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Is VBAC Delivery Allowed in San Antonio Area Hospitals?

VBAC (Vaginal Birth After Cesarean) is becoming more and more rare in our country, and many doctors and hospitals are not willing to allow their patients to attempt it, even though the evidence does not support their position. With the national cesarean rate at over 30% and San Antonio’s rate up to 45% at some local hospitals, this is an issue that every pregnant woman needs to be aware of. Preventing a woman’s first c-section is of course the best route to take, but for those women who have already had one or more c-sections, it can feel as if they have no options but to submit to further surgery with each child.

The International Cesarean Awareness Network is an informational, supportive, and advocacy organization that is seeking to raise awareness of these issues and hopefully lower the rate of c-sections and raise the VBAC rates over time. ICAN has put together a database of hospitals across the country and listed what their VBAC policies are. The information was gathered by volunteers who called their local hospitals with a list of questions, and some hospitals were more willing than others in providing the information. Also, there are 3 labels that are given to the hospitals, and they can be a bit confusing. “Banned” is the easy one, this means that the hospital has an official policy which does not allow VBAC’s. “De facto ban” means that the hospital does not have an official policy banning VBAC, but in practice there are no doctors who will agree to attend one at that hospital. “Allowed” means that the hospital has a policy that allows VBAC’s. This does not mean that they are necessarily supportive of VBAC’s, however. Some of the hospitals were willing to give out the names of doctors who will attend VBAC’s, and others were not.

In a nutshell, what does all of this mean? Well, having a hospital that is supportive of VBAC is important and very helpful. But the bottom line is that a woman needs to have her doctor’s full support, or it’s not going to happen.

Here is a list of the hospitals that are in ICAN’s database and the label they have been given. Next to each hospital I have listed any doctors or practices that were given as possibly supportive of VBAC. This information is subject to change at any time, please go to ICAN’s website for a complete and updated list.

“Allowed” Hospitals in San Antonio Area
Christus Santa Rosa (Dr. Nguyen)
Nix Health Care Center (Dr. Vanwingerden)
North Central Baptist (Northeast OB/GYN and Riverwalk OB/GYN)
Northeast Baptist (Women Partners)
Southwest General Hospital
Southwest Texas Methodist Hospital (Dr. Kuhl)
St. Luke’s Baptist (Lone Star OB/GYN)
University Health System
Frio Regional Hospital in Pearsall (Dr. Garza and Dr. Camero)

“De Facto Ban” Hospitals in San Antonio Area
Metropolitan Methodist
Baptist Medical Center
Central Texas Medical Center in San Marcos

“Banned” Hospitals in San Antonio Area
Hill Country Memorial Hospital in Fredericksburg
Guadalupe Valley Hospital in Seguin

Recovering From a Cesarean Birth: Tips on Healing

Cesarean birth is major abdominal surgery. New mothers need and deserve to have extra support during this special time of birth and healing. Women who have experienced either a planned or an unplanned cesarean section react to the surgery in very individual ways. Some women physically heal very quickly; others report that recovery took several weeks or even months. Avoid putting time limits on yourself. Emotionally, women’s feelings about their cesarean sections vary in range from acceptance, to disappointment, to devastation. Some women need as much emotional support as physical support for a healthy recovery. Each woman heals and grows into her new role of motherhood at her own pace. In time, you will regain your energy level and sense of well being.

To Relieve Pain and Assist Physical Healing:

At hospital:

* Ask for physical assistance, and keep nurses’ call button within easy reach.
* Take pain medication as needed for comfort. Try to avoid pain medications containing codeine as they cause constipation, making it hard to void after cesarean surgery.
* If possible, obtain a private room so that a family member may remain with you.
* Use pillows to support your abdomen when turning, standing, coughing, and when feeding the baby.
* Rest as much as possible and limit visitors. Sleep when baby sleeps.
* Rock in a rocking chair as soon as possible after surgery to speed recovery and reduce gas.
* Take short walks.
* Eat nutritious food and drink plenty of fluids. Avoid cold and carbonated beverages.
* The surgery will slow down your digestive tract, to help with constipation, try an over-the-counter stool softener, NOT a laxative.
* Each time you stand after the surgery stretch up to uncramp stomach muscles and reduce adhesions.

At home:

* Have several diapering stations so you can change baby easily.
* Let others do household chores like cooking, cleaning, and laundry.
* Check the incision daily, or have someone check it for redness, which can be a sign of infection.
* Have a list to things that need done, so when people ask, you can remember what needs done.
* Take care of yourself and your baby only.
* Remember not to lift anything heavier than your baby.
* Stay in your pajamas, so people remember you are recovering from birth and surgery.
* On the other hand, sometimes taking a shower and getting dressed really does wonders psychologically. Even in the hospital, it can help to put on your OWN clothes.
* Keep the baby near you at night so you do not have to get up.
* Have a basket that you can carry easily with nutritious snacks, fingernail clippers, lotion, a book, and other little necessary things in it.
* Eat well and drink water freely. Have a pitcher of water or juice near you.
* If you have other children, secure assistance in caring for them from family and friends.
* Consider hiring a postpartum doula.
* Increase activity gradually.

To Promote Emotional Healing:

* Keep your baby near you as much as possible and get to know your new baby.
* Breastfeed your baby to promote bonding, and release beneficial mothering hormones.
* Share your feelings with others and talk about your experience as much as you feel necessary.
* It is normal to experience a wide range of emotions including relief, happiness, sadness, anger, and feelings of loss and failure.
* Write your baby’s birth story.
* Write letters to the hospital and your doctor, explaining what you did and did not like about your birth- you can mail them, or not, but it is beneficial to write your thoughts down.
* Seek support from available resources including breastfeeding, parental, and cesarean support groups.

Read books on natural childbirth, cesarean birth, and vaginal birth after cesarean (VBAC). There are many varied reasons why a birth may have ended in a cesarean section. If you plan to have any more children, it is important for you to know that it is very likely you can have a vaginal birth next time. When you are ready to learn about VBAC, ICAN can help you find the information and support you need.

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© International Cesarean Awareness Network, Inc. All Rights Reserved

Rachel’s birth was the best experience I have had. My family, doula/friend, and doctor, made it all easy for me.

I was having a VBA2C…..my other doctor would not allow me to continue services with them….because I wanted to try to Labor….. I had been at the  Above Rubies Retreat April 23rd… had gotten home and started feeling twinges at about 10:30 pm but I went to bed. I woke up at 3:30 am on April 24th with severe pains and I started timing them but they were not steady. So I waited for a few hours then around 6:30 am the pains were back and steady at 5 min apart. We called Brenda to let her know and Josh called in to work, and I labored. I walked and squatted, got in the tub,got in the bed, and got on the ball. Brenda was great, she fixed me Emergen-C and a peanut butter shake—I turned my nose up at that.  She was so encouraging to me. The pains were still five minutes apart, so around 12 am on April 25th,  I decided to go into the hospital. Yes, I went - DH was not comfy with a homebirth and with the doctor change we didn’t have much time to find a midwife.

Of course the Nurses did the protocol and hooked me up, but I got out of bed every chance I had. I just should have put my foot down and said no, but anyway anything the nurse wanted to do was held off cuz I was gathering my peeps up to help inform us of what they were doing and give us time to think. Soooo, I had no pains meds! Doc Van’s associate came in and checked me, I really wanted Dr Van to be there, and finally she came.  I pushed for 40 mintues and during that time I was kinda not trying hard enough and Dr. Van said to me, hey you are almost there –  just push some more and she is out. I remember Brenda saying hey look at the mirror you can see her hair - and that was it.  I pushed and out came Rachel. It was soooo awesome.

*Brenda’s comments: Brandy is a good friend of mine, and this was my first birth as a doula! It has also been my longest birth to date, her labor was 30 hours and I was with her nearly the whole time. I loved being able to support Brandy, and was so proud of her for having the courage to stand up for what she wanted in the face of much opposition. She also did a fantastic job staying positive during her long labor. Brandy has made herself available to answer questions for other moms who are considering a VBAC – please contact me and I will be glad to put you in touch with her.