Wednesday, March 24, 2010

Letter to the Editor: VBAC's in Birth Centers

The following is a letter to the editor of the Sarasota Herald-Tribune. Buried under mountains of letters about the school tax and health care reform, it did not print, but as today is the AHCA hearing proposing the ban of VBACs in Florida birth centers, I thought it timely to post.

Kudos for printing Denise Grady’s article “A Hospital Where Babies Can Arrive When Ready” on March 7 (page 9A). The featured Navajo hospital boasts healthy outcomes and a low c-section rate by encouraging vaginal birth after cesarean (VBAC). Their facility has a 32% VBAC rate, four times the national average.

Experts agree that increasing VBAC access is an integral step in reducing our dangerously high c-section rates (Florida ranks second in the nation at 38%). A VBAC conference was held by the National Institutes of Health this month, resulting in a consensus that recommends that “hospitals, maternity care providers, healthcare and professional liability insurers, consumers, and policymakers collaborate on the development of integrated services that could mitigate or even eliminate current barriers to trial of labor.”

Regardless of this recommendation, which was backed by three days of evidence supporting the safety of VBAC, Florida's Agency for Health Care Administration will move to permanently ban VBAC’s in Florida birth centers this Wednesday. Florida women with prior surgeries are already limited in their choice of birth place, as fewer than half of Florida hospitals allow VBAC. Sarasota Memorial does welcome VBAC candidates, but with fewer than 1% of Florida obstetricians accepting them as patients, SMH only sees about 1-3 successful VBAC’s monthly.

Women are legally obligated to receive balanced information about the risks and benefits of VBAC as well as the risks and benefits of repeat surgery. Armed with this information, the choice of birth place is a decision that should ultimately be made by a woman and her care provider, and not by the state.

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