Birth procedure investigated; woman to picket board

Lawrence resident Devina Garrett believes every person has a right to say “yes” or “no” to medical treatment.

“I also think every person should educate themselves so they can make their own informed decision,” she said. “Too many people rely on the advice of their doctor.”

Garrett’s beliefs today are leading her to Topeka, where she will picket the Kansas State Board of Healing Arts.

A board committee is holding a closed hearing regarding Dr. Josie Norris, medical director of the Topeka Birth & Women’s Center. Norris said the state board had determined she should not be allowed to do vaginal births after cesarean section deliveries – also known as VBACs – outside of a hospital.

Garrett said she and others would picket the board from 8:30 a.m. to noon.

“I’m going to hold up a sign and walk along the sidewalk for four hours, and whoever sees me, I hope they learn something new, and I’m going to hand out pamphlets,” she said.

Norris said the situation arose after a complaint was filed against her saying she performed VBACs in her office. She said the VBACs happen in a birthing center. But the complaint spurred an investigation.

Lawrence T. Buening Jr., executive director of the Board of Healing Arts, wouldn’t confirm or deny an investigation, citing laws that stipulate complaints to the board must remain confidential, he said.

“We have review committees and disciplinary committees meeting continually,” he said. “The next public board meeting is Aug. 13, and there will not be any public discussion until at least that date.”

Norris said a committee today would discuss a potential settlement agreement with her. She said she didn’t know what action she would take until she read the settlement terms. But if she disagrees with it, there will be another hearing.

“It’s my belief that this is a loss of rights for women,” Norris said. “We’re one of the few places in the area that provides this option.”

Under fire

Having a VBAC at a birthing center has been criticized of late. The American College Of Obstetricians and Gynecologists strongly advised women against attempting a VBAC unless in a hospital.

The most common concern with VBACs is the potential of uterine rupture, which can lead to emergency surgery.

Norris said she considered the risk low and said just as many problems were connected to repeat cesarean sections. But women should have both options, she said.

“We have a choice to get on a motorcycle without a helmet in Kansas,” she said. “I think the chances are far greater for that person to have a head injury in an accident compared to a woman giving birth. But we haven’t taken any measures to force people to wear helmets.”

The American College Of Obstetricians and Gynecologists also stated in its 2003 standards that an anesthesiologist and an obstetrician should be immediately available during the delivery in case an emergency cesarean section was needed.

Other policies

Some hospitals have a policy of not allowing a woman to have a natural birth if she has had a previous cesarean delivery. Those hospitals include Stormont-Vail Regional Health Center and St. Francis Health Center, both in Topeka.

Lawrence Memorial Hospital has not been doing VBACs, said Isabel Schmedemann, director of LMH’s maternal-child ward.

“But it’s really a physician’s decision and not a hospital decision,” she said.

Schmedemann said the reality, right now, was that the American College Of Obstetricians and Gynecologists has suggested VBACs were too risky if an anesthesiologist wasn’t immediately available. Physicians want to make sure their patients are safe, she said.

But the biggest factor limiting the availability of VBACs is that insurers are saying the procedure is uninsurable or charging premiums too high for physicians to handle, Schmedemann said.

“This has been such a struggle for our physicians and our staff because truly they want to be able to provide what patients want and a lot of patients would like VBACs,” she said.