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...
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.
where are the feminists when you need them. :chair:
She and I talked at length about her feelings of being a failure if she had surgery rather than tough it out and have a vag delivery. It was hard to convince her that it was OK to choose a cesarean. The point is the delivery of a healthy baby.
She finally did choose surgery and it went well. Her recovery was a snap compared to the fractured pelvis.
I wonder where these women got the idea that they were failures if they didn't have a "natural" birth.
That really bothers the heck out of me. Where is the failure in having a healthy baby? I can't stand it when women feel as though they have failed. :angryfire Another thing I hear is that they feel they have been cheated out of a real birth. Come on!!! My children may not have passed through the birth canal on their way into the world but they are just as real, just as wanted, just as loved and I couldn't be any more a real mother. Giving birth lady partslly does not a woman make and certainly does not make one a good mother.
I wonder what they'll do if mom says no? I wouldn't submit to a stat section just because my hospital didn't believe in allowing women to try to deliver lady partslly.
That really bothers the heck out of me. Where is the failure in having a healthy baby? I can't stand it when women feel as though they have failed. :angryfire Another thing I hear is that they feel they have been cheated out of a real birth. Come on!!! My children may not have passed through the birth canal on their way into the world but they are just as real, just as wanted, just as loved and I couldn't be any more a real mother. Giving birth lady partslly does not a woman make and certainly does not make one a good mother.
Feelings of failure are very real to a lot of women. Being blown off by nurses who feel it's no big deal makes it a lot worse for many new moms. In the early 70s, only 5% of births were c-sections. Today that number is 30.2%. Why were women able to push babies out 30-40 years ago and now so many women need c-sections?
A c-section is not a pleasant experience for a lot of women. We CANNOT treat it like it's no big deal. Many women mourn the fact that they are not the first person to hold their babies and they are unable to care for their babies in the days following birth. I know plenty of women that have suffered from PTSD after c-sections. C-sections are no big deal to some women but that doesn't mean we can invalidate the feelings of women who do not welcome a surgical birth.
I wonder what they'll do if mom says no? I wouldn't submit to a stat section just because my hospital didn't believe in allowing women to try to deliver lady partslly.
A hospital cannot force a woman into surgery. Some women have invoked EMTALA rights to refuse surgery. A hospital can try to get a court order but that's a little difficult when mom's in labor. Usually hospitals force women to be hooked up to monitors and make vbac very difficult so that she is pretty much forced into a repeat c-s.
Feelings of failure are very real to a lot of women. Being blown off by nurses who feel it's no big deal makes it a lot worse for many new moms. In the early 70s, only 5% of births were c-sections. Today that number is 30.2%. Why were women able to push babies out 30-40 years ago and now so many women need c-sections?
A c-section is not a pleasant experience for a lot of women. We CANNOT treat it like it's no big deal. Many women mourn the fact that they are not the first person to hold their babies and they are unable to care for their babies in the days following birth. I know plenty of women that have suffered from PTSD after c-sections. C-sections are no big deal to some women but that doesn't mean we can invalidate the feelings of women who do not welcome a surgical birth.
A hospital cannot force a woman into surgery. Some women have invoked EMTALA rights to refuse surgery. A hospital can try to get a court order but that's a little difficult when mom's in labor. Usually hospitals force women to be hooked up to monitors and make vbac very difficult so that she is pretty much forced into a repeat c-s.
I do think the population delivering is somewhat different than in the 70s and that is affecting c-section rates. They didn't have too many 13 year olds or 42 year olds delivering back then. They certainly didn't have 24 weekers being delivered with any hope of surviving. They also didn't have women suing for any little problem and insurance carriers pricing them out of business. I really think that's what it comes down to. If you have a vag birth with a bad outcome you will get sued and have to pay because they'll say you should have done a c-section. It doesn't seem to matter if the poor outcome had anything to do with the fact that it was a lady partsl delivery or not.
Women can care for their children after c-sections. Ours all do unless they are so sick they're in ICU or something afterwards. If they are having PTSD afterwards, they need to see a counsellor. I think part of the reason they feel like failures is they hear people telling them that every woman should be able to give birth lady partslly. That isn't true.
I would be hesitant to say hospitals force women to do anything. Without a court order they can't "force". I support a woman's right to attempt a VBAC. I would question why she would go to a hospital if she didn't want to be monitored though.
I wonder what they'll do if mom says no? I wouldn't submit to a stat section just because my hospital didn't believe in allowing women to try to deliver lady partslly.
Good question, I have wondered that myself....anyone have this happen?
I wonder what they'll do if mom says no? I wouldn't submit to a stat section just because my hospital didn't believe in allowing women to try to deliver lady partslly.
A stat section is a totally different issue than a repeat or elective section. I would heed my physicians advice regarding a stat section.
It's like that commercial. Doctor on the phone: ok, now pick up the scalpel and make an incision......Makes just as much sense as not heeding the advice of the physician that the Mom has selected to care for her and her unborn child. Mom might as well stay home and deliver herself.
If a Mom said no to a section because the hospital did approve of VBAC's then I suppose, if possible, the patient would be transferred to another hospital who did approve of VBAC's, or if not possible the Mom would have to accept responsibility for the outcome. Likely things would be fine but if not it's totally in Mom's hands and on her conscious.
I have had many instances of moms that have a scheduled section on the books that come in laboring, some have even come in pushing, and at that point, without fail, the docs order a stat section. No mom has ever said "no, I'm pushing, lets just go ahead with lady partsl", or anything to that effect. I know what you are talking about Dutch, but what about in a case like this?
Just as a side note, the teen birth rate, from every study I have read, is a LOT lower now than it was in 1970. I think the biggest issue now is the lawsuit rate.
A stat section is a totally different issue than a repeat or elective section. I would heed my physicians advice regarding a stat section.
It's like that commercial. Doctor on the phone: ok, now pick up the scalpel and make an incision......Makes just as much sense as not heeding the advice of the physician that the Mom has selected to care for her and her unborn child. Mom might as well stay home and deliver herself.
If a Mom said no to a section because the hospital did approve of VBAC's then I suppose, if possible, the patient would be transferred to another hospital who did approve of VBAC's, or if not possible the Mom would have to accept responsibility for the outcome. Likely things would be fine but if not it's totally in Mom's hands and on her conscious.
What she's talking about isn't a stat section for any medical reason, but they are still calling them stats. All that really means is done right NOW. I wouldn't submit to that without a medical reason.
I have had many instances of moms that have a scheduled section on the books that come in laboring, some have even come in pushing, and at that point, without fail, the docs order a stat section. No mom has ever said "no, I'm pushing, lets just go ahead with lady partsl", or anything to that effect. I know what you are talking about Dutch, but what about in a case like this?
I don't honestly know but where I worked that has happened. The Mom would always say "I'm having a section no matter what" and in my experience the doctor's have said "no were going lady partsl sorry". It's got to be different everywhere and different between doctors. That's just what I've been part to. This one patient I'll never forget. She came in pushing. The doctor was not there yet. She was crowning big time when the doctor arrived and she was hollaring "Hurry doc! I'm having a section! Get washed up quick!" She delivered so quickly the doctor didn't have time to do anything. The other nurse and myself delivered the baby. The next day she said "wow, who would have thought I could really do it. No episiotomy, no pain meds, wow that was really awesome!"
What she's talking about isn't a stat section for any medical reason, but they are still calling them stats. All that really means is done right NOW. I wouldn't submit to that without a medical reason.
Things have obviously changed since I did L&D. It's been about 15 years ago. Back then "stat" was an urgent emergency section.
I had a primary section for a frank breech presentation. I elected to have a repeat section with my second delivery. I lost 2 babies between my sections (24 wks) and had experienced 2 traumatic lady partsl deliveries. I felt safer with a repeat section. Had I come in in active labor I have no doubt I would have gone VBAC.
Just as a side note, the teen birth rate, from every study I have read, is a LOT lower now than it was in 1970. I think the biggest issue now is the lawsuit rate.
Yep - if you talk to doctors the fear of lawsuit is the biggest driver in increased c-sections. However, there are very few vbac lawsuits. In fact, the biggest malpractice firm in NJ could not name 1 vbac lawsuit they've done. In addition, very few doctors could name a specific vbac lawsuit. It's sad that doctor fears are being taken out on vbacs when there is no evidence that vbacs are causing more lawsuits.
I wonder what they'll do if mom says no? I wouldn't submit to a stat section just because my hospital didn't believe in allowing women to try to deliver lady partslly.
We did have a ER drop-in challenge them. She refused to sign consent for a c-section. They told her they would not care for her. She was in relatively early labor w/ no problems. They told her to go deliver some place else. None of the docs were willing to deliver her lady partslly, especially without seeing her prenatally. Of course if she had come in delivering precip, they'd have had no choice.
DutchgirlRN, ASN, RN
3,932 Posts
That really bothers the heck out of me. Where is the failure in having a healthy baby? I can't stand it when women feel as though they have failed. :angryfire Another thing I hear is that they feel they have been cheated out of a real birth. Come on!!! My children may not have passed through the birth canal on their way into the world but they are just as real, just as wanted, just as loved and I couldn't be any more a real mother. Giving birth lady partslly does not a woman make and certainly does not make one a good mother.