Monday, December 03, 2007

de facto ban

de facto - ACTUALLY : in fact : in reality

In other words, when something is de facto, it has the force of reality without being spelled out in so many words.

A hospital here in Houston,
West Houston Medical Center, has placed a de facto ban on the "risky" procedure of women having a vaginal birth after a cesarean section (VBAC) by no longer guaranteeing the availability of anesthesiologists after normal working hours for VBAC patients. You can read an article from a couple of weeks ago in the Houston Chronicle here. Without the promise of available anesthesiologists, in case of emergency, few doctors will be willing to allow women to have VBACs, forcing them into the new reality of "once a cesarean, always a cesarean".

Some physicians cite the risks of the procedure - mainly the 1 percent chance [actually, less than 1%] the uterus will rupture along the C-section scar - as reason to perform repeat C-sections instead.
But C-sections, too, carry risks, particularly those associated with surgery, such as infection. So which option is better for a woman often hinges on her pregnancy, including whether she's likely to have the same complications that required a C-section during the previous birth.
For doctors, C-sections can be more appealing because there's less chance of a lawsuit. In the small percentage of VBAC cases that result in uterine rupture, an unpredictable complication, a C-section must be performed immediately to save the life of both the mother and the baby. (from the
Chronicle article)
What this is really about is not the women's health, or about the safety of one option over the other. This is simply about two things:
  1. doctors fear lawsuits, and their insurance companies fear them even more, and
  2. doctors like schedules and dislike having to be available 24/7 waiting for a birth to happen naturally when they can set it for 8:00 Monday morning and be done with it in an hour.
Right now, there is something you can do about this. A petition is being gathered (a real one, not some goofy add your name to the e-mail chain) that can be signed on-line. Go sign the petition, and it will be presented to the hospital per their stated mission of listening to the community.

This is something that Mrs. E and I are very passionate about. The birth of our little boy, now nine months old, was through VBAC. It was perfectly safe, and low risk, with the only problems coming from medical staff who indirectly expressed their disdain for us nutballs who make their life hard. Birth is not about the hospital getting it's way, and it is not about the insurance company finding the cheapest solution and maximizing their profits. Birth is about a mother, a father, and a child coming into the world. Give them the options to birth that baby in the best way possible for them, not for some third-party's interests. Please join us in signing this petition.

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Anonymous said...

Thank you so much for posting this topic! Hubby and I are also very very passionate about this.

Douglas said...

That's interesting/very odd. Do you have to be a Houstonite to sign the petition?


euphrony said...

No, you don't. There are people from all over who have signed it.

UPDATE: West Houston Medical Center will be publishing on their website their policy on VBAC: in short, VBACs are welcomed and supported. Individual doctors will continue to decide whether or not they wish to attend VBACs. In addition, they are acking the paper to print a claification.

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