FOR IMMEDIATE RELEASE
September 5, 2016
Contact: Dawn Thompson
Phone: (760) 840-8723
HOSPITALS AND PROVIDERS IGNORE NATIONAL GUIDELINES AND VIOLATE PATIENT AUTONOMY
Advocacy group appeals to nations’ obstetricians to offer greater access to vaginal birth
San Diego, CA— Families, healthcare providers, birth professional and concerned citizens will gather around the country on Labor Day and throughout the week in 75 different cities around the country. They are calling for better access to vaginal birth after cesarean (VBAC) and more respectful treatment of women during childbirth, including their rights to full information and decision-making in their care. They gather as part of Improving Birth’s fifth annual national Rally to Improve Birth, this Labor Day week across the U.S. and Canada. Participants in the rally want to raise awareness for evidence-based birth practices and ask local maternal health providers to make a concerted effort to support VBACs.
Although the American College of Obstetricians and Gynecologists states that vaginal birth after cesarean is a safe option for most women, access to this option is still limited all over the United States. It’s estimated that as many as 40% of hospitals in the US have outright bans, or de facto bans, meaning there aren’t any providers willing to accept patients seeking a trial of labor after cesarean. “After moving at 27 weeks pregnant, I interviewed more than a dozen doctors in my new community, who all refused to support my choice at attempt a VBAC. I was forced to stay with my previous provider and drive 6 hours each way for prenatal care”, said Erin Bailey, mom turned birth activist. “I had to temporarily move back once I was closer to my due date at my own expense.”
“The National Institutes of Health has affirmed the safety of VBAC and encourages women to have access. But parents continue to receive misinformation from providers and encounter hospital policies that “don’t allow” VBAC,” said Jen Kamel of VBAC Facts, a consumer advocacy and information source. “The care that pregnant people receive should be consistent with medical evidence and national guidelines. Unfortunately, this is not happening across the country.”
“Bans in hospitals are typically driven by liability concerns. The reality is, birth is not 100% safe and surgical birth comes with its own set of long and short-term risks, which are often not discussed with patients in order for them to make a fully informed choice,” said Dawn Thompson, President of the national consumer advocacy group ImprovingBirth. “There are other ways of dealing with the liability pressures that providers and hospitals face, but the answer definitely isn’t to violate a patient’s autonomy and their right to informed consent and refusal.”
“The research on VBAC only looks at short term, physical endpoints. It does not address the long-term impact on the mother from cesarean delivery, like the risks of life-threatening placenta accreta in future pregnancies. It does not look at the long term health effects to the child from cesarean delivery, which are now well documented like, disturbance of the gut microbiome and increased rates of obesity, diabetes, asthma, allergies, and other concerns,” said Dr. Emiliano Chavira, MD, a practicing maternal fetal medicine specialist in Los Angeles. He adds, “The literature also does not address the issue of the impact of cesarean delivery on breastfeeding, bonding and attachment, and the psychological well-being of the mother. For many women, a cesarean delivery is a terrifying and traumatic experience, and many women suffer postpartum depression as well as post-traumatic stress disorder as a direct result of being forced into surgery. Thus, the small benefits of the cesarean delivery come at a substantial human cost.”
For more information on a rally location near you, visit our Find a Rally page. For more information on Improving Birth, contact Dawn.Thompson@ImprovingBirth.org.
ImprovingBirth is a national nonprofit 501(c)(3) consumer advocacy organization working to improve the maternity care system by offering tools that inform, support, engage and empower the consumer to get in the driver's seat of their childbirth experience and put pressure on the maternity care system to improve. For more information, visit www.ImprovingBirth.org. Download the Press Kit at bit.ly/ImprovingBirthPressKit.
Legal brief from lawyers and consumers on behalf of American women, including 42 firsthand accounts of mistreatment, filed in the matter of Dray Vs. Staten Island Hospital, et al. (PDF)
Improving Birth's #BreaktheSilence campaign (photos from women)
We are a 501(c)(3) organization run by moms, for moms. Our mission is to bring evidence-based care and humanity to childbirth.
ImprovingBirth.org was founded in 2012 by Dawn Thompson in San Diego, CA. As a mother of six, Dawn experienced first-hand the effects of non-evidence-based, non-individualized care — with a traumatic Cesarean for her first birth, and two more C-sections after that when she was unable to find supportive care for vaginal birth. In her work as a doula over ten years, she saw what was happening to women in her area, and she finally decided to do something. She organized an impromptu rally at a local hospital after news leaked that their Thursday/Friday C-section rates soared to 80%. Just six months later, she took that rally national, and in September 2012, the first annual Labor Day rally was attended by almost 10,000 people in over 100 cities across the U.S.
Dawn was joined in October 2012 by volunteer board members Cristen Pascucci, a political and communications strategist, and Rebecca Dekker, PhD, RN, APRN, a nurse researcher, university professor, and founder of Evidence Based Birth.
IB.org grew to a national presence over the next year, joining hands with sister organizations BirthNetwork National, International Cesarean Awareness Network, and Human Rights in Childbirth. Today, it is made up of representatives in over 160 cities across the country, working locally to improve birth in their communities through rallies, support groups, childbirth education, and hands-on efforts with local hospitals. The executive board has doubled in size, and the team now includes expert advisers and a task force of about 20 part-time volunteers.
Throughout this, IB.org has remained primarily an advocacy organization, supporting mothers in their rights, in access to the highest quality information about their care, and in helping them to find providers who practice evidence-based, respectful care.
Around the country this Labor Day week, Improving Birth representatives are reaching out to local media and the public about disrespect and abuse in maternity care. Here are a few examples of dozens of stories from around the country:
2015 Press Release and Letter to ACOG
FOR IMMEDIATE RELEASE
September 7, 2015
Contact: Cristen Pascucci (443-622-2892)
THOUSANDS RALLY AGAINST DISRESPECT AND ABUSE IN CHILDBIRTH
Advocacy group appeals to nations’ obstetricians to hold doctors accountable
San Diego—Today and this week, thousands of women and families will gather at 85 locations around the country and Canada to call for more respectful treatment of women during childbirth, including their rights to full information and decision-making in their care. The rallies are part of Improving Birth’s fourth annual national Rally to Improve Birth, taking place this Labor Day week.
“The anonymous essay recently published in the Annals of Internal Medicine that described disrespectful treatment of women by their doctors in reproductive health care was shocking, but not surprising to us,” said Dawn Thompson, founder and president of Improving Birth, the national consumer movement for better maternity care. “Every single day, we hear from women around the country that they were ignored, bullied, and even forced in childbirth—especially women who are informed and challenging the status quo.”
Research shows it takes an average of 15 to 20 years for best medical evidence to be implemented into practice. In the meantime, the national Cesarean rate of 1 in 3 births is widely acknowledged as too high by national health and medical organizations, many of which have recommended reducing the use of various childbirth interventions that impose additional health risks on mothers and babies. The U.S. is the only developed country with a rising maternal mortality rate, with African-American women four times more likely to die from pregnancy-related causes.
In a letter this week to the American College of Obstetricians and Gynecologists, advocates asked the obstetricians’ organization to join them “as allies” to address such conduct among its members, as “women are losing trust in the industry” (see bit.ly/ImprovingBirthPressKit). The World Health Organization recently identified “disrespect and abuse during facility-based childbirth” as a pressing global issue (see bit.ly/WHOpreventdisrespect), and several U.S.-based organizations that endorsed the WHO statement—Improving Birth, Human Rights in Childbirth, and the Birth Rights Bar Association—have been founded in the past few years to address these systemic issues.
“There’s no real system of accountability,” said Dawn Thompson, founder and president of Improving Birth. “We are appealing to ACOG because women’s complaints to hospitals and medical boards are routinely dismissed and ignored. Doctors and consumers must come together to solve this problem from the inside out.”
Rally Locations: bit.ly/findarally.
Press Kit: bit.ly/ImprovingBirthPressKit.
Improving Birth is a national nonprofit 501(c)(3) organization advocating for respectful, evidence-based care in childbirth. For more information, visit www.ImprovingBirth.org.
September 4, 2015
Hal Lawrence, III, MD, Executive Vice President & CEO
Mark DeFrancesco, MD, President
Thomas Gellhaus, MD, President-Elect
American College of Obstetricians and Gynecologists
P.O. Box 70620
Washington, DC 20024-9998
Dear Dr. Lawrence, Dr. DeFrancesco, and Dr. Gellhaus:
We write on behalf of the thousands of women and families represented by Improving Birth, the national consumer movement to improve maternity care in the U.S. As you may recall, Improving Birth represented pregnant and birthing women in a meeting with ACOG leadership this past May. During that meeting, we were pleased to hear of your objectives regarding recognizing women as the decision-makers in their maternity care, as well as ACOG's move toward more collaborative relationships among the various maternal health care providers. It is exciting to see that we share these common goals.
On the heels of the anonymous essay published recently in the Annals of Internal Medicine about abuse of women receiving reproductive health care from obstetrician/gynecologists, we are writing today to touch back on an extremely important topic we discussed at our May meeting: an alarming--and alarmingly frequent--stream of consumer feedback to Improving Birth about instances of disrespect, misinformation, and abuse at the hands of maternity care providers. We are deeply concerned by the daily reports we hear from women about failures of physicians and hospitals to provide informed consent and to honor informed refusal, as well as the use of coercive and bullying tactics to gain consent for procedures declined by the mother. In just the last four years, several organizations have sprung up to address these issues--Improving Birth, Human Rights in Childbirth, and the Birth Rights Bar Association--all of whom have endorsed, on behalf of U.S. women, the World Health Organization's statement Prevention and elimination of disrespect and abuse during facility-based childbirth.
These reports from women are critical to public health not least because they shed light upon the statistics that are so concerning to us all at a population level--- high and variable Cesarean rates, low and variable VBAC rates, and the continued popularity of episiotomy in some facilities, among other measures. The presumption that women are willingly accepting greater health risks by consenting to unnecessary or contra-indicated procedures makes sense only when we recognize the fact that too many women are not being given full and accurate information, and often, they are not even given a choice in their care. We can confirm that both of these things are happening around the country, and they are resulting in emotional and physical trauma and other negative maternal health impacts. Further, many consumers report that experience with or awareness of subpar and/or abusive hospital maternity care was an important factor in their subsequent decision to give birth outside of hospitals, whether or not out-of-hospital birth was integrated into the overall health care community.
Unfortunately, there does not seem to be any effective or meaningful system of accountability regarding such mistreatment in maternity care. Our volunteers around the country and the women who contact us regularly report that complaints made to hospitals are routinely ignored or justified as mere communication lapses, while responses from state licensing boards are glacially slow and investigations, if they are conducted, take place behind closed doors. Litigation is a last resort, but is a blunt and slow-moving tool, inaccessible for most women, although the existence of groups like Human Rights in Childbirth and the Birth Rights Bar Association network means we have been able to steer several women to attorneys recently. In sum, no one is in charge of protecting women in their maternity care, and women are losing trust in the industry.
In light of this lack of oversight or regulation, we are appealing to you to join us as allies, to help spur corrective action. ACOG’s excellent ethics committee opinions on informed consent and use of force against women in maternity care are explicit regarding pregnant women’s rights with respect to care providers. We ask that ACOG honor the women its members serve by joining us to address and eliminate all such unethical conduct among its members.
Building on last year's viral "Break the Silence" campaign about mistreatment of women in their maternity care (bit.ly/breakthesilencephoto), this year's national Rally to Improve Birth features the theme of "Respectful Care." In all U.S. rally locations this Labor Day week, we will be addressing the media and the public about the need for more respectful maternity care, including, importantly, making women's rights to informed consent and informed refusal a reality in all aspects of their reproductive health care.
We hope these public demonstrations will help move the conversation forward, and we would like to extend an invitation to your organization and members to be a part of the conversation that is happening around the country. Women want to trust their doctors, but doctors must be worthy of that trust. How can we work together to ensure that happens?
Thank you for your attention to this issue, and we look forward to hearing from you soon to talk about how consumers and physicians can collaborate to make maternity care safer for women. We know there is so much we can achieve together.
Dawn Thompson, President, Board of Directors
Cristen Pascucci, Vice President, Board of Directors
Heather Thompson, PhD, Secretary, Board of Directors
Mandi Hardy Hillman, PhD, Member, Board of Directors