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My chat with the ACOG VP & CEO about VBAC

by | May 22, 2019 | Legislation, VBAC | 1 comment

Earlier this month, I attended Mom Congress 2019 with 150 other advocates from all over the United States. We gathered to learn about and lobby for the Momnibus bill package, a bipartisan effort to address maternal mortality, maternal mental health, and paid family leave. (Check out some quick infographics here.)

I had a chance to learn more about these issues and deepen relationships with other maternal health advocates. (We have to use our collective power!)

My team met with Congresswomen Katie Hill and Judy Chu to share information about the Momnibus bill package and ask for their support.

Group photo with Katie Hill

Katie Hill meets with Mom Congress 2019 representatives to discuss Momnibus bill package

 

I also had an opportunity to chat with Christy Turlington Burns from Every Mother Counts about VBAC access.

In fact, I try to slide VBAC into the conversation as often as I can so more people realize that the evidence supports it, ACOG encourages access, and yet so many women do not know VBAC is an option. Once they know just those few facts, the conversation blossoms and their minds open.

 

Group photo with Christy Turlington

Christy Turlington meets with Mom Congress 2019 representatives

So when I learned that Dr. Lisa M. Hollier, the American College of Obstetricians & Gynecologists (ACOG) Interim Executive VP and CEO, would be speaking on a panel, I knew I had to have a moment with her as well.

On one hand, so many OB/GYNs and hospitals say that they have to do certain things because “ACOG requires it,” but then they completely ignore other recommendations ACOG makes.

ACOG seems to simultaneously have a lot of power in terms of influencing care and yet none at all when it comes to enforcing things like VBAC access.

As a former ACOG President Jeanne A. Conry, MD, PhD said, “ACOG guidelines are not mandates, and there are no ACOG police that enforce their use.”

Meanwhile, hospitals around the United States ban VBAC and require repeat cesareans exposing birthing parents and their babies to complications more serious than uterine rupture. They claim that they have to ban VBAC because ACOG requires them to have 24/7 anesthesia in order to offer VBAC. (This is not true by the way.)

This is a real challenge for parents who want a VBAC.

So when the opportunity presented to speak to Dr. Hollier, I wanted to share with her what was happening on the ground in terms of VBAC access.

I pointed out ACOG’s VBAC guidelines and that hospitals and obstetricians are simply not listening.

Despite these supportive guidelines that encourage access and denounce forced cesareans, there is a 90% repeat cesarean rate in America and coercion still happens. 

The fall out of all of this is huge. The truth is cesareans have contributed to 28% of maternal deaths in California. (Morton, 2019) As 1 in 8 births in America take place in California, it can give us a good indication of what is happening nationwide.

I was the last person in line who got to speak to her and had to quickly shared these thoughts before she left.

While she didn’t have any reply to my comments, I felt that she was listening. At least I hope she was listening.

I also had the opportunity to address Dr. Jean Ko, PhD, an epidemiologist with the Division of Reproductive Health at the Centers for Disease Control and Prevention.

One of the things I shared is how receiving disrespectful care impacts the subsequent pregnancy.

This fallout is intensified if the prior birth was traumatic or resulted in a cesarean which makes future pregnancies more complicated given the difficulty many experience as they navigate their options, seek accurate information, and try to access VBAC.

I wanted her to know that birth trauma can result in a lost of trust in the medical system as a whole. It also plays a role in maternal mental health conditions like post-partum depression and post-traumatic stress disorder.

And this undoubtedly impacts how they feel as they enter their next pregnancy and try to figure out how to keep that trauma from reoccurring.

As I move through this world, and have these little moments to highlight what parents are experiencing to people in various areas of influence, I  hope it makes a difference.

My next trip will be to the Decolonize Birth Conference this September 21st in Brooklyn, New York. This year’s theme is “Truth and Reconciliation for a Liberated Reproductive Justice Movement” and I can’t wait. (Watch the Ancient Song Doula Services Facebook page for updates.)

Here’s one thing I know to be true: If we want to improve maternal deaths in America, we have to start by addressing outcomes among Black and Native communities. That means centering Black and Native women.

Also, mark your calendars for May 3 – 5, 2020 for Mom Congress 2020.

Final thought: Attending events like this so I can plant seeds, create relationships (because it’s all relationships), and try to make shift happen on the state and federal level is only possible because of parents who purchase my educational programs, perinatal professionals who join my professional membership, and others who bring me out to speak in their communities.

So if you have supported my work, thank you.

As much as I have helped you, you have helped me too, and together, we will increase VBAC access!

Jen

PS: If you could talk directly to Dr. Hollier, what would you want her to know about VBAC access? Leave a comment below!

Resources Cited

Morton, C. (2019, April 26). How to decrease maternal deaths. (J. Kamel, Interviewer) Retrieved from https://vbacfacts.com/membership

 

What do you think?
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What do you think? Leave a comment.

1 Comment

  1. Hi Jen,
    This comment is more of in support of the VBAC movement. I work at LAC-USC Medical Center, L&D. And I am proud to say that our doctors do offer TOLAC and VBAC options to our previous x1 c/s patients and or prev x1 with subsequent VBACs, and anyone with a well documented scar and history, this option is always offered to them. However if patient insists in-spite of previous x2 or more and still insists on TOLAC, they would be given a chance and be thoroughly counseled by our MFMs.
    I myself was able to convince my niece to have a VBAC after a c/section by explaining thoroughly to her how this is done and reassuring her that safety is the utmost importance with this plan.
    I’m glad to see this issue being brought up to address the mortality rate of our birth outcome in this country.
    Thanks for taking time to read this comment.

    Reply

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Jen Kamel

As a nationally recognized consumer advocate and Founder of VBAC Facts®, Jen helps perinatal professionals, and cesarean parents, achieve clarity on vaginal birth after cesarean (VBAC) through her educational courses for parents, online membership for professionals, continuing education trainings, and consulting services. She speaks at conferences across the country, presents Grand Rounds at hospitals, advises advocates seeking legislative change in their state, and serves as a expert witness in legal proceedings. She envisions a time when every pregnant person seeking VBAC has access to unbiased information, respectful providers, and community support, so they can plan the birth of their choosing in the setting they desire.

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Free Report Reveals...

Parents pregnant after a cesarean face so much misinformation about VBAC. As a result, many who are good VBAC candidates are coerced into repeat cesareans. This free report provides quick clarity on 5 uterine rupture myths so you can tell fact from fiction and avoid the bait & switch.

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