Anatomy and Physiology of a VBAC Ban

I’m doing research for an upcoming presentation for Happy Mama regarding VBAC Bans.  We’re finally at the point in my community where this issue has to be addressed head on.  VBACs aren’t actually banned in Missoula at Community Medical Center, but they are rare because of the criteria in place discouraging women from having a vaginal birth after one or more cesareans.  This is NOT an evidence-based practice – to obstruct women’s access to natural birth.  What is more concerning regarding the medical climate in Missoula is that the cesarean rate is above 31% and therefore on par with the national average which is already twice the rate recommended by the World Health Organization.  According the the CMC website:

More babies are born at Community Medical Center than any other hospital in Montana. CMC is the hospital of choice for many families because family-centered care is accentuated in obstetric and newborn services.

All the more reason to ensure that CMC is providing the highest level of ethical, supportive, and evidence-based care.  First, I will contact Tracey Thompson, the Director of Women’s & Children’s Services at the hospital.  I’ve talked with her before, but when I called in a more formal capacity as an ICAN leader, she didn’t return my call.  If I do not receive what I need from her, I’ll call and talk with a labor & delivery nurse.  Depending on what I find out, I will contact the hospital’s Board of Directors and the President & CEO, Steve Carlson.

I am investigating discrepancies that have been reported regarding Community’s VBAC policy.  I have been told that the OB must be bed-side when overseeing a VBAC.  (Not great for mom; not great for the doc; not great for the doc’s other patients.)  I have been told that the OB must be on campus when a VBAC patient is in labor.  This has been particularly problematic for Dr. Lynn Montgomery’s practice, since his birth center is about 3 whole minutes from the hospital and therefore NOT on campus.  [Lynn Montgomery died from a massive heart attack at age 51.  I do need to write about him.  He is sorely missed in our community.]  Since Dr. Montgomery’s death, his CNMs have lost their privileges at the hospital.  Isn’t that horrible?  And it is my understanding that area OBs are more than happy to take business away from the birth center (sure we’ll take your clients) but won’t back up the CNMs at the hospital or donate their services temporarily to help keep the Birth Center in business.  More on that later.

Here are excellent resources to consult when you have questions about VBAC Bans:

VBAC Ban Stories & News

Google search: “VBAC ban” petition

Additional Resources

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4 thoughts on “Anatomy and Physiology of a VBAC Ban

  1. Does anyone know, of the 16 VBACs even undertaken at Community in Missoula, who the Dr. was/were? Were they all under Montgomery? Is there ANYONE in Missoula who will truly undertake a VBAC at a hospital vs. just saying they will? The local midwives will do HBACs, but what about for people who live a bit away from town and the risk of transfer in the 20-40% of unsuccessful VBACs is just too high?

  2. Possibly the OBs and CNM at Western MT Clinic. I transferred from their care over to Montgomery, but I know they are supposed to be one of the more supportive practices. Nancy Everett (CNM) has had a VBAC. She was surprised when I told her that hospital officials indicated that there had only been 16 VBACs at the hospital in 2006. She assumed there had been more, and I got the impression that she had attended more VBACs than that. I could be wrong there, but that was my “take.”

    There are good OBs in town, but they are trained surgical specialists. I think even with a supportive provider it’s getting harder and harder to have a hospital VBAC.

    Please e-mail me labortrials AT gmail DOT com if you’d like to continue the conversation and get involved in birth advocacy in the greater Missoula area.

  3. I had two unwanted c-sections with my daughters, now 8 and 6. When we got pregnant again, I assumed I would be stuck with another. Instead I found a wonderful midwife and her team in a birthing center in Idaho, where I lived at the time. I finally got my natural birth third time around!!
    A word on scar tissue: mine was so bad that my placenta hung up on it, making delivery of it (the placenta) almost impossible. After 24 hours of tough labor and delivering my son, I pushed for another hour and a half trying. Finally, my midwives and doula had to physically hold me down and go inside to retrieve it. It was horrible but only lasted a minute.
    The c-section rate in the us is ridiculous and the public is so woefully misinformed. And no one tells the mothers that that decision to have the surgery (usually at a scary point in labor, or at the very least, an exhausted point when you shouldn’t be making a decision like that) will alter your ability/choices to deliver another baby down the road. Not only was my scar tissue an issue, but so was the fact that my doctor with c-section #2 only stitched me up once, instead of twice, increasing my chance for rupture.
    All in all, I finally felt ‘redeemed’ and got to experience everything I wanted with my son!
    Sorry to jump here with my story since you don’t even know me! I followed a link from some other blog – I don’t actually know how I got here!
    But good luck to you, and don’t give up. You can totally do this and make a difference for others along the way.

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