Dr. Andrew Kotaska recently spoke at the 56th annual meeting of the American College of Nurse Midwives held in San Antonio where he discussed VBACs and released a form patients give to their care provider, if the provider is denying a trial of labour for a vaginal birth after cesarean (VBAC). This is revolutionary, since when do everyday expectant mothers get to ask their doctor to sign anything...unless it's a prescription of course?!
We encourage women who are denied a trial of labour to print off this form and take it with them to their next prenatal appointment. Understand your rights as a pregnant mother, this is your body, your baby and your birth. A doctor cannot make you do anything you're not comfortable with. Many of you may think your doctor will abandon you and refuse to sign this form, if you do not agree to a repeat cesarean section. This very well could happen, although if your doctor has your best interests in mind they should understand that your relationship with him or her, known as the therapeutic alliance should be of the upmost importance in protecting.
If this is not the case and your doctor becomes offended, unfortunately it is possible that your doctor may choose to discontinue caring for you and your unborn child. Some doctors will abandon their patients if the woman rejects certain recommendations and if this is the case, you will need to find a new care provider. There are physicians whose main goal is protecting their own self interests in respect to time, money, insurance (malpractice suits) and at times external regulations (hospitals not allowing VBACs).
Ideally a physician should inform their patient of their recommendations, accept the fact that the woman is entitled to disagree with their recommendations and not withdraw their support from her. In the event the physician should need more support caring for a patient they should seek expertise from other qualified health care providers. The Royal College of Midwives policy says it best “If a woman rejects your advice, you must continue to give the best care you possibly can, seeking support from other members of the health care team as necessary”.
Note: this VBAC Form came courtesy of Birth Sense, see the full article from the conference here.