OB/hospital won't "allow" VBA2C -- what to do? - Page 2 - Mothering Forums

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#31 of 40 Old 06-28-2006, 05:42 PM
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yeah, there is a med school here: Oregon Health Sciences University (OHSU) but they don't work with the insurance provider this mama has...

waiting to hear from my sister doulas who hopefully have suggestions for her...

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#32 of 40 Old 06-30-2006, 12:18 PM
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Did you see the latest study about vbamc? Maybe take that to your dr.

Here's a summary from USA today: By Rita Rubin, USA TODAY
A study out today could lead to an increase in the number of pregnant women who try for a vaginal birth after a cesarean section, a type of delivery called a VBAC.
The study, published in Obstetrics & Gynecology, involved 17,890 women with a prior C-section who delivered at one of 19 academic U.S. medical centers from 1999 through 2002.

It found that those who'd had multiple C-sections were no more likely to have a uterine tear, or rupture, than those who'd had only one C-section. Ruptures occurred in nine of 975 women with multiple previous C-sections, or 0.9%, and 115 of 16,915 women with just one prior C-section, or 0.7%. Women with multiple C-sections were more likely to need a blood transfusion or a hysterectomy if they tried for a VBAC, but their actual risk was just 3.2% and 0.6% respectively.

"I think most practitioners have with time shied away from offering VBAC to women with multiple prior cesareans because of a perceived risk of uterine rupture," says lead author Mark Landon, a professor of obstetrics and gynecology at The Ohio State University in Columbus. If such women have an increased risk of rupture, it must be quite small, Landon said.

Gary Hankins, chairman of the American College of Obstetricians and Gynecologists' obstetrics practice committee, said he expects his group will now revise its VBAC advice for women who've had multiple C-sections.

In 2004, Hankins' committee said that the only women with multiple C-sections who are candidates for a VBAC are those with a prior vaginal delivery. The new study found that having a prior vaginal delivery made no difference.

VBAC has become one of the most hotly debated topics in obstetrics. In 1999, the obstetricians and gynecologists group advised that it only be allowed in hospitals with an "immediately available" surgical team. That guideline stemmed from concerns about the risk of a potentially catastrophic rupture in laboring women with a C-section scar on their uterus.

By 2004, the VBAC rate had dropped to 9.2%. Many hospitals and doctors would not allow any woman to attempt one.

"I think the important message from Landon's paper, and from our work, is that VBAC in women with multiple prior C-sections is very reasonable," says George Macones, chairman of the Department of Obstetrics and Gynecology at Washington University in St. Louis and author of a study last year that found only a small increased rupture risk in such women.
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#33 of 40 Old 06-30-2006, 09:07 PM - Thread Starter
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I appreciate everyones replies, but it looks like a no go for me. It's not that I don't or can't fight this but due to other reasons (referred to in an earlier post, where I said I'd give details in PM - which I have to a few). Anyway, unless I go into labor prior to 39 weeks and wait it out a bit, I'll probably have another c/s.
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#34 of 40 Old 07-02-2006, 10:29 AM
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Hi, I am new. Are you familiar with EMTALA? If you familiarize yourself with that, you have much better chances of VBAC, even in an unfriendly setting.
I was really disturbed to read the post about how they would wheel you in and do it with you yelling, "I do not consent!" I am trying to imagine that, and believe me, I am not ignorant by any means about hospitals and c-sections (I've had one). They would be sued, and they would lose. The OBs would lose their licenses. The hospital would be fined and/or worse. This is all according to every law and regulation on the books. I'm sure someone will jump in and tell me how naive I am, lol. I'm just saying that it would be a clear case of battery and I can't imagine what their legal defense would be to that. Without a court order, they CAN'T do that and get away with it. They count on the ignorance of laboring women to do their dirty work. It's horrible.
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#35 of 40 Old 07-04-2006, 04:28 PM
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OP - I'm sorry you had a negative experience on the ICAN email list. Please remember that the ladies on the list are individuals and shouldn't be considered representative of the organization as a whole. The organization and it's local chapters are a WONDERFUL resource. I would encourage you to see if you can find a local chapter, they may have some resources that you haven't been able to tap into yet.

I would highly suggest that you hire a Montrice (they can assess dilation and monitor fetal heart tones) to labor with at home. I don't know that going in at 7cms will be your magic ticket to a VBAC. I would agree with pps as there have been OBS who have pushed the baby back up and hauled the women off for c/s anyway. Maybe you can labor most of the time at home, switch to laboring in the parking lot (van/rv?) and go into the ER pushing?

I wish that I had better advice. I really hate that our medical system has put all of us in this very awkward position. NO WOMAN should be faced with this when planning for the arrival of their little one. You'll certainly be in my thoughts and prayers!
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#36 of 40 Old 07-04-2006, 09:50 PM
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I am also going for a VBA2C I have had a lot of resistence too...I went through a lot of OB's before finding one that would allow my VBA2C and I would definately recommend a doula even if you can find a MW who will take you (none here will take a VBA2C). A doula is an advocate for you so they can help you communicate that you do not want a C/S...which you do have every right to refuse!
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#37 of 40 Old 07-08-2006, 12:22 PM
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Wow. I'm so sorry you got blasted from the ICAN list. I have been there for over three years now, & even though the women will challenge you, & ask questions about your previous cesareans, I have never seen anyone get blasted for their cesareans. I am no-mail now....so maybe I missed it....the moderator there would not stand for that. (she is the co-leader for my local chapter) You should of emailed her. That list is too far valuable to let some people run you off.



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#38 of 40 Old 07-08-2006, 03:20 PM
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#39 of 40 Old 07-09-2006, 04:18 PM
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yelling, "I do not consent!" I am trying to imagine that, and believe me, I am not ignorant by any means about hospitals and c-sections (I've had one). They would be sued, and they would lose.
Without a court order, they CAN'T do that and get away with it.
You've actually hit the nail on the head here...hospitals have gotten court orders requiring mothers to undergo c/s against their wishes. It's not common (and a mama would probably be able to sue afterwards), but it does happen. Although a mama can still leave the hospital against doctor's advice prior to the court order being handed down, those mama's can face criminal charges...especially if something happens to the infant.

The American Journal of Obstetrics and Gynecology published a review titled "Court-ordered cesarean section: an analysis of ethical concerns in compelling cases" and the Journal of Obstetric, Gynecologic, and NeoNatal Nursing published "Maternal-fetal conflict: court-ordered cesarean section". You can find several cases reviewed online at http://www.lifescapes.org/Papers/COCS%20Hahn%201987.htm and http://advocatesforpregnantwomen.org...interventions/

It's icky...but it does happen. Just one more reason to know your rights, have phsycial support, and have all the I's dotted and T's crossed before entering a hospital for a VBAC. "Just showing up" sounds good, but in the long run it may not be the best course of action!

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#40 of 40 Old 07-11-2006, 12:27 AM
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Come to St. Louis. My ob does vba2c. He told me the rate of ur isn't that much higher than vba1c.
Who is your OB? I haven't decided if I want to tell mine about my VBA2C plans or just suprise her when I show up in labor. I'm thinking I should have a back-up plan for if I do decide to tell her. PM me if you don't want to post it here.
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