Originally Posted by Storm Bride
I think I agree that a fully informed mother should have the choice of birth. However, we're talking about what OBs support. And, the same professionals who jumped all over a woman's "right to choose a cesarean" don't seem to believe that women have the right to choose a homebirth or a VBAC...and god forbid choosing a VBAC at home. I think that's a fairly serious double standard.
Also - fully informed is an interesting concept. I've had three c-sections that I didn't want. I've only been "fully informed" if there is no risk to a c-section, because no doctor involved in my care has ever so much as mentioned any risk to me. My first one was done over my protests and I was bullied and coerced (to my lasting regret) into my second and third. Nobody thought I had any right to choose whether or not I was unnecessarily cut open. Nobody thought I had any right to choose (or even know!) which drugs were pumped into my body. But, now that they've done the damage, they're very willing to defend my right to "choose" to have it done again.
I hope none of the women who want to choose an elective primary cesarean with no medical indicators mistakenly believe that they'll have any further right to choose, if things don't go as well as they're expecting.
1. OB's can and do tell women every day that they will not attend a VBAC delivery if that is how mom chooses to deliver. At this point in time, it often has very little to do with what the OB thinks about VBAC at all, it's more about the fact that malpractice premiums for docs who attend VBACs are through the roof (if they can even get coverage, since many policies now refuse to cover the doc in the event of a lawsuit resulting from a VBAC attempt). It's about the fact that many hospitals across the country are unable and/or unwilling to meet the very strict guidelines set forth by ACOG for VBAC patients. Malpractice carriers for hospitals are also refusing to cover hospitals who are sued as a result of a VBAC gone wrong.
As for a doc not 'allowing' a woman to have a homebirth...how exactly are they going to STOP her from doing so? They certainly aren't likely to pat her on the back and tell her to 'go for it' with their blessing, but they can't FORCE her to go to the hospital, so I fail to see how an OB being unsupportive of homebirth or HBAC is even applicable to the discussion.
2. You had THREE c-sections and never signed a consent form for any of them? I truly am shocked. Speechless. What hospital(s) did this occur in? My understanding is that a consent form MUST be signed by either the patient or patient's next of kin if patient is incapacitated. The only way they could section you otherwise is if you presented unconscious with no next of kin and you &/or baby were in danger of dying.
3. A woman can CHOOSE to birth vaginally (or attempt to do so) after a dozen c-sections. She is unlikely to find a midwife willing to attend her birth, but NOBODY can FORCE her to have surgery again. Ever.
I do think it's a sucky choice to put a woman in...either ERCS or VBAC with no licensed provider present at the birth. However, women suing for VBACs gone wrong has done much to create the current climate where malpractice carriers aren't willing to take the risk of paying out millions of dollars when a VBAC goes wrong and mom wants someone to pay for HER decision to take that risk to begin with.
I also believe that a woman who CHOOSES to have an elective section should understand that it may very well be impossible to find someone willing to attend any future attempts at vaginal birth. That's part of the package deal of asking for an elective section IMO and should be explained and discussed fully prior to surgery. It should also be discussed that some women' can only 'handle' a limited number of sections, so if she wants a half dozen kids, elective primary c-section isn't a very good plan overall. To me, those are part of the risks associated with elective primary c-section and should be covered under informed consent.
In the end, there's a big difference between woman being unable to find a doc willing to attend a VBAC attempt and a woman being unable to find a doc willing to perform a c-section. The woman refused a VBAC *can* choose to have her baby vaginally right by herself if it came down to it and was THAT important to her. The woman refused an elective section can't just hack her belly open when the time comes. She *must* have a doc willing to operate, thus the doc truly does hold all the cards in that particular situation.