Press Release Archive for July, 2011
CABC VBAC Policy – Adopted June 2008
July 28, 2011
POLICY REGARDING VAGINAL BIRTH AFTER CESAREAN SECTION IN ACCREDITED BIRTH CENTERS
STANDARD V. Quality of services
The Birth Center provides high quality, family-centered, maternal and newborn services to healthy women anticipating an uncomplicated pregnancy, labor, and birth that reflect applicable professional standards for conduct of the practitioners responsible for services rendered and recognize the basic human rights of the childbearing woman and her family.
Since CABC last published its indicator on VBAC under standard 5, there have been significant updates in professional organization positions on VBAC in birth centers and a new published multi-center research study on the risks of VBAC.
A February 6, 2008 ACOG news release states that ACOG considers hospitals, birth centers within hospital complexes, and freestanding accredited birth centers to be the appropriate places for birth and VBAC. The news release further states that ACOG recognizes the Standards of the American Association of Birth Centers.
On February 1, 2008 The American Association of Birth Centers stated, “Whether or not to do VBACs in your center is a decision for individual providers.” It then went on to list 5 criteria birth centers should incorporate into their decisions regarding VBAC.
The February issue of The Journal of Obstetrics & Gynecology published results of a multi-center research study on “Labor Outcomes With Increasing Number of Prior Vaginal Births After Cesarean Delivery.” The conclusion stated, in part, “Women with prior successful VBAC attempts are at low risk for maternal and neonatal complications during subsequent VBAC attempts.”
In response to these developments above, CABC will now accept VBAC in accredited centers as appropriate if the following indicators are met and documented:
1. client has had only one prior c/sec
2. client has a documented low transverse incision
3. ultrasound demonstrates placental location is not anterior and low lying (ie, not over old scar)
4. client has signed a VBAC-specific informed consent
5. client has had one or more successful prior VBACs
6. client meets all other risk criteria of the birth center
CABC will evaluate on a case-by-case basis centers’ desiring to do primary or first time VBAC. These centers must document meeting items 1, 2, 3, 4, and 6 above plus:
1. Center must document ability to transfer care to a facility with 24/7 availability of anesthesia and obstetrical attendance.
2. Center must be located in close proximity to the transfer facility.
CABC still recognizes that VBAC in Accredited Centers can occur under Standard 9. The center would need to demonstrate compliance with the standard and its indicators.
ACOG News Release 2-6-2008 ACOG Office of Communications 202-484-3321
American Association of Birth Centers 2-01-2008 Statement regarding feasibility of another VBAC study :www.Birth Centers.org
Obstetrics and Gynecology (2008;285-291) Labor Outcomes With Increasing Number of Prior Vaginal Births After Cesarean Delivery.
Press Release Archive for July, 2011
Evidence Supporting Allowing PO Intake During Labor
July 23, 2011
Some birth centers have recently had pressure from their collaborative physicians and/or hospitals to change their policy of allowing laboring mothers to eat and drink as they wish. Here is a an excellent review of the evidence supporting no restriction of PO intake during labor. You can even get CEU’s!
http://www.nursingcenter.com/prodev/ce_article.asp?tid=1036626
The CABC will be adding an indicator that there is a policy of not restricting PO intake during labor in accredited birth centers in order to provide support for birth centers who face pressure to restrict intake.
Press Release Archive for July, 2011
CABC Workshops
July 20, 2011
We will be offering two workshops in Denver on Thursday, September 1 prior to the American Association of Birth Centers Annual Birth Institute.
Reaching for Excellence: Preparing for Accreditation
If you are opening a new birth center or have been open for years, attend this workshop for a detailed look at the accreditation process and what you will need to do to become accredited. The information gained from this workshop will help to make your accreditation process less stressful and more successful!
Site Visitor Training
This is an exciting time to join the CABC site visitor team! We have an unprecedented number of birth centers seeking accreditation. And we are moving to all electronic submission of documents by both and the site visitors. If you have ever considered becoming a site visitor, this is a great time to attend the training!
Register for the workshops in Denver here http://www.birthcenters.org/conferences/page.php?id=28
We look forward to meeting you!