R. Renee Gaiski MSN, CNM

07/31/2026

Interesting comparison of epidural and water immersion. NB groups were self-selected, which may have influenced results. "Spontaneous vaginal birth was almost 17 times more likely in the water immersion group [94.5% vs 50.6%] (OR = 16.866 [6.540, 43.480], p < 0.001), whereas the odds of having a cesarean birth were almost 40 times higher in the epidural group [0.7 vs 21.9%] (OR = 39.346 [3.610, 429.120], p < 0.001). The odds of having an intact perineum were more than two times higher for the water immersion group (OR = 2.606 [1.290, 5.250], p = 0.007), whereas having an episiotomy was more than eight times more likely for the epidural group [4.1 vs 26.1%] (OR = 8.307 [2.800, 24.610], p < 0.001). Newborns in the water immersion group showed a better 5 min Apgar score and umbilical cord arterial pH and lower rates in admissions at the Neonatal Intensive Care Unit. Conclusions: Women choosing water immersion as an analgesic method were no more likely to experience adverse outcomes and presented better results than women choosing epidural analgesia." Full paper here https://www.mdpi.com/2227-9032/12/19/1919

07/15/2026

05/13/2026

What's normal pump output?

We've all seen those MASSIVE freezer stashes. We see the oversupply moms showing the overflowing bottles. And we love that for them.

However, those are not the most common scenarios.

When pumping in addition to feeds at the breast, a typical amount is 0.5-2ozs COMBINED from both breasts.

When pumping to replace a feeding, 2-4ozs is common.

And yes, occasionally some people do pump the amount seen in both bottles at one session for 5+ ozs.

Aim to produce the amount of milk your baby needs. You do not need to aim to produce extra to reach your long term breastfeeding goals.

👇🏽 How much milk do you typically pump?

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