You’re certainly not the only one who is outraged. I tried in vain to point out to my provider that ACOG released a statement last July encouraging their community to avoid repeat cesareans, and she tried to blame it on the anesthesiologist. Oh yes, it’s totally the people who dispense epidurals for cesareans that are stopping my provider from giving me the birth I want. Seriously, I not only have to deal with someone telling me I can’t attempt a vaginal birth, but one who doesn’t even have the guts to admit that she’s the one stopping me from it! Something you might want to keep in mind, no provider or hospital can actually force you to have a c-section. You always have the legal right to deny any form of medical treatment, and hospitals are required by law to accept a woman in labor. It’s not pretty, and it’s not every woman who is brave enough to do it, but you can actually back them against a wall in this regard. You can read more about it here: http://www.ican-online.org/vbac/your-right-refuse-what-do-if-your-hospital-has-banned-vbac-q

Oh god I’m so happy to be French…

I’m currently pregnant with my second and am looking to do a VBAC. Our local hospital is one of the ones that refuses to do VBACs. My insurance (through the Army) will pay for me to go to another hospital to do it, but I’ll have to drive over an hour while in labor. It doesn’t sound like much fun, but I’d rather do that than go through a c-section and the recovery again. And if we end up having the baby in the van on the way to the other hospital, at least I won’t have had to go through the c-section again.

In a country where people sue each other for much less, is it any wonder that doctors are scared of their patients? You attempt a VBAC and something goes wrong, it’s automatically the dr’s fault. They’re just covering their butts.

I am scheduled for a cesarean on November 1st. In the city where I live, of all of the hospitals here (there are numerous) only one allows a woman to try for a VBAC. It is the university/research hospital. A few more facts in my case:

1) I had one cesarean previously. I believe it was because I was induced, and because I reacted so much to the epidural – I could feel NOTHING from the waist down. I pushed for hours for nothing.

2) My insurance (different from the first time I was pregnant) that I have offers me this option: I either schedule a cesarean this time around, and pay a certain deductible, or I try to have a VBAC at that one hospital, and if for some reason, I have to have a cesarean instead, I am forced to pay extra on top of that deductible, as it will then be considered a complication.

I am up against a wall. I have no choice but to go with the scheduled cesarean. In my case, I am not that worried about it, I guess. I mean, I believe that I will be fine, and that my baby will be fine. However, in principle, and as part of the broader problem, I am simply disgusted by insurance providers and hospitals and OBs who block a woman’s choice when medical evidence is so much in our favor.

Only time will tell. Hopefully in only a few short years, VBACs will be commonplace across this country.

I totally agree… i had a vbac and my female ob and i were so happy to do it.all was well and my baby was 9pds!… my question is who is on the board of these hospitals? any women? i wonder… it is messed up that women don’t have control and it is a shame that the hospital and the state is saying if you want control then you have to have it at home by your self! otherwise you do it our way. would they do it this way if it were a man? i believe the question is warranted.

@Theresa, The hospital boards are often made up of men, or people who can afford to buy a position, which doesn’t do much for the every day folk unfortunately.

I am pregnant with my husbands and I 7th child and i plan to do a vbac. My first 3 births were vaginal and then i had 2 c-sections. 1 b/c of a breech presentation and the other was emergency. My 6th child was born vbac with no problems and i plan to do it again. the recovery is so much faster and i wouldn’t have it any other way. my ob has delivered all of my children except #6 b/c he wasn’t on call. he knows my body and my history well so he is willing to work with me. thank goodness for such a great and wonderful doctor. i hope this gives any women hope that it can be done b/c i am proof.

Thank goodness I had my VBAC in 2002, not now. It was the best thing possible and I am so glad I didn’t have to fight for such a normal thing.

I am sure that this Jane, who claims, fairly convincingly, b.c. of the medical jargon on a failed VBAC case, that she is an OB, has good intentions – but, Jane, the way you present your argument doesn’t help your own cause. It isn’t comforting to know that budget alone drives the motives of a hospital board. It isn’t comforting to know that an OB is apparently stressed to the max regarding her chosen career. It isn’t comforting to know that an OB has this much animosity toward her chosen patient group. It is up to all women to make sure that choices like a safely chosen VBAC is an option. I know that you aren’t concerned about insurance provider practices, but it is a big issue in my case, and I don’t blame simply the doctor, nor do I believe any of these women do, for the state of our birthing choices. It feels out of our hands, and when it deals with something so important as this, it FEELS like the biggest conspiracy. Profit-driven health care is who we need to blame. OBs like yourself need to calm down and realize the source of our angst, ok?

Thanks Jane for your comments and information. I’m having my 2nd baby on Nov. 4th in an scheduled C-section because my first was an emergency C-section. I really contimplated a VBAC, but am a little nervous about it so close to my last delivery (my 1st baby just turned one, so it will only be 14 months since the surgery). I was thinking my doctor just wants me to do the c-section because it’s quick and easy and will make more money!! It’s good to know that’s not the case. My niece had to have an emergency c-section and almost died because they were trying to go natural and had her push for 3-hours straght. When they finally did the c-section, the baby was stuck in the canal and had to be pushed and pulled out. My niece had over 250 stiches and was lucky to survive. The thought of something like that happening is so scary!
I’m good with my choice of a 2nd c-section (and my recovery from the 1st one was amazing!! I don’t know if it was me or my doc. that made it so good, but I can’t complain one bit)!

I think you’re right Joy. Shall we draft up a Patient Autonomy Constitutional Amendment together? I bet in the current political atmosphere, it wouldn’t be difficult to garner support for such an amendment. I think tort reform is important as well though. Defensive medicine is really getting out of hand. I just don’t think it’s coming anytime soon, seeing as most politicians receive a great deal of money from lawyers.

I spend a lot of time on Solace for Mothers, a forum for women who have experienced birth trauma. Many of these women suffer from post traumatic stress disorder (PTSD) for years after they give birth. I can’t convey in words the kind of hell they suffer, but through inquiry I have found a common thread in all their experiences. Choice, and respect. Ultimately, these women made an informed decision for themselves and their little ones, and those choices were ignored by their care providers. Some even relate screaming “no” and trying to kick nurses, only be be sedated. In my case, I politely said “no” (to a repeat cesarean), and they effectively said, “too bad.” I knew kicking and screaming would do no good. They’d have their way with me regardless.

This time, I went in, politely said “no” again, received the same response, and took my business elsewhere. Unfortunately, that meant I had to go underground for reasons similar to some of those listed in the original post. I don’t feel like fighting for VBAC while in labor is very conducive to a good experience.

I can’t speak to US experience, but in Canada, part of the problem is the experience of the OB/GYNs. The default to C-section for many complicated births mean that there is little in the way of experience for many when dealing with breech and VBAC.

One thing I think women also need to consider when examining their birth options, is why you are choosing a certain path. What brought you to a c-section in the first place and why do you want a VBAC? In my case I had a breech baby that was not moving the first time. When I asked to go for a VBAC the OB/GYN was happy to let me try because she said I had a good attitude and that goes a long way towards success. In other words, I preferred a VBAC, but I wasn’t going to lose my mind if it didn’t happen. I had a toddler at home, I simply didn’t want the recovery of a c-section. It had nothing to do with my first experience.

This ties to my bigger point. We took a class, run by our health authority, on VBAC to remind ourselves about labour. The doula teaching the class had us do an exercise with double sided cards. One side said things like short labour, tearing, or epidural. The other side said things like long labour, episiotomy, and drug-free. We were supposed to pick our preferences and rank them. Both my husband and I took one look at the cards and raised our hands. Where was the card for healthy baby? Healthy mom? The focus was so much on the labour experience and not the ultimate outcome. So we set the cards aside and waited until we discussed the actual techniques for coping/helping with labour.

So many times the focus is on the labour experience for the mom. I’m not dismissing that, but frankly, it isn’t the most important thing. It’s like paying all that attention to a wedding when it is a 1 day affair and ignoring the fact that you are getting married. Your goal should be a healthy baby, regardless of how it arrives.

(And yes, I was able to have a hospital VBAC, but it was indeed risky at times. I had great doctors and nurses. More importantly, I have a healthy and adventurous 2.5 year old!)

Kristen, as much as I hear so many people villify vbac moms for wanting an “experience” over a healthy baby, I have yet to hear from a single mom, anywhere, that wouldn’t gladly wheel herself down to the operating theater if surgery was what her baby truly needed. But so many times, it has nothing to do with the health of the baby, and everything to do with her care provider’s or hospital’s perception of risk. Unfortunately, risk is involved in any decision a woman makes during pregnancy and birth. A woman who chooses a repeat c-section has a higher risk of dying during childbirth, has a higher risk of complications, stillbirth, ectopic pregnancy, and life- and/or uterus-threatening placenta problems in future pregnancies, as well as of secondary infertility. A woman choosing a vbac has a higher risk of uterine rupture, cord prolapse, and other labor complications. It’s not a matter of one choice being necessarily safer than the other; it’s a matter of which risks are more acceptable to the mother, and which outcome provides the most likely chance of a healthy baby *and* a healthy mother in the current and all future pregnancies. Why should a doctor, or a hospital board, or insurance companies decide for a mother what is the most acceptable risk for her to undertake? All we vbac moms want is the ability to make the best decision for ourselves and our families, instead of being forced to undergo a surgery because someone else, somewhere, is afraid of being held responsible if the risk we’ve chosen to undertake ends up coming to pass.

Stop blaming moms for wanting to be healthy, sane, fertile, and autonomous. And care providers, if you’re so terrified of women choosing vbac, then don’t cut us in the first place.