Hospitals With No-VBAC Policies Are Finally Being Challenged, Thanks to New Guidelines


RyanJLane

VBACs -- or vaginal births after cesarean -- are a huge topic of discussion in the medical field. There's no denying that there can be certain risks when a mom goes for a natural birth following a previous C-section, but many medical organizations and mothers alike believe that physicians and hospitals go too far when they essentially ban them. With the help of a new set of guidelines, the American College of Obstetricians and Gynecologists (ACOG) is on track to change that.

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The ACOG has supported women's right to delivery vaginally after C-sections for many years. The organization has presented information supporting the belief that VBACs are safe for mothers as long as proper care and preparation is taken by their physicians. But due to dated beliefs and unchanging hospital policies, there are still many women who do not have access to their desired delivery procedures.

More from CafeMom: The 'VBAC Project' Puts the Spotlight on Moms on Labor Day

In an effort to finally push outdated hospital policies forward, the ACOG has updated its guidelines, actively pushing back against physicians and medical institutions that have solid "no VBAC" policies in place.

While these new guidelines do support the idea that VBACs should not be attempted in home-birth settings, they also say that they should be an option for any woman who is giving birth in a facility that is equipped to handle emergency deliveries.

Dr. Jeffrey L. Ecker, a physician at Massachusetts General Hospital in Boston and past vice chair of the ACOG's committee on practice bulletins-obstetrics, approximated in a report for the ACOG that 60 to 80 percent of women who attempt VBACs are successful in their deliveries. 

For VBACs, the largest risk centers around the possibility of uterine rupture. But even that risk is exceedingly rare, only occurring in about 1 out of every 1,000 women. Even with this knowledge, many medical institutions and physicians outright refuse to perform VBACs due to the possible threat of disaster. 

"Despite a 23 percent increase in VBACs from 1985 to 1996, that number has since plummeted as the cesarean delivery rate has continued to trend upward," said Dr. Mark Turrentine, chair of the ACOG's committee on practice bulletins-obstetrics, in an official press release. "This is the opposite of what we want to see happening, and it's because there is still a great deal of misunderstanding regarding the safety of [trial of labor after cesarean delivery] and VBAC and a reticence to consider this a viable option due to medical liability concerns."

These hospital regulations against VBACs have made many women take desperate measures, like actively going against their doctor's wishes or even staging protests against what they believe to be unfair rules. 

Dr. Mara Rosner, assistant professor in the Department of Obstetrics and Gynecology at NYU Langone Health, shared with the Huffington Post that she believes the ACOG's new guidelines will have a serious impact in the medical community. "For us, as physicians, to have ACOG's support is really important," she said. "If ACOG came out and said, 'VBACs are not appropriate,' we would listen. This emboldens physicians who might be more reticent to offer VBAC to maybe consider it."

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These guideline changes are certainly just the first step. While they don't dictate what physicians and hospitals are legally allowed to do, they do open the door for progress. We may have a little way to go before hospitals all over the country begin easing up on their VBAC rules, but we are definitely one step closer to giving women what they want -- the right to choose what is best for them.
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