When It Comes To Refusing C-Sections, We Need To Give Women A Little More Credit

Last week, a doctor threatened to call the police on a woman who was refusing a c-section. Now, a woman in Ireland – who is two weeks overdue according to hospital records – has consented to an emergency c-section after being taken to High Court by the hospital. When are people going to realize that the spiking trend in c-section births is making women believe that hospitals don’t actually have their best interests in mind?

The woman disputed her due date – which she claims is actually March 18th, not February 24th as the hospital claimed. The hospital was concerned about the scar on her uterus from a previous c-section – claiming that if she delivered naturally it could rupture, putting herself and her baby in grave danger. The baby was delivered via emergency c-section – weighing in at a little less than seven pounds. The weight of the baby itself makes me question whether the woman was in fact right about her due date.

The previous post I referenced was a very different situation than this one. Apparently, that doctor was supportive of the woman’s desire for VBAC until “complications” arose. In this case, however, it was the woman’s due date that had everyone up in arms – a due date that she disputed.

People get annoyed when women take their health into their own hands. With mixed messages from the medical community and those trying to get the facts about VBAC out there – I’m not surprised. VBAC has become something that is almost impossible to achieve in some states. The Florida hospital where I hope to have a successful VBAC in a few months has a 43% c-section rate. That terrifies me. That along with the fact that in the state of Florida a doctor and an anesthesiologist have to be present for the entire birth – makes my VBAC seem almost impossible to achieve.

The risk of uterine rupture associated with VBAC is actually really, really low. With no prior vaginal births it is 0.87%. With every successful VBAC you have it gets even lower: 0.45% with one successful VBAC, 0.38% with two. And these statistics include all ruptures – not just catastrophic ones. The risk of catastrophic rupture that effects the health or life of the mother and baby is even lower. From VBAC.com:

For women whose labors begin spontaneously, uterine rupture is reported to be less than 1% and the risks similar to those for women having a first birth.

Medical experts state that the risk of a uterine rupture with one prior low-horizontal incision is not higher than any other unforeseen complication that can occur in labor such as fetal distress, maternal hemorrhage from a premature separation of the placenta or a prolapsed umbilical cord.

I think it’s important to remember these statistics when we hear stories of women refusing medically recommended c-sections. It seems as if even those of us that are the staunchest supporters of a woman’s right to choose what happens to and with her body are quick to judge women who take their deliveries into their own hands. From a comment on the story of the woman who was almost arrested for her refusal of a c-section: “I think it’s completely arrogant for a woman to thumb her nose at her highly experienced and highly educated doctor, especially at the expense of her child’s safety.”

In 2010 the National Institutes of Health (NIH) sponsored a Consensus Development Conference to review safety of and access to VBAC. The panel’s ultimate conclusion was this:

”The data reviewed in this report show that both trial of labor and elective repeat cesarean delivery for a pregnant woman with one prior transverse uterine incision have important risks and benefits and that these risks and benefits differ for the woman and her fetus. This poses a profound ethical dilemma for the woman as well as her caregivers, because benefit for the woman may come at the price of increased risk for the fetus and vice versa”¦ When trial of labor and elective repeat cesarean delivery are medically equivalent options, a shared decision-making process should be adopted and, whenever possible, the woman’s preference should be honored.”

(photo: Naypong/ Shutterstock.com)