A buzz was created when the news broke that Banner Hospitals in Phoenix, Arizona have set in place a policy banning elective cesareans and inductions before 39 weeks to take effect starting in mid-July of this year. The hospital made the decision based on evidence which showed that it is healthier for baby to be delivered no earlier than 39 weeks, absent clear medical necessity. The hospital will continue to perform medically necessary cesareans and inductions before 39 weeks.
As the news spread across the web, many discussions sprang up questioning whether this decision might start us down a slippery slope with regards to respecting women’s choices in childbirth. Many women expressed concern that the same reasoning–purported risk to the baby–might be used to uphold or promote VBAC bans in some hospitals. ICAN, in our Statement of Beliefs, states that it is unethical for a physician to recommend and/or perform a non-medically indicated cesarean. We also believe that VBAC bans are unenforceable and unethical. Evidence-based care should be at the forefront of decision making when it comes to women’s health, and it seems that Banner Hospitals agree, at least with regard to the timing of elective cesareans and inductions.
What do you think? Will this start us down a slippery slope?
4 Responses
Well, I think that they are two different beasts; Banning elective c-sections/inductions prior to 39 weeks & VBACs. One is potentially harmful in an unnatural, absolute intervention way, the other is completely natural – as far as your body working as it was made. I think it’s great & hope that it makes people & other hospitals recognize that c-sections & inductions that are not medically necessary can be harmful, because that seems to be glossed over often times.
Too many women have unnecessary inductions or c-sections the day they “hit” 37 weeks, which is silly, since that date is made on a guess. An educated guess, but a guess. Waiting to 39 weeks for that stuff is going to allow for errors in the guess date, as well as allowing the baby to cook longer. I think that’s only going to improve the infant/birth mortality rates, which is always a good thing.
While I believe women should have the right to choose to try for the birth that is best for them, it needs to be done safely. And it needs to be an educated decision, not something to be taken lightly, or something they are convinced/told to do for the wrong reasons, like a care provider wanting to be off in time to get somewhere or go on vacation. I think this is more like climbing stairs than going down a slippery slope. Next step, allowing women to safely choose to attempt a VBA(M)C.
I’m not sure how I feel about the ban. The article made it sound like there are scores of women going around selecting these operations of their own accord. I believe many of these women are “electing” cesareans based on the recommendations of their doctors. These recommendations may or may not come from a place of evidence-based care. Eliminating elective cesareans still doesn’t address issues of women being cut for “failure to wait” or to stem the cascade of interventions…
I support the ban. Granted, my second was a 37 week repeat c-section. It was medically necessary as she was becoming non-reactive. BUT She was soo little and frail compaired to my 41 weeker.
Also, this goes to support the new study redefining full term at 39-41 weeks (http://www.webmd.com/baby/news/20110523/study-gives-new-view-of-full-term-pregnancy).
Regardless, women need to be able to chose. They need to not be afraid to tell their doctor “no, its going to be MY way”