For me, the conclusions found in the above article are simply common sense. Of course the baby is better at deciding its time of birth than we providers could ever be. Nature provides for good outcomes in most cases and we should be very cautious when intervening in the natural process of childbirth. Almost 10 years ago, my practice of midwives was informed that we could no longer allow women to attempt a vaginal birth after a cesarean section. That changed our practice forever. We never realized that we were being cavalier about an initial attempt for a vaginal birth but from that moment we realized that we had only one chance to avoid the need for a VBAC. We began to analyze our every decision and direction in our care to evaluate how they might be impacting our cesarean section rate. The biggest change in our care has been to WAIT for labor to begin spontaneously. Induction of labor is a rare event in our practice, only for true medical complications. And our primary cesarean rate is 10%. We see babies born 2 weeks early who look overdue and babies born 2 weeks late who look early. The reality is that the baby is still the expert at choosing his/her own birth day. Lisa Lederer – Midwives of New Jersey
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