The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA
An interactive resource for moms on easy steps they can take to reduce exposure to chemical toxins during pregnancy.
Other excellent resources about avoiding toxins during pregnancy
These are easy to read and understand and are beautifully presented.
Are you referring to "Laparoelytrotomy" which is an abdominal wall incision followed by mobilisation of the bladder and then an incision into the vagina ???
If so this is seldom extraperitoneal and can only be done if the cervix
is completely dilated. When done it is usually by accident and many times
never even recognized by the surgeon. This is usually a patient who gets
to complete dilatation and then pushes for 3-4 hours without descent. In
this situation the cervix retracts upwards and the vagina is where the
lower uterine cervix "ought to be". The main thing about recognizing it
is that it is not a contraindication to trial of labor the next time since
no uterine incision was made.
There was just an article in the Clinical Opinion section of Obstetrics
and Gynecology by Dr. Robert Goodlin describing this procedure and suggesting
it as a possible answer to preventing the occurrence of a uterine scar
so that subsequent VBAC will be safer. I think it was within the past 3
months. I must say I was rather flabbergasted at the idea. I'd be interested
in hearing other comments.
I was amazed it got past the editors/referees !
It was a small series, some cases entered ( on intention to treat basis
) didn't get the procedure. His conclusion was no-one should be doing this
except in a prospective study - yet he admits doing it with no such basis
over several years.
We discussed it in our journal club - couldn't understand why all/most
of the eligible women didn't have vaginal births - using forceps or Ventouse
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