Reversing Hospital VBAC Bans

WHAT IF IT DIDN'T HAVE TO BE THIS WAY?

Did you know that increasing the number of women having VBACs is a part of a science-based, 10-year national objective for improving the health of all Americans?

It's true. It's called Healthy People 2020 and they want to bring the VBAC rate up to 18.3% by 2020.

The fastest way to do this? Make VBAC more accessible in the hospital.

If we work together, we can change hospital policy and achieve this goal!

IMAGINE WHAT IT WOULD FEEL LIKE TO REVERSE YOUR HOSPITAL'S VBAC BAN

You have created massive change in the lives of thousands of families. You have garnered the respect of your community while creating life long allies and friendships.

You accomplished what so many said wasn’t possible: You reversed a VBAC ban that will impact the lives of real parents and babies across your community and beyond.

Women whose only option was to have a repeat cesarean can now avoid surgery and plan a hospital VBAC without having to travel hundreds of miles to the next closest VBAC friendly facility.

Those who wish to plan an out-of-hospital birth may still do so, but those who desire to birth in the hospital now can.

Women are no longer forced into unassisted births or unnecessary cesareans because they can't afford a midwife or to travel to birth.

Your work will improve outcomes for moms and babies by decreasing the rate of placenta previa and accreta as well as the complications they cause including premature birth, hemorrhage, hysterectomy, infection, NICU and ICU admissions, and death.

What would it feel like to lead the charge and improve the state of maternity care in your community?

MEET SARA: HOW A VBAC BAN IMPACTED HER BIRTH

It didn’t take long for it all to fall apart.

Sara wanted a VBAC. Per national guidelines, she was a candidate.

But it wasn't an option in her community. Her only option was a repeat cesarean.

The one hospital with an L&D unit in her town had banned VBAC... and it was over 100 miles to the closest hospital that supported VBAC.

When midwives transferred their home VBAC patients to this VBAC ban hospital, they were met with hostility and women were coerced into cesareans. As a result, midwives stopped attending home birth VBACs.

Sara found a VBAC supportive OB over 50 miles away who worked at a VBAC ban hospital. He said he would support her.

But his official stance was written into her medical records, "I advised her that if she wants a VBAC, she needs to go to a hospital that supports it."

PLAYING HOSPITAL HOPSCOTCH

When she arrived at the hospital, her doctor would tell her how the hospital banned VBAC. And she would say how she refused surgery. And he would attend her VBAC.

It was their plan. But how it was all going to play out on the day of her labor... no one could predict.

When she went into labor, she called her doctor. He was at another hospital - which also banned VBAC - supporting two first time moms in labor.

He suggested that she go to a third hospital - which also banned VBAC. He said to tell the nurses that she was driving to the hospital that supported VBAC when she stopped at this hospital because labor was progressing quickly.

When she arrived, the nurses were harsh, judgmental and rude. They asked, "What are you doing here?"

When Sara gave them the story, they flatly said, "We don't do VBACs here."

COULD THEY KICK HER OUT?

They replied, "We don't do VBACs here. It's against our policy."

Sara wondered if they would actually turn her away.

A doctor examined Sara and recommended that she have a cesarean.

But the exam found that Sara and her baby were doing well, so Sara stated that she would be refusing a C-section.

WHEN HER HEART BROKE

However, after many hours of labor, her cervix started to swell.

The doctor supporting her said that she could continue laboring as the baby and her were fine, but she didn't think that Sara would progress any further.

Sara decided to have a cesarean... again.

HOW I MADE THE CHOICE TO BECOME A VBAC ACTIVIST

I’m listening to Sara, a professor and mother of two tell her birth story… and it’s difficult to hear.

I’m speaking on a panel with an obstetrician and a perinatologist discussing hospital VBAC bans. These are hospital policies that require all women with a prior cesarean to have a repeat cesarean.

While we reviewed the evidence, the guidelines, and ethics of such policies, mothers recalled the complicated and convoluted plans they had to cook up in response to the one hospital in their town banning VBAC.

One mother shared how she drove over 200 miles round trip, in legendary Los Angeles traffic, throughout her pregnancy and in labor, in order to birth at a VBAC friendly hospital.

Another shared how she planned a home birth with an obstetrician as that was the only way she could have a VBAC without traveling outside her county.

Yet it was Sara's story that brought me to tears. Why was it so complicated?

They were equipped to manage a gun shot wound or injuries from severe car accidents requiring emergency surgery... but they claimed they could not manage a uterine rupture.

A woman is three times more likely to die during a repeat cesarean than a VBAC.

Yet this hospital, along with others across the country, lead women to believe that they have no option but a repeat cesarean at that facility. Women were simply not “allowed” to have a VBAC.

I had been working on improving VBAC access since I had my own cesarean in 2004.

Through the process of preparing for my next birth, I uncovered my power, found my voice, and had a victorious VBAC in 2007.

That day I was transformed into an advocate for VBAC access.

At two weeks post-partum, I started VBAC Facts because so few women had access to VBAC even thought the American College of OB/GYNs affirmed the safety of VBAC and encouraged women to have access to the option.

I spent years and thousands of hours learning everything I could about VBAC and created my signature program, “The Truth About VBAC.”

I became a Continuing Education Provider for the California Board of Registered Nursing and spoke around the country to hundreds of parents, professionals, and providers who wanted to understand the medical evidence and political realities surrounding VBAC.

There was only one problem.

While this program transformed the births and lives of hundreds of people, and I was reaching millions through my website, it wasn’t enough.

While those moments were life changing for those individuals, it really was just a drop in the bucket.

I needed to do more.

All the information in the world didn't matter if women were coming up against hospital policies that were presented as equivalent to law.

Women who dared to challenge those policies in labor were threatened with court ordered cesareans, psychiatric evaluations, and child protective services.

Or they were just outright lied to and made to believe their cesarean was medically necessary.

Stories surfaced in the media of women and babies suffering, or even dying, from placenta accreta, a cesarean-related complication.

I FELT LIKE I WAS FAILING

It wasn’t enough to have the information, if parents couldn’t access VBAC in the first place. And when they are in labor, that is not the time to try to change policy.

I thought about everything I had learned about VBAC bans. How they are established and how they are overturned.

All the reasons behind them: medical malpractice insurance, liability concerns, the interpretation of national guidelines, the lack of provider support, and a public that really believed that VBAC bans were rooted in patient safety.

How communities battling VBAC bans were hitting a brick wall. Hospitals simply ignored letter writing campaigns, internet petitions, and protests. And advocates didn’t have a coordinated plan on what to do next. So they lost momentum and the movement dissipated.

THE MISSING PIECE

People were unsuccessful in reversing bans because there was no coordinated, organized effort.

People didn’t know how to get started or have a roadmap to tell them what to do next.

Hundreds of people across the country wanted to reverse their local hospital’s VBAC ban and they all had the same struggles:

• How do you even begin?
• How are VBAC bans reversed?
• How do you create a plan?
• Find allies within the hospital?
• And what do you do if the hospital just completely ignores you?

MY AH HA MOMENT

All of this is swirling in my mind as I listen to Sara recall her story.

I knew I had to do something.

I knew the research on VBAC and hospital policies. I had case studies of VBAC ban reversals. I understood how institutional change was made.

I had everything I needed to put together a system to reversing VBAC bans.

And beyond that, I had contacts throughout the country and the ability to reach tens of thousands of people at the push of a button… and that audience was growing daily.

The time had come to pull all of that together, engage the public, and create some real, tangible change beyond the individual pregnant person.

To make hospital VBAC more accessible would revolutionize the maternity care available to hundreds of thousands of families and improve outcomes across America.

LET'S CREATE SOME CHANGE

This is the first product of it's kind: a program specifically designed to reverse hospital VBAC bans in America.

Through weekly online presentations, you will receive a step-by-step action plan for reversing VBAC bans so you know exactly how to get started and what to do next.

We will get started on Thursday, December 8th at 11am PST and will meet through March 9th, taking a break on December 29 and January 5th. You can attend live or watch the recording later, so don't worry about falling behind.

In December we will lay the groundwork and our weekly action items will be short and easy to accommodate the holiday season. In January, we will hit the ground running!

And you won't be doing it alone! You will work alongside, receive support from, and exchange ideas with a community of like-minded allies across the country as they too move through the five phase system.

Step One: Understand the facts. The fastest way to lose credibility is to cite inaccurate information. So the first step of the process is to learn about VBACs so you can confidently and clearly discuss the facts while identifying and disarming misinformation.

Step Two: Consider the hospital’s perspective. The next piece is to actually learn why hospitals ban VBAC, and how hospital VBAC policies vary across the country, so you can work with your hospital and create a solution that addresses their specific concerns.

Step Three: Create your team. Once you do that, it's time to gather up concerned citizens in your community and cultivate relationships with hospital based allies to assemble your League of Maternal Health Champions so you can feel the support of your community, understand the inner workings of your hospital, and amplify your collective power and voice.

Step Four: Collaborate with the hospital. Here’s where you pull everything together! Once you have assembled your team, you will learn how to make initial contact with the hospital! Your objective is to start the conversation and build bridges with medical providers and administrators at your hospital so you can really hear their concerns and work towards a common goal while representing the voices of your community.

Step Five: Engage the “Stonewall Solution.” So what if your hospital just ignores you? What then? You will learn multiple tactics on how on to connect with various regulatory agencies, get the media involved, coordinate rallies and protests, and apply legal pressure so the hospital knows you are not going away until the ban is reversed.