ICAN VBAC ban/allow list!!

Earlier I blogged about the VBAC article in Time magazine, and now the awesome, wonderful, and amazing volunteers of ICAN have put together a comprehensive list of all the hospitals in America, and whether they allow VBACs or not. The number of hours that it took for all the volunteers to call the hospitals and enter the information was incredible — somebody estimated that it would have taken $100,000, had they been paid, so this truly was a tremendous effort.

Unfortunately almost half of the hospitals have either a formal VBAC ban or a de facto VBAC ban — that is, there is no official policy against allowing VBACs at that hospital, but no doctor will actually attend one.

But just because a hospital is listed as “allowing” VBACs doesn’t mean you’ll actually get one, or that it will be easy. Many of the volunteers who called hospitals noted that many hospitals or doctors had such strict guidelines for the VBACs they allowed that it would be difficult for anyone to actually have a successful VBAC. Some restrictions include that the woman has to have had a successful VBAC already in order to attempt another one, or at least that she has to have a “proven pelvis” — a vaginal birth. That means that if her first baby was breech and she’s currently pregnant with her second, then she will not be allowed even a chance at a vaginal birth. Other hospitals won’t allow women who have had more than one C-section to attempt a VBAC. Some hospitals or doctors require that women attempting a VBAC to give birth by 5:00 p.m., or be wheeled back for an automatic C-section — regardless of any other factor!

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11 Responses

  1. The two hospitals where I had my babies were not on the list. I wonder why because they are huge hospitals in a huge city.

    Thanks for alerting us to this link. I’m absolutely amazed that it was put together by volunteers.

    • Scout234,

      Please be sure to alert the ICAN staff, so that they can call the hospitals and add them to the list. I know that they were working off of lists that they could find — typically online lists that supposedly listed “every hospital in the state” — although many times there were duplicates of hospitals, or two names for the same hospital, or one big conglomeration of hospitals that went by different names in various cities but had the same policies — quite confusing! Also, it’s possible that some hospitals were overlooked, or the information was entered inaccurately. I know that ICAN wants it to be complete and up-to-date, so would be grateful to anyone who points out a hospital that was missed.

  2. Wow, that is CRAZY!!!! I can’t believe how sick and uptight people have gotten about restrictive VBAC policies!! And here in AZ, homebirth midwives can’t do HBAC, so people are pretty much stuck with repeat c/s or UC, unless they are VERY gutsy and want to fight – and most women don’t have the nerve or the support (especially from nervous hubbies). What a mess!

  3. I would take this list with a handful of salt. The designation of “de facto ban” is based on ONE conversation with whomever the caller was able to reach on the phone. seemed to be OB nurses rather than, say, a charge nurse or the head of women’s and children’s services.

    it seems very arbitrary whether a hospital was designated “de facto ban” or “allows”. 2 hospitals in my area had virtually identical narrative details yet received different designations. Another nearby hospital received label of “de facto” when I know for a fact the only OB practice in that little town is totally on board with VBACs.

    women are basing some pretty serious decisions on this hospital list. check your facts, everyone.

    • Abundant B’earth — you are right about the limitations of the list. I happen to know that many of the people involved in entering the information into the computer would work late into the night, sometimes to 2, 3, or 4 a.m., so obviously there may be errors, or a judgment call on the part of the person who called or entered the information as to whether there was a de facto ban or not. And you’re right that if a nurse answers the phone and doesn’t know a doctor in town that will do VBACs, then it will be put down as a de facto ban, when it may just be nurse ignorance. Sometimes the tone of voice of the person answering the questions in the maternity ward may have made a difference — as you may imagine, there can be a huge difference between a reluctant and an enthusiastic “we have no policy banning VBACs”; and I know there were some questions answered such as, “Well, you can *try*….” [with the tone of voice saying loud and clear, "but you'll never make it!"] However, it is important to realize that while it was perhaps the result of a single phone call, had these women been just “ordinary” post-C-section moms trying to find out if they could have a VBAC, then this is what they would have been told. It was difficult or even impossible for the L&D wing to even be *reached* in some of these hospitals, much less the charge nurse or someone more authoritative; and often it is the nurses “in the trenches” who have a better (or at least more honest) view of what happens in their hospitals. A person in charge may cavil or try to obfuscate the facts — sort of a “bait and switch” to get women to plan to give birth in that hospital — even if s/he actually knows more than the nurse who answered the phone. But make no mistake — if women wanting a VBAC had been told what these callers were told, then they would think that they could not have a VBAC, and that is a very important point.

      So, yes, anyone who has better information — whether it is because of “inside knowledge” that contradicts what was told the ICAN caller(s) or what was mistakenly entered into the database — please contact the most appropriate person at the ICAN website to get this changed. I already know that at least one hospital has changed their VBAC policy as the result of this database of knowledge becoming public. If you are looking for a VBAC-friendly hospital, you can use this list to start from, and call your local hospitals to see if they’ve had a change of policy since they were initially called. I know that at least one hospital had on the website some very pro-mother stuff, and even made it sound like they were pro-VBAC, but when they were actually called, it became obvious that the hospital was not truly supportive of VBAC. Some “VBAC allowed” hospitals were questioned as to how many VBACs were successful in the previous year, and even though they “allowed” VBACs, they only had a success rate of less than 10%. Hardly VBAC friendly!

      Whether the hospital is listed as allowed, denied, de facto, or determined by doctor, you may still need to do some extra work to make sure that it will be VBAC friendly, and not just “well, we technically allow VBACs, but we have such strict standards about it that nobody actually *has* one.”

  4. I submitted a comment to the list for the hospital I had my son at but it’s in queue at the moment.
    I just wanted to say you must always check with your doctor, and not count this list as golden. My OB was a good doctor but she’s in the list as allowing VBACs when she told me in the hospital right after my son’s c-section birth that all of my subsequent births would have to be c-sections.
    It really upset me given the situation was by far not what I had been hoping.
    Always double check your information!!
    We’re trying to get pregnant now and we are going to try for a home natural vbac. We live right down the street from the hospital in case of emergency but I’m really looking forward to being able to make my own decisions this time around!

    • Lindsay,

      That’s good advice — the list is definitely subject to human error, and of course hospitals and doctors can change their preferences at will.

      However, make sure that there isn’t some sort of contraindication for VBAC for you — although it’s rare nowadays, some C-sections are done with a vertical incision, or for some other reason make VBAC not a good idea. Of course, it’s more likely your doctor was *not* saying this, but it’s easy enough to verify, just to make sure.

  5. This is a sad new age. When I was 18 I was told my small framed body was to expect a 10lb baby, we opted after very careful consideration, for a c-section. Biggest mistake ever. I delivered in 2005 a healthy 6.5lb baby… no where near 10lbs. I had some minor complications with infection, but overall the discomfort and basically being compleatly helpless after was enough to bring down my spirits about a new baby. With our second, i was determined to have a VBAC. In feb 2007 I went into labor and delivered a happy healthy baby VBAC with no complications, at holy cross hospital in silver spring, md. My next 2 children where delivered at OU medical center(okc, ok hospital) VBAC in 2008 and 2009, no complications. I am now about to birth my 5th child, and was planning on a vbac, but have found that even the hopsitals around here(salisbury md.) Allow it on the list, that I was told to expect to have a very difficult time finding an actual doctor to do anything to help deliver a vbac, despite my willingness to sign every waiver they ask, and despite my health, fitness, and past successes. I am looking at the actual possibility that I may have to drive 3 hours away in active labor just to have a hospital who would be willing to do a vbac. THIS COUNTRY NEEDS TO GET BACK TO HAVING KIDS THE OLD FASION WAY, WITHOUT SURGERY AS THE FIRST SUGGESTION, AND AS AN EASY WAY OUT! I guess im old fasioned, even if I am only 24. Please encourage all your preggo friends to at leat attempt a vaginal birth before optioning for a c-section… I wish I never had a c-section, it has complicated one of the most simple things I life, of just having your baby the good ole fasion way, push push push.

  6. I am in almost the same boat as holly above.My first child was born via emergency c-section in 1994.I was in full active labor when i got to the hospital and it turned out her heart rate dropped and she was breech the cord was around her neck 3 times and she had a bowel movement. It was that or lose her and I almost lost her any way.I ended up getting an infection in the incision,it was the worst.When I had my second child in 2000 I thought for sure i had to have a repeat c and i was told then that I could have what was called a vbac.I had no problems with delivery or recovery. Now i am pregnant with my third child I was so excited when i found out(i like to space them out) and when the midwife i was seeing told me i had to have a c-section my heart just broke. I thought i could argue my way out of it but my obgyn doc just would not listen.I am now 27 weeks and today the doctor forced me to sign a consent form for the c-section even though I told him i was going to deliver at a hospital that allowed vbac and that his midwife said they could set it all up for me. The only concern that I had was if I went into labor and could not make it to the other hospital which is 1 to 1.5 hours away and had to goto the local hospital what would happen there.He said well the would give you the c-section anyway. If anyone has any suggestions on how to fight for our rights i am all ears. I feel helpless this is supposed to be america,we are supposed to have freedom of choice and my rights have been taken away by a bunch of “What Ifs”.Every time i think about it i just cry,and now i am more stressed than ever.

  7. I’m looking to have a double VBAC in a hospital with a midwife and doctor. I’m in Rowlett. Is there anyone that could recommend a doctor that would do it? Thank you.

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