VBAC

My doula on VBAC hospital rates

There has been a lot of discussion on my local ICAN message board on various local hospital VBAC rates. My doula just posted this explanation today and I thought it was so well worded that I'd share it here.

 

This figure (a hospital's VBAC percentage - in this case it was about 2%) just includes ALL women who had a previous cesarean and then delivered again- which ones were VBAC and which were not. The percentage is how many of them had a vaginal delivery versus another cesarean. The statistic does not indicate whether or not they tried a vaginal delivery or not- only that there was no "risk factor" to exclude them from the statistic, and that they had a previous cesarean and with their next baby, did they then VBAC or RCS.

So when one looks at the statistic, one has to think about it like this- does this facility encourage women to try to VBAC or discourage it? Is this facility excessively restrictive of the conditions under which it will "allow" much less encourage VBAC? Are there a number of care providers at this facility offering VBAC or pretty much just one, thus the total number of VBAC's out of all the women delivering who had a prior cesarean is quite low?

So the statistic is not "how many trials of labor were successful" but 
"of how many people who COULD have been a VBAC, how many actually WERE successful VBAC's? Bottom line.

Because we all know that there are plenty of people who say, "sure... if all goes well... if the planets align... if you have a 6 lb baby in an 8 hour labor Monday thru Friday before 6:00 p.m. before 39 weeks while laying on your back on a monitor... then you can VBAC" so the mom thinks she is going to VBAC... and lo and behold, she doesn't go into labor soon enough or they tell her the baby is going to be huge or whatever, and she "has to" schedule the c/s... not to mention the people who ask about it and are told, "oh, you can not have a baby vaginally because..." so they don't even "try" or "think they are going to get to 
try"... Even GETTING to the trial of labor without having the plug pulled on the VBAC is challenging in a hospital's birth culture where "1-2% of women ACTUALLY have a VBAC"... that's a 98%-99% of the time, SOMEHOW or another, it just DOES NOT HAPPEN. So one has to be very careful when planning to swim upstream with a current rushing 98-99% in the opposite direction. 
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Re: My doula on VBAC hospital rates

  • Interesting. It never occurred to me that hospitals might quite a VBAC rate that way. Mine quotes their VBAC success rate and their overall CS rate both medically indicated and elective together.
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