March 11, 2010

The NIH VBAC Conference Hits Close to Home

As a mother who had a vaginal birth for my first child, and due to umbilical cord entanglement, had a cesarean for my twins, I've been following the National Institutes of Health Consensus Development Conference on Vaginal Birth After Cesarean with great interest. It has recently hit me that if my husband and I decide to expand our family, that I cannot go to just any healthcare provider. Not all physicians in the Raleigh area would be supportive of my decision to attempt a vaginal birth. That idea is mind boggling! The thought that a doctor or hospital would not support my birth choice is something I never imagined that I would have to deal with.

The NIH conference earlier this week examined the availability and access to VBAC for pregnant women The panel reiterated what many evidence-based practitioners believe, that expectant mothers should have the option to pursue a vaginal birth after a having had prior cesarean. Seems like a no brainer, right?

Unfortunately, while 60% to 80% of women who attempt a VBAC have a successful vaginal birth, the reality is that there are hospitals and care providers that limit that option for mothers. Some facilities and doctors ban the procedure outright. The risk of uterine rupture, which is often stated as a reason not to pursue a VBAC, is less than 1%. Not to minimize that small percentage, but is the fear of litigation a reason to limit this birth option for millions of women? The panel recognizes the medical and legal issues surrounding VBAC, but urges all stakeholders to overcome the barriers to allow access for pregnant women.

You an read the panels draft report here. The conference was an excellent opportunity to shine a spotlight on the availability of VBAC, maternal care and birth options in our country. It is an important discussion that we as birth professionals, mothers and healthcare providers need to work together to move forward.

The Conference is available by webcast at the NIH website.

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