The ban on pre-term elective deliveries rolling through many hospitals in the country right now has hit Portland, and now all 17 Portland area hospitals are putting what they call a “hard stop” on all elective cesareans and inductions before 39 weeks of gestation starting September 1. The Portland Tribune is reporting the story online here and notes that after the ban takes effect, “….induced births even one day before 39 weeks will now require patients to present their case to a designated arbiter at the hospital and prove that there is a medical reason why the early birth should take place.”
Do you think this ban will soon be instituted in hospitals all over the nation?
6 Responses
I sure hope so! Inductions and cesareans can be very useful or necessary, but I feel that hospitals and their staff these days go beyond abuse of these procedures.
GOOD! It’s about time that doctors that are going on vacation and golfing can’t schedule around that now. Unless there is a medical reason a baby shouldn’t be born before then. It’s sad that it had to come to this.
I have to say that I also hope such bans will become standard, nationwide practice. The word “elective” is a critical part of the ban on cesareans and inductions before 39 weeks. It sounds like this practice is very much in line with evidence-based best practices for maternal/fetal outcome.
So do the doctors have to make their case when recommending early inductions? This is a step in the right direction but I really think that most “elective” inductions are instigated by the doctor rather than the mom.
When does it become the baby’s delivery-not just about the mother’s birth experience? What happens when you vbac in a hospital without OR back up and you and your baby may die or your baby may suffer severe brain damage? What will you do? Knowingly placing your and your baby’s life in danger to prove a point?
If you were in a rural area and your water broke at 32 weeks and you had to be medevac’d out-would you be transferred out or stay and have a severely damaged or dead baby? Why should vbac-ing in a facility not able to comply with ACOG guideline be an option for delivery?
Shame on facilities that CAN do VBACs ban them! They are the cowards. But is it worth uterine rupture and possible fetal/maternal death to feel empowered?
@ob nurse, it’s not just about mom’s experience- it IS about having the safest birth possible for mom, baby, & mom’s future babies. Banning VBACs at rural facilities because a hospital doesn’t feel equipped to handle the risk of uterine rupture in a planned VBAC doesn’t solve the problem. A uterine rupture can happen before a scheduled cesarean date. Should we tell all women, even those with previously unscarred uteri that they shouldn’t even plan to get pregnant at all unless their closest facilities have 24/7 in-house anesthesia? It’s not just scarred mamas & their babies that are at risk. If a hospital isn’t comfortable handling the risk of a uterine rupture in a planned VBAC, how do they feel capable of handling the risk of fetal distress, cord prolapse, or placental abruption for ANY mother/baby?
It’s not for you or me or ACOG or a facility or anyone else to make each individual mother’s personal decision. You’re right, some women may not be comfortable with the risk of VBAC’ing at a facility that may not have 24/7 anesthesia in-house, and that is certainly their choice to choose a planned repeat cesarean if that’s what they feel is best. But what about the women who truly feel that given the research, the benefits of planning a VBAC still outweigh the risks? Cesareans aren’t risk-free, especially as the number of scars on a uterus accumulates. It would be much easier if it was a risk vs. no risk choice, but it’s not.
The most fair thing to do is to be honest with ALL women- scarred or unscarred- about the capabilities and limitations of the care providers and facilities available to them and let them make their own decisions with that in mind. There are NO one-size-fits-all formulas for birth.
I’ll believe that VBAC bans are really for the mother’s/baby’s good at facilities without 24/7 anesthesia when those same facilities have induction, augmentation, episiotomy, and cesarean rates within evidence-based standards. I have a hard time believing when a facility or group like ACOG says “it’s for your own good” when they have intervention rates far exceeding the evidence-based standards of care.