Anyone "fight" a hospital for the right to VBAC, & win?

[danalyn]

If so, I would love to hear your story. 

I am 13 weeks pg with #7.   My fifth and sixth were both cs.  The thought of a 3rd CS makes my  stomach turn.  Hosp. currently has a vbac ban, though I've been told (by nurses at the hosp) that they are very close to getting epidurals there.  I'm thinking that would mean they'd then  have 24/7 annesthesia (sp?) on staff.  I was told previously that they have not, which is why there's a ban.  As i read what I'm writing , i'm shocked at how ridiculous that sounds.  A HOSP. WITHOUT ANESTHESIA (SP?) ALWAYS AVAILABLE?  GIMME A BREAK.  anyway, regardless, i would love to fight this hosp.on my RIGHT to birth, and my right to refuse major surgery... my vag. births have all been induced, 2 times i went 14 days "over".  I birthed a 10 lb baby once, and my other babe who was "late" was 8 lbs.  My first cs was b/c baby developed a 10cm ovarian cyst in utero (discovered at 33 weeks) and I developed severe polyhydramnios.  I've written about this before here.  2nd cs was b/c of the ban.  Nearest hosp that allows vbacs is an hour away, they wouldn't even attempt an induction til i was 2 weeks "over".  baby was born (cs) on due date, he was 10.3 lbs, had a true knot, and a neuchal cord.  ????????  anyway, that's my story.  I have an appointment this a.m with the doc (had her for my 4 most recents babes, and I really like her, she's very pro vbac so she says)  she's also chief of staff and I hope she can LMK how likely they are to lift the ban in the next few mos.  I may very well be going to duluth.  AND I WILL BE SEEING A CHIRO TO POSSIBLY HELP "NATURAL" LABOR BECOME A POSSSIBLITY.  i was in a car  accident 20 years ago, in which i broke my tail bone and pelvic bone, which may cause the "signals" to NOT work THE WAY THEY'RE SUPPOSED TO.  CENTRAL NERVOUS SYSTEM THING,  i guess,  allowing natural labor.  i saw this same chiro in the very latter stages of my most recent pregnancy.  anyway.......  would love to hear stories of mamas who have successfully fought a vbac ban. 

[lyterae]

I have not fought the ban... I decided that during pregnancy was not the time that I wanted to be fighting, our midwife is over an hour away (in good weather) and we are having a homebirth. The nearest hospital that "allows" a VBAC is also an hour away, but I know that it would require more interventions than I desire. If you haven't searched out ICAN, they may have more resources on fighting the ban.

[danalyn]

thanks, unfortunately HB is not an option for me.  :( due to not being able to afford one....

[lyterae]

Originally Posted by danalyn 

thanks, unfortunately HB is not an option for me.  :( due to not being able to afford one....

 I completely understand that aspect of it, we have to pay out of pocket as well.. Most of the midwives we've talked to are very accomadating with payment plans and what not. I would encourage you to ask if you haven't. :hug

It's a terrible spot to be in, I spent the first 8 weeks terrified that I was going to have to go to a hospital again and we finally started questioning our local midwives about potential payment plan information.

[Buzzer Beater]

OP I'm sorry I can't help you with a story of a win... or even a fight. The minute I got pg last year I started looking into my options to fight the ban here at our local hospital. I ended up with a lawyer whom I contacted through Barbara Stratton of ICAN of Baltimore. (You can contact her at ICAN easily.) Unfortunately the lawyer couldn't figure out a legal strategy and nothing came of it. Apparently since my hospital is private, legally they can offer or not offer whatever services they please. And give crazy dumb "excuses" for it involving lack of anesthesiologists.  Another option laid out to me in the beginning was to fight on a grass roots level- go to the media, hold rallies, picket etc. I'm just not that woman. I never did find a story with a positive ending, you know, some mama making the big guys change their policy. I still keep an eye on the media... maybe you'll be the one? I wish you luck on your journey and with your pg. I hope you get your vbac.

ETA I actually found out later through my ob and my gp that our vbac ban is written into the contracts of the anesthesiologists here, who refused to sit on call for vbacs. Apparently they don't mind being called for regular c/sec or other emergencies, but didn't want to hang around for some of us.

[cairomama]

An hour away is not far to go. I flew from Korea to the US (to my parents house) and then drove two hours for my VBAC. 

Why not meet with the practice at the hospital that is an hour away?

Work on positioning and watch your sugar in-take. 

[NewSolarMomma]

I'm with cairomomma- I passed up many hospitals that were closer to go to the one I wanted, and it was worth it! The hospital I chose was an hour and 20 min away, straight driving. BUT I had to cross the US/Mexico border at the busiest US crossing, then drive another hour, just to get there! my DH doesn't have a passport or fast pass like I do, so taking him can add 15 min to 3 hours!!! luckily my water broke at 1am so the line was short.

Even if the wait was 5 hours, it would have been well worth it! I cannot say how much difference a good hospital and OB makes! I couldn't say enough good things about the hospital I went to. The most striking thing about it was how before ANY procedure or ANYTHING, everyone always first told you what they wanted to do, explained it, discussed further if you had questions, offered an alternative if asked, and then asked permission. Even the cleaning lady politely asked if she could clean my bathroom while I was out of the room! From the Surgoen and Ob to the waitress that took my food order, every single person was ULTRA polite and supportive, nothing I asked for was to small for immediate attention with a good attitude too!

I can't imagine my labor had I been at a different, lesser hospital. I can only imagine a nightmare! My labor had been 36 hrs, plus 5 of pushing before the CS was discussed. Turned out DS was stuck! I was SOOOO scared, but the staff was so amazing it made all the difference. Plus, they are hardcore about BF and had lactation nurses there right away, and as often as requested, and had birth balls and other related stuff to use- no stirrups! I am planning my VBAC there, I would not go anywhere else even if I had to fly to get there. (I chickened out on HB)

sorry to ramble, in short I just wanted to say that a GOOD hospital or MW is WORTH the added hassle and drive. If its really far, or you are scared of precipitous labor, say in a hotel nearby. The $ cost is less than the emotional cost of a traumatic birth at a place you hate!

Good luck!

[courtenay_e]

Fighting the ban won't work.  They don't care what the evidence says.  Your best bet is to travel farther to a hospital that SUPPORTS (not just allows) VBAC, OR to calll all of the homebirth midwives in the area and FIND one who will work with you.  There is almost ALWAYS one or two midwives in an area who will either cut her fee or allow you to make payments till the cows come home. 

[buckeyedoc]

It's not ideal, but there are women who show up in labor and decline a c/s. It's best to have a good support group with you (partner, doula) for confidence.

[TCA2008]

I encourage you to write a very clear letter to the hospital you intend to birth at stating you do not intend to consent to a repeat c-section.  Enclose the current VBAC guidelines issued by ACOG which state no woman should be forced into a c-section.  ACOG also states a woman with two prior c-sections should be offered a VBAC, and as you have already had 4 vaginal deliveries, clearly a VBAC is indicated in your case.

http://www.acog.org/from_home/publications/press_releases/nr07-21-10-1.cfm 

In your case, clearly a repeat c-section has more risks, you should state that in your letter.  Send it certified to the head of OB, anesthesia, risk management, and the head nurse of OB/GYN

Even if you choose to go to another hospital, send this letter, hospitals need to hear from more women who refused forced c-sections.

BTW, I had a homebirth after two c-sections, but originally, I was planning a VBA2C at a local hospital that didn't allow VBACs after more than one c-section.  I wrote letters, met with them, and they agreed to make a "special exception" for me. 

Now is the time to fight them, get everything in writing.  In your letter, offer to meet with them to show them the evidence that your life is in much greater danger from a repeat cesarean, and if the hospital attempts to force you into surgery against your will, you consider this a blatant violation of your right to bodily autonomy, and a clear violation of ACOG's ethics policy.

You can pm me if you'd like to see my letters or other studies I have.

Challenge them!

Also, definitely bring a doula or additional support person with you, stay at home as long as you can, and make sure you bring all of your written letters so the doula can be clear "She already clearly wrote in her letter she will not consent to a repeat c-section because of the risks.

[mrsberman]

I haven't had to fight policy and I pray I don't. I spoke with my MW about it (I have to drive an hour to see her because the hospital 3 minutes from me has a "ban") and she said she wouldn't recommend trying to fight it or showing up pushing. When I spoke to her about the new ACOG guidelines she said that no one is listening to them (at least in our area). The whole situation is frustrating.

[jenniro]

I know you posted almost a month ago, but I am so excited that I almost wet myself.  I was in a car accident 16 years ago and broke my pelvis (non-displaced and healed well).  When I went into labor with my first child, I had many unneccesary interventions that ended in a c-sec.  My doc said my car accident made it impossible for babies to engage in my pelvis.  When I get preg, I am determined to have a VBA2C and it is so nice to hear that a car accident did not stop you from delivering vaginally. 

As to your question about VBAC bans.  I live in a very small town that has a small hospital with a VBAC ban.  They do have a surgical staff and perform c-sec and general surgeries, but obviously no OR staff in house 24/7.  What do they do if a FTM has an obstetrical emergency?  The same thing they would do if I have an emergency!  Call in the staff or the doc might take the baby out right there in the delivery room.  I understand the risks of a VBA2C and I understand the risks of a 3rd section.  The town is small enough (pop 3000) that I know all the docs and maybe one of them will work with me, but if not, I plan on staying home as long as possible and refusing a c-sec.  Not ideal, but it is what I've got to work with.

VBAC bans are more about lawsuit prevention, and  hospital administrators and insurance companies making medical decisions they are not qualified to make.  It has very little to do with safety of mom and babe.  You may not get the ban lifted before you give birth, and if another hospital that is supportive is an option, I would advise going there.  Maybe losing your business can be a protest to the ban, and if more women demanded safer birthing practices, it might change the climate surrounding VBACs.  If the ban hospital is the only option, you might have to fight in labor, which is not fun.  I went to a hospital 2 hours away in another state to attempt a VBAC.  Had been doing prenatal with one doc who was not on call when I was in labor and found out when I got there that they weren't really supportive, just tolerant, and ended up with another c-sec after trying to fight for 12 hours.  So, if fighting while in labor is the only option, have someone to support you.

[A_Random_Phrase]

You could lurk on the UC forum to see if that might be an option for you if you are unable to succeed in your fight for your rights - or if it looks like it might be too much of a battle. http://www.mothering.com/community/forum/list/306

[LisaSedai]

I just read on another board a VBA2C Mom got her delivery in a Ban hospital in Florida. Her Dr scheduled her for a RCS at 38 weeks and she didn't show for it. He called her and she told him she wanted to wait until labor so the baby could at least choose his birthday. He reluctantly let her. Think she went to 41 weeks and went into labor. She put off going to the hospital until she knew she was really far along. The ER Dr checked her and she was 8cm. They sent her to L&D and they were trying to make her consent for C/S and she kept screaming NO at them, that she had to push. Then they tried to get the husband to consent and she screamed NO at him too. The Dr gave up and she delivered vaginally after like 4 pushes. The Dr is getting reviewed by the hospital, I guess they are not pleased that he wasn't a good enough bully to force her to get cut.

[A_Random_Phrase]

Oh, LisaSedai, that is choice. I don't know whether to laugh or cry.


At least she was smart enough to circumvent the system.

I was talking to a lady a few months ago that works at the hospital where I had my last child. I told her he was vaginal. (She had been there for my first baby, which had been a c/s). She told me that they always did c/s for a c/s mom - no vbacs (even though my second baby was vbac, in another state) and that I had been lucky to have had my last child in that window of a year or two when they were "allowing" vbacs.

Sometimes we don't really know how blessed we are, until much later.

[danalyn]

Coming back to this thread that I started.  Thanks to those who have responded.  I am now 23/24 weeks.  Please, I hope no one flames me for this, but I haven't even started my OB care.  I did make calls to the hosp.   an hour away that allows VBACs, only to be told that no one is supportive of a VBA2C.  well, a couple OBs there "might" be but it's unlikely, so the nurse told me.  She told me I'd have to be prepared for the likelihood of an on-call doc not letting me continue to labor if I wasn't progressing.  I was stunned.  I said how could the doc stop me?  She then told me my potential reg. OB and I would have to come to some sort of agreement beforehand regarding how long I would labor.   OMG.  and she was serious?  well, I do have to be realistic.  Have I spoken here about my history of NOT going into labor "naturally"?  I can't remember.  well, that's how I've been for all of my 4 vag. births.  so, there are not many  induction options for VBACs, correct?  I'm just going to HAVE to go into labor on my own, somehow.  that's why I'm just going to go to my reg.  OB near home.  When it's time,i will go to the hosp (with the ban) and give birth.  sounds good to me.  :)        

ETA:  I wanted to say that I am SO excited to go through this forum & read all the awesome threads! 

[A_Random_Phrase]

I was six months along before I got prenatal care with child #2 (first vbac) and 5 or 6 with child #3.

[mommyrebecca919]

Originally Posted by danalyn 

Coming back to this thread that I started.  Thanks to those who have responded.  I am now 23/24 weeks.  Please, I hope no one flames me for this, but I haven't even started my OB care.  I did make calls to the hosp.   an hour away that allows VBACs, only to be told that no one is supportive of a VBA2C.  well, a couple OBs there "might" be but it's unlikely, so the nurse told me.  She told me I'd have to be prepared for the likelihood of an on-call doc not letting me continue to labor if I wasn't progressing.  I was stunned.  I said how could the doc stop me?  She then told me my potential reg. OB and I would have to come to some sort of agreement beforehand regarding how long I would labor.   OMG.  and she was serious?  well, I do have to be realistic.  Have I spoken here about my history of NOT going into labor "naturally"?  I can't remember.  well, that's how I've been for all of my 4 vag. births.  so, there are not many  induction options for VBACs, correct?  I'm just going to HAVE to go into labor on my own, somehow.  that's why I'm just going to go to my reg.  OB near home.  When it's time,i will go to the hosp (with the ban) and give birth.  sounds good to me.  :)        

ETA:  I wanted to say that I am SO excited to go through this forum & read all the awesome threads! 

This sounds a lot like what was going on with me. I am planning a HBA2C or VBA2C in a birthing center in April. My OB who I still see, but will cut off care before he schedules my c/s, does not do VBAC's only after 1 c/s. I found a midwife about 45 minutes away more than willing to take me. I do have to pay out of pocket, but my insurance is more than likely going to reimburse, atleast a portion of it. Since I am seeing her so late in my pregnancy (Ill be 31 weeks this Wednesday) she is really working with me and I will be making payments, however I am giving her a good chunk upfront this week. There are 2 hospitals here, one with a VBAC ban and the other doesnt have one, but all OB's who deliver there wont do them after 2 c-sections. Im pretty sure VBAC at home are illegal in the state of New Mexico, but my midwife 45 minutes away is in Texas( we are right one the state line) so if it turns out it is illegal for her to attend a HBAC I will just be birthing in the birthing center over there. Sounds like you got a good plan, I hated to "fight" with a hospital/doctors, which is why a midwife was the answer for me. I know many will work with you on payment if you explain your situation and most insurance reimburse a portion.