Nine months ago, Jennifer Saavedra was pregnant with her second child. After her first daughter was born by cesarean section 2½ years earlier, the Redding woman decided that she wanted to experience a natural birth at least once in her life.
But having her child at a local hospital is almost out of the question.
Redding’s only birthing center, Mercy Medical Center, all but refuses to perform a vaginal birth after a woman has had a previous C-section.
The hospital’s policy isn’t unique. Because of liability and patient-safety concerns, more and more hospitals around the country have chosen to stop the practice, which experts say is contributing to a national rise in cesarean rates.
That leaves local women like Saavedra, a 43-year-old former “figure competitor” — a type of body builder — with few options. They can either have the baby at home with a local midwife or travel several hours to a hospital in Sacramento or the San Francisco Bay area, where a doctor may elect to have a natural birth.
... recent changes to national care standards, hospital staffing levels and threats from lawsuits also factor into Mercy officials’ decision six years ago to stop performing VBACs.
De Soto said the risk of a complication during a VBAC actually is “very low,” Although traditionally around half of the women who try to have a VBAC at a hospital end up having a C-section anyway.
Fairly appalling statistics! At least 75% women who choose a VBAC can be successful, provided that the environment for labour and birth is conducive to natural birth, and provided that the woman's chosen care provider is supportive of her intention to have a VBAC.
Fewer than 1 percent of healthy women who try a VBAC run the risk a “catastrophic event,” like tearing the scar tissue on their uterus from their first C-section ...
The tear can quickly become a massive hemorrhage, which could lead to removal of the woman’s uterus. The sudden blood loss also could choke off oxygen to the unborn baby, sometimes fatally, he said.
De Soto said the hospital is unwilling to take that risk.
But ... multiple C-sections come with their own risks, which are often downplayed by the medical establishment.
... multiple C-sections increase a woman’s risk of future uterine hemorrhaging and hysterectomies.
There’s also an added risk of other problems caused by building scar tissue that develops from multiple surgeries ...
Women who have multiple C-sections have greater chances of having sexual problems, incontinence, bowel obstructions and infertility, she said.
“I’ve never once heard a doctor mention that to a patient,” she said.
‘Avoid the first one’
Although that is a really pertinent statement to make, it's also an unfair comment. A woman having her first baby has no experience of labour and of the terrain that she will find herself in once she steps into hospital. She may not have considered homebirth, even though her chance of having a caeasrean would be far less than 10% had she chosen a homebirth with a midwife. Is it an unfair expectation that a woman having her first baby will know all that she needs to know and have the support that she needs to have, in order to avoid that first caesarean?
Peaceman said patient safety worries — as well as multimillion-dollar malpractice lawsuits — are very much on the minds of doctors. It’s the same in Redding.
... Saavedra said she planned her VBAC [and] ... quickly decided that UC Davis would be impractical and expensive. The university hospital requires women to stay near the birth center for almost a month before the birth just in case the baby comes early, she said.
After doing her own research, she chose to have the birth at home with McNeill.
Sarah was born Sept. 27, a healthy 6 pounds, 9 ounces. McNeill gave Sarah her first bath in Saavedra’s bathroom sink.
Saavedra’s story is one shared by only about 20 Redding women each year.
McNeill, a registered nurse and licensed midwife, said she usually performs at least one VBAC every two months or so. Redding’s other midwife, Dena Burgess, said that she may do 10 a year.
The women who elect to have the procedure are a special breed, local midwives say.
McNeill said such women are usually health-conscious and informed. They’re also confident enough to question the medical establishment, and they’re passionate about their own health care decisions, Burgess said.
“When women have a VBAC, it’s like so — I hate the word “empowering”; I hate that word — but it changes them,” she said.
Renee Harris, 38, of Redding said she knows that feeling all too well.
The home-school mother of seven children has had two VBACs. She’s planning another VBAC when her newest baby is due next month.
She said she decided to go the home-birthing route after doctors in Colorado performed a C-section when she had twins.
“I felt like the decisions were made for me,” Harris said of that birth ... “I’m not going in for major abdominal surgery if I just don’t need it,” she said.