“Carmaggedon” birth story?

My daughter Nora lives in Los Angeles, Cal., so I am aware that Angelenos are so dreading the shutdown of 10 miles of the I-405 expressway there for road work this weekend they have dubbed the event "Carmageddon."

Nora is going to walk or take buses as much as she can this weekend, and being from Chicago, she is comfortable with those activities. But many Angelenos are famously more car-bound than she is.

Carmageddon

Los Angeles commuter traffic

Crosstown airline flights between the suburbs of Long Beach and Burbank are sold out this weekend and the police department is asking celebrities to urge their Twitter followers to avoid the expressway and, indeed, to drive in the city as little as possible.

But Jenny Benjamin, writing in The Stir today, brings up an interesting and, to her and other expectant moms, urgent point: What happens if your baby decides to be born in L.A. this weekend?

Pregnant with twins, less than two weeks shy of her due date, a 30-minute drive away ("without traffic") from the hospital she carefully chose for its neonatal intensive care unit, Benjamin considers the possibility of an early labor and aks, "For the love of all things good and holy, what am I going to do?!?!"

Will her husband wind up delivering the twins (one of whom is in a transverse position) on the side of the road? Should she call an ambulance? "Ambulances aren't hovercrafts -- they're going to get stuck in the same traffic!" Benjamin notes.

Her doctor lives close to the hospital. "Good to know at least one of us will be able to get there," she writes.

"Aargh, it's times like this that I really wish that Segways had caught on!" Benjamin frets.

The best solution, she notes, is not to have the babies this weekend. "I have about as much control over that as I do the traffic," Benjamin writes. "Maybe I should see how much my husband knows about home birthing."

It’s a boy for Cruz, Bardem

The Spanish movie star couple Penelope Cruz and Javier Bardem reportedly welcomed a baby boy, their first child, on Jan. 22 at Cedars Sinai Hospital in Los Angeles.

Bardem was nominated for an Academy Award on Tuesday for best actor for his role in Alejandro Gonzalez Inarritu's new film, Biutiful.

He won a best supporting actor Oscar in 2007 for his role as a psychopath in No Country for Old Men. Cruz won a best supporting actress Oscar in 2008 for Vicky Cristina Barcelona.

Cruz, 36, and Bardem, 41, were married in July in the Bahamas. The couple, who met nearly 20 years ago on the set of Jamon Jamon, Cruz's first movie, reunited while making Vicky Cristina Barcelona for Woody Allen in 2007.

Fears about VBAC

Taffy Brodesser-Akner's first-person piece in the Los Angeles Times today about her impending birth is a candid, affecting counterpoint to a symposium the National Institutes of Health held last month in Washington, D.C.

With her first baby, born 2 1/2 years ago, Brodesser-Akner endured an emergency Caesarean section after 29 hours of labor, she writes. The experience left her traumatized. Now in the early weeks of her third trimester, waiting to deliver her second child, she is hoping for a vaginal birth after Caesarean, or VBAC.

The VBAC has been the subject of a lot of discussion lately. The NIH held a three-day conference on the topic that encouraged supporters of the VBAC -- and there are many -- by recommending that the VBAC be a more readily available option than it has been in the past.

In her essay, Brodesser-Akner writes, "I agree that women should have the right to try for a VBAC; I'm just not sure if they should try for one. Rather, I'm not sure if I should."

Of women who want a VBAC in a particular pregnancy, she writes, "the more honest and maybe the more uncomfortable way to say it, is that they want to give it a shot. They want a TOLAC, a trial of labor after a C-section."Pregnant Graffiti

Only 60 to 80 percent of women who attempt a VBAC actually get to have that vaginal delivery, Brodesser-Akner writes; the remaining women wind up getting another C-section. And perhaps 1 percent will have a uterine rupture (with a previous low transverse uterine incision, the most favorable for a VBAC; other types of incisions carry more risk), which can threaten the lives of both mother and child.

"When a uterus ruptures...things go wrong fast — and they go wrong big," she writes, adding that a high-risk obstetrician told her that one-quarter of those ruptures end in hysterectomies, brain damage and/or the baby's death.

"As that doctor said to me, 'The risk may be low, but it's 100% when it's happening to you,' she writes.

Brodesser-Akner is right. Every pregnancy is different, and I can assure you from experience that when you find yourself living out that small, shocking statistic, it is 100 percent real. And I am one of the lucky ones.

But why couldn't she be in that 60 to 80 percent of women who have the "normal" birth experience she says she desires? And if she births in a hospital with capable OB/GYNs who perform a good number of Caesareans -- and 24-hour anesthesiology coverage -- she should have the backup she requires in case of an emergency. That shouldn't be hard to find in Los Angeles.

Any birth can take a turn toward the worst-case scenario, and it's impossible to fully predict which ones actually will do so. It is probably all too easy for a woman who had a wretched experience during her last birth to imagine all the things that could go wrong.

But the numbers are with mothers in general; that is, the odds are in their favor. The fact that the pendulum might be swinging back toward a trial of labor in some challenging situations is, I think, a good thing. And I am by no means alone.

I would tell Brodesser-Akner what I tell my own daughters, not only about childbirth but about life in general: Don't let your fears rule your life. Don't be foolhardy, but don't think the cosmos is out to get you, either. I know it's a cliche, but it's true: The most dangerous thing many of us will ever do is ride around in  cars (or worse yet, on bikes), and nobody seems to spend much time worrying about that.

Whatever she decides, I hope Brodesser-Akner has a beautiful birth story to tell this time. It should be one of the best days of her life.

Image by Petteri Sulonen