The Declining Provider: Refusal, Responsibility, and ReasonablenessEvidence shows that most women who give birth by cesarean section can successfully – and safely – give birth vaginally in future pregnancies. Yet in the United States, most such patients instead undergo repeat c-sections, in large part because of the dearth of institutions and practitioners that offer VBAC (vaginal birth after cesarean). Are providers justified in refusing to support VBAC? Is it reasonable for mothers to demand this option? Whose responsibility is it to ensure that an evidence-based option is available? Weaving together threads of medical science, public health, bioethics, consumer advocacy, medico-legal concerns, and reproductive justice, Fisch examines how we arrived at our current VBAC position, its implications for maternal and child health, and the connection to other instances of declining providers.
Deborah Fisch, JD
Affiliate, Program for Sexual Rights and Reproductive Justice at the University of Michigan
Recorded December 4, 2013