Wednesday, October 1, 2008

Reproductive Choices

I am confused. Perhaps someone can explain to me why lawmakers are so willing to give a woman the power to control her reproductive system in some things and not in others.

Why are lawmakers willing to uphold Roe v. Wade and give women the right to terminate their pregnancies, but there is no federal law or court case granting legal authority to all women the right to choose to have a vaginal birth after having a cesarean.

In some states, such as Washington, it is illegal to have a VBAC in a free standing birth center. This puts women in a position of either birthing at home, or birthing in a hospital. And to add insult to injury, many hospitals do not allow VBACs in their facilities, and many midwives are not willing to take on VBAC clients. This is a multifaceted problem for them, as malpractice suits can cost a midwife more than money, it can cost her the right to practice in her state. And the final blow, some insurances, like Medicaid, do not cover VBAC if it is not preformed in a hospital.

Don't get me wrong, there is nothing wrong with choosing to birth at home or in a hospital, but to be told where you cannot birth your child, to have an entire option just wiped out for you, simply because you have had a cesarean section in the past is criminal, in my opinion.

Sure there are ways to fight it. But let's examine these options....

1. You can have a home birth, assisted or unassisted. Effectively avoiding the issue entirely, taking the power out of the hands of the medical establishment to make the choice for you... passive resistance.

This is the option many women take, however some states have made it illegal to have an out of hospital VBAC by statute or legal precedence... or by making it so uncomfortable for the family seeking out of hospital VBAC by threatening negligence or abuse that it is not feasible to proceed.

2.You can simply, or not so simply, refuse to undergo a repeat cesarean with complete open communication with your provider and your chosen hospital.

Make your birth a legal statement in this one place at this one time. Fight for however long it takes to be heard, and sometimes be ignored... birthing your child in a less than hospitable climate because you know that it is illegal to be forced to undergo a surgery against your will.

3. You can conveniently not show up at your chosen hospital till it is too late to preform the cesarean.

Many women choose this option and then end up having their children before getting to the hospital, or they misjudge their progress and get to the facility too early and have to fight head on with a staff that is dead set against it. Some hospitals that I spoke with actually stated that they would have me taken by ambulance to another hospital rather than allow me to have a VBAC in their facility... Can you imagine? Some other hospitals stated that they would "act in the best interests of the health and saftey of the mother and child" regardless of the wishes of the mother. This of course is illegal and can bring about heavy litigation, but savvy lawyers who are retained by said hospitals could argue that the woman was endangering the life of her unborn child or that she was incapable of making rational decisions and that the hospital stepped in to make the decision for her.

In any of these cases, your pregnancy is fraught with stress and worry about the decisions you face. And who wants to make their baby the next Roe v. Wade?

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