The American College of Obstetricians and Gynecologists (ACOG) issued a statement in 2004 supporting a woman's right to choose VBAC.
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Yet, they stated that in order to do so, you must have a physician available to provide emergency care immediately. Hospitals began to interpret this as meaning that there must be a surgical team constantly present. As this is a huge cost, especially for smaller community Hospitals, many stopped doing them and even went so far as to ban them.
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The American Academy of Family Physicians (AAFP) then went on to review the information in 2005. They recommended, "TOLAC should not be restricted to facilities with available surgical teams present throughout labor since there is no evidence that these additional resources result in improved outcomes" They were not endorsing VBACS at home or out of hospital, but they did say the need for a constant surgical team did not improve outcomes.
However, many providers and facilities continue to resist VBACS. Because of the negative outlook by many providers, the presentation of the VBAC consent can be daunting and scary for parents to read.
I want you to remember that when presented with the consent, consider the cesarean consent as well.
A VBAC consent can be very frightening for you to read and to sign. But I want to remind you that if you are a candidate, VBACs are highly successful and uterine ruptures are extremely rare.
Inside this section if the intent of the consent. The entire purpose of the VBAC consent is to provide you with the information needed to make an informed decision. An informed decision means that you have been presented with all the information needed to make a educated decision.
Medical informed consent is essential to the physician's ability to diagnose and treat patients as well as the patient's right to accept or reject clinical evaluation, treatment, or both. Medical informed consent should be an exchange of ideas that buttresses the patient-physician relationship. The consent process should be the foundation of the fiduciary relationship between a patient and a physician. Physicians must recognize that informed medical choice is an educational process and has the potential to affect the patient-physician alliance to their mutual benefit. Physicians must give patients equality in the covenant by educating them to make informed choices. When physicians and patients take medical informed consent seriously, the patient-physician relationship becomes a true partnership with shared decision-making authority and responsibility for outcomes. Physicians need to understand informed medical consent from an ethical foundation, as codified by statutory law in many states, and from a generalized common-law perspective requiring medical practice consistent with the standard of care. It is fundamental to the patient-physician relationship that each partner understands and accepts the degree of autonomy the patient desires in the decision-making process.MayoClinicproceedings.org
As with all surgeries, a cesarean carries risks, however, a repeat cesarean carries the normal surgery risks but also extra risks.
This section is where you acknowledge that you have read the form, have been informed of the options, risks, and benefits.
In this section you choose whether you want a consent to a TOLAC (trial of labor after cesarean) and the option to VBAC or a repeat cesarean section.
You and your provider will sign this section.
VBAC Consent Four (This is my favorite)
Mama the VBAC consent can be scary when it is presented to you and your partner. I want you to understand that there are risks but there are also benefits. Education is key and knowledge is power. Educate yourself so that you can choose the best route for YOU!
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