Last week, I shared the eleven things that I love about ACOG’s latest VBAC guidelines. And with good reason. There’s some excellent new language as well as reiterations of positions that they presented back in 2010. But there are a few places where ACOG misses the mark and these are the three areas that gave me the most concern.
I’m in an online group for labor & delivery nurses where the discussion of vaginal birth after cesarean (VBAC) at home came up. While some understood the massive VBAC barriers many women face, others simply said, “Find a hospital that supports VBAC.” I left a late-night comment stating that “finding another hospital that supports VBAC” is just not a reality in many areas of the country. It’s literally not possible. Not even in the highly populated state of California. I also suggested rather than calling women stupid or debating the validity of the decision to have a home VBAC , we should consider why women make this decision.
“Home birth is not for everyone but informed choice is. The patronizing statement, “home delivery is for pizza”, is unprofessional and has no place in the legitimate discussion. Some suggest making hospital birth more homelike.
My intention in attending this meeting was to amplify the voice of the consumer. I think sometimes it’s difficult for OBs who attend VBACs, or for those who live in communities where they have access to hospitals that allow VBAC, to understand that not everyone lives in that world.
There has been a lot of confusion regarding AB1308, the legislation that went through at the beginning of this year in the state of California. It said that LMs were no longer allowed to attend home births in some situations (such as breech, beyond 42 weeks gestation, etc) and other situations required a physician to sign off on the home birth.
A mom seeking a VBAC runs into major roadblocks at her local hospital which has a VBAC ban. VBAC Facts compiled a list of options based on real live decisions of women who VBACed despite bans. Did you deliver at a VBAC ban hospital? What was your strategy? Are you a health care provider at a VBAC ban hospital and have some insight?