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VBAC
preping for a vbac...long
in VBAC
Hi ladies! I'm new to this board and looking for advice on trying a vbac. My daughter is 10 months old. DH and are plan to start ttc after her first bday. With my first pregnancy I was induced on my due date because of her size. I was only 1 cm dialated going in but about 14 hours after the pitocin was started I was fully dialated. She was still not descending so I was given an hour and told that if she did not come down in that time we'd have to talk about a c-section. When my dr came back she was still in the same position so he suggested a c section and I lost it. The nurse actually told me (after the dr left the room) not to let him scare me with the csection threat...that he threatens people like that all the time. Anyway, he gave me another half hour, then came back and suggested I "try some practice pushes to see if i could bring her down." I was allowed 3 pushes...literally...then he checked me and said she had moved down a bit but not enough and that I would need to have the csection. I fought, I cried but I gave in because I felt like I was fighting a loosing battle. I had a horrible experience with my csection and a long recovery. As soon as it was over I knew I never wanted to go through that again. It made me question if I would ever have the big family dh and I have always wanted. i'm excited about having a vbac and I know I can do it. my only worry is finding the right person (hopefully mw) to support me in it. Im planning to set up meetings with a few mw before we even start ttc but I dont really know what kind of questions I should be asking. Any suggestions? Also, I've been flip flopping between a home birth and a hospital birth so i'd love to hear personal experiences on both if you dont mind sharing. TIA!
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Re: preping for a vbac...long
Hi and welcome!
Wow, I am so sorry about your previous experience. That sounds awful. I want to smack that doctor for you! I'm glad that you are looking for a new provider. Finding a truly supportive OB/midwife practice was the best thing that I did to prepare for my VBAC. The questions I asked were things like:
- Do you have any restrictions on what type of person you will allow to have a VBAC?
- At what point in pregnancy, if any, do you automatically induce? Is it different for your "regular" vs VBAC patients?
- About how many VBAC patients do you see per year? What is the "success" rate?
- Do you require continuous or intermittent monitoring during labor?
- Will I be allowed freedom of movement? Can I get in the shower or tub? Can I push in different positions?
- Will I be allowed to eat and drink during labor?
The next thing I did was ask around to see what kinds of experiences people had had with each provider. This was important to me, because my first OB did kind of a bait and switch, where he pretended to be ok with a VBAC until I was about 16 weeks, at which point he told me to schedule my RCS or find another doctor. I used my local bump board, citysearch, and ICAN forums to make sure that my new choice was truly supportive, and not just playing games with me.
I ended up having a hospital birth. It was very important to DH, and honestly, given the complications I had had during my previous pregnancy it was probably the best choice. It went very well - the nursing staff was amazing. For my next birth I am strongly considering a birthing center, mainly because I'd really like to labor in a tub.
Wow. I cannot believe that your doctor was so incredibly impatient. He must have had something important to get to. And how "big" did your DD end up being?
Anyways - I'd run far from that doctor. Check with your local ICAN chapter for a VBAC friendly OB or MW.
I'm REALLY hoping for an HBAC provided that a MW will have me.
Rated "L" For Life Blog
The definition of macrosomia (big baby) is at least 10 lbs. Your baby was quite normal! I'm so sorry your doctor was such a jerk (not a strong enough word for someone who cares so little about your body, but?).
My c/s was unplanned but not forced on me and I feel it was necessary even though I had done everything "right" to prepare for a natural, unmedicated birth. For that reason, even though I knew it was incredibly unlikely to happen again, I never considered HBAC. I really don't think that there is enough trusting birth, positive thinking, or believing in yourself to make the possibility that you need medical interventions go away, and when lives are at stake, it's not a risk I'm willing to take. I do admit it's easier for me to say that as someone who lives in a VBAC-default society. I knew my care providers wouldn't force me into an RCS. If you find a hospital with supportive staff, a hospital VBAC can be a beautiful, wonderful thing. Mine was!
Good luck with your upcoming TTC and in finding the right care for you!
Rach gave you a lot of great questions. I would also talk about what happened during your labor last time and how that could be handled differently if the same situation arose again--would they be willing to let you push longer, in different positions, etc. as long as the baby and you both were doing ok? Or would they also recommend a c/s right away?
As for home vs. hospital birth. It's definitely a person choice. IMO a home birth will give you a higher chance at having a VBAC and more autonomy to give birth the way you want. I think home birth providers are more willing to "allow" things like different positioning, laboring or giving birth in water, eating in labor, etc. With a homebirth, you are less likely to run into defensive medicine, where your provider has to put their own legal concerns ahead of your medical needs. At a hospital, you may have a lower chance at VBAC (although hopefully if they really support VBAC, they will still give you a good chance) and you may have more restrictions on what you are allowed to do and how you should give birth. The downside of homebirth is that in the event that a rupture does occur, you will not be in a hospital and it might take you longer to get a needed c-section. In a hospital, those resources should be more readily available (although sometimes it can also take a hospital a while to get all the staff ready and actually do the c/s). So I think those are the main things you need to consider. I think either is a valid choice and it depends on what you feel most comfortable with.
GL!
I think there are a lot of women who choose out of hospital birth (whether at home or at a freestanding birth center) who did *not* make that choice because they feel that birth is risk-free. It's not so much a naive trusting of birth as much as they look at the risks and benefits of hospital vs. OOH and come to a different conclusion about managing those risks.
For example.
"As a VBAC mother, if I go to a hospital, I will be more likely to have another c-section. If I have another c-section, I am more likely to die. I am more likely to have a hysterectomy. I am more likely to have serious placental problems in a future pregnancy. I will be more likely to have more PPD/PTSD and be unable to care for my children. If I stay home, there is a risk that I will lose my baby, but that risk seems smaller to me than the risk of having another c/s if I go to the hospital. Furthermore, studies on home birth show that neonatal outcomes are good. Therefore, home birth is most likely to lead to a healthy mother and baby."
Anyone else considering a HBAC please weigh in if you don't agree.
Precisely why I stated:
If you find a good hospital, your chances of RCS aren't any higher, so those concerns don't exist.
I'm jealous--it would be hard to find a hospital in the US that you could really say that about.
Anyway I'm sorry if my post sounded like I was criticizing your decision about where to birth. I didn't meant to sound like that--I was thinking more in general terms of why a woman might choose home birth.
I agree 100%. I am choosing HBAC, and I believe that it is safer and will give me the best chance at avoiding unnecessary interventions.