"The hospital won't allow." Who is "the hospital"?

[Ambivalent Dreams]

I am 41 weeks and planning a VBAC. My OB and I agreed early on that as long as baby and I are healthy, we would not attempt an induction or c-section until I was 42 weeks. Now, she tells me that if I do not go into labor on my own, she cannot do an induction because of my previous c-section. She says the hospital won't allow it and she will have to do a repeat c-section.

Who exactly is "the hospital"? I want to talk with them and plead my case.

[alicia9178]

"The hospital" is essentially the lawers and their insurance company. What they are essentially saying is that they will not cover the Dr. to do an induction because if something happens they can get thier pants sued off. Hospitals are all about policy that covers their butt essentially.

[turnquia]

Originally Posted by alicia9178

"The hospital" is essentially the lawers and their insurance company. What they are essentially saying is that they will not cover the Dr. to do an induction because if something happens they can get thier pants sued off. Hospitals are all about policy that covers their butt essentially.

Yup this.

However you can explicetly say I do not consent to a C-section. Your violating my patient bill of rights. If you look on the ICAN site they have all sorts of information on helping navigate things.

They cannot force you into anything. They can push your doctors hand at things, but they cannot make you do anything. Nor can they refuse to treat you if your doctor says for medical reasons that you need an induction at 42 weeks. You can also throw in and cite NUMEROUS studies that show repeat c-sections are less safe than vaginal delivery. But be careful if you do choose induction, because certain methods make a VBAC more dangerous (but sounds like your doc knows this)
Good luck!

[AlexisT]

I'm not sure you can make them induce. You can refuse a section, and wait for labor. IOW, you can refuse treatment. But you can't make them give you a treatment they don't want to give. They also have the right to refuse to perform an action. Labor is simply what will happen if you keep waiting, so you're not making the doctor do anything by refusing a section. But they have the right to refuse to hook up that bag of Pit.

[~Em~]

Originally Posted by AlexisT

I'm not sure you can make them induce. You can refuse a section, and wait for labor. IOW, you can refuse treatment. But you can't make them give you a treatment they don't want to give. They also have the right to refuse to perform an action. Labor is simply what will happen if you keep waiting, so you're not making the doctor do anything by refusing a section. But they have the right to refuse to hook up that bag of Pit.

Right - you can't. The hospital policy and the doctor's insurance are separate, though. Even if the doc is cool with it, he/she cannot perform treatments that the hospital prohibits. If the doc does so, he/she will have their privileges revoked and their livelihood compromised - and I doubt other hospitals would want to work with someone who ignores the rules. There are probably other legal ramifications, too, depending on the contract she/he has with the hospital.

While there are more natural methods of spurring on labor that you could look into, Pit and cervadil are generally contraindicated for VBACS because they do carry extra risk of UR.

[womenswisdom]

IF you decided induction was appropriate at 42 weeks (and you will most likely go into labor before then anyways), then maybe discuss the possibility of a foley bulb induction. That would not increase your risk of rupture, since it is mechanical induction and not chemical/hormonal. Of course, you could just continue to wait it out even after 42 weeks and they will not come to your door and make you have a RCS!

[alicia9178]

Originally Posted by turnquia

Yup this.

However you can explicetly say I do not consent to a C-section. Your violating my patient bill of rights. If you look on the ICAN site they have all sorts of information on helping navigate things.

They cannot force you into anything. They can push your doctors hand at things, but they cannot make you do anything. Nor can they refuse to treat you if your doctor says for medical reasons that you need an induction at 42 weeks. You can also throw in and cite NUMEROUS studies that show repeat c-sections are less safe than vaginal delivery. But be careful if you do choose induction, because certain methods make a VBAC more dangerous (but sounds like your doc knows this)
Good luck!

HOWEVER....if your water is not ruptured and you are not in "active" labor, they can make you transport to an appropriate facility, which would suck in labor.

[Amatullah0]

Originally Posted by alicia9178

HOWEVER....if your water is not ruptured and you are not in "active" labor, they can make you transport to an appropriate facility, which would suck in labor.

But don't they have to provide the transportation, according to EMTALA? (I'm not sure about this one)

But OP, good luck! I would suggest hiring a doula, and a different hospital or a homebirth/freestanding birth center midwife, or even considering UC.

And to your question of "who is the hospital" I half want to suggest that you go to the hospital, stand out side of the building, and ask the brick "so why can't I have my VBA-VBAC?" and see what it says. And bring your OB with you.

ETA: many midwives, and doulas will offer their services at a reduced rate, on a payment plan, for free, or even for barter, to women who can't afford their fee.

ETA: OH WOW! I just realized how far along you are now, 42 wks, huh? So, how are you doing? Baby yet?

[ckberkey]

Are you still PG? Would love to know how it worked out. I hope you are babymooning right now.