Any words of wisdom for those of us attempting a VBAC?

breezelikewind

I labored for 24 hours on pitocin with DS1 in December 2011 and only dilated to less than 1cm. My doctor wanted me to have the CS once I reached 24 hours from when my water broke due to potential infection. I should also mention that DS1 was born at 11:35 p.m. on Christmas Eve, so I have wondered whether the holiday played a part in the CS recommendation, but maybe not since I've heard other people mention the 24 hour rule.

I really want to have the VBAC, especially since I have a toddler at home who will not understand a long recovery that prevents me from giving him the attention he's used to. One thing I didn't like about my last hospital experience is that the nurses really "tie" you to the bed by hooking up all the fetal monitors...I just cannot imagine that sitting in bed for 24 hours did anything to progress my labor. Any advice for a successful VBAC is appreciated! 

jesselayne8

Stay home as long as possible. Get a doula to avdocate for you. Usually you can pace beside the bed or sit on a birthing ball and still have the monitors on. Check and see if your hospital has wireless monitors so you can walk the halls.

BTW DD was born at 1145pm Dec 23rd. I never progressed past 4cm.

laurenmae1228

No advice...just commiseration! Another 24 hour labor here. Never progressed past "barely" 3cm (even after a Foley cath induction). They maxed me out on pitocin for hours, but I "failed to progress". After the c, you could see that DS's head was indeed cone-shaped, so he obviously wasn't as high as they kept saying he was, but still no reason as to why my labor "didnt work" though. Like you, I HATED being tied down to the bed. I literally had to stay in the EXACT same position for 2 hours at one point (BEFORE my epidural, I might add), because if I moved the SLIGHTEST bit, the monitors went haywire. Turns out, it was actually just DS running away from the monitor at every chance! And also like you, I REALLY want to Vbac since we're planning on DS being a toddler at that point. I also had a NIGHTMARE recovery from the c (and a 2nd surgery at 14 weeks postpartum to fix the opened incision/seroma), and am beyond terrified of going through anything like that again, with not only a newborn but a toddler as well. Unfortunately, I had gestational diabetes and am genetically likely to have it again, which automatically puts me in the high risk pregnancy category, and if I have to go on insulin again, supposedly makes the placenta deteriorate more rapidly than normal, thus, you're supposedly not allowed to go past 40 weeks, and most docs dont like going past 39. Ugh. I HATE feeling like Im just going to be set up for failure all over again. 

keg

I highly recommend finding a provider that is truly supportive of VBACs.  If you have a local ICAN group, I highly recommend talking with them to figure out who in your area is supportive and who is just blowing smoke up your a$$. :-)  I also recommend going with a doula because she is likely to be able to help with pain management and different positions, even while on monitors. 

MrsRucinski85

No advice, but I had a very similar situation... only mine was on Jan 2nd! I was induced twice and nothing happened, second time around he broke my water and still not past 1cm and I ended up with a c/s.
I am very hopeful to VBAC for my next pregnancy.

nosoup4u

Like everyone else said, look around for a truly supportive provider. Some hospitals have telemetry/wireless monitoring units, so you can walk around even with CFM. But I would also recommend staying home until your labor is really started, so you won't be in the hospital as long. Good luck!

cecilyandgautam

laurenmae1228:

No advice...just commiseration! Another 24 hour labor here. Never progressed past "barely" 3cm (even after a Foley cath induction). They maxed me out on pitocin for hours, but I "failed to progress". After the c, you could see that DS's head was indeed cone-shaped, so he obviously wasn't as high as they kept saying he was, but still no reason as to why my labor "didnt work" though. Like you, I HATED being tied down to the bed. I literally had to stay in the EXACT same position for 2 hours at one point (BEFORE my epidural, I might add), because if I moved the SLIGHTEST bit, the monitors went haywire. Turns out, it was actually just DS running away from the monitor at every chance! And also like you, I REALLY want to Vbac since we're planning on DS being a toddler at that point. I also had a NIGHTMARE recovery from the c (and a 2nd surgery at 14 weeks postpartum to fix the opened incision/seroma), and am beyond terrified of going through anything like that again, with not only a newborn but a toddler as well. Unfortunately, I had gestational diabetes and am genetically likely to have it again, which automatically puts me in the high risk pregnancy category, and if I have to go on insulin again, supposedly makes the placenta deteriorate more rapidly than normal, thus, you're supposedly not allowed to go past 40 weeks, and most docs dont like going past 39. Ugh. I HATE feeling like Im just going to be set up for failure all over again. 

I so feel for your story and it makes me a little teary. I just wanted to put out there that the midwife practice with the highest vaginal birth rate in my area (note: they are hospital based but have an even lower c-section rate than the next most popular practice that does home births!), strongly advocates that their patients eat low-carb diets with *zero* white sugar and white flour. They swear that the diet, along with 30-60 minutes of walking a day does wonders for otherwise high-risk moms. Their patients say it's really hard to stick to, but this practice does not turn away moms for having GD like many midwife practices do and they have really amazing success rates. So, it might be worth a try and might help keep the GD at bay, or at least make it manageable through diet without insulin. I have my fingers crossed for you! 

kelly321

I second everyone who has said that a supportive provider is absolutely key, but I also wanted to reassure you that even if things don't go as planned and you end up with a RCS, it's not the end of the world even with a toddler. I wanted to VBAC for the same reason you said - I have a toddler at home and didn't want to have the long c/s recovery. However, my uterus started to rupture and I had to have a RCS. I'm now 12 days out, and I can honestly say that everything with DD (22 months) is just fine. I haven't picked her up yet, so DH or MIL/SIL have been with me to help me get her in and out of her crib and high chair, but I either kneel down to give her a hug, or I sit on the floor with her, or I help her climb up on the couch to sit on my lap while we read.

So I totally understand and support your decision for a VBAC attempt, but just wanted to let you know that even if it ends up not working out, things with your DS will be fine!  I know that was my biggest worry.

A37licia

I think an important thing to do for a successful VBAC is to have a very good support network, including your spouse and whoever will be delivering the baby. For a woman's first VBAC, she needs to know everyone is behind her and that she can do it. And she needs to know it herself. I read a ton of VBAC stories, which helped greatly.  Seek the birth location that will support you, and I highly recommend a doula experienced in VBACs if you are in the hospital.

 As for labor itself, you are right in your thoughts about being tied to the bed. 

Remind yourself that you will not have a repeat of what happened before. This birth will be different. 

Become as educated as you can about the position of the baby influencing labor. I learned that through reading blogs, birth stories, and talking to people.   There are SO MANY c/s that occurred because baby was malpositioned and the care providers didn't have a clue how to help.

My labor was 17 hours with my son, ended in c/s. He was big and posterior, and he might have been able to be born vaginally, but the support and knowledge wasn't there for me to have that happen and get him turned and get me up out of bed to work on it. My VBAC was 2 hours. TWO HOURS! There was no question she was coming out. 

Something I have observed a lot is a poor position can lead to weeks of prodromal labor, and once labor actually starts when baby gets situated, it can go very quickly.  Spinningbabies.com has good info on positions, and my VBAC baby kept going posterior. The night we got her to turn through rebozo sifting, I went into labor. 

breezelikewind

Wow, this is all great advice...thanks for sharing your experiences! I've already decided that I'm not going to the hospital until my water breaks or I'm having enough contractions that I'm worried about the baby being born in the car. I can't take another day of sitting, and they were crazy about the monitors last time. I also really appreciate hearing Kelly's RCS experience...I don't want an RCS, but I know it's a possibility that I have to consider.

A37licia

Something else to consider is not even going in as soon as your water breaks, unless you're in transition or pushing when that happens.  There are certain checks you can do, and my water has always broken early, and I continued to labor at home (granted, second birth was at home anyway). Now, I used midwives who are usually ok with that after asking a few questions (is baby moving, and is the fluid clear or pink) so I'm sure OB's standard protocol is you COME IN when your water breaks no matter what, if you call them.

However, something else to consider is your labor might move along very well once your water breaks that it'd be a good time anyway. 

So, say your water breaks first, to start labor, before you have any contractions. You don't want to go in just yet, and you may not want to call quite yet until you get a good pattern down, and you could conveniently forget what time your water broke.  I'd become familiar with what you need to check (ie no cord coming out, baby is moving and water is pink or clear, have a pad close by so you can catch some and examine it) so that you can labor at home until you're in active labor. 

After my water broke with my second child (home birth), I put on a depends from the small pack I bought for post partum, and didn't have to worry about leaking while I labored. She was born about two hours after my water broke.

And, I just want to add, based on your first birth, I think you can absolutely have confidence that this birth will be a vaginal birth.  Not only that, your attitude about achieving it and your interest in educating yourself about how to get there is an exceptional tool for you to have for success.

bumpuser2548131

My hospital had a mobile fetal monitoring unit. That was REALLY nice, because I was able to walk around in early labor before I got my epidural. I totally agree with you, though. I feel like confining a woman to a bed is NOT going to increase her chances of sucessfully VBACing or sucessfully managing her pain.