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.
The statistic “Only 6% of uterine ruptures are catastrophic” is from the Evidence Report (Guise 2010) which was the basis of the 2010 NIH VBAC Conference and it refers to the rate of infant death due to uterine rupture.