Does what my Dr said about VBAC sound right?
sunnydays99
member
With DS I went into labor naturally (water broke at home and contractions started shortly after) and progressed to 10(ish)cm in about 10 hours. I say 10ish b/c one nurse told me I could start pushing then another one came in, checked me and said she could feel a lip of cervix still. I stopped pushing and they gave me pitocin. After 3 hours of zero progress (lip of cervix never went away, DS didn't descend farther and his heart rate didn't have the variability they wanted) they decided on a c-section.
ETA: I should mention also that DS was sunny side up.
My Dr. told me that it is very unlikely that I would be able to do a vbac b/c in her experience if women went into labor naturally and progress to 10cm and still aren't able to deliver then their pelvis is just too small. I have a hard time believing this. She said that I could definitely try but that they wouldn't let me labor as long if there is no progress again.
I'm not pg yet (will be trying soon), but I am constantly struggling with this.
Thanks!
Re: Does what my Dr said about VBAC sound right?
This, definitely. It is VERY rare for a woman to have a pelvis too small to deliver a baby. Your child didn't descend because of how he was positioned. It makes me nervous when I hear doctors putting restrictions on you before you are even pregnant. There is no reason why you can't let labor take it's course if you and baby are fine. Why put a time restraint on you?
Thanks so much ladies - that's exactly what I was hoping to hear!!
This Dr. isn't my regular Dr. She was just on call and did the c/s and I had a follow up with her. I will discuss vbac with my regular Dr. once I am actually pg. I really want to try b/c I was so incredible disappointed with having a c/s. I'm just nervous that I'll try and end up with a c/s again and feel like a failure all over again
NO NO NO NO NO NO NO!!!! IT'S NOT TRUE AT ALL!!!!
my first baby was posterior. i dilated to 10cm. my baby never descended past 0 station. i had a surgical birth after 40 hours of labor.
my second baby was anterior. i dilated to 10cm. my baby came out of my vagina just fine. my pelvis opened and my baby came out.
i really hate that doctors put this type of useless fear in women. your body is not a lemon, it is meant to do this. most likely the malpositioning of your baby, combined with the cervical lip (which, btw, i also had at my second birth, but my midwife reached in and held it back while i labored), largely contributed to your baby not descending, not the size of your pelvis.
besides, a woman with a tiny pelvis can birth a 10lb baby while a woman with a large pelvis cannot birth a 6lb baby. it has nothing to do with the size of the pelvis, but all to do with how much the pelvis can open. your baby was not in the right position.
there are many things you can do during pregnancy to encourage optimal fetal positioning. here's what i did: throughout: regular exercise (walking, swimming), never reclining - instead leaning slightly forward; first tri-monthly chiropractor and massage, second tri-chiro and massage every three weeks, hypnotherapy to create birthing imagery and prenatal bonding; third tri - monthly then bi-weekly then weekly acupuncture, weekly chiro and massage, extensive hypnotherapy (done at home) to encourage optimal fetal positioning.
i posted my recent birth story on this board...it's a few posts below.
This is exactly what happened to me. I dilated all the way and my baby was sunny side-up and got stuck. My doctor told me I would not be able to deliver vaginally ever unless I had a preemie.
Here are some things to think about:
1. About 60-70% of women who try for VBAC after a primary cesarean for cephalopelvic disproportion (pelvis is too small) are able to deliver vaginally. Considering that the overall vaginal delivery rate in the US is only 68%, your odds sound pretty good.
2. Sunny side-up or OP babies have high rates of cesarean delivery. When the doctor attempts to manually rotate the baby, the cesarean rate drops significantly. This shows that it's the baby's position, not size, that is impeding vaginally delivery in many cases. You should find a provider who knows different ways to handle OP position besides just doing surgery.
3. Different pushing positions can change the size and shape of your pelvis. If you were pushing on your back, that makes your pelvis smaller and pushes your tailbone into the birth canal. Positions like squatting and hands and knees open the pelvis up much more. Some women really need to try different positions, especially if they have a baby that is not left occiput anterior.
4. This study found that if you had a cesarean for a non-recurrent reason, like the baby's position, and you were dilated 8 or more centimeters, you have the best odds for VBAC. There are some studies that find the opposite, but I don't think they properly accounted for the reason for your primary cesarean. I also wonder how much provider bias plays into this--if a doctor knows you had a CPD diagnosis, they may be more likely to section you because they may subconsciously think you will need a c/s anyway. Anyway here is the link to the study: https://informahealthcare.com/doi/abs/10.3109/14767050902874089
5. There are things you can do to prevent OP position or turn the baby to anterior. Avoid an epidural, which has a high correlation to OP position. Stay active in labor. Try laboring in positions like on your hands and knees. There are different techniques for turning an OP baby that you can find online or in natural childbirth books. Your doctor can also try to manually turn the baby. And like I said above, pushing in different positions can help. You can also have someone try a hip squeeze on you while you push, to help open the bottom of your pelvis.
HTH!
I labored in the shower up until I was ready to start pushing, then I was in bed. I got an epidural shortly after and therefore stayed in bed until the c/s
I will definitely not be using the same Dr. next time around. In Canada it's a bit different. I go to my family Dr until 20 weeks then switch to someone who delivers (either an OB or a GP). I will definitely choose someone who is more supportive!
Thank you for all of the responses. I was so discouraged when the Dr told me my chances of vbac were so slim but now I feel a lot more confident!
I had a c section because after 2 hours of pushing my daughter never descended. I was told that I had a low likelihood of a successful VBAC with that historry, but that my OB would happily work with me. It took 3 hours of pushing and forceps assistance, but I did have a VBAC. Both of my girls were sunny side up, which did not help.
I will say I had a truly VBAC supportive office, and when my blood pressure was rising (I had pre-e with my first) they did offer a pitocin induction instead of an automatic C (there was no way they could risk waiting for me to go into labor when I was showing signs of pre-e) and that was crucial. At my first appointment (8 weeks, new practice) they had had 2 successful VBACs in the past 2 weeks, so I had a great feeling about the practice from the beginning.
That was me with DS. ?I ended up agreeing to a c-sec for him because he was having decelerations that weren't coming back up fast enough. ?
DD ended up being sunny side up as well and my OB ( a different one) realized that my tailbone protruded into the pelvic space, which made the openning narrower. ?But after 3 hours of pushing and with the help of the vacuum to get her over my tailbone, I had a successful VBAC! ?I was told my chances of a successful VBAC were about 20%, but I went for it anyway.