regional medical center: Finding Willing Doctors To Perform Vaginal Delivery After Caesarean Sometimes A Challenge

Finding Willing Doctors To Perform Vaginal Delivery After Caesarean Sometimes A Challenge

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Main Category: Pregnancy / Obstetrics
Also Included In: Women's Health / Gynecology
Article Date: 15 May 2012 - 16:00 PDT

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After a series of Caesarean sections and vaginal deliveries, Melissa Lunsford wants a vaginal delivery for her fourth child. To find a willing doctor or hospital that would enable a vaginal delivery for her fourth pregnancy proved to be a challenge.

An advocate of vaginal births after Caesarean section (VBAC) from the Ben Taub General Hospital, one of the top VBAC hospitals in Texas says that many women share Mrs. Lunsford's plight.

Dr. Christina Marie Davidson, chief, Obstetrics and Gynecology Services at the Ben Taub General Hospital, and assistant professor at the Department of Obstetrics and Gynecology at the Division of Maternal Fetal Medicine at the Baylor College of Medicine declares:

"For some physicians and hospitals, the prospect of offering a trial of labor after a Caesarean delivery is too risky. While risks exist, the possibility of delivering vaginally is still a viable option for many women."

To find a physician and hospital that offers VBAC procedures can be a challenging task. The majority of doctors or hospitals have no access to around-the-clock hospital coverage by specialists, including obstetricians, gynecologists and anesthetists, or specialist facilities, such as neonatology with a neonatal intensive care unit, operating room availability for emergent Caesarean deliveries, massive blood banking and expert nursing.

The Harris County Hospital District, which includes the Ben Taub General Hospital and Lyndon B. Johnson General Hospital, as well as the Women and Infant Services have all necessary facilities and medical coverage make the option to have a vaginal birth after a C-section delivery a viable option, including for those who previously had multiple C-section deliveries.

According to a 2009 report by the Texas State Department of Health Services, the Ben Taub and LBJ hospital share the state's highest VBAC rate of all hospitals, with 27.86% and 29.58% respectively. In comparison with the VBAC national rate of 8%, the rates of both hospitals are generally three times higher. Davidson comments:

"We believe women should have that choice. We can't guarantee that they'll have a VBAC delivery every time, but we can certainly plan for it."

Previous successful vaginal delivery or VBAC â€¨
If the previous C-section was for other reasons than cervix complications or infant not descending through birth canal
Natural onset of labor â€¨
Women below the age of 35 years

â€¨â€¨Mrs Lunsford was repeatedly discouraged by being informed about the inherent risks and dangers and decided to conduct her own research on the Internet. Encouraged by successful testimonials she set out to search for a VBAC-friendly doctor.

She says:

"Everyone I talked to, including my friends, basically told me it was silly to think of delivering vaginally again after a Caesarean. But, it is important to me and something I knew I wanted."

She finally came across Dr. Davidson after having contacted 10 doctors already, who is not only an expert but also a passionate supporter of VBACs.

Dr. Davidson says:

"Women who choose to have a vaginal birth after Caesarean should have that option and not be discouraged because of a lack of knowledge or resources."

Mrs Lunsford adds that the chance to deliver her son as naturally as possible is worth the effort, saying: "It is important to me and important to my entire healthcare team."

Written Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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Selasa, 15 Mei 2012

Finding Willing Doctors To Perform Vaginal Delivery After Caesarean Sometimes A Challenge

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