Episode 282 What You Need to Know About Assessing Risk

Hearing about risk is hard. Interpreting risk is even harder, but deciding which risks are comfortable for you is an essential part of birth! Meagan and Julie discuss how to tell the difference between relative and absolute risk, and what kind of conversations to have with your provider to help you better understand what the numbers mean.  They also quote many stats and risk percentages around topics like blood transfusions, uterine rupture, eating during labor, epidurals, Pitocin, AROM, and episiotomies.   And if you don’t feel comfortable with accepting a certain risk, that is OKAY. We support your birthing in the way that feels best to you! Risk of Uterine Rupture with Vaginal Birth after Cesarean in Twin Gestations Journal of Perinatal Education Article What are the chances of being struck by lightning? Needed Website How to VBAC: The Ultimate Prep Course for Parents Full Transcript under Episode Details  02:52 Review of the Week 06:08 Determining acceptable risk for you and your provider  08:00 Absolute versus relative risk 15:21 More conversations need to happen 25:29 Risk of blood transfusion in VBAC, second C-section, and third C-section 30:37 Understanding the meaning of statistical significance  32:05 “The United States is intervention intensive”  36:27 Eating during labor and the risk of aspiration under anesthesia 43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentages 44:43 The perspective of birth doulas and birth photographers Meagan: Hello, hello everybody. Guess who I have today? Julie! Julie: Hello.  Meagan: Hello. It’s so good to have you on today.  Julie: Of course. It’s always fun to be here.  Meagan: It really is. It’s so fun. When we sit and chat before, it just feels so comfortable like that is the norm still for me even though it has been a while, it just feels so normal and I love it. I miss you and I love you and I am so excited to be here with you today.  You guys, we are going to talk a little bit about risk. We know that in the VBAC world, there’s a lot of risk that comes up. I should say a lot of talk about risk that comes up whether it be is it safe to even have a VBAC? Is it safe to be induced? What are our real risks of uterine rupture? Is it safe to VBAC with an epidural or without an epidural? What about at home out of the hospital? Is that safe? I don’t know. Let’s talk about that today.  Julie: Let’s talk about it.  Meagan: Let’s talk about it. I think it’s really important to note that no matter what— and we’re going to talk about this for sure today, but no matter what, you have to take the risks that you are presented and that is given and still decide what’s best for you. That risk doesn’t mean that is what you have to or can’t do. Right?  So I think while you are listening, be mindful or kind of keep that in the back of your mind of, “Okay, I’m hearing. I’m learning.” Let’s figure out what this really means and then let’s figure out what’s truly best for you and your baby. 02:52 Review of the Week I do have a Review of the Week so I want to hurry and read that, then Julie and I will dive into risk and assessing.  Julie: Dun dun, we’re ready.  Meagan: We are ready.  Okay, holy cow. This is a really long review, so— Julie: You can do it.  Meagan: Thank you to Sara R-2019 on Apple Podcasts for leaving this review. I love how Julie was like, “You can do it,” because she knows that I get ahead of what I’m reading in my mind and then I can’t read, so let’s see how many times it takes to read this review.  Julie: You’ve got this.  Meagan: Okay. It says, “A balanced and positive perspective.” It says, “As a physician myself I think it is unusual to find balanced resources for patients that represent the medical facts but also the patient experience and correct for some of the inaccuracies in medicine. This podcast does an amazing job of striking this balance! “I h