VBAC

The irony of continous monitoring & thoughts on doulas

So my hospital will require it and my dr. said I could stay home as long as possible (suggested wait unitl 2-3 min apart contractions).

I love the irony of it all.... I'm considered higher risk so I require continious monitoring but will have more sucess if I stall comming in and get less monitoring then I would if they offered intermitent monitoring.

 I have no issues with my dr. I just find this quite ironic.

Side note, she just had a VBAC patient sucessfully deliever 35 minutes after arriving at the hospital.

Now I'm debating a doula to help with all the at home labouring. I'm not sure though, I really like to be in  control of the process and am not sure how I feel about having another person there. I've emailed a few with some prelim questions and may interview a few based on the responses and DH's thoughts.  Anyone have any great doula insight?

 

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Re: The irony of continous monitoring & thoughts on doulas

  • I loved having a doula.  I was nervous because I am shy around people I don't know well and the idea of someone being there during some of the most private, vulnerable moments of my life made me nervous.  I also mostly like to be left alone if I'm in pain or not feeling well.  But I had worked as a doula myself and seen how much of a difference it made for women, so I knew I had to just get past it.  And honestly, once I was in labor none of those things bothered me.  I didn't care if my doula saw me naked or crying and I found her presence to be very helpful, not distracting and annoying.  The doula actually helped me feel more in control of what was going on, not less, because she helped me stay calm and focused.

    And yes, I agree about the monitoring thing being ironic.  My friend was attempting a VBAC with an OB who'd had a VBAC herself.  The OB told her that staying home a long time in labor was key to her own VBAC success--but then insisted that my friend come to the hospital in early labor and have continuous monitoring.  It shows how a doctor can't or won't always recommend what they think is best or even what they would do themselves in that situation.  Instead of a blanket policy, I think tailoring everything to the individual would result in more sensible and effective care.  But that's not how the system works unfortunately.

    FWIW my friend ended up with an unplanned repeat c/s for FTP and said if she could do it all over again, the two things she would change were staying home longer and hiring a doula.  

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  • I think it's good that your OB is trying to help you out by allowing you to stay home for a while.  She seems to be aware of the problems caused by continuous monitoring and is trying to give you the best chances for your VBAC.  I'd go for the doula.  You can still be in control-she is there to help you if/when you need it.  I was ready to hire a doula for DH's benefit more than my own before we decided to go with a homebirth.

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  • Are you considered higher risk becuase you are a VBAC or something else?  I know all of the VBAC supportive docs and midwive I have talked to said that VBAC does not make you higher risk (if they are worried about rupture, your risk with a scarred uterus is around .07% and a first time mom's is about .05% or something like that--I don't remember the exact numbers).

    I think it is a really really good idea to stay home as long as possible.  CFM has been shown to have higher rates of c/s without better outcomes and that makes me personally uncomfortable.

    I pushed DD out about 30 minutes after we got to the hospital and right before we left I asked my doula if she was sure I was in labor because I didn't want to go if she wasn't really sure it was labor (it took about 15 minutes to get the hospital from my house so DD was born about 45 min after I asked if it was really labor).

    I would hire a doula whether I was plannng to labor at home or not.  I think they are so very important.  I really don't think I could have done it without my doulas.  Neither H nor I ever felt like they were trying to take over or anything, they were just there to add extra encouragement and support and help where we needed it (like with DS before my mom got there to take him or to get me water when I didn't want to be left alone during labor).

    We are planning a homebirth this time and I still want a doula, but H doesn't.  Not hiring a doula but hiring a midwife is sort of our compromise because I wanted a midwife and doula assisted homebirth and he wanted a unassisted homebirth.  Still though, I have in the back of my mind that if I want a doula when I am laboring I will call one last minute.  They are worth their weight in gold plus some IMO.

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  • ShansBride - The "higher risk" is the VBAC and how the hospital will clasify me.

    Thanks ladies.

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  • LOL  I totally hear you.  I'm GBS+ and a VBACer, and despite that, the nurse when I went in for a L&D tour even told me to stay at home as long as possible.  Loved that she said that and thought it was so ironic!  I actually thanked her - she probably thought I was crazy!

    As for the doula - I didn't have one last time, and really wish I had.  Will have one this time.  VBAC success goes way up statistically.  I'm really excited about having someone there who has a bit more insight on when to go in (I've never been in labor before, so between the GBS thing and the VBAC thing, I'm nervous I'd get there and be at 2 cm or some such).  My doula is really experienced, so I feel that (while she's not a medical professional) she'll be able to give a bit of insight into some of that stuff, as well as tell DH & I what questions we should ask of our medical professionals (something that was hard to do in the moment with the last L&D).   I figure (and she even has said) if I need time alone with DH or just want her gone at some point, I can tell her.  I don't anticipate that happening, though.  DH really likes her, too, which makes me think that it will give him more confidence to help me during L&D, which is very important to me.

    Sorry for the rambling! :)

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