Comment of the Week: "Better response to ALL obstetric emergencies"

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By Jill Arnold

We haven’t done a Comment of the Week for awhile. JoyCNM left this on the post, Bringing Back the VBAC. Thank you, Joy.

I’m glad to hear more discussion about the third step in this discussion, better response to ALL obstetric emergencies, instead of focusing on just uterine rupture.  Having been a nurse for 10 years prior to becoming a midwife, I have seen the poor response capable in a small community hospital to any obstetric emergency.  On off hours, there might be only ONE anesthesiologist for the entire hospital.  This was the case in my last employ where we delivered 300-400 babies a year.  If we had an emergency when someone else was having an appendectomy at 3 in the morning, we waited, sometimes up to the magical “30 minutes” for the other anesthesiologist to get there.  Small community hospitals use this scenario to say they do not have the resources to employ an anesthesiologist just for the OB floor and they, therefore, cannot do VBACs.  I have always asked myself, no shouted to myself, “What about all the other OB emergencies?”  If you can’t handle uterine rupture, you can’t handle other OB emergencies, and therefore you shouldn’t have an OB unit!  This need for “readily” or “immediately” available emergency response has been the smoke screen for preventing VBACs in many hospitals for many years.