VBAC Bans in Georgia: What You Need to Know About VBA3C and Other Thorny VBAC Issues
Georgia has the worst maternal mortality rate in the country, which in turn has the worst maternal mortality rate in the wealthy world. C-sections are a leading cause of childbirth injuries and deaths, yet doctors are all-too-eager to recommend them. Statistics on the total number of c-sections suggest that at least half are unnecessary. Yet many birthing people feel pressured into repeat c-sections. If you want to have a vaginal birth after a c-section (VBAC), your doctor might tell you you’re not allowed to. If you’ve only had one or two c-sections, then having a VBAC usually just requires switching providers. But if you’ve had three or more prior c-sections, you will have great difficulty finding a provider who will “let” you. Here’s what you need to know about Georgia’s unofficial VBAC ban, and how you can fight back.
Is VBAC Safe?
Evidence-Based Birth has an exceptional roundup of recent research on VBAC. If you’re unsure whether VBAC is safe, or are questioning someone else’s VBAC decision, it’s a great resource. VBAC does increase the risk of uterine rupture, though the absolute risk is still low. Moreover, having a vaginal birth may lower certain other risks, such as the risk of infections or serious surgical complications. A vaginal birth usually means you can go home earlier, hold your baby immediately, and be up walking shortly after giving birth.
So there’s no right choice that is totally safe in all scenarios. Instead, making birth decisions is all about weighing risks—and all childbirth choices involve some risk.
Is it Legal for Me to Have a VBAC After Three or More C-sections (VBA3C)?
It is legal to have a VBAC after three or more C-sections, even if your doctor doesn’t want you to.
In fact, it is technically illegal for a doctor to force you into a C-section, though your doctor can certainly attempt to coerce you by telling you you have to have a C-section, telling you a VBAC is too risky, or making other (mostly unfounded) threats.
Informed consent and informed refusal are constitutional rights, even for pregnant people. The only exception to this is if a doctor seeks and receives a court order. To do so, the doctor would have to show that you are not competent to make sound decisions for yourself and your baby, and that the risk of a VBAC is too great. Most doctors never go that far, because most patients consent to the C-section. If you refuse a C-section in labor or show up pushing, the odds that a doctor will have time to seek a court order are low—and the odds they will get one are even lower.
The Problem With VBA3C in Georgia
So if doctors can’t force you to get a C-section, why is it so hard to get a VBAC? It comes down to two factors: hospital policies and provider willingness.
Some providers just aren’t comfortable attending a VBAC. They usually make this clear in their office policies, and demand that their patients schedule a C-section late in pregnancy.
Even when a provider is comfortable attending a VBA3C, though, hospital policies can get in the way. Hospital policies are not law; they cannot override patient consent. What they can do is tell a doctor how they can practice if they wish to keep their hospital privileges. This puts VBAC-supportive doctors in an impossible bind: they can’t legally force their patients to have a C-section, but they can lose their hospital privileges for attending a VBAC the hospital has banned. Some doctors are honest with patients about this conundrum. Others lie and say the patient is legally required to have surgery.
Can My Doctor Make Me Have a C-section?
Without a court order, your doctor cannot force you to have a C-section, even when hospital policy bans VBAC, even if the doctor does not want to attend your birth, even if the doctor is mad at you. What your doctor can do is make your birth experience very difficult. This is why it’s so important to have a clear plan before you go into labor. You must be prepared to push back against shame and guilt. You must also be armed with information about your legal rights.
Strategies for Having a Successful VBA3C in Georgia
Federal law prohibits hospitals from turning away people in labor. This means that, if you show up to the hospital in labor, they have to treat you—even if you decline a C-section. You might not get your preferred doctor, and you might not get the sort of compassionate care you deserve, but you are entitled to care. The further along you are in labor, the less likely it is that they will be able to pressure you into a repeat C-section. To learn more about strategies for having a successful VBA3C in Georgia, read our comprehensive guide, How to Decline a C-Section and Have a VBAC.
The Georgia Birth Advocacy Coalition only recommends this aggressive approach if you are trying for a VBAC after three or more C-sections. Otherwise, there are plenty of doctors and hospitals in the state that will let you have a VBAC without much pushback. So early in pregnancy, ask your doctor where they stand on VBAC. It’s also a good idea to ask them to interview them more generally about birth practices, so check out this guide. ICAN also offers a Georgia support group where you can ask about your doctor’s VBAC approach and get recommendations for a doctor who want give you pushback. Don’t wait till the last minute. And don’t fight with a provider who won’t honor your wishes when there are better providers out there.