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Entries from December 1, 2011 - December 31, 2011

Thursday
Dec222011

Working to Ban VBAC at Your Hospital? Then Stop Griping About Home Birth

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I posted this prompt over yonder on the Facebook page:

Here is question posted here by Nicole: “So what are you supposed to do when the hospital closest to you has a VBAC ban? Show up when ready to push?” What did you do? Stories?

Responses are pasted below.

 

I don’t think people realize that the decision to stop doing VBACs at hospitals that are fully capable of providing them isn’t made with a ton of fanfare and parliamentary procedure and such. It happens at a regular old staff meeting and gets in the minutes like anything else. This latest one I just heard about sounded like it might have fallen somewhere on the priority list just before, “Hey, could we get the vending machine guy to start stocking Luna Bars?”

So if you’re one of those providers that is privy to this kind of bullshit and feel like speaking up, print this post and stick in front of their face and tell them that all of this is on them. They assume responsibility for all of this for restricting access to vaginal birth in hospitals. And tell them to enjoy their damn Luna Bar.

 

 

 

Responses:

 

Susan

Go to a hospital further from you? Hire a homebirth midwife?

 

Rose

how far away is the next closest hospital? I mean, you could go to the hospital anytime and just refuse to have a cesarean.

 

Melissa

If you are comfortable with home birth, you might contact your closest ICAN chapter for the names of midwives who would be willing to catch.

 

Tami

Find a competent hospital!!!

 

Earthy

You have a right to refuse a cesarean. But personally I would not step foot inside a hospital with that attitude. Can you make a home birth happen?

 

Sandra

I opted for a birth center rather than the hospital with a VBAC ban, but if you don’t have an option, I’d say show up crowning.

 

Maria

found a skilled midwife and had a homebirth

 

Tera

hire a homebirth midwife

 

Erin

i had my baby at home

 

Crystal

go in crowning :)

 

Melissa

Read a few books and catch your own baby!

 

Joy

Birth center or home birth. ;-)

 

Jessica

I UBAC’d! :-)

 

Carla

If you have access to midwifery care, do it at home.

 

Polly

UBAC?

 

Michelle

Choose a place you are comfortable with even if it is farther away. I chose a birthing center an hour away, and had my dream waterbirth. It’s worth to commit to the experience you want, even if it’s not the most convenient. Hope this helps!

 

Stacie

That’s one option if you’re uncomfortable with homebirth and/or a longer commute to a friendlier hospital, but it certainly won’t be your easiest or most pleasant option. It sucks to have to fight anyone in the middle of trying to have a baby, so it’s just a matter of weighing what feels safest to you with your willingness to argue your way through your birth, should you happen to encounter hostility upon arrival.

 

Jessica

UBAC - Unassisted Birth After Cesarean :-)

 

Stephanie

Hospitals in my area aren’t supportive of VBAC. I see a homebirth midwife an hour away from me. Hoping for an HBAC in May.

 

Sally

Hire a midwife and stay home! It really is as easy as that!

 

Kristen

went to the hospital that allowed vbacs. an hour away.

 

Sally

Stay home until you need to push;)

 

Tracy

http://midwiferytoday.com/articles/50ways_vbac.asp

 

Dena

homebirth

 

Tracy

PUSH the Medicaid aspect of it. Even if you are not on it this still holds them to rules!

 

Vickii

Just say no.

 

Tracy

6. One of the most promising routes to reversing the VBAC bans that we probably have is to file complaints through the Medicaid system. Women who file the complaints don’t have be on Medicaid themselves in order to complain—just make sure that the hospital itself receives federal funding. Here, in Katie’s words (referenced previously), is the rundown on how and why to approach Medicaid:

All hospitals that receive federal funding (approximately 80% of them do) must adhere to the Center for Medicare and Medicaid Service’s (CMS) Conditions of Participation (CoP), which require hospitals to honor patient rights as defined by the Patient Self-Determination Act, the Consumer Bill of Rights and Responsibilities, the Emergency Medical Treatment and Active Labor Act (EMTALA) and the large body of case law upholding the right to refuse treatment, to be fully informed of the risks, benefits, and alternatives of any proposed treatment and to participate in all treatment decisions.Hospitals that fail to adhere to the CoP are subject to heavy fines and risk losing their right to qualify for Medicare and Medicaid funding. In addition, the CoP requires that hospitals institute an internal grievance process and give patients the information they need to know about how to file a complaint and where to appeal in the case of an unfavorable ruling.

Pregnant women who plan to give birth at a hospital that performs repeat cesareans on all VBAC mothers should start first by filing a complaint with the Chief Compliance Officer, whose job it is to ensure that the CoP are met. If the hospital has no Chief Compliance Officer, then call and ask to receive the necessary information to file a complaint for a violation of the Center for Medicare and Medicaid Service’s Conditions of Participation.

The hospital must respond to an initial complaint within one week or else offer an explanation of the reasons for the delay and an estimated time frame for a response; failure to do so is in itself a violation of the CoP. If the hospital’s Chief Compliance Officer or other designated agent issues an unfavorable ruling, then the next step is to appeal to the Office of the Inspector General at the Department of Health and Human Services. If HHS also rules in favor of the hospital, then you may appeal to the Department of Justice, which is authorized to bring litigation against hospitals on behalf of their patients.

 

Brittany

Tracy, can you explain that because that could be really helpful!!!

 

Brandi

I had a friend who did the show up and push thing but that in itself is a danger and a stress. I’d look for a homebirth alternative if that’s available in the area.

 

Greta

how far is the next closest?

 

Melek

I’d either HBAC or travel, maybe staying in hotel out of town close to my DD. Only if I had no other options would I birth in a place like that, and I’d hire a monitrice and go in with my baby falling out of me

 

Tracy

@ Brittany I pasted the section explaining how but if you have more questions I believe the gal working on the legality of bans wrote this article and you could contact her :)

 

Sarah

Worst case I considered w/my breech baby - pull the seats out of the minivan and get a midwife to attend me in the parking lot of the hospital.

Going to a hospital to birth planning to refuse a c-section is pretty problematic. (1) There are cases of court-ordered c-sections obtained while mom is in labor. (2) More likely - the doc is already convinced that what you are doing is putting baby in danger. S/he is going to tell you repeatedly about how your baby is near death and do everything s/he can to force a c-section. At some point you or your partner is likely to cave. (3) If you are going to show up crowning, why go at all? Stay home for an underground homebirth or unassisted birth.

 

Chelsea

Just had my home birth (vbac) at home 4 months ago! it was amazing. dont rule it out. I ruled it out at first until i got the support i needed (other moms who had birth vbac at home successfully, talked with a midwife, did reasearch, read books & watched movies) these things gave me the confidence I needed to birth at home. It was the best decision of my life. Good luck to you on your journey!

 

Diana

Stay home. I had a VBAC after a classical incision, at home. Then I had another homebirth after that. Wouldn’t do it any other way!

 

Anisa

Home birth or drive further to the next hospital. But really - just stay home!!

 

Cassandra

I’d home birth. But it’s cool if you aren’t comfortable with that. But consider it may also mean you aren’t comfortable laboring at home until it’s time to crash the hospital at 9-10cm.

Use your local ICAN and doulas to find a VBAC friendly hospital and consider laboring in a hotel close by with a jacuzzi in the room(if the hospital doesn’t have one) until things get serious;)

 

Julie

One of the midwives I work closely with (as a doula) told me that once she supported a woman to labour at home then dropped her off the hospital when she was 10cm dilated and actively pushing (she was “not allowed” into the hospital, a disgraceful situation) - and the woman STILL ended up with another caesarean. Stay home, stay safe and give birth. You hire a surgeon to oversee your natural birth - you get surgery. Stay home away from that sharp cutting stuff so your womb or your yoni don’t get cut. Hire a midwife who specialises in natural birth - and you are more likely to get just that. It is really a pitiful state of affairs that the only way a woman can get a decent go at a VBAC is if she has a homebirth - I realise not all women want to homebirth. But think about it - the reason you are in this situation to start with is because hospitals are (these days) crap at supporting normal birth (excluding genuine obstetric emergencies like PE & PP and the small percentage of necessary caesareans - I’m talking about the unneccesareans for Failure to Wait, IOL Cascade, Big Baby etc). If the obstetric model couldn’t support you appropriately to have a normal physiological vaginal birth the first time (2nd, 3rd, 4th time etc), the obstetric model is not suddenly going to be the perfect place for you to have a VBAC. Homebirth is wonderful, I’ve had 4 and attended scores - but I understand it’s not everyone’s choice and it’s disgusting that hospitals are now so institutionalised, corporatised and under the control of lawyers, obstetricians and powerful pharmaceutical companies that they are far from Vaginal birth & VBAC-friendly - they are places where a lot of money gets made FROM using intervention - not from refraining from using it. Meanwhile, the culture of fear around birth means that people caught up in the system have hardly ever seen an unhindered birth and they just can’t believe in something they have never seen or rarely see. They believe it is a dire emergency and tha things are about to go horrendously wrong any second - because that is what they know and that is what they see. If a birth with every intervention and all manner of interruptions and monitoring and surveillance can go so horribly wrong, according to their logic, it follows that an unhindered birth is equally precarious and just as likely to end in a train wreck.

 

Joy

‎”show up crowning” is an oversimplistic and frankly uncool thing to offer this woman. The stress alone of car travel during birthing is an awful thing to plan to do, and almost guarantees a hectic and certainly non peaceful unnatural SCENE. homebirth is an option but costly and who knows if she would even be a good candidate for that. Truly the only thing to do would be to find a VBAC friendly CAREGIVER. then the wheres and whens and hows can realistically be discussed.

Its an awful, litigious, hostile time to be a pregnant woman right now, and it does suck to have to fight and battle—-but do it now, NOT IN LABOR. if possible.

If you show up at a no-vbac hospital and they are assholes to you, the stress alone could give them whatever “blip” on their omnipresent belly-band readouts to freak them out, and whoooops theres your section!

 

Mama of 5:

Vag hospital

Csection

Homebirth HBAC

Failed ubac attempt/repeat csec

Planned hospital vbac turned c

 

Get a caregiver who supports your rights to VBAC and then you guys figure out where to give birth.

 

 

Melissa

I agree that a monitrice may be a good option if you absolutely must go to the hospital. If I were in a position to VBAC, I would like to be able to have some monitoring while I stayed home as long as possible.

 

Melissa

Many mothers in our area drive 4 hours to Denver or Boulder a week before they’re due (if they’re lucky), some even make the drive while in labor.

 

Tanya

I agree, Joy. Please stay home. If you plan on turning up to hospital late in the 2nd stage I cannot imagine how stressful you will be waiting for the correct time and will probably end up birthing in a very uncomfortable position/environment. Good luck for your birth, Nicole.

 

Olivia

Have a homebirth.

 

Christy

We traveled over an hour for our last 2. If we can’t stand up to the demands of a dr how are we going to raise teenagers? there are great resources here. Get in touch with how u feel and only work with those that respect it. Plain and simple.

 

Diane

I found a doc 80 miles away and delivered at a Vbac friendly hospital there. It was a beautiful and amazing experience even though I had to go all that way in labor. I’d do it again no question.

 

Sarah

I agree with Joy, Also get a doula…helped me labor at home and during my long car ride.

 

Tami

They may be unable to do VBACS due to being sued over stupid mistakes by the Drs! I’d run away FAST!

 

Ivey

HBAC!!

 

Laura

I so needed to know this info!!! THANK YOU FOR POSTING!

 

Stephanie

I’m traveling 1.5 hours out of state to a different hospital, that is vbac supportive :P

 

Laura

Also, after reading ALL of the comments I realize I still don’t feel a whole lot better.

I’m 14 weeks almost, have found a birth center to birth at. This will be a VBAC after 1 c-section. I’m 45 minutes from the birth center and also from the hospitals. If somewhere along the lines, the midwives don’t feel comfortable continuing my care, or something happens in the labor process that they cannot accomodate, the only option is to send me to the hospital(s). There are 2 right next to each other, right next to the center. Neither allow VBAC’s.

I know that not EVERY situation that goes a little different is going to require a c-section and so I’m a little confused as to what is going to happen IF this scenario comes up.

Legally, say I’m mid-birth or crowning or something equal-I CAN still go and refuse a c-section and the hospital still provide care for me, right?

 

Maryen

Yes you can refuse a c-section. There is a wonderful documentary about exactly this called “a breech in the system”. She turns up in labour, baby is breech, refuses a c-section and has a natural birth!!! Director is Karin Ecker.

 

Allyson

I chose to have a VBAC during the Ice Storm of the Century in Canada. It was a declared state of emergency at the time and they completely forgot about which orifice I was supposed to be birthing my babe from. I ended up with a Nurse/Midwife as all the “important nurses” were in the OR. Nurse Irene is a big part of the reason that our daughter was born healthy and happy 10 minutes after I dilated!

 

Kristi

I switched to a VBAC supportive provider and planned my birth at a VBAC supporting hospital an hour away. We had to drive past 2 closer hospitals to get there, but worth it.

 

Yanna

Many of us who have had previously complicated pregnancies don’t necessarily have the leisure of UBAC or HBAC, as in many cases, depending on our previous condition, no responsible midwife would agree to help us birth at home. With a growing number of diabetic mothers, I think it’s important to examine how we can facilitate better birthing conditions for ourselves and others.

 

Jessica

Is any of those things valid with multiple c sections?

 

MaryBeth

I traveled two hours away to my ICAN listed OB who supported me, listened to me, and gave me no time limits so I could have my VBAC 67 hours post membrane rupture! I will do it again when it’s time for #3. You will never regret the drive, I promise. Nothing in comparison to a VBAC. Worth the gas money; you will save thousands versus another section.

 

Meghan

Where is the closest hospital that will allow vbacs? I had to drive a bit farther for a vbac but totally worth it.

 

Bonnie

I have recently been fighting with my hospital for the right to have a vba2c… they have a strict ‘policy’ against it.. but the thing is, here in australia, a policy is just that, a policy and not law. I suggest to Nicole, do your research, learn the risks associated with vaginal birth before csection, risks associated with repeat csections and risks associated with vbac. I had a successful outcome on Tuesday as i went in armed with my information and used the words “legal right to informed consent’ meaning as a woman you can choose how you birth and they have a duty of care to deliver your child (provided you are willing to accept csection if complications occur).

the risks associated with repeat csection are in many cases higher and than a vbac.

goodluck nicole and remember - arm yourself with information, local laws and most importantly, dont be bullied into having an unnecessary csection xoxo

 

Sandra

@Laura - YES - if you do not consent to surgery they can’t perform it. They can (and most likely will) attempt to coerce you into a C section.

For what it’s worth, I have an almost 5 month old. During my pregnancy I saw an OB and planned to birth at an anti-VBAC hospital. However, I attended my best friend’s VBAC at about 37 weeks of pregnancy (mine - she was just over 40 weeks) and came home telling my husband I did not want to give birth in a hospital if I didn’t have to. So we called our midwife from my prior pregnancy (which ended in a C section - was a planned homebirth). She took me on and we planned to go to the birth center about an hour away, which would allow us to be closer to an supportive hospital IF I needed to transfer for pain medication. As it turned out we did not need to transfer - I had a labor just short of 6 hours. Arrived at the birth center ready to get in the tub and push. The drive there was uncomfortable, but not nearly as bad as I had feared.

Educate yourself on what to expect in the hospital as far as the things they will say to pressure you into surgery - a great resource for VBACs is Birthing Beautiful Ideas - check out her VBAC Scare Tactics series here: http://birthingbeautifulideas.com/?page_id=674

 

Ashley

Im so glad our local hospital (quarter mile away) is vbac supportive. My OBs rate is as high as the national average but he also does vbacs. Not sure if ill ever have another child but if i do itll be a vbac!

 

Brittany

This just makes me angry. I don’t see how a hospital can say no vbac. Just remember this, they can’t make you do what you don’t want 2 do. They can’t put your hand to paper and make you sign your name okaying a surgery you don’t want. Refuse. Remember, you are paying them, not the other way around, they do what you want, period. I had a c after 48hrs of labor and they cut me up and down instead of from side 2 side! 2 years later I had a v-bac and 13months after my first v-bac I had another. I flat out refused to lay on my back and be cut open, I fought and refused and got my way along with a healthy baby and a much faster recovery. Good Luck=)

 

Donna

I had a VBAC at an anti-VBAC hospital 7 months ago today. My doctor informed me of the risks, but also agreed I was a good candidate for VBAC. The hospital was aware that I would be coming. No one gave me any grief. You have to be as informed as possible and then make the decision that you feel most comfortable with. Good luck! :)

 

Heather

Stay home. It’s safer. Some facilities unintentionally (or even intentionally) punish women who exercise their rights. Get some good prenatal care based on good nutrition (hint: it’s unlikely you’ll get that from an OB) and the rest will take care of itself.

 

Tara

I would find another hospital even if its father away. I have issues trusting any hospital that attempts to ban babies from being born vaginally, cs or no cs. I am perfectly capable of deciding which risks I’m more comfortable with. And btw, the hospital closest to me does have a vbac ban and my old ob from a different hospital had zero intentions on supporting my plans to vbac. I found another a little further away to deliver at. And when they pushed for a rcs at the end of my pregnancy I stood my ground and said no! A wk later I did deliver my baby via vbac. It was worth every second of the fight.

 

Christy

I just wanted to add something. Did you say you are 16w? You are just in the start of your journey. One thing I have learned as the mom of 7 is that when you feel like you cant make a decision, it is often because it is not time to make it. A beautiful thing floods the pregnant body along with all of those hormones..INTUITION. If I were you I would do this: meditate, pray, or do whatever you like to do to get into a calm place in your mind. Then make one well informed choice after another. Are you with a care provider now that can do your 4m scan? Do you want one? In all of these posts I haven’t noticed why you needed the first C. I was at a birth that ended in a C, and i can tell you that she was NOT going to get that big head out. On the other end of it, I was nearly pressured into a C by a OB that was aiming to be a surgeon. And, I know that my first delivery ended in a C because of errors made by my OB through my pregnancy. So, stay calm. Take in all of this great info and find a provider that is moderate and educated. (Congrats on the pregnancy BTW!)

 

Tessa

I’m driving over an hour to get to care providers and hospital that will allow VBAC.

Even if they ban VBAC, you can refuse. But around here, if you aren’t pushing yet, they’ll send you by ambulance to the hospitals 1 hr away. They won’t allow you to deliver there until you are pushing and head is presenting. even then they still try to make you consent to RCS.

 

Susana

Planning an HBAC. My OB (previously known as Dr Teddy Bear) was patronizing, mean and frankly insulting when I said I wanted to VBAC (who am I to know better than him, is the line I got) staying home this time, and hope for the best…

 

Amanda

Luckily we have a teaching hospital so I refused the dr on call and accepted the residents and they gave me an hour to push. I had a very quick labor. And an amazing vbac!

 

 

 

Thank you all for your replies.