ICAN State by State VBAC Hospital Policy Summary

The information collected here was collected to identify VBAC policies in individual hospitals. We wanted to identify those hospitals that have official bans against VBAC in place. In some ways, these were the simplest calls. It is unlikely that we are mistaken about these hospitals. The more difficult hospitals were those with de facto bans in place. This is defined as a hospital that indicates there is no official policy against VBAC but in reality there are no doctors who will agree to attend one, or the restrictions on a VBAC are so extreme as to make it very unlikely a VBAC would be achieved. Our callers asked a series of questions to try to accurately identify hospitals where there is no official ban but there is no option for VBAC. Obviously, this is a “softer number”, because we were dependent on more subjective information to make this determination. It is important to acknowledge this when using these numbers, especially when giving them to a reporter. If you have time, it would be worth calling these hospitals yourself and seeing what responses you get. You can find the contact information on the VBAC Hospital Policy Database.

It is also very important to understand that even the hospitals that do “allow” VBAC, and that were able to give us names of physicians who are known to support VBAC, very few of these hospitals actually do very many VBACs. We would estimate that no more than 10% of the hospitals we called were truly “VBAC supportive”, based on the comments of the people we talked to. Making sure you emphasize this point is crucial in presenting the VBAC access crisis accurately – the number of official bans is truly only the tip of the iceberg.

I’ve also included the state cesarean rate and VBAC rate data for each state. These numbers are from the National Vital Statistics Report. Births: Final Data for 2006. A couple of comments on these numbers: the cesarean rate is defined as the percentage of births that end in a cesarean. However, some states only report “low risk” cesareans in this rate – in other words, cesareans of breech or multiples are NOT included in this number. Unfortunately, I don’t have a good list of which states do this, we just know it does happen. Obviously, the states are not eager to let us know if they report this way. VBAC rate is defined as the percentage of women with a previous cesarean who then have a subsequent vaginal birth. The percentage is NOT that of total births (unlike the cesarean rate) but a percentage of ONLY the women with a previous cesarean who had a birth that year. So, if you wanted to find out the VBAC rate relative to the total number of births, you’d need to divide the total number of VBACs by the total number of births. Needless to say, that number is going to be very small.

Alabama:
51 total hospitals
8 Official Bans (16%)
6 de facto
33.4% c/s rate
5.2% VBAC rate

Alaska:
17 total hospitals
5 Official Bans (29%)
2 de facto
23% c/s rate
17.7% VBAC rate

Arizona:
27 total hospitals
9 Official Bans (33%)
4 de facto
26.5% c/s rate
5.5% VBAC rate

Arkansas:
43 total hospitals
16 Official Bans (37%)
9 de facto
33.2% c/s rate
4.6% VBAC rate

California:
251 total hospitals
96 Official Bans (38%)
17 de facto
31.3% c/s rate
5.2% VBAC rate

Colorado:
56 total hospitals
24 Official bans (43%)
3 de facto bans
25.3% c/s rate
10.2% VBAC rate

Connecticut:
28 total hospitals
1 Official ban (4%)
2 de facto bans
34.1% c/s rate
6.2% VBAC rate

District of Columbia:
5 total hospitals
0 Official bans (0%)
0 de facto bans
30.6% c/s rate 2006
6.4% VBAC rate

Delaware:
5 total hospitals
2 official bans (40%)
0 de facto bans
30.7% c/s rate
9.8% VBAC rate

Florida:
101 total hospitals
25 Official bans (25%)
31 de facto bans
36.1% c/s rate
5.4% VBAC rate

Georgia:
78 total hospitals
12 official bans (15%)
16 de facto bans
31.3% c/s rate
4.7% VBAC rate

Hawaii:
12 total hospitals
6 official bans (50%)
1 de facto bans
25.6% c/s rate
11.0% VBAC rate

Idaho:
26 total hospitals
14 official bans (54%)
1 de facto ban
22.8% c/s rate
17.5% VBAC rate

Illinois:
111 total hospitals
19 official bans (17%)
5 de facto bans
29.6% c/s rate
8.0% VBAC rate

Indiana:
97 total hospitals
26 official bans (27%)
16 de facto bans
29% c/s rate
5.8% VBAC rate

Iowa:
70 total hospitals
45 official bans (64%)
8 de facto bans
27.7% c/s rate
7.9% VBAC rate

Kansas:
67 total hospitals
31 official bans (46%)
13 de facto bans
29.3% c/s rate
10.6% VBAC rate

Kentucky:
30 total hospitals
6 banned (20%)
3 de facto bans
34.5% c/s rate
6.1% VBAC rate

Louisiana:
50 total hospitals
5 official bans (10%)
12 de facto bans
35.4% c/s rate
2.5% VBAC rate

Maine:
27 total hospitals
15 official bans (56%)
5 de facto bans
29.9% c/s rate
5.5% VBAC rate

Massachusetts:
49 total hospitals
13 official bans (27%)
5 de facto bans
33.2% c/s rate
8.2% VBAC rate

Maryland:
34 total hospitals
3 official bans (9%)
0 de facto bans
32.2% c/s rate
8.7% VBAC rate

Michigan:
93 total hospitals
29 official bans (31%)
5 de facto bans
29.8% c/s rate
7.8% VBAC rate

Minnesota:
96 total hospitals
30 official bans (31%)
25 de facto bans
25.4% c/s rate
9.7% VBAC rate

Mississippi:
38 total hospitals
8 official bans (21%)
6 de facto bans
35.4% c/s rate
3.1% VBAC rate

Missouri:
66 total hospitals
16 official bans (24%)
11 de facto bans
30.2% c/s rate
7.3% VBAC rate

Montana:
26 total hospitals
12 official bans (46%)
2 de facto bans
28% c/s rate
10.2% VBAC rate

Nebraska:
58 total hospitals
28 official bans (48%)
14 de facto bans
28.8% c/s rate
9.7% VBAC rate

Nevada:
18 total hospitals
8 official bans (44%)
5 de facto bans
32.3 % c/s rate
4.4% VBAC rate

New Hampshire:
22 total hospitals
6 official bans (27%)
3 de facto bans
29.9% c/s rate
13.4% VBAC rate

New Jersey:
48 total hospitals
5 official bans (10%)
6 de facto bans
37.4% c/s rate
8.8% VBAC rate

New Mexico:
23 total hospitals
12 official bans (52%)
3 de facto bans
23.3% c/s rate
12.0% VBAC rate

New York:
141 total hospitals
24 official bans (16%)
15 de facto bans
32.6% c/s rate
9.8% VBAC rate (excludes NYC)
13.1% VBAC rate, NYC

North Carolina:
67 total hospitals
17 official bans (25%)
9 de facto bans
29.9% c/s rate
7.7% VBAC rate

North Dakota:
11 total hospitals
5 official bans (45%)
1 de facto ban
27.8% c/s rate
14.1% VBAC rate

Ohio:

112 total hospitals
37 official bans (33%)
8 de facto bans
29.3% c/s rate
12.6% VBAC rate

Oklahoma:
60 total hospitals
28 official bans (47%)
19 de facto bans
33.3% c/s rate
2.6% VBAC rate

Oregon:
54 total hospitals
23 official bans (42%)
9 de facto bans
28.2% c/s rate
9.3% VBAC rate

Pennsylvania:
97 total hospitals
6 official bans (6%)
17 de facto bans
29.7% c/s rate
13.8% VBAC rate

Puerto Rico:
24 total hospitals
0 official bans (0%)
12 de facto bans
48.3% c/s rate
7.5% VBAC rate

Rhode Island:
7 total hospitals
3 official bans (43%)
0 de facto bans
31.1% c/s rate
8.4% VBAC rate

South Carolina:
46 total hospitals
13 official bans (28%)
7 de facto bans
32.9% c/s rate
10.2% VBAC rate

South Dakota:
21 total hospitals
2 official bans (10%)
2 de facto bans
27% c/s rate
16.1% VBAC rate

Tennessee:
60 total hospitals
13 official bans (22%)
6 de facto bans
32.4 % c/s rate
11.3% VBAC rate

Texas:
138 total hospitals
20 official bans (14%)
24 de facto bans
33.2% c/s rate
9.4% VBAC rate

Utah:
36 total hospitals
9 official bans (25%)
7 de facto bans
21.5% c/s rate
18.7% VBAC rate

Virginia:
53 total hospitals
8 official bans (15%)
6 de facto bans
32.4% c/s rate
5.4% VBAC rate

Vermont:
12 total hospitals
3 official bans (25%)
0 de facto bans
26% c/s rate
20.9% VBAC rate

Washington:
68 total hospitals
28 official bans (41%)
2 de facto bans
28.4% c/s rate
12.4% VBAC rate

West Virginia:
23 total hospitals
9 official bans (39%)
2 de facto bans
35.2% c/s rate
4.9% VBAC rate

Wisconsin:
72 total hospitals
19 official bans (26%)
6 de facto bans
24.6% c/s rate
12.1% VBAC rate

Wyoming:
21 total hospitals
13 official bans (62%)
3 de facto bans
26.3% c/s rate
8.5% VBAC rate