Saturday, March 27, 2010

Why Prochoicers should care about VBAC access

I learned something new today! (An important part of daily life.)

One of the lovely members of Abortioneers explained to me over Twitter that the scars from a c-section can be reason to deny a woman an abortion.

I had never even thought of this. I knew of women being denied a vaginal birth because of their risk of uterine rupture, but I had never considered women being denied an abortion because of previous c-section(s). It shouldn't have surprised me, of course. 60% of women who abort already have at least one child, which means they've already given birth at least once. And with a c-section rate at somewhere around 32% or more, depending upon the state, it makes perfect sense that many women wishing to obtain an abortion would have had c-sections.

This past week, when I haven't been worrying about real life, I've been trying to think of a way that the birthing activists and abortion rights activists could be brought together, to fight together for reproductive justice. Could this be it?

I know that prochoicers who fight for abortion rights, when they think about it, fight for all reproductive rights. However, a lot of our time is spent focused solely on abortion rights. I think a lot of people, even feminist activists, don't realize that women have trouble accessing vaginal birth. The stigma surrounding abortion makes it obvious to us how difficult accessing abortion can be. But there isn't a stigma surrounding vaginal birth (except inside a hospital room behind closed doors). We're just never told that women are denied vaginal births after c-sections, unless we suffer it ourselves or find our way into the birthing community.

Even though I'm sure abortion right activists care about birthing rights, I can see where some might decide to focus solely on abortion rights. However, when we consider the above, birthing rights BECOME abortion rights. If a woman is forced to go through repeat c-sections, and then she is denied an abortion because of her c-sections? That's an abortion rights issue. We can't change that a woman is denied an abortion because of medical reasons. But we CAN change that she is forced into a repeat c-section for no reason besides hospital policy.

If we care about abortion rights, we have to care about birthing rights.

Now just to figure out how to bring the birthing community majority into abortion rights activism. :-)


  1. It's only crazy docs that would refuse abortion due to c-section. Continuing pregnancy to term is much more risky with prior c-section than abortion.

  2. NYCProChoiceMD - that's true, but unfortunately not all doctors are comfortable with taking on the risk, particularly if they haven't done it before or don't have the facility to manage a complication. And we know not all hospitals allow their docs to perform abortions. So it's not that it's impossible to get an abortion, but certainly more difficult depending on where you live.

    Dnd doctors tend to practice individual medicine and not public health, with good reason but sometimes to a fault. They're not to blame for that; their profession is set up that way. So the fact that a patient's risk from continuing pregnancy (meaning under some other doc, most often) is higher than her risk from having an abortion with "me," a hypothetical doctor*, doesn't necessarily change my decision to say "No, I can't perform that abortion, you'll have to find someone else."

    *I am not actually a doctor! And, on that note, I'm definitely not contradicting your medical knowledge on this point. These are just the realities of seeking an abortion in a system which fragments pregnancy care such that many docs aren't trained, equipped or allowed to perform abortions, much less abortions with cases presumed to have preexisting risk. When I was a case manager for a national abortion access service, I had SO MANY clients sent from one clinic to another, wasting time on consultations and money on ultrasounds only to be told over and over that they'd have to go elsewhere, or that their care would incur an extra "high-risk fee" of several hundred dollars. Depending on where you live or how much money you have access to, this can basically mean No Abortion, whether docs mean it that way or not. And I'm still not blaming the docs. Just saying it sucks.

  3. Oh jeez - sorry my comment was so long! Like I said, this ought to be going into tomorrow's post :)

  4. (Ooh, one more thing - the reason for all the ultrasounds is to DETERMINE if a woman has placenta issues that would make abortion riskier - I wouldn't say that abortion is denied just on the basis of c-section, at all; just that if a placenta problem exists, it might.)

  5. I agree that hospital policies need to be changed i.e. not allowing vaginal birth after c-section. They have to pay higher premiums to take the risk - so they don't take the risk. Instead, they force women to have repeat c-sections. It's not right.

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  7. Every woman has right to dream of having a baby. Tubal reversal allows a woman the ability to conceive naturally without any harm. Although tubal ligation is considered a permanent method of birth control.