HBAC

(Homebirth after Caesarean) I found this video on Hathor's site, and got all teary, reminiscing over the HBACs that I have been privileged to attend:

Right now, our practice will only work with women who have had one C-section. Since we're a group practice, we've established protocols to determine what we consider 'low-risk'. Mainly, these protocols have been determined by my partners, most of whom have double the years in practice and have attended more births, so I bow to their experience. In light of the rising C-section rate (which is above 25% around here, I believe; it's nigh impossible to get the local hospitals to submit their stats) and the refusal of several hospitals, as well as many OB/GYN practices to work with VBACs, I have been mulling over adding a few conditions to our protocols to allow us to work with moms to HBA2C. What I've come up with so far would definitely limit the exceptions: both previous surgeries closed with single-layer interrupted Vicryl and Dexon suture, neither c-section resulting from fetal distress. But most importantly, I would have to trust the mom. This sounds subjective, and protocol-wrecking, but after having taken a phone call and information from a mom who later called the office and gave different information, I realize that desperation can get in the way of trust and truth, and creates a bad environment in which to birth. Now I need to do some more research before presenting this idea to my partners...