VBAC friendly Dr Long Island?

jbandkb

DH and I will be trying for baby #2 soon and I'm very interested in trying for a VBAC. Does anyone use any of the Dr's from the Ann and Julies Woman Comprehensive Center in Manhasset? Or know if any of those Dr are VBAC friendly? That is where my OB is from. They deliver at LIJ.

JulesNY

Hi -- I see you posted this in October, so you may or may not be pregnant with #2 and have gained info already, but if not I thought I'd offer my 2 cents (having just found your post now).

I use the same practice as you.  #1 was a last-minute emergency C/S due to complications (preeclampsia, placental abruption, fetal position and distress, etc.) with my primary OB, Dr. Appelbaum.  I was full term, had gone into labor on my own, and had made it to 10 cm.  C/S was low, transverse incision.  The first thing Appelbaum said to me in the recovery room was that I would be a great VBAC candidate for #2.

Fast forward to #2 in 2012... after my first appt, Appelbaum went out on leave for an extended period and I hopped around with her different associates to both get to know them and feel out their stance on VBAC.  My impressions as a whole: all of the associates are pro-VBAC in theory, with varying thresholds of risk.  Common thread throughout conversations: we believe vaginal birth is best and we'll let you try if you go into labor on your own (i.e., no induction) before 41 weeks.  If I had to put them on a scale as to who seemed most confident in going for VBAC; Drs. Toles, Shulz, and Altmann (along with Appelbaum), take the top.  Dr. Toles takes a very relaxed approach, he assured me that 41 wks, 0 days, is not necessarily the "line in the sand" -- and he even told me a story about ordering a Pitocin induction to get a non-laboring 41 wk patient going for TOLAC/VBAC.  Dr. Shulz is Toles' complete opposite, very type-A, detail-oriented -- but she prides herself on a history of low C/S rate and she told me that their practice is the one to use if you want to attempt a VBAC at LIJ; she said they attend more VBACs than any other OBs delivering at LIJ.  Dr. Altmann possesses a mix of the qualities I liked in Toles and Shulz.  As for the remaining OBs, Dr. Hippolyte and Dr. Powers, I saw them less frequently as they gave the impression of having more reservations, focusing a lot on the potential (albeit unlikely) risks associated with VBAC and drawing those "lines in the sand."

As for my outcome... VBAC!  It was not without excitement, however.  Dr. Leah Kaufman was on call and attended the birth (she is wonderful; not listed above, however, as she's left the practice to take an appointment at SUNY Upstate).  I ended up being moved into an OR as a precaution because the tracings began to show decel's that were not bouncing back up quickly enough for the staff's liking.  They wanted to be ready to act quickly in case things got worse.  I was over 9 cm at that point, however, so Dr. Kaufman gave me oxygen and an injection to slow down the contractions (they were one on top of another, no down time), which worked to improve DD's heart rate, and after 15 or so minutes of pushing, success!

What I learned from the whole experience: ask lots of questions, make appts. with the different OBs, and don't be afraid to express what your preferences are and why.  Every OB fears the potential of uterine rupture; I explained to them that my bigger fear was going for multiple repeat C/S and the risks associated with repeat surgeries over scar tissue (should we continue having kids).  When framed in that context, all of the OBs seemed willing to listen and work with me.

Good luck to you!  If you have any additional questions, let me know.  Also -- don't know if your 1st was born at old facility or new one -- but let me tell you, the new Katz facility is AMAZING.

JulesNY

Reply posted twice initially, so I've deleted the copy.  I will add the following link, however, which may be helpful to you.  It's maternity stats on LIJ from 2011:

https://hospitals.nyhealth.gov/browse_view.php?pfi=1630&p=svc&subpage=maternity

The numbers alone don't tell the whole story, of course (for example, 816 RCS -- but no indication as to how many were elective and scheduled to begin with versus unsuccessful VBACs).  They did report 101 VBACs, higher raw number and percentage than some of the other LI-area hospitals (NS & Winthrop; I haven't compared others.)

Also, the women here may be a good resource to you: https://www.facebook.com/icanoflongisland