Hospitals claim natural births following C-sections too ri$ky

  1. Hospitals claim natural births following C-sections too ri$ky

    By Kay Lazar
    Friday, May 14, 2004

    Citing the rising costs of malpractice lawsuits, a major hospital chain serving Southeastern Massachusetts will no longer offer women the choice of delivering their babies vaginally if they previously delivered by Caesarean section.

    ``This decision was made with great difficulty by the hospitals' leadership after months of careful consideration,'' Dr. Ronald Goodspeed, president of Southcoast Hospitals Group, said in a statement. Southcoast Hospitals include Charlton in Fall River, St. Luke's in New Bedford and Tobey in Wareham.

    The Southcoast Group joins a long list of other New England hospitals - mostly smaller facilities - that have dropped vaginal births after Caesareans, known as VBACs. The hospitals say liability concerns and stricter guidelines that require them to have a full emergency team always available are too costly.

    ``It's sad that a woman can't decide for herself how to have a baby . . . and a person can't find reliable health care close to their home,'' said Cara Barbero, 36, a New Bedford mom who previously had a Caesarean but later delivered two healthy babies vaginally at Tobey Hospital, including a daughter just seven weeks ago.

    Dr. Robert Barbieri, chief of obstetrics and gynecology at Brigham and Women's Hospital, said there is less than a 1 percent chance of a woman's uterus rupturing during a VBAC because of scarring from a previous Caesarean. The Brigham continues to offer VBACs.

    ``Many women really want to try VBAC and I think it's important for the medical community to respond to that desire,'' he said.

    He noted that Caesarean surgeries also pose risks and require longer recovery times.

    But huge lawsuits from the rare, bad VBACs are scaring hospitals, said Dr. Ronald Burkman, head of the Massachusetts American College of Obstetrics and Gynecology.


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  2. 21 Comments

  3. by   fergus51
    It's disgusting. It isn't safety that guides practice in some places, it's the fear of liability. Ever since that junk study came out a few years ago (showed an increase risk of rupture with VBACS induces with pit- DUH!) people have been paranoid about it.
  4. by   SmilingBluEyes
    It is indeed a fear of liability as well as anesthesia and obstetric staff refusing to stay in house , dedicated to this one person, while she as a TOLAC, labors. It's that simple. I have worked in a hospital that did NOT do VBAC and these were the reasons why.
  5. by   nekhismom
    I think it's sick. We have FAR TOO MANY c/s at my hospital anyway, and this just fuels the fire. :angryfire:
  6. by   Energizer Bunny
    Ya know, we are sooo lucky that at the hospital where I delivered, the c/s rate was only 9% and they were willing to try anything. I definately want to work there when I am done with school.
  7. by   Q.
    I pretty much echo Fergus's sentiments on this. It is a complete shame that medical decisions are being made based on fear of litigation, however, we as a society have only ourselves to blame for that.
  8. by   BeachNurse
    I was very upset when my doctors told me that they did not want me to attempt VBAC last year. Their rationale was that if they let me labor it would have to be under controlled conditions when all necessary staff would be at the hospital, and they did not want to give me Pitocin (necessary for scheduling an induced labor).

    My prior C-section had been in 1995--so I did not understand the fear of rupture. That baby had weighed 8lbs, 13 oz and had quite a large head..they sectioned me after 12-13 hours of labor. This time I did have my daughter by scheduled C-section at 39 weeks, and she weighed 8lbs, 2oz. True she was a large baby also, however I would like to have been given the option to try (plus her head was smaller so you never know!) The C section and recovery went very smoothly but I still regret not pushing the issue to labor.
  9. by   fergus51
    I can understand limiting VBACs when staffing is an issue as it is in smaller hospitals that don't have an OB or OR staff in house 24/7. I just can't understand it being the routine.
  10. by   hock1
    Actually it is risky if you're talking lawsuit. I had a successful vbac as did the other women in my support group. Did it after two csect with a lay midwife. The hard part is finding doctor, nurse, patient who know when to say when.
  11. by   ang75
    Our group of OB's here do not like doing VBAC's. They really won't say why just that it is not the safest way. I disagree. I just went to my OB confirm appt (YEAH? Just figured it out 3 wks ago ) and overheard two docs discussing it about another pt. They would allow her to VBAC if she absolutely insisted but weren't tooo happy about it. My hus. is an FP with OB privelages and he is all for VBACs as long as there are no other obvious complications. Different strokes for different folks. But I do agree, medicine is being practiced based off of liability now a days, not what's best for the pt.
  12. by   fergus51
    The real problem is that it's the PERCEPTION of what will limit liability that governs practice. I haven't seen any evidence that VBACs result in more malpractice suits.

    It's like the 20 minute strip we always do or EFM for low risk women. There is NO evidence to support either and the use of EFM in low risk labors is actually harmful but we do it as a CYA thing on occasion. I just find it so frustrating that there seems to be so little middle ground in OB. We either get people who want all natural ("Who cares if the FH is 50, I want a vag birth!") or completely medicalized.
  13. by   TinyNurse
    yay for vbac!!!!! my best friend had a successful one last year!!!
    xoxo jen
  14. by   fiestynurse
    ....
    Last edit by fiestynurse on Dec 24, '04

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