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J&MsMom
member
Is your OB VBAC friendly?
J&MsMom
member
I might be looking to switch OBs and I wanted to attempt a VBAC. Does anyone have a Dr. or MW that is friendly to VBACs?
Thanks!
Max born July 25
Big sisters Alex and Layla
This discussion has been closed.
Re: Is your OB VBAC friendly?
Max born July 25
Big sisters Alex and Layla
Perfectly Female, they seem to be, I chose to have a repeat c-s but they would've let me do a VBAC, even though my 2nd was due 20mo after I had my 1st
Be careful... I found that many practices who seem VBAC friendly do a bait and switch on you in the last 4 weeks of your pregnancy when it feels too late to switch, and all of a sudden give you condition after condition that would make your planned VBAC attempt not ok.... this is what happened to me in March last year.
I was really happy with my OB/midwife practice until the 8th month when I met with an OB who told me out of the blue that I would not be "allowed" to try for my VBAC if 1) I went a single day past my due date, 2) they "estimated" that the baby was over 7 lbs. 8 oz. (my first baby was 8 lbs 1 oz so I was sure my next boy would be at least that), and 3) I would have to come to the hospital as soon as labor began in order to have continuous fetal monitoring. I cried after that appointment.
After my first birth led to an emergency C-section due to "fetal distress" (which is totally subjective by the way) I did more research into all of this and found that continuous fetal monitoring leads to 3x more likelihood of C-section, because in the normal course of labor, the baby's heartrate fluctuates and if they are monitoring you 24/7, they are bound to come across a few numbers that cause them "concern" especially when they are scared that you're trying a VBAC in the first place!!!!
Long story short, I was only able to find one doctor in this area who honestly is willing to let women try for a VBAC in the hospital setting - Dr. Tchabo at VHC. Unfortunately, after meeting with him, I realized that he is now on his way to retirement so he works fewer shifts, so your chance of him actually being on call when you are in labor is slim - he now "outsources" the times he is off call to another OB practice, whose VBAC rates are as low as the next doctor. And, he works with residents to a great extent so there is a high likelihood that the resident could be delivering you (or worse, that he would be supervising a resident giving you a C-section).
The online forum stories all warned that you basically have to show up at the hospital already at 8 or 9 cm to have a chance at your VBAC.
OK, sorry to ramble a bit....... in my case, I didn't feel confident that I could achieve a VBAC in the hospital setting where I felt that they are so nervous about being sued they would push a repeat C-section on me at the smallest hint of anything being out of the ordinary. So, I made the very hard decision to plan a homebirth. I got my VBAC!
Good luck ---- be SO sure that you have a doctor/midwife who really has your back.
Be sure to check your OB's C-section rates, and your hospital's rates, too:
https://icanofnova.org/articles/OB_Cesarean_Rates
OMG, EVERYTHING she said above!!! most of them say they are vbac friendly, but most of them are not, when it really comes down to it.
i regularly attend the ICAN of NoVA meetings and i can't tell you how many moms (actually, ALL of them, no joke, every single mom who has an OB has come in saying this) come in towards the end of their pregnancies, very upset because the OB who had been so VBAC friendly at the beginning of their pregnancy was now showing truer colors, fear mongering and threatening scheduled surgeries for babies that didn't arrive by 40 weeks (or any other artificial number - babies come when they are ready).
Dr. Tchabo is the last of his kind. sadly.
please consider attending an ICAN meeting. they meet monthly and are a really great resource for getting the real skinny on area OBs. i do recall the ICAN leader mentioning another OB who might be a candidate to replace Dr. Tchabo as the area's leading OB for mother/baby-friendly labor.
Thanks ladies. I will look into an ICAN meeting. My husband is very worried because I have had two c-sections but I showed him the research about VBACs after two and he still is nervous.
We will see.
Max born July 25
Big sisters Alex and Layla
I agree w/pp about being leary of OBs but at some point you have to trust someone. I had to switch from my midwives office at 34 weeks because their backup OBs who are required to assist with VBACs were fearmongering and had a strict 40 week or c/s policy. I am currently w/Women First OB/GYN and they are being very supportive and have given me an additional 8 days past my EDD for my body to go into spontaneous labor. I looked into HBAC but couldn't find anyone so late in my pregnancy.
If you really want to VBAC you need to make sure you are informed on the most current ACOG guidelines and be your own advocate. No one can force you to have a RCS especially if you and your baby are completely healthy.
TTC #1 Cycle 14 - IUI#1=BFN, IUI#2=BFP | TTC #2 Cycle 8=BFP!!
Re: Loudoun Physicians for Women - Dr. Brown has said she will let me go to 41 weeks but then will schedule a c-section. The other 3 docs (who are younger) have all been leaning towards just scheduling it. I am a very low risk VBAC at this point, so I am pretty sure they are used to erring on the side of "caution". My strategy at this point is to stay at home until I'm pretty sure I have to push and then go to the hospital, which is literally 5 minutes from my house. I'm exaggerating, but only a bit. If I could have found a midwife who would have taken me, that's what I would have done. I'm fed up with the whole OB industry.
My thought process is that they can't force me to schedule a c-section - they can threaten me and try to scare me into it, but they can't force me. Obviously, if there are complications between now and then - scary bleeding, pre-eclampsia, baby is breech, etc., I will reevaluate and do what's best for the baby. I just don't want to be pushed into anything. I had a terrible birth experience last time and was pushed into a completely unneccessary CS.
If you've had 2 previous CS, you might want to check the current recommendations on VBAC. I don't think you will find a practice that will allow a VBAC attempt after 2 previous CS. If you do find one, more power to you!! Good luck!
a note to all: the risk that OBs get anxious about in a vbac is uterine rupture. for a VBA1C, the risk is minimal (studies have shown rates ranging from 0.2 - 1.5%), which is, in most circumstances (low, transverse incision, no other risk factors) not significantly greater than the risk of uterine rupture for a first time mother (rates range from 0.012 - 0.07).
additionally, the rate for vbacs includes every rupture, including those too small to require any intervention, which is to say that just bc you have a bleed doesn't necessarily = emergency. i am not familiar with the rates for vba1+c.
there are indicators of imminent uterine rupture that can be observed during labor. the problem with staying home until you are ready to have your baby is you are on your own with no one to observe you for presentation of such indicators (the uterus contracts differently when rupture is imminent - a qualified MW can observe this change because mom's behavior and perhaps facial expressions change).
because OBs and nurses in a hospital setting cannot be with you for your entire labor, many want continuous fetal monitoring (i think most require it if you have an epidural), so that they can observe the changes in your contractions. there are actually mixed reviews over whether continuous fetal monitoring predisposes you to complications requiring interventions, but i digress.
the point is, staying home might not be the best if you are planning a vbac, unless you have a birth professional with you...a MW or a doula who has a midwifery or nursing background.
to the OP - please post if you plan to go to the meeting next week! would love to meet you! many of the women there have husbands who aren't so on board, too...might be able to give you some ideas.
Mine are! I go to Greenbriar. Drs. Pickford, Gopal and Shin are VBAC friendly, Dr. Werthiem not as much. Dr. W. did my section with DD #1 and Dr. Shin did my VBAC with DD #2. They also maintained, the whole time, that I would have to have a repeat if I didn't go in to labor by 40 weeks. But close to my due date I convinced them to let me go another week. Then at the 41 week mark I convinced them to let me go to 42 weeks. They agreed, but had to schedule the section for one day before 42 w due to their schedule (all the docs were booked for surgery on my 42 w day and they couldn't add another section - plus it was a Friday and they didn't want to do a section on the weekend
). I did agree to have additional monitoring to get them to agree to keep putting off the section. I ended up going into labor 11 days past my due date and delivered a 9 lb 6 oz baby.
Dr. Shin was AMAZING. I can not say enough about how great she was. Even though I was fully dialated and had pushed for an hour and a half, DD #2 was having the same problem DD #1 had (trouble getting past my pelvic bone). She never once suggested going to a section. She just told me to be patient and relax. I did a lot of breathing and zoned out (even though I had an epidural). She came back 1.5 hours later, my epidural had mainly worn off and we were ready to push again. Two pushes later DD #2 was born. Dr. W. probably would have tried to convince me to go to a section after our first pushing attempt failed. I really think if you stick to your guns, you can get what you want. He is, by far, the most conservative of the group. The only bad thing was that because I was a VBAC I had to be hooked up to the fetal monitors the whole time - the docs would not budge on that. Given that, I could not handle the contractions while in bed, so I got the epidural. In the end, the epidural is what got me through the birth of a big baby. I'm only 5"1' and DD #2 was big - both Dr. Shin and the L&D nurse were shocked when she came out of me
My first birth was an emergency section after 30 hours of pitocin-induced labor. My second birth was less than 12 hours of labor (including my water breaking) and a wonderful delivery. My recovery was a breeze (and my section recovery was very easy). I wish you luck in getting your VBAC.
ETA: Oops, just saw that you have had two previous sections. Not sure about Greenbriar's policy on that.
I have done some research and even the ACOG says that women who have had two c-sections should be allowed to attempt a trail of labor. Depending on the study the risk of rupture is anywhere from .03%- 3.0%.
I am most likely not going to be able to find a Dr. that will let me but I want to research it before I give up and schedule a repeat.
Max born July 25
Big sisters Alex and Layla