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Yahoo!Thank you for the informative article on the increasingly limited birth choices in Santa Barbara [“Special Delivery,” 7/17/08, independent.com/specialdelivery]. Cottage Hospital is unwilling to take responsibility for the effective ban on Vaginal Birth After Cesarean, yet many of the obstetricians in our area say that "the hospital does not allow VBACs." While our community's only in-hospital labor and delivery care providers are busy passing the buck, women who do not want another surgical delivery have no choice but to consent, or to drive two to five hours (depending on traffic), often while in labor, to Los Angeles to be "allowed" to birth their babies vaginally.
"Current risk management policies across the United States restricting a trial of labor after previous cesarean section appear to be based on malpractice concerns rather than on available statistical and scientific evidence (American Academy of Family Physicians, AAFP, 2005)."
A wide body of law protects the rights of patients, including pregnant and birthing women, to true informed consent (accurate information about the risks and benefits of treatment options, including that of no treatment), and including the right to informed refusal of treatment.
Our community's only remaining in-hospital birth care providers have a responsibility to offer a safety net should cesarean or other medical intervention become indicated, and otherwise to support the normal physiologic process of labor and birth. Supporting parents in making well-informed decisions for themselves may be a better protection against malpractice than making blanket decisions for all parents behind closed doors. In any case, it is the right thing to do. —Kolmi Majundar
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