Ban on VBAC at SE Mass. hospitals

[karen ann]

I usually don't post on this forum, but I saw something that'll probably be of interest here. While I was at my great-aunt's house in Fall River, MA yesterday, I saw the lead article of the Fall River Herald News was a protest at St. Luke's Hospital over Southcoast Hosptials Group's new policy.

As of June 1, all hospitals in the Southcoast Hospitals Group, St. Luke’s, Charlton Memorial Hospital in Fall River and Tobey Hospital in Wareham, will no longer allow women who have previously had C-sections to have vaginal deliveries.

(link to full article)

There's a link at the end of the article to post an opinion.

[dukeswalker]

Ugh!!! : That BURNS me!!!! In AZ we're having a similar problem. For whatever reason in the metroponitan Phx. area there isn't a single hospital on the East side that will allow a VBAC mom to give birth there. There have even been reports where a VBAC mom has shown up and they have told her that they would be STOPPING her labor to do a c-section!!!! ARE YOU KIDDING ME????? So - In order to give birth the way it was intended my dh and I are driving 45 minutes (1.25 hours in rush hour) to the closest hospital that will "allow" a VBAC.

My midwife actually has a mom who is driving down here from a town about 2 hours from her office to give birth at a hospital 3 hours from her home becuse after having 1 c=section followed by 4 VBACs the hospital in her town will not allow her to give birth there...

[Greaseball]

Actually, if you want to give birth the way it was intended...well, you know.

I hear a lot of these no-VBAC hospitals are even making women who have had vbacs in the past have a csec instead! Even though she has a "proven uterus" and all that.

Maybe letter-writing would work. Tell your hospital you will be choosing another one, or a home birth. I even read something from ACOG saying they were questioning their own vbac guidelines because since a lot of hospitals were not able to comply with them, women were choosing *gasp* home births!

Most women have a better chance of a vbac if they refuse to follow ACOG guidelines.

[cottonwood]

It's going on all over. Here too.

[Colorful~Mama]

dukeswalker - i had a wonderful vba2c experience at phoenix baptist hospital last july.

just thought i'd mention that the midwife, nurses...everyone was terrific

[dukeswalker]

colorful-mama:

That is GREAT to hear!!! Thats actually where we plan on being when this little one comes into this world! Did you work with one of the midwives from the Birthing Center? Also - how much interevention did you have? This will be my 2nd VBAC and I am wondering how they are going to be about trying to insist upon constant monitoring/iv/etc...

[pinky]

Gosh, I am so spoiled! I am planning a hospital VBAC, and no-one is treating it like anything other than a normal low-risk birth. (Well, my midwife did suggest that I might want to consider not doing all of my laboring at home.) In fact, everyone I've dealt with has just said, "You're planning a vaginal birth, right?" Of course, I'm dealing with midwives and family practice docs, so I guess they're not the norm....though my understanding is that there are plenty of OB's around here that do VBAC's as well.

I can't imagine how it would feel to be told that I must have elective major surgery in order to birth my baby. That's CRAZY!

[Foobar]

I read a similar article about 1 week ago. My DH was furious (nope, I did not have a c-sec) that anyone would be forced to have major surgery because of a 1-2% chance of a problem.

He thinks it is a money maker, I tend to agree

[Colorful~Mama]

Thats actually where we plan on being when this little one comes into this world! Did you work with one of the midwives from the Birthing Center? Also - how much interevention did you have? This will be my 2nd VBAC and I am wondering how they are going to be about trying to insist upon constant monitoring/iv/etc

Heather...
Yep, i worked with Suzanne at the birthing center, tho Maryanne was on call and helped catch Roman when he came. I had very little intervention. I didn't go to the hospital till my water broke and i was in active labor. I was at 5cm when we got there and contrax were intense and 2 minutes apart. I got there at 11pm and gave birth at a few minutes before 1am.
I didn't care by the time i got there bout monitoring honestly. Told them to go ahead and hook me up to whatever the hell they wanted. lol. I was screaming for an epi i think and saying 'hell with natural childbirth' at that point. lol. But i had a great personal coach (she's a mama here on mothering) with me and dh was great. they stalled till it was too late for meds and i was pushing.
So he came naturally and midwife caught. They respected my wishes to let the cord pulse. then my teenage dd cut the cord. They never took him from me till we were ready to let them weigh/clean him off while i got my two little stitches. Then he was with me and we coslept all night. No one tried to take him, bathe him, give him anything - they respected my wishes against eye ointment etc.
they pretty much left us alone and checked in to make sure i had something to eat/drink was comfortable etc. We were discharged at noon the following day. woulda been sooner i'm sure but ahad to wait for the ped to do his rounds and he was late . go figure.
it was a great experience really for a hospital birth.

Good luck

[pinky]

Originally Posted by Foobar

He thinks it is a money maker, I tend to agree

I agree that it's about money, but I don't think it's about higher fees from cesareans. It's about fear of litigation. In a way, it's the ACOG's fault--part of their VBAC guidelines include 24-hr emergency access to an immediate cesarean, which many hospitals cannot/do not provide. So hospitals are running scared that they will be liable if there is a VBAC that goes badly and they weren't able to provide that "immediate" cesarean. I don't know about this particular case, but it's my understanding that in at least some areas, hospitals are banning VBACS against the wishes and advice of their attending docs.

Never mind that there are other complications that occur more frequently (like fetal distress) that have an equal or greater need for an immediate cesarean, and that doesn't prevent hospitals from delivering babies. It's not hard to argue that if a hospital can't provide an emergency c/s fast enough to make VBAC's safe, then they don't have any business delivering babies at all.

Ack! All this makes me crazy! Why can't health care be based on RESEARCH and EVIDENCE-BASED STUDIES instead of FEAR OF LITIGATION???

[gurumama]

That is just WRONG. I posted a "reader opinion."

[jennay]

Originally Posted by pinky

Gosh, I am so spoiled! I am planning a hospital VBAC, and no-one is treating it like anything other than a normal low-risk birth. (Well, my midwife did suggest that I might want to consider not doing all of my laboring at home.) In fact, everyone I've dealt with has just said, "You're planning a vaginal birth, right?" Of course, I'm dealing with midwives and family practice docs, so I guess they're not the norm....though my understanding is that there are plenty of OB's around here that do VBAC's as well.

I can't imagine how it would feel to be told that I must have elective major surgery in order to birth my baby. That's CRAZY!

That was my experience here in Maryland as well...my OB practice is highly supportive of VBACs. I feel so blessed I was able to have my VBAC the way I did! Of course, I got to the hospital 7-8 centimeters dilated and he was born less than an hour and a half after I got checked in. No one had any time to give me any grief!!!

Before the nurse checked me and saw I was almost 8 she said I didn't need to be hooked up to the monitors the whole time (which I was expecting) and said I could walk around.

After Ben was born at least two nurses came and "welcomed me" to the VBAC club!

I would be infuriated if someone tried to tell me I had to have a c-section after I'd already had a VBAC!!!

[Piglet68]

My OB said he would be supportive if I wanted a VBAC. I was surprised given that this is the Midwest.

When I had my U/S I was asked to participate in a study of uterine wall dimensions in "normal" pregnant women. The doc looked at my scar and said it was a nice healing. When I asked if such technology could be used to screen women who might be at risk for rupture, thus allowing more women to go ahead with VBAC, she said she hoped so and that it was something they were working on.

One of our physician researchers was telling us the other day about a friend of his who is an OB and was successfully sued for malpractice: the baby was born with spina bifida and the mother sued b/c he didn't make her have a C/S. You will not believe the amount awarded:

THIRTY MILLION DOLLARS.

The US needs to put a stop to these ridiculous cases. Parents go into it thinking doctors are GODS and just blindly do whatever, then sue the pants off them when things don't go perfectly. This is just WRONG.

Honestly, the more I hear about these cases the less and less I blame the OB's and the more I blame the legal system. Our docs all agreed that the high rate of C/S was almost solely litigation-driven. And they all thought the rate was WAY too high here (again, surprised me, given some were just residents and again, we're in a pretty conservative part of the country).

[spero]

Most of the local hosps in my area no longer offer the VBAC option. Even if you've VBACd there before

I don't blame the medical community. I blame our litigious society. If judges would stop handing out these ridiculously insane malpractice settlements left and right, this wouldn't be happening.

[Mom2baldie]

Pinky,

In my area, its the other way around. The local hospital doesnt have an official stance on VBACs but all of the OBs that deliver out of there refuse to allow VBACs.

It is totally about fear of litigation, but if you are a woman who may not be completely informed about the matter, you will be told that it is because they arent equipped to handle a rupture if it occured. However, they routinely perform AROM. I wonder if they are able to manage an emergency cesarean when a cord prolapses? Why yes, they are.

Either way, it sucks.

[JayGee]

Ugh, this burns me too....

I just had a wonderful hospital VBAC on March 28, and found out recently that the hospital where I delivered began banning VBACs on April 1!!!! Talk about getting in under the wire !

[lollaleeloo]

Originally Posted by Greaseball

I hear a lot of these no-VBAC hospitals are even making women who have had vbacs in the past have a csec instead! Even though she has a "proven uterus" and all that.

I live in upstate NY and that is the policy for both hospitals in Saratoga and believe it or not, I actually took this into account when making travelling plans during my last pregnancy. I actually refused to go to our company's Christmas party because it was held too close for comfort to one of the hospitals in question. No way was I going to risk having all my plans & preparation tossed out the window due to a random encounter with hospital administrative policy.

One of my coworkers' wives just had their first child via FTP c-section (at 23!) and they live in Saratoga county. She told me how disappointed she was that they didn't discuss the possibility of her having a VBAC because she heard they're much easier to recover from and they always wanted a big family. I didn't have the heart to tell her that the reason they didn't discuss VBAC with her is because she'll never have one if they have any say in the matter. We are right back to Once a C-section, Always a C-section, and most women are never informed that the first surgical birth they consent to will very likely condemn them to a lifetime of surgical births. It's bad enough that they've added so many dangerous interventions that they've made vaginal births in hospitals almost as dangerous as first time surgical births. When you consider that these automatic repeat c-sections are performed primarily for benefit of the doctor and the hospital, and not the woman or the child, you can see why it's becoming impossible for me to discuss the matter without launching into a careening bug-eyed rant every time. She's currently deep into processing her way through the usual "they said we would have died" issues, so I decided to bite my tongue in order to avoid making her feel put on the defensive (having seen that particular cloud from both sides now). In any case, she'll find out soon enough what lies in store for her when they get ready to have another baby.

---
eta:
It's still possible to have a VBAC in most hospitals in Albany county (where I live now) & Schenectady county (where I had 2 children), but not all, since this policy is spreading across NYS as well.

[KKmama]

Pinky said:

It's not hard to argue that if a hospital can't provide an emergency c/s fast enough to make VBAC's safe, then they don't have any business delivering babies at all.

That's what I keep coming back to.

[Attached_Mom_to_7]

I actually live right here in F.R.,MA, and my friend whom is due in Oct. is being forced to have a section. SHe is on her fifth child and she had a section with her first then had 3 successful VBACS. Whenever she told me this one, I just could not beleive it myself!!! She may try to goto R.I. I just don't think it will be an option for her

[Kerlowyn]

Attached_Mom_to_7

If your friend is looking to get into Womans & Infants, she may want to be sure she has an awesome midwife. Back in my doula days, I went to many births there, they are highly interventional! W&I is 10 minutes from my house, but I am having my baby in December at Mt Auburn Hospital in Cambridge instead, even though it is an hour away. I had DS2 there in 2002, and I could,not believe how hands off they were, during the birth and afterwords!

According to their literature: "32% of mothers who had previously had a CS attempted a VBAC and of those women 66% were able to have a vaginal birth"
I have also heard good things about Sturdy Hospital in Attleboro.

Some MDC mommas had a demonstration at St Luke's Hospital in New Bedford MA back on May 27th. I could not make it, it was my prime time for morning sickness <yuck> Maybe one of them will post here and tell us how it went???