No more VBACs

Specialties Ob/Gyn

Published

our ob unit has just stopped doing vbacs. now all previous c-sections will be repeats and those showing up in labor (unless precipping in the bed) will be stat sections.

apparently anesthesia is tired of having to stay in house for them and the obs are, too. they were constantly grumbling among themselves... but she's your patient, you told her you'd do the vbac, not me... yada, yada, yada... :nono:

if doc's did more to prevent the primary c-section, this wouldn't be so bad - but with all the social inductions and sections for ftp (aka. failure to be patient) and cpd (aka. couldn't produce a real diagnosis), the future for lady partsl birth around here looks grim. :o

where are the feminists when you need them. :chair:

Specializes in NICU.

We do VBAC's w/o batting an eyelash. But, we can also do a crash section in about 10 minutes flat should it become necessary. (The last one I was involved with was about 7 minutes)

It's usually (IME) moms who wants rcs. If that's what I was familiar with, I might pick it too.

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Anyone who has really read my posts knows how I feel about VBAC (supportive, in case it was missed).

But we cannot ignore the risks any hospital and physician or midwife (and yes, L/D nurse)--- takes in attending any birth, VBAC included. The reason VBAC is seen as so "hairy" is due to the potential catastrophic possiblity that is raised when you attempt VBAC. On paper, it looks like a nightmare to those taking the risks. In no place did I ever say surgery was risk-free or completely desireable or safe. But the risks are more "manageable" if you will, in repeat scheduled c/s than TOLAC, at least in the statistical minds of insurers, who let's face it, pretty well RUN the hospitals and govern our practices. Don't shoot the messengers here; hate the message.

I doubt too many here would forgo their right to sue if their outcome was unfavorable or tragic, even if the providers involved did nothing wrong to bring about such an outcome---sometimes bad things happen despite our efforts, as we know. Not all bad outcomes are a direct result of unwarranted intervention.

Enough from me.

Up Vote Up Vote ×

I'm sorry SBE ~ I am certainly not trying to shoot the messanger. I've just seen so many women get pushed into c-sections b/c their doctors give them the idea that it is so much safer when it's really not. There are risks both ways. If doctors would work on lowering the primary c-section rate, this issue wouldn't be such a dramatic one. But I live in NJ where we are #1 for c-sections. We have sveral hospitals with 50% c-section rates. It angers me to see so many women forced into surgery and repeat surgery unncessarily.

disclaimer!! I am all for c-sections that are medically necessary and save the life of a baby or mother. However, it's hard to believe that ANY hospital needs to have a c-s rate of 50%

Up Vote Up Vote ×
Specializes in Community, OB, Nursery.

disclaimer!! I am all for c-sections that are medically necessary and save the life of a baby or mother. However, it's hard to believe that ANY hospital needs to have a c-s rate of 50%

I work in a high-risk teaching hospital & our c/s rate runs about 25-30%. I wish it were even lower than that.

Up Vote Up Vote ×
Specializes in OB L&D Mother/Baby.

We rarely do vbac's there is one that I can think of off the top of my head in which the woman had a nsvd with first baby then a pcs wtih number two because of breech presentation, then with the third she really wanted to have a vbac and dr let her but we had to schedule her and she was induced (which is sad but still) I think the big problem for the dr's is that they'd have to sit there all day and wait for her to deliver because they have to be available.

One of the girls that I work with had a c/s with number one for breech, number two was vag and she asked our OB if she could do a vbac if she were to have a number three and the OB said that she would do it for her.

Our c/s rate last month was rediculous. I believe that it was 64%... Half were primary half repeats... Sad sad story for us. That is not our norm but I'm thinking that if we are going to continue to section women for the littlest reason (one was IUGR?? with a history of a traumatic vag delivery of a 9.5lber, this primary section resulted in a perfect 6lb 14oz baby that I'm sure the could have been an easy delivery for her) then we'll have to continue to schedule repeats and that's not going to do much for our stats UGGH!!

Up Vote Up Vote ×

Our section rate for the last year just came out. We were at 20%. This coming from a large high risk, teaching hospital. Our National average is 25% so I think we are doing pretty well. Alot of our stats do have to do with the fact that our OB's will allow vbacs where other places in the country will not.

Up Vote Up Vote ×
Specializes in High Risk In Patient OB/GYN.

c/s rate is over 25% in America, it's actually pushing 30%. PRIMARY c/s rate is 24%.

Both disgusting numbers.:angryfire

Up Vote Up Vote ×

The national c-section rate for 2005 was 30.2% in the US. Pretty bad! Louisiana and NJ led the way with rates just under 37%. I know Louisiana's largest malpractice insurer will no longer cover doctors to attend vbacs so midwives are the only option there.

Up Vote Up Vote ×
Specializes in nursery, L and D.

I actually think that our hospital does a pretty good job with VBAC's and C/s, we have alot of great L and D nurses that try their best to prevent a p C/S and we allow VBACs if mom wants......most of the OBs are supportive of these.

Up Vote Up Vote ×
Specializes in Ante-Intra-Postpartum, Post Gyne.

I would not go to your hospital.:o

Up Vote Up Vote ×
I would not go to your hospital.:o

Exactly. And I'm sure many women will decide to go elsewhere. All the hospitals around here still do VBACs (thank goodness) but I did travel 45 minutes to a different hospital so I could VBAC with a midwife and more natural birth setting with telemetry so I wasn't stuck strapped to a bed. My VBAC baby was 10 days past her EDD and 9lbs- a beautiful birth.

I'm on the ICAN (international cesarean awareness network) list and it seems like more and more hospitals are not 'allowing' VBACs, so women are networking to find more competent care.

Up Vote Up Vote ×

I have 4 kids and never had a c-section (3 over 9lb and not easy) so I dont know much about it. What is the big danger to having a normal birth? Is it realistically possible that uterus could rupture after a c/s? I have had more of my family or friends have c/s with in my op no good 'real' reason. My girlfriend told me that her doc came in and told her after she was in labor for a while that she was too 'small' and she never even got to try and push.

When I had my last baby I was surprised when I got offered a c-section right away by the first resident I saw. I declined and had a fairly easy birth with no episiotomy. I am not sure why he offered. Mabye it was because my third baby was 9lb 12oz? I dont know.

Up Vote Up Vote ×
+ Add a Comment