VBAC Sabotage ? Is Your Doctor REALLY That VBAC Friendly?

Jb&Jb

https://bellybelly.com.au/birth/vbac-sabotage-is-your-doctor-really-vbac-friendly

lkf041

I wish I would have read this or been more educated on vbacs when I was pregnant with #2!  I had a RCS from a "vbac friendly" doc who said I can't go past my due date.  

myantonia

Great article! 

My doc has layed out a few of those rules.... which I'm trying to negotiate with her.  Hopefully I can navigate those while still using this group of doctors (i.e. the only ones covered by my insurance!) 

kcvasquez

Thank you for posting this, I have been wondering if my "VBAC friendly" doctor was really that friendly about it...and after reading that, I know that she is not. Sadly she is "the most friendly" of all OB's in this area (that is within 72 miles of where I live) and it's either her or nobody. Our hospital does not have a high success rate of VBACs and they have very few women who do a TOLAC because the doctors tend to scare them out of it. But reading information like this from other sources makes me feel better because I have more knowledge behind my decision. 

Geekchick921

Meh.  This article makes some good points, but some of these items are hospital policies that doctors (and hospital-based midwifes) have to abide, like how long VBAC patients can go overdue and being on continuous fetal monitoring.  Most of the hospitals around here have put serious restrictions on VBACs, if they allow them at all, so it may be all you can get and it may be out of your healthcare provider's hands.

On that note, CFM sucks (I had to be on it with DD because I was being induced and I hate that I have to be on it again) but prolonged deceleration of fetal heart rate is, by far, the most reliable symptom of a uterine rupture, and I wouldn't blame the most VBAC-friendly doctor or midwife in the world for wanting their VBAC patients on CFM in hopes of detecting a rupture promptly.  With DD, the nurses acted annoyed when they had to adjust my monitor if I so much as rolled over.  With my CNM, she gets all of her VBAC patients out of bed to sit on a birthing ball or just mull around their room as far as the cables will allow.

FTR, I totally agree with 3, 4, 6, 7, 8 (though this can easily be a hospital policy thing, too.  I have to have a hep lock), and 9. 

Things I would consider to be much more appropriate items for this list would be, firstly, a change to #1, and it's a doctor that won't let a VBAC patient go overdue or even get TO their due date.  Another thing would be doctors that claim to be VBAC friendly but start planting seeds of doubt regarding your ability to VBAC even at first and second trimester appointments.  Also along those lines, doctors that start pushing for C-section because you're not starting to dilate and efface as soon as you're full-term, as if it means anything about when you'll go into labor.  Personally, I have seen all these things mentioned on TB and other message boards and they all seem like the most underhanded kinds of baiting and switching their patients.

 And I'd personally rather have a doctor or midwife that would even TRY to induce me instead of jumping right to an RCS.  My CNM will induce me if I go to 41 weeks (hospital policy) and there are doctors at that same hospital that will do the same, but there are plenty of doctors that won't induce at all, even though the ACOG says quite clearly that inducing for a ToL is an option.

iris427

I disagree with #2.  There is evidence that a VBAC can be safely induced with certain methods.  In fact, when I hear of an OB or MW who is willing to consider induction under certain circumstances, then I think "wow that's someone who is really trying to help that mom have a VBAC, awesome!"

I think CFM with VBAC has some pros and cons.  I had intermittent monitoring with my VBAC but I don't think a doctor or midwife should be written off because they want their VBAC moms to have CFM.

I agree with most of the other points.