Midwives (LCM) can't do VBAC after 40 weeks, advice?

HikerBride07

I just found out yesterday that the Loudoun County Midwives are no longer able to VBAC after 40 weeks because their backup doctors have set a policy that they will not assist after that.  So now my options are 1) be forced to have a c-section at 40 weeks and stay with the midwives for my prenatal care, or 2) switch to another practice. 

I am so torn about what to do.  I do not want to switch practices but it is likely that this baby will not come before 40 weeks (I was induced w/DD 10 days past her due date which was accurate based on my IUI date).  I am so irritated that they would change their policy especially after the NIH just released their updated findings on the safety of a VBAC trial of labor.

Any advice or experience with other practices in Loudoun who will wait until at least 41 weeks?

DCtoLowcountry

Could you explain your concerns to the midwives and get them to "adjust" your due date accordingly? My midwives were always comfortable using the latest possible due date to allow for more flexibility. GL.

Baby4OT

I don't know of anyone, but I've never looked into anything VBAC related. I just wanted to say good luck! It's a little sneaky-sounding, but pp's suggestion might work. I forget - did you have an IUI again (do you know exactly when baby was conceived?)?

HikerBride07

  They've already "added" 3 days by using a different method of dating.  We do know the conception date (no IUI this time) so EDD is accurate.  I am really upset that I am probably not going to have any control or choice over my birth experience again.  I am crossing my fingers that this LO decides to come on it's own and "on time".  I just have a feeling it will be past the EDD again.  I don't think any of the women in my family have delivered early or on time.   

2vthokies

I took my birthing class at LCM a couple years ago when I was pg with DD#1 even though I was going to Greenbriar OB/GYN.  I didn't go to LCM because they didn't take my insurance.  I remember discussing VBACs in the class and, if I remember correctly, they didn't do them period.  I would have switched to them this time around, but I ended up with a section after my first pregnancy and figured they wouldn't take me.

I stuck with Greenbriar and am currently at 41 weeks waiting for labor to start.  The docs initially told me that at 41 weeks I would have to schedule a section, but since my EDD was 9/10 (a Friday), Dr. Gopal agreed to set my section date to 9/20.  As I was leaving my appointment on Wednesday, Dr. Gopal was checking a patient out and overheard me discussing my section date with the receptionist.  She mentioned that if I wanted to stall longer, I should call her.  I have a biophysical ultrasound today to check things out and plan to call this afternoon to see if I can squeeze out another couple days - maybe get to Wednesday.  Dr. Weirtheim is not the biggest proponent of VBACs (but his reasoning for me was based on my previous labor - I really don't know if that's his global position).  Drs. Pickford and Gopal have been on board from the beginning - especially Dr. Gopal who had both her kids med-free.

I empathize with the position you are in - it's tough wanting a VBAC and not getting the support you want.  I'm surprised that LCM doesn't use more "progressive" OBs.  I would have loved to go to LCM/use midwives, but I'm happy that my OBs are supportive of VBACs.

ETA: I didn't answer you with any advice - I guess I would decide if staying with LCM is more important than having a VBAC.  I'm sure there are other midwives in the area that will do VBACs after 40 weeks, just as there are OBs that will.  Do some research/make some phone calls.  You definitely have plenty of time.  If Greenbriar had told me they didn't do VBACs I would have looked for another care provider.

vtmezzo

I'm positive LCM doesn't do VBACs...I wanted to switch to them for this pregnancy, but then I called and found out they wouldn't do VBACs unless you were their patient the first go round and got approval from the doc who did your c-section. I'm currently with Loudoun Physicians for Women and am very pleased so far - as of right now I'm clear for a VBAC with them. Good luck!! I was induced 10 days early with DS and am planning on staying at my house until the last possible second this time in the hopes that this one will come on his/her own.

HikerBride07

vtmezzo:

I'm positive LCM doesn't do VBACs...I wanted to switch to them for this pregnancy, but then I called and found out they wouldn't do VBACs unless you were their patient the first go round and got approval from the doc who did your c-section.

I was with LCM last time, so up until now, our plan was for me to have up until 42 weeks to VBAC, the change in policy was not their choice it was their backup docs.  They will still support me on a VBAC this time but only up to 40 weeks.

Does Loudoun Physicians for Women have a cutoff for VBAC?  Will they let you go up to 42 weeks?  

2vthokies

After my biophysical u/s today I called Greenbriar to see if they would be willing to move the c/s date a few more days.  They agreed to move it to Friday (my official 42 w date), but I ended up scheduling it for Thursday morning because the two Friday morning c/s slots are already booked.  I may be able to do it Friday afternoon after 3 pm, but I'm not sure I'll be able to fast that long.  I live in Sterling and make the trek to Greenbriar, but they only deliver at Fair Oaks and Loudoun does have the Birthing Inn which is really nice.  I don't know if their policy would change based on being a new patient.  Even if I ultimately end up with a CBAC, I feel like I have been a part of the decision making process and I am really happy that they have been willing to work with me.  Good luck with your decision!

rnin02

I think Dr Stokes with Women's Healthcare Associates will do a later vbac, you could check with him. He's one of the greatest OBs at the birthing inn, imo. https://www.whcal.com/home 

I really don't have much advice to give you, that's a hard situation. I was rejected by LCM (I still hold a grudge, lol;) because Paula was afraid I would end up getting transferred out later with blood pressure issues so I went to Women's Healthcare Associates and loved everyone I saw, including the office staff. I will say the backup OBs for LCM are all really good doctors, and pretty personable, so if you decide to stick with LCM and end with a c/s at least there won't be some yucky OB doing it. It does suck they changed their policy. 

femmeftle9

OP, my OBGYN is in Fairfax and told me that while I would be a candidate for a VBAC, that they would not let me go past 40 weeks.

Now seeing your post, I'm wondering if there was some sort of consensus in the medical community about no VBACs after 40 weeks.