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Mother-sized Activism at Work in Iowa

Photo credit: Birgit Amadori

Photo credit: Birgit Amadori

Have you contacted your local hospitals and OB providers yet to ask about their practices in light of ACOG’s new VBAC recommendations?

Stephanie Windgardner in Sioux City, Iowa has. She shares:

My [OB] office previously stated the ACOG guidelines as why I could not try for a VBAC with my next child. Since the guidelines changed, I emailed to see if their standard of care was going to change along with them. Here is my email to them, their reply, and after what they replied, I felt the need to reply back to them- just want to get awareness out there that in my city (Sioux City, Iowa) and the tri-state area of Nebraska, Iowa, and South Dakota, that there are two hospitals, and two OB offices, none of which will “allow” or attend VBAC. I will be going to Omaha or Sioux Falls when I have my next child likely, so that I can have a chance at VBAC! This is a good hour and a half drive for me.

Here is part of Stephanie’s first email to her OB’s office:

After a lot of research and other opinions, I have decided I want to pursue a VBAC with my next child. I am not pregnant yet, but my husband and I plan to begin trying to conceive early next year.

After the release recently of the new ACOG guidelines, I was curious if the physicians in your office would be taking on VBAC patients. I see on your website your practice seems to follow all of the ACOG guidelines, and refer to them for more information.

I really appreciate any information you can give me. If VBAC is not an option…then I want to seek out other options before my yearly check up this fall, so that I can become familiar with a new doctor.

Thank you for your time.

Stephanie Winegardner

And here is her OB office’s reply:

Good afternoon Stephanie, we hope your having a great day.  I wanted to let you know that our office and the two hospitals in town do not do VBAC’s.  I am very sorry that you had a horrible experience with your last child and we would be more then glad to see you but you would have to have another c-section.

If we can be of any more help, please let us know.


Unsatisfied with this response, Stephanie wrote one more email, asking her OB’s office why they won’t be changing their standard of care in line with ACOG’s new guidelines. As of today, she has not heard anything back.

Kudos to Stephanie for taking a mother-sized step toward better maternity care in he community. If you have contacted your hospitals or OB practices since ACOG’s recommendations, share your stories with us!

To find out what hospital policies are in your area, check ICAN’s VBAC Policy Database.


  1. ICAN chapters in Iowa have formed in Iowa City, Quad Cities and NE Iowa. Iowa City has become a hub for VBAC births at the UIHC with the team of certified nurse midwives. We are lucky to have the VBAC and if desired natural birth friendly hospital. As a doula who specializes in VBACs I work with women who are driving up to 3 hours to give birth in Iowa City. How sad that women have to go to such lengths to receive care. Thank you to ICAN for the education, support and advocacy needed for change.

    Jun-Nicole Matsushita
    Certified Birth Doula
    Bamboo Birth Services
    “experience empowering no-to-low intervention hospital births”

  2. I am with Jun on that, I am a doula & childbirth educator, as well as the leader of the Quad Cities ICAN chapter & have served the Iowa City area as well. Here in the Quad Cites the VBAC environment is very mixed, but Iowa City is very pro vbac. My last baby was born at U of I and I had a wonderful experience. I have also met many couples travelling hours to birth there. My suggestion would be to get the word out, demand that OBs take note of the new quidelines & if enough demand is there I believe they will loosen up their stance.

  3. Penny Stafford says:

    I am 39 weeks pregnant with my third child. I have been on a rollercoaster with my OB group about having a VBAC after two csections. I have done TONS of research, talked to doulas, midwives and doctors, and I have gone back and forth between having a repeat csection or a VBAC. Finally, I threw caution to the wind and am going out on a limb by planning to go to the hospital without a specific doctor to be called upon. My OB has agreed to provide pre and postnatal care, but I am well aware that he will not deliver me. Especially in light of the new ACOG guidelines, a woman cannot be forced into having a csection if everything is going well. I live in Memphis,TN and we have ONE doctor that WILL NOT accept insurance but will deliver after two csections. Everyone else just won’t do it. A doctor in the same group as my current OB HAD agreed to deliver me by VBAC but changed his mind when I was 28 weeks, so finding a new doc was impossible. I had a traumatic experience with my second csection and swore I’d never have another one. My suggestions for anyone wanting a VBAC is to look into ALL the risk and benefits (benefits to you and baby outweigh risks after one low transverse csection and baby is in right position and both of you are healthy), and know your legal rights as a mother. NO ONE can force you to do something you don’t want to do, unless it is for the life of you or your baby. Knowing when the doctors are just trying to scare you into doing what they want you to do is where your knowledge comes in.

  4. Jill Leibel says:

    This is a useful article. I’m always looking for relevant resources to show our residents, and your piece is absolutely worth sharing!

  5. Suzannah says:

    I had a CSection with my first in NYC. My doctor told me I’d be a prime candidate for VBAC. Sadly we had to move out of NYC and home to Delaware…. The first OB/GYN practice I went to had THREE midwives! I was thrilled. Had heard so many wonderful stories about them. THen the doctors told me NO, they did not support VBAC and neither did the hospital. I went to 5 other doctors within 1 hour raidus and none would support. Finally I had decided that I would do the 2 hour drive to the hospital that did support VBAC, but couldnot find a doctor in that area! After a discussion with the highrisk doctor at the hospital two hours away, he recommended a practice an hour closer to me! Although they did not recommend, they did support my decision and I had a successful VBAC! Keep searching and follow your heart…and have your partner ready to stand up for you – because after 24hours of labor, you get delerious and when they mention CSection you need someone to support your voice!

  6. Shelly Wilcox says:

    I am not happy for this what I say but I have to say: If we have the right to terminate a birth we have the right to have a birth anywhere and anyway we want. It is not right for hospitals to make women take the back of the bus for their rights.

    The hospital I was going to have my second child in, said it was okay to have a v-back with him. Said v-backs carry some risk but so do births in general. Each successive c-section after the first, is more dangerous to the mother. More so than just having the child v-back. The studies for the rupturing uterus are flawed leaving some data unreported and unclear on weather the rupture problem they had with v-backs were from using drugs on women like pitocin after a previous c-section.

    The one thing I noticed in the whole health and childbearing world, pain and failure is the main motivational factor with doctors. You wont hear most of them saying you can do it even though it painful, women have had babies for centuries without doctors. When you get to the hospital weather you are sick or healthy they put an Iv in you when you come in the door to birth. We hear from most doctors- “in case there are complications” “in case you need pain meds” in this way we have our mind worried to the point of- the doctor is the only thing that will save us giving birth. If this is true why is the USA last on the list for mothers and babies mortality rates and why is there better birthing statistics for women with midwives and doulas?

    We need birthing centers for women that cover every avenue of natural birth. Ones that take in people with previous conditions. We need to take the sick and dying out of the childbirth senario and replace it with the healthy and you can do it attitude! If we do not show our daughters that a little bit of pain is a normal for a babies out come, we are going to breed a whole culture of daughters that think pain meds come with birthing and c-sections are normal. I bet if there were problems with a man to where he could not get treated in a hospital unless he were circumsized, it would get response and more hospitals would change the policy. Now women that have had incesions can not try to have a baby naturally – who the hell are the hospitals to tell us what to do with our bodies and babies?

    All evidence supports if you are an otherwise healthy mom and baby, v-back is possible. Its the hospitals policy, this whole rediculous-two anethisologists on call- that is holding women back. If it is not rediculous then they should have two always on call. How hard is it to give birthing women the rights they deserve? We have the right to procreate, we have the right to give birth in the way women want to! Call your hospitals and demand they uphold the new laws- we can not loose the right to have our own choice about birth and many who have had c-sections already have lost their choice. Not right!

    How long will it be before they just say vaginal birth is too risky and c-sections is the only way to perform giving birth? Or how about we can only have one child c-section and we will not be admitted after that at all? Or shoot lets just go for all women can only have one child.

    After the doctors rushed me into my first c-section,(I was against them and had my husband with me to protest-it did not matter). I was not ready to quit trying, I was healthy and the baby was healthy, they did not want to wait for me and the doctor had a soccer team with her son to get to. ( I will never disrespect the gynocologist that birthed my first two babies-she saved my moms life,but my mom was sick ) On the second v-back they told me I could have the baby naturally up until the last two months of my pregnancy, they had all my money and they said I could switch to a practice two hours away- with no refund. Two months, I was paying cash! So I opted for a c-section and was crushed by the second round of doctor bills. 17,000 for an emergency c-section and 9,000 for regular. Natural baby 4500.

    Since the hospitals would not take me for a v-back when I got pregnant with my third child- I would rather die than go through another c-section anyway! I wanted to stay home and try to have the baby naturally without doctors just with my husband- DANGEROUS AND MY ONLY OPTION. Until my friend told me of Midwives and Doulas. If it wasnt for them, I would have been on my own, no choices. Thank god for being with the care of a certified midwife! There is that for a choice, but many states do not accept certified midwives so then what do you do? The option of no choice leaves many women to do it on their own.

    I have been running into women since I had my babies that feel the same as me. They wont set foot in a hospital because the hospitals do not listen to what you want. There is something wrong with hospitals when they scare people to the point they dont want to be addmitted!

    I am going to call my hospital, I am very courious.

    I had two c-sections one in 01, one in 03, I went on to have two successful homebirths with Midwife and Doula in 05 and 07. In comparison: I am 6 foot and the hospital beds where 1 and half foot to short, the floors were hard, the bathrooms stunk, the nurses did not listen to my needs. Homebirth: every need was listened too, my health was cared for right down to what I ate everyday, and the home environment was clean and quiet, with family around tell me I could do it. Plus home birth was 2000 dollars including any of the same tests the doctors would give. And the prenatal and postpartum visits including breastfeeding education – all part of the package. Even though my overall experience in the hospital was not bad I LOVED my home birth felt so very right and natural.

    If you are worried about a v-back after c-section- study it. you will find many different books and centers everywhere that support v-backs. The studies are out there. who are you going to believe the books that are there to give you information or a doctor waiting to go to their kids game, making money off your decisions? Which information would you think is more biased? Always read where your information comes from- most important part when making birthing decisions.