West Michigan women seeking a vaginal birth after Cesarean section (or VBAC) make up a significant portion of our clients at Over the Moon Doula Services. Helping to navigate the journey through what many medical practitioners call "a trial of labor" is something we are particularly passionate about.
It is an interesting climate in the Grand Rapids and lakeshore areas, and additionally a particular time in the medical landscape surrounding VBAC, to pursue such birthing goals. In 2010, the American Congress of Obstetricians & Gynecologists (ACOG), which oversees OB/GYNs, updated its recommended guidelines of practice on VBAC stating that "attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery." Even six years after the guidelines changed, however, some facilities and/or providers are still not following those new guidelines and are operating under antiquated recommendations. Here is what we've learned through our work supporting many VBACs in this area:
In Grand Rapids, most, if not all providers at Spectrum Butterworth, Metro Health
and Saint Mary's Hospitals follow guidelines and encourage VBAC, however, each
falls on a spectrum ranging from "VBAC-tolerant" to "VBAC-friendly", and
knowing how to find your provider on the spectrum is crucial.
On the lakeshore, Holland hospital policy allows for VBAC, while hospital policies
at Hackley Hospital in Muskegon, North Ottawa Community Hospital in Grand
Haven and Zeeland Community Hospital do not allow for trials of labor for
VBAC because of limited staffing to provide an emergent Cesarean surgery.
Following ACOG guidelines, a trial of labor for most healthy women is encouraged
if access to emergent surgical care is available. This would include 24/7 anesthesia,
and additional operating room staff. Guidelines encourage a discussion with the
expectant mother about the limitations of the hospital, but discourages coercion
into a routine repeat Cesarean.
In Fremont, Michigan, the same is true of Gerber Memorial Hospital, a small
community hospital owned by Spectrum Health. This hospital, which is about a 35
minute drive from Muskegon, does not staff anesthesiologists 24/7, but chooses to
factor in the wishes and informed choice of the expectant mother and so
offers a refusal of repeat Cesarean form for those wishing to pursue VBAC there.
A discussion about provider options would be incomplete without including the many skilled and capable midwives in the area. There are Certified Nurse Midwives who technically can provide care in the hospital for those seeking VBAC, under the stipulation that a collaborating OB is available. Because of logistical factors, however, not all hospital CNMs are able to offer VBAC care.
Meanwhile, the options to VBAC out of a hospital are plentiful, with a Certified Nurse Midwife-run birth center in Greenville, MI and a handful of experienced professional and lay midwives providing comprehensive homebirth care.
Aligning information and support is one of the BEST jumping off points for pursuing a VBAC in Grand Rapids or on the lakeshore. Providing our services, which are proven to reduce odds for Cesarean, to families pursuing VBAC always has a special spot in our hearts.
International Cesarean Awareness Network of Grand Rapids