Questions to ask OB about VBAC

RumbleLina

I have a pre-conception visit with my OB next week.  I need to ask her a few questions before we actively TTC as well as understand her stance on VBACing. My long story short is that I had an induction for high bp/pre-e, ended in an emergency c/s and was diagnosed with cephalopelvic disproportion (I think it is is a crock). I know she has hinted that she is pro-c/s already but we haven't had an in-depth talk about it and also how I do not trust in my diagnosis.  I do not want to get pregnant first than see her for the first time at my 2nd appointment only to find out she isn't supportive. 

So, my questions here is if there are any "must ask" questions when talking to your, or a potential, OB regarding their opinion on VBACing. Extra points to those who can add in any information regarding cephalopelvic disproportion into the mix/

tlew12778

If you scroll down there's a post about questions to ask an OB about VBAC. 

But honestly if she CS you for CPD before I'd be concerned already. CPD is very very rare.  

RumbleLina

tlew12778:

If you scroll down there's a post about questions to ask an OB about VBAC. 

But honestly if she CS you for CPD before I'd be concerned already. CPD is very very rare.  

Thanks, I did look but obviously missed it.

She was not the one who preformed the c/s and dx the CPD. She was out of town when I needed to be induced so she was never at my labor/birth. I semi expect having to find a new OB though.

Twizzle

Sometimes docs put CPD on the report to kind of cover themselves for insurance purposes.  Meaning that there isn't much to justify the c/s so they call it CPD.  If the OB who did the c/s is in the same practice as yours, they probably have similar philosophies and are pro c/s.  Check with ICAN in your area to get some recommendations for pro VBAC providers.

nosoup4u

Ask for your operative records, or bring them with and ask about the c/s itself (though chances are you'll have to go through the office to get your records). True CPD is rare, and being induced can definitely up your chances of having a c/s.

Some things to find out:

How long are they comfortable waiting for labor to begin (41+ is a good answer!)

Do they ever induce with VBAC? If so, what do they use?

What should you expect in labor (continuous monitoring and hep lock are standard), do they insist on an epidural or on you staying in bed during labor

How many VBACs have they done

Do they know any other providers who do support VBAC (if she's as non-supportive as you are thinking!)

Good luck! And good job being proactive in looking for a provider before your next pregnancy.

RumbleLina

Thank you! Those are some great questions to ask.

I did request my records a long time ago and I went semi through them with her because I was thinking maybe DS was positioned wrong but I am thinking I should go through them again with more of an overall view.

I also did even think that they used CPD as an excuse for insurance purposes. I didn't know that a c/s needed a reasoning behind it I guess. I do believe that the CPD is a cop out though which is why I need to be proactive.

akbride25

After having a c/s with DD1, I was labeled as possible CPD. My first delivery had been very difficult with 5 hours of pushing, and the second ended with a c/s for Failure to Progress/Descend.

I just had a successful VBAC and only ended up pushing for 14 minutes. There were no problems that would have been associated with CPD.

tlew12778

I'd be weary of any practice that even discusses induction before term for size. Induction certainly has its medical necessities (like pre-e) but size is very subjective on u/s. 

Keep in mind that not even all VBAC providers will allow induction.  

RumbleLina

I found a website for questions I wanted to post it here just in case anyone else is looking around for questions as well.

 

https://vbacfacts.com/2009/06/06/interviewing-care-providers-questions-to-ask/