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VBAC
ILoveRunning
member
Due dates and VBAC
ILoveRunning
member
in VBAC
One thing I have noticed in many posts on this board is that RCS are often schedule on (or shortly after) the due date, even if a mother wants to VBAC. Is there a reason for this that is unique to VBAC? Is there a reason a VBACing mom can't wait for 41 or 42 weeks? I understand why a RCS would be scheduled over an induction, but can't understand why the default is RCS at 40 weeks rather then later.
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Re: Due dates and VBAC
A lot of OBs (mistakenly) feel that a VBAC has a higher probability of success if the baby is smaller. Hence, they want to avoid the situation where the mother will fail to VBAC a big baby at 42 weeks and then need a c-section anyway. The risks of a rcs are greater if the cs follows a trial of labor, so the OB would prefer to just go straight to the cs when the baby measures big.
There is a study, however, that disproves the idea that there is a correlation between baby size and probability of successful VBAC. A lot of women have birthed very large babies vaginally ... VBACs included.
Because OBs, like most people, believe in CYA above all else.
I had a vbac at 41wk2d. So it does happen. My OB would have been happy to do a RCS on my due date, but he didn't push me into it. I was on the schedule for a RCS at 41wk3d. He might have let another woman go to 42wk, but I had GD as well so that was his outer limit.
I think there are two factors here, which pps already mentioned: CYA and simple misinformation. A lot of doctors don't keep up on all the VBAC literature and there is a lot of misinformation about there about what is safe or unsafe for VBAC. A lot of doctors place restrictions on VBAC that are unnecessary. VBACs gone wrong also put the OB at a risk for a lawsuit, especially because of the general perception that VBAC is more dangerous than RCS. I also think some doctors think that a VBAC mom's body is less likely to work right and if you haven't gone into labor by 40 weeks it's not going to happen so you should just do the RCS (which isn't true).
My OB was fine with me going to 42 weeks if necessary with my VBAC.
I can understand why an OB might put a limit on someone if they have GD, and can also understand why OBs have a general inclination towards induction at 40 weeks (although I don't necessarily agree). It just struck me as odd that having a VBAC in and of itself, would make it necessary to book a RCS for 40 weeks if a woman hasn't gone into labor on her own. It really does seem like a bait and switch.
Chavay, I don't know much about your situation, or whether there is a medical reason for them wanting you to go two weeks early, but I would definitely urge you to do some research. Ask them why they want to schedule that early. Even if you ended up with a RCS, those two weeks can be very important for a fetuses development. Good luck!
Nope, no medical reason....even my OB said that there was nothing except "the system" dictating this. Our state is one if not the most difficult states to secure a VBAC in and I believe was listed recently as being the highest for c-section rates over all in the country. We're even banned legally from birthing centers...so my options are to have to fight tooth and nail (and even be turned away) to attempt a VBAC or to give homebirth. Other cities in our state have some docs with good reps which will still allow an attempt...in my rather large city there is only one doc with a consistant rep of not saying "sure" upfront but then pushing c-sections later....and she's not available at this time. Argh.
This is not the struggle I even knew I was going to have, and it certainly has taken over my daily thoughts with pregnancy. I've been procrastinating because I keep hitting red tape trying to find a way to do this without having to travel hours away around the time of my due-date. I hit a sorta mind-freeze scare.
I'm trying to decide how to fight this for myself (i'm so introverted by nature, it's not funny...I don't want to fight a cause) but am considering that I might be doing my own daughter (who is now in her early 20s) a favor by figuring out a game plan that could open doors for others in my situation. It makes me very uncomfortable and scared...I have no clue what to do first.
I'm so sorry you are having to go through this. I can't imagine what it must be like to have to go through so much red tape. I read your other post and will try to respond tonight (I'm at work right now). In the mean time I would definitely encourage you to scope out your ICAN network some more (sounds like you have).
Yeah, all the dumb reasons everyone else already said.
I'm really impressed that my practice will let me wait to schedule a RCS until 42 weeks. And even then, I don't HAVE TO schedule it (meaning, I can wait until I get to 42 weeks to do that, I don't need to have it in the books).
Gaah it pisses me off that you are being put in this situation.
There is more and more evidence coming out that babies shouldn't be electively delivered before 39 weeks. Babies born electively at 37 or 38 weeks have higher risks of respiratory distress, NICU admission and even death. So if they are pushing you to have a c/s at 38 weeks without a medical reason, I'd definitely consider saying no.
I hope you can work things out and have a VBAC. Our medical system makes me so angry sometimes.
Bingo!
The general attitude seems to be if you've had a c/s, you just weren't build for birthing babies in the first place (eye roll), and they might as well get the RCS over with.
It is such bs that you're being forced to deal with this ridiculous stress during your pregnancy. Ditto Iris as usual, especially about the added risks of rcs before 39 weeks (as the mom of a late term preemie that had breathing issues at birth that really gets me) and an extra "wtf is wrong with this system!!!??" for good measure.
Good luck to you. If you need moral support we're here for ya!
eta: As far as what to do first - I would try to get in contact with someone from ICAN. Hopefully they've dealt with situations like this before and can give you some tips.