AVH to stop birth procedure
April 9, 2002
The Aspen Valley Hospital board of directors voted Monday to suspend the use of a controversial birthing procedure.
The hospital will stop allowing vaginal births after Caesarean section, known as VBACs, while physicians investigate the procedure. With the board’s vote, AVH joins the ranks of Valley View Hospital in Glenwood Springs and Clagett Memorial Hospital in Rifle in temporarily banning VBACs.
The birthing method came under fire recently when, during a meeting of AVH’s medical executive committee, officials determined the hospital was not properly equipped to handle the risks that come with a VBAC. Citing a study published by the New England Journal of Medicine, the committee decided VBACs cause too many “quality of care” issues that could compromise patients’ health. For example, the procedure results in a 5.6 percent increase in the rate of uterine ruptures and a 5 percent increase in the infant mortality rate, according to the study in the Journal of Medicine.
“[The hospital is] unable to provide the level of care necessary for the best possible outcome of mother and newborn,” said committee member Dr. Dennis Cirillo.
He rattled off a list of things AVH would need in case a VBAC goes wrong, including a larger neonatal ICU staff, a special room designated for C-section births and better access to basic supplies such as blood.
“It sounds like you’re not equipped to take any births, which makes me nervous,” said expectant mother Andrea Olson, in attendance at Monday’s meeting. “It sounds like, instead of stopping these little procedures, [we should be] getting better quality care.”
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Cirillo assured her that most births were perfectly safe at AVH, but cautioned that elective procedures such VBACs were considered dangerous in smaller communities.
“We all choose to live in this mountain community and give up certain comforts,” Cirillo said. “If it was my child, we would go to a place where all of those things would be in place.”
Olson, a Basalt resident who is six weeks away from delivering her second child, said she attended the meeting to determine whether her VBAC request would be denied.
“We will be doing a home birth if we’re not allowed a VBAC,” she said.
A home birth would be a better option than choosing a VBAC elsewhere, Olson said. Since Grand Junction and Denver are the closest cities that house VBAC-equipped hospitals, Olson said she would prefer not to make the risky drive downvalley while in labor.
If an emergency occurs in the rush to Grand Junction, Olson said, an expectant mother would have no choice but “what, having to squat in a ditch?”
Local resident Georgiana Lily made one last plea to the board before the VBAC discussion was suspended for the day. Lily, citing the fact that a VBAC is considered an elective procedure, asked the board to allow expectant parents – or any patient looking into voluntary surgery – to assess the risks of their decisions on their own.
“I want to get you guys off the hook,” Lily said. “You have to let us be responsible for ourselves and assist us with our choices. If I make a bad choice, I’m the one who will suffer the consequences.”
With the unanimous support of his fellow board members, Tom Griffiths moved to suspend VBACs with the provision that AVH “continue to re-evaluate our capabilities” where the procedure is concerned.
After the board’s vote, Olson asked her obstetrician, Dr. Mallory Harling, if giving birth to her baby at AVH would mean an automatic C-section despite her wishes for a vaginal birth.
“I don’t know,” Harling answered. “My obstetrical decisions have been usurped.”