What my doc said about VBAC
I asked a couple weeks back at my first appt and he said that I could try it--but that they can't offer any "help"---if I got stuck at 6cm they can't give me pitocin to help me reach 10.....and that more times than not, the VBACs result in a c/s anyways. He wasn't telling me I couldn't do it--just giving me all the info.
I've tried searching (google really) to see what other docs in the area might do VBACs--but not finding good info. I'm not even sure I want to switch--I like the practice for the most part. BUT the thought of recovery from a c/s again with an almost 3 yr old plus newborn with very little help at home seems like a nightmare.
Background--I went in to be induced after 10 days late but before they could even give me pitocin (just got set up on monitors), the baby went in to distress and they had to do the c/s (cord was around the neck). Up to that point I hadn't made ANY progress on my own and that was why I was being induced. My mom was in labor with me for 36 hrs before they had to do a c/s--I wonder how much is genetics??????
I'd love to hear some feedback---I wouldn't mind trying this option.
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Re: What my doc said about VBAC
Your doctor doesn't sound like he is really supportive of VBAC--or maybe he is and he just sucks at his job? There are a lot of studies showing that the majority of women who go for a VBAC deliver vaginally, including women who had their original cesarean for failure to progress or cephalopelvic disproportion. So the fact that your OB is telling you that most VBACs end in a cesarean anyway is a big red flag that this is not a good provider to stick with if you want a VBAC.
I don't think there is anything genetically wrong with you. Lots of FTP and CPD cases are really the result of provider impatience, inductions before your body is ready, or undiagnosed fetal malpositions. Not to mention the important fact that every labor is different. That the majority of women who try VBAC are able to deliver vaginally attests to these things, IMO.
Yeah, I agree with Iris - if you have a doctor telling you things like most women don't successfully VBAC, then you need to find a new provider. 70% of VBAC attempts are successful, but it does depend on your provider, frankly, and how much they are really willing to support VBAC.
Where in the south suburbs are you? Because if you're willing to travel, UIC Midwife group (which has offices all over the city, and I think they attend at other hospitals, not just UIC) is great for VBACs - I think they have the best rate in the city (and can personally attest to them!). West Suburban Midwives (in Oak Park) are also great for VBAC, as are Swedish Covenant (though they are hella north). hth
DS2 - Oct 2010 (my VBAC baby!)
I understand his reluctance to use pit, it does increase the odds of rupture. But if it were to help you have a successful VBAC, well that is something that you should discuss with him, or your new provider if you switch, to decide how you feel about the risks and benefits of either of those if that situation happened to occur. It would be good to ask ahead of time and of course about any other questions that you have. ACOG has recently changed their recommendations on VBACs and they are more open to induction and augmentation now, though that doesn't mean that the docs have to practice that way, it's just a guideline.
I agree with PPs about VBAC success as well. On average 60-80% of women who attempt VBAC will be successful. But of course it depends a lot on the setting and your provider. If they let you try a VBAC, but in reality aren't comfortable with them, they will be more likely to go to a RCS earlier than a truly supportive provider. If you really want to avoid a RCS, and I were you, I would try very hard to switch providers. Good luck with whatever you decide!
As the others have mentioned, your Dr may not be as supportive as he lets on or simply hasnt done many VBACs. Women who attempt VBACs have about a 75% success rate- assuming they have a care provider who isnt bringing down the success rate by setting arbitrary time limits and, etc. That's just about the same chance of a vaginal birth as any first time mom who's never had a c-section
Most Drs/Midwives wont induce a VBAC with no natural progress, but once you're in active labor, augmenting agents like pitocin are usually fine.
I was stalled out at 6cm for about 12 hours and my midwives and I discussed pitocin to help make my contractions more productive. We agreed on it and I used it. My midwives tend to err on the side of as few interventions as possible so I knew they wouldnt suggest it unless they really felt it would help. Plus, I'd done enough research to know that pitocin during active VBAC labor wasnt really considered any more of a risk than pitocin during active labor for a first time mother.
Just my experience-- I was given pit. for my VBAC to start labor AND used it throughout the entire labor. They induced me at 41 weeks. I had a successful VBAC.
Your doctor really doesn't sound supportive of a VBAC. I used a midwife. I interviewed OBGYNs in the area and they all told me similar stories that yours did. One actually told me that they "say" they are but really they will make me have a CS in some way or another and that I should look into a different hospital (which I did, with a midwife).
This. Well, not the bit about the triplets, but I can have pitocin from the moment I'm in established labour. THe additional risk is much, much smaller than if you are properly induced.
My MW said it's to do with controlling the pessaries and gell they put in you to induce vs the pitocin/oxytocin used to speed things up??
You dr does not sound like he is really on board with a VBAC, he's already setting you up for failure. Since you really don't want to switch practices, maybe there is someone there that would be more supportive or your descion to try.
I know four people, myself included, that have tried for VBACs and we have all succeeded in the endevour. As far as the pitocin thing, I am not sure what standard practice is, but I was given a small dose of it with my VBAC when I was teetering on the edge between 9-10cm for a few hours. The nurse explained that it was less than the standard dose they start people on, just enough to give my contractions a little hmph.
I wish genetics played a role! I was my mother's longest labor at 5.5 hrs, my little sister would have been born in the car if my father would have taken a shower before they left(the doctor ended up giving them money back because he got there just as my mother pushed her out).
I have been on both sides of this:
I have done an all natural labor after my water broke- and delivered under heavy pressure to deliver by the 12 hr mark due to "risk of infection" Pitocin was not an option due to "risk of uterine rupture" A wise old doula and hoku pressure points saved the day.
8 years later may water broke again- also before I was in labor...
this time I was given 12 hrs to be in REALLY active labor and 24 hrs to deliver. If I was not in really active labor by 12 hrs... they wanted to start pitocin. I didn't have my sage of a doula this time to think of a good negotiation- Compared to the first time around- this offer was pretty generous- and even though I didn't want to do it their way and have no doubt that things would have wrapped up fine without chemical assisting- I did take the Pit at 12 hrs and delivered around 15. (without any pain meds- something important to me and something I did worry about with the pit)
They are so fickle with their dang protocols... different doctors, different hospitals, different states, or different years- the same woman can be given totally different barriers to acessing the full range of birthing options.