VBAC:When to go to the hospital?

MaVieEstBelle

Hi Everyone,

I've been lurking a lot on this board and would really appreciate some help from you.

My doctor is only about 70% behind me on VBACing my second child (I'm 22 weeks). First was c-section due to "Failure to Progress" after 12 hours of labor on Pitocin. I still regret not waiting out longer...

He says if I want a VBAC I have to either a) show up with a head between my legs or b) progress at 2 cm for the first three hours and 1 cm for the last three. If I stall at any point, it's an immediate c-section. These restrictions seem like they are setting me up for failure.

I don't want to change doctors b/c where I leave there is only one doctor who is actually 100% VBAC friendly, but delivers at a hospital that is known to be disgusting. I'd rather take my chances with my current OB.

My question is: When should I show up at the hospital so that I have the best chance of progressing? I didn't even know I was having contractions the first time and ended up in the hospital the day of her birth because I couldn't feel her moving. I regret having stayed that day. I should have just left and let my labor progress at home since my water hadn't even broken. I was barely 1 cm dilated when I got there & only got to 4 cm. 

I know what labor pains feel like now, but you really don't know if you are dilating or not. I'm also nervous about being GBS positive. My water didn't break last time, but if it does this time, do I really have to "rush" to the hospital immediately the way the doctors make it seem? I feel like then my chances will be even less. And, in a VBAC scenario, I'm nervous something might go wrong while I'm waiting it out since I won't be monitored.  

Thanks for your advice.Sorry it's so long.

 

 

Twizzle

There was a post on this a couple weeks ago

https://community.thebump.com/cs/ks/forums/thread/65210295.aspx

Your doc doesn't sound very supportive of VBAC so if I were you I would try to labor at home as long as possible, even if your water breaks.  I know what you mean about being nervous about not being monitored at home though.  I feel the same way and right now I am looking into hiring a monitrice to be there with me at home. 

cchill01

MaVieEstBelle:

He says if I want a VBAC I have to either a) show up with a head between my legs or b) progress at 2 cm for the first three hours and 1 cm for the last three. If I stall at any point, it's an immediate c-section. These restrictions seem like they are setting me up for failure.

This is madness.  How on earth could anyone live up to this?  And why should they? 

I am planning to stay at home as long as possible, but my guess is that I'll get to the hospital around 4-5cms. My DH would never be able to survive the stress of staying at home until there's a "head between my legs."  Especially, if I have to go to the far away hospital - which is an hour away (long story).  Most people I've talked to have taken at least another 4-6 hours once they check into the hospital.

 

skio

I'm sorry you're feeling all this! Hoping for a VBAC after a failure to progress c/s can be a tumultuous ride. I'm not pregnant yet, but I'll be in your boat when I am.

First - have you looked into midwife delivery in your area? Or hiring a doula? I would strongly urge you to do so, especially from the sound of your doctor. I don't know why he would put those strict restrictions on you, but he does not sound very VBAC-friendly and you really, really need support if you plan to do this. Your doc has to support, your hospital has to support. If you have a doula with you who can vouch for your birth plan and help keep you on track when the doctor starts stressing surgery, it would help greatly. Please consider it.

Remember that sometimes water doesn't break until well into labor; sometimes it doesn't break at all. Water breaking doesn't mean you have to rush to the hospital; it doesn't mean active labor has started. BUT I do not know anything about being GBS positive, so I can not say whether you need to be monitored if your water breaks or not. I can say that for my next pregnancy, I plan to labor at home as long as possible. I will have a doula to come check on me and root me on, and I will have a doppler at home to listen to baby's heartbeat to make myself feel better about not being at a medical facility. I will also monitor my own temp to make sure I don't develop a fever, especially if my water breaks.

I went to the hospital too soon last time, too. I had labored for 7 hours at home and my contrax were 5-6 mins apart for over two hours, so I thought it was time. But I was also super excited and overly nervous about hitting traffic or getting stuck in the snow or whatever, so I wanted to get there. I was only 2cm when I got there; I wish I had waited another 7 hours, which is how long it took me to get to 5cm.

I'm babbling now, but my suggestions are to prepare and educate yourself as best you can. Consider getting a doula and a doppler to have at home with you, and read some books/take some classes about labor and what to expect so that you can be in tune with your body and not worry about every pain. Believe that you can do this! Here are some links that you may find helpful:

https://www.childbirthconnection.org/article.asp?ck=10213&ClickedLink=293&area=27

https://www.midwiferytoday.com/articles/vbacchoice.asp

https://doulamomma.wordpress.com/2009/07/22/when-your-water-breaks-before-labor-begins/

https://www.amazon.com/Silent-Knife-Cesarean-Prevention-Vaginal/dp/0897890272/ref=sr_1_4?ie=UTF8&qid=1329960024&sr=8-4&tag=vglnk-c1345-20

https://www.vbac.com/acogs-revised-vbac-guidelines/

selockar

If you are going to stay with this ob I would highly recommend a doula. They will come to your home when you're in labor and can help you determine when to go to the hospital. I would also look into med free birth. If you have to labor at home until the head shows you won't be able to get the epidural.

MaVieEstBelle

Thank you all for your advice & for the link to the previous posting on this topic. 

I am going to be looking in to hiring a doula or monitrice. 

Harper'smom

I went to the birth center when contractions were 3-1-1. Your provider is setting you up to fail. I second looking into nb even if you get the epi at the hospital because if you need to labor at home for the long haul you want to be prepared.