Dear President Obama,
In the United States there are over 800 hospitals that officially ban women from having vaginal births after a previous cesarean (VBAC). There are many more hospitals that do not officially ban VBAC, but either do not have any physicians who will accept a woman planning a VBAC as a patient or have restrictions that effectively prevent women from having VBACs.
These policies are out of sync with medical research. There is abundant peer-reviewed research showing that VBAC is a safe option for most women and their babies. Yet, practices by hospitals and physicians have driven the VBAC rate across the country to just barely over 10%. Research shows that the VBAC rate could be as high as 60-80% in a supportive, evidence-based environment.
Above all, it is unacceptable to force women to undergo invasive and expensive surgery because of the business and financial interest of health care providers. Refusing to offer a woman the opportunity to have a VBAC violates the well-established practice of informed consent and refusal. Misleading women as to the safety of VBAC is both unethical and immoral.
Hospitals that ban VBAC indicate the ban stems from their inability to handle an emergency if one occurs in a VBAC patient. However, if a hospital is capable of handling the rare emergencies that can occur during any delivery, then they are capable of providing safe care for women planning VBACs. If they are not safe enough for VBACs then we must ask if they are safe for any woman in childbirth. They simply cannot have it both ways.
As our economy falters, we must also consider the economic implications of these bans. Unnecessary repeat cesarean surgeries cost the American tax payer hundreds of millions of dollars every year. We simply cannot afford to continue to subsidize a system that puts the financial and legal concerns of insurance companies and hospital corporations ahead of the physical well being of women and their children. We must also recognize the inherent conflict of interest when the organizations that set clinical guidelines around VBAC are also representing the financial and professional interests of their physician members.
I am asking you to look into the practices of hospitals and physicians in our country with respect to VBAC. I hope you will use your office to advocate for patient’s rights and uphold the value of evidence based care in hospitals across the United States.