Thursday, March 11, 2010

NIH conference emphasizes safety of VBAC

Here are some of the positive findings from the NIH conference on VBAC held this week (we'll get into the negative issues surrounding informed consent/refusal that came up later):

"After reviewing earlier studies, the expert panel found that VBAC was about as safe as first-time vaginal childbirth. "

"According to the new panel, uterine rupture occurs in less than one percent of the women who attempt VBAC, and fewer than 4 in 100,000 women die. While uterine rupture is more rare in repeat cesarean, the risk of maternal death is about three times higher. Women who undergo several cesareans also seem to have a higher risk of having their womb removed."

Long story short: VBAC deaths - 4 in 100,000, repeat c-section deaths - 12 in 100,000

"Despite the enthusiasm surrounding VBAC, surveys have shown that as many as one-third of US hospitals and half of all physicians will not perform it."

Why? Because most hospitals dictate that there must be a full surgical staff and OB on standby for the entire labor.

But wait a minute, shouldn't any hospital that provides obstetric services have that available? What happens in the event of an emergency that requires a cesarean under other circumstances? It seems a little prejudicial to deny one women who is at no higher risk of needing a c-section vaginal birth while allowing a first time mom to labor and attempt vaginal delivery.

Many doctors claim this is dictated by insurance policies, but why those insurance policies overlook this obvious flaw is troubling. And perhaps the best way to combat this issue is to get our insurance companies involved. After all I'm guessing your HMO would rather pay for a vaginal birth than a cesarean, which can cost 4 times as much and result in a much longer hospital stay.

In the end, you have a right to say no to repeat cesarean, but you have to be willing to change doctors and possibly hospitals.

Read the full report from Reuters here:


Post a Comment