Ever use the VBAC calculator? Then you will want to listen to physician scientist and VBAC calculator researcher Dr. Nicholas Rubashkin, MD, PhD, an Associate Professor at UC San Francisco, as he reviews the historical and cultural implications of the VBAC calculator, a tool used to predict vaginal birth after cesarean (VBAC) odds. The conversation uncovers how the calculator has propagated racist assumptions that Black and Hispanic bodies are less capable of vaginal birth, the consequences of those assumptions on maternal care, and the problematic "60% threshold." They explore how to shift the conversation from risk-based to goal-oriented, how problems remain even after race and ethnicity were removed from the tool, recent research out of Sweden, and the fundamental ethical issues at the root of the calculator. The episode also addresses the concept of "controlling risk in advance," ethical implications of using surgery as a default solution, why some midwives don't use the calculator, and provides insights into future research and practices aimed at increasing equitable access to VBAC. 02:11 His Training and Background09:25 How He Decided to Study the VBAC Calculator11:25 Is VBAC a Political Issue?13:38 New Limitations on Research Grants16:48 The Many VBAC Calculators20:37 How to Define Uterine Rupture21:45 Race as a Risk Factor23:28 The Power of Lived Experience in Research25:55 It's Not Race, It's Racism27:56 How Race & Racism Were Built Into the Calculator29:28 Race & Ethnicity Removed from the VBAC Calculator32:13 A New Form of Scientific Racism33:03 Removing Race, Problems Remain35:34 Response to VBAC Calculator Critique38:34 Reader Q: Validate Prior FTP Cesarean42:27 Swedish Study: 10cm FTP Diagnosis & Future VBAC Odds43:36 Script for Using the Calculator44:44 Reader Q: Psychosocial Elements of FTP47:07 Science Beyond VBAC Calculator Comes From Oncology!47:59 Calculator Contributes to Informed Consent?51:04 Where to Start: VBAC Calculator & Informed Consent 54:01 Controlling Risk in Advance01:01:02 The Fundamental Ethical Issue01:03:16 The 60% Threshold01:08:02 The "Necessity" of The 40/41-Week Scheduled Cesarean 01:10:28 Goal Oriented ConversationsHave a comment or question for the podcast? Want to suggest a guest we should interview or a topic we should discuss? Go to https://vbacfacts.com/podcast to give us your feedback!Downloadable Checklist: The 5 Simple Steps to Planning a VBAC | VBAC Facts®Downloadable Report: Top 5 Uterine Rupture Myths Debunked Once and For All | VBAC Facts®Contribute to the VBAC Facts® BIPOC Scholarship Fund | VBAC Facts®Vaginal Birth After Cesarean Calculator (MFMU)Episode 6 Decoding the VBAC Calculator: Science, Bias, and Decision Making | The VBAC Facts® Podcast - Apple PodcastsStudy finds that VBAC calculators underpredict VBAC odds. They are also racially biased. | VBAC Facts®Consulting for Parents, Professionals, Legal & Policy Teams │ VBAC Facts® Professional Speaking with Jen Kamel │ VBAC Facts®Sign up for your copy of...

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