What do I need to ask at the next appt for VBAC candidacy?

lilbit923

I don't want to go to my next appt with partial information. I know my OB will spew off the 1% UR rate to me again. For my ultrasounds I have been asking if the scar appears to be in good condition from the last c-section and each time I'm told yes.

I've not been told anything about the placenta being in poor shape or in the wrong position. I've read some about placenta placement being near the previous c-section scar can be a problem so if you ladies could inform me of this...awesome.

My SIL (NICU nursery nurse) and I were talking about this after I had posted to you ladies the other day. She mentioned (we have the same OB) to tell our OB that I am aware of the risks of uterine rupture and what could happen but that I would like to try and VBAC. I would like to do this. I don't feel I was 'robbed' of my birth experience with my son's birth...there were too many complications with him to even consider a vaginal delivery.

With my daughter, I had a gut feeling about her. She felt smaller, wasn't as heavy in my womb and my body WAS responding favorably to labor. I was 100% effaced for a heavily scarred cervix from cancer where I was told effacing would never happen. I was so thrilled. I thought YES!! I can totally do this! I felt my epidural was given too early. When I was having contractions I was grunting and my nurse, I felt, jumped the gun and wrote my nonverbal cues were on a pain scale of 7-8 whereas I was telling them my pain was at a 3-4. I think I just needed more time.

I'm not trying to tell any nurse how to do her job but I know my body. I've had it for 35 years and I just met this nurse. If I am in pain I will tell you. If I am not in pain, I'll keep to myself. Once she mentioned my non-verbals were at a 7-8 then my room flooded with people. I felt the entire process of the epi since I wasn't in 'pain' enough for it not to matter. I felt with people making decisions for me is what 'robbed' my birth experience. I felt it was done too early since my water had not broken and I wanted to labor longer. I felt, after that point, that whatever I said didn't matter...people were going to do what they wanted. I just sobbed.

I've never been the type to tell someone their job but I feel really strongly about this. I would like to try and see if I can. If the baby isn't in position, my body doesn't respond favorably or we both go into distress then the game plan is c-section. I can accept that. I just didn't like having decisions made for me as though I had no choice.

Not sure if that makes sense. I never verbalized this with my OB since I didn't feel I could. Once I had Emma I immediately felt a sense of loss and wanted to be pregnant again. I don't mean this to sound like I am not grateful for the care I received. I am. I am also thankful Emma was born healthy.

Since VBAC has never been an option presented to me, I'd like to know what questions to ask in my u/s beyond placenta placement, scar condition, etc and be able to present these findings to my OB. I want to make certain she doesn't think I'm being obstinate with her. If we have the worst case scenario delivery again then by all means, get me to the OR.

 

ShansBride

I want to first say that I am sorry you were treated like that with your DD.  I think you are justified in feeling robbed there.

On the issue of VBA2C, your rupture rate is about 0.9% and of those .09% of ruptures, there is no data stating how severe the rupture was (so it could have been catastophic where mother and/or baby died, or it could have been superficial where they didn't even realize it unless the doctor stuck his hand inside the woman's uterus to feel--which I wouldn't recommend, or it could have been anything in between).

As far as the placement of the placenta, from what I have read, it is really only an issue if the placenta is over the scar.  But still, at 26 weeks, it could move so where it is not is not an absolute.

Honestly, though, I feel like if you have to talk your doc into a TOL, then she is probably not the doc for you.  I think when you are planning a VBAC (or really any birth) you need a provider who has similar views on birth to you.  I think you need someone who is going to support you.

I have 5 friends who have attempted a VBA2C and all 5 of them pushed their babies out.  I know it can be done, but I think if you want to do it, you need someone who beleives in you just as much (if not more) than you believe in yourself.

lilbit923

ShansBride:

I want to first say that I am sorry you were treated like that with your DD.  I think you are justified in feeling robbed there.

On the issue of VBA2C, your rupture rate is about 0.9% and of those .09% of ruptures, there is no data stating how severe the rupture was (so it could have been catastophic where mother and/or baby died, or it could have been superficial where they didn't even realize it unless the doctor stuck his hand inside the woman's uterus to feel--which I wouldn't recommend, or it could have been anything in between).

As far as the placement of the placenta, from what I have read, it is really only an issue if the placenta is over the scar.  But still, at 26 weeks, it could move so where it is not is not an absolute.

Honestly, though, I feel like if you have to talk your doc into a TOL, then she is probably not the doc for you.  I think when you are planning a VBAC (or really any birth) you need a provider who has similar views on birth to you.  I think you need someone who is going to support you.

I have 5 friends who have attempted a VBA2C and all 5 of them pushed their babies out.  I know it can be done, but I think if you want to do it, you need someone who beleives in you just as much (if not more) than you believe in yourself.

I think if I can stand to go through hours of lipo without the medicine taking effect to put me in twilight sedation then I'm capable of telling a nurse when something hurts or not. I'd hate to switch OB's this late in the game. She's all I've ever known for deliveries. I'm so tempted to labor at home if my body goes into labor again on its own.