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Newsweek: VBAC Access Makes Medical Sense

ICAN chapter leaders Allison Denenberg and Barbara Stratton, along with president Desirre Andrews, were featured in a Newsweek article yesterday on VBAC.  The article asks the question:  if the evidence for VBAC safety is so clear, why aren’t doctors supporting it?

VBAC advocates hope that health-care reform, with its emphasis on evidence-based medicine, might help turn the tide on VBACs. The VBAC stigma among doctors and hospitals, based more on fears about multi-million-dollar lawsuits than on data, has forced many women to switch providers, often traveling out of their way to find a supportive OB or midwife and a willing hospital. Since 1996, one third of hospitals and half of physicians no longer allow women to have a VBAC.

Allison shares her primary and repeat cesarean experiences, highlighting that even if a repeat cesarean is the outcome, the opportunity to try for VBAC is crucial.

When she was pregnant with her second child, Allison Denenberg signed on with one of northern Virginia’s VBAC go-to doctors to avoid another C-section. Denenberg didn’t want to have to recover from abdominal surgery while taking care of a toddler and a new baby. She wanted to breastfeed, which can be more challenging after a C-section (positioning a baby to nurse can be uncomfortable and many women find that their milk takes several days to come in). She wanted her baby to pick his or her own birthday. And she wanted a positive birthing experience; after her first C-section, Denenberg worried that she hadn’t pushed effectively and blamed herself.

This time, Denenberg wanted to bond with her baby uninterrupted after birth without a surgical curtain in the way and she wanted to care for her baby “without having to call somebody for help,” she says. A Virginia chapter leader for the International Cesarean Awareness Network (ICAN), an advocacy group that supports VBACs, Denenberg feared that if she didn’t try to deliver her second baby vaginally, she might suffer postpartum depression. In the end—after a 24-hour labor, including three and half hours of pushing—Denenberg underwent a repeat C-section because her baby wasn’t budging. It wasn’t the outcome she wanted, but it was “awesome,” says Denenberg, because she was in control, and her OB cheerleaded her efforts. “It’s a woman’s right,” she says.

Barbara and Desirre are cited on the issue of choice – a woman’s right to make her own informed decisions about childbirth, including VBAC.

Often overlooked is a woman’s fundamental and primal desire to undergo the birthing rite of passage, to have a baby the way babies have been born from the beginning of humankind, complete with the roller coaster of emotional and physical experiences—pain, joy, power, and, ultimately, an overwhelming sense of accomplishment. That desire, and women’s frustration over the lack of support and accessibility, has led ICAN’s Barbara Stratton, based in Baltimore, to organize protest rallies at hospitals with “VBAC bans.” Their signs get right to the point: THANKS, BUT ONCE WAS ENOUGH and CHOOSY MOMS CHOOSE VBAC.

Choice, the ultimate imperative, has been lost for many women. When malpractice insurers refuse to cover VBACs and hospitals fear litigation, doctors can’t offer them and women can’t have them, says Dr. Howard Minkoff, chair of obstetrics and gynecology at Maimonides Medical Center in Brooklyn, N.Y. Now it’s up to ACOG, which sets professional standards, to respond to NIH’s call. What women need are doctors and hospitals that support VBACs, complete information about risks and benefits, and a medical provider who works with them in tandem. “Women are not irrational crazy creatures,” says ICAN president Desirre Andrews. They’re capable of making well-informed decisions for themselves and their babies. Having a VBAC should be one of them.

Be sure to read the full article here.

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