Saddened by decision
April 11, 2002
I am appalled and saddened by AVH’s ban on VBACs (vaginal birth after caesareans). This is a giant step backwards for a hospital who, up until Monday, had been a progressive one.
Now, women desiring to have a VBAC have to either travel 100 miles to Grand Junction with a laboring mother in the car (How many babies will be born on the highway – unattended?) or move her family to Denver for the last month of her pregnancy. Both of these options are not feasible for women and their families.
The study that the board cited as the most significant reason for halting this practice was a flawed one. First off, it used insurance billing codes for its diagnosis of uterine rupture, and secondly, it didn’t distinguish those labors that began spontaneously (normal labor) from those in which medication was used to induce labor.
It is well known by birth professionals that some of the medications used to induce labor can cause such violent contractions that the normal, healthy uteri (one that doesn’t even have a scar) have ruptured.
The real conclusion of the study AVH is using to back its halt of VBAC is that induction of labor is dangerous for a woman who has a prior history of caesarean section. While the hospital says this ban isn’t money or liability related, think about the current caesarean rate at AVH – it is around 15 percent.
Now think about all of those women being coerced into a repeat caesarean. How much money do they stand to gain? A lot.
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Next, it is assumed that caesareans are benign. No one is mentioning the risk involved with repeat caesarean. Studies show that accumulating caesareans increase the risk of: infertility, chronic pain and bowel problems, the embryo implanting outside of the uterus (ectopic pregnancy), the placenta overlaying the cervix (placenta previa), the placenta detaching before the birth (placental abruption), the placenta growing into or through the muscular wall of the uterus (placenta accreta or percreta).
The last three are life-threatening; placenta accreta particularly so. Planned repeat caesarean also puts babies at risk for breathing difficulties. One problem, persistent pulmonary hypertension, can be deadly.
Finally, the board argued that it wasn’t safe to have a VBAC at AVH because they didn’t have a dedicated caesarean operating room, in case an emergency caesarean needed to be performed.
“The general hospital population has about the same potential for an emergency in labor as the potential for the scar giving way in a VBAC. If it isn’t safe for VBAC labors in hospitals that cannot perform an immediate caesarean, then it isn’t safe for any woman to labor there.”
I want to applaud doctors Harling and Nagel, who really know the true research and lobbied hard for the continuation of a woman’s right to give birth normally in Aspen. Unfortunately the board did not listen to the doctors, even though the 300 VBACs at AVH attended by Dr. Harling had absolutely NO maternal or infant complications. (As a matter of interest, there were no OB’s on the board.)
This decision was made by a cardiologist, a plastic surgeon and a lawyer, among others. The decision by AVH to ban VBACs impacts everybody in our community who values choice in health care. AVH is taking the decision-making power away from consumers and telling us we are to submit to scheduled repeat caesareans.
Please research this information for yourself and tell AVH that women deserve to decide for themselves.