Are my OB preferences too pie in the sky? Natural & VBAC friendly?

cecilyandgautam

We were trying for a home birth and things weren't going smoothly, so we transferred to the hospital after 24 hrs+ of water broken, then ended up with a c-section when things got even more complicated - long story short, I'll be aiming for a VBAC when it comes time for baby #2 (not just yet, but I would like to find a new OB soon to start building trust). 

But we're still naturally inclined - no IV unless I'm dehydrated, drinking plenty of fluids while in labor, being mobile & free during labor - not confined to a bed.

Do OBs exist out there who would be comfortable with this for a VBAC? Who would be willing to accommodate a woman in labor who's not sedated, lying in bed? All the local listserves that rave about VBAC-friendly OBs don't seem to list any natural & VBAC friendly services. It seems so either/or. Like natural is only any option for low risk mothers. 

I'm scared that these people just don't exist and if I really want a VBAC, I'll just have to labor at home for as long as I can stand it, which is what I did last time, but with a VBAC, that's probably not the safest way to go. I labored at home for 17 hours last time and would have lasted longer if the midwives had let me relax a little. 

Sorry this is so jumbled, I get really anxious just thinking about it.  

Twizzle

You could look into home birth if you are comfortable with that.

I have found providers/a hospital who will generally work with most of what you have posted.  I do have to have continuous fetal monitoring, but they have wireless units so I can still be mobile.  I do have to get IV access upon checkin, but not necessarily any IV fluids.  I haven't asked about drinking fluids.  They are very pro natural birth.

I don't know if it exists in your area, but you can start by contacting your local ICAN chapter.  I have found that to be the best source for VBAC friendly providers. 

cchill01

Twizzle:

I have found providers/a hospital who will generally work with most of what you have posted.  I do have to have continuous fetal monitoring, but they have wireless units so I can still be mobile.  I do have to get IV access upon checkin, but not necessarily any IV fluids.  I haven't asked about drinking fluids.  They are very pro natural birth.

I found a midwife who practices in a VBAC semi-friendly hospital.  She will do whatever she can, within hospital rules.  I was allowed to go to 41 weeks and have a little bit of pitocin.  But, I had to have an IV and continuous monitoring.  I was able to stand up and go to the bathroom or rock beside my bed.  I don't think I would have wanted to walk much more than that anyway. 

Other than the pit, I was able to deliver naturally.  

I wouldn't start panicing until you start looking around. 

nosoup4u

My sister had a HBAC with a traveling MW who has tons of experience with VBAC women, and will come to you. Her rates are pretty competitive, too. PM me if you want her info!

I hired a doula who was getting her CPM license, and who could have been a montrice in a pinch. I also had hospital-based MWs who were med-free friendly, and who told me to stay at home for a good long time.

I think the only thing that no one will budge on is constant monitoring - it's a requirement for any hospital VBAC I've ever heard/read about.

Also look into family practitioners - I found a doctor at my family practice who supports med-free VBACs, but I decided to go with a MW group instead.

Good luck!

iris427

VBAC and natural birth friendly providers definitely exist.  Have you talked to any local doulas or natural birth educators to see what they have heard?  I hope you can find someone.  

hopecounts

My new OB is fine with NUVBAC with the one exception of requiring continuous external monitoring. the hospital has telemetry units though and provided there is one available I'll be able to use it.

I'd say keep looking and maybe contact some local doulas I found my OB through a personal reference from a mom who had a NUVBAC and a doula rec. and since they both recommended him I set up my annual with him for the same reason you;re looking, I wanted to get comfortable with him.

I'm not pregnant yet either but hopefully in the fall so wanted to start preparing.

lostaspen

I had similar wants for my vbac and knew it wouldn't happen in the hospital, so I found an amazing midwife and had a home birth.

cecilyandgautam

Thank you for your replies! I feel a little more relieved with your personal stories of success.

I'm still a little nervous about the idea of a homebirth since the one we attempted ended up being so stressful and the midwives, who we thought would be nurturing, spent the whole time telling me how I wasn't trying hard enough - they assumed my contractions weren't progressing because I appeared "too relaxed" but I had studied the Bradley method and I was using every ounce of strength I had to maintain calm. Once we got to the hospital, it was clear my contractions had been progressing & strong, but other complications were impeding labor. It kinda put me off to the whole midwife model - it sounds great, but in practice, it doesn't seem to exist, or didn't exist for me when I needed it. The OBs at the hospital were much kinder to me in the end so I'm leaning towards a hospital VBAC but again, don't want the standard (IV, wires everywhere, constrained to the bed) stuff. I'd be fine with continuous tele-monitoring, but otherwise would want to be left alone. For the most part, I actually just want to be left alone during labor - I don't know if a midwife or an OB could really offer me that, so in head sometimes I imagine an unassisted birth, even though that's not really what I think is best. 

So you can see I'm torn and feeling distrustful given my experience, but I need to find a new OB so I'll try to find one I can trust for just routine stuff in the meantime and if I can't find one by the time I'm expecting baby #2, then I'll reconsider the midwife option.  A few Qs:

-what's a NUVBAC?

-what's a montrice? 

Demedoll

I think it depends on where you live. Check out the ICAN and VBAC sites, you can even try to google VBAC friendly doctors who could then let you know about the hospital policies where they deliver.Some areas have VBAC support groups you can chat with to see who they use and whatnot.

I found a doctor that is completely comfortable with no IV, no pain meds, movement until I need to be not moving, etc. He is also fine having a doula in there with us. My first child I was labor 25+ hours with no meds but then the baby had merconium in there and her heart rate was off so we had to do an emergency csec. This time around we are trying for a natural labor again and the doctor is fine with it. He said the only way he will opt for a csec is if there is fetal distress again. So there are doctors out there and hospitals that are supportive of natural labor. It just takes some research sometimes and calling around.

Good luck!

lostaspen

I interviewed providers before I was pregnant with my second--I had 3 pages of questions for them.  The midwife I ended up with was attentive, but noninvasive throughout my labor.  She only did one cervical check when I was stalled for 12 hours--I went to her office and she suggested a few things to get things moving again (they worked!).  I could ask her for a recommendation for midwives in your area if you're interested (email me at lostaspen at gmaildotcom).

Ktande22

Not that Im any kind of expert or would want to recommend something dangerous but just for an encouraging story.  My DH's mom was tired of her 4 c/s and she decided not to go that route with 5 so my FIL is running around the house getting ready for hospital and ding dong midwife shows up and baby gets delivered at home.  She goes on to have 2 other VBAC babies at home after that the next one being my DH!  Amazing story of success after 4 c/s!  I really am anxious as well about trying to VBAC! 

penguingrrl

My hospital and OB required that the port be put in for an epidural just in case I needed an emergency C (that way you avoid general anesthesia) but I was not required to have drugs with it. My OB was totally fine with me walking around and avoiding meds as long as I chose. I ended up opting for the epidural for my own reasons and was very glad I did because it saved my energy for 3 hours of pushing (at which time the epidural was turned off so I would follow my body and push correctly).

I've known a few people who had a midwife assisted unmedicated VBAC with success, so that's another route to consider if it's an option in your area (my hospital is highly supportive of that, as I said the epidural port needed to go in, but no meds were administered).