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Creating Waves of Awareness

Mom fights, gets the delivery she wants
By Elizabeth Cohen, CNN Senior Medical Correspondent
December 17, 2009 9:17 a.m. EST

Joy Szabo changed homes so she wouldn't be forced to have a C-section. Marcus Anthony was born vaginally on December 5.

An estimated one in three babies in the U.S. is born via cesarean section
A slightly higher risk of complications have made VBACs less common
In a non-emergency situation, a woman may be able to discuss vaginal delivery options

(CNN) -- Seven months into her pregnancy with her fourth child, Joy Szabo's obstetrician gave her some news she didn't want to hear: Because she'd had a previous Caesarean section, the hospital where she planned to deliver was insisting she have another one.

Szabo wanted a vaginal delivery, and argued with hospital executives, but they stood firm: They refused to do vaginal births after Caesareans (VBACs) because they have a slightly higher risk for complications.

After they lost that fight, Szabo and her husband, Jeff, made an unusual decision. About three weeks before her due date, Szabo moved nearly six hours away from their home in Page, Arizona, to Phoenix to give birth at a hospital that does permit women to have VBACs.

In the end, the Szabos got the birth they wanted. On December 5, their son Marcus Anthony was born in Phoenix via an uncomplicated vaginal delivery, weighing seven pounds and 13 ounces.

"It's a tough situation. Mom is tired. Dad is tired and nervous, and most people haven't spent their lives reading obstetrical textbooks...
--Dr. Bruce Flamm

"It was such an easy birth," Szabo says. "I was in the pains of labor for about four or five hours, then I pushed once, and he popped out."

The Szabos' story has a happy ending, but it shows that with the rising C-section rate -- now one in three babies is born via Caesarean -- women who want vaginal births sometimes have to fight to get them.

That fight is especially difficult when the decision to perform a Caesarean is made in the delivery room when there's often not much time to talk and consider all the options.

"It's a tough situation," says Dr. Bruce Flamm, a spokesman for the American College of Obstetricians and Gynecologists. "Mom is tired. Dad is tired and nervous, and most people haven't spent their lives reading obstetrical textbooks and don't know all the details involved."

Dina Ste. Marie was told she'd need a C-section, but a simple change in position allowed Isabella to come out vaginally.

Dina Ste. Marie, from Whitby, Ontario, remembers a tense moment in the delivery room three years ago when she was in labor with her first child. She'd been eight centimeters dilated for six hours, and the baby wasn't budging.

"We were near the end, but it just wasn't ending," she remembers.

When her obstetrician suggested she might be headed for a C-section, her doula, Stefanie Antunes, remembered a maneuver she'd seen midwives use to get a reluctant baby to come through the birth canal.

"Stefanie said if I laid down flat on my back it might help the baby get in a new position," Ste. Marie says. "I distinctly remember the labor nurse looking at her like she had 10 heads, but she said, 'You can try it if you want.' "

Ste. Marie got on her back, and the baby started moving around. Twenty-five minutes later, her daughter, Isabella, was born.

"It was such a major relief," says Ste. Marie. "I really wanted to avoid a C-section if I could."

Read more Empowered Patient stories
Not every mother wants to avoid a C-section -- in fact, some request them -- but if you do, here are some tips for what to ask your doctor (or midwife) in the delivery room if the suggestion is made that it's time to give up on a vaginal birth and head to the operating room.

Video: How to get the birth you want

1. "Doctor, is this an emergency, or do we have time to talk?"
Sometimes you need a C-section to save your life, your baby's life, or both. In those cases, there's no room for discussion.

Delivery room emergencies include excessive bleeding, a breech position where the baby is headed out foot-first, or when the baby has certain heart rate problems, according to Flamm.

"In these situations, this is not a good time to talk about your desires for a natural birth," Flamm says.

This is a very tough discussion to have in the delivery room. You're vulnerable, because you're talking about your baby's well-being.
--Debbie Levy, certified nurse midwife

2. "Doctor, what would happen if we waited an hour or two?"
The vast majority of the time, when your doctor or midwife tells you it's time for a C-section, it's not an emergency, Flamm says.

In many cases, women just need more time to labor, he adds. In fact, he says the No. 1 reason for a C-section is "failure to progress" during labor. "If that's what we're talking about, then it's not an emergency," he says.

3. "Doctor, are you sure the baby is too big for me to deliver?"
Sometimes parents are told a baby is too big to deliver vaginally. Dr. Ware Branch, medical director of women and newborns clinical program at Intermountain Healthcare in Utah, says parents should ask whether a C-section is absolutely necessary, especially if labor hasn't advanced very far.

"If it was my wife in labor and she's three or four centimeters dilated and the obstetrician says the baby's head is too big and she can't deliver him, I'd say, 'Nonsense, she hasn't really had a trial of labor, doctor.' "

4. "Doctor, is there something else I can try before having a C-section?"
Antunes, a spokeswoman for DONA International, which certifies doulas, says there may be options such as maneuvers like the one she used on Ste. Marie to get a slow labor moving.

You shouldn't be afraid to speak up and say you'd like to try to labor longer.
--Debbie Levy, certified nurse midwife

5. "Doctor, can we talk more about the baby's heart rate?"
If you're told you need a C-section because of the baby's heart rate, try to get your doctor or midwife to be as specific as possible.

Some heart-rate problems mean a C-section is necessary immediately, but other types of heart-rate issues are not nearly as serious, and you may be able to labor longer.
"This is a very gray area," says Debbie Levy, a certified nurse midwife in Marietta, Georgia. "It takes years to learn how to read fetal heart tones, and it's not an exact science."

Levy says it can be difficult to ask these questions when the person delivering your baby says it's time for a C-section, especially since mom and dad are often exhausted.
"This is a very tough discussion to have in the delivery room," she says. "You're vulnerable, because you're talking about your baby's well-being."

But she says as long as it's not an emergency, you should have these delivery room conversations with your doctor or midwife.

"You shouldn't be afraid to speak up and say you'd like to try to labor longer," she says.

CNN's Sabriya Rice contributed to this report.

All good questions that need to be addressed to assist young and older couples planning a child. They need to be prepared and understand what to expect, and how to 'ready' their body for the work ahead. Each pregnancy, birthing and delivery is unique. How can we help people who live in fear of the pain, the possibility of mental, emotional and physical scarring? We must have more trained doulas, nurses and doctors who can use homeopathy appropriately.


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Replies to This Discussion

I also have a feeling that eating GMO's is having an impact on the amount of C-sections. Elesewhere on HWC i have posted what is happening in Bali Indonesia, where women need C-sections because of umbilical cord problems. For the education of the fraternity I shall repost it here.

From: iburobin
To: gina_tyler
Subject: Re: placenta cord concerns
Date: Mon, 16 Feb 2009 18:34:00 +0800

DEar Sister midwives... (and docs) please excuse this group email to friends...
I am writing from Indonesia, the country who got GMO soy first... to share what I am seeing, and ask if you too are seeing the same, and begin a dialog....
in 2008 Bumi Sehat Bali received 573 babies. We saw and increase in retained placentas (we often see hemorrhage - attached is the paper on green revolution rice and it's impact on maternal mortality in Bali). Also I am seeing an increase in velamentous cord insertion.
One would expect given the rate of malnourishment here - that the birthing women would use every bit of Qi to push out their babies (and we go so gently) - leaving little or not much Qi for releasing the placenta and involution. However, in 2008 and so far in 2009 we have seen many too many 'sticky' placentas, two even had to be transported (we do manual removal on site when absolutely necessary - but 2 really had to go in, one for a hysterectomy, in another - Dr. Wedagama nearly took her into surgery... but was able to remove the placenta (over 1 liter blood loss!). In the last 6 weeks of 2008 I had to go after 4 placentas!!! It was not pretty, and I do not take it lightly. (usually never more than 1 per year)
Also most shocking is the empirical experience ( I have no research to prove it) of seeing an increase of velamentous umbilical cord insertion and short cords.
two weeks ago we had Padma, a vegetarian for 15 + years... third baby died the week before birth - from what was diagnosed as a cord accident. This 4th baby was born healthy... but the cord was flat and 4 to 5 cm wide (looked like a tape worm) and had five skinny vulnerable vessels arriving each separately to the placenta!!! The placenta was not the lovely placentas I know and love (I am doing a book on placentas - so I am having a love affair with them). There was no Wharton's jelly to speak of, and I am seeing a decrease in Wharton's jelly among all our babies.

Last week a young mom lost her baby in labor... suddenly FHT went from 150 to zero exactly 15 minutes between listening times... there was no dipping or drop in heart tones, but we were concerned as they had gone up to 160 and once above... but easily stabilized with position change of mother. We had no time to transport before infant demise. Five hours later a lovely baby girl was born dead. There was no hope. This mom is very poor, husband no job. The cord was less than 30 cm long and had been pulled too hard as it was wrapped tightly around her foot.
Yesterday evening we had a 2nd time mom come in,very poor and malnourished. On arrival FHT were above 160, she was 9 cm, but nothing we did to try to stabilize baby worked... and when we got up to 188 and climbing (that is with O2 support! and hands and knees) we transported... stat cesarean, baby was very weak low apgars... but she has come around and my staff midwife has gotten her out of hospital nursery and onto breast. This baby would not have survived our normal hands-off gentle birth. Saved by O2, a doppler and cesarean - is this the kind of drama the placentas want now????
Cords are shorter. We don't cut them for a minimum of 3 hours at Bumi Sehat and many families choose lotus birth... so we hang out with the cords a long time. Last week our midwife Ayu had to cut a cord after birth of head, as the body would not follow, it was that short a nuchal cord... she had never had to do this before in her life as a midwife!
These are just a few stories... but we are seeing many less dramatic examples of shorter cords, velamentous cord insertion, diminished Wharton's jelly, and strange looking placentas.
This morning Dita having her second baby was stuck at 9 cm (with crazy transient but strong intermittent urge to push) from 7 pm to next morning at 8:30 she finally got complete. After hands and knees with butt up, moxa Kidney 1 and pulsatilla to dis-engage baby from pelvis and then elephant walking stairs to bring him down right.... we had had strange bleeding in first stage, but baby remained strong and stabile, mom also was quite well through the long labor - but I was spooked to speed this up in any way... just wanted the cord to stretch gently. 20 minutes before the birth FHT were suddenly absent. Hands and knees, O2 and slowly slowly, he came back. Now Dita was really urging to get her baby out. He was most stabile when she squatted, but this was not our preffered gentle birth... Dita did it (we had not time to transport - I actually considered episiotomy - imagine, and had ready a quiwi to vacuum him out!!!)her son was born by her own power and all of our prayers to Allah. Allhumdullilah!! our 3.6 kilo Baby boy's cord was short, just about 40 cm. velamentous insertion... AGAIN. Yet another.
Last week we had a five babies in a 12 hour night... two had velamentous cord insertions! It's just not average anymore. In five days time I saw one fatal cord accident, another cord problem leading to stat cesarean birth, and today another incident of deep fetal distress due to cord problems. BTW - none of these three were nuchal cords, just short and velamentous.
What are you midwives seeing? please send this round to your friends... I am curious.
The study I read concerning M16 genetically modified corn showed that when fed to pregnant mice, ALL THE OFFSPRING, in one generation, had alterations of ALL the cells in ALL their organs!!! Can you see why I am worried about our precious placentas? I did not make this connection, until I began to see an increase in abnormalities and pathology due to placenta and cord troubles. The fact that so many Indonesian women depend upon genetically modified soy products (tempe and tofu) for their day to day protein - and the early introduction of GMO soy here... well it got me wondering??
Dr, Hariyasa... Are you seeing an increase in this kind of cord and placenta problem at R.S. Sangla and Harapan Bunda? Some midwives at R.S. Ari Canti say they are seeing more problems. Dr. John... are you seeing more problems like this in Maui? Iowa? England? Australia? East Coast? Gina, are you seeing anything like this in your practice?? I HOPE this is not a trend or a pattern. We really don't want GMO foods, or anything, i.e. environmental pollutants etc. to make changes in placentas. It would be shattering.

Om Shanti, Ibu Robin LIm

Monsanto's Roundup Residues in GM Food Cause Cell Damage

* GM Watch (EU), January 5, 2009
Straight to the Source

COMMENT, Dr Brian John: This new article from CRIIGEN shows that Roundup residues found in GM food and feed can cause cell damage and even death -- even at very low levels. The authors say that their research "... points to undesirable effects which are currently masked or hidden from scientific scrutiny."
Yet another example of harm associated with GM crops which are currently on the market. In this case the harm is "indirect" -- but it is nonetheless inescapable since all RR crops used for feed and food purposes will contain RR residues at or above the studied level.
--- ---
Glyphosate Formulations Induce Apoptosis and Necrosis in Human Umbilical, Embryonic, and Placental Cells
by Nora Benachour and Gilles-Eric Séralini*
Chem. Res. Toxicol., Article DOI: 10.1021/tx800218n
Publication Date (Web): December 23, 2008
Copyright © 2008 American Chemical Society
We have evaluated the toxicity of four glyphosate (G)-based herbicides in Roundup (R) formulations, from 105 times dilutions, on three different human cell types. This dilution level is far below agricultural recommendations and corresponds to low levels of residues in food or feed. The formulations have been compared to G alone and with its main metabolite AMPA or with one known adjuvant of R formulations, POEA. HUVEC primary neonate umbilical cord vein cells have been tested with 293 embryonic kidney and JEG3 placental cell lines. All R formulations cause total cell death within 24 h, through an inhibition of the mitochondrial succinate dehydrogenase activity, and necrosis, by release of cytosolic adenylate kinase measuring membrane damage. They also induce apoptosis via activation of enzymatic caspases 3/7 activity. This is confirmed by characteristic DNA fragmentation, nuclear shrinkage (pyknosis), and nuclear fragmentation (karyorrhexis), which is demonstrated by DA PI in apoptotic round cells. G provokes only apoptosis, and HUVEC are 100 times more sensitive overall at this level. The deleterious effects are not proportional to G concentrations but rather depend on the nature of the adjuvants. AMPA and POEA separately and synergistically damage cell membranes like R but at different concentrations. Their mixtures are generally even more harmful with G. In conclusion, the R adjuvants like POEA change human cell permeability and amplify toxicity induced already by G, through apoptosis and necrosis. The real threshold of G toxicity must take into account the presence of adjuvants but also G metabolism and time-amplified effects or bioaccumulation. This should be discussed when analyzing the in vivo toxic actions of R. This work clearly confirms that the adjuvants in Roundup formulations are not inert. Moreover, the proprietary mixtures available on the market could cause cell damage and even death around residual levels to be expected, especia lly in food and feed derived from R formulation-treated crops.
Press Release: CRIIGEN - January 2009


For the first time, the toxicity mechanisms of four different Roundup formulations were studied in human cells. They act at doses where they are not herbicides anymore. The cells were neonatal cells freshly isolated from the umbilical cord, or less sensitive cell lines specially used to measure pollutant toxicity. The various components of these major herbicides were tested because they are among the most common in the world. Their residues are among the major pollutants, and moreover they are authorized as residues contaminating GM foods and feed at the tested levels.
As a matter of fact, Roundup formulations are the most common herbicides used with cultivated GMOs. Roundup Ready soya, the main GMO imported in Europe for food and feed, contains Roundup residues. In this research, the formulations were diluted at minimal doses (up to 100,000 times or more) and they programmed cell death in a few hours in a cumulative manner. We also noted membrane and DNA damages, and found that the formulations inhibit cell respiration. In addition, it was shown that the mixture of the components used as Roundup adjuvants amplified the action of the active principle called glyphosate; one of its metabolites may be even more toxic. These effects are greatly underestimated by the legislation, which does not take these phenomena into account, but instead simply sets arbitrary contaminant thresholds in food or feed. The rules apply to glyphosate whatever its formulation may be, this is wrong.
The authorizations for using these Roundup herbicides must now clearly be revised, since their toxic effects depend on, and are multiplied by, other compounds used in the mixtures placed on the market; and glyphosate is only one of them. The detailed blood analyses of each mammal which has received this herbicide during regulatory tests before commercial release must be published immediately, since our research points to undesirable effects which are currently masked or hidden from scientific scrutiny.
This independent work was performed by Nora Benachour and Prof. Gilles-Eric Séralini in the University of Caen in France. It is published in the Scientific American journal Chemical Research in Toxicology. It was supported by CRIIGEN and the Regional Council of Basse Normandie. The support of the Human Earth Foundation and Denis Guichard Foundation is also acknowledged.
Contact in France: Pr Gilles-Eric Séralini, Biochemistry, Institute of Biology, University of Caen, Esplanade de la Paix, 14032 Caen, France.
Tel: 33(0) 2-31-56-56-84. Fax: 33(0)2-31-56-53-20.
Corinne Lepage
President of CRIIGEN
"Glyphosate Formulations Induce Apoptosis and Necrosis in Human Umbilical, Embryonic and Placental Cells" by Nora Benachour and Gilles-Eric Séralini. (
--- ---
Full text:

Re: GMO /reproductive problems

Sun, 22 February, 2009 0:25:37
Robin Lim
HI Dr. Gina,
Where did you find this??? it is exactly my fear... and worry.
if we add the GM soy to the roundup poison KaviRaj described, commonly used in Bali, plus malnutrition, pollution - we have a recipe for disaster.
I am afraid to tell Indonesian women to avoid eating tempe, as for the poor it is their only source of protein.
We had a baby yesterday, lovely birth, cord seemed a reasonable length to us... well it was only 42 cm (normal range 60 to 70 cm) - we are now so accustomed to the short cords, we consider it lucky to get 40 cm!!!
Much love, Om Shanti, Ibu Robin

> GM soy, reproductive problems, and infant mortality
> * More than half the offspring of mother rats fed GM soy died within three weeks.[26]
> * Male rats[27] and mice[28] fed GM soy showed changes in their testicles; the mice had altered young sperm cells.
> * The DNA of mouse embryos whose parents ate GM soy functioned differently than those whose parents ate non-GM soy.[29]
Many offspring of female rats fed GM soy were considerably smaller,
and more than half died within three weeks (compared to 10% of the
non-GM soy controls).[30]

Bt crops linked to sterility, disease, and death

* When sheep grazed on Bt cotton plants after harvest, within a week 1 in 4 died. Shepherds estimate 10,000 sheep deaths in one region of India.[31]
* Farmers in Europe and Asia say that cows, water buffaloes, chickens, and horses died from eating Bt corn varieties.[32]
* About two dozen US farmers report that Bt corn varieties caused widespread sterility in pigs or cows.[33]
* Filipinos in at least five villages fell sick when a nearby Bt corn variety was pollinating.[34]

The stomach lining of rats fed GM potatoes showed excessive cell growth, a condition that may be a precursor to cancer. Rats also had damaged organs and immune systems.[35]

Functioning GM genes remain inside you

Unlike safety evaluations for drugs, there are no human clinical trials of GM foods. The only published human feeding experiment verified that genetic material inserted into GM soy transfers into the DNA of intestinal bacteria and continues to function.[36] This means that long after we stop eating GM foods, we may still have their GM proteins produced continuously inside us.

* If the antibiotic gene inserted into most GM crops were to transfer, it could create super diseases, resistant to antibiotics.
* If the gene that creates Bt -toxin in GM corn were to transfer, it might turn our intestinal flora into living pesticide factories.
* Animal studies show that DNA in food can travel into organs throughout the body, even into the fetus.[37]

GM food supplement caused deadly epidemic

In the 1980s, a contaminated brand of a food supplement called L-tryptophan killed about 100 Americans and caused sickness and disability in another 5,000-10,000 people. The source of contaminants was almost certainly the genetic engineering process used in its production.[38] The disease took years to find and was almost overlooked. It was only identified because the symptoms were unique, acute, and fast-acting. If all three characteristics were not in place, the deadly GM supplement might never have been

55.6% Mortality in Rats Whose Mothers Were Fed GM Soy

A recent Russian study found that an astounding 55.6% of the offspring of female rats fed genetically engineered soy flour died within three weeks. The female rats had received 5-7 grams of the Roundup Ready variety of soybeans, beginning two weeks before conception and continuing through nursing. By comparison, only 9% of the offspring of rats fed non-GM soy died. Furthermore, offspring from the GM-fed group were significantly stunted—36% weighed less than 20 grams after 2 weeks, compared to only 6.7% from the non-GM soy control group.
The study was conducted by Dr. Irina Ermakova, a leading scientist at the Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences (RAS). It was originally presented on October 10, 2005 to the symposium on genetic modification in Russia, organized by the National Association for Genetic Security (NAGS).
Click; more Jeffrey Smith's newsletter article on this study.


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