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Monday, June 23, 2008

Hospital Ban to Draw "VBAC" Protest

Interesting issue expressed in this press release I received....especially coupled with the pending closure of the Goleta Valley Cottage Hospital Birth Center. Any of us that care about individual rights have to wonder about the "wisdom" of a health care system that seems structured around malpractice avoidance...is this a policy guided by health, cost or risk of legal action? -- SDLG


Santa Barbara Families Protest Hospital Ban on Vaginal Birth After Cesarean (VBAC)


June 23rd Rally Highlights Plight of Cesarean Mothers

Santa Barbara, CA, June 23, 2008 – Dozens of parents and concerned community members, supported by the Birth Action Coalition and the International Cesarean Awareness Network (ICAN), will rally outside Cottage Hospital in Santa Barbara on June 23rd at 11a.m. against the hospital's refusal to allow them a natural birth. Women in Santa Barbara County who have previously given birth by cesarean section have been banned since 2003 from choosing a vaginal birth at Cottage Hospital. This policy is part of a growing national trend. The International Cesarean Awareness Network (ICAN) has documented vaginal birth after cesarean (VBAC) bans at 280 hospitals nationwide. Rally supporters will gather to raise awareness about the VBAC ban and to request that it be reversed.

The Birth Action Coalition's goal is to "work to create supportive birth environments in the Ventura and Santa Barbara areas."

"Families in our community want better birth options for all women. We are saddened by Cottage Hospital's decision to close the Goleta Valley Birthing Center, which was one of only 40 hospitals in the country to receive the World Health Organization's "Baby Friendly" designation. And for five years now, women with a prior cesarean have been facing a choice between a forced repeat cesarean, or traveling great distances while in labor to give birth at facilities that still allow VBAC," said Jessica Barton, the Santa Barbara coordinator of the Birth Action Coalition.

VBAC is a safe and desirable option for many woman. With a vaginal delivery, most women spend less time in the hospital and are back on their feet more quickly to care for their new baby and older children. For some women, having a baby vaginally is more emotionally satisfying than having a cesarean. Mom can hold her baby sooner, and bonding and breastfeeding often get off to an easier start. Some families wish to avoid the health risks that may be incurred with a cesarean. Last, most doctors recommend that women not have more than two or three cesareans, so for those who want to have more children, VBAC is an important option that can prevent extra scarring on the uterus.

Concerns over liability and the slim chance of a medical complication known as uterine rupture have fueled VBAC bans across the nation, even though VBAC is a safe option and cesarean delivery is not risk-free. According to a 2006 study published by the American College of Obstetrics and Gynecology, ACOG "A trial of labor after cesarean seems to be as safe for the mother and infant as planned cesarean delivery, and the hospital stay is shorter." In addition, a cesarean section is major surgery and is subject to the risks of major surgery including hemorrhage, infection, hysterectomy, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirths in future pregnancies and emotional distress.

Potential risks to babies include low birth weight, prematurity, and respiratory problems. Studies also show that babies delivered by cesarean are more likely to suffer from asthma in childhood and adulthood. The recovery from a cesarean is much longer than for a vaginal birth, involving more pain, more difficulty establishing breastfeeding, and a longer hospital stay. Birth advocates recognize that when a cesarean is necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved.

"Patients should be treated according to their individual needs. A blanket ban ignores the fact that the vast majority of women can safely and successfully deliver subsequent babies without going through another major abdominal surgery. If Cottage Hospital can't handle VBAC emergencies, then they can't handle any birth emergency and should get out of the birth business," says Barbara Stratton of ICAN.

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18 Comments:

Anonymous Five West said...

Cottage has been getting extremely poor legal advice lately on a number of issues. Who is their corporate counsel? They need someone less inhuman and less paranoid risk adverse.

6/23/2008 7:27 AM  
Anonymous VBAC Jack said...

No offense, Sara but don't you think there are more important local issues right now? This one seems to fall into a pretty narrow range of interest.

6/23/2008 9:58 AM  
Anonymous First District Streetfighter said...

The Medical-Industrial Complex again doing what is best for their interests and not the patients.

Besides the services charged for another C-section yield more cash revenue.

They are dictating the medical treatment based on what pays the most.

6/23/2008 12:41 PM  
Anonymous sylvianne said...

It's called a monopoly, folks. Remember the state of the art birthing facility at the late, great St. Francis, which so conveniently was managed to run into the ground, then shut down and bought up by Cottage for practically nothing. Why would anyone be surprised by this? They haven't fulfilled their responsibilities to this community in so many ways. Demonstrate just like the nurses who tried to unionize--they got nowhere either. sad, sad, sad...

6/23/2008 3:04 PM  
Blogger Sara De la Guerra said...

VBAC Jack -- maybe, maybe not. This is an issue that presents itself on the sly -- to women who are expecting and I think it means a lot to any woman that has had a C-Section and wants another child. I would hope you think I cover the "more important" issues with vigor -- most of the time. If there is anything I am missing -- let me know, I'd be happy to look into it.

6/23/2008 6:53 PM  
Anonymous VBAC Sue said...

why is it that when an issue directly impacts women, people such as "vbac jack" feel compelled to say there are "more important" issues than this "pretty narrow" one.
I mean really

6/23/2008 7:46 PM  
Blogger Kimberly Rivers said...

VBAC Jack: this is such a larger issue than just about women who have had a previous cesarean, it is about informed consent & the right to refusal of treatment. It affects anyone who ever has to go a hospital and get treatment for anything.

And it effects something everyone on this earth has experience with: How Babies come into the world. Birth Matters. It effects every aspect of who we are and how we approach those around us, beginning well, the moment (and actually the nine months before) we are born. There are lasting physical and emotional effects to many babies and moms after any cesarean, and the emotional toll after this surgery (and it is major abdominal surgery) can be serious on the mother.. and her entire family.

Anyway, just wanted to show that this is a bigger and very important issue. Thanks Sara for putting it on your blog and starting this discussion!

Birth Matters! Working to Protect Choice in Childbirth. Kimberly Rivers

6/23/2008 7:49 PM  
OpenID grugnog said...

It was a fantastic rally - we got about 40 people and coverage in the several local papers and TV outlets.

The hospital claimed that 'they' have not banned VBACs, but that there are no OB/GYNs who will perform one - however this is a significant departure from their existing policy (we have a letter from them a couple of months ago defending the ban) and what's more we know of several OB/GYNs who would love to offer a VBAC but who are somehow under the impression that it is banned. Surely not a coincidence.

Anyway, we would encourage anyone interested in learning more to check out the Birth Action Coalition website which has information about this issue and things you can do about it.

This might seem like it has a 'narrow' range of interest, but when you consider that getting on for a third of births are now cesareans (eek!) and that the vast majority of people will go through the birth experience at some point in their lives this affects more people than you would think. Regardless of the number of people affected this is a fundamental patient (i.e. human) rights issue - people should have the right to decline surgery.

6/23/2008 8:10 PM  
Anonymous Follow The Money said...

This obviously is the fault of all those neighborhood nazis who wanted the Hospital to install more street trees during the mega building project now ongoing.

That is why The Hospital is short of funds and cannot afford VBACs.

Werffft: how is that fund raising now going for that next $15 million?

6/23/2008 9:38 PM  
Anonymous Nurse Ratchet said...

Taking control of health care policy and putting it back into the hands of the paying patient and out of the corporate medical industry is ... news.

The medical industry is the biggest PAC of all. Why is that? Aren't they content just being the most expensive unaccountable expense in everyone's budget?

6/23/2008 10:30 PM  
Anonymous SickOfCorporateMedicos said...

Welcome to the new state of medical care in the United States.

Your options are non-existent. Your care is determined by bean-counters. For every condition that exists, there is a "standard of care", and regardless of the risks or benefits, that is all you shall be allowed to have.

Nevermind that some options are irreversible. Nevermind there may be non-surgical options.
The STANDARD OF CARE shall rule.

Screw you and your choices!

6/23/2008 11:23 PM  
Blogger Becky said...

It's not a "narrow range of interest" when it potentially affects everyone giving birth in SB.

Also, the difficulty in having a VBAC is why some women have had trouble getting medical insurance after a C-section. More hospitals refusing or avoiding VBACs means more women being screwed by insurance after one C-section.

6/23/2008 11:54 PM  
Anonymous Curious said...

I wonder...
... what's to stop a woman from not implicitly cooperating?

If she shows up at the hospital in labor, would they turn her away?

What implications would arise should a woman decide to do that?

What if she 'scheduled' the C-section and then the day before, called the doc & hosp. and said "oh my GOSH bad news, my (person of family or close friend) has suffered (trauma, emergency) and I must rush to their side, immediately!"

I mean, really?

What could they do?

6/24/2008 8:32 PM  
Blogger Jessica said...

People do this occasionally and it can work. The thing is, the hospital staff will be breathing down the woman's neck the whole time trying to get her to agree to a cesarean, and while in labor most women aren't in the frame of mind to have a battle. They need to focus on the task at hand. For the process of giving birth you need to feel supported. All the negativity can make it harder to progress in labor. I have even read about cases (Jennifer Block's book "Pushed" has examples) where women were referred to child protective services or given court orders to have a cesarean. However, what you suggest has been done all over the US, including at Cottage Hospital. It's just not an ideal situation.

6/24/2008 9:48 PM  
Anonymous No Need to be Coy Roy said...

Get out the back Jack, and start an NA chapter...for Nitwits Anonymous. The only thing "narrow" here is your mind. You don't have to be a woman to be offended by the Cottage policy or your attitude.

6/24/2008 11:00 PM  
Anonymous editrix said...

In a wierd juxtapostion of issues, Cottage's head administrator, Ron Werft, was prominently pictured on the front page of the News Press(although not identified) in the audience at the McCain event yesterday--at about the same time this protest was taking place. Priorities, obviously required him to hobnob with the rich and famous, rather than to focus on the concerns of the mere common folk aced out of medical choices under his administration--that seems more about buildings than patients.

6/25/2008 3:26 PM  
Anonymous SickOfCorporateMedicos said...

I was cleaning out my wallet and came across the business card of someone at Cottage Hospital - Santa Barbara. On the back is printed,

"The Mission of Cottage Health System is to provide superior health care through a commitment to our communities and to our core values of excellence, integrity and compassion."

No, really. That'z what it says. I couldn't make that up.

6/28/2008 8:30 PM  
Blogger savanna said...

So what's next??
Are we going to stay quite and never protest again ?????????????????????????????????????

We need to protest until it's VBAC is back!

12/03/2008 9:56 PM  

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