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Donna Marie
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| Posted: Feb 27 2008 at 11:26am | IP Logged
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I can't believe this...
our local baby-friendly hospital (they let you do whatever you want with your newborn without whisking them away at all hours of the night to give them baths and keep them in the nursery) will NOT accept VBAC patients...at all. My former midwife practice has been trying to fight them for some time now. The local OBGYNs are perfectly happy with the hospital's new rule that they won't accept VBAC patents...so why change? There is some rule that they have to have an anesthesiologist on full time and they don't want to have that provision ($$) so the rule is..no VBACS...sheesh!...why make a woman go through surgery unnecessarily?? ...and this hospital and my old midwife practice is only 4 minutes from my house!
The next hospital down the line (25 min away)
will pay lip service that they do allow VBACs and will try to push a C Section...
Looks like I have to jump the border into PA and go to a Midwife practice in Allentown... 1hr and 10 min away.
This midwife trained my former midwife and evidentially is very experienced. I was told she is a great patient advocate and this consoles me...but! This is going to cost me much in gas money...wear and tear on the supervan and time...sheesh
Wish me luck.
We are just beginning...I wonder what else I will need to get an education in so that I can protect my rights and the rights of my unborn baby. Does anyone have any advice to offer? I am way too green with this subject and I want to be educated...
God love you!
Donna Marie from NJ
hs momma to 7dc + one more due 10/08
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God love you!
Donna Marie from NJ
hs momma to 9dc!!
Finding Elegant Simplicity
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SusanJ
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I had a VBAC with my second and decided to go with a "lay" midwife or "direct entry" midwife. She was very reasonably priced, came to my home for prenatal exams and was fantastic with postpartum care and follow-up. The birth was at home, obviously, and was really wonderful. This particular midwife is sort of known in my area for VBACS and had one herself so I was confident that she would give me good care. You might look into that option.
Susan
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JodieLyn
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It's not just them.. it's the medical insurance setting those rules.. and it's everywhere.
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mellyrose
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| Posted: Feb 27 2008 at 12:40pm | IP Logged
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The rules are similar in Arizona. When I had Nate (2002), I had a VBAC and there were no issues at the time. When I was pregnant in 2004, suddenly I couldn't find a doc or hospital that took our insurance that would let me VBAC again. I miscarried that child, but found a doctor willing to do a VBAC. When I got pregnant again with Lydia, luckily the doctor and the hospital she delivered at were willing to do a VBAC (although the hospital didn't like to do them, they weren't against the rules.)
Lydia ended up a c-section bc of pre-eclampsia, but I was grateful to have found a willing doctor, if I would have been able to VBAC again.
Also, legally in AZ, midwives cannot care for women who want to deliver VBAC at home. I had considered a homebirth, but didn't want to do so unassisted.
When I looked into it in 2004, it was driven by the insurance companies more than anything -- which is a shame, I think! And ridiculous as well considering how much more a c-section costs vs. vaginal birth on average!
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JodieLyn
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| Posted: Feb 27 2008 at 12:48pm | IP Logged
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It goes something like this Melanie
Once upon a time it was "once a section always a section", then women demanded to be allowed to VBAC.. and it was going well so insurance demanded that all women (regardless of cause) attempt VBAC.. and that was a disaster.. and it's eventually come around to the whole "must have an anesthesiologist in the hospital 24/7" for the hospital's insurance to ok VBACs there.
Some hospitals work around that somewhat.. like I think I've heard of some that will do an induction so that the VBAC happens with an anesthesiologist there even if they don't have one on 24/7.. things like that.
And in the meantime, c-sections have become all the more routine for any so called "complication" (gee it's taking you longer than average to birth that baby.. better get 'em out with a c-section type of thing) so it's locking women into a very difficult position. Those that only have one or two children max. aren't too concerned about it.. but women who have or want more.. it can make it very difficult. 
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G-18, B-17, G-15, G-14, B-13, B-11, G-9, B-7, B-5, B-4
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SusanJ
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Just wanted to point out that it is never illegal for a woman to give birth at home (not that anyone was suggesting that). Our midwife lives in MD where she is not allowed to practice legally. She does, anyway, and I'm not sure what dh and I would do if we lived in a state in that situation.
Susan
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sewcrazy
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A hospital would have a very hard time forcing you to have a c-section. I have a dr and hospital with a no VBAC rule and have still VBACed 3 times. You must consent to surgery, and a hospital cannot turn away a woman in labor. To force a VBAC they have to get a court order showing that you are willfully doing harm to your child, or are incompetent to make the decision. And that isn't easy to do quickly. We have a notorized statement explaining our wishes and reasones for our refusal for a unnecessary c-section ready just in case, and a neighbor who is a lawyer ready to represent us.
I have argued while pushing that they do not have my permission to cut me open. This can make you unpopular with administration, but most LD nurse will support you. Yes it does add stress to delivery time. My dr knows I won't agree, but tells me that ACOG guideline require that he warn me about everything that I risk with my "foolish" insistance on VBAC. I rebut with the complications I risk from major abdominal surgery coupled with recovering from pregnancy and childbirth. 
C-sections are not evil, and can be life saving. My 13 year old son was a true emergency csection--no baby heart beat and I was losing blood (sorry if TMI) through a torn placenta. But that is thankfully a rare occurence, and didn't mean that the rest of my children had to be born surgically.
Sorry. I get on a soap box about this. 
LeeAnn
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Martha
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yeah, don't get me on my soapbox either.
my 3rd was a non emergency c-sec (breech)
I've had FIVE uncomplicated VBACs and yet even with the last VBAC, I had to fight, argue, and sneak to delivery without c-section. 
It is my #1 fear and stress, even worse than the HMG sickness worries shoudl I get pregnant again.
Whether a hospital can turn you away depends on:
1. if it's a private hospital or public.
private can send you to a public hostital if you refuse to sign waivers and are not in a life threatening situation.
and
2. whether you are unstable or not. no hospital can turn away an unstable patient. if you are stable (not in a life threatening situation) they can and have sent patients to public hospitals.
Actually the hardest thing is finding an ob that will even take you! Most flat out say they do not do VBACs and will refuse to take a patient that won't sign the waiver. There's exactly 2 in my entire county that accept VBACs and obviously they can't take all the pregnant ladies that want them. None of the midwives here take VBAC patients.
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SusanJ
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I don't know if your local hospital is still an option given the above but you might also look into hiring a VBAC friendly doula who can go with you. A doula does cost money but probably less than a two-hour round trip commute for all your prenatals. A doula can do all that arguing for you or, at least, buy you time with the doctors to think through your arguments (a doula can't speak for you, medically). A doula will also be able to assist you with moving labor along quickly and effeciently so that you don't end up "needing" a C-section. Part of the reason VBACs are difficult in hospitals is not because they aren't "allowed" but because there are so many standard interventions that it becomes difficult, if not impossible, to give birth normally. A doula can help you get intermittent (instead of constant) fetal monitoring, help you find good positions for laboring and pushing, support your dh as he supports you, etc.
Just something to look in to.
Susan
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SallyT
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Re the doula suggestion: I had a doula assist with my first VBAC (first child was an emergency section; the other 3 have been VBACs), and she was wonderful in holding off the rather more anxious doctors until I could deliver. But that was ten years ago, when doctors, hospitals, and insurance companies were more open to VBAC than they are now. I had my third child in a hospital with a midwife in England, where despite the previous c-section I was still treated as a regular old low-maintenance pregnancy. I returned to the states pregnant with our youngest and had a heck of a time finding an OB who would deliver my baby without a C-section. I remember storming out of one doctor's office in big fat pregnant tears. We ended up having to go to the big urban teaching hospital, where until I delivered the baby in two pushes all the staff around me made it clear that they fully believed that they were going to be cutting me open. *sigh*
Part of me wishes I'd had a homebirth for that one -- here in Memphis we don't have CNMs who deliver in hospitals -- but then again, this was the baby who ended up having Group B Strep, so in the end I was grateful to be in this massively interventive hospital, where they caught the infection before she even got seriously sick . . . God does arrange things for a reason . . .
I really do feel for you. C-sections aren't the end of the world, of course, but if you don't have to have one, for an immediate,pressing, life-or-death reason, then it's tough to swallow even the idea of having one.
Susan's doula recommendation is really good, though. I loved the doula we had at our older son's birth, and she did smooth the way in lots of ways that we couldn't have accomplished on our own.
Good luck to you!
Sally
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Topic: VBAC care...sheesh!
