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Denise Punger MD FAAFP IBCLC
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Dear Friends,                                                                                   

I will be attending the ONEVOICE Observance in Atlanta on February 14th (near Northside Hospitalone of the largest birthing hospitals in the Southeast with a cesarean rate of 31%), with CAPPA the national doula and CBE organization that has facilitated this event.

Locally on the Treasure Coast-- where I intend to set up private practice within a few months-- I encourage you to attend and take a stance against American College of Obstetrics and Gynecologys (ACOG) policy to ethically justify cesarean sections in elective situations without any medical necessity. While this may not seem to apply to you, lets think about it a minute.

One and a half years ago the birth center closed because "equivalent services were being offered at the hospital" and "woman who were previously inclined to seek "birth center type-care" were now opting for homebirths." I was told both by administrators who viewed this as proof the Birth Center had fulfilled its mission. They claimed standards at the hospital had risen and competition from the homebirth movement was taking away potential clients.

The next spiral downhill was that some area hospitals no longer offered vaginal birth after cesarean section (VBAC) because anesthesia services were not available on the premises 24/7. While women are successfully planning non-medicated, emotionally and spiritually satisfying, women (and family) centered VBACs at home with qualified midwives, at the hospital more and more woman have become victims of medicated (cytotec and other induction) of a fear-based, medical/surgical model of birth. Unfortunately the hospital administrators, OBs, anesthesiologists, ICUs and pediatricians only see the consequences of the latter type of birth. Few hospital representatives and physicians have ever had the chance to see this beautiful side of birth. They cant even imagine.

Now, I also hear that visitors are being limited to two or three at one of the hospitals to accompany a woman in labor. (I had nine at my five month-olds surprise-doubling- footling breech homebirth!)

Treasure Coast ONEVOICE volunteers have called area OBs to see who still does VBAC. Depending on where you live on the Treasure Coast you might have to drive at least an hour to find a physician provider. Even if you have depended on a midwife in the past to deliver your babies naturally and you feel like none of this applies to you; you may not have a homebirth option in the future. The midwives are being overworked and driven out. You could be turned away just because there is not enough providers. Women who have had recent cesareans and previously told they could VBAC in the future are just now finding out they dont have vaginal birth options on the Treasure Coast.

There are a few reasons to have a cesarean. Personal choice is not one of them. And the few other reasons that justify cesarean dont account for to 1/3 of babies being born by cesarean.

Women are just as guilty for this high cesarean section rate. They dont come prepared to cope with labor for their first birth, which has significant impact for breastfeeding and future births options. In my own patient-care experience many women just cant hear what I am saying as a physician advocate for natural woman centered birth. I guess because they have been so polluted with fear from the medical model seen on TV and heard about from friends.

Healthy people 2010 have a goal to reduce cesareans to 15% by 2010. We are no where near this goal and very little is being done about it.

It is up to all of us to make an impact with hospital administrators, physicians, ACOG and other women. ONEVOICE and local co-ordinators have done an excellent job facilitating this from scratchno budget or advertisingby word of mouth. My guestimate is about 15 women are committed to attend on February 14th, but imagine how much more of an impact we could make with your concern as awareness increases in the community with national backup. Five locations in Florida are having an observance, about 26 nationwide. The Treasure Coast community of mothers has been a leader in the birth and breastfeeding community setting an example to other communities and will continue to be leaders this time also.

Denise Punger MD FAAFP IBCLC

Rome, Georgia (previously Hobe Sound)











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Denise Punger MD FAAFP IBCLC
4640 S. 25th Street
Ft. Pierce, Florida, 34981
Copyright 2005