Last year, ICAN began the task of calling all the hospitals in the USA to determine how many of them support VBAC vs how many of them outright banned VBAC or had no doctors willing to attend VBAC. A couple weeks ago, we stepped up our efforts to ensure that ALL hospitals offering maternity serviced were contacted. Why? A writer from TIME magazine faced the same struggle many pregnant women today face: finding a VBAC supportive care providers. I have it on good authority (that "authority" would be ICAN's advocacy director) that this woman had to change providers and fight while in labor to get her VBAC. She found ICAN when she was pregnant with her VBAC child, after she was told at 6 months she had only a 17% chance of VBAC so why not just schedule a c-section.
So she wrote this wonderful article on VBAC and the pressure to schedule a repeat c-section. Articles like this make beg to ask the question of the obstetrical community, "Why?" It seems that it every other branch of medicine doctors and hospitals brag of their ability to perform minimally invasive procedures. Surgery is getting less invasive as doctors find ways to use existing orifices in the body to perform surgery rather than making new cuts. Birth has it's own dedicated orifice in the female body; yet, unlike the rest of medicine, obstetrics is trending to the MORE invasive. Many doctors now equate "choices in childbirth" with "the right to choose a surgical birth."
The Trouble With Repeat Cesareans
By Pamela Paul
For many pregnant women in America, it is easier today to walk into a hospital and request major abdominal surgery than it is to give birth as nature intended. Jessica Barton knows this all too well. At 33, the curriculum developer in Santa Barbara, Calif., is expecting her second child in June. But since her first child ended up being delivered by cesarean section, she can't find an obstetrician in her county who will let her even try to push this go-round. And she could locate only one doctor in nearby Ventura County who allows the option of vaginal birth after cesarean (VBAC). But what if he's not on call the day she goes into labor? That's why, in order to give birth the old-fashioned way, Barton is planning to go to UCLA Medical Center in Los Angeles. "One of my biggest worries is the 100-mile drive to the hospital," she says. "It can take from 2 to 3 1/2 hours. I know it will be uncomfortable, and I worry about waiting too long and giving birth in the car."
Much ado has been made recently of women who choose to have cesareans, but little attention has been paid to the vast number of moms who are forced to have them. More than 9 out of 10 births following a C-section are now surgical deliveries, proving that "once a cesarean, always a cesarean"--an axiom thought to be outmoded in the 1990s--is alive and kicking. Indeed, the International Cesarean Awareness Network (ICAN), a grass-roots group, recently called 2,850 hospitals that have labor and delivery wards and found that 28% of them don't allow VBACs, up from 10% in its previous survey, in 2004. ICAN's latest findings note that another 21% of hospitals have what it calls "de facto bans," i.e., the hospitals have no official policies against VBAC, but no obstetricians will perform them. (Read "The Year in Medicine 2008: From A to Z.")
Why the VBAC-lash?
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