VBAC's

Specialties Ob/Gyn

Published

Its better to remain silent and thought a fool then to speak out and

remove all doubt-Ben Franklin

At my hospital we deliver about 600 babies a year and still have 2 General Practitioners delivering. ACOGG has recently come out with new recomendations regarding VBAC's which states that a

physician able to perform a stat section be immed. available (in house) during the duration of the labor. We do not have anesthesia in house 24/7 but on call and expected to arrive within 10 mins of notification (ya right!). Anyway my question is how are other facilities handling this? Are smaller community hospitals doing VBAC's? If so do you have a policy and procedure that you could share. Its unfortunate but we are thinking of not attempting VBAC's because of this recommendation and the possible legalities involved.

Specializes in cardiac, diabetes, OB/GYN.

Our OB chief has recently become quite wary of VBACs due to recent literature coming across the boards. He used to almost INSIST that I try to VBAC it ( I was having none of it)...It is weird how things change, but don't forget, we are not a metropolitan center where anesthesia is always around so that might impact on his thoughts, though I have noticed everyone else is down playing them also....I will have to ask him (the Chief) what the deal is with the new thinking. He is usually up to date with new stuff....

I was following this thread a couple of days ago and thinking. Our docs are not routinly in house for V-BAC's (they are all about 5-15 mins out) We also don't have a dedicated anesthesiologist for OB. Last night I was talking with our midwife who said we get by the docs not being in house because we have "an" OB in house at all times. Now most of these patients are not his responisiblity because he only covers the Kaiser patients that come to our hospital. But he could do a crash section if needed.

according to new ACCog guidelines anesthesia and ob doc must be in house for VBACS

Originally posted by mark_LD_RN

according to new ACCog guidelines anesthesia and ob doc must be in house for VBACS

I need to get a copy and PLASTER it on our bulitin board at work! Our docs are NOT in house EVER at night...No matter WHAT we have going on:( :( . We do about 200 deliveries a month and have had some PRETTY scary close calls. Anesthisia only has to be in house if we have a laboring epidural, but the OB....thats a different story!

Specializes in OB, Post Partum, Home Health.

Yeah, Mark, where can we find that in writing? I would love to keep a copy stashed away in my locker for just the right moment!!!

Specializes in correctional, psych, ICU, CCU, ER.

First kid,-c-section, 12 years later, at age 41, pregnant again. Docotr insists I try VBAC. High, high risk preg. and he decided to take vacation 2 weeks before due date.

Next day, I go into labor, and find out, that, gee, VBAC is great, BUT, at your age, weight (250 at the time) and your last is 12, this is like a new Mom. Labored form 0600 to 1600, was told might be another 12 hrs, might have to section you anyway,,,,,,no, no, I have a better idea, call the surg team, section me NOW, while everybody is awake and alert and we have daylight. (Joey was delivered at 1900, c-section and weighed almost 9 lbs),,, hmmm, don't think you would have been able to push this one out!! said the on call doc, who had taken over at 1900.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

yup VBAC's definately have their downside and risks....you cannot be too careful. I am in agreement w/you decision, here jailrn, i would have said and done the exact same thing too.......baby/mom's safety are numero uno, not method of delivery.

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