"rules" for a VBAC

Ladydianna

I've been seeing two different OB's for this pregnancy.  One is all about me trying for a VBAC no matter what.  The other (my regular gyn and the dr. who delivered DD.)  tells me at this point I am an excellant candidate for a VBAC but there are certain "goals" (I say rules) she would like me to achive in order to be successful.  She doesn't want me gaining more than 30 lbs, b/c I started w/ an excess of belly fat.  She wants me to have two more u/s one at 32 wks and one at 38 to make sure my kidneys/lo kidneys aren't inflamed again. She also wants me to schedule a csec for 41 1/2 weeks b/c she won't induce me. 

Is this common?  I was all about doing an all natural birth w/ DD so when I wasn't able to I was extremely disapointed.

And DH doesn't want me to try for a VBAC at all.  Is anyone else having this problem?

ShansBride

I think a lot of OBs put restrictions on VBACing women.  I don't know anything about kidney issues, but I can say that when I got pregnant with DD, H didn't want me to VBAC.  He was totally against it and wanted me to sign up for another c/s.  I was totally against another c/s.  It was hard for us to work through that, but I finally told him that I would have another c/s if he layed on the table next to me and let them slice him open from hip to hip too.  He said that would be silly and pointless and I said I know.  I think that sort of made him realize that a c/s wasn't necessary.

It is really hard when your spouse isn't on the same page as you are.  I think for us, taking Bradley classes helped, and it also helped when I told him the reasons I wanted to VBAC (better for baby, better for me, easier to care for older child, I could cook dinner, I could move, shorter hospital stay, etc.)

I also want to add that I think it is especially important to have others support you when your H doesn't understand why you want a VBAC.  Have you looked into a local ICAN meeting?  Maybe even taking your H to one would help.

wendylaine

I am not sure about the kidney problems you may have, but I do know that ulrasound that late in the game give your doctor a very good opportunity to say things about the baby's size or low supply and try to talk you into a c-section. Just be aware of what they are doing. If at all possible try to stick with the doctor who is more supprtive. 41 1/2 weeks is not horrible but I would push for at least 42 weeks. You can always adress going further when the time comes and just delay it.

nosoup4u

wendylaine:

I am not sure about the kidney problems you may have, but I do know that ulrasound that late in the game give your doctor a very good opportunity to say things about the baby's size or low supply and try to talk you into a c-section. Just be aware of what they are doing. If at all possible try to stick with the doctor who is more supprtive. 41 1/2 weeks is not horrible but I would push for at least 42 weeks. You can always adress going further when the time comes and just delay it.

Agreed. it sounds like your doctor is really trying to set you up for a repeat c-section, frankly. Do the doctors practice together, or can you switch to only seeing the more supportive one? I mainly saw one MW in a large group, but I had an appointment with another one once who claimed I'd have to have a repeat section if I didn't go into labor by 41 weeks - but my usual MW didn't suggest one when I went over 41 weeks, so I think it really depends on the provider.

As for your DH, I would really try to get him to understand the importance of supporting you for a VBAC, bc if you end up having to refuse a section or something with your doctor, you'll need all the support you can get. I also second checking out ICAN. Good luck!

papagena

wendylaine:

I am not sure about the kidney problems you may have, but I do know that ulrasound that late in the game give your doctor a very good opportunity to say things about the baby's size or low supply and try to talk you into a c-section. Just be aware of what they are doing. If at all possible try to stick with the doctor who is more supprtive. 41 1/2 weeks is not horrible but I would push for at least 42 weeks. You can always adress going further when the time comes and just delay it.

This, however if you did have issues with your last pg, there may be a good medical reason for the u/s.  Mine wanted to do an u/s later in the game just to look at baby's positioning, which, IMO, is most definitely excessive.  No matter what position he/she is in, he/she is not in medical danger from it in utero (that I'm aware - and DS was never in any distress throughout any part of my pg or induction), and it can change at any time, so it doesn't really give a good picture whether or not I can VBAC.   Sorry - side rant.  

My OB wouldn't induce, which is fairly common. My FP doctor will use pitocin if I want. Everyone who I've talked to wants me to either have a repeat c/s or induction shortly after 41 weeks - not uncommon, although I plan on holding out until 42 if it comes to that.

Ladydianna

When I was 32 weeks I was in extreme pain on my right side.  When I went in for an u/s they found out that my right kidney was so dialated it had almost stopped working.  It was b/c dd was pressing on my ureter (sp?) and causing them to become backed up. I was in the hospital for 3 days while they pumped me full of fluids and anti-biotics.  By 37 weeks my left kidney was dialated as well and dd's were starting to back up, so they offered me an induction or c-sec in two days.  At that point I was already 3 cm's dialated but after speaking with DH we decided to do the section, b/c we were told there was a risk of kidney failure for me or the baby.  I decided that I would rather just have a csec than go through being induced, just to end up with one anyway.

L'Etincelle

I thought the restrictions my OBs were putting on "allowing" me to attempt a "trial of labor" were ridiculous. That I not go past 40 weeks, that the baby not be "estimated" at over 7 lbs 8 oz... Plus they were requiring continuous fetal monitoring at the hospital which increases the likelihood of the subjective determination of "fetal distress" 3-fold. So, at the last minute, I switched to wonderful, supportive midwives who knew I would acheive a VBAC, and I had my 9 lbs 8 oz boy at home.

If a VBAC is important to you, follow your instincts and switch to an OB or midwife who fully supports you (no matter how late in your pregnancy you are - I switched at 34 weeks or so)!!! You can do it!

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L'Etincelle:

I thought the restrictions my OBs were putting on "allowing" me to attempt a "trial of labor" were ridiculous. That I not go past 40 weeks, that the baby not be "estimated" at over 7 lbs 8 oz... Plus they were requiring continuous fetal monitoring at the hospital which increases the likelihood of the subjective determination of "fetal distress" 3-fold. So, at the last minute, I switched to wonderful, supportive midwives who knew I would acheive a VBAC, and I had my 9 lbs 8 oz boy at home.

If a VBAC is important to you, follow your instincts and switch to an OB or midwife who fully supports you (no matter how late in your pregnancy you are - I switched at 34 weeks or so)!!! You can do it!

This exactly! I switched at 28 weeks and it was the best decision I ever made.

As for your DH.... mine was not on board with a VBAC either but I showed him all the research I did, told him how low the risks were for uterine rupture (he said that was his reasoning for not wanting me to VBAC). He was also able to talk to my OB with me and I think that helped ease his fears. After I delivered DD#2, he told me he was glad we got to experience it.