R. Renee Gaiski MSN, CNM

10/07/2025

10/06/2025

Va**nal estrogen use in breast cancer survivors: a systematic review and meta-analysis of recurrence and mortality risks https://ow.ly/XLG350VmTXN

07/11/2025

Raise your hand if this is among the top ten questions you get from people considering a non-hospital birth.

Reposted from .labornurse

A nuchal cord is a medical way of saying that baby’s cord is wrapped around their neck. ⁣⁠
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This is something you’ve probably heard about and you may even know someone who had this happen during their birth. ⁣⁠
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❗This isn’t at all surprising because nuchal cords are actually quite common – occurring in a little more than 1 in 3 births!⁣⁠
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And even though the idea of the cord being wrapped around the neck seems very scary, in reality, the chance of any complications is rare. ⁣⁠
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Sometimes we know about nuchal cords ahead of time because they are seen on ultrasound, but in many cases, we don’t know until baby is born.⁣⁠
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👉🏻 The most common complication occurs during labor. ⁣⁠
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Basically, when the cord is wrapped around baby’s neck, it can be compressed during contractions, which in turn reduces the amount of blood (and therefore oxygen) that is getting to baby. ⁣⁠
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Often time, we see a decrease in baby’s heart rate on the fetal monitor, which tells us the cord is being compressed in some way - and many times we can intervene!⁣⁠
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🤔 Did you know that this usually isn’t a cause for complications during birth?⁠

04/15/2025

You read that right.

Per the American College of OB/GYN's 2019 VBAC guidelines, the risk of maternal death during a planned vaginal birth after cesarean (VBAC) is 0.0019%.

Expressed another way, that is a risk of 1 in 52,600.

Did you have any idea the risk was that low?

Whereas the risk of maternal death with an elective repeat cesarean after one cesarean is 0.0096% or 1 in 10,000.

Again, both really small numbers but the risk of maternal death is five times higher in a repeat cesarean.

This is why when pregnant people are threatened with "you could die if you plan a VBAC," it falls flat.

But it is often really successful in coercing someone into a repeat cesarean... as well as eroding patient autonomy and any trust when the birthing person learns the facts.

As a L&D nurse told us, "There is no real informed consent anymore."

This is just yet another example.

ETA: Some people asked in the comments about the risk of fetal death. We discuss that here: https://vbacfacts.com/2012/04/03/confusing-fact-only-6-of-uterine-ruptures-are-catastrophic/

Others have asked about vaginal birth after classical cesarean: https://vbacfacts.com/2021/08/10/vbac-after-classical-t-j-incision/

… or after two cesareans: https://vbacfacts.com/vba2c

… or after three or more cesareans: https://vbacfacts.com/vba3c

Also, you can download our free resources including:

- a report debunking the top 5 uterine rupture myths: https://vbacfacts.com/report

- a handout busting the top 3 VBAC myths using national guidelines: https://vbacfacts.com/acogmyths

- and a VBAC planning checklist: https://vbacfacts.com/checklist

VBAC Facts

03/07/2025

AJOG Expert Review in Labor: Water birth: a systematic review and meta-analysis of maternal and neonatal outcomes https://ow.ly/nr7O50R9Nzi

12/10/2024

10/12/2023

Attn lovely ladies: I’m going to take next July/Aug off, could you pretty please with a cherry on top not get pregnant between now and the next 6-8 weeks?

Edit: 5 beautiful ladies did not listen and called for July due dates, so July is open and I’ve now made Aug and Sept my vacation time. 🤣🤣

04/20/2023

I have not vetted this class, but it’s free!

Free resource from the #1 natural birth and baby brand.

07/20/2022

Amazing! This so clearly shows the “two bags of water” that I often talk about with people when we are chatting about “water breaking”.

05/06/2022

A day late, but good not to share. ❤️

My thoughts on the International Day of the Midwife:

Being a midwife has given me everything
And cost me everything

Being a midwife gives me euphoric highs
And Valley of the Shadow of Death lows

Being a midwife gave some of my most amazing relationships
And striped away countless others

Being a midwife is both
Energizing and draining
Fulfilling and frustrating
Fast and Furious
and a Slow Dance
I jump tall buildings to get to you
I Walk a Tightrope with you
I carry you out of burning buildings
I talk you off the ledge
I win Ocsars and then hand them over to you

My kids are proud of me
And also in therapy
My friends love me
But know they can’t depend on me

My life is lived
In 10 month segments
That start with a phone call
Or a text
About a line on a stick
And end when that red line
Is a healthy human, week six
My calendar has notes like
EW 37 weeks
Which means
I’m now on a leash
Until EW wakes me up one night
At 5-1-1
And I go running
And disappear for days

My phone is never off
My gas tank is never empty
Nor is my trunk
Or my back seat

I am loved
And hated
Admired
And feared
Sought out
And avoided

But at night
(Or morning
Or at 2:00 in the afternoon)
When I finally lay down
I’m satisfied
With what I did
With who I am
With how I made a difference
And I wouldn’t want to be
Any else

Because although being a midwife has cost me everything

It has also given me

Everything ❤️

04/24/2022

I’m often asked about children attending births of their siblings. I find this to be true.

04/12/2022

This is why we speak up. If you want to see the system change to support true informed consent in pregnancy/ birth, then welcome to the club! 👇

Repost:

It is easy to turn practitioners into the villains of the birth world (and yes, there are some who are), but many of them are at the mercy of a paternalistic, litigation-driven system that ties their hands. If they have a desire to provide truly evidence-based care (and yes, there are some who do) that happens to go against hospital or birthplace policy, they are at real risk of having disciplinary action taken against their license, losing privileges at a given birthplace, or even losing their license and livelihood altogether. They practice from a place of fear, so their care, in turn, is often fear-driven and fear-based.

I think it’s fair to say that the current state of the maternity system is a reflection of the current state of society. Fear-based practice or fear-based governance both yield the same result: limiting choices and restricting freedoms in an effort to maintain control while still presenting the illusion of consent. The self-protective mantra of these systems becomes “the fewer choices they have, the less risk we have.” In birth, women are told they have choices and are presented with a distorted version of consent and “shared decision making” as long as it conforms to the system’s acceptable levels of risk and benefit. If it doesn’t, then the default is to hide behind the seemingly-altruistic shield of safety.

“I want to have my twins at home.”
“You can’t, it isn’t safe.”

“I want to have a vaginal breech birth.”
“You can’t, it isn’t safe.”

“I want to have a vaginal birth, even though I’ve had X number of cesareans.”
“You can’t, it isn’t safe.”

And so the mainstream medical model continues to contract in on itself, limiting mothers’ choices, limiting midwifery scope, limiting practitioner skill, all in the name of risk reduction masquerading solely as safety. If we don’t let them do it, it can’t hurt us. If we don’t let them learn it, soon it won’t even be an option.

Here’s the only safe bet I know: the current system is so infused and infected with fear that any number of alterations, exceptions, policies, procedures, laws…any attempt to “fix” it is futile. It is unrecognizable as a safe space for true physiological birth. That safe space is a space entirely separate, one that, with enough outcry, can become the new way to birth.

A new way and a return to the old way. A way built on trust, autonomy, and freedom. This is the way I want. If you want it too, don’t stay silent any longer.