This is the third and final installment of my series on VBACs, C-Sections and patient rights. This blog post will focus on whether or not hospital bans on VBACs is legally enforceable or not, and what you can do if your hospital has a ban on VBACs.
First and foremost, bans on VBACs are policies, not laws. I recall the way my former ob-gyn explained things to me just before I was backed into having a c-section. She made it sound as if it were the law in Massachusetts that all future deliveries would be mandated to be c-sections. She didn't come out and specifically say that, but she implied it. When I was training to specialize in Prenatal Massage, Labor Support Massage, and Postpartum Massage, many other Massage Therapists in my class were also under the impression that our state had made VBACs illegal. Thankfully, we had several midwives taking the course that set the record straight.
Here's the bottom line: hospital bans on VBACs are NOT legally enforceable. No hospital can lawfully force you to have any treatment or procedure that you do not want to have! As a patient, you have the right to refuse treatment. If your healthcare provider or any medical facility claims that you are required to have a c-section, or any other procedure for that matter, they are violating the law.
That does not mean that hospital staff and ob-gyns won't try to convince you that they do have the right to enforce the policy banning VBACs. Dealing with authority figures, and doctors often play that role, can result in a perceived imbalance of power unfavorable to the patient. This is where it pays to be properly informed about your rights as a patient.
Hospitals are also required by law to treat any woman who comes to their facility in active labor. If that hospital has banned VBACs, you may NOT be turned away for refusing a c-section. You are protected by the federal Emergency Medical Treatment and Active Labor Act (EMTALA). A common response for hospitals with a ban on VBACs is to attempt to transfer you to a different hospital by ambulance. However, the hospital must get your consent to move you. Understand that they are trying to skirt the law, and stand your ground. They are in the wrong- not you!
For a step-by-step guide to protect your rights, check out the International Cesarean Awareness Network (ICAN) web site, specifically this page where you will find instructions on how to file a grievance with the hospital's Chief Compliance Officer, what to do if they dismiss your complaint, how to document your refusal to an automatic repeat c-section, how to report EMTALA violations, and information on filing lawsuits.
As a reminder, my posts are referring to repeat c-sections that are not medically necessary, but repeat c-sections to accomodate policy only. The first surgery was risky enough, even in those cases where they were necessary.
Live better, a little every day.