Wanting a vbac — The Bump
VBAC

Wanting a vbac

Hi all!

We are expecting baby #2 (6 weeks along) and really want a vbac. DD was refusing to be born, so I was induced but stalled at 7cm. It really was a horrible experience. I wasn't responding to the numbing meds so I was given more than normal so that they could do the c-section and essentially force her out. I felt, and still feel, like I missed out on her birth because of all the drugs. Unfortunately, the hospital where we live has a vbac ban. We are now on the hunt for an ob/gyn and hospital that are willing to perform a vbac. Does anyone have any advice on what kinds of questions we should ask while on our search?

Thanks so much!! 

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Re: Wanting a vbac

  • I got nothing for questions. Have you thought of asking your current OB for a referral? I know in my situation that my hospital does not do VBAC's. So when I had the convo with my old OB she said I'd have to transfer to one of their partners at a different hospital. Which is what I opted to do. I have to travel 45 minutes for doc appointments now and to deliver at a VBAC friendly hospital. However, I think it will all be worth it.
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  • They referred me to another ob/gyn in a nearby city, about 45 min away. They review your records first and then let you know if they think you are a good candidate. Still waiting for a response. Thanks for the idea though!
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  • Here's a list of questions from ICAN:

     

    - What is your rate of inductions?

    - What are your partners perspectives on VBAC?

    - What percentage of your patients do you assist yourself? (most docs are in group practices and take turns being on call for births)

    - What is your cesarean rate (beware if it is in the 20s or higher or doc can't answer)

    - How many VBACs do you attend be year? (Don't expect a huge number. Look for enthusiasm and knowledge.  Qualities are lacking if he/she asks you to sign a VBAC consent form that exaggerates the side effects of VBAC and includes none of the risks of a repeat c-section.  These seem to be more common in Central Ohio)

    - Of those patients in your practice who wanted VBACs, how many were successful (expect at least 35%)

    - What do you think my chances are of VBAC success, given my childbirth history?  (look for enthusiasm about VBACs, especially yours.  Look for someone who treats you as an individual).

    - In what instances is a repeat c-section necessary?

    - What kind of monitoring would you require in labor?

    - Do you support alternative birth positions?

    - What are the hospital policies regarding VBACs (i.e. continuous monitoring, mandatory epidural, allowed to eat/drink, etc.)

    - What are some reasons that you might deny a trial of labor?

    - If I go past 42 weeks what methods might you use to encourage labor?

    - How do you usually manage a post-date pregnancy? (42 weeks per the World Health Organization) How do you manage suspected CPD?

    - Ask for an example of when a repeat c-section would be medically necessary.

    - Ask, "what if my labor stalled at 4cm?  What would you do to help encourage labor to get going again?"

    - Ask if a provider uses medications or non-invasive methods like moving and walking.

    - What will you do to help prevent tearing?

    - What's a reasonable length of time for a VBAC labor if I'm healthy and my baby appears to be healthy?  (research indicates greater success rates when women have more leeway on length of labor)

    - How many people can I have with me during labor?  what is the hospital's policy?

    - What are your usual recommendations about IVs, pitocin, prostaglandin gel, amniotomy, epidurals, confinement to bed, EFM, pushing positions and so on.  (can also call L&D and ask the nurses what to expect with a particular provider.  Some will discuss others will not.)

    - How close together are your appointments?  (the closer they are the more you'll have to wait and less time you'll have with your doctor)

    - Look for someone with "heart."  Is he/she empathetic?  Attitude can enhance or inhibit the likelihood of VBAC.  Does he/she make you feel good about your decision?  Do they listen and answer your questions?  Do they offer support when you voice your fears?  Do they take your calls?

     

     

    GL!


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  • Have you also interviewed midwives?! If the hospital has a ban, birthing at home is a safe and responsible option for most women.

    Even if Homebirth isn't where you feel safe delivering, the discussions with women who trust birth, and your ability to birth can give you a different perspective on birth and great insights into discussions to have with your OB.
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