i feel like providers should have to disclose their c/s & vbac rates if asked

Mrs. Braxton · March 2011

I'm in the process of trying to find a provider for my vbac. I called one practice today to ask a few questions and they pretty much avoided any question I asked about vbac. They said they would do them but didnt answer any questions about the conditions for vbac, restrictions put on labor, success rates, etc. I'm so nervous about a bait and switch type situation and I really wish there was somewhere you could go (kinda like the bar assoc is to attorneys) to get info, complaints, etc. Part of me feels like im being paranoid but this means so much to me! I would do absolutely anything to make my vbac happen. Any tips on finding the right provider or important questions to ask would be appreciated. I already have a list of questions but I want to make sure im not missing a thing!

Jb&Jb · March 2011

Read to the bottom for some good questions to ask your provider when interviewing for VBAC:

https://talk.sagemama.net/2011/02/14/so-you-want-a-vbac.aspx

Also if you have a local ICAN chapter, you can try emailing the Chapter Leader or go to a meeting to find any suggestions on the go-to VBAC doctors/midwives in your area.

iris427 · March 2011

Yeah, it would be nice if there were more transparency here.

Who did you talk to at that practice? If it was a receptionist, they might not have known what to tell you. If it were a midwife or doctor who was being evasive about answering your questions, then I'd be more concerned.

To find my doctor, I looked on local boards for VBAC/natural birth recommendations. Even if you want to have an epidural, someone who has a good reputation for supporting natural births will probably be supportive of VBAC too (but not always). My doctor got lots of rave reviews.

So then I called him and told him I was looking for a VBAC provider and I would like to meet with him to see if it would be a good fit. My husband and I went in and just had a long chat with him--not a medical appointment, just talking. I told him about the circumstances that led to my c/s and asked him about a zillion questions. I was really happy with his responses. He talked a lot in detail, was specific about things and his answers lined up with all the research I'd done on my own.

I also met with a local midwifery practice. They also seemed like a good VBAC option and had good numbers (12% overall c/s rate, all of their VBACs in the previous year were successful) but I was really unhappy with how they handled my annual exam and an early miscarriage I had right before this pregnancy. That made me question whether I'd want them handling a whole pregnancy and birth.

So to sum this up, I'd look for a practice that will really sit and talk to you for a while and answer your questions with specific, detailed answers. I'd ask about restrictions on VBAC, their c/s and VBAC rates, how they would handle the situation that led to your first c/s, anything else you are specifically concerned about, etc. HTH.

McMookie · March 2011

When I called to schedule an initial appointment with my new group, I asked the receptionist if the group did VBACs and her response was "on a case by case basis," which spooked me to say the least. Luckily, she answers the phone and does not "catch" babies. All of the midwives in the group are very pro-VBAC, so as PP said, be aware of who you are talking to when getting information.

Mrs. Braxton · March 2011

iris427:
Yeah, it would be nice if there were more transparency here.
Who did you talk to at that practice? If it was a receptionist, they might not have known what to tell you. If it were a midwife or doctor who was being evasive about answering your questions, then I'd be more concerned.
To find my doctor, I looked on local boards for VBAC/natural birth recommendations. Even if you want to have an epidural, someone who has a good reputation for supporting natural births will probably be supportive of VBAC too (but not always). My doctor got lots of rave reviews.
So then I called him and told him I was looking for a VBAC provider and I would like to meet with him to see if it would be a good fit. My husband and I went in and just had a long chat with him--not a medical appointment, just talking. I told him about the circumstances that led to my c/s and asked him about a zillion questions. I was really happy with his responses. He talked a lot in detail, was specific about things and his answers lined up with all the research I'd done on my own.
I also met with a local midwifery practice. They also seemed like a good VBAC option and had good numbers (12% overall c/s rate, all of their VBACs in the previous year were successful) but I was really unhappy with how they handled my annual exam and an early miscarriage I had right before this pregnancy. That made me question whether I'd want them handling a whole pregnancy and birth.
So to sum this up, I'd look for a practice that will really sit and talk to you for a while and answer your questions with specific, detailed answers. I'd ask about restrictions on VBAC, their c/s and VBAC rates, how they would handle the situation that led to your first c/s, anything else you are specifically concerned about, etc. HTH.

I started out talking to a receptionist, who told me they do handle vbacs. The, when I started asking more questions she transfered me to a nurse. Since I didn't actually talk to a dr or midwife I won't completely write them off but they're definitely at the bottom of the list. i was also a little turned off by the fact that they're a huge practice. Theres 4 doctors and 6 midwife and you have to rotate through all of them. My last provider was like that and there were serious issues with communication within the office.

iris427 · March 2011

Mrs. Braxton:

I started out talking to a receptionist, who told me they do handle vbacs. The, when I started asking more questions she transfered me to a nurse. Since I didn't actually talk to a dr or midwife I won't completely write them off but they're definitely at the bottom of the list. i was also a little turned off by the fact that they're a huge practice. Theres 4 doctors and 6 midwife and you have to rotate through all of them. My last provider was like that and there were serious issues with communication within the office.

That would put me off too. I prefer small practices and I think it's even more important if you want to do something that's seen as out of the norm, like a VBAC or a med-free birth. For my first pregnancy I switched from an office with 11 doctors to one with 2. My current OB has a solo practice and I really like it.

changingnames · March 2011

I think ICAN would be a great resource for you. Do they not have to tell you their rates? My doctor told me all his numbers when I asked- maybe if you asked her to find out and call you back with the exact numbers and special circs?

MissyOlivePants · March 2011

My only thought about getting their VBAC rates would be that it could still be skewed. Meaning - they may allow for attempts, but for how long & at what point do they start pushing for a c/s.

iris427 · March 2011

MissyOlivePants:
My only thought about getting their VBAC rates would be that it could still be skewed. Meaning - they may allow for attempts, but for how long & at what point do they start pushing for a c/s.

But if they tell you they do VBACs but only have a 30% success rate, that would tell you that they are either placing a lot of restrictions on VBAC to the point where few mothers can have one, or that they don't know how to promote vaginal births. A good VBAC provider should have rates around 70% or higher IMO--that tells you that they are supportive of VBAC and have the skill and knowledge to safely help most of those moms deliver vaginally.

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