Mom has to move 350 miles to avoid C-section

[fgg]

Mom won't be forced to have C-section

(CNN) -- Jeff Szabo was by his wife's side when she gave birth to their son Gabriel seven years ago, and he was right there holding Joy's hand when their younger sons Michael and Daniel were born, too.
Jeff Szabo was there when Joy gave birth to (from left) Gabriel, Michael and Daniel, but will probably miss No. 4.

Joy is now eight months pregnant, but when this baby is born, her husband will most likely be more than 300 miles away.

The reason: Their local hospital in Page, Arizona, won't deliver the Szabos' baby vaginally as the Szabos wish, so a week or so before her November 21 due date, Joy will drive 350 miles to be near a hospital in Phoenix that will.
Their local hospital says they'll only deliver the Szabos' baby, another boy, via Caesarean section. Joy had her second son, Michael, by C-section. Page Hospital says it won't do a vaginal birth after a woman has had a C-section -- known as a VBAC -- because it has a higher than usual risk for complications.

So Joy plans to move to Phoenix in November, while Jeff stays in Page, in far northern Arizona, to take care of their three children and run the family computer business.

"I'm so upset about this," Jeff says. "I've been there in the delivery room for all the other boys and I won't be there for this baby, and I won't be there for Joy."

The Szabos and a growing number of other families are facing the choice of Mom having a surgery she doesn't want or attempting a vaginal birth at a hospital that, in most cases, would be far away.

A mother's choice

The Szabos' story began in 2004 when she was in labor with Michael. Complications arose and doctors at Page Hospital feared the baby wasn't getting enough oxygen, and so they performed an emergency Caesarean section.

"I'm grateful for that C-section," Joy says. "It saved Michael's life."

Two years later, Szabo had a successful, uncomplicated vaginal delivery with son Daniel at the same hospital. She assumed she could have a vaginal birth this time too, but, she says, a month ago her doctor told her Page Hospital had changed its policy and she'd have to have a C-section.

Studies have shown VBACs carry with them an increased risk of a uterine rupture compared with births in women who've never had a C-section, but the risk is less than 1 percent, according to the American College of Obstetrics and Gynecologists.

The results of a uterine rupture can be devastating: The baby could die or have permanent brain damage.

"I know there's a risk with a VBAC, but we think the risks of surgery are worse," Joy Szabo says. C-section risks include breathing problems for the baby and infections and bleeding for the mother, according to the Mayo Clinic.

"And I don't want to have to recover from surgery when I'll have four children at home, at least not voluntarily," says Joy.

After their discussion with their doctor, the Szabos made an appointment to speak with Page Hospital's CEO, Sandy Haryasz. When the couple told her about their desire for a vaginal birth, they say Haryasz would not budge, even telling them she would get a court order if necessary to ensure Joy delivered via C-section.

"I was a bit flabbergasted, because that seemed rather extreme," Joy says. "I'd already had a VBAC at Page and it went fine. And if something happened, I know they can do an emergency C-section, because they did one for Michael."

Conflict over guidelines

Michele Grim, a spokeswoman for the hospital, said Haryasz could not comment on her discussion with the Szabos because of patient confidentiality laws.

Banner Health, which owns Page Hospital, says it decided to stop performing VBACs at Page when ACOG, the obstetricians' group, established guidelines for hospitals that Page Hospital was not adequately staffed to satisfy.

The ACOG guidelines recommend "24/7 coverage of both physician and anesthesiologist," and that "two physicians be immediately available during the entire period of labor," Banner Health said in a statement.

But ACOG spokesman Gregory Phillips says that's not what the guidelines say. "These appear to be Banner's interpretations of the stated recommendation," says Gregory Phillips.

The ACOG guidelines recommend that doctors consider several factors when determining if a VBAC is possible. For example, two criteria that can be considered are whether there's physician availability throughout active labor, and whether anesthesia and staff can be available for an emergency C-section.

Since the ACOG guidelines came out in 2004, more and more hospitals have refused to do VBACs. Today, nearly half of hospitals won't do VBACs, either because the hospital has banned them or because doctors won't do them, according to a survey of nearly 3,000 hospitals by the International Cesarean Awareness Network, a grassroots group that has fought against VBAC bans.

Missing his son's birth

To get around the ban, Joy Szabo plans on moving to an apartment in Phoenix in the middle of November. They have no friends or family there, but a doula, or childbirth assistant, will drive her to the hospital when she goes into labor.

The Szabos have no option but to separate to get the birth they want, but in other situations, women don't have to go to such extremes.

For example, some women don't want to be induced into labor, or don't want an episiotomy.

The key is to look around for a doctor or midwife who shares your philosophy by asking questions about their induction rate, or whether they perform episiotomies routinely, according to Carol Sakala, director of programs for the Childbirth Connection, a nonprofit advocacy and education group.

Also, choosing the right hospital or birthing center makes a big difference. "The institution you walk into profoundly affects you," Sakala says. "A really good thing is to ask doulas for their recommendations, because they've worked at multiple hospitals and have a good feel for what happens in each of them."

For more information on getting the birth you want, see these recommendations from Lamaze International.

The Szabos know there's little chance Jeff will make it in time for the birth. "With our other sons, her labor only lasted three hours. It'll take me five hours to get to Phoenix," Jeff says, noting that with three little kids along for the ride, it will take even longer.

"Of course I'm scared that I won't be there," he adds. "It's my job as the dad to make sure the baby's OK after the birth, to follow him around and make sure he has 10 fingers and 10 toes. Now the chances of that happening are slim to none."

[Shinola]

It's unfortunate they had to make this decision.

I know there's a risk with a VBAC, but we think the risks of surgery are worse," Joy Szabo says.

I totally agree. This hospital policy has nothing to do with mothers' and infants' actual well-being. It has to do with malpractice-suit potential, and/or insurance issues--in other words, money. Money is clearly more important than humans.

[MontanaMama]

We already have a very cantankerous thread on this couple.

Forced C-Section akin to rape?

Shinola, that was my point. The policy was not medically necessary.

[LynnieD]

Oh lordy..

[MrsDark]

I want to be sympathetic. But unless we're talking Charles Manson style, forced C-Section is NOT even close to rape. Go waste the money (you could probably use as a family with 4 kids) moving your dumb ass 350 miles away because you stretching your vag out instead of having a clean slice from a scheduled C (big BIG difference than with an emergency C) is THAT important.

It'll be a kick in the ass if after all this horseshit she ended up needing an emergency C anyway.

[Laurent]

I can't drum up sympathy for this woman. It's not like there are residency requirements to what hospital you use, so why she's acting like a drama queen and saying she has to "move" is beyond me. And even if she does have to, so what? If she wants a vaginal birth, then it makes walking around sense that you go to a hospital that will perform them after you've had a C-section. If she's horribly inconvenienced, then so be it. She wants what she wants, so she needs to go somewhere that can give it to her, instead of expecting everyone else to bend to her will.

[Mel1973]

yes, because delivering vaginally, in Phoenix without your husband or kids is clearly the better option.

[AliceInWonderland]

yeah seems like a non-issue to me and i had to laugh at this line in the "story":

The Szabos and a growing number of other families are facing the choice of Mom having a surgery she doesn't want or attempting a vaginal birth at a hospital that, in most cases, would be far away.

really? this is such an epidemic CNN

[Moongirl]

^^Our local hospital has the same policy; we have even had patients of our facility who may have had their 1st child by c/s 15 years ago, subsequently had 4 normal deliveries, and are still being required to have another c/s due to their prior history of one. We had one pt. who decided she would deliver at a hospital 45 minutes away; we arranged an appt. w/ a local ob-gyn in that town, and she ended up delivering here by c/s anyway (her choice).
One of our docs at one point was telling a few of her pts. that they *may* want to wait until they are fully contracting to go to the hospital (if they arrive fully dilated, thay kind of have to deliver vaginally) to avoid another c/s...

[gas_chick]

Gonna be funny if she has to have another c section after all this.

[MontanaMama]

Ok, I'll weigh in again. I do not understand the hate for this woman. She does not want a medically unnecessary surgery. She does not want to be cut open and her doctors don't think she needs to be (having already delivered VBAC). It is hospital "policy" that dictates this. You would all prefer to have a hospital administrator decide your care/treatment over your doctor? Cuz that's what this is. This is exactly what's wrong with the healthcare industry, administrators making decisions about what people can and cannot have done with their bodies without regard for the person and that is not nec. medically necessary or sound. This woman is not asking for MORE care, she is not asking for extraordinary care, she is asking to give birth to her child in the least invasive and least expensive way, requiring a lot less medical personnel, intervention, etc. For those of you who have had children, you didn't prepare a birth plan? You didn't think you should have a voice in your own care? I seriously cannot wrap my mind around why this board has had such a visceral dislike for this woman's circumstance (putting aside the erroneous/offensive misuse of the word rape, but good god, where are all the threads of hatred for athletes that misuse the word as applied to sporting events?)

[Mel1973]

Gonna be funny if she has to have another c section after all this.

I'm gonna laugh my tits off! Yeah, now you're 350 miles away from your husband and family and have to have a surgery... who's gonna get to hold your baby for those first few minutes? The nurses.

[tictac]

My babies dictated my birth plan, not me.

[twitchy2.0]

Gonna be funny if she has to have another c section after all this.

No, not even remotely funny to need an emergency c section.

[Laurent]

Ok, I'll weigh in again. I do not understand the hate for this woman. She does not want a medically unnecessary surgery. She does not want to be cut open and her doctors don't think she needs to be (having already delivered VBAC). It is hospital "policy" that dictates this. You would all prefer to have a hospital administrator decide your care/treatment over your doctor? Cuz that's what this is. This is exactly what's wrong with the healthcare industry, administrators making decisions about what people can and cannot have done with their bodies without regard for the person and that is not nec. medically necessary or sound. This woman is not asking for MORE care, she is not asking for extraordinary care, she is asking to give birth to her child in the least invasive and least expensive way, requiring a lot less medical personnel, intervention, etc. For those of you who have had children, you didn't prepare a birth plan? You didn't think you should have a voice in your own care? I seriously cannot wrap my mind around why this board has had such a visceral dislike for this woman's circumstance (putting aside the erroneous/offensive misuse of the word rape, but good god, where are all the threads of hatred for athletes that misuse the word as applied to sporting events?)

I think she is entitled to her decision to have a vaginal birth, but I also think that the hospital is entitled to their policy decisions.

If their policy is to not allow patients in their facility to have a vaginal birth after already having a C-section, then she should find a hospital whose policies coincide with her wishes, not cry foul because they won't bend to her wishes.

I admit that I was initially repulsed by her attempt to analogize this to rape, but that's cooled, and I still don't have any sympathy. I understand a woman not wanting to have a C-section if she doesn't want it, but I think she needs to find a hospital that will accomodate her.