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

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#1 of 40 Old 06-24-2006, 04:33 PM - Thread Starter
 
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Help -- After much research, my OB/hospital/insurance will not "allow" VBA2C. For a couple of very valid reasons, HB is not going to happen (I wish; I would be happy to say what these reasons are via PM if needed).

Here's my thinking on this though. If I go into labor and either have an MW there checking me or check myself -- if I wait until, say, 7+ cm and THEN go into the hospital, will they still do a c/s? I hate to ask the OB this, because then he'll know of "my plan". :

Do you think waiting until 7ish cm is good enough to avoid a c/s? Or should I wait longer? FWIW, I am about 14 minutes from the ER (during normal traffic).

A nurse friend of mine swears up and down that if I wait until 7 cm, they will allow VBAC. But I've heard horror stories of doc's pushing babies back up just to do a c/s. :

I am reading most anything I can find online. I did join the VBAC/ICAN support group on Yahoo, but I was blasted for my first two c/s (both of which were necessary in saving my children's lives, and I was/am not a fan of c/s, keep in mind). So I didn't post after that, as I just don't have the time to defend my actions.

I am trying to find an MW in the Portland (OR) area right now, that will take me on. Suggestions for that? I have an OB doing my regular prenatal stuff, as it is a must (another valid reason, though I'd prefer an MW solely, believe me). I've thought about a DOULA, but I think I'd prefer an MW?
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#2 of 40 Old 06-24-2006, 04:46 PM
 
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I honestly can't remember the statutes, I would have to look them up, but I am pretty sure the hospital can not turn you away and definetely can not FORCE you to have a section without court consent, which would take awhile to get. That might be an option. Of course you would have to be ready to fight, but you would stand a better chance of vbac'ing that way. Good luck and I hope it works out... sorry I wasn't more help!
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#3 of 40 Old 06-24-2006, 04:56 PM - Thread Starter
 
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I keep hearing and reading that they cannot force me into a c/s. But I know while in labor, I won't have the strength to be arguing with them either. And I don't want to be the PITA pregnant woman that no OB wants to see prior to going into labor either.

I'll have at least three if not four people with me when going to the hospital. So I am thinking they can help me fight if necessary. But I'd love to avoid that. This is why I am hoping waiting until 7+ cm will mean no need to fight, just allow me to birth vaginally. ??
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#4 of 40 Old 06-24-2006, 05:08 PM
 
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They will force a section. There are women here who were wheeled in yelling "I do not consent" There are women here who had a baby pushed back up and were sectioned. They will do a section.

Keep looking for a midwife, find a different hospital, do what you need to.

good luck!

-Angela
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#5 of 40 Old 06-24-2006, 05:18 PM - Thread Starter
 
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Call me naive but how do they do a c/s on someone saying they do not consent? And don't you have to sign a form prior to the c/s? I think I did, though I don't quite remember for sure.

Since our insurance and hospital are affiliated (not sure how else to call it), I am pretty much stuck. I'll see what other hospitals they allow me to use. I know in emergency situ's, they allow me to use any hospital, no matter where. But in non-emergency situ's, they won't cover unless it's their hospital. I'll have to make some more calls on Monday and find out.

I may also press the issue with my OB now. I can always switch if needed I figure.
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#6 of 40 Old 06-24-2006, 05:32 PM
 
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FWIW, at our hospital there is a 40% CS rate. And last year they banned VBAC for insurance reasons... So I would wait until the LAST possible moment if I were you. It seems that if there was a ban on VBAC here then they probably would force a CS even if you didn't want it. I know mothers here who have traveled to other cities to VBAC. It's totally ironic to think with such a high CS rate and vbac ban, those CS mothers will have to deliver all subsequent babies CS, too. Racketeering on the hospital's part? One mother I knew went to have an induction, it wasn't proceeding fast enough so they scheduled CS, then labor kicked in for real before the CS but they did it anyway. It seems they are concerned with uterine rupture and death in the case of an emergency. I've seen studies that show uterine rupture and emergency CS rates are about equal for VB and VBAC. If you ask me it's the drugs they give you to induce/speed up labor that cause the uterus so much problems. Just let the poor mothers be, for goodness' sake!
Andi

Andi, wife of Seraphim
Mom to Elijah (6/05) and Moses (6/08) and baby Joshua, UBAC February 18, 2011!

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#7 of 40 Old 06-24-2006, 05:35 PM
 
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I don't know as thankfully I've not been in that situation, but I know there are moms here who were wheeled into OR SAYING "I DO NOT CONSENT" and yet they were still sectioned.

good luck!

-Angela
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#8 of 40 Old 06-24-2006, 05:52 PM - Thread Starter
 
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Thank you ladies. After speaking with an MW here, she said she knows of NO OB's that will allow VBA2C. And her network of other MW's is quite large. Great.. I'm feeling even more deflated now about this.

So basically, I'll have to arrive at the ER with the head out in order to have a VBAC. Crazy.
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#9 of 40 Old 06-24-2006, 05:53 PM
 
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Hmmmm. Well. And this is not the "doula" me talking, but the "don't you freaking dare tell me what to do, especially when I know the stats and risks, and am a grown-up" me talking. I would find out which other hospitals in your area your insurance covers. I would have a midwife monitor you during your labor, wait until you're feeling the URGE TO PUSH, then go to the new hospital ER...and "forget" to tell them that you're a vbac unless an issue comes up. And read as much as you can about what can go wrong during a vbac and the signs of those problems.

I don't think it's a good idea to count soley on a doula, as they are trained in support, not monitoring a VBAC and other risks mama. It would be putting unfair liability on her. That said, having a doula TOO would be a great idea, as she would be some kind of "continuity of care" through the whole thing...and I can see it being stressful. Perhaps even rent a van and when you're around seven go in the van (without seats in the back?) and labor to pushing in the parking lot of the chosen hospital...then go in and finish there? But if you're going to stay home as long as possible anyway...? No pressure, but you know the thought process here.

Mama to two awesome kids. Wife to a wonderful, attached, loving husband. I love my job-- I'm a Midwife, Doula and Childbirth Educator, Classes forming now!

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#10 of 40 Old 06-24-2006, 06:06 PM
 
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My thought is that you deserve a peaceful, no-worry birth with a place and a caregiver you trust.

If you are fighting and worrying and your adrenaline is way up, there's a chance that your body will not allow itself to labor.

Keep searching for a new doc. Many times it isn't the "hospital policy" that keeps women from vbac, it's "doctor's policy" and they just blame it on hospital policy. Keep looking for a doctor- even one that is hours away. I'd drive many hours to have what I wanted in a birthplace and caregiver, if that's what it came down to. And if I had to pay a lot of money for it- it would be worth it to me to escape surgery that is unneccesary. Better my pocketbook than my life.

If you want to know your rights, read this:
"The federal Emergency Treatment and Advanced Labor Act (EMTALA) requires hopsitals to admit women in active labor and to abide by their treatment wishes until the baby and placenta are delivered. The act was originally passed to prevent hospitals from "dumping" patients who can't pay, but its since been applied in all sorts of other ways and includes specific provisions that apply to laboring women. The attorneys we've consulted on the VBAC ban issue have told us that hosptials are much more afraid of being found in violation of EMTALA than they are of malpractice suits because the act is routinely enforced and each violation subjects them to fines between $50,000 and $100,000. I can't emphasize enough the importance to individuals who may find themselves in this situation of memorizing phrases such as "It's a violation of my rights under EMTALA to force me to undergo a cesarean," or "I'm invoking my right under EMTALA to refuse a, b, c." Whether the hospital in question says it bans VBACs is unimportant; according to EMTALA, you have the right to be admitted to a hospital once you're in active labor and, once admitted, you have the right to refuse any recommended treatment. You can also remind them that VBAC isn't a tratement, it's the natural culmination of a normal physiological process. Cesareans are the treatment. Also, it's helpful to know that EMTALA begins to apply once you are anywhere within 250 feet of a hosptial; you don't have to be in the emergency room. You can be standing in the hospital parking lot, and if they so much as touch you against your express consent, they are in violation of EMTALA. For anyone interested in reading more, we've compiled a legal primer on the rights of pregnant women at: <http://www.birthpolicy.org/.
Editor's Note: To learn more about this important subject, go to
<http://www.emtala.com/>www.emtala.com. There you will find frequently asked questions, as well as links to the statue and case law."
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#11 of 40 Old 06-24-2006, 06:09 PM
 
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If you find yourself in the position of having to stick w/ this hospital then I suggest you get an "informed consent" and hospital's patient bill of rights form from the hospital's risk management department. Every patient, regardless of condition, has the right to decline any treatment. If the hospital "forces" a section on you against your wishes, you can sue for assault and battery, including any resulting injury to you and your baby as result of their negligence. You will need to fillout the informed consent form prior to going to the hosp, and it must detail your wishes to decline a c-section. Also, get a copy of your surgical reports from the previous sections, so you know what sort of incisions were cut on the uterus. but very important, have your wishes in WRITING, and make sure the hosp staff gat's a copy of them when you walk in. Just my .02. I live in South Florida and I am in the same position as you are. Good luck mama.
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#12 of 40 Old 06-24-2006, 06:58 PM - Thread Starter
 
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Aw, thank you ladies, so much. We have a van, I've already pictured myself laboring in the third row.

I really appreciate all of the information and suggestions. I've thought about a doula, just to talk me through labor, in case I lose focus. I did well during my first labor, of course I didn't even make it to transition before I was rushed for a c/s.

I am guessing I have to ask specifically for my c/s records. I requested copies of my records from the hospital. They just sent my pre-birth records, not actual surgical records or post-surgery records.
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#13 of 40 Old 06-24-2006, 06:58 PM
 
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This is something really good to read:

http://www.ican-online.org/resources..._vbacbanqa.pdf
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#14 of 40 Old 06-24-2006, 07:37 PM
 
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Quote:
Originally Posted by mfp02
I am guessing I have to ask specifically for my c/s records. I requested copies of my records from the hospital. They just sent my pre-birth records, not actual surgical records or post-surgery records.
That's a bit disturbing. If you request all your records from a certain date, you should be given all your records. Be specific about what dates you want and state that you want your COMPLETE records.
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#15 of 40 Old 06-24-2006, 07:39 PM
 
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Most offices will only give the bare minimum of what's requested, so you DO need to ask for what SPECIFIC records you're looking for.
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#16 of 40 Old 06-24-2006, 07:52 PM - Thread Starter
 
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Thanks for that link, Amy. I read the entire page and bookmarked it.

I think the hospital did just give the bare minimum. I wasn't wanting to pay, so they just copied 20-ish pages. I can't imagine how big the file is with the surgical reports.
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#17 of 40 Old 06-24-2006, 08:42 PM
 
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sorry you got blasted on the ICAN yahoo group... that's awful...

i have to say the three women who run the local ICAN chapter here in the Portland area are absolutely amazing and open and full of resources. they hold meetings on the third Monday of every month, and if you pm me your email address, I will pass it on to them so they can notify you of their meetings and give you the location.

wishing you peace and wisdom and a healthy pregnancy...

~claudia
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#18 of 40 Old 06-24-2006, 08:51 PM
 
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Quote:
Originally Posted by courtenay_e
I would have a midwife monitor you during your labor, wait until you're feeling the URGE TO PUSH, then go to the new hospital ER...and "forget" to tell them that you're a vbac unless an issue comes up.
This is pretty much exactly what I was thinking, but I also second one of the PP who said that if you are having to fight about this you may have problems with labor getting going anyway. I'd definitely keep looking, even if it's a few hours away, to find a place with people you trust and that will support you.

Does your insurance company not cover at all for "out of network" providers? We have our "preferred" ones that they cover more for but we can go anywhere we want if we're willing to pay 10% more than for the preferred providers. Ugh, insurance, right?!

Good luck to you, mama!

Heidi
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#19 of 40 Old 06-24-2006, 08:56 PM - Thread Starter
 
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Out of network is paid up to 80%, as long as I go to one of their hospitals. If I go to a hospital not on their list, then it must be an emergency situ or they will not cover it.

The cost is not mine and ultimately someone elses, but I don't them paying an arm and a leg either (they already are; long story).

I too thought about forgetting to mention my previous two c/s. And though the scars are almost invisible, I know when pg, they become more obvious as my belly grows.

Thanks Claudia. I've only heard awesome things about ICAN. But I posted one question a few months back, and I had literally 30+ emails from Mama's blasting me about my second c/s, some even for the first.
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#20 of 40 Old 06-25-2006, 02:03 AM
 
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Moved to VBAC.

anna kiss partner to jon radical mama to aleks (8/02) and bastian (5/05)
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#21 of 40 Old 06-25-2006, 11:57 AM
 
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Quote:
Originally Posted by mfp02
I am trying to find an MW in the Portland (OR) area right now, that will take me on. Suggestions for that? I have an OB doing my regular prenatal stuff, as it is a must (another valid reason, though I'd prefer an MW solely, believe me). I've thought about a DOULA, but I think I'd prefer an MW?
I would contact local doulas just to ask them if they know any other Doctors or maybe a CNM who could take you on and would be supportive of VBAC.
It sounds like you really need to switch care providers.
You are going to have enough on your mind while you're in labor.. you shouldn't have to worry about being sectioned against your will if you go in too early :

~e, wife to my sweet T partners.gif, mama to my turtleman (8) , sunshine (6 vbac.gif), and monkey (2)
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#22 of 40 Old 06-26-2006, 02:52 AM
 
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My surgical record from my c section was only a page or two long, for what it's worth. Mighty interesting reading though, yuck!
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#23 of 40 Old 06-26-2006, 02:53 AM
 
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forgot to mention that I had a great VBAC with my second child! I know it is stressful and unfair that we have to stand up for our rights, but they are yours. Don't let anyone take away your birth for the sake of "the rules".
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#24 of 40 Old 06-26-2006, 03:35 AM - Thread Starter
 
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I definitely have time, thank goodness. I am just itching to find someone supportive of what I want of course. And I wouldn't be doing this if I in anyway thought I was at more risk than the next woman for rupture. But my c/s were "perfect" (as odd as it sounds), small incisions, nothing drastic, everything went well. So I have faith that my body will be able to do this, given the right support system of course.

Thank you ladies so much. I'll definitely keep contacting people. It looks like I may have to make actual appt's with OB's and CNM's in the office to talk with them. Doula's and MW's around here (quite a few anyway) swear up and down they know of no one that would support me in this.
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#25 of 40 Old 06-26-2006, 03:05 PM
 
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would it be okay to post a message on our local doula list asking about a vba2c hospital based provider? i can pm you any info that comes my way...

~claudia
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#26 of 40 Old 06-26-2006, 03:20 PM
 
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I don't mean to change the topic, but why would you get blasted on a VBAC site for having had a C-sec? Wouldn't just about everyone on a VBAC site have had at least one C-sec? Or am I missing something?
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#27 of 40 Old 06-26-2006, 05:22 PM - Thread Starter
 
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Claudia - Feel free, thank you!!

Mamabadger - I know, it sounds strange. But I think it's due to why I had my second c/s. I had that one due to malpresentation and I was not comfortable with an external version. Well, quite a few gals were nasty because I refused the version. Also because I scheduled the c/s and didn't go into labor prior. But I had that c/s at 39 weeks (39.5 technically), so I was pretty close to the magical number of 40 (which means squat anyway).
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#28 of 40 Old 06-27-2006, 11:57 PM
 
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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.

Many hugs. I know you're in a tough spot.
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#29 of 40 Old 06-28-2006, 02:34 AM - Thread Starter
 
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Quote:
Originally Posted by MommyDOK
Come to St. Louis. My ob does vba2c. He told me the rate of ur isn't that much higher than vba1c.

Many hugs. I know you're in a tough spot.
Can you ask him if he has a brother that is an OB in Portland? Maybe his brothers has the same belief (which is true!). Or maybe he knows a colleage(sp) in Oregon that thinks the same way as him about vba2c?

I hope to find someone here. I am mulling it over in my head right now. I just have other things to worry about at the moment, but this will be on my mind constantly until the birth I think.
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#30 of 40 Old 06-28-2006, 04:10 PM
 
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Are you close to a med school? My ob (see my pp) is the head of the ob department at a med schooo. Usually, they are more up-to-date on the research.
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