37 weeks and planning a VBAC, but scared...
I have switched care providers twice during this pregnancy in order to have the best chance for my VBAC. I have hired a wonderful doula, and have felt very confident about VBAC'ing! That being said, I had a less than enjoyable conversation with my mom yesterday about all of this.
My mother is a reasonable, understanding person. We have always been very close. At the beginning, she didn't know much about VBAC's but listened intently as I attempted to educate her about what I planned to do. She seemed all for my decision. Not that I need her approval, but it's nice to have it. Fast-forward to the conversation yesterday. She was talking to a woman at our church who just happens to be a NICU nurse in the hospital where I will be giving birth. She has worked there for 20 years. My mom nonchalantly told her I was trying for a VBAC. She immediately said "talk her out of it. I have seen way too many babies in the NICU as a result of a VBAC gone wrong."
My mom came to me in tears, telling me what this woman had said. It caught me totally off guard. I proceeded to tell about the risks that a repeat c-section also carried, and the statistics that show how the risk of uterine rupture are less than 1%. Her worry is that I have only been basing my research on 1-sided studies from pro-VBAC sources. Ug. The bottom line is she so scared now that something will happen, and I can't seem to convince her otherwise.
Does anyone know of any reliable non-biased medical statistics or research that I can pass on to her about VBAC's? She has gotten me worried now, and I'm trying not to second-guess my decision that I have been ok with for so long. I need some advice ladies. Thanks for reading.
Re: 37 weeks and planning a VBAC, but scared...
This NICU nurse may have a very biased opinion/memory, so keep that in mind. She may think that a lot of VBACs result in NICU stays for the baby, while neglecting to remember or acknowledge how many c/s babies are there. And I bet she's not keeping track of how many VBACs and c/s occur in the hospital, and the percent of each that are from something going wrong vs how many are completely normal and healthy. Basically her story and opinion are anecdotal and I wouldn't put much weight in them without documented evidence from the hospital/your doctor.
That being said, here are two sources I would consider non-biased:
https://journals.lww.com/greenjournal/abstract/2004/11000/results_of_the_national_study_of_vaginal_birth.9.aspxc
https://birthwithoutfearblog.com/2011/09/06/a-uterine-rupture-a-look-at-20-peer-reviewed-publications/
I hope those help!
I second everything that pp said but wanted to add that in my experience (and this is my third pregnacy) these types of comments are common with all women as they get closer to their due date - VBAC or not. I think that as a country / culture we have medicalized and dramaticized birth so heavily that people cannot help but focus on the risks and pain and dangers associated with childbirth. You hear it all the time with people feeling the need to tell pregnant woman about every horrible situation that could arise during the process. Women seem to love to share their bad birth stories with pregnant women. As you get later in pregnancy seemingly natural birth friendly or VBAC friendly doctors start pushing interventions in order to avoid "big babies" or "deteriorating placentas" and the like.
I'm just about 38 weeks along and I've had several people who seemed very supportive early on come to me recently with their concerns. My take on it is that for me at least (and by your post I'm assuming you too) I spent a lot of time both before my pregnancy and early on in my pregnancy researching the risks and coming to terms with the fact that there are risks either way and I need to go in whatever direction I feel most comfortable with. But now that I'm huge and birth is obviously immenent my friends and family are finally realizing that these risks are real and many of them just assume that the CS is risk free despite all evidence to the contrary.
The best you can do is direct them to accurate information regarding the risks of both VBAC and CS (I don't have any links but isn't there a VBAC blog associated with this board that has good links?) and stay positive yourself. Make sure that you have a labor support team in place that doesn't have these reservations and stay positive. If you had planned on having your mom support you through the labor maybe think again about that decision and look at alternatives. GL!
Unfortunately, it's hard to see the forest from the trees. And NICU nurses are not even looking at all the trees, they're only looking at the sick trees. Every baby they see is a case of something gone wrong and some of those are going to be VBACs.
In my experience, those on the front lines of medicine are some of the most resistant to change. Not only are they used to doing things a certain way, they are also defensive of the way that they've been treating their past patients. No one wants to hear that they've been giving bad advice or not doing the best for their patients. And there's always a horror story for every scenario, but it's just a single story among thousands of happy endings.
Here's a fairly anti-VBAC article, related to the new Australian study. But, even though it would be considered anti-vbac, they state numerous times that there are risks associated with both and that both are viable options.
https://www.bbc.co.uk/news/health-17353803
Good Luck!
No offense, but that Birth Without Fear blog really isn't a good source. There are various posts on there that have the wrong rate of UR stated, or use confusing stats to make it look lower than it actually is.
OP - ACOG came out in 2010 with a statement that VBAC is a reasonable option for women who've had c/s. They aren't exactly a wild-and-wacky bunch of people, so if even they say VBAC is safe, it's safe.
I think the NIH consensus is a good unbiased source, as is Childbirth Connection. Links are here:
https://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/
https://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/weighing-the-pros-and-cons/
https://www.childbirthconnection.org/article.asp?ck=10210&ClickedLink=293&area=27
Good luck. My sister had a HBAC around the same time I had my VBAC, and our cousin's DH wrote my sister an email about how he's seen some bad outcomes with VBAC (he's an anesthesiologist). It was totally none of his business, and really not cool for him to do it.
I think it's okay for strangers/relatives to express concern if they're worried, but ultimately VBAC isn't some crazy dangerous choice to make.
DS2 - Oct 2010 (my VBAC baby!)
Stay strong. Here's an article from the New England Journal of Medicine, a pretty objective source:
https://www.nejm.org/doi/full/10.1056/NEJMoa040405#t=articleTop
If you look at the tables, you can see that:
1. Risk to the mother is lower in VBAC than in RCS.
2. As long as you are not induced, the risk of rupture is 4 out of 1000 (.04%), and most of those are minor.