Posts Tagged ‘press release’

September 7th, 2010

OB’s Aren’t Listening to ACOG

OB’s aren’t listening to ACOG. While this is a huge shock for some people, it is not surprising for others. But how did I come to this conclusion?  Well, becoming pregnant put me in a position I was not comfortable being in yet. Being a woman looking for a trial of labor after two previous cesarean sections.   One that was not medically necessary at all, and one that saved my youngest son. While I believe if things had been done slightly differently the second could have been avoidable, but it was a catch 22.

In July of this year, ACOG released new VBAC recommendations in response to the growing cesarean rate, complications that are a direct result of that, the falling VBAC numbers, and the lack of access for VBAC that was all brought out in the National Health Institute’s VBAC Consensus back in March.  I was lucky enough to be able to watch the entire conference from home, and take a ton of great information from it. But it also hit ACOG hard because their representatives knew that their guideline changes essentially caused the decline in VBAC access for women Nationally.

On July 21st, ACOG made a new press release detailing some of their new VBAC guidelines, which included a statement on women with two previous cesarean deliveries.

In keeping with past recommendations, most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered a TOLAC. In addition, “The College guidelines now clearly say that women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a TOLAC,” said Jeffrey L. Ecker, MD, from Massachusetts General Hospital in Boston and immediate past vice chair of the Committee on Practice Bulletins-Obstetrics who co-wrote the document with William A. Grobman, MD, from Northwestern University in Chicago.

Ok, so what is the big deal right?  It says right there that ACOG supports and finds a trial of labor acceptable and essentially a safe option for women with two prior cesarean sections.

So what is the hang up? Apparently all the same OB/GYN’s out there that were quick to jump ship on VBAC when the guidelines changed years ago with new guidelines on the readiness of Anesthesia in the hospital, are NOT as quick to jump back ON the VBAC bus despite the clinical information showing it to be a safe choice.

Where does that leave me right now?

Screwed!  I have a hand full of options I am looking into at this point, but I can’t go see the midwives I was with because their backup OB practice won’t take me on… I have an appointment with a high risk Perinatology group who seems to be open to my request, but the two words high risk scare me because I know it is going to limit the availability of a natural birth. Although the positive of it all is a friend of mine, who had two home births, and came down with a horrible blood disorder during her third pregnancy had a 100% natural hands off birth with this same practice. So… I have hope…

We’ll see!