Dilemma...what questions to ask? (long...sorry!)

Daisy41459

Hi ladies,

I've posted here a few times, but just to give you all some background, my son was born via c/s after a fast (9 hours), unmedicated labor and 3+ hours of pushing because he was in a posterior position.  He never entered the birth canal.  He was 7 lbs. 7 oz.  I sunk into a deep depression after his birth and still have emotional scarring to this day.

My OB knows how badly I want a VBAC (discussed it with her when DS was only 3 days old).

At my appt. today (I'm 24 1/2 weeks), she said that we needed to have a serious talk re: VBAC.  The doctors in the practice (4 of them) were discussing VBAC and how they need to be more accommodating to their patients and allow more VBACs to happen (so yay to that!)  She then went on to tell me the following:

1.  My preferred hospital currently will not accept VBAC patients (OB said they're working on that).

2. My OB said that she supports me 100% even though she says in her opinion I will not be successful.  But she totally agrees with my body, my choice, and would allow me a TOL.

3.  One of the doctors in the group will not support VBAC.

Sooo....my doctor said that if I want this to happen, I need to find another doctor because if I go into labor and unsupportive doctor is on call and she (my OB) is unavailable, I'd be marched straight to the OR, and my doctor wants what's best for me.

I am so overwhelmed and confused.  OB said we'll talk about my decision at my next appt. (Jan. 17).  This isn't so much a WWYD dilemma, but what questions should I ask my current OB and a new one (if I do decide to go that route)?

Thanks in advance ladies.  I *really* appreciate it.

nosoup4u

PinkLily1234:

Also, remember that no one can "march you straight into the OR" without your consent.  You said that your preferred hospital won't accept VBAC patients right now, is there another hospital within a reasonable distance?

Not to be a Debbie Downer, but they kinda can...https://rixarixa.blogspot.com/2007/06/pregnant-women-are-second-class.html There's a case in Florida in which a woman having a VBAC was forced into a c-section, and it was court-ordered (totally outrageous, but it happens). 

OP - It is good your OB is bring upfront about your chances of being able to VBAC. I think the biggest thing in finding a new provider is asking them how intervention-heavy they are with VBACs, can you go until 42 weeks, can you labor however you'd like (don't have to stay in bed), stuff like that. Hope it works out! And FWIW, my VBAC baby was 2+ lbs and 2+ inches bigger than my first, who was also OP like your LO. 

ChavayJakov

Hey - I only have a quick minute before I have to run.

I was in much the same situation as you...still sorta/kinda am.  I had a c-section (medically necessary) followed by TWO successful vaginal births (one medicated/epidural, the last one unmedicated/no epidural).  Despite my delivering two babies successfully, all with the same OB that did the c-section, I'm now still considered in the state of FL as a VBAC...I'm looked at just the same as a woman who has had ZERO successful vaginal births following a VBAC.  In the state of FL it is very difficult to find a supportive doctor and a supportive hospital.  If your hospital does not accept VBACs...it might be that they do but have an "unofficial ban" on VBACs.  Here in my state, women have to find someone or resort to home births...we are not even allowed in birthing centers.

My OB was the one that broke the news that things had changed and that I would no longer be allowed to attempt a VBAC at his hospital (the only one through which he practiced).  He told me that there was at that time no medical reason for me to have to endure a c-section and gave me some doctor's names who he thought might help.  They didn't/couldn't (I never got to see them because of their staff turning me away over the phone).

That is where I would start first, however...ask those who are pro-VBAC to recommend doctor's names for you, as well as to inform you which hospital might better serve you.

Then I would go on Facebook (or google) for your local I-CAN board.  I-CAN stands for International Caesarean Awareness Network (here is there blog by the way:  https://blog.ican-online.org).  I found great support through mine.  If your local board is not very active, then join a board that is closest to you geographically speaking.    Those boards are typically filled with doulas, mothers like yourselves, mothers who have gone down this journey already (saving you from reinventing the wheel of research) and sometimes midwives.  Be warned ahead of time, some of the women can be downright militant..and those "positive" affirmations and suggestions can bring on about as much stress as your doctors already have/will.  You have to have a strong constitution going into a VBAC situation.  However, they will provide you with doctor's in their areas and their reputations of fulfilling VBACs...they'll also give you feedback on a lot of other things, like procedures, etc that may be presented to you.  For *me* this helped a lot.  There were not a lot of pro-VBAC docs in my area, and of those that were, there weren't a lot that actually followed through or spoke positively about them (kinda like your doc who said they were 100% certain you couldn't make it).

Almost simultaneously I would recommend either hiring a doula to help support you.  It is an added expense, and at least my insurance doesn't cover their help.  Depending upon your geographical region the price can be steep.  However, they will help you as an advocate once you are in the hospital and can help calm your nerves during your third trimester.  I waited until the eleventh hour because I was so tied up internally in knots about my feeling of being herded towards c-section no matter what (once I found a supportive OB, there was one OB in the practice that was not on the same page...like you, if I get her on call then I have a less likely chance of a full shot of VBAC.  I lucked out and found a doula that has experience - positive experience  - with that particular doctor and who knows what nurses are pro VBAC in the hospital I'm scheduled to deliver in).  With that I-CAN board, you can receive recommendations on doulas as well.  Or check out the reps of doulas that you find on your own.

Additionally, I mentioned nurses in hospitals...my doula said that you can actually "fire" a nurse from attending you while you are in there.  I had no idea that one could do that..I pretty much thought you got who you got.  She knows a few names on the floor and will be asking for them or for those who are positive about natural births to be the ones assigned to my room.  You can suggest the same to your doula, or if you go sans doula, just make the request yourself.  Maybe even put it in your birth plan.

If I think of anything more, I'll come back to this post later.

vanillacourage

I gave my thoughts in this thread. 
https://community.thebump.com/cs/ks/forums/61579932/ShowThread.aspx#61579932