VBAC research help.

bumpuser5078523

I think a few of you had VBACs?

I need to make my birth plan (mostly stating what I want to opt out of or avoid) and I'm having a hard time thinking of things to research and include. I didn't labor at all so I don't know what to expect. (I was induced at 37 weeks for to preeclampsia and didn't progress at all.)

I'm looking for things you included and websites that aren't biased. I want to keep it safe, but not go for all the unnecessary stuff or textbook labor requirements. (I'm told I have to have a textbook labor and delivery, which I don't agree with. Like not stalling during labor, which they mentioned, but it's totally normal.)

Help!

Rrrrrachel

I think evidence based birth is a great website. It's not comprehensive, though. I would ask for intermittent vs continuous monitoring, as few cervical checks as possible (they can be very painful in labor), no pain medicine offered unless you ask, to be able to eat and drink and move freely, hep lock vs iv, and generally just to be left alone to labor as much as possible. How much of that appeals to you or is possible given your vbac status I obviously couldn't say.

Oh and I always say no eye goop and no bath, immediate skin to skin for the first hour, and all tests and procedure done in room. Obviously excepting an emergency.

I would be a high maintenance hospital delivery in other words.

candlequeen

I'm not sure about websites but here's what I did. I stayed active and walked around My back yard almost daily. I took EPO by mouth in the a.m. and inserted one at bedtime. I went into labor at 39 weeks. I stayed home and timed contractions until I thought I was about to die! My mw had me come into the office and put me on the monitor. They were 6 mins apart and strong! I went home and finished packing and tried to relax. I went to hospital and once they admitted me I didn't get back out of bed but that's bc I wanted an epi at some point. I waited till 5 cm for my epi. They had to refresh it at one point bc of the pain. I told them NO PITOCIN! when I stopped at about 7 or 8 cm the mw asked if a "whiff" of pitocin was ok and I said yes. It got me to 10 cm within an hour! I only pushed 20 mins. Please let me know if you want anymore info. I'm happy to help and I'm praying you get your vbac. It's truly amazing!

Rrrrrachel

Staying home as long as possible is a good idea!

candlequeen

Oh, I also asked for no goop on the eyes and we waited until the cord stopped pulsing before cutting. I had immediate skin to skin. Bath came later

bumpuser5078523

My doctor has been supportive, but we haven't talked about it much.

Between her and my NP, I have been told I have to have a textbook labor and delivery, which I don't agree with. I will also have to wear monitors, but I can still use the labor tub and walk around. I was told I have to have an IV but I already talked her into a hep lock. She suggested reminding the nurses to flush it every few hours so it doesn't go bad.

With my induction, they let me eat and drink until I asked for the c-section. I even got to do skin to skin for a few minutes after they removed him and right when we got to the room and then we nursed. (He was having trouble regulating his temp.)

I'm hoping to be left alone for most of the time and have a nice relaxing labor and delivery. I secretly want to "accidentally" have him in the tub.

bumpuser5078523

PS - Keep it coming, ladies. I'm writing all this down. Anything you want to share is awesome!

candlequeen

They might not leave you alone like you want bc it's a vbac. If something were to go wrong (heaven forbid) then they could be held responsible.

candlequeen

https://forums.thebump.com/discussion/comment/73857506#Comment_73857506

Here is the link to my story on the vbac board. I forgot a few details I know you don't want meds so my story is different but I hope it at least encourages you!

Rrrrrachel

Skin to skin is the best way to help them regulate temp! When my sister had her c section they kept taking the baby way and outting him under the warmer. Made me nuts.

ComeMai

. I'd ask about being able to do alternate birthing positions. I found birthing on my side so much easier than the traditional, on your back position. (I've done both) I also tried water birth & just couldn't get comfortable. My hospital has a sample birth plan on their website which gave me an idea of the requests they're used to.

candlequeen

Yes! I labored on my side too. It was suggested by my MW

Rrrrrachel

My first I delivered on my side and I've always turned my nose up to flat in your back, but the second time my midwife suggested delivering on my back and I'll be darned if I didn't deliver a 9 pound baby in six minutes!

Mandmeesh

I also decline the crap they give you after to expel the placenta. Is it oxytocin? I had to talk my mid wife into that one...but I didn't need it

I also asked for nurses to keep the lights low and speak softly.

I read and really liked natural birth: the Bradley way. Mind set is really important for me

bumpuser5078523

I know they are worried about the slim chance of rupture, which is why I will wear the monitors, which will hopefully keep them away? I think I will wear them anyway.

With Logan they had me do skin to skin for at least an hour before visitors so he could regulate. And he had to stay wrapped in blankets and guests weren't allowed to unwrap him. Overall I was very happy with the hospital and the staff I worked with. They even let me sleep with him on my chest, which some places don't.

I didn't know about the meds for expelling the placenta. I'll look into that one.

I'll also look online about VBAC birth plans.

Last time I really liked the idea behind Hypnobirthing, minus the annoying tracks. I liked how peaceful it looked online and the idea of no/minimal pushing. I didn't look into Bradley, though, which is popular. I should.

bumpuser5078523

I love your birth story, Candlequeen!

Reminded me of another question. Breaking waters. Some people are against it and the only reason I remember is it puts you on the clock. I need to ask about this one too. I know it can be helpful after a certain point, I think.

Rrrrrachel

It's a shot of pitocin they give you and it's not really to help expel the placenta, fwiu it's to help prevent hemmoraging. I've had it both times nbd.

candlequeen

Yes! I labored on my side too. It was suggested by my MW

doeie04 said:

I love your birth story, Candlequeen!

Reminded me of another question. Breaking waters. Some people are against it and the only reason I remember is it puts you on the clock. I need to ask about this one too. I know it can be helpful after a certain point, I think.

It's true they like for you to deliver within 24 hrs after breaking water. It was in an effort to get me further I think. I totally trusted my mw so I listened to everything! I don't think she would've done it if she didn't think I could vbac at that point. Which is also why I agreed to pitocin eventually but not much of it.

mmm50

I was a member of VBAC Facts on Facebook before it became invite only because someone had posted group member's stories on her blog.... so now you have to know someone to get in, but it is a fabulous resource.  

I am planning a VBAC next time around, and my provider (CNM with OB support) is extremely supportive.  She practices at 3 hospitals and told me which one to use because they are least likely to push a C-section (one of the hospitals has the highest c section rate in Ohio- an already high state, so that was scary to realize).  

With my C section (water broke, no labor on my own, pit, made to 10, pushed for 3 hours, but membranes had been ruptured for 48 hours and I had a bad fever and he didn't move so I opted for a C) they let DH hold him right away (after waiting for the cord to stop pulsing and cutting it) and my arms were free so I could kiss and cuddle and kind of "hold" him while still in the OR.  DH stayed with him the whole time.  They checked him for a few minutes while I was being sewn up, then DH took him out to see family while they put me in recovery.  Within 5 or so minutes of being in recovery DH was back with N and we were nursing.  They also let my mom and inlaws come to recovery after about 30 minutes to make sure I was stable), which was great because they took pictures.  

I had continuous internal monitoring once the pitocin started at hour 36 or so, but they let me occasionally unplug the monitors to walk around, go to the bathroom, etc.  Basically if I was within the cord's distance I stayed plugged in, and would unplug and walk for a few minutes at a time.  

My biggest concerns are:

- If I need a C section, I prefer to avoid general anesthesia if at all possible.  For me this means that if a C section is likely, I'd rather have a discussion about it and agree to it and get a spinal before it becomes an emergency situation. 

- Being allowed to go to 42 weeks.  My provider has no problem with this, but won't do an induction for a VBAC unless you have a good Bishop score.  

- I really would like to avoid a pitocin induction/augmentation.  Pitocin was a horrible experience for me, so if it was going to become a possible necessity I would have a long talk with my provider about whether she thought it would work.  If it wasn't likely to work, I would definitely consider a c section.  

mrshudson618

This isn't really about VBACs specifically and not something to go in your birth plan, but could help. The book "natural hospital birth" had a suggestion that I found to be really helpful.
Every time something that you are not fully comfortable with is suggested, ask if it can wait an hour, or even just wait 5-10 minutes. After the allotted time, ask if it can wait a little more.
This can allow you more time to progress on your own, but also help both you and the dr to access how seriously the intervention is needed.(For example the Dr might be saying its time to do another section, but if you ask to wait an hr, he might realize that he was trying to get it done before the nurses shift change or something. On the other hand, he might refuse to let you wait even 5 minutes, which could tell you that yes, the section is necessary and urgent).
If you are stalled using this technique might help.

bumpuser5078523

I found a few VBAC birth plans online last night and modified them to our wishes.

I didn't even think to put stuff in there in case of a RCS. Our first one was great, under the circumstances, but there are a few things I would change. (Delayed cord cutting, more skin to skin, I would like to watch.)

I think I want to not have continuous monitoring and no hep lock or IV, which might be a battle. I'm going to research the monitoring a bit more, though. With Logan, I have seen how fast they can get an IV in, and I know I don't need that the whole time "just in case".

countrycotton

The only thing I would say is to avoid cervadil if possible. It is used to thin the cervix and is awful! And for your own comfort as few cervix checks as possible. I don't know what a "textbook" birth is, every birth is unique. If the doctor recommends something talk about what you are comfortable with and go from there. You know what they say about the best laid plans. Be open to what happens, and regardless of what happens it will all be ok once that beautiful baby is in your arms.

bumpuser5078523

I am completely open to a c-section if it is needed. I just need to do my research so I have the best possible chance at my VBAC.

Last time we went from a homebirth with a midwife to transferring out to a doctor due to preeclampsia. My blood pressure got bad and the side effects of the meds had me begging for a c-section after 22 hours of induction. It sucked, but I tried my best, and have come to peace with his birth.

mrshudson618

doeie04 said:

I am completely open to a c-section if it is needed. I just need to do my research so I have the best possible chance at my VBAC. Last time we went from a homebirth with a midwife to transferring out to a doctor due to preeclampsia. My blood pressure got bad and the side effects of the meds had me begging for a c-section after 22 hours of induction. It sucked, but I tried my best, and have come to peace with his birth.

I love your attitude about this btw

bumpuser5078523

Thanks!