Whereas: There is a health care crisis in America and midwives and birth centers have an important role to play in structuring solutions; and
Whereas: Access to care for women seeking a vaginal birth after cesarean (VBAC) is an ever increasing problem; and
Whereas: The current national cesarean section rate is over 30%, and 60-70% in some institutions, despite evidence that a rate of 5% to 15% would be optimal; and
Whereas: Planned VBACs are comparatively safe for selected mothers; and
Whereas: Hospitals have eliminated choice of VBAC rather than implement the recommendation of the authors of the 10 year National Study of VBAC in Birth Centers, which was to permit the midwife/physician team to care for VBAC mothers in the hospital to achieve optimum outcomes; and
Whereas: The Commission for the Accreditation of Birth Centers (CABC) has taken the position that an accredited birth center doing VBACs must be part of a national prospective study on VBAC to maintain accreditation; and
Whereas: As women seek a supportive provider for VBACs and find their options shrinking, requests for birth center providers to attend VBACs increase; and
Whereas: Some birth centers have indicated they are willing to and have the collaborative system in place to care for women seeking VBAC but must be participating in a national study to do it; and
Whereas: It is projected that it would take well over 10 years to collect enough data on VBAC in birth centers for analysis; and
Whereas: The healthcare climate has changed dramatically since AABC launched the National Study of VBAC in Birth Centers in 1990; and
Whereas: More research that supports VBAC will be published in the medical journals in the coming months; and
Whereas: AABC has developed the Uniform Data Set (UDS), a web-based data collection tool for studying optimal birth, that may be used by all providers in all settings; and
Whereas: The UDS includes fields to collect data on VBACs; and
Whereas: AABC has given priority to launching a National Study of Optimal Birth; and
Whereas: The AABC Board has struggled with how this small organization can respond to the very large VBAC issue; therefore
Be it resolved that: After long and extensive review of the feasibility of AABC conducting another study on VBAC in birth centers, the AABC Board of Directors has determined it is not possible for the Association conduct such a study at this time and will instead continue to advocate to policymakers for access to VBAC.
AABC: 1.22.08