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These "repeat c-sections" have become so common that they now account for nearly , births annually in the United States, about 10 percent of births each year. And it doesn't seem that this number will be getting any lower, as an increasing number of hospitals that formerly permitted women to try for vaginal birth after cesarean VBAC now prohibit the practice, making a return trip to the O. Because it 's getting harder and harder to find medical centers that allow VBAC, the rate has plunged by nearly two-thirds, from Ask doctors what's behind the ban, and you'll hear the same answer: fear of lawsuits.
Trying for a VBAC carries with it a 1 percent risk of uterine rupture. This dangerous complication is an emergency that requires surgical repair--or, in some cases, a hysterectomy--to stop potentially life-threatening blood loss. In , ACOG responded to concerns about VBAC risks with new practice guidelines, saying that the delivery should only be provided at hospitals equipped to do an immediate c-section if anything went wrong, instead of within 30 minutes' notice, as was previously required. Minkoff delivers babies, but not for smaller hospitals.
How far should ob-gyns go to save an unborn baby they consider at risk? Some of the very doctors you'd most expect to advocate for pregnant women actually support forced c-sections, a University of Chicago study found. When the researchers surveyed directors of 42 maternal-fetal medicine programs around the country, 14 percent reported that their hospital had used court orders to compel unwilling women to have O. What's more, 21 percent of these specialists in the care of pregnant patients consider coerced c-sections "ethically justified" to spare a fetus possible harm--even over the woman's physical resistance, as long as her struggles weren't strenuous enough to endanger her or the baby.
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ACOG adamantly disagrees. In , its ethics committee ruled that it's never right for health care providers to subject pregnant women to physical force, even with a court order authorizing a c-section or other procedure. The committee also said that seeking such orders against a patient's wishes is "rarely if ever acceptable. So what should happen if a doctor is convinced that a vaginal birth would be disastrous? However, doctors' opinions can also be tragically wrong. Years ago, a Washington, D. Since the mom was in such poor health, the hospital's doctors believed that delivering the week fetus immediately would give it a better chance of survival than waiting for a natural delivery.
The result? Carder and her baby both died soon after the operation. Later, in a landmark ruling, an appeals court overturned the order, finding that Carder had a right to make medical decisions for herself and her unborn child. Her family also received an undisclosed financial settlement from the hospital. And since doctors and moms can both be wrong, and if they can't agree on the best way to give birth, ultimately it has to be the woman's choice. When surgery is being considered, experts say pregnant women need to feel confident that their wishes will prevail, whether they consent to an elective or emergency c-section or decline one they deem medically unnecessary, as Amber Marlowe did.
Want to avoid a c-section? See "Getting the birth experience you want," above.
In 25 years of delivering babies, Dr. Minkoff has learned to respect his patients' decisions about how they want to give birth--even if he doesn't always agree. And that's the way it should be, because she has the most at stake. If you're pregnant, you've probably given a lot of thought to how you'd like to give birth. You may be determined to avoid a c-section, if at all possible.
Or you may feel vaginal birth isn't right for you, perhaps because you've had a previous c-section, face a difficult delivery due to twins or a breech baby, or fear complications, such as the slight risk of pelvic floor injuries. But whatever way you're leaning, use these tips to make an informed decision, and get the medical support you need. Discuss your doctor's criteria for c-sections.
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While dangerous conditions like placenta previa or fetal distress mandate a trip to the O. That will clue you in to your caregiver's approach, since some doctors are quick to advise surgical birth in this situation, and others will try to stimulate contractions with drugs or have you walk around or change positions to see if that helps. To learn more about situations that warrant a c-section, read "Will you need a cesarean?
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Talk to other moms. Friends can tip you off to what really goes on in the delivery room, says Anne Lyerly, M.
And if it's a group practice, try to find out as much as you can about women's experiences with the other doctors, since it's possible that one of them might end up handling your delivery. Check on hospital policies.
Pictures from the previous releases are also being attached for reference.
If you're considering a vaginal birth after cesarean VBAC , it may not be permitted at medical facilities in your community. Funeral service to follow at PM. Wayne Garvest Franklin. Gladys Willis. Those left to cherish her memory are sons, Amos Davis, Jr. Lauderdale, FL; fourteen grandchildren; and a host of great grandchildren, nieces, nephews, cousins, family and friends. Brother Alvin Peters will officiate the service. Herschell L. Herschell, attended DeRidder High School then began his career as a building contractor.
He worked in every phase of the construction industry for over forty years. Visitation will begin at PM until the time of funeral service at PM. He was known for his entertaining stories and quick-witted remarks. He will be greatly missed by all those who knew him. Linda Elmore Enos. It is with our deepest sorrow that we announce the death of our beloved wife, loving mother, doting grandmother and great-grandmother, Linda Faye Elmore Enos on March 7, Reverend Donald Chavis will officiate the service.
Bobby Lawrence Egan. William "Billy" Bass. Billie Dee Myers. Billie was married to Harold Myers, who precedes her in death.
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Funeral service will be at AM, Tuesday, February 26, Helen Irine Newcomb Swain. Helen Irine Newcomb Swain, 73, wife of Rev. George A. Swain, Sr. She is survived by her loving husband, Rev. Frank Swain, Jr. Clifford Molloy Mount. Brother Larry Laurent will officiate the service.
Jane Kennedy Odom. Reverend Jeff Phillips will officiate the service. Jonathan Garruth Prudhomme. He was preceded in death by his grandparents, Garruth J. Reverend Dr. Jim Jones will officiate the service. Stella Mae Hudson. Visitation will be held on Thursday, February 14, from PM. Beginning at PM there will be a fellowship where family and friends can share their memories and stories. Reverend Glenn Burks will officiate the service. Doris Stafford Williams. Funeral service will be Wednesday February 6, at PM. He was preceded in death by his father, Charles DeLoach and grandparents, S.
Pastor George Lee Glass will officiate the service. James "Jimmy" Young. He was the first of six children, with five sisters, Cathy, Juanita, Earline and Linda. Those left behind to cherish his memory are his seven children; Steven L. Jacqueline loved to help feed the homeless and was passionate about attending Bible study with her church family at Unity and Christ Fellowship Church. Pastor Paul Fairley will officiate the service. Evelyn Estelle Cole. Those left to cherish her memory are her loving husband of 65 years, Jack D.
Cole, Sr. Evelyn enjoyed working with Roberta Doty to document all of the cemetery headstones in the Beauregard Parish cemeteries copies available in the local library. Deborah Ann Ross Mears. Those left to cherish her memory are her spouse, Glen Mears, Sr.
Murphy Joseph LaPoint. Murphy loved to spend time gardening. He favored any variety of flowers, but his favorite color of flower was yellow. LaPointe and wife Wendy; Nelton W. Father Corey Campeaux will officiate the service. Madden Blake Alford.