My Local Midwife/OB VBAC Policy

In the interest of anonymity I will not tell you where I live exactly, or what practice I am speaking of in this post. I will tell you this: the trend is nationwide, it is staggeringly illogical and we need to do something about it.

I went in yesterday to my local OB/midwife group to see if they could get heart tones for me. I’ve had symptoms or warning signs of miscarriage for about 2 weeks and just couldn’t stand the “tentativeness” any longer. I needed to know.

I sat in the exam room, fully dressed still, as the midwife and a student midwife came into the room. I say “came into” but they really didn’t. Before they put down my chart, before they introduced themselves, before they even closed the door, they said that I needed to be aware of this hospital’s VBAC policy before they proceded with the appointment.

“Oh, I’m aware of it.” I said, smiling.

“Well good. Then next time you’ll be in to see a doctor and he will get you scheduled.”

“I won’t be in to see the doctor next time and no, we will not be scheduling me.” (for an elective section) Still smiling I added, “I’m here for THIS appointment today. That’s all. And just for the record, that policy stinks.”

She replied, “I understand. It’s not about us, it’s about anesthesia. They are the ones with the issue with it, they are why we don’t do them anymore. We don’t really know why.”

I said, “Yes, I’m aware of the ACOG bulletin regarding VBAC’s which is probably the “proof” they used to support their position. I’m also aware of the totally illogical presumptions that a VBAC ban is based on. If it’s unsafe for me , a VBAC mom, to birth here because I might need an emergency c-section and anesthesia isn’t always immediately available, then explain how it is safe for ANY woman to birth here. Suppose she has an abruption? Or non-reassuring heart-tones? Or any of the other hundred reasons women get sectioned these days?”

Deer in the headlights. Looks at the ground. She doesn’t like it either, but she’s stuck. Or maybe she doesn’t know what to do. I want to believe she knows better. She says, “Well I didn’t tell you this, but they can’t technically cut on you without your consent.”

“Oh yes.” chuckling now, “I know that full well. Trust me.”

I said all of this with my sweetest southern smile and tone of voice. Not inflammatory or rude or condescending. Just sweet, sweet, sweet.

The appointment continued with the student midwife doing the risk assessment, genetic screening questions come next.

“Does anyone in your family or the baby’s father’s family have mental retardation or autism?”

“Wow. I dont like that categorization of autism with mental retardation, but yes. My son has autism.”

“But you don’t want genetic screening test done?”

“No. I don’t.”

“Why not? You realize we can screen for some of these things?”

Oh give me a break! If we could screen for autism IN-UTERO then we’d have a CURE for it. Jeez Loueeez!!!!!!!!!!!! No less than 5 times did the subject of genetic screening come up. With LOTS of eye contact.

They were very kind and found heart tones (yeah!). I left with a script for prenatal vitamins, a packet about the lovely “birthing suites” my hospital has, a free formula coupon book (which they strongly discourage but still hand out), and a sheet of paper for blood work. Plus an appointment for an ultrasound next week to rule out multiple pregnancies or ectopic. Though I really dont’ have symptoms of either other than my uterus feeling a little bigger than 10 weeks.

Can we say… “Mul-ti-pa-ra” ????

Highly educational visit. I’m not sure what I want to do from this point on. Keep going to appointments, push this VBAC thing since I have a voice there now, while at the same time having NO intentions of delivering there? There is such a startling contrast in true midwifery care and hospital birthing care. Wow. I’m still shocked.

 

 

 

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