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2008 Cesarean Statistics in PA: VBAC Bans (3 of 4)

On the topic of VBAC bans, 19 hospitals in PA reported having “De Facto” bans (D), while 5 reported having “official” bans (B) in the survey done by ICAN in early 2009.  Oddly, 2 of the hospitals reported to have a VBAC ban have VBAC rates over 10%–12.2% at Bloomsburg Hospital in Cambria County, and 14% at St Joseph Medical Center a bit closer to me in Reading, Berks County.  I have to wonder if in each of these cases, the person who was answering the ICAN caller was simply unaware of what the policy was? 

I also wonder about Allegheny General Hospital in Pittsburgh (9.5% VBAC) and Holy Redeemer Hospital in Montgomery County (7.2%), both of which seem large enough to staff adequate anesthesia services.  Many hospitals that have VBAC bans will cite not being able to staff 24 hr anesthesia as the reason, and all 5 of the hospitals with “official” bans handle less than 700 births per year.  Of those with “defacto” bans, 73.6% handle less than 1000 births per year; while across the state, 54.9% of hospitals that routinely handle birth serve less than 1000 births per year, so the size of the hospital does seem to be an issue.  However, with 26.4% of hospitals with “defacto bans” in place serving well over 1000 births per year, some up to nearly 3000 births, obviously other factors are coming into play than merely concerns about lack of adequate staffing.

Of the hospitals that are covered in the ICAN data base, 27% report having VBAC bans.  ANY hospital that has an LDR should be able to handle VBAC in my mind, both from a safety of the laboring dyad standpoint and from a civil rights of the laboring mother standpoint.   Given that, I believe that even one hospital with a VBAC ban is one hospital too many, and should be protested.

Some people will report this as good news though compared to the 50% rate of bans nationwide that ICAN reported, however, I believe it is deceptive.  If you consider any hospital with a VBAC rate of less than 5% to have a “De Facto” ban in addition to those that claimed to have bans, then 39 out of 113 hospitals have VBAC bans, or 34.5% of the hospitals with LDR’s.  If you hold to stricter criteria of any hospital with a VBAC rate less than 10%, then an additional 22 hospitals get added to the list, for a ban rate of 54%.

Suprisingly, 16 of the 113 hospitals with LDR’s (14%) are not listed in the ICAN database.  Given the low VBAC rate in this group (except Chestnut Hill Hospital in Philadelphia), it is probable that a majority of them have some sort of a VBAC ban in place.  I’m going to guess that their omission from the database may be related to the relative lack of local ICAN groups in PA.  Fortunately, in the past few months we have seen the start of at least two ICAN groups in PA–one in the Lehigh Valley (icanofthelehighvalley@yahoo.com), and one in Southeast PA.

Next in the series:  Primary Cesarean Rate, What First Time Moms NEED to Understand

Tags: cesarean, ICAN, VBAC, VBAC/Cesarean