July 2019 VBAC Thread — The Bump
July 2019 Moms

July 2019 VBAC Thread

This thread is a place for the women of this board who are interested in a VBAC to discuss all things related to. 

Note: If you are not trying for a VBAC, please keep your comments on the supportive or inquisitive side. We are all aware of the risks, and they are unique to each individual depending on many factors.
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Re: July 2019 VBAC Thread

  • I go here!

    Thanks for starting this thread @mamanbebe !

    My middle daughter was a footling breech CS, and my third was a VBAC. Hoping to have another VBAC in July. We are going to tour a new birthing center this week so I can ask the staff about policies etc. They use a laborist model which means you get the OB on shift, not necessarily your regular OB. My OB is very pro-natural birth with minimal medical intervention so I want to get a feel for the vibe at this new place. Otherwise I'll go with my old hospital if it guarantees my OB.
    mamanbebe
  • I’m I’m here too!!!

    I decided not to go back to where I had DD because I didn’t like the way the induction/ECS took place...had my first visit at a different clinic a few weeks ago and liked their VBAC view (let me go until 41+3 to try to go naturally, ok with an induction if I’m at least somewhat effaced...). However, there were other things I didn’t like about the visit so now I’m on hospital number 3!

    I haven’t had my first visit at the new one but it’s the American hospital. Losing the (huge) advantage of a free birth as it’s a private hospital. However, I’m really hoping that I feel comforted in their policies and that they are listening to me (my main issues with the French level 1 hospital system!)

    My goal at this point is to be OK with the birth experience I have - very worried about attempting a VBAC that ends in a ECS and having bad PPD like my first experience. 
    mamanbebeCbeanz
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  • I go here too! Thanks for starting this. I don’t know if my dr will allow a vbac yet.  My first was a big baby that got stuck. They said a vbac depends on the size of this baby.  Anxiously waiting to find out if it’s an option.  If it’s an option I worry about laboring and ending up with a csection anyways. I’ve heard from multiple people that the recovery from a scheduled c is a lot easier than when you labor before the csection.
    mamanbebeCbeanz
  • @Cbeanz You're welcome :) Good luck with the birthing center visit this week! What was your VBAC with your third like? 

    @frenchbaby18 I hope you feel good about the hospital you choose. Is the american hospital more pro-VBAC or is it just the overall setup that is more comforting than the last clinic you visited? 

    @mama_bear19 I hope you get the VBAC that you want. I would encourage you to read Ina May's Guide to Childbirth or even watch the documentary on her Birth Story: Ina May Gaskin and The Farm Midwives (it was on Tubi app on Appletv for free when I watched it). It has a lot of useful info on laboring, positioning and pushing, and real birth stories with big stuck babies that you might find reassuring :) 

    I go here too (surprise!)

    I had a scheduled CS with DS at 41w because I was afraid of getting pumped full of pitocin and ending up with a complicated emergency CS anyway. As it turned out DS had rotated in the womb and wasn't at all engaged, which would have led to that ECS. Recovery was hard in the sense of terrible problems breastfeeding and definite ppd. If I have to do a CS again, I will, but I'm really hoping not. I'm working with a lovely midwifery birth center close to my home and so far I'm feeling pretty good about things, so far. 
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  • @mamanbebe Overall, it was an OK birth - it all depends so much on the nurse.  She was older, and retired but came in part time for L&D.  She just kept screaming at me. Screaming to get off the floor, screaming to roll onto my back, screaming "The head is out! The head is out!" because she wasn't comfortable being with a laboring mom who didn't want to be laying flat on a bed. I wanted hydrotherapy SO BADLY.  With my first, they didn't have time to fill the tub between when I asked for it and it was time to push. With my second, she was a CS.  This time I just wanted to get in the damn shower, and again, I wasn't allowed. It may sound trivial, but it's what I wanted and I'm fed up with not getting the little luxuries that make a big difference in labor.  This time I will rip the f*cking IV out of my arm and get in the shower no matter what anyone says.

    I'm also upset that my husband basically missed the moment of birth because she sent him to get the OB in the hallway.  But there was just so much happening at once.

    Recovery was a dream.  Within 24 hours we were discharged and I was at the park playing with my girls, wearing my newborn in the ergo. A kid at the park asked how old my baby was, and I replied, "She was born yesterday." 

    *******************************************************
    Here is my birth story from March 2017:
    At 38w5d, my water broke at home. In laws got there quickly to stay with the girls, and we headed to the hospital around 6pm. We got penicillin started, and I found out my OB was on an overnight shift way across town so they assigned another random hospital OB to me. She struck me as pro CS, which was the main thing I was trying to avoid. She kept referring to me as TOLAC rather than VBAC, for example. They told me I couldn't labor in the tub due to my water breaking (my regular OB had approved tub labor so I was disappointed) but she said the shower was still an option for later when things got going. She started me on pitocin pretty early and I had contractions that were uncomfortable but not painful all through the night. I dilated to about 8cm pretty comfortably and was even able to nap a little.
    Around 8am there was a shift change, my OB showed up, and things got intense fast. The pitocin contractions went full throttle and didn't let up for an hour. I counted breaths as I got a short break every 15 breaths or so. It helped me manage the intense pain. I asked to get in the shower and the new nurse refused bc I had an IV. Again disappointed but I couldn't advocate due to the intense pain.  I used hands and knees on the floor. I nearly reached my breaking point and felt like my body would explode. But right as I thought I couldn't take it any longer, I felt a strong urge to push. STRONG. No time to get the pushing bar out. The nurse sent DH to the hall to call the OB in. She yelled at me to turn onto my back but a hand and knees position was the only thing that felt right. She was physically trying to push me onto my side but it was too late - I pushed the head out and felt crowning! She caught my baby in a panic before the OB walked through the door! 

    Baby girl #3 was 6lb. 5oz and 19.5" long! By the strength of her kicks I guessed she was way bigger! She's nursing well and we'll go home tomorrow!
    *********************************************************
  • Would love to try for a vbac this time around but haven't gotten the official word from my OB if I'm a candidate yet. Also, my placenta is currently covering my cervix so that needs to move out of the way. My water broke at 38 weeks with my first and after laboring for 18 hours, I developed a really high fever (infection). They let me push for an hour and a half only to end up needing an ECS because his heart rate got way too high. Would really love to try for a vbac but will be ok if I have to schedule a CS. I have an ultrasound tomorrow to check placenta location and at that point I'll ask I can try for a vbac or not. 
  • @mrsjqg1024 Good luck tomorrow!

    @Cbeanz That makes me so mad hearing about your crappy nurse :( I'm glad you were able to still birth in the position that was right for you despite her being a screamy bully, you definitely don't need those vibes when you're trying to bring life into this world <3 I hope this time it's much much smoother! 
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  • @mamanbebe I don’t know the VBAC policies yet...we will see!! I think my indecision around birthing centers/hospitals is really just a manifestation of my anxiety related to my last birthing experience...(well, I think this based on my therapy sessions hahahahaha). 

    For me it’s the problem I have a hard time getting over with in the French hospital system. You have access to amazing doctors, drugs and equipment and everything is free. This is wonderful. However, it’s not treated like a service industry in any way. They are way behind in “patient empowerment” and you have to believe that the doctors are always right.

    I work with doctors in my day to day job and i see how different they are in terms of how up to date they are with guidelines, how they prioritize treatment decisions etc. And it has inspired me to want to be even more active in decisions relating to my health and baby. However, low risk pregnancies here are all followed in Level 1 clinics exclusively by midwives who have to follow hospital protocol. While I love the idea of midwives, especially for the birth, they can be very stressful about other things (like my whole saga on testing positive for toxoplasmosis...). Right now my number one goal is reducing my anxiety!!!

    Sorry that was a very long answer :)
    Cbeanz
  • @frenchbaby18 ; Thanks for sharing that perspective.  I would have a problem with that Dr-is-always-right mentality as well.  I used to think doctors knew everything - or at least had my best interest in mind. But now I believe that many physicians (OBs especially) make decisions based on what will be least likely to end up in a lawsuit. I've become much more proactive when it comes to my own health, and I seek out physicians who I believe fundamentally will do the right thing.  But they are sometimes hard to find.
    frenchbaby18mamanbebe
  • @frenchbaby18 I can see how that is very frustrating. I wonder how the american hospital works differently in France, given that it's not under the thumb of US regulations. It would be nice if it worked out to be a nice balance of the two somehow, so that you felt comfortable in the quality of your care but also be able to advocate for your own choices in laboring and delivery. Keeping my fingers crossed for you! 
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  • @mamanbebe I’m also curious!!! We will see. Who knows, I may go back to the VBAC friendly place near my house even though I hated my first visit based on their handling of toxoplasmosis and my questions about what they have in place for moms that struggled in the past with PPD and anxiety...

    They have some very cheesy videos online that look like they were made in the late 90’s but they use lots of the key words in their communications that are reassuring. Plus I was already assigned a “Maternity Navigator” who answers emails quickly which I appreciate for scheduling and stuff...they also do standard American things like NIPT (too late but still). It’s probably the same as any private hospital here haha as they need people to come to them and pay! I’m still waiting for the quote on how’s much the birth will cost to make sure it’s not insane...although by insane I mean like more than $2,000 not US price insane :) my husband thinks I’m crazy :) 
    mamanbebeCbeanz
  • @frenchbaby18 omg that price tag is amazing compared to the US haha, I'd probably be doing the same thing :) Good luck and let us know how it goes! 
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  • I don't have anything to add, but I am planning a vbac, too.
    Cbeanz
  • jenniferjoy37jenniferjoy37
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    edited January 31
    I really, really wanted to try for a VBAC but my OB said this was not an option at all. Since I had DD 12 months ago via CS due to pre-e, they said that in order to have a VBAC I needed to let my uterus heal for 18 months before getting pregnant again. Their research shows that the percentage of uterine rupture greatly decreasss after 18 months, so this mama gets another CS. Dreams squashed, but I completely understand. I would rather be around for my kids than bleed out because of a rupture. Good luck all you mamas doing VBAC! 
    foodislove
  • My doctor is totally on board with a VBAC up until a certain point in the pregnancy. Basically I need to be scheduled for a c-sec by 40 weeks if it doesn't come naturally. M was a bit of a big baby (8lbs even, not too big but I am a small size), and since I didn't progress past 3cm even on the pitocen last time, no induction, and a lot depends on Dibbun's size and positioning too.

    If I end up with a c-sec... yeah, I'm gonna be disappointed and nervous, but after seeing my bestie just do 55hrs with a c-sec, I'd rather get more sleep than I did last time.
    BFP ♡ Jan 2016 - M born Oct 2016
    PPD for 1yr+ post-pregnancy
    BFP ♡ Sept 2018 - CP @ 5 weeks
    BFP ♡ Nov 2018 - Baby R due Jul 2019


  • @foodislove Full moon is July 16th, so maybe that'll help! 
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  • Thanks for your feedback @mamanbebe!  I found out a vbac isn’t off the table yet so that’s good.  They’ll give me a better idea later on. They’ll probably have me schedule a csection at 40-41 wks.
    mamanbebeCbeanz
  • Yay, my placenta has moved up! I also got word that I am good to try for a vbac. I was worried since I had gotten some conflicting answers and because my pregnancies were 1 year apart, but looks like I'm good to go! If I end up needing a c-section, at least I know what to expect this time but I'm happy that I at least get to try for a vbac. 
    mamanbebeCbeanz
  • @mrsjqg1024 Congrats on the good news!!
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  • They say I'm a good candidate for a VBAC! My first was a vacuum delivery after 5 1/2 hours of pushing. My second was an emergency cs because of her position and nothing we tried was working. Both circumstances were sort of unique and I always progress really well, however because I needed help with both deliveries there's always a possibility that I won't be able to go natural.  I think what's most important to me at this point is that I really want to hold my baby on my chest immediately after delivery. I never got the chance to do that! So if I would need a cs, I'm going to talk to them about that! I've heard of a gentle cs, but not sure if my hospital does them. I'm just trying not to get my hopes up too high and be realistic!
    Cbeanz
  • @kingdommom I think generally the baby-friendly hospitals do the gentle type cs. 

    https://www.babyfriendlyusa.org/for-parents/find-a-baby-friendly-facility/ 

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  • I hope it’s okay that I bring this back up. I was at the dr and they said they would not stop me from attempting a vbac even if they thought my chance of success was low. One of my concerns with a vbac is ending up w a csection after a failed TOL as I have heard planned csection recoveries are much easier.  For those of you set on a vbac, what made you decide the risk of another csection after laboring was worth trying for a vbac?
  • @Cbeanz ; I think you are my hero!! I haven't often heard stories of successful VBACs with pitocin and without epidural pain meds! 

    I am really hoping for a VBAC this time and have been told that I am a candidate. I had my daughter at 36 weeks after my water broke and my labor started immediately after. I labored for about 9 hours before they checked me and told me she was breech (her foot was through my cervix) and they did an emergency cs. 

    Looking for all the tips I can get. For those with one or more VBACs under your belt, anything you did that you think attributed to a positive experience?
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  • My repeat c-sec is scheduled in case kiddo doesn't come on their own by the 18th, given the size of M last time around. I'm praying labor starts on its own early, baby is the right direction and I progress without assistance. I wish there was something *I* could do but I feel like it's just up to fate at this point. :(
    BFP ♡ Jan 2016 - M born Oct 2016
    PPD for 1yr+ post-pregnancy
    BFP ♡ Sept 2018 - CP @ 5 weeks
    BFP ♡ Nov 2018 - Baby R due Jul 2019


    Cbeanz
  • CbeanzCbeanz
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    @leendenny ; You're sweet!  I had two pitocin births without epidural.  It is 100% possible even though I will say the pain was more intense than my non-pitocin labor (which ended in CS for footling breech).

    One thing that REALLY helped was to have control over the dosing. Not all nurses allow this, so I am sure to ask for a nurse who does. Once contractions start becoming very regular I have demanded they dial back the dosing rate or turn it off completely. When your body takes over you don't need a high pitocin dose to keep labor progressing - it just adds unnecessary pain.  I am so hopeful that I don't need pitocin again this time. I would love to have one truly natural delivery without a fucking IV, pardon the language.
    leendenny
  • @cbeanz Okay, so, I'm really surprised they let you have pitocin. My OBGYN made it clear I wasn't allowed pitocin this time around because of the higher likelihood that the scar could potentially rupture from the more intense contractions. Did your doctor offer up this option up front? I'm wondering if I mention pitocen to start and to dial back, whether or not this would be an option for me.

    My first c-sec was primarily because M's heartrate was dropping rapidly, so my pitocen dose never really got a chance to up above a 1-3 (really). I only ever dilated to 3cm, 75% effaced with the cytotec to start the induction. They would have let me go into the next day if not for the dropping heartrate.
    BFP ♡ Jan 2016 - M born Oct 2016
    PPD for 1yr+ post-pregnancy
    BFP ♡ Sept 2018 - CP @ 5 weeks
    BFP ♡ Nov 2018 - Baby R due Jul 2019


  • CbeanzCbeanz
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    edited March 1
    @foodislove There is a link between Cytotec and uterine rupture.  There is less of a concern with pitocin although I know that my OB wanted to use as little pitocin as possible.  Because my water broke before labor started and I was Strep B +, and I was already 5cm dilated, pitocin was the fastest and least invasive way of having the baby born before the clock ran out on my water breaking.

    Here is a good document about induction and VBAC:

    https://www.aafp.org/dam/AAFP/documents/patient_care/clinical_recommendations/AAFP PVBAC guideline.pdf

    Check out Recommendation #5 on Page 8.

    "There does not appear to be an increased risk of uterine rupture associated with oxytocin augmentation of labor." (Reference 17)
  • @cbeanz Thank you so much for sharing that!
    BFP ♡ Jan 2016 - M born Oct 2016
    PPD for 1yr+ post-pregnancy
    BFP ♡ Sept 2018 - CP @ 5 weeks
    BFP ♡ Nov 2018 - Baby R due Jul 2019


    Cbeanz
  • @mamanbebe Sorry this is such a late response, but thank you! My hospital is on that list!! I will definitely be checking into that option.
  • onaedonaed
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    I had a successful VBAC with my second. 

    At first my doctor wasn’t sold that I was a good candidate (first pregnancy didn’t advance, he was largish, and sons heart rate started and I ended up with an emergency c section). When I read the VBAC waiver I almost psyched myself out...however ultimately I decided to go for the  VBAC anyway for a few reasons 1) I had a toddler at home that I knew would also want my attention and to be picked up so a vaginal recovery would be much easier 2) I had a crappy recovery from my first c-section at the hospital, and wanted my first moments with the second to be more positive 3) I knew we’d want more kids after #2, and each repeat c-section can also add complications, so I was aiming to reduce the number of times we reopened that incision 4) a part of me just wanted to at least try

    Ultimately my doctor and I scheduled a c-section, but agreed to go for VBAC if he came early/ on time. Luckily he came the day of my scheduled csection, and it all worked out. 


    I labeled 12 hours, which included a few rounds of pitocin (you can only have a smaller dosage of pitocin because of risk of rupture), before taking the epidural. 5 hours later he was in my arms, I was smiling, laughing, and eating normal food. When I went home 2 days later I was already off pain meds. This was just a much more positive experience than my first time. Hoping for another vbAc with this one!

    Cbeanzmama_bear19
  • My new MFM doctor is supportive of a VBAC even with the twins. He said as long as babies and Instay healthy and Baby A is head down he doesn’t see any reason I can’t try. He said the twins might even be a little easier on me since they will be significantly smaller than my son. Like some of you already mentioned he would like to see me go into labor on my own and does not like to induce VBACs with medication. He said we would try a sweep or things like that first if need be.
    mamanbebeCbeanz
  • mizzmegmizzmeg
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    Good luck mommas on your VBAC! Remember your rights and don’t let anyone push you around. I had to find a doctor for my VBAC and it was amazing. DD1 was a c/s for failure to progress (bs if you ask me) and I was told my hips were too small. Jokes on them, DD2 was a lb larger and 23” long, beating out her sister by almost 4 inches. She was an induced VBAC. 4 day induction before she finally arrived! 

    For this pregnancy, I’m stuck. I have an option to have a C/S or a VBAC. I only want the c/s so they can do a tubal litigation at the same time. Otherwise I want my natural birth. 


    Cbeanz
  • @mizzmeg If you have the tubal separately, it's only a laparoscopic surgery through your belly button with much easier recovery. Does that impact your decision at all? 
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  • Is anyone second guessing their decision for a vbac? I had to sign a form listing all benefits and risks for a vbac and I’m not sure about my decision anymore. I keep thinking that if the baby dies or is permanently impaired bc of uterine rupture, I don’t know how I’d cope with that.  
  • @mama_bear19 I'm sorry you're feeling nervous, but the risk of uterine rupture is incredibly slim.. like less than 1%. Vbacs used to be normal and encouraged but some women had babies very close together, which led to uterine rupture in some cases, so insurance companies started to push back instead of helping to develop safer protocols.

    Usually around 34-36 weeks they do an ultrasound to check the scar integrity and placement to assess the risk of rupture during labor. How long ago was your previous C? 
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  • @mamanbebe I know the risk of uterine rupture is low, but it’s still hard to get those complications out of my mind. My csection was 3.5 years ago.  
    My drs are supportive of a vbac.  They are not recommending one way or the other and letting me decide.  On one hand I feel like I should still try bc the chances are so low. On the other hand I’m tempted to just let fear take over and schedule a rcs at 39 weeks.  I know there are risks with a rcs, but they seem less severe for the baby.
  • @mama_bear19 the choice is truly yours but I think that given the amount of time, if your ultrasound shows that the scar looks good I would think you are an ideal candidate with the spacing. It’s been 5 years since mine and I’m feeling really confident in the safety of a vbac, I just hope by body goes into labor naturally since it was far from ready to last time. I support you no matter what though <3 
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  • Thank you @mamanbebe! TB won’t let me love anything!
    mamanbebe
  • CbeanzCbeanz
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    edited April 23
    If you look into the research, almost all cases of (rare) uterine rupture are also associated with illicit drug use (cocaine). In fact uterine rupture is a risk for women who abuse cocaine whether they've had a prior C-section or not. The corrected risk for women attempting VBAC who do not use cocaine is much lower than the oft quoted 1%. I'm not sure if that brings you any comfort, but I think you're a good candidate.

    Edited to tag: @mama_bear19
  • hakelehakele
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    @mama_bear19 Guess You better lay off the cocaine! 🤣 
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