I watched the web cast of the NIH Consensus Development Conference on Vaginal Birth After Cesarean: New Insights, which is occurring this week. Dr. Michael Socol, chief of OB-GYN at Northwestern, distilled the problem down to its essence. He said (I am paraphrasing) that if it were possible for women to sign a binding consent giving up their right to sue in the event of uterine rupture, there would be no need for the conference. Every doctor would be offering a VBAC to every eligible patient.It is liability that is driving the restriction of VBAC. Successful lawsuits have led malpractice insurers to void a doctors’ malpractice policies for presiding over VBACs.
Unfortunately, the law does not allow patients to sign away their right to file malpractice suits. Since that is the case, doctors have stopped doing VBACs.
During the question and answer session, a woman (it looked like Henci Goer, but the lighting was too poor to be sure) made the typically sanctimonious comment that patients should be “informed” that doctors would putting their liability concerns ahead of the patients’ well being. The comment accomplished nothing beyond demonstrating that the woman had no understanding of the issues involved.
Let me make it easier for VBAC activists to understand:
What would you do if your health insurance company made a rule that anyone who attempts a VBAC would automatically void their health insurance policy and lose all coverage forever. In other words, you’d be on the hook for your $15,000 hospital stay and your baby’s hospital stay. Not only that, your well baby visits to the pediatrician would no longer be covered. Your older child’s epilepsy medications would no longer be covered, nor would his occupational therapy. Your husband would have to pay for the medication used to control his blood pressure. You’d be out at least an additional $10,000 each and every year forever.
On the other hand, if you consented to an elective repeat C-section, everything would be covered and you would not lose any insurance benefits.
What would you do then? Would you be willing to void your health insurance policy and threaten the financial security of your family in order to have a vaginal delivery? Is a vaginal delivery worth paying $15,000 out of pocket AND all your health expenses for the rest of your life, totaling hundreds of thousands of dollars?
And if it’s not worth voiding your health insurance policy and being personally responsible for tens or even hundreds of thousands of dollars, why is it worth voiding a doctors’ malpractice policy?
