Henci,

Thanks for your as-usual excellent responses.  Your analysis of the problem has been similar to my own line of thinking-- somethine along the lines of "you have a 1 in 6500 chance of losing your VBAC baby (and that's hospital statistics based upon .5% rupture rate and 5% of ruptures resulting in baby dying-- this is the stat I found)  OR a 1 in 5000 chance of the woman herself dying due to a planned cesarean (according to "Guide to Effective Care in Childbirth")  -- and as Bruce Flamm writes, while the loss of a baby is sad, the loss of a healthy mother is fairly inexcusable-- ie.  it is preferable to risk the life of the baby than that of the mother from an ethical standpoint-- a painful dilemma that all are put in due to the first cesarean.

In any case, my devil's advocate question is-- why are so many women dying in cesareans actually?  I live in NYC, and would LOVE to have disclosure about our local hospitals-- some of the fancy ones like NYU and Cornell who do almost 40% c/s and have high volume-- does it not make sense that they should be losing a couple of women each year?  But you never hear anything about it.  And the hospitals are not required to disclose.

My point is that how can we really prove that "top" OB care can't use interventions in a less risky way?  It's so hard for anyone to believe (even me to some extent) that a woman at a renowned medical center with a prominent OB practice has the same risks of dying from a c/s as a woman who gets her care from an inner city clinic, does not receive personal care by anyone who remembers her, and then has a c/s.  One of the stats that I am thinking of that kind of backs this up is the fact that while Hispanic and Black women have less interventions used on them, they have much higher maternal mortality rates.

Are the old 1 in 5000 for c/s and 1 in 20,000 mortality rates for NSVD equally applicable to everyone regardless of culture or economic echelon or medical care-- I want to understand those statistics and their application better.  It seems maternal mortality is so poorly understood and studied.

Thanks,

Shayna