why the anti-VBAC stance in hospitals?

SmilingBluEyes · Apr 3, 2003

The risk of prolapsed cord is NOT the same thing, although very emergent. Believe me, there is little that matches a ruptured uterus in they way of catastrophic OB occurences. Understand, within MINUTES, both mom and baby likely will DIE without immediate intervention. BOTH PATIENTS ARE AT RISK FOR IMMINENT DEATH----not just baby as in prolapsed cord. Prolapsed cord is an emergency, as are other OB emergencies, but it is less likely to result in a dead MOM AND BABY if treatment is appropriate and immediate. With some OB emergencies,yes, minutes do count....with rupture SECONDS do. For TWO patients.

Sable's mom · Apr 4, 2003

I second Smilingblueeyes remarks. Prolasped cord et al require fast action, but there are some things that staff can do while you are setting up for the section. With uterine rupture, unless the surgeon in at the bedside you will probably have 2 deathe. Only other complication nearly that devestating - or fast is a complete abruptio. IMHO.

l_e_mae · Apr 4, 2003

ok, obviously, I don't know what I'm talking about :chair:

thanks for setting me straight though!

on that note, with attempting a vbac, There is a hospital about 10 min. from us that allows vbacs but doesnt' have an obgyn on staff, I was thinking that I should go to a different hospital (the next closest is 1 hour away) in case something did happen, there would be someone there to do an emergent section.

does this sound like a good idea (for my own safety) or am I being over cautious?

thanks!

fergus51 · Apr 4, 2003

I would want to be in a hospital with an ob on staff if I were in your position. Good luck with the VBAC, and most of all I hope you enjoy the new addition to your family for years to come.

SmilingBluEyes · Apr 4, 2003

i second fergus' post. I wish you the best, whatever you decide.

Sable's mom · Apr 5, 2003

I agree with Smilingblueyes and fergus - good luck with whatever you decide, but I would seriously consider delivering at a facility with an ob/gyn on staff.

mark_LD_RN · Apr 5, 2003

Oh, by the way our protocol say doc must be in house for vbac. :) and i feel that is the only way to go. it also requires a good nurse that will pay attention to any of the subtle signs of impending uterine rupture

l_e_mae · Apr 6, 2003

thanks for all the replies! I think I will be going to the hospital that is an hour away....I still have 6 months to be pregnant first though! I just get a little ahead of myself sometimes!

thanks again!

mother/babyRN, RN · Apr 6, 2003

There was a study within the last year ( forget who did it- it is posted in our labor area) proporting an increased incidence of uterine rupture with VBACs...Although most disagree with the findings, me included, as a major increase in risk, our docs told us that due to the nature of people suing over every thing that could possibly go wrong, having that sort of statistic actually published caused them and many insurance carriers, to take the unfortunate stance against them. It is mostly about potential litigation. My new facility cannot do them now because their insurance won't allow it...Sad, but true. I opted not to have vbacs when they were popular and pretty much pushed on csection patients, but I absolutely support the decisions of those who would like to attempt one. Sad that the general public, who is still in great and appropriate favor of them, are the very same public who would sue in a heartbeat, citing that and several other recent study findings, as their backup to win...Can't win on this issue I guess, at least not until another study or series of studies comes out against it...Docs in the other hospital will do one if a patient absolutely insists , however, the consent has been reformulated to make certain that they know the enhanced risks or alleged risks recently cited...Insurance companies figure they would rather be safe than sorry...

allnurses Guide · Apr 6, 2003

Everyone is different . . . I had three normal vag deliveries and then an emergency cesarean with my last (the one to the left on my lap). I didn't like the "emergency" reason but I much preferred the cesarean to going through hours and hours of labor. I went to my husband's high school reunion 5 days later.

Go figure . . . :cool:

Mimi2RN, ASN, RN · Apr 6, 2003

We had a vbac crash section, uterus had ruptured, baby was half out but the placenta was still attached. Baby was fine, and both survived.

Usually it's not such a good outcome......we haven't lost a mom, but the babies don't make it.

mother/babyRN, RN · Apr 6, 2003

To tell you the truth I thought recovering from my csections was better than recovering from my delivery. I would rather hurt in the incision than "down there"...Just personal choice....I think you should do what is best for you...And I think that hospitals should have anesthesia available at all times, whether or not one seeks a vbac or not...Quoting all sorts of statistics doesn't change the fact that stuff happens despite vbacs or the lack of them. The only uterine ruptures I have seen so far have not been on vbacs, but that is just the roll of the dice...