What makes a good VBAC candidate?
Stephanie2167
member
We are in discussion on trying for LO#2 this fall. I am constantly debating between RCS and VBAC. DH is against VBAC and wants a RCS. I'm the same way depending on the day.
But I wonder what makes ones person a better candidate for a VBAC over another. I made is all the way to 9cm without pitocin. After my epidural the doctor came in and was concerned about DDs heart rate. They monitored it for an hour. I never felt the urge to push. The doctor was pushing on my pelvic bones to try and strech them out so she would come down farther.
I ended up with a c-section and the cord was around DDs neck. We assume that is why she never dropped far enough down and why I never felt the urge to push.
But since I made it fully without pitocin I feel I might be a good candidate for a VBAC.
What has been your understanding?
BTW - any good books to read on the subject of VBAC?
Re: What makes a good VBAC candidate?
I can't really comment on much of your post because my situation was different. I am a good candidate b/c the only reason I had a c/s was because DD was a footling breech. But I bolded that part of your post b/c my DH was really against a VBAC too until I start researching it and finding that it is the safer route for me and the baby. I thought I was really going to have to "sell" him on it once I decided but he said that ultimately it is my decision since it is my body.
I don't know everything that made a good candidate, at my first appointment I asked my doctor if I was a candidate and he said yes.
I had a c/s after I was induced and stalled at 6cm. Grayson wouldn't drop and after 24 hours of labor apparently he just didn't think it would happen. Sometimes I kick myself for not waiting longer, but it is what it is.
As for my husband - I think he is hoping for a RCS, but the reality is I'm the one doing the research, I know I'm a good candidate, I have my OB behind me saying it's okay, and at the end of the day, I'm the one that has to go through the birth and recovery. While I'm sure we will have lots of discussions about it, my vote counts as 2 because I'm the mom.
A "good" VBAC candidate can be defined in so many ways, and honestly it really depends on your care provider that you end up choosing. Some will say as long as you weren't labeled "FTP" or "CPD" that you're a good candidate. Others will say only those with a low transverse uterine incision are candidates, and only if they go into labor by 39 weeks, etc. It really varies quite a bit.
To me, you sound like a great candidate because you dilated to 9cm and it appears the only reason for your c/s was due to fetal heart tones and the cord preventing your DD from descending... but I'm not a medical professional.
Check out the VBAC bumpies blog for birth stories, links/resources, and reading lists
https://vbacbumpies.blogspot.com/p/recommended-books.html
As for your DH, show him the research and risks for both RCS and VBAC. Talk openly about how you are feeling and why. My DH was so furious about the way my labor with DD was "managed" by the on-call OB, that he was adamant we learn more about my birthing options for subsequent pregnancies. So we did, and we were both on board with VBAC after going through the information together.
HTH and GL!
ETA: typo
~Sweet Girl *8/18/08* c-section ~ Sweet Boy *12/2/10* VBAC ~ Sweet Boy *8/14/12* VBAC~
VBAC Birth Story 2VBAC Birth Story
First off, you do sound like a great candidate.
As for your DH, he needs to do more research. I think my DH feared a VBAC until he started researching. Once he realized I was three times more likely to die during a RCS he joined the VBAC team. He also came to many of my appointments with my midwife and she was really patient and answered all of his questions and concerns. I'd recommend that too.
Each OB will tell you differently:
Background on my OB he is not a fan of VBACs but said he would never deny a good candidate the option. If he thinks someone is a good candidate he will talk to them about VBAC. If they are not a good candidate he won't bring it up unless they do.
Good candidate to him is someone who has had a V birth then had a csection due to breech or something similar and now for their third wants to go VBAC. He prefers VBACs when the woman in question has already had a V birth and he knows her body can do it.
He did not consider me one which I was really ok with.
The best vbac candidate is someone who didn't have a vaginal birth due to a problem with the baby rather than a problem with the mom. So bad positioning (breech, transverse, just slightly crooked, whatever), cord issues, heart rate issues - those are all problems that the baby had and there's no reason to think that the next baby will have them.
I has a csec with my first due to merconium and fetal stress but we are going to try a VBAC for #2 in a couple of months. From what my OBs have told me good candidates for VBAC on second pregnancy waited at least a year between the first birth and conceiving the second child, had to have a csec due to fetal heart rate stress, had a csec for slow progression (not a good reason for csec but it happens all the time), had a cesec due to breech, women with low transverse incisions from their csec, and the baby is expected to be under 10 lbs and the head is down.
My doc said ACOG states that a VBAC is safer than a repeat csec but risk of uterine rupture and other complications become more likely if the mother is induced. If you decide to try for a VBAC you want to go into labor naturally.
As a side note, you can do things like squats and stretching to help prep and assist the baby's decent. Also things like epidurals have a tendency to delay the labor so you might want to consider going without meds. I labored for 25 hours with my first one with no meds and was fine. Having a tub reduces the pain and having a doula helps with mental focus and pain management.
I'm sure there is plenty of information out there if you wanted to pick up a book or two. ICAN has a facebook page and some regional websites. Some cities have ICAN or VBAC groups that meet to discuss VBACs and whatnot. You might be able to find a group to attend that could put your mind at ease about some things. It might benefit your husband as well.
Good luck!