Yesterday I came across still another story in the news about a pregnant woman who had to travel hundreds of miles in order to have a VBAC. This was the woman’s fourth pregnancy – her first birth was a vaginal one; her second, a cesarean surgery; and her third a successful VBAC. She was an ideal candidate for a VBAC (and did go on to have a successful VBAC). What is particularly frustrating about this woman’s story is the assertion of the spokesman for Banner Health who said that her local hospital is capable of providing emergency cesarean surgery, but not willing to offer VBACs. Huh? The article says that VBAC services differ significantly from other emergency services, as ACOG guidelines recommend two physicians to be immediately available during the entire period of labor, which can be 24 hours or more. However, this is what ACOG actually says:
“Because uterine rupture may be catastrophic VBAC should be attempted in institutions equipped to respond to emergencies with physicians immediately available to provide emergency care.”
I interpret ACOG’s statement to mean that a hospital that offers VBAC services should be able to respond immediately to any obstetric emergency. (But not that the hospital is held to higher standards for VBACS.)
When candidates for VBAC are selected according to recommended criteria, research studies consistently support the safety of VBAC. Thank goodness, leading experts and researchers from around the country will be meeting March 8-10 in Bethesda, Maryland to develop consensus guidelines for VBAC. This National Institutes for Health-sponsored meeting is free and open to the public. You can register to attend the meeting or to watch the proceedings via the Web. You can also request a free copy of the final conference statement (and recommendations). Think about taking the time to attend or to watch via the Web this important meeting. The recommendations from this meeting have the potential to substantially bring down the soaring cesarean rate and to provide women who have had cesarean surgery with choice regarding their future births.