By Lauren Cooper
This article is part of A Woman's Guide to VBAC: Navigating the NIH Consensus Recommendations, a collection of resources that address the most common and pressing questions women may have about their birth choices. View all sections in the guide, including a link to the authors, on the index page.
The cesarean rate is climbing and access to VBAC support is dwindling. According to the NIH VBAC Consensus Statement, women deserve access to VBAC and the final decision between a repeat cesarean and a VBAC should be the mother’s. There are many things you can do to take action, bring attention to this growing issue, and ignite change in your area.
- Contact your elected officials. Call, write, or fax your elected officials to let them know that VBAC access is an important issue to you. Let them know the hurdles that their constituents face when it comes to accessing evidence-based care, and offer ideas about what they can do to help.
- Are you unhappy with the care you received during birth or with being refused the option of VBAC? File a complaint with the facility and your state’s Department of Health.
- The NIH VBAC Consensus Statement strongly urged the American Congress of Obstetricians and Gynecologists (ACOG) and the American Society of Anesthesiologists (ASA) to reassess their recommendation that anesthesia be immediately available in order for facilities to offer VBAC. Four months after the NIH Statement was published, ACOG released an update to their VBAC practice bulletin in which they did revise this very recommendation. The revised recommendation encourages care providers and women wanting a VBAC to discuss the various capabilities and resources at their particular hospitals, even if those hospitals don’t have the resources for an immediate cesarean delivery. In addition, the new recommendation claims that patient autonomy is paramount and that women themselves should be able to consider and take on a potentially increased risk of planning a VBAC in a hospital without “immediately available” resources. Make sure to include these revisions in any letters, emails, or phone calls you make in your attempts to increase VBAC access in your area.
- Write letters to the editor of local publications. Reference any recent coverage the newspaper may have done regarding birth issues, cesareans, or VBAC access, include your contact information, and keep your letter short (250 words or less).
- Write a press release or pitch a story idea about VBAC bans or difficulty accessing VBAC support to your local media. Be prepared in case a member of the media contacts you for additional information.
- Urge local care providers and facilities to provide their intervention statistics. The NIH panel notes that this is currently lacking, and that care providers should share not only their VBAC rates but also their plans for responding to obstetric emergencies. Access to this information is valuable to women when interviewing care providers and planning for the birth that they feel is safest for them and their babies. Connect with CIMS GACstats Ambassadors to learn how to help facilitate transparency in maternity care.
- Get involved with other organizations in your area that share your goals. Part of ICAN’s mission is to help women access VBAC; contact your local chapter to become more involved, or start your own chapter. Also, Lamaze International has an extensive list of Birth Networks and many volunteer opportunities.
- Partner with other area organizations to hold a VBAC awareness event. This could be a rally, a local action planning meeting, or an informational fair for the public.
The NIH Consensus Statement on VBAC states that there are many factors contributing to the decline in VBAC access and many facets of this issue that need further research and support. Raising awareness locally urges care providers in your area to practice evidence-based care, helps women be more aware of their options, and encourages implementation of the NIH panel’s recommendations that make VBAC support more accessible.