Legal Challenge for Right to VBAC
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Low Income Women Pushed into Unnecessary Surgeries: Support My Legal Challenge!
Like many women in Oregon and other places around the country, especially rural areas, I was denied the right to have a vaginal birth after Cesarean (VBAC) by both my state insurance and local hospital policy. Now, with the support of my family and community, I’m leading a challenge to the state on behalf of every woman who believes in the right to decide where and how she gives birth.
When I got pregnant the first time, I imagined and planned on a beautiful natural birth. What I ended up with instead was an emergency C-section after a very prolonged and traumatic labor. While it was far from my ideal birth plan, it was a necessary blessing that ended with me having a healthy baby boy to hold.
Now, pregnant with my second, I want a chance for the gentle, natural birth that didn't happen last time. But, as an Oregon woman covered by Medicaid (I’m a newly graduated Naturopathic Physician just starting practice), I don’t have the option, and many others like me don’t, either.
UNNECESSARY SURGERIES
Now that I have had a Cesarean, my plan for birth is considered a VBAC (vaginal birth after cesarean). The American College of Obstetricians and Gynecologists supports planned VBACs as “safe” and “appropriate” for most women, and it is legal in Oregon for women to have a VBAC in the location of their choice, with a doctor or midwife.
In spite of guidelines from national groups that also include the National Institutes of Health and the American Academy of Family Physicians, and the abundant evidence of safety of VBAC over the increased risk of repeated elective C-sections, many hospitals still “ban” VBACs.
Such is the case in my town. The only hospital in my area has a strict “no VBAC” policy (VBAC ban)--in other words, if you’ve ever had a Cesarean for any reason, you must have surgery for all future births whether or not you need it. This policy is not only outdated and not based on evidence, it’s unethical.
VBAC bans like this exist all over the country--one advocacy organization estimated over 40% of U.S. hospitals have policies banning VBAC or no provider that will support it.
So, women like me who don’t want unnecessary surgery must give birth outside of a hospital. In my area, we are fortunate that a birth center exists, run by an experienced Certified Nurse Midwife, that does support VBAC and informed choice in a safe, respectful environment. In Oregon, it is perfectly legal for midwives to support women in VBACs either in or outside of a hospital.
Oregon Medicaid recently released a new set of exclusions for out-of-hospital births and VBAC is right at the top. So, even though this is a legal and covered birth option, Oregon Medicaid is telling me and women like me that they will only pay for us to give birth in a hospital--which for some of us, due to VBAC bans, means major surgery we don’t want and don’t need. (Imagine how much it costs the state to pay for these expensive surgeries!)
ILLEGAL DENIAL
I’m not the only one. Women all over Oregon are saying they’re being denied coverage for out-of-hospital births with state-licensed midwives. These denials disproportionately affect women of color and low-income, who already face higher Cesarean rates, higher mortality rates, and higher barriers to safe, equal treatment.
The Oregon Health Authority (OHA), the agency denying our coverage, is responsible for following state and federal law--not for making decisions about who should give birth where. In refusing to cover these births, OHA has violated state and/or federal laws that require that Medicaid coverage must apply to home, hospital, and birth center birth with either midwives or doctors.
FOR ALL OF US
Update: I went into labor on March 18 and had a precious little girl in a healthy, safe vaginal birth (read more about her beautiful birth ). I am blessed and fortunate that my extended family was able to scrape together funds so that I could go to our local birth center. I am so grateful they were able to pay for me to avoid unnecessary surgery.
But what about every other low-income woman in Oregon who can’t afford to do that--who doesn’t have the resources to fight a forced surgery?
What about the basic right of each person to decide where it is safest for her to give birth?
I’m paying my birth forward by filing an appeal with the Oregon Health Plan, asking them to reconsider its denial of coverage for my out-of-hospital birth. I’m demanding that Oregon not only follow its own laws but also comply with the Affordable Care Act, which mandates access to the full scope of midwifery practice for Medicaid enrollees who give birth in a freestanding (out-of-hospital) birth center.
I was able to hire an internationally known human rights lawyer who specializes in childbirth law, who agreed to help me with the appeal because she believes in my case. If my appeal is denied, we will file a lawsuit, on behalf of all the other women who deserve the right to decide where and how they give birth.
I am depending on you to help us take this case forward and set a precedent for all of Oregon… for any place where women are being forced into surgery just because they can’t pay to get out of it. I know that if we all pitch in, we can make this change!
PAY YOUR BIRTH FORWARD
If you had a safe, supported birth with your child(ren), please give a little something in memory of it and help another woman have that same opportunity.
If you had a traumatic or unsafe birth, or a forced Cesarean due to a VBAC ban in your area, please give to help change that dynamic for other women.
If you believe in equal treatment, equal access to healthcare, and human rights for people giving birth, please give to ensure that no one has to buy their way out of unnecessary surgery.
IF YOU’VE BEEN AFFECTED BY A VBAC BAN OR DENIED THE RIGHT TO DECIDE HOW YOU GIVE BIRTH, PLEASE LEAVE A COMMENT BELOW.
MORE INFORMATION
My story on the local NPR station: http://ijpr.org/post/denied-vaginal-birth-after-cesarean#stream/0
My full story on my blog: http://wholesomemamamedicine.blogspot.com/2016/03/vbac-in-face-of-denial.html?m=1
Like many women in Oregon and other places around the country, especially rural areas, I was denied the right to have a vaginal birth after Cesarean (VBAC) by both my state insurance and local hospital policy. Now, with the support of my family and community, I’m leading a challenge to the state on behalf of every woman who believes in the right to decide where and how she gives birth.
When I got pregnant the first time, I imagined and planned on a beautiful natural birth. What I ended up with instead was an emergency C-section after a very prolonged and traumatic labor. While it was far from my ideal birth plan, it was a necessary blessing that ended with me having a healthy baby boy to hold.
Now, pregnant with my second, I want a chance for the gentle, natural birth that didn't happen last time. But, as an Oregon woman covered by Medicaid (I’m a newly graduated Naturopathic Physician just starting practice), I don’t have the option, and many others like me don’t, either.
UNNECESSARY SURGERIES
Now that I have had a Cesarean, my plan for birth is considered a VBAC (vaginal birth after cesarean). The American College of Obstetricians and Gynecologists supports planned VBACs as “safe” and “appropriate” for most women, and it is legal in Oregon for women to have a VBAC in the location of their choice, with a doctor or midwife.
In spite of guidelines from national groups that also include the National Institutes of Health and the American Academy of Family Physicians, and the abundant evidence of safety of VBAC over the increased risk of repeated elective C-sections, many hospitals still “ban” VBACs.
Such is the case in my town. The only hospital in my area has a strict “no VBAC” policy (VBAC ban)--in other words, if you’ve ever had a Cesarean for any reason, you must have surgery for all future births whether or not you need it. This policy is not only outdated and not based on evidence, it’s unethical.
VBAC bans like this exist all over the country--one advocacy organization estimated over 40% of U.S. hospitals have policies banning VBAC or no provider that will support it.
So, women like me who don’t want unnecessary surgery must give birth outside of a hospital. In my area, we are fortunate that a birth center exists, run by an experienced Certified Nurse Midwife, that does support VBAC and informed choice in a safe, respectful environment. In Oregon, it is perfectly legal for midwives to support women in VBACs either in or outside of a hospital.
Oregon Medicaid recently released a new set of exclusions for out-of-hospital births and VBAC is right at the top. So, even though this is a legal and covered birth option, Oregon Medicaid is telling me and women like me that they will only pay for us to give birth in a hospital--which for some of us, due to VBAC bans, means major surgery we don’t want and don’t need. (Imagine how much it costs the state to pay for these expensive surgeries!)
ILLEGAL DENIAL
I’m not the only one. Women all over Oregon are saying they’re being denied coverage for out-of-hospital births with state-licensed midwives. These denials disproportionately affect women of color and low-income, who already face higher Cesarean rates, higher mortality rates, and higher barriers to safe, equal treatment.
The Oregon Health Authority (OHA), the agency denying our coverage, is responsible for following state and federal law--not for making decisions about who should give birth where. In refusing to cover these births, OHA has violated state and/or federal laws that require that Medicaid coverage must apply to home, hospital, and birth center birth with either midwives or doctors.
FOR ALL OF US
Update: I went into labor on March 18 and had a precious little girl in a healthy, safe vaginal birth (read more about her beautiful birth ). I am blessed and fortunate that my extended family was able to scrape together funds so that I could go to our local birth center. I am so grateful they were able to pay for me to avoid unnecessary surgery.
But what about every other low-income woman in Oregon who can’t afford to do that--who doesn’t have the resources to fight a forced surgery?
What about the basic right of each person to decide where it is safest for her to give birth?
I’m paying my birth forward by filing an appeal with the Oregon Health Plan, asking them to reconsider its denial of coverage for my out-of-hospital birth. I’m demanding that Oregon not only follow its own laws but also comply with the Affordable Care Act, which mandates access to the full scope of midwifery practice for Medicaid enrollees who give birth in a freestanding (out-of-hospital) birth center.
I was able to hire an internationally known human rights lawyer who specializes in childbirth law, who agreed to help me with the appeal because she believes in my case. If my appeal is denied, we will file a lawsuit, on behalf of all the other women who deserve the right to decide where and how they give birth.
I am depending on you to help us take this case forward and set a precedent for all of Oregon… for any place where women are being forced into surgery just because they can’t pay to get out of it. I know that if we all pitch in, we can make this change!
PAY YOUR BIRTH FORWARD
If you had a safe, supported birth with your child(ren), please give a little something in memory of it and help another woman have that same opportunity.
If you had a traumatic or unsafe birth, or a forced Cesarean due to a VBAC ban in your area, please give to help change that dynamic for other women.
If you believe in equal treatment, equal access to healthcare, and human rights for people giving birth, please give to ensure that no one has to buy their way out of unnecessary surgery.
IF YOU’VE BEEN AFFECTED BY A VBAC BAN OR DENIED THE RIGHT TO DECIDE HOW YOU GIVE BIRTH, PLEASE LEAVE A COMMENT BELOW.
MORE INFORMATION
My story on the local NPR station: http://ijpr.org/post/denied-vaginal-birth-after-cesarean#stream/0
My full story on my blog: http://wholesomemamamedicine.blogspot.com/2016/03/vbac-in-face-of-denial.html?m=1
Organizer
Laura Blevins
Organizer
Klamath Falls, OR
