Last OB visit left me discouraged — The Bump
VBAC

Last OB visit left me discouraged

I showed one of the doctors in my OB practice my birth plan the other day. Now I feel deflated...
I think that my CS last time around really could have been avoided with proper coaching and assistance from hospital staff, rather than a rush to just do a CS. I am ADEMATE about vbac this time around.

My birth plan is pretty standard, minimal interventions etc. I planned on laboring at home for as long as possible to begin with. To this she replied that I was to go to L & D when my contractions were 10 mins apart! WHAT?!?!?
Then, next, I ask for intermittent monitoring, so that I can labor in the tub, shower, walk the halls, ball, or whatever else helps me along. She said that for vbac, we are constantly monitored, so this was a no go.
So how the hell am I supposed to be successful when she's going to confine me to a bed at frigging 10 minute apart contractions??

I feel like a rebel, but I'm not going to go in that early. And I'm actually wondering if I could ask for an internal monitor, would that allow me to be more mobile?

It is VERY important to me to vbac. I had a horrible CS experience, and mentally and emotionally I am still not over it. My first was natural (now 10) so I know my body can do it. I also know that I do NOT want to have to care for a newborn and a 22 month old while recovering from a CS.


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Re: Last OB visit left me discouraged

  • I think something we forget is that the doctor works for us, therefore we call the shots.  Yes, they are the doctor and have the training and experience but I think something everyone who on this page has learned is that when it comes to maternity some doctors practice CYA medicine instead of evidenced based medicine.  

    You get to decide when to leave for the hospital.  You can refuse the monitoring.  Though I'm sure they will pressure you like crazy and that could be too much to deal with in labor.  My hospital has a VBAC ban and I asked my midwife what would happen if someone refused to sign the surgical consent.  She said they would have an OR on standby and that the patient would be pressured to sign the form or transfer to another hospital if there was enough time.  She recommended laboring at home until at least 8cm if I wanted to try a VBAC at that hospital.  

    Is finding another doctor an option for you?  If it is and you switch make sure to tell your OB exactly why you and your money are leaving her practice.  

  • I was told to go in t 10 minutes before I had my daughter, but I was progressing a lot before labor, so that may be why. But I think 10 mintues can be pretty standard. But I would probably wait too. My contractions were never 10 minutes apart. I too was told constant monitoring. I ended up having the on call , not vbac friendly doctor deliver, she switched me to internal monitoring, I did not care for it. But, when I had external monitoring, I was able to get up and move a bit. I am sorry you are discouraged, and I hope you the best!
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  • You're going to be hard-pressed to find a provider that agrees to intermittent monitoring with a VBAC. Does the hospital have any telemetry (wireless) units? The downside to internal monitors is that they have to break your water to do it, so that's not ideal if it hasn't broken on its own yet. 

    10 minutes between contractions is really early. Like Holly said, I was in very early labor with DS2 when they were 10 minutes apart. If you've already had a vaginal birth, then I would wait until 5 minutes or so (or when you're at the point you remember was pretty far into labor. 

    Do you have any other provider options? Will they let you stay out of bed when you show up? Even with a tethered external monitor, you can still stay upright next to the bed. And you could also take LOTS of "bathroom breaks" when you're there (to be able to get out of the bed). Keep asking questions and see what they say. Good luck!
    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

  • For my first VBAC, I was continuously monitored, but could stay right by the bed - better than nothing.  Which I did till transition when all I could do was lay down.  I remember the nurse who had to come into adjust the straps every 30 seconds b/c I and baby kept moving around on her.  If it hadn't been so focused on the ctx I would have bitten her head off.  

    My doc is also asking I come in when ctx are somewhere b/t 2-5 minutes apart, which sounds OK to me (though I would prefer even later - we'll have to see how it goes)  

    One thing to consider - my doc is going a 38 wk ultrasound of my c/s scar and if it measures over a certain thickness (I think 3mm), there's a very little chance of rupture - and he'll be much more comfortable giving me a little more leeway.  You might ask about this, just a good FYI before you're in labor.

    Good luck! 


  • skioskio member
    edited July 2013
    Don't be discouraged. Try to stay relaxed and trust in yourself; you can do this, no matter the restrictions.

    Ditto asking about telemetry monitors. And NO to internal monitoring. My hospital didn't have telemetry monitoring, and my OB wanted me monitored constantly, too. I talked to my doula about this and our plan to counteract was this: Stay out of the bed as much as possible despite the monitors, since the wires allowed me 15 feet of length. Also, take a ton of bathroom breaks! Hey can't stop you from peeing. You will have to be taken off the monitors and it'll get you walking and also, sitting on the toilet is great for helping labor progress.

    As far as getting to the hospital when contractions are 10 mins apart, eff that. I had contractions 10 mins apart every other day for two weeks leading up to actual labor. Contrax that far apart don't always mean labor, and if you land in the hospital with practice labor, it could be bad. Again, trust your body. You'll know when it's real labor and when it's time to go to the hospital. My OB mentioned that he wanted me at the hospital pretty soon after active labor began both because I was a VBAC and because I was 4cm dilated at 40w. But I didn't listen. Labor started around 5pm. My doula came over around 10pm. We left for the hospital at 11:30pm and got there at midnight. I was 9cm upon arrival and had my VBAC 4 hours later. It was PERFECT. I didn't see it that way at the time, because I showed up begging for drugs and it was too late, lol. But that's actually what I wanted, so it was awesome in the end.

    Stand your ground! Lots of luck. :)
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  • I'm planning a VBAC also and I'm due in 3 days. I chose to work with a midwife and I also have a doula to help me through. Both of them encouraged me to labour at home for as long as possible. I'm not even supposed to call my midwife until my contractions are 4 mins apart and lasting for a minute. So, all that to say - I'd definitely take her recommendations with a grain of salt. And ditto to what people said above. Refuse the monitoring and maybe have whomever will be there with you to help advocate on your behalf. I had a terrible c-section experience too and a lot of that was bc of how long I spent at the hospital while in labour. I should never have gone in that early and the combo of the epi and pitocin and being bedridden for the majority of my labour made me swear I'd do it differently this time. Stick to your guns. You can do this. Good luck. Wish you all the best
  • @InMemoryViggo, I can't begin to fathom what you have gone through but instilling fear in someone who really wants a VBAC isn't helpful when you have no idea what her medical situation is. If you have no idea what her first pregnancy was like, what kind of incision she has, or the reason for CS - you shouldn't try to talk her out of a VBAC. Every labor is unique, especially for women who have already had a child, so her decisions should be left to her and her OB who are the most informed about her pregnancy.

    @carrie3303  the first day I was in labor I had external monitoring and can't tell you how frustrated I was that they had to come in every 20-30 minutes to adjust the straps because every time I moved, they would lose the heartbeat. Nothing was wrong, but by shifting even the slightest bit meant shifting the straps too. My contractions weren't strong, so I tried to sleep - what a joke. The second day I switched to the internal monitor and it made a HUGE difference. I could nap, walk around my room, sit on the birthing ball, etc. I know other people aren't a fan. I'm not sure if I would do it again since they have to break your water and that puts a "time limit" on your labor, but it definitely has its positives.
    Baby Birthday Ticker Ticker
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  • I would contact your local ICAN chapter and try and find a more supportive provider personally. Good luck to you!
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  • Do you have to stay in bed just because you are in labor?
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