Changes in VBAC at Mercy - Mothering Forums

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#1 of 23 Old 10-16-2008, 10:50 PM - Thread Starter
 
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Just an FYI....

I found out today that Evelyn Muhlhan's "backup" OB at Mercy is no longer allowing VBAC's.

This doesn't affect me directly ( I hope!) as I'm planning a HBAC but it DOES mean that if we did have to transport, Mercy is no longer the "best" option as Evelyn will not be allowed to stay with me and deliver the baby. She would be treated there as she would be at any other hospital because I am a VBAC patient.

I also know that Evelyn and Kathy Slone have different OB backups and if you do want to VBAC in the hospital, Kathy's practice are (currently) still allowed to do that.

I don't know any more information on this and its just very sad that yet another choice has been removed for VBAC moms in the Baltimore area.
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#2 of 23 Old 10-16-2008, 11:59 PM
 
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That is sad. Did you find that out from Evelyn? Any idea what the OB's reasoning is?
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#3 of 23 Old 10-17-2008, 08:55 AM
 
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I'm really sorry to hear that. I hope you have a beautiful HBAC!
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#4 of 23 Old 10-17-2008, 09:44 AM - Thread Starter
 
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Originally Posted by jrowe View Post
That is sad. Did you find that out from Evelyn? Any idea what the OB's reasoning is?
Yes, I did find out from Evelyn at my appt....and as far as reasoning? The best they can guess is malpractice. I don't know if a "real" reason was given. Although at the back of my mind, I'm wondering if any of it is political. I know that there is a plan to re-open the Baltimore Birth Center and Evelyn is involved. Given the new decisions about accredited birth centers and VBAC's (they may now be allowed) that would certainly take a good bit of business from Mercy. I don't want to by cynical, but......you never know if that hasn't played some part also.
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#5 of 23 Old 10-18-2008, 08:23 PM
 
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i also spoke to evelyn a few days ago and she mentioned this and said the reason is that her backup doesn't want to 'labor-sit' anymore...i think meaning that if a vbac mom comes in w/ e, the back-up OB has to be there the entire time 'in case'

i'm sure there could also be political reasons, but that's what evelyn told me

there's also someone new at ABC...i think she used to work w/ e at the birth center...i can't remember her name, i think maybe susan?

DS September 2008 and DD September 2010
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#6 of 23 Old 10-19-2008, 06:17 PM
 
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Hi, ladies!

Don't fear too much. I know it is a perfect birth when your preferred midwife can catch your VBAC baby at your intended hospital but you can always switch to another VBAC-friendly midwifery group until Evelyn and her back-up gets this ironed out or you can simply show up at any hospital anytime and refuse to consent to a c/s. It helps if you show up late in labor and near ready to push!

Here's your childbirth rights!!

http://www.trustingourbodies.com/ChildbirthRights.html
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#7 of 23 Old 10-23-2008, 09:03 PM
 
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Originally Posted by kryztuh View Post
[COLOR="Navy"]i also spoke to evelyn a few days ago and she mentioned this and said the reason is that her backup doesn't want to 'labor-sit' anymore...i think meaning that if a vbac mom comes in w/ e, the back-up OB has to be there the entire time 'in case'COLOR]
Doesn't want to labor-sit, huh? Figures.
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#8 of 23 Old 10-24-2008, 01:39 PM
 
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I blame the hospital more than I blame on him :

What's the scoop with the birthing center?
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#9 of 23 Old 10-24-2008, 02:24 PM
 
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I work at Mercy and am HAPPY to bring this discussion directly to Altas (Head of OB) and Michele Schwarzman (Director of Child /Maternal Health). We are really trying to get away from this kind of stuff. I am pretty sure this is not a Mercy policy, rather the OB's policy. I am guessing her back up is Dr. Lawyer, because that is who she offered to me last week when I miscarried (20w). Even though I was distraught I was with it enough to say NO thank you! I gave her alternative OB's and said I would wait until they were able to see me. Of course that is more difficult in an emer. transfer situation. In any case I do not think it is right to deny VBAC, the research backs us up. And god-forbid an OB works a few hours for a labor of all things!
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#10 of 23 Old 10-24-2008, 09:47 PM
 
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I am really sorry about your loss.

Jen
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#11 of 23 Old 10-25-2008, 11:33 AM
 
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I too am sorry for your loss.
For whatever it's worth...and I'm sure everyone is pretty cautious but, I would be very careful about seeing Dr Lawyer for anything. When I was younger and before I considered having children, I was a patient of his. I chose him from a referral and found him to be extremely clinical, rude and not very organized. On 3 occassions my chart was confused with other patients who shared the same name. These staff/clerical errors ended up being costly as I was given and sent for unnecessary testing as well as an emotional toll from being lectured by Dr Lawyer for my "life style". The clerical errors confusing me with the patients classified me as someone in a high risk group of multiple partners, drug abuser... At my last visit he yelled at me and when I asked him to check the chart to make sure that it was my info, he asked me to verify my address then slammed his fist on his desk. When he returned with "my chart", he never apologized for the mistake or his actions. I did report him to the state and the Atty General's office.

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#12 of 23 Old 10-25-2008, 02:25 PM
 
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Thanks for sharing that. I was really surprised when Evelyn pulled his name out of a hat as who she would contact! At our initial consultation she mentioned not haveing any particular OB she works with and advised me to choose my 'back-up', which seems sensible on all accounts.

I want to reiterate that I do not believe Mercy has a 'policy' per se on VBAC, but I do know differnt OBs perform very differently/autonomusly at Mercy. Some I would reccomend and others I would NOT...case in point!

(Thank you for the kind words - some days are better than others)
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#13 of 23 Old 10-26-2008, 11:13 AM
 
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I think she recommends him only because he is her official back up for her homebirth practice. It was a surprise when I found out as well...their styles are quite different. From speaking with some other midwives, it sounds like it is often the case that you more or less take what you can get in a back up for those rare times that you need to transfer.
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#14 of 23 Old 10-26-2008, 09:57 PM
 
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Kathy Slone's group does VBACs. It's a shame Evelyn doesnt anymore, but it's no surprise that Dr Lawyer has vetoed it... Hope the Birth Center reopening goes through!
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#15 of 23 Old 10-27-2008, 12:29 PM
 
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The info I got from Mercy is this:
1. Yes, Lawyer is no longer doing VBACs due to fear of lawsuits.
2. He does very little in the way of bedside practice since he has hired new midwives and an additional physician

Finally a quote from M. Schwarzman Dir. of Child/maternal Health: "There is no policy prohibiting VBACs. Our statistics remain consistent at 24 to 26% successful VBAC each month."

I am not sure how that stacks up to other hospitals but at least Mercy is 'doing' Vbacs.

Hope that helps in some way for moms lookin gto Evelyn for VBACs.
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#16 of 23 Old 10-27-2008, 02:04 PM
 
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I thought Mercy's policy was to allow them as long as an OB was hanging around. And the doctor didn't want to anymore. Is this also not true?

BTW, Evelyn referred to me Dr. Atlas when I needed an ECV, and he was great, and actually a supporter of VBAC in our discussions.
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#17 of 23 Old 10-27-2008, 03:50 PM
 
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24 to 26% of the women who attempt them get them or is it that 24 to 26% of the births at Mercy are VBACs?

I don't have any way of comparing a VBAC rate from one hospital to the next as the only info I can get from the state is the number of VBACs done at each hospital but it isn't given as a rate according to how many attempted them. Plus, the chart they post has several hospitals listed as "n/a" even though to my knowledge we only have one VBAC ban in the state.

-Barbara Stratton


Quote:
Originally Posted by Maidenwisdom View Post
The info I got from Mercy is this:
1. Yes, Lawyer is no longer doing VBACs due to fear of lawsuits.
2. He does very little in the way of bedside practice since he has hired new midwives and an additional physician

Finally a quote from M. Schwarzman Dir. of Child/maternal Health: "There is no policy prohibiting VBACs. Our statistics remain consistent at 24 to 26% successful VBAC each month."

I am not sure how that stacks up to other hospitals but at least Mercy is 'doing' Vbacs.

Hope that helps in some way for moms lookin gto Evelyn for VBACs.
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#18 of 23 Old 10-27-2008, 04:11 PM
 
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And THIS is why I'm going to medical school instead of becoming a cnm/cpm. I want to be the back up for these midwives that are serving our community.

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#19 of 23 Old 10-29-2008, 09:47 PM
 
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You are awesome, mysticmomma!
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#20 of 23 Old 10-29-2008, 10:20 PM
 
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Thanks! I hope to be able to stay in Baltimore, but not sure of my chances at Hopkins or UM as a nontraditional student. It's gonna be 10 years before I get there anyway. We've got 2 more years, finish RN and AS in BIO. THen 2 years to finish BS BIO, then 4 years medical school, then residency... geez. I need to get back to attending births again as a doula. Gotta keep my recent patient contact up.

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#21 of 23 Old 10-30-2008, 02:23 AM
 
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Originally Posted by mysticmomma View Post
And THIS is why I'm going to medical school instead of becoming a cnm/cpm. I want to be the back up for these midwives that are serving our community.
Bless you. I am on that timetable for being a midwife so someday I will be calling on your for backup!
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#22 of 23 Old 10-30-2008, 02:07 PM
 
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Originally Posted by womancaredoula View Post
24 to 26% of the women who attempt them get them or is it that 24 to 26% of the births at Mercy are VBACs?
I assume the former.
The latter doesn't really make sense...
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#23 of 23 Old 11-14-2008, 01:36 PM
 
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Wow 24-26% is quite low but I would venture to guess that is lowered by other physicians like Dr. Lawyer who won't do them.

A good provider's rate should be above 70% but really 90%. Our homebirth midwives have excellent VBAC rates. 25% is sadly disappointing but that is the entire hospital's rate not any one provider.

Does anyone know what Kathy's practice rate is? What about SB VBAC rate?

All of my doula clients thus far have 100% VBAC rates and they've chosen either Evelyn, KC or SB midwives. I'll stick to recommending what I know works until told otherwise by colleagues with high success rates and low intervention/induction rates.

Most importantly, what their current birth outcomes are. Any practice's birth outcomes can change depending on what's going on at that practice. I'm always trying to keep up with who is having success and who is not following the midwifery model of care any longer. I want to refer my couples to a place they can trust.
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