Mom has to move 350 miles to avoid C-section

[MrsDark]

She could always have a home birth.

[Shinola]

Originally Posted by MrsDark

She could always have a home birth.

She could, maybe. Some midwives will do a VBAC. But even though I did have a home birth and it was a great experience, if I'd had a C-section previously, I'd rather not give birth at home.

[MrsDark]

Maybe next time she'll investigate and plan ahead before getting knocked up.

Or she could move here. I've met OB's in Miami who make it their personal mission to have women delivering vaginally if at all possible.

[scooter]

Originally Posted by 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...

So she's having her 6th child and this is her concern..a c section? Is she a polyg?

[*DIVA!]

She just want the option of having another baby at a later time. If she has this third c-section, then no more kiddos...

[scooter]

I dont get these people who have 4+ children, especially in this economy.

[misrule]

Originally Posted by 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.

spot on. The hospitals argument is that if something does go wrong, and an emergency c-section is required, they don't have the resources (staff eg) to accommodate that. And if you're going into hospital for the birth (whichever kind) in the first place, it's fair to assume that you expect them to be able to deal with whatever situation arises.
If the hospital can't provide the necessary care required in the case of an emergency, it would be negligent to accept a patient in a scenario where that may arise.

If she's that determined to deliver vaginally in that particular hospital, let her pay to bring out an anesthesiologist and medical staff to be on standby to come to her assistance should she need it. She's not being FORCED into unnecessary surgery, she's being forced to seek the appropriate medical care from a facility with the resources to provide it.

[MontanaMama]

But the thing is that the hospital CAN provide the care. The have labor and delivery, which means they must be able to deal with an emergency c-section, they just prefer not to and have drawn a brightline at VBAC, which is not in line with the medical community, it is simply an administrative decision. If she stayed in her home and had her child at the hospital where her other children were born she would be forced into a medically unnecessary surgery, at the decision of hospital administrators, not on the advice of her doctor.

[misrule]

^^^The hospital do have labour and delivery, but not the resources to deal with an emergency ceasarian.
I'm not saying this woman should be forced into having a procedure she is not comfortable with - no one should - but if what she wants isn't available she has the choice to go elsewhere. She is in no way being forced to have this procedure. In an ideal world she wouldn't have to, but sadly we don't live in an ideal world, especially when it comes to healthcare.

Here's a statement from the hospital, posted on the previous thread (thanks Twitchy!):

“Page Hospital is, as many small communities are, challenged with resources,” said Chief Executive Officer Sandy Haryasz. “Page simply does not have the physician resources to respond to an emergency. Currently, we have two physicians who are delivering babies and a third physician will be joining us next week.

“Three physicians cannot provide the coverage recommended by ACOG (American College of Obstetrics and Gynecology). The physicians must be immediately available because of the risks of a VBAC and we cannot provide that in Page. In addition, we cannot provide an anesthesiologist to be readily available because we only have one anesthesiologist.”

Joy thinks it is against her legal rights to force her to have unnecessary surgery that might place her and her baby at greater risk of harm than delivering naturally. Her only option to having natural birth is to travel to a women’s care clinic in Phoenix or have unassisted home delivery.

While the hospital’s new policy not to do VBACs is unwritten, Haryasz said the decision is not based on money, but on there not being enough “volume” to warrant hiring another physician or emergency anesthesiologist.

“This is about providing quality safe care to all our patients,” Haryasz said. “The hospital would have to cancel surgeries or any other procedure because that doctor or anesthesiologist would have to be available to her while she’s in labor, which could take hours or days.”

So it sounds like this facility only deals with scheduled, elective surgery. The reason they have drawn a line at VBAC is within the ACOG guidelines - they don't have enough staff to deal with any emergency situations resulting from a VBAC gone wrong.

It sucks, I'm not disputing that, but the fact is that everywhere hospitals are finding themselves stretched with resources and are simply unable to offer every procedure that a local patient may want to have.
Perhaps her local hospital has undergone funding cuts or other changes that have had to force it to withdraw the procedure since she had her last child. But the hospital is not just being an administrative bully, they just aren't willing to put people at risk when they know that if worst came to worst, they would be unable to provide the treatment for them. The hospital has to run to a budget, otherwise the hospital may disappear altogether.

[Shinola]

There is no way this hospital can be unprepared for dealing with an emergency C-section. The number of hospital births nationally that end up with emergency C-sections is huge. For years it's been commonplace to plan for vaginal delivery and end up with a C-section you didn't want. The hospital couldn't do obstetrics at all if it didn't have resources for unplanned C-sections.

But possibly there's an increasing trend toward pushing planned C-sections whenever possible, because of course that is just less trouble for hospitals and their staffs? Wouldn't surprise me. Birth is just so inconvenient, you know--an organic process that unfolds in its own way and its own time, different for each mother and each infant, unpredictable, and it even has this, like, emotional and spiritual stuff going on in it--therefore, in almost every way, birth is not something that hospitals are necessarily going to be able to accommodate well. It might be well to ask whether business considerations should be the leading factor in medical care, or whether human needs should be the leading factor, with economic considerations falling in line behind human-centered medical decisions.

My mom has worked in hospitals for all of her adult life, and she will be the first to tell you that in U.S. hospitals, the administration sometimes--often--knows nothing whatsoever about the practice of medicine yet makes intrusive decisions about medical care that impact the staff and the patients negatively.

[MontanaMama]

Shinola, you are far more eloquent than I. Well said!

[misrule]

Again, I agree it's an unfortunate situation for her, but if the hospital says they can't provide the service she wants, she is still not being forced to have the alternative procedure done. She has a choice.

The hospitals decision is more than likely based on a risk assessment regarding the potential for a VBAC to take a turn for the worse, potential worst case scenarios, and the litigation that could result when the mother turns around and sues as a result. The c-section possibly carries a lower 'worst case' outcome which is why for VBAC deliveries they feel they don't have the resources to adequately deal with an emergency situation - less chance of a lawsuit.

It's awful that this is the sort of thing it comes down to, and I don't agree with this sort of thinking, but I can see where they are coming from - I think it's a terribly sad reflection on society when people will serve a hospital or medical provider with a lawsuit anytime anything goes wrong. Yes, Sometimes they are at fault, and sometimes it's just that any medical procedure has risks associated with it and people are suffering and want to point the finger. Sometimes people are just greedy.

But having said that - my local hospital doesn't even offer accident and emergency services. Nor does my parents'. There are fully trained medical staff on site, but it is not a service they offer. So if I gash my head open, I can't walk in and demand they treat me because they happen to be the most convenient option for me (they have local anesthetic and nurses capable of putting in a row of stitches, after all) - I have to get someone to take me the 40+ minute drive to the nearest available accident and emergency. It's not cool, but it's life. I've had friends have to temporarily move to different cities so their children could receive chemo, because that was the closest location the service was available.
Of course the medical needs of the community should dictate the services available, but the world is run by big business, and in most cases, in all industries, the upper management making the decisions knows little to nothing about the actual practice of those on the front line. Bureaucracy boils down to $$$, and that horrible term "cost effectiveness"

I don't agree with it. But I accept that's the way things will be for a while yet.

Oddly enough - recently there's actually been a push AGAINST c-sections - except in the case of emergencies - over here. Which of course is 99% to do with the additional cost of the procedure. Interesting for me, anyway. I deal with these fun situations for a living, so I guess I've inevitably become a little more hardened towards these issues out of necessity.

[JuicyLucy]

Originally Posted by Mel1973

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

[MrsDark]

Originally Posted by *DIVA!

She just want the option of having another baby at a later time. If she has this third c-section, then no more kiddos...

Really? Better tell that to my old hospital, which has regularly performed repeat C's on women who are having number 4, 5, 6 by C.

[Sunshine]

Let her move. Those people really annoy me. They are the ones who get mad when our doctors say "No, I won't give you the klonopin like all your friends have. or No, I won't give you the 200 vicodin you want to feel better."

I worked with 4 OB's, none would do a VBAC. That was even with a major hospital.

Healthcare is NOT a service industry. It is NOT McDonald's. It is a service provider not a service industry.

If she doesn;t like their policy, then go some where else.