2/20/09

VBAC and Forced Repeat Cesareans


Time magazine just released an article about VBAC and forced repeat cesareans, called The Trouble With Repeat Cesareans. With a few exceptions, ICAN (International Cesarean Awareness Network) has contacted every American hospital that has a maternity ward. As you'll see in the article, 28% of U.S. hospitals have an outright ban on VBACs, and another 21% have a "de facto" ban: while VBACs are technically allowed at the hospital, no doctor will attend them. To find out the VBAC policies in your local hospitals, visit ICAN's VBAC policy database. I know for a fact Oklahoma MDs are known for refusing VBACS. In fact the only way to have a VBAC here is to have a home birth with a midwife or deliver at OU and I believe Dr. Robert Ryan at St. Anthony's is now offering VBAC's.

I was just talking to a friend last night and because she had a emergency Cesarean her OB told her she would HAVE TO have a Cesarean with her current pregnancy. She was even lead to believe that VBAC's are illegal in Oklahoma!!!

The fact is that many MD's REFUSE to offer them because they believe they are more likely to get sued for malpractice if they don't cut than if they do. The fact is that the risk of intrauterine rupture is very low for Cesareans and they are (in my opinion) more risky than a standard VBAC.

I also believe that some MD's prefer cesareans because they can have a "convenient" labor. This topic makes my skin crawl because it seems to become less and less about the mother's right to choose or about her quality of care. It saddens me, and I hope we can increase awareness here in Oklahoma (and everywhere) about VBACs.

According to the Patient Care Partnership of the American Hospital Association, you have the right to refuse recommended treatment, including a cesarean section.

If you refuse a recommendation, alternative treatment should be provided. In this case, a VBAC. You can also sign informed consent form for a VBAC stating that you understand the risks and benefits of the procedure, which should negate any issues with malpractice.

I think access to VBAC is one of the most pressing maternity care issues in this country, along with the disturbingly high cesarean rate (31.1% as of 2006).

Please advertise this article widely, making sure to link to the original article on Time's website. The more traffic it gets, the longer it will remain online.


From the article:
For many pregnant women in America, it is easier today to walk into a hospital and request major abdominal surgery than it is to give birth as nature intended. Jessica Barton knows this all too well. At 33, the curriculum developer in Santa Barbara, Calif., is expecting her second child in June. But since her first child ended up being delivered by cesarean section, she can't find an obstetrician in her county who will let her even try to push this go-round. And she could locate only one doctor in nearby Ventura County who allows the option of vaginal birth after cesarean (VBAC). But what if he's not on call the day she goes into labor? That's why, in order to give birth the old-fashioned way, Barton is planning to go to UCLA Medical Center in Los Angeles. "One of my biggest worries is the 100-mile drive to the hospital," she says. "It can take from 2 to 3 1/2 hours. I know it will be uncomfortable, and I worry about waiting too long and giving birth in the car."Much ado has been made recently of women who choose to have cesareans, but little attention has been paid to the vast number of moms who are forced to have them. More than 9 out of 10 births following a C-section are now surgical deliveries, proving that "once a cesarean, always a cesarean"--an axiom thought to be outmoded in the 1990s--is alive and kicking. Indeed, the International Cesarean Awareness Network (ICAN), a grass-roots group, recently called 2,850 hospitals that have labor and delivery wards and found that 28% of them don't allow VBACs, up from 10% in its previous survey, in 2004. ICAN's latest findings note that another 21% of hospitals have what it calls "de facto bans," i.e., the hospitals have no official policies against VBAC, but no obstetricians will perform them.Read the rest of the article here.

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