I spent the last eight posts going through the story of the birth of our daughter for a reason. I wanted everyone who reads this blog to know exactly where we (my wife and I) were coming from with our anticipation (arguably trepidation) of our second.

Since that experience, my wife has seen her obstetrician several times, and discussed subsequent births. Although there was a possibility that she could have a successful vaginal birth after cesarean (VBAC), our concern was that it wasn’t necessarily the R.O.P. that was the cause of all our problems last time. We believe that there is a good chance that my wife’s pelvis may have been the issue that necessitated the c-section.

So, after much internal discussion (and admittedly some tears), we have decided? to have a scheduled c-section for baby number two. It wasn’t an easy decision, but we think it will be the best thing for us.

This decision means we will have a very different experience than last time. There will (likely) be no discussion of whether she’s feeling constipated or contractions. There will be no water breaking in the middle of the night. We will be able to prepare ourselves as well as our daughter for the baby’s arrival, and I think that will work out well for all of us in the end.

What are your feelings about VBAC, or just scheduled c-sections in general? How do you feel about the (supposed) recent rise in scheduled c-sections?

Mothers who have delivered their babies by cesarean section may face being denied the opportunity to attempt a vaginal birth with subsequent pregnancies. And now they are facing another obstacle: being denied health insurance.

Most mothers who deliver by cesarean section must usually deliver any future babies surgically, as more and more doctors refuse to take on pregnant patients who wish to attempt a vaginal birth after a cesarean, a VBAC.

Women who deliver vaginally after a cesarean birth are at a slight risk of a uterine rupture where the uterus splits open along the previous surgery incision – as horrible as it sounds and often fatal for mother and baby. The risk is very small and some doctors believe it’s similar to the inherent risks of major surgery, which is what a cesarean section is. Still, doctors don’t like being sued, and most insist that mothers have another cesarean section.

And now, private insurance companies are penalizing women who have delivered by cesareans, because if they get pregnant again, it’s likely they will need to have another cesarean.

In a story from the New York Times, mothers who delivered their babies by cesarean are being refused individual health insurance, or can only receive coverage by paying much higher premiums.

Health insurance companies are denying women coverage because the average cesarean birth costs a lot more than the average vaginal one. Surgery is more expensive, requires more doctors, more medicines and supplies, and a longer hospital stay, usually 4-5 days. The bill can run around $35,000. Mothers who have uncomplicated vaginal births usually get to go home the day after if they wish – $7,000 is a typical cost.

Insurance companies don’t want to foot the bill, so they are starting to make mothers pay, or denying them coverage altogether. In some states, this is illegal, but in many others, mothers are being discriminated against.

In 2006, more than 1.2 million cesarean sections were performed, and about half-a-million were repeat cesareans. It adds up to almost a third of all births in the USA. At the moment, only some individual insurance policies are denying women or asking for higher premiums, but if more follow suit it could have enormous financial and health implications for millions of women in this country.

The International Ceseran Awareness Network, ICAN, is a non-profit organization concerned about the rising cesearean rate in the USA. ICAN believes there are too many unnecessary cesarean sections performed for non-medical reasons, by doctors scared of lawsuits, or trying to make childbirth more convenient for them and hospitals. ICAN’s website has a front-page article on this story, and has letters for concerned mothers to write to lawmakers, and to their insurance companies.

The ICAN website also has lots of rsources for mothers who want to try for a VBAC, and links to local support groups.

Mothers who have had a cesarean birth: are you pregnant again and are fighting with your doctors for a VBAC? Have you seen your health premiums increase? What has been your experience?

Or are you reluctant to get pregnant again because of the necessity of having another cesarean?

Or are you lucky enough to have a supportive doctor for a VBAC? Please share your story!