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Old 04-19-2012, 10:10 PM   #1
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I Wrote a letter to the hospital administration

requesting to VBAC (they are "banned" there)...let me know what you think of it? Do you think it could be effective? Has anyone ever gotten the hospital to allow them to VBAC without them freaking out? I heard horror stories of hospitals calling CPS and taking the other children away from parents for refusing a c-section, but I know a lot of that is fear mongering and most of it is probably fabricated. The thought does scare me though, because we tend to go against the "all mighty" medical system as it is (don't do baby well visits after the first few months, don't vaccinate, don't do vit. D drops, refuse to give my 1 year old cow milk because I'm *gasp* still breastfeeding, etc.) so I'm sure there would be a lot for them to pick from that makes me an unfit mother. (I'm being sarcastic - I think I'm a pretty good mother myself.) Anyways, the letter.



To whom it concerns:

I am currently pregnant, and I’ve begun to seek prenatal care for my upcoming birth in late November or early December. I had my first daughter at Texas County Memorial hospital by cesarean section in February of 2011. All things considered, my time at TCMH was pleasant, and I was made to feel very comfortable during and after labor. As I understand it, TCMH does not allow VBAC births per hospital policy, but I am requesting an exception to that policy. After reviewing all the medical literature, including the ACOG’s revised guidelines that state,

“Women and their physicians may still make a plan for a TOLAC (trial of labor after cesarean) in situations where there may not be "immediately available" staff to handle emergencies, but it requires a thorough discussion of the local health care system, the available resources, and the potential for incremental risk,”

I have decided that a VBAC is a safer choice for me than scheduling a repeat c-section. I understand the risks of a uterine rupture during a TOLAC are between 0.5% and 0.9% if I am not induced. I also understand the risks associate with a failed TOLAC and the risks associated with an elective c-section.

The ACOG also states that restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will. As well as that if a physician is uncomfortable with a patient's desire to undergo VBAC, it is appropriate to refer her to another physician or center. I am asking for the hospital’s blessing to allow me to seek a physician with TCMH who is comfortable with allowing me to VBAC. I am a good candidate for a TOLAC, and I will discuss the matter extensively with my physician who will be able to review my medical records. In the event my situation changes and I am no longer a good candidate for a TOLAC, I will change my plans accordingly.

I am willing to sign a Consent for VBAC form and can even provide one if preferred. I am also willing to sign an Against Medical Advice form or any other forms to legally relinquish the hospital from any legal or financial responsibilities should something go wrong during my TOLAC.

Should I be denied the privilege of VBACing at TCMH, I will be forced to travel over 65 miles for all my prenatal care and while in labor for the right to give birth vaginally, and this is obviously not ideal. I do not feel that it is right for me to lose my rights to a normal birth at a hospital that is easily accessible because of one previous cesarean, when I am fully informed of the risks, especially with the ACOG’s revised guidelines.

Thank you for considering my request, and I look forward to hearing from you and birthing in your hospital this fall. You can contact me at xxx-xxx-xxxx to discuss this matter further.
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Old 04-19-2012, 10:30 PM   #2
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Re: I Wrote a letter to the hospital administration

It reads great IMO. You'll have to update with the response you get! Good luck, mama!
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Old 04-19-2012, 10:30 PM   #3
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I'd let you vbac in my hospital with that letter. Sounds good to me.
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Old 04-20-2012, 09:16 AM   #4
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Re: I Wrote a letter to the hospital administration

sounds like a great letter!

I'm searching for a VBAC provider right now and might have to travel out of state, over 4 hrs. I went to a hospital 2 hrs from me for my last VBAC attempt. Hospitals with VBAC-bans just plain stink!
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Old 04-20-2012, 09:18 AM   #5
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Beautifully written
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Old 04-21-2012, 01:06 PM   #6
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Re: I Wrote a letter to the hospital administration

Beautiful!

I wish they would make it easier. I know that you can always refuse a c-section, but scary things like you mentioned (CPS...) are always a possibility. Good luck! I hope they allow you to birth YOUR way!
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Old 04-21-2012, 01:35 PM   #7
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Re: I Wrote a letter to the hospital administration

That sounds great! Have you already sent it?

My only concern is that signing something saying that you are going AMA (against medical advice) can open you up to insurance denying to pay for the birth. I'm not 100% positive on that in every situation, but I am 100% positive that checking out of a hospital early, AMA, or an number of other AMA decisions can cause insurance to deny claims. In fact, I know that if you leave a hospital AMA after birth, they can deny paying for the entire birth. So, I wouldn't be willing to sign that unless you clear it with your insurance or unless it is a risk you are willing to take.

I really hope they give you permission. That is just a ridiculous policy.
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Old 04-21-2012, 02:36 PM   #8
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Re: I Wrote a letter to the hospital administration

Quote:
Originally Posted by HeatherlovesCDs View Post
That sounds great! Have you already sent it?

My only concern is that signing something saying that you are going AMA (against medical advice) can open you up to insurance denying to pay for the birth. I'm not 100% positive on that in every situation, but I am 100% positive that checking out of a hospital early, AMA, or an number of other AMA decisions can cause insurance to deny claims. In fact, I know that if you leave a hospital AMA after birth, they can deny paying for the entire birth. So, I wouldn't be willing to sign that unless you clear it with your insurance or unless it is a risk you are willing to take.

I really hope they give you permission. That is just a ridiculous policy.
I'd also omit the AMA reference. By definition, AMA would mean you were going against their policy (which you're seeking to gain an exception for, rather than simply refusing to comply).
Technically, hospital policy or not, you can already refuse a C-section... AMA. If what you want is their blessing and support, stay far far away from saying it's AMA.

Also, I would list the risk of uterine rupture for normal non-VBAC births (as it isn't much lower), and cite sources.

Finally, I would make sure to briefly list some of the verified risks of C-section, which are much more common.


That aside, I think the letter is killer! Go get em!
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Old 05-27-2012, 03:51 PM   #9
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Re: I Wrote a letter to the hospital administration

Quote:
Originally Posted by HeatherlovesCDs View Post
That sounds great! Have you already sent it?

My only concern is that signing something saying that you are going AMA (against medical advice) can open you up to insurance denying to pay for the birth. I'm not 100% positive on that in every situation, but I am 100% positive that checking out of a hospital early, AMA, or an number of other AMA decisions can cause insurance to deny claims. In fact, I know that if you leave a hospital AMA after birth, they can deny paying for the entire birth. So, I wouldn't be willing to sign that unless you clear it with your insurance or unless it is a risk you are willing to take.

I really hope they give you permission. That is just a ridiculous policy.
NOT true. AMA will not get a claim denied
http://www.annemergmed.com/article/S...798-3/fulltext

http://www.epmonthly.com/whitecoat/2...you-leave-ama/
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Old 04-21-2012, 01:51 PM   #10
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Re: I Wrote a letter to the hospital administration

waiting to hear reply
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