Are VBACS always unmedicated??

smiling76

I'm curious about this since I read that many don't use any intervention (in order to insure success).  I was never a "go natural" kind of girl even when planning my birth plan for DS---I figured I'd go as far as possible and then get the epi if I felt I needed it.  Just curious how many VBACs get epis vs totally natural.

 

Jb&Jb

This is something I'm struggling with right now.  After most of the reading I've been doing, I'm getting the impression that the Epidural does several things, such as immobilize you which can slow down labor because you're in a position that isn't ideal to help work the baby down as well as makes it WAY easier for them to start with interventions that can snowball into more and more interventions that hinder labor as well. 

I feel like I'm getting a late start on the game in my decision to try to go natural because I haven't taken any classes or read any books specific to methods of coping with pain.  I'm worried that if I don't learn some coping mechanisms I will cave into the epidural.  My only reason for wanting to try go natural is to improve my odds of avoiding a repeat cesarean. 

I'm sure there have been plenty successful VBACs with epidural, but I think people get so focused on trying to give themselves the best chance at it that they pull out all of the stops.

papagena

I don't have statistics, but not all VBACs are natural.  I've heard VBAC stories with epis before.  I did a poll the other day, and there are many gals here who aren't planning on going w/o pain meds for their VBACs.  I do think it is important to know the risks and definitely to wait until you're well into labor before getting it (or using it if you think it will help you relax if you're having a problem progressing).

browneyedgrl4282

I just watched Ricki lake's The business of being born! It said in there if you use PIT you have a greater chance of uterine rupture! Not sure how true that is but the movies in very interesting!

browneyedgrl4282

flgirl79:

browneyedgrl4282:

I just watched Ricki lake's The business of being born! It said in there if you use PIT you have a greater chance of uterine rupture! Not sure how true that is but the movies in very interesting!

My doctor told me that I am not to have pitocin for this reason.

I actually asked my OB the other day (he is retiring so i can no longer use him after monday) and he said that in vbac you should do everything on your body's terms and not allow an intervention! he was talking about how back in his earlier years of practicing they didn't see anything wrong with doing VBACS and when they starting to use PIT more they had more problems!

papagena

browneyedgrl4282:

I just watched Ricki lake's The business of being born! It said in there if you use PIT you have a greater chance of uterine rupture! Not sure how true that is but the movies in very interesting!

It is true.  The last time I read something on it, it said it ups the risk of rupture by about 10%.  I've also read that they started realizing it was a big problem and they had more issues with it when they used stronger concentrations of pitocin.  My OB wouldn't use any kind of pit or prostaglandin  (sp?) cervical ripener for those reasons (they also up your chances).  My current doc will use pit, but no prostaglandins.  I'm not sure if I'd go for the pit if offered or not at this point. 

ETA:  I meant to add/imply that lower doses of pit seem to reduce the risk compared to back when they routinely used the higher dosages on VBAC patients/in general. 

disbride061103

flgirl79:

browneyedgrl4282:

I just watched Ricki lake's The business of being born! It said in there if you use PIT you have a greater chance of uterine rupture! Not sure how true that is but the movies in very interesting!

My doctor told me that I am not to have pitocin for this reason.

PIT can slightly increase the chance of uterine rupture, but when used cautiously and in minimal/moderate doses, it can be used safely. I was induced using s foley cat followed by PIT. My doc was comfortable using a low dose of PIT. They would not use the same amount of PIT as they would use on a non-VBAC patient, but it was used.

spark&echo

My husband's cousin has had three VBACs with epidurals.  In my case, I thought it was best to go natural because all the interventions are what led to my having a c/s in the first place.

Jen&Len

You're allowed an epidural.  I did wait longer this time to get it so that it wouldn't impede labor...then it didn't work until I was 9cm, which was not my plan at all!  The plus side for an epidural is that IF something were to happen (e.g. rupture), they can numb you up with the epi rather than GA (I guess depending on how bad the rupture is).

cutiegirl147

I had a sucessful VBAC with an epidural.  It was a little rocky at first though and I almost ended up with another c/s.  I probably would've waited a little longer if I had know exactly how much it would slow my labor down.  For some reason the nurse was under the impression that I'd be getting pitocen in the morning when my doc arrived, even though she knew I was attempting a VBAC.  But when the doctor got there she said no pitocen (which she had already discussed with me, so I was confused when the nurse suggested it) and that it was likely that I'd be getting a c/s.  Luckily after she broke my water I went from 4 cm to 10 cm in less than an hour, after about 10 hours of no progress!  So it can be done with an epidural, but prepare yourself for the chance of it slowing you down and having a c/s as your only other option.  I hadn't discussed this with my doctor much and I was very upset when I thought I was getting another c/s after I'd been in labor for 10 hours and had a miserable night.  In the end though, I still would have done the epidural even if I'd known before how much it'd slow me down because I'm a wimp, I just wouldn't have been so upset when it came to c/s discussion.  At the time I felt like those 10 hours were a total waste and I was mad at the nurse for not having me wait longer, but had I been more prepared for the effects of the epidural I think I wouldn't have been so upset because I'd have known what to expect. 

userdeleted

I had a successful VBAC with an epidural. I did wait until I was 5 cm to get it because I wanted to make sure my labor was progressing well first.

Luv4Minnesota

I am reading "The VBAC Companion" and it states that waiting until you atr at least 5cm does not increase the risk for c/s.  

I haven't decided which way I will go yet.  I still feel like even though my epi didn't stall my labor it did prevent me from feeling contractions/the urge to push and without it I could have pushed more effectively and possibly avoided my c/s.

Although, with that said, my OB told me whan I brought that up as a concern that it was his position and there was nothing I could have done differently.

oh-and that book also has stories of successful vbacs w/epis so yes it is possible.

OHbrideinTN

I want to go natural, but my doc said they like for you to have an epi so that if you do need an emergency c/s then you don't have to go under general anesthesia.  I'm still hoping to avoid it.  As some of the previous posters mentioned, I think the epi the first time may have contributed to my eventual c/s. 

jen5-03

I felt like having an epi stalled my first labor and led to my c/s. So I was trying to go unmedicated for my VBAC.

Well, it turned out that my labor "stalled" without having an epi, so I guess it wasn't fair to blame the epi for my problems the 1st time!

The good news is that after my progress stalled, I got the epi but continued to labor and eventually had a successful VBAC. Apparently I just have really long slow labors - WAY off the normal labor charts. I am fortunate that my 2nd OB was very very patient. More patient than I was because I totally would have gone with a c/s at several points and he just kept saying I was doing fine.

hollywoodgirl311

My VBAC was unmedicated by choice after speaking to my OB's and doing research.  For me, I have a very strong reaction to any drugs that are put in my system and with my epidural for DS I couldn't move at all and felt horrible. My body got to 6cm before DS was in distress and we had the c/s.  Could I have made it to a 10 if he hadn't had the cord around him?  Maybe the docs said, maybe not.  I blamed myself for a very long time, wondering if my epi was what caused everything to go downhill. They only told me that the least amount of intervention possible, to both bring on labor as well as during, the better my odds for a VBAC.

Choosing natural for DD was a goal for me to succeed in after not getting through it with DS as well as my way of saying I gave my VBAC every possible chance, so if I did end up with another c/s I would know it wasn't from an epi like I feared with DS, but because it was the right thing to do. I still had back labor with DD but going into it with more preparation on techniques to overcome the pain made all the difference. While I still wonder if my own choice to have the epi was the cause of the surgery, I don't hold the same guilt that I felt for so long and no longer wonder if my body is "defective", which was how I viewed it after DS.

hollywoodgirl311

OHbrideinTN:

I want to go natural, but my doc said they like for you to have an epi so that if you do need an emergency c/s then you don't have to go under general anesthesia.  I'm still hoping to avoid it.  As some of the previous posters mentioned, I think the epi the first time may have contributed to my eventual c/s. 

 

My docs didn't mention having the epi as a back up plan but I was required to have an IV with a saline block as my "just in case" where they would quickly be able to give me GA if the situation arose. Even though GA was a scary thought, the idea of not being able to walk and move around during labor was worse for me.  During my whole labor, I laid down only 3 times (all of which were to check my cervix) and then for the 30 mins of pushing.  When I am in pain or stressed I have to move constantly lol