Epi question 2+VBAC'ers

mamacrunch

First of all if an intro for this board is protocol, I am anmagyari, have have 1 vaginal birth and 1 c/s. DS is 18 months and I just found out in June I am expecting again.

As of right now I have seen my OB (who is new to me) once, before seeing him his nurse informed me that I must have a RCS because that office did not perform VBACs, I never asked she volunteered this info, before the doctor met me in all.

I had really wanted a VBAC attempt as my section was only because my son was sunnyside up and I would not progress fast enough so after 24h of labor and only reaching 7cm my old OB sectioned me.

Well I just found out that 2 of my high school friends are also in this same practice seeing the same OB as I and they are being allowed to VBAC so my appt Friday I am going to push it.


So FINALLY my question: For those of you that have had a VBAC already I hear they recommend you receive an epi in the event of uterine rupture or some other reason that require a Emerg. section So if you have the epi how are you to know that your ute is rupturing? Do they have some monitor? Is there something physical that is very noticeable?

I know this question sounds idiotic, but I really want to know as much as possible because if my new OB will allow my attempt then I want as much info as possible.

Getting the baby out either way is scaring the *** out of me. Also I will be 25 months between deliveries. 

nosoup4u

You had the c/s for your second baby? Having had one vaginal birth (no matter when) makes you an ideal candidate for a VBAC. If the OB says no, look for a new OB. 

Re: Epidural, it's not required for a VBAC. Lots of us on here have had med-free VBACs. It wasn't a requirement for my VBAC. 

RootBeer29

An epi was not required for my VBAC but I did have one.  They used an internal uterine pressure monitor on me to help watch for rupture signs.

skio

Thankfully, while my OB brought up the benefits of having an epi in place, he didn't require it or push it. If he did, I would've gone elsewhere. I did not want an epi; it was the start of the downfall of my first labor. I understood that I would have to be knocked out in the case of an emergency and was okay with that.

They monitor for rupture by monitoring the baby. And monitoring you for hemorrhage and pain.

A37licia

This doesn't answer the point of your post, but can you find another OB? Even if does change and "allow" you, he might be the exact type of OB that switches on you in the end.

There can be a change in contraction pattern to indicate rupture, and changes in baby's hearttones, before there is any identifiable pain. But they want the epi in you so they can section you if it doesn't go their way, really. If they were supportive of VBAC, they would not require an epi and would allow you to labor how you choose.  I would get an epi personally if my labor dictated it, but I would not consent to one "just because". I achieved an unmedicated VBAC two years ago and am planning my second.

This is an applicable article I'd encourage you to read. 

https://vbacfacts.com/2012/06/22/can-you-feel-a-uterine-rupture-with-an-epidural/

lalamakita

I'm 36 weeks and having a vbac in the next couple weeks.  I was not required to have an epi during my vbac labor.  But I did have a hep/saline lock for antibiotics and fluids so I'm sure they would have used that for general anesthesia if I'd needed it.  

My doc wants me monitored during labor and he says the monitors are very accurate and can detect if your uterus seems to be about to rupture.  

The other thing I'll have in 2 weeks is an ultrasound of my c/s scar to see how thick it is and if it's less than a certain thickness, he'll recommend a RCS, or if it's thicker, he says I'll be given the green light.  Since I've already had a VBAC 5 years ago (and my c/s was 7 years ago) I'm not worried there'll be a problem.  You could see if your doc will do this for you too - just seems like good information before you're in labor.

Good luck