EBB 396 - Inequities in VBAC Access with Dr. Nicholas Rubashkin, MD, PhD

About this episode

Dr. Rebecca Dekker and Dr. Nicholas Rubashkin discuss the inequities in access to vaginal birth after cesarean (VBAC) and the systemic barriers families face.

The evidence shows that vaginal birth after cesarean (VBAC) is a safe option for many families, but it's still frequently inaccessible to them. In this episode, Dr. Rebecca Dekker and Dr. Nicholas Rubashkin discuss the systemic barriers that limit families' opportunities to choose a VBAC. They explore how hospital policies, outdated guidelines, and clinical tools like the VBAC calculator have shaped who's a "good candidate" and who is not. Dr. Rubashkin also shares insights from his research on inequities in maternity care, including how race-adjusted algorithms reinforce disparities, why the "immediately available" standard still impacts hospital policies today, and how geography, provider practices, and induction policies can influence VBAC access. Plus, hear evidence-based strategies for advocating for a VBAC, including how to evaluate providers and interpret VBAC rates. (01:36) Dr. Rubashkin's background and path into obstetrics (08:32) Major barriers to VBAC access in the U.S. (11:37) The "immediately available" standard explained (14:38) Misconceptions about emergency cesarean availability (16:58) Ethical and legal implications of VBAC restrictions (18:02) Institutional…

People in this episode

Host: Rebecca Dekker

Guest: Nicholas Rubashkin

Topics covered

• VBAC
• maternity care
• systemic barriers
• health disparities
• advocacy
• hospital policies

Keywords

• VBAC
• cesarean
• maternity care
• health disparities
• hospital policies
• advocacy
• induction

Mentioned in this episode

Organizations: ACOG

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