Given a 50/50 chance.

fatbarbie0226

Hello! I've been a lurker for a few months but post on the May 2014 board. I am 31 weeks pregnant with my second.
A little background, I live in an area with small hospitals which do not allow VBACs due to staffing issues. Recently, a hospital 30 mins from me started allowing VBACs again. In order for me to deliver at that hospital, I would need to switch doctors at almost 32 weeks.
My first c/s was due to failure to progress. Water broke at home and after 20 hours of labor, I never dilated past 2 cm. I discussed with my doctor and she said I didn't progress because my baby was "sunny side up" and wouldn't drop into my already smallish pelvis. She said if all the stars align, I have a 50/50 chance of having a vaginal birth. She also said that this is my one chance of a VBAC because no hospitals in our area will consider a VBA2C.
So what do you think? Is it worth it to change doctors this late into the pregnancy and drive 30 mins to every appointment and to the hospital when I'm in labor for a 50% chance of a VBAC?
Or do I stick with a doctor who I have built a repertoire with through two pregnancies, but face c/s with a toddler to care for and all other future pregnancies that may come?
Decisions, decisions....

mmks

I will do anything to avoid a RCS, so I would change Drs even at 32 weeks. I am driving 35 mins to my midwives and I know it will suck when I'm in labor, but I love them, so it is very worth it for me!
FWIW - your dr can't tell how small your pelvis is just by looking at you. Have confidence that your body won't grow a baby that you can't birth!

fatbarbie0226

Thanks for the responses, ladies.
I went to a consult today in the town 30 minutes away. The doctor there informed me that the hospital is allowing VBACs only to discourage women from attempting them at home. They will not have a whole OR team there in case of uterine rupture and the doctor can be 10 minutes away from the hospital while you are attempting your VBAC. This scares me a little because if your uterus does rupture (less than a 1% chance), they have less than 10 minutes to get the baby out to prevent brain damage and/or death! So basically it's the same situation I would be in if I attempted a VBAC at the hospital less than 2 minutes away from my house, but that hospital claims they don't allow VBACs. Basically, the doctor told me that they can't force me to have a c-section and will treat me even if I refused surgery and forced them to care for me through my VBAC.

I just hesitate because I don't want the doctors and nurses to resent me because I am going against hospital policy. I need their support! And how would that work with insurance? Could they refuse to cover me if I went against hospital policy?  

I am planning on having more kids (a little more spread out than my first two, planning on waiting until this baby is 2 years old before trying to get pregnant with #3) so that is why I want to attempt a VBAC so badly. But the unknown and uncertainty is killing me.

ILoveRunning

Yikes!  I am sorry that it wasn't a more reassuring appointment.  I am always surprised that there are hospitals that don't have an OR ready to go 24/7.  Failed VBACs are not the only reason for an emergent c-section.  KWIM?

I am not sure what I would do in your situation.  I don't think that a 50/50 chance is all that bad.  When you consider that the c-section rate at an average hospital is 70/30 to begin with.  However, if you do not feel comfortable with the idea of not having staff on hand, then it really doesn't matter what your chances of success are.  I can't imagine that the staff would resent you, as long as you were firm but kind in your conviction.  I am not sure about insurance, so you might want to ask your OB for further guidance.

cecilyandgautam

It does sound like your main provider just pulled that 50/50 shot out of thin air. In my experience, VBAC supportive providers don't do that. They review your history, determine with you whether you're a good candidate, and from there on out offer words of encouragement. It would concern me that your doc is prepping you mentally that it's just a toss up as to whether or not this is going to work out. I'm sorry you're in this situation - I'd be looking for a new provider at this point, or at least a really awesome doula who's super experienced with VBACs. 

Good luck!