Meet Rachel, Florida

Hoping for a VBAC for her third delivery, Rachel’s pregnancy becomes complicated with missed diagnosis and high interventions.

Rachel had her first baby by C-section at 17. Now 22, pregnant with her third baby, she hopes this one will be born naturally and vaginally. Jennie Joseph, her midwife, is worried though that Rachel has abnormally high blood sugar. When hospital lab tests fail to diagnose the problem, Jennie prescribes home blood glucose testing, which clearly indicates that Rachel has gestational diabetes that puts both Rachel and her baby at increased risk for birth complications.

Rachel begins leaking fluid at 35 weeks and Jennie refers her to the hospital for evaluation, knowing that her diabetes and premature baby fall outside Jennie’s scope of practice. Instead of offering Rachel the option for a trial of labor, she’s immediately wheeled in for a third C-section. Inconsistencies in the quality of healthcare provided to low-income, at-risk women often results in both missed diagnoses and unnecessarily high intervention and C-section rates.

As Jennie says, “it would have been really empowering for Rachel if she’d been given the chance to see the labor unfold and see where it was going.”

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