A Woman's Right to Choose a VBAC

Arizona woman won't be forced into unwanted surgery.


This CNN headline caught my eye: "Mom won't be forced to have C-section." A woman currently expecting her fourth child is making national news for standing up for her reproductive rights, in the delivery room.

Joy Szabo delivered her first son seven years ago by normal vaginal delivery. Son number two was an emergency cesarean section and number three, another vaginal delivery.

Both the c-section and the subsequent VBAC (vaginal birth after cesarean) were done at Page Hospital in Page, Arizona.

Baby number four is due next month and Joy will travel hundreds of miles from home to deliver. Why? Because Page Hospital refuses to allow her to have another VBAC. They've changed policies, won't make an exception and are willing to take legal action to force Joy to have a cesarean. The article reports the Szabos met with Page Hospital's CEO, Sandy Haryasz. It states, "When the couple told her about their desire for a vaginal birth, they say Haryasz would not budge, even telling them she would get a court order if necessary to ensure Joy delivered via C-section." Seriously!

Joy and her husband know the slightly increased but potentially disastrous risks associated with VBACs—a less than 1% chance of uterine rupture caused by the stress of contractions on the previous cesarean scar. Joy has already safely delivered two babies vaginally and one by VBAC. Cesareans are major abdominal surgery and take four to six weeks for recovery. Joy will have four small children. She doesn't want the increased risks for mother and baby and the more complicated recovery associated with another cesarean. She knows what she's talking about and has made an empowered choice about her own body and baby.

So, the week before her due date, she'll travel alone to Phoenix to be near a hospital that does VBACs. Her husband will stay home to take care of their young sons and Joy will hire a doula to drive her to the hospital when labor starts. That's the choice she feels forced to make. Deliver alone among strangers or submit to surgery.

The American College of Obstetrics and Gynecology is quoted as saying that Banner Health, the owner of Page Hospital isn't necessarily following their guidelines about when to do, or not do VBAC. They're following their own interpretation of the guidelines.

Banner Health is not alone in refusing to do VBACs. More than half of American hospitals no longer do them. Why not? They won't take that less than 1% risk. Though more than 99% of women can safely have a VBAC and cesareans carry plenty of risks themselves (hemorrhage, infection, and respiratory complications are just a few), these hospitals feel their hands are tied. If one of their patients is in that 1% they'll be sued. Their insurance premiums would skyrocket and frankly, they're not willing to lose that money.

My response? Go Joy! While many women happily go along with whatever their doctor recommends or hospital demands: "Another cesarean? Sure, sign me up;" many others are saying "NO!" Joy knows that if trouble arises any hospital can do an emergency c-section. She's willing to take the risk but she's not willing to be forced into unwanted and most likely unnecessary surgery.

This is one of the many issues that must be addressed in our national focus for health reform. The medical insurance industry is dictating how women are allowed to give birth. They're playing up rare risks and using scare tactics to force women to submit to insurance and legal money-saving, surgical procedures. They're putting Page Hospital into a position where they feel the need to defend their policies by taking legal action against their own patients.

Seriously? Isn't there another way around this nonsense? My suggestion, if a woman wants a VBAC, let her sign a legal waiver. Let the patient and her doctor do what they decide is best. It's time for big change, ladies, when a woman's right to choose what happens to her body is regulated by executives, insurance agencies and attorneys. By the way, Joy's doctor was willing to do the VBAC until the hospital said, "no."

Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to jeanne@jeannefaulkner.com.

This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.