The last link does say this, which seems to contradict your claim
This document is an educational tool designed to assist practitioners in providing appropriate radiologic care for
patients. Practice Parameters and Technical Standards are not inflexible rules or requirements of practice and are not
intended, nor should they be used, to establish a legal standard of care1. For these reasons and those set forth below,
the American College of Radiology and our collaborating medical specialty societies caution against the use of these
documents in litigation in which the clinical decisions of a practitioner are called into question.
The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the
practitioner in light of all the circumstances presented. Thus, an approach that differs from the guidance in this
document, standing alone, does not necessarily imply that the approach was below the standard of care. To the
contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in this
document when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of
the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of
this document. However, a practitioner who employs an approach substantially different from the guidance in this
document is advised to document in the patient record information sufficient to explain the approach taken.
In terms of the uterine rupture....first of all, the available literature seems to totally discourage VBAC if the woman has had more than 2 C-sections. She has had three.
In terms of making her have the child C-section.....C-sections have not just anesthesia and surgical risks, they have risk of post operative complications.
She has to sign a consent for surgery for a reason. It is inherently a potentially dangerous process.
I see more risk to her than the baby. If she is already in the hospital with her OBGYN there for the delivery, a crash C-section can occur in minutes - especially when the mother is already in a place that can manage this.
I see this as a risk to benefit issue. Just like any other person having a procedure, they get to choose what risks they are willing to take for whatever benefit. Every day in this country, patients do not chose the path medically or surgically that their MD thinks is best. Not unusual. It is choice. Not so sure why this situation would be any different.
Now, if the facility is unable to manage a patient that needs a crash C-section, that needs to be known to all pregnant patients who are considering delivering their baby that facility.
But like I said, VBAC is usual, but it seems that it is acknowledged that usually discouraged after 2 C-sections. But as a CPS issue. Please. Forcing a woman to have a surgery - way to go medival on her.....
As for the rest, you are repeating things as if it changes the issue. OB's are sued even after waivers, etc all the time-all they need is a lawyer to say the pt didn't really understand what the complications meant. They dont want to perform the procedure more because of the much HIGHER incidence of failure to progress (around 1/3 of cases-which often revert to emergent CS, compared to 3-5% chance at the highest risk of uterine rupture-which is of course catastrophic and also much higher than the gen pop.)