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VBAC
Monitoring (and refusal of) ?
I've been told that as I'm 'high risk' (e.g. I'm a vbac - I know), that I will have to have continuous monitoring as soon as I'm admitted, which should really be as soon as I'm having regular contractions.
While I know that I can delay going in, I know full well that I'll probably want to go be checked, to make sure I'm not making incredibly fast progress. (For reference, it took me 48 hours of back labour and 5min contractions to get to 3cm with DS.)
I'd like to think that I'll go in all bolshie and strong and say 'no, you can monitor me every X minutes, etc but that's it', but I'm worried that, like last time, I'll just listen to the MWs.
So what strategies do you think I can use to stay strong? Is there an accepted frequency/length of monitoring that I should aim for? I know they've told me that they'll 'check' me every 2 hours as a second time mom, but I don't know if saying 15min of monitoring every 2 hours would even work, you know? (THey could very easily not come back for 2 hours...)
Any advice? (Sorry it's so garbled!)
Mum to W (4) and M (nearly 2)
This discussion has been closed.
Re: Monitoring (and refusal of) ?
Any chance they have wireless monitoring? Our hospital does, so I'm probably not going to fight too much on the monitoring aspect. I believe I can even use the shower with them... well, I'll be using the shower either way, even if they have to come off for a bit.
Sorry - I guess other than that I don't have much advice. I'm interested to hear what others say, in case I find that even the wireless monitors are a PITA.
I had wireless monitoring for a while during my induction (until I got an epidural) and it was great. I could walk to halls, try all kinds of positions and labor in the shower and there was never an issue with the monitors being in the way or failing to pick up the FHR. Of course, you still have the other problems with CFM but at least you are not tethered to a machine.
OP:
I've talked to my OB about intermittent monitoring for VBAC and he is on board with it. He doesn't think continuous monitoring is necessary for VBAC, but I think it's kind of a tough issue. CFM does not really have benefits to a normal, low-risk labor. Does the <1% chance of rupture make a VBAC labor truly high risk, enough to warrant all the risks associated with CFM? I don't know.
I'm not sure about how often you will need to be monitored if you go the intermittent route; I will have to ask my doctor about this and see what he does. Every 2 hours might be too long; on the other hand, the hospital staff may get really annoyed with having to come in more often to monitor you, and you might run into issues with them agreeing to do it. It's really hard to stand up against routine hospital policies but if you feel best with intermittent monitoring I think it's definitely worth talking to your midwives about. Maybe instead of saying "You can only monitor me every X minutes," talk to them about your concerns at a prenatal appointment and ask them what they think about intermittent monitoring and how often would be acceptable--show them that you value their medical input and want to try and find a solution that meets both of your needs.
Check to see if your hospital has wireless monitoring, my does and it was fantastic. I could move and walk, the only place it could not go with me was in the tub. That said, I declined continous monitoring and was backed up with a note attached to my file by my OB...so talk to your OB and see if they would be willing to back your descion. The nurses would come every few hours and check my progress and the hook me up to the monitors for a 15 minute span. They were great about it though, there was no nastiness about it.
Nope, no wireless monitoring. (The joys of socialised healthcare.) Last time I was even told to lie still as the monitors kept slipping off, so Im not optimistic about the quality of them this time!
I've brought this up a few times now and it's been brushed aside as 'we'll see once you're in labour, nothing in guaranteed'.
Ah well - just another reason I doubt the vbac will happen! Still, there are more important things!
You could always have to "poop" a lot and make frequent bathroom runs!
Even though I'm going with a midwife group w. a high VBAC success rate, they still require CFM b/c the birthing center is attached to the hospital and they had to fight for that. It is wireless though and they even do VBAC waterbirths, so I'm not fighting it since the midwives understand the limitations of CFM as well.
At some point, I'd probably just become a royal *** and refuse the monitoring - what are they going to do? kick you out? It was all the midwives could do to get me to lay down to get checked when I came in, so there's no way they could have gotten me to do anything else that involved lying down without extreme resistence. And, btw, I was dilated to 9 when I walked through the door after only 4 hours of labor which was completely different than the 24 hours augmented labor with my first where it took a lot longer to get anywhere close to that.
Did the MWs say you have to be at the hospital as soon as your having contractions? Because my MW knew I was going to wait until reeeally active labor (and most other providers say the same thing, even for VBACs), even though it meant no CFM at home - it's the paradox that is being a VBAC, I guess. If I were you, I'd wait until things were really going before going in, especially bc you're skeptical of how supportive they'll be when you show up.
Does England have AMA forms? Because that's your other option, if you refuse something, they can't refuse you care, but you can sign a form that says you acknowledge that you're not doing what they advise. It is hard to do, can you talk to your DH about supporting you or talking to them for you? I turned down an AFI u/s the day before I went into labor, and my DH wasn't able to be with me - it was hard, and I signed an AMA, but the nurse and MW were both nice about it after I said no...
Were you induced with your first labor? Second labors are usually faster, and it might go a lot faster than you might think. I think less checking is better, though I'm the type who didn't want any cervical checks in either of my labors (and when I got them during my first, I requested my MW not tell me how far I was along...). hth
DS2 - Oct 2010 (my VBAC baby!)
I hear you on the many exciting things the NHS does not offer! I had DD in Durham (near Newcastle) and we are now in Oxford. I have no idea what to expect once I am pg and hoping for a VBAC (ttc in the spring).
Are you working with a midwife and what does she say? What would happen if you refused continuous monitoring? I can't imagine that they are going to tie you down and force them on you. I would just say no but I am kind of a trouble maker. GL!
m/c at 13 weeks - March 23, 2011
Well, I've heard great things about having babies on the NHS - most women I know felt really empowered by the experience. But I think if you're one of the 30% who end up with a c/s, it seals your fate re: all subsequent pregnancies/deliveries.
It depends a LOT on the trusts, and even hospitals, so Oxford may be very different.
I see a midwife for my check ups, but I'm officially consultant (OB) led (again, b/c I'm high risk), and so she has no say apart from the regular care aspects. I would LOVE her to deliver DD, but not an option. Re: refusing, she's been very political and opting otu of an opinion. :-/
You're all right, I don't have to agree - I can refuse continuous monitoring. I just remember what it was like last time, and unless things do go more quickly, I think I'll be weak. I was advised to go in asap, so probably will early on. (That's my problem: I submit to scaremongering.)
Thanks ladies!