How does a "VBAC Ban" work, anyway?

SAMarshall · 10-23-2009, 01:18 PM

I understand that some hospitals have policies due to insurance or whatever it is that say they can't "do" VBACs, but what does that mean exactly? I mean, do they actually refuse women who are in labor at the doors unless they consent to an immediate c-section? Can they actually force a woman to have a c-section or leave the hospital? From what I understand, no one can actually be forced to undergo surgery, so how do they enforce the policy? I know there are court orders and things like that, but those take time. I guess I just don't understand the politics of it all.

~RememberToForget~ · 10-23-2009, 07:28 PM

I'd be interested to know what others say about this as well but at my hospital it had been said by someone that "if you came in pushing you would end up with a c/s."

mamatolevi · 10-23-2009, 07:39 PM

Under federal law any hospital that accepts federal money cannot turn away a woman in labor for any reason. You have the right to refuse any procedure.

VBAC ban hospitals can't legally force you into surgery but they can do tons of other things to make you pretty freakin' miserable. Badgering, refusing to let you out of bed, playing the dead baby card, making you deal with all kinds of policies and procedures... I know that one hospital in Tacoma WA with a vbac ban WILL NOT allow any vbac mom who comes in to have anesthesia services or pain medication unless she consents to surgery. Gotta love those ethics.

Some hospitals actuall threaten to get court orders to force c/s. I don't know how often they actually go to the trouble though.

SAMarshall · 10-23-2009, 07:53 PM

I decided to try to find more info online. I googled "what is a vbac ban?" and found a few interesting sites. It seems that legally and ethically, there really isn't such a thing, but as the previous poster said, they sure can try to make things difficult.

http://icanofportland.org/VBACBan.aspx

Anyone else have any insight?

khaoskat · 10-23-2009, 08:55 PM

Basically don't sign the consent forms they present you with, otherwise you are consenting to do whatever the docs feel best.

They can threaten, but often times by the time they get the consent order it is too late.

**SalmonBayDoula** · 10-23-2009, 09:01 PM

Here is a great link to more information from the International Cesarean Awareness Network, about the Emergency Medical Treatment and Active Labor Act which says that a hospital can only transfer a laboring woman if she is not in active labor, and if she presents in active labor, they must provide treatment, and may not due a cesarean without consent!

As mamatolevi stated, they can make life pretty miserable, but they cannot assault you or tie you down in order to perform surgery.

Can they deny you pain meds??? can't believe this meets The Joint Commission (Formerly JAHCO) regulations.

ICAN has some great resources about dealing with VBAC bans!

Good luck!
Sharon

crescentmoonmama · 10-23-2009, 09:21 PM

Actually, there are quite a few documented cases of court ordered Cesarean sections. Additionally, I am aware of some ICAN mothers who were sectioned while protesting - no court order was obtained. One of the mothers brought a law suit against the hospital and practitioner and lost.

While this should not be happening, it most definitely does. EMTALA only requires that you receive treatment - the standard of care (hospital protocols including VBAC policies are part of that standard, unfortunately).

Theoretically, patients are supposed to be able to refuse procedures but more than a fair share of doulas and other support persons have witnessed the diminished authority that parents have once they have shown up for that "standard of care."

It's the difference between theories and reality.

mamatolevi · 10-24-2009, 08:03 PM

I need to correct what I said earlier. I stated:

" I know that one hospital in Tacoma WA with a vbac ban WILL NOT allow any vbac mom who comes in to have anesthesia services or pain medication unless she consents to surgery."

Upon further thought about my conversation with the L&D nurse from that hospital, she only said that anesthesia would not provide services. She did not specify no pain meds and I did not think (in my astonishment) to confirm if pain meds were included in the ban.

DocsNemesis · 10-24-2009, 08:46 PM

Wow, which hospital is that? You can PM me if we're not supposed to name hospitals, I'm just curious-I'm from Tacoma and don't live far from there now.

I second not just signing consent forms willy nilly as well. I actually had fun with that with my first, I went through the papers and crossed out anything I didn't like, initialed them, and then signed the forms. I don't know how *legal* that is, but its what I did and the hospital seemed highly annoyed with me, lol. I was just trying to be a bratty 18 year old, I guess I succeeded. Oddly I almost had a cesarean with him and refused, I don't think it had to do with the forms, but who knows-he didn't argue with me, he just did a huge episiotomy and my son was born all of 10 seconds later (even as an 18 year old, having a cesarean when my sons head was RIGHT THERE just didn't make sense to me).

Anyway, definitely read those consent forms before you sign!