The International Cesarean Awareness Network has conducted a survey of hospitals across the U.S., in which they asked labor and delivery nurses at each facility whether a VBAC (vaginal birth after cesarean) could be had and whether there were any doctors at each who supported VBACs. Respondents were also asked how far an individual might have to travel to find a hospital that does offer VBACs, whether they knew the name of a doctor who does VBACs, and what would happen if a person showed up at that hospital and refused a c-section.
This information has been used to create a VBAC Policy Database, which can be searched by VBAC policy, or browsed by state. Each hospital surveyed has been categorized as allowing, banning, or having a de facto ban on VBACs (according to ICAN, a “de facto” ban means that surveyors were unable to identify any doctors practicing at the hospital who would provide VBAC support). For each facility, clicking on the name will lead to a hospital-specific page with additional details, such as the date they were surveyed and their actual answers to the survey questions.
One limitation of the data is in which L&D nurses were allowed to answer the questions authoritatively – callers asked to speak to the charge nurse, but if unavailable callers might have spoken to another nurse who may have had limited knowledge of hospital policies. However, the database seems like an excellent starting point for women, families and advocates concerned about this issue. ICAN also frames the database as a starting point, explaining:
“As always, you need to call any hospital you are considering and ask the hard questions yourself. Policies change, people who answer the phone can be uninformed and we don’t guarantee any of the information collected here. We are a community of women seeking out the most informed birth choices possible. We welcome your contributions to this pool of information.”
In order to allow those contributions to the information, the database has a very cool feature – for each hospital, comments can be left just like on blogs – so if you have a different experience than what the VBAC Ban Database would suggest, or have other personal comments on a facility, you can add a comment to the page for that hospital.
Finally, ICAN suggests that there has been an increase in VBAC bans since they last conducted a similar survey:
“The survey shows a near triple increase (174%) from November 2004, when ICAN conducted the first count of hospitals forbidding women from having a VBAC. In 2004, banning hospitals numbered 300. The latest survey, conducted in January 2009, counted 821 hospitals formally banning VBAC and 612 with ‘de facto’ ban.”
For additional discussion of this topic, see our excerpt from Our Bodies, Ourselves: Pregnancy and Birth, Vaginal Birth After Cesarean (VBAC) or Repeat Cesarean Section?