no woman should ever been forced into surgery against her will, but it has happened. I also encourage you to show up with a doula and as many support people (witnesses) as possible so that when you refuse the section there are a number of people to repeat "She said no." But I wouldn't wait until labor to refuse. When you are over 36 weeks, write a detailed letter to the hospital stating that you are birthing there in (month) and you are refusing a repeat c-section, and you want to make sure that all potential staff that could be caring for you are aware in advance that you are refusing a repeat section.
Most doctors would not drop a woman after 36 weeks, but even if your doctor threatened to drop you, the hospital cannot deny you care if you show up in labor - they must take you.
Suggested information to include:
am planning a vaginal birth at (hospital) sometime in (month). I have had two previous c-sections, and
have decided, after reviewing all of the medical literature, that a VBAC
birth is safer for me than scheduling a cesarean section. I have received
excellent prenatal care during my pregnancy, and I have been looking very
forward to my VBAC birth at (hospital). I sincerely hope that you will
support and assist me in having the best vaginal birth possible. I am
writing to request a meeting to review the following things:
1. I want to ensure that the VBAC policy at (hospital) is supportive
of VBAC births and the rights of pregnant women to make their own birth
2. I want to request that (hospital) draft a formal policy statement
that under no circumstances would staff pressure or coerce a woman to
undergo a cesarean if she has made an informed refusal for surgery - in
other words, it is important that there is no policy stating that women with
more than one c-section are "restricted" from having a vaginal birth.
3. I want my medical record at (hospital) to be clearly marked that
I have already made a fully informed choice to refuse a cesarean, and that I
do not intend to argue or fight with staff about a cesarean when I arrive in
labor to vaginally deliver my baby.
4. I want the enclosed medical literature showing that a VBAC birth
after multiple cesarean sections is safe (my risk of uterine rupture is less
than 1% if I am not induced), and that my risks from a third cesarean are
high, making a cesarean risky and dangerous for me to be placed in my chart
so that all hospital personnel assisting with my VBAC know that I have been
fully informed of my risks. I am truly scared of the risks of a third
cesarean, my risk of death is much higher with a cesarean than with a
vaginal birth, and I cannot undertake this risk for me or for my other
children unless some emergency warrants it (cord prolapsed, placental
abruption, etc.). It is my hope that if the staff understands my concerns,
everyone will work with me to ensure I have the best vaginal birth possible.
I thank you very much for your time in reviewing the enclosed literature and
for considering my concerns.
I hope that once we meet, I can rest assured that policies are in place
that support a woman's right to VBAC, and that no woman will have to face
pressure to have a cesarean after they have made an informed refusal for
surgery. After knowing that (hospital) will be supportive of my VBAC, I
will be able to just focus on having a healthy pregnancy and preparing for
my upcoming vaginal birth at (hospital). I appreciate you
making time in your busy schedule to discuss my concerns, and working with
me to ensure I have the best birth possible at (hospital).
Here is the suggested literature to include:
Please also send a copy of your letter to ACOG, asking them to take action to put an end to unethical VBAC "bans." ACOG is reading letters being sent. Please make sure they hear from you:
Douglas H. Kirkpatrick, MD, President
The American College of Obstetricians and Gynecologists
PO Box 96920
Washington, DC 20090-2188