Is there anything your doctor "required" that you disagreed with regarding your VBAC?

jalaiaa

I'm not sure if this is the right question to ask but I'm just starting to formulate a birth plan etc. and wondered if there is anything that your doctor said you had to have/couldn't have etc. because it was a VBAC.

For example, I want to try for a natural delivery so I do not want an epidural, would prefer not to have an IV and do not want continuous monitoring. But I don't know if these are things "required" by docs if you're going to have a VBAC. I won't be going over any of this until my next visit with my doc, but want to be informed. 

Is there anything that your doctor said was required because you were having a VBAC? Did you decline interventions? If so, what? 

holly321

I go for my first appointment tomorrow, and I am going to ask what the "rules" are for me. 
The only one that I know that upsets me if that I can't have a version if the next baby is breech.  I also know I can't be induced, which I am fine with, since I was doing pretty good and was only 39 weeks.  I know the first isn't always an indication,  but if it is for me, I should have no issue going into labor.

preg_amy

I was required to have CFM, but I was okay with that because my hospital had telemetry monitors, so I could still move around and get in the tub.  If they didn't have the telemetry monitors, I would have had more of an issue with it.

I also was required to have a saline lock, which I also didn't mind.

I ended up needing some pitocin during my pushing stage to get my contractions a little closer together so I could push more effectively.  They don't usually allow that, but my MWs talked with the OBs and decided it would be okay.

Kristine Schilling

every Dr will have a slightly different set of rules. based on their experience and in some cases,the state regulations.

My Dr is o.k. with no induction medications. She is fine with no Epi unless it looks like my VBAC is going to become an RCS. And while she wants a shunt in, she doesnt mind a lack of IV started.

However.... She really really wants me on constant fetal monitoring because my last PG was a CS due to fetal distress. I want freedom of movement so that I can control my discomfort during labor and the hosp. doesnt have portable monitors. *sigh* we are still "discussing" this.

ChavayJakov

Honestly, some of what is "required" is "required" only in the sense that that particular doctor is only offering you A, B and C as a route/option.  Sometimes it is the hospital.  It doesn't mean that out there, somewhere, a woman is getting choices that you won't get simply because of their pick of doctor, hospital or state (or country...I'm speaking with an online acquaintance from another message board, a pediatrician, who said that in her country women are encouraged to VBAC and she can't understand why it is such a fight here in the states).

My original OB said the hospital put a ban on all VBACs because they wanted an anesthesiologist on the floor at all times, and his didn't have that (which sounded a bit weird for me).  Turns out, after joining another board which discussed this local hospital, that there was an OB there that was performing VBACs under certain conditions...and that my original OB's hands weren't as tied as he was letting on.  That hospital doesn't allow as much freedom as the hospital I eventually switched to.  The one I switched to allows intermiten (sp?) fetal monitoring, allows us to walk around, a heplock instead of an IV - which from my previous birthing experiences at the former hospital were not allowed.  You'll need to check not only with the doctor's philosophy but to ask if the hospital allows/disallows some of those things.

Of course, every L&D is slightly different, so while they can tell you that X won't lead to Y...that's only if a Z doesn't pop in there as well.  They can speak in generalities and in what they see is most common, or in what they are most confident in doing if X pops up, but they can't speak exhaustively because of the variants.  

I just had a very unnerving example of this...my practice has more than one OB and medwives on staff and a patient has to see everyone in the practice.  The practice is known to be the most pro-VBAC in our city.  Still, if you ask all of them the same question, you'll see some variants in their answers.  And sometimes those variants seem as if they are saying the opposite of what another might have said.  That's just because their emphasis is on a different part of the question, or what they've personally seen or comfort level is slightly different than the person before them.  I was sent into a crying jag two days ago during an appointment when I was told that if I couldn't or wouldn't agree to take Pitocin that I would be headed to a c-section.  I have been fighting against having a c-section for so long (and there is a rubrik that is against me in that although right now there is no medical reason for me to seek one) that I've become ultra-sensitive and feel that everything is herding me to c-section.  My husband, in speaking with me and another doc today in a different office for an ultra sound, suggested that I'm hearing things more strongly worded and not as conversation that is a small window of consideration not intended to be exhaustive.  This could be true, because it's difficult to have a VBAC here and I've been fighting so long before transferring to this new office...I might need some time to readjust to a lesser degree of "fight mode."  Ask questions, verify what you are hearing, study, ask questions again.  Ask the doctor what his requirements are - are there weight limits for the baby, is there a time limit they feel comfortable with most women (40 wks? 41?  two weeks over?) and then switch it to you specifically, asking them to consider you at this point, and if that changes the outcome at all.  Ask him about the hospital you are to deliver in, and when you take their tour, ask the same questions about will they/won't they allow certain things.  Then put together your birth plans with those things vital. 

MrsJordanalmond

i am required to have constant fetal monitoring.  if everything looks fine, i am hoping to convince folks at the hospital to give me 15 minutes per hour for walking around, etc. (my hospital doesn't have the fancy walking monitors).

my hospital will also not allow for induction ... if i'm in labor they will allow for augmenting with low dose of pitocin, but not induction out of nothing (they only use cytotec for cevical ripening which is totally contraindicated for VBAC, cervadil isn't an option???).  normally this wouldn't bother me since i would try to avoid being induced - BUT - i'm also 42 and my OB has a policy of not allowing AMA moms to go past 41 weeks.  so the prohibition of induction means a r/c/s if my baby doesn't cooperate and come on his own by 12/26 (yikes, 1.5 weeks away).

these policies bother me, a lot ... especially since they are not ACOG or AMA recommendations but based on convenience, fear of litigation and money.  

the only thing that has 'helped' is that i have know and questioned by OB practice about their policies since early pregnancy, so i have had some time to adjust to the things i can't change.  i've also hired a doula, and am doing acupuncture to try and ensure that i don't go past 41 weeks.  

nosoup4u

The only requirements were continuous monitoring and a hep/saline lock, which is pretty standard for any hospital VBAC. I negotiated past 41 weeks, but mainly because my due date was pretty fuzzy to begin with, and my MW was laid back and gave me the benefit of the doubt. I was never asked to have an epidural just in case, and my MW knew I was planning on a med-free labor and birth. 

cwifekmom

My OB didn't have many requirements, anything he suggested I could opt out of.  I was induced at 39 weeks due to high bp- with pitocin.  He left the induction up to me, I chose to go with it as I was on bedrest and growing very anxious and I have high anxiety anyway.  I did have to have continous monitoring due to the induction, which I was fine with.  I was able to walk around my room, unhook to go to the bathroom, labored on the ball most of the time, so there were no issues with it.  I had an IV because I was group B strep and I didn't mind it, but otherwise I would not have had to have one.  He lets patients go 42+, so I knew that would not be a concern.  I would just talk to your OB about the things you do not want to see what their policy is and how negotiable they are to see if it is the right practice for you.

kcvasquez

I don't know how it is in your state, but technically most states cannot force you to do anything, even have CFM. They can push it on you and make you feel bad but they cannot just walk over strap it on you and tell you that it's required for you to have birth. Women are allowed to say no to any and every procedure "required" it's hard when they're telling you that you have to have it in order to deliver there, but if you're in active labor legally they cannot turn you away. It would be the same if you go into an emergency room, they have a legal obligation to give you medical care. Just something to think about, it's always good to know that you have the option to say no to anything you don't feel will be helpful to your labor!

Aloe0l

Where I am, both the VBAC friendly doctors require internal fetal monitoring, which I'm not a fan of.  But, I know two women who recently went through it, and said it wasn't that bad.  And, they said it did limit mobility, but it didn't force them to be bedridden.  THey could unhook the device and go to use the bathroom, etc.  One gal said she would just go use the bathroom for a really long time until she got "caught," and then would hook back up.    But she could still use a labor ball, and move for the most part.