Vbac in the state of Washington — The Bump

Vbac in the state of Washington

I had my son in March of this year and found out I was pregnant again a few days after he turned 7mo! I had planned a natural home birth with my son, but because he was breech and I had low fluid I ended up having a scheduled csection.

 I would love to have a natural vbac this time around, but I'm still on medicaid for the time being and everything in finding out says I have to have to have a hospital birth. Has anyone done prenatal/ postpartum care though a midwife and pay out of pocket for birth? I should be around 10 weeks right now and I haven't been able to figure out where to go for prenatal care :/ is there a good source to find a vbac supportive Dr?? 

I'm totally confused by all this!

Re: Vbac in the state of Washington

  • As a midwife in Washington and someone attempting a VBAC this May, I feel like I can answer your question.

    You have choices: homebirth with a midwife, or hospital birth with a midwife or OB. A lot of what I have to say pertains specifically to Western Washington, but could also be applied to the rest of the state.

    Personally, I have medicaid. I'm choosing a home birth with midwives which means prenatal and postpartum care is covered but the birth is not: I'm paying for that portion out of pocket. If you want to VBAC at home with midwives, be aware that not all midwives offer this option. Join ICAN Seattle facebook and ask them for their list of VBAC friendly providers. It's not illegal in our state for midwives to care for VBACs, but there is a reputation issue so homebirth midwives tend to not advertise this service. Most homebirth midwives offering VBAC have strict requirements for potential homebirth candidates. These might include requiring a consult with an OB, having a 20-week ultrasound, and testing for gestational diabetes. These are to rule out any other complication that would compound your risk.

    Choosing to birth in a hospital is also a valid option. Midwives who work in hospitals are constricted to what the doctors allow them to do so not all hospital midwives can care for VBACs. You can call to find out. Finding a truly supportive OB is challenging but not impossible. Many appear supportive at your first visit but once you get closer to term, will enforce all their restrictions much to your surprise (these might be a scheduled c-section by 40 weeks, or induction by 39 weeks). Again, the ICAN Seattle group can recommend docs known to be supportive. If going the hospital route, I definitely recommend hiring a doula with VBAC experience! 

    There's also a co-care option where a midwife cares for you prenatally and postpartum but you give birth in the hospital with an OB.

    Wherever you live in Washington, I HIGHLY recommend taking Sharon Muza's VBAC your way class! It is a one day class and lays out the evidence to empower you wherever you choose to birth. Especially if you choose to birth in the hospital, nurses and doctors alike tend to portray VBAC information in a misleading way and this class will set you straight so you know what's true and false.

    Arming yourself with knowledge, faith in your body, a fantastic support system/birth team, and a bit of luck is what you need to achieve a VBAC. I wish it wasn't such an uphill challenge but I have hope that in the future, mamas won't face these challenges. 

    Best of luck! Let me know if you have any more questions.
  • How do I find more information about co-care options? 
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