whatever reason, do not releasebabies without assistance.) My bookbecame the number one Amazonbestseller and sold out of its firstprinting in six weeks, not in spite ofthe fact that I’m “just a mother,” butbecause of it.

Though the “experts” don’t know ityet, birth doesn’t belong to them. Itbelongs to us. We are the rock starsof birth. They can only cut or pullbabies out. We deliver them. Theycan help us weigh the risks and ben-efits of a trial of labor, cesarean,repeat cesarean, induction, strippingof membranes, epidural, and otherinterventions. But only a mother hasthe right to decide what will happento her body and her baby’s body.Nobody is more invested in a

Roanna Rosewood Gets RealAbout Her Amazon Best Seller,“Cut, Stapled & Mended”

Thoughthe‘experts’don’tknow ityet, birthdoesn’tbelong tothem.It belongsto us ”

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By Christa Billings"Cut, Stapled and Mended: When One Woman ReclaimedHer Body and Gave Birth on Her Own Terms AfterCesarean," a memoir by Roanna Rosewood, nailed some ofmy inner-most thoughts that, to this day, I still struggle toexplain in words. It is as if the author was in my head sharingmy thoughts and feelings about my own births.

This is not the typical “birth is wonderful” book often written bybirth activists. Instead, it passionately explains the heartfeltemotions one goes through when giving birth by cesarean.Mainstream culture typically thinks a cesarean mother should bethrilled with joy with her new baby. But it’s not this simple for mostmothers. It’s not that we don’t love our babies; we do. Thiscontradiction can be hard to explain in words but “Cut, Stapled andMended” nails it by demonstrating how a mother can be grateful for herbaby and traumatized, angry and/or sad about what happened to her.

Roanna’s first cesarean was unnecessary. The second saved her life.When she found herself pregnant a third time, Roanna contemplatesscheduling another cesarean, “Could it be a ‘success’ if I accept it now,instead of fighting for and losing a natural birth?”

Though she decides to attempt a trial of labor, this time she is not braveor confident. So she turns to a laugh-out-loud array of alternativepractitioners in an attempt to find someone to “fix” her body and helpher prepare for birth. In the end, Roanna does give birth on her ownterms. But it’s nothing like what she expected. She writes, “I was not astrong warrior; I didn’t gently breathe my baby into the world. It wasn’tpretty. I screamed. I lunged. I whined. I glared and swore. There wasnothing ladylike or dignified or composed or graceful about me.” In spiteof this, Roanna’s experience leaves both her and the reader “craving togive birth again and again,” through glimpsing the raw beauty and gloryof physiological birth.

Like Roanna, I also gave birth at home after two cesareans on my ownterms. As a women and birth activist, I can really connect with thetransformation that the birth journey takes us through. Women

around the world will connect with the way this book puts theirmost inner thoughts and feelings surrounding birth into

words. I recommend this book to all womenlooking to give birth and exploring their birth

options. It truly describes how the birth ofyour children can transform your life.This book shows that a cesareansection surgery is not just anotherway to have a baby, and that howthe mother feels about herexperience does matter, as the

mothers of ICAN(International CesareanAwareness Network)know all too well.

A First-TimeMom Finds ICAN

by Kiedra Hernandez

Few moments impact you like the onewhen you find out you are pregnant.When we found out we were expect-

ing we were so excited! But then after it allsank in I realized, “Oh my! I am going to bea mother!!” I immediately immersed my-self in research on everything from preg-nancy symptoms to pricey baby gadgets.

It was during myquest for knowl-edge that I learnedabout the BradleyMethod. Their phi-losophy was in linewith my own be-liefs and wants forour delivery, sowe enrolled in

classes. During one of our Bradley class-es, members from the local ICAN chaptercame in to educate us about VBACs andbirthing options.

After that class I knew I wanted to getinvolved in ICAN. Although I haven’t had ababy yet, I really believe in ICAN’s mis-sion. I had no idea there were so manychoices regarding labor! All I knew aboutbirthing was that it was excruciatinglypainful if it was natural and the only otheroption was a cesarean.

In the few months I've been involved withICAN I have learned the importance ofknowing all your options, as well as havinga support system to advocate with you.When I first found out I was pregnant, Iwas overwhelmed. So many websites areclearly biased or are more of a discussionforum (which is nice in its own way), but Ialso wanted solid facts on what my realoptions are going to be. That is one ofthe many great things about ICAN;this organization provides wonder-ful education. That is why Iam so passionate about be-ing a part of its work.

Kiedra is due any day now!Look for her follow-up storyin the next Clarion to findout how her birth went.

I havelearned theimportanceof knowing

all youroptions

Photo credit: Roanna Rosewood

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Here are a sample of the studiesthat show that there is no changein neonatal outcome1- 6 and thereare almost the same number ofstudies that show that there is aslight increase in risk withvaginal delivery.7-10 [See studyreferences on following page.]The studies will say there is “nostatistically significant differ-ence” when it comes to the dif-ference in outcomes; there areno easy answers.

The biggest factor in neona-tal outcome in the studies wasnot mode of delivery. The deter-minant seemed to be birth weightand gestational age. In thestudies that factored for gesta-tional age and/or the birthweight, the conclusions werethat the longer gestation and thelarger the baby, the better theneonatal outcome. 2,9,10,11

There was one point ofagreement across the stud-ies: they concluded that there isno way to generalize practice, orthat there is not enough evi-dence one way or the other toestablish a set protocol forpreterm delivery. The recom-mendation is to evaluate eachcase individually, and to look atthe whole maternal risk profile:weight gain, blood pressure,presence or lack of gestationalor other forms of diabetes. If apatient should present withpreterm labor, all those thingsplus any additional factors in thematernal profile should be evalu-ated. A decision about mode ofdelivery should be made with the

patient once all the maternalfactors have been considered.

If you have a history of pretermdelivery, or if you just want tohave a contingency plan for anypossible variations of labor, hereare the things you may want toconsider if you are choosing toprepare for a VBAC with yournext pregnancy:

Have open communicationand honest dialogue withyour care provider. Youalready have a gut check in place  when you talk to care providersabout scenarios around yourVBAC. What do they say whenyou ask, “Can I VBAC if I go intoearly labor?” Your care providercan give you a simple yes or nowithout thinking of the implica-tions of that answer. Later on,she may change her mind if shesaid yes, because she didn’t haveall the information when she saidyes to you. Instead, considerasking a question that makes the

care provider answer based onhis past experience, “What hashappened with previous VBACpatients who have pretermlabor?” Questions that invite himto think and participate will be atruer representation of his carephilosophy.

Hire a care provider you trustimplicitly. This piggybacks onthe first point. If you get any redflags in this or any conversationabout your choice to VBAC, askaround your ICAN chapter to getfeedback from other mothers.What has been their experiencewith your provider? If theyswitched care, who did they useand how did it go? Did they feelempowered by their new providerto make informed consentdecisions? If you are faced within-the-moment decision points inyour labor, do you trust that yourcare provider will make thedecision that is in the bestinterest for you and your baby?

Preterm Labor continued from page 1

continued on next page

8volume 30 issue 3

Articles and Studies About PretermLabor and Mode of Delivery

1. Ljustina S, Berisavac II, Berisavac M, Kovacević-Vukolić L, Velicković-Aleksić V, Marković N. Analysis ofintracranial hemorrhage grade in preterm singletonpregnancies delivered vaginally or by cesarean section.Vojnosanit Pregl 2013; 70(3): 255 258.

2. Alfirevic Z, Milan SJ, Livio S. Caesarean sectionversus vaginal delivery for preterm birth in singletons.Cochrane Database of Systematic Reviews 2012, Issue6. Art. No.: CD000078. DOI:10.1002/14651858.CD000078.pub2.

3. Stock SJ, Bricker L, Norman JE. Immediate versusdeferred delivery of the preterm baby with suspectedfetal compromise for improving outcomes. CochraneDatabase of Systematic Reviews 2012, Issue 7. Art. No.:CD008968. DOI: 10.1002/14651858.CD008968.pub2.

4. Smriti Ray Chaudhuri Bhatta and Remon Keriakos,“Review of the Recent Literature on the Mode ofDelivery for Singleton Vertex Preterm Babies,” Journal

of Pregnancy, vol. 2011, Article ID186560, 5 pages, 2011.doi:10.1155/2011/186560

5. Riskin A, Riskin-Mashiah S, BaderD, Kugelman A, Lerner-GevaL, Boyko V, Reichman B.Delivery mode and severe intraventricular hemorrhage in single, very lowbirth weight, vertex infants. ObstetGynecol. 2008 Jul;112(1):21-8. doi:10.1097/AOG.0b013e31817cfdf1.

6. Paul DA, Sciscione A, LeefKH, Stefano JL. Caesarean deliveryand outcome in very low birthweightinfants. Aust N Z J ObstetGynaecol. 2002 Feb; 42(1):41-5.

7. Gawade PL, WhitcombBW, Chasan-Taber L, PekowPS, Ronnenberg AG, Shah B, PlevyakMP, Markenson GR. Second stage of

labor and intraventricular hemorrhage in early preterminfants in the vertex presentation. Journal of Maternal-Fetal and Neonatal Medicine, September 2013, Vol. 26,No. 13 : Pages 1292-1298

8. Michael H. Malloy. Impact of Cesarean Section onNeonatal Mortality Rates Among Very Preterm Infantsin the United States, 2000 2003. Pediatrics August2008; 122:2 285-292; doi:10.1542/peds.2007-2620

9. Muhuri PK, Macdorman MF, Menacker F. Method ofdelivery and neonatal mortality among very low birthweight infants in the United States. Matern ChildHealth J. 2006 Jan;10(1):47-53.

10. Lee HC, Gould JB. Survival advantage associatedwith cesarean delivery in very low birth weight vertexneonates. Obstet Gynecol. 2006 Jan;107(1):97-105.

11. Altman M, Vanpée M, Cnattingius S, Norman M.Neonatal morbidity in moderately preterm infants: aSwedish national population-based study. JPediatr. 2011 Feb;158(2):239-44

Do what you can do to decrease your risk ofpreterm labor. Be mindful that even if you doeverything right, preterm labor happens. Accordingto the March of Dimes, these are the things you cando to decrease your risk of preterm labor:

§ Don’t smoke, drink alcohol or take street drugs.

§ Go to your first prenatal appointment as soon asyou think you are pregnant.

§ Get treated for chronic health conditions, suchas thyroid function, diabetes and high bloodpressure.

§ Protect yourself from infec-tions and avoid harmful sub-stances.

§ Reduce your stress.

§ Educate yourself about inter-birth intervals for VBAC.

As mentioned above, the only thingthat the studies agreed on was thatdeciding on the mode of deliveryfor a preterm infant was individualand should be based on themother’s whole health history, nota broad sweeping generalization. Ifyour care provider is trying to peg you into a prede-termined path, she is not following evidence-basedcare. The ideal care provider will take the time tolearn about you, your health history, and treat youas an individual. They are out there, and plugginginto your ICAN resource base will help you find themin time for your VBAC journey.

The bottom line is that this is your baby andyour birth. While it may not go exactly as youenvision, you are in a position to learn more and dodifferently this time. Consider setting your end goalto be one of having an empowered birth experience.Even if you should have a repeat cesarean, it will bebecause you chose it as the best path for a HealthyMom, Healthy Baby outcome.

Preterm Laborcontinued from page 7

Read moreabout

pretermlabor here:

www.marchofdimes.com/pregnancy/reduce-your-risk-of-preterm-labor-

and-birth.aspx

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by Catherine Harper

I was blindsided by my first birth ex-perience, a prolonged labor thateventually resulted in a cesarean

section. While I fell in love with my sweet sonimmediately, I grieved the loss of my natural

birth for months, and constantly sought outinformation and support to help me cope with my

feelings of sadness.

Shortly after my son’s birth, I ran across ICAN andfound solace through sharing my story in the forums.

It was a safe place to visit, surroundedby other women who understood mypain and grief. I read through theWhite Papers and suggested books,took webinars as they were offered,and became friends with other localmembers. ICAN gave me the strengthand courage I needed to begin healingfrom my first cesarean.

When I became pregnant the second time, I knew with confi-dence that I would attempt a VBAC. I was armed with re-search and tremendous support from friends and family,though there was still that nagging feeling at the back of mymind that I might realistically face another cesarean.

Because I have a few autoimmune issues, my pregnancy wasconsidered high-risk, and I saw a perinatologist regularly, alongwith the staff at my obstetrician and midwives’ office. I wasextremely vocal about my desire for a VBAC, and as my preg-nancy progressed and the possibility of an induction was men-tioned, I refused to commit to an actual date, since I wanted togo into labor naturally when my baby was ready to be born.

It’s safe to say that my husband and I butted heads with mydoctors on more than one occasion, though, eventually, theyrealized and began to respect my plans for a VBAC. I wrote abirth plan, complete with all of the trappings of a natural birth,and also asked for specific requirements in case a cesareanbecame necessary.

As I grew closer to my second son’sarrival, I began to focus on having thebest birth for him, however he en-tered the world. Of course, my pre-ferred choice was a VBAC, but incase that didn’t happen, I was de-termined to prevent the feelingsof loss and sadness that so tightlygripped me after my older son’sbirth. This time around, I wasalready the mother to oneyoung child, and I wanted to

give birth and recover quickly to begin caring for both ofmy children.

Since attempting a VBAC does, by its very definition, in-clude the risk of a cesarean, I focused specifically on thethings I wanted to change the second time around. I knewwhat issues and circumstances caused me pain and griefduring my first birth experience, so I worked to avoid orchange those during my VBAC. I asked questions, soughtpermission, asked more questions, and pressed for an-swers. At times, I knew I annoyed the medical staff, but Iwas on a more important mission to have the best birth formy baby and myself, and I was stubborn and determined.

My second labor was short and beautiful, and I felt incomplete control, recognizing the stages as they hap-pened. After hours of pushing, I began to realize that myson was not descending, just as his brother didn’t, and inthe back of my mind, I knew another cesarean was looming.

When my doctor made the sug-gestion, it was hard to hear, but Iwas ready this time, and I told myhusband, “You know what to do.”This time, we were prepared, andmy son’s birth, though it was sur-gical, was a beautiful and healingexperience.

As my second son was born, mydoctor gently told my husband tostand up, and camera in hand, hefilmed our son’s arrival into thisworld. As she guided our babyout, my doctor welcomed him and called him by his name,a moment I will never forget. Though I was unable to holdhim in that moment, his birth was witnessed by my doctorand my husband, and the love in the room was palpable.

My husband never left our son’s side, and he held andcomforted him as soon as possible. With my first son’sbirth, being separated from him caused me endlessamounts of grief; but this time, I chose to find comfort inthe knowledge that my new baby was safe in his father’sarms.

When our son was first examined, my husband called outhis weight to the room, and everyone cheered in excite-ment. The mood in the room was happy, and we werecelebrating a birthday, as my nurse reminded me. Therewas no idle chit-chat, and I felt the joy and relief that comein those first moments after birth.

In recovery, my nurse gave our family privacy and allowedus to spend several hours nursing and cuddling as we gotto know our new baby. I think she recognized my desire

An Empowered Birth:It's Not Exclusive to VBAC

I askedquestions,

soughtpermission,asked morequestions,

and pressedfor answers

I began tofocus on

having thebest birth

for my son,however heentered the

world

I foundsolace

throughsharing

my story

continued on next page

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An Empowered Birth: continued from page 9for things to be different, and I was adamant that I nursemy baby immediately following surgery.

It was such a different scene than the one I experienced asan exhausted and utterly overwhelmed first-time mother.My postpartum nurse, who was also pregnant, expressedher sadness that I didn’t achieve a VBAC, and I reassuredher that my son’s birth was a truly wonderful experience.Then she stayed with me through the first long night ofcluster feeding, and reassured me that I was doing a great job.

As soon as I was up and about, I began asking to go home.My first labor and delivery left me in the hospital for fivelong days, and this time, I had a little boy waiting for me athome. I wanted to see him and begin my new life as a momto two little boys. My nurses encouraged me to get going,and gave me the strength I needed to return to health assoon as possible, though my physical recovery was moredifficult the second time around.

Returning home was a wonderful experience and my heartfelt light and free. I reveled in my new baby, and though Ihad moments of doubt here and there, I took pride in mybirth and felt comforted by it.

Though I had a CBAC, I felt truly empowered and in controlthe entire time, which was a drastically different experi-ence than my first birth. Looking back now, three yearslater, I realize that by changing my mindset, I was able to

have the healing birth I wanted, even though the outcomewasn’t my first choice.

It seems incredible that the disappointment and hurt causedby a cesarean could be healed by a second cesarean, but thatis exactly what happened. I faced head-on the very thing Ifeared most, and by changing my perceptions and takingcontrol, I had the best birth for my baby and for me.

A few resources that comforted me both before and aftermy CBAC are:

§ ICAN (including the forums, webinars, and White Papers).

§ Kmom’s Plus-Size Pregnancy Website (useful informa-tion for mothers of all sizes).

§ “Having a Cesarean-in-Awareness” by Virginia Bobroand Donna Moore, from Birthing From Within(wonderful suggestions for changing your percep-tion of surgical birth).

§ “Ended Beginnings: Healing Childbearing Losses”by Claudia Panuthos and Catherine Romeo,1984 (an old, but helpful book).

§ “Cocoon” Birth Mandala by Amy Haderer-Swagman (a visual image of an empower-ing cesarean).

Have great pictures from your labor or birth? Submit them to publications@ican-online.orgfor an opportunity to be published in future Clarion issues.

Abby Schweitzer, from Phoenix, labors with the support of her twodoulas, husband and midwife as she prepares to welcome her VBAC baby at home.

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11volume 30 issue 3

By: Jessica Franks

Meet the Leaders: Jessica Frankshas been a co-leader for ICAN ofPhoenix for three years. She is

also the Assistant Chapter Director and anadmin for ICAN International on Facebook.

Jenni Froment recently took over as leader forICAN of Phoenix in May. She started planning

her VBA2C after researching how to have agentle cesarean and realizing that VBAC was a

great option. Abby Schweitzer is the newestco-leader. She relocated from Illinois to Phoenix

last year and is very passionate about birth. Shehad a beautiful homebirth last year with her son. All

of us together make an amazing team.

In the Community: On a broad scale, we haveover 270 members in our Facebook group. Our mem-bers include supportive care providers, childbirth ed-ucators and doulas. We host two meetings a monthwith anywhere from six to 25 people at each meetingand cover a variety of topics. Some past topics havebeen: Physical Healing After a Cesarean; EmotionalHealing After Birth; How to Get Your Partner and Familyon Board; Uterine Rupture; What to Expect at the Hospi-tal; Homebirth; Planning a Gentle Cesarean and WhyDoulas are Important. We have some fun too, hostingholiday parties and Birth Art Night. I like to think we havea topic for everyone no matter where they are on theirhealing journey.

Our website has evolved into a great resource for ourcommunity. We have our Calendar of Events, a Meet theLeaders section, Blogs We Love, a survey for new membersand a section for members to subscribe to ICAN Interna-tional. Even more exciting, we have almost 30 beautifulbabies listed on our website, complete with birth stories.Check us out! http://icanofphoenix.weebly.com/index.html

Mother-to-Mother Support: Just like ICAN Inter-national, the mother-to-mother support is the corner-stone of our chapter. Our group is made up of strong,passionate and supportive women. I am amazed everyday at the determination expressed in this group. Thepast few years we have, as a chapter, experienced alittle bit of everything: homebirth transfers; VBA2C;HBAC; a VBA2C with a bicornuate uterus; a VBACafter three cesareans; empowering CBACs; a twinhomebirth of mono-di twins, one born in the waterand one breech; a VBAC after four cesareans thathappened so fast he was unintentionally born athome, and more VBACs than I can count.Through it all, the mother-to-mother connec-

tion has been the foundationand enveloping supportand compassion we haveall needed on our veryunique journeys. Phonecalls, meals, bearing ofsouls, playdates, emailsand overall generosity isplentiful in our group.

Fundraisers: This springwe put on a picnic for our ICANfamilies, open to the community. We raffled offtickets, memberships and gift certificates tolocal events and businesses, all of which weredonated to ICAN of Phoenix. It was a greatturnout and a fun event to host during Cesare-an Awareness Month. We have plans to con-duct larger fundraisers and kick-startlocal advocacy for ICAN andCesarean Awareness.

The volunteer hourswe put forth to keep ourchapter running is not al-ways easy, but the wom-en in our group are ourmotivation and a con-stant reminder that all ofour hard work is worth it.These are women that I havelaughed with and cried with.They were there every step of the way while Idealt with postpartum depression and pre-pared for my own VBAC. They were the firstpeople I wanted to tell when I “pushed a babyout of my VAGINA.” If my intended VBAC hadended in a cesarean, I know they would havebeen there with love, support, com-passion and probably a fewmeals.

ICAN of Phoenix is what itis because of the peoplewe help along the way.Women from differentwalks of life, all connect-ed by their cesareanscar(s). It’s amazing whatwomen can accomplishwhen they band together.

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What Does ICAN Look Like In...

11volume 30 issue 3

volume 30 issue 3

12

my full name: LaQuitha Glass.

my nicknames: Quitha.

my title with ICAN: Co-leader of ICANof Evansville, Project Coordinator with ICAN,Support Webinar volunteer.

my ICAN chapter: ICAN of Evansville.

my hometown: It's always hard to answerthis because I was an army brat growing up, so Imoved once every three to four years upthrough college.

my children: I have two kids, one born byplanned cesarean due to breech presentation in2009 and one unmedicated VBAC in 2011.

the moment that led me to volun-teer for ICAN: I decided to volunteer withICAN after I VBAC’d my daughter in 2011. I was so appreciative of the supportand information that I received from ICAN and other sources that I reallywanted to pay it forward.

Favorite moment from my birth(s): With my cesarean, myfavorite moment was getting to hold and nurse my baby for the first time. Ittook a while for me to see her after finishing the surgery and going torecovery, so it was amazing to be able to hold her and be introduced to herformally. With my second birth, my favorite moment from the birth was whenI finally made it to the pushing stage and delivered her.

how ICAN Has helped me: ICAN was such asupport for me during my birth journey. It really

helped me learn how to not only be supported,but to also be supportive to others.

random Fact about me: I was a sev-enth grade English teacher for two years anda fifth grade teacher for one year before get-ting married and becoming a stay-at-homemom.

three words to describe me: Inquisi-tive, Helpful, Empathetic

my Favorite quote: Go confidently in thedirection of your dreams. Live the life you have

imagined. - Henry David Thoreau

what inspires me: I love being surrounded by and creating positiveenergy! It really creates a breeding ground for creativity!

ICAN is full of amazingwomen who volunteertheir time to progressthe organization andsupport other womenas they themselveswere supported duringtheir healing times andbirth journeys.

This fall we get to meetan ICAN member whohas been a major playerbehind the scenes. Hersweet spirit, “can do”attitude and efficientwork manner have madeher an invaluablemember for ICAN. MeetLaQuitha!

meet LaQuithaICAN's Featured Member for the Fall

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When enough women

realize that birthis a time of greatopportunityto get in touchwith their truepower, andwhen theyare willing toassumeresponsibilityfor this, we willreclaim thepower of birthand help movetechnologywhere it belongs– in the serviceof birthingwomen, nottheir master.–Christiane Northrup

13volume 30 issue 3

Rachel BruceCristina CageMegan CarterLauren CooperSarah Dulany-WilhelmiKarin FinleyKelly FischerKatherine Jackson

Rebecca JamesRachel JimenezMelinda KaneJennifer KeithRebecca LewisStacie MeredithElaine MillsSarah Oakley

Jessica PearlmanTaylor PfaffendorfMary SandvigAmanda SantoBarbara StrattonMichelle SunSomer TorresLonika Utterback

Maria HishikawaPenny KimAnna WasilikKendra RothertAlexis DiazBrooke SmithSarah ShannonJean Greenberg

Amberle HeathMaureen F HetrickKristin HultgrenChristine StrainEmile ToufighianTamar WilliamsMelissa McNultyLisa Heffner

Lisa CarguelloChristine WoodardLisa HouchinsElizabeth KooyEva GavinDaisy FulghamBirgit Kaneko

Association for SafeAlternatives in Childbirth

ICAN Inc.Desirre AndrewsMadeleine & David ArnowDawn AshbridgeCarrie BallekJanice BantherLily BeckLaura BentzMark Bower

Professional Subscriber

Victoria L. BrownMary CaellaighJoyce Chernick

Krista Cornish ScottChristie Craigie-CarterBerna DiehlDonna DietzJuli DuncanBruce Flamm MDJane FrankAnne FryeSharon GrahamNichole GrawerKathleen Gray FarthingJenny GriebenowAnn HampsonMorgan HanzlikRebecca Hoogstraten

Gretchen HumphriesTonya JamoisMaria KorfiatisDawn KubikMichelle LoringJill MacCorkleSabrina McIntyreSandy MintzShannon MitchellSharon NottinghamMichelle & Gary OrlofskyMollie PetersheimJoy PiggottMichael J. Rosenthal MDKristina Rutkowski

Cindy SinarsKathleen SkestosMichelle SmilowitzCharmane StoutPam UdyClaudia VilleneuvePamela ViredayWendy WarburtonWendy WelshCatherine WhiteSarah WindenPriscilla Young CollettoTerrie & Dan YoussiEsther & Thomas Zorn

ICAN recog-nizes andthanks all ourfive and tenyear subscrib-ing members.A specialthanks goesout to all ourLifetime Sub-scribing Mem-bers. Weappreciateyour supportand commit-ment to ICAN.