Guest Column: Rockford hospital denies natural childbirth
By Judith C. Wrzesinski
The ability to give birth naturally is one of womens crowning achievements. Unfortunately, fewer women are being allowed the experience. In alarming numbers, many women in the Rockford area are being denied a vaginal birth if they have ever had a cesarean section. The rate of local attempted vaginal births after cesarean (VBAC) at SwedishAmerican Hospital has dropped from last years 50 percent to less than 10 percent. These numbers are somewhat higher at the other two Rockford hospitals. Many of the smaller community hospitals have stopped allowing VBACs altogether. The reason:
most VBAC attempts are either induced (begun) or augmented (strengthened) with a drug called Pitocin. A 2001 study in The New England Journal of Medicine warns that Pitocin induction carries a slightly higher risk of uterine rupture, a potentially deadly complication, compared to naturally beginning labor. A 1999 study in The American Journal of Obstetrics and Gynecology showed augmentation to be a bit riskier than non-augmented labor for VBAC candidates. It appears that any use of Pitocin causes most of the ruptures, and that VBACs are much safer when women are allowed to labor naturally.
The American College of Obstetricians and Gynecologists (ACOG) recommends attempting VBAC: Most women with one previous cesarean delivery with a low-transverse incision are candidates for VBAC and should be counseled about VBAC and offered a trial of labor (July, 1999).
So, why are hospitals allowing so few VBAC attempts? The 1999 ACOG guidelines require the availabiIity of anesthesia and personnel for emergency cesarean delivery. At the Level I trauma centers in Rockford, St. Anthony and Rockford Memorial, anesthesiologists are always available. But at SwedishAmerican, an anesthesiologist must be specifically called in for a woman attempting a VBAC. They apparently do not see the importance of making VBAC available.
We must also question why there are so many inductions. Many women are being told that they should have their labor induced on or barely beyond their due date. But an overdue baby can be closely and safely monitored by antenatal testing such as Non-Stress Tests or Biophysical Profiles. A woman induced with Pitocin is more likely to have a long, painful labor, with a higher risk of a C-section. Countries with the lowest infant mortality rates maintain cesarean rates of less than 10 percent. Our national rate of cesarean section jumped 7 percent in 2001, to the highest-ever level of 24.4 percent. Currently our government is trying to reduce the rate to about 15 percent.
C-sections have become so ingrained in our culture that they seem almost routine, but they have serious risks. They are major abdominal surgeries, with long, painful recovery periods. If the epidural was not placed properly, a woman may get a severe spinal headache that can last a week, or she may have back pain for years. Other serious complications can occur, involving the bladder or the need for a hysterectomy. Anesthesia complications, as well as hemorrhage and infection, can lead to death. Research from the Mayo Clinic shows that a mothers risk of death is four times higher after a c-section compared to a vaginal birth. C-sections also come with the risk of uterine rupture prior to labor in future pregnancies. Even if there are no serious problems, women have longer, more expensive hospital stays, increasing medical costs. C-sections make it much more difficult to establish a nursing relationship between mother and baby. C-sections have consequences for the baby as well, causing more difficulty breathing, since the fluids in the lungs have not been squeezed out in the tight fit of the birth canal.
The benefits of VBAC are numerous. The mother experiences faster healing, less pain, and lower risk of hemorrhage, infection, or death. VBACs usually result in shorter hospital stays, which lowers medical expenses. All the tremendous physical and emotional benefits of nursing begin more easily. Finally, a naturally birthing mother has the joy of knowing that she did it!
We are created to naturally succeed in birthing our babies. Giving birth can be compared to reaching the peak of a mountain, with the benefit of keeping that wonderful baby. Many women have spoken of the trust they felt in their bodies, and in themselves, when they were able to accomplish vaginal birth. I truly hope that local hospitals will give women every opportunity to experience it.
Judith C. Wrezesinski is a Certified Nurse-Midwife affiliated with LABOR (Local Alliance for Birth Options in Rockford).