VBAC

Out of hospital VBACs

I'm curious if anyone has had either an HBAC or Birth Center VBAC and any experiences.  I was planning a home birth with DD and ended up with a C-section.  I'm an excellent candidate to VBAC but am deciding when the time comes where I would want to give birth.  Midwife attended VBACs are legal in WI   so that isn't an issue.  Out of curiosity I asked my MW before any of this if she did VBACS, and she does, However the doctor she usually goes to for backup care (he delivered DD) does not back HBACS.  There is a birth center 1.5 hours away which does VBACS and they send transfers to a near by hospital.  I've contacted them for info and am still waiting for a reply.  Just want to see what other experiences are.  I know the risk of a rupture is still low, but it still will play a role in my decision where to birth.  Thanks for any advice. 

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Re: Out of hospital VBACs

  • I hope it's okay that I'm responding as I'm not a vbac mama but I know there's a doctor in Milwaukee that does vbacs- he was in the book Pushed but I'm sorry I can't remember his name....otherwise there is a birthcenter and midwives (two practices that I know of) in case that might help, in Appleton, I don't know if it's closer or not though. GL!

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  • My DH would not support a HB.  He's still trying to figure out a way to teleport a baby from a belly.  Joking aside, the stress of having to run to the hospital as an emergency is too much for me.  I'm not a great VBAC candidate, so I know I could very well be one of the 20-30% who tries and fails.  I'd rather be in place at a hospital or very close (birthing center in or near a hospital). 

    Unfortunately in our area, none of the birth centers I've found will support a VBAC.  My plan is to surround myself with support (a MW and doula), but be at a hospital.

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  • I'm planning a HBAC at a friends house since we live in the mountain (30+ minutes from hospital).  The midwife I have this time does HB and HBACs, though she does require a u/s in the third tri to make sure the placenta isn't over the c/s scar.  I've done so much reading into VBACs, natural births and home births that I know this is the right decision for me/us.  Also my c/s was primarily due to cascading interventions, so I don't want to have to fight them this time.
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  • There are a couple girls on the board that have had HBACs and birth center VBACs.... I'm sure they'll pipe in.

     

    I'm not sure if you're looking into Madison Birth Center, but I'm pretty sure they don't allow first VBACs.... only once you have a previous VBAC.  (I'll be attempting my VBAC at St. Marys next month and would be happy to share my experience if that's one of the hospitals you're looking at). 

     

    Would you be able to use your midwife for the homebirth.... but then in the case of an emergency transfer to your nearest hospital and then use the backup doctor (since he doesn't attend home births)? If you show up at the hospital, they can't refuse to treat you.  

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  • I had an HBAC with an ob/gyn.  I live literally a mile from a major hospital so the ability to get to the hospital within minutes was a factor I considered.  I didn't have any formal back-up arrangement with anyone.  If we needed to transfer, we would just get whomever was on-call, which is not ideal but I was OK with it.  None of the birth centers near me are legally permitted to do VBAC so that was one reason I chose a home birth. 

    I have found only one study on out of hospital VBAC.  While the authors of this study recommend that VBAC only be done in the hospital, if you look at the results of the study, they had very good outcomes--the overall UR rate was 0.4% and when they took out women who were past 42 weeks or had more than 1 prior cesarean, the UR rate dropped to 0.2%.

    My HBAC was great and I am very happy I chose to deliver at home.  

    https://journals.lww.com/greenjournal/abstract/2004/11000/results_of_the_national_study_of_vaginal_birth.9.aspx

    https://www.lamaze.org/Research/WhenResearchisFlawed/VBACLieberman/tabid/176/Default.aspx 

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  • i had a CPM assisted hbac last year. it was a wonderful experience.

    would your MW assist you even if her back up OB does not support hbac? would that mean in the event of a hospital transfer you'd get whoever was at the hospital that day? i think that wouldn't be ideal, but if i really liked the MW, it probably wouldn't be a deal breaker. after all, if i needed a hospital transfer during labor, it's because something is wrong and it doesn't really matter who the OB is.  

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  • imagemyantonia:

    There are a couple girls on the board that have had HBACs and birth center VBACs.... I'm sure they'll pipe in.

     

    I'm not sure if you're looking into Madison Birth Center, but I'm pretty sure they don't allow first VBACs.... only once you have a previous VBAC.  (I'll be attempting my VBAC at St. Marys next month and would be happy to share my experience if that's one of the hospitals you're looking at). 

     

    Would you be able to use your midwife for the homebirth.... but then in the case of an emergency transfer to your nearest hospital and then use the backup doctor (since he doesn't attend home births)? If you show up at the hospital, they can't refuse to treat you.  

    The doctor won't do backup for HBACS if something happens at home.  The closest hospital is 2 blocks away, but it is a very very small hospital.  I'll ask my MW if they even have an OB on-call.  Madison is about 3 hours away from us, so wouldn't be the best choice.  I'm looking into the birth center in menomenee falls (sp) it is a bit over an hour, but i know they do VBACs.  Iris, thanks for the statistics. 

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  • I have no idea where you are in WI but I know that Dr. Hartung in Hudson supports HBACs and has been back up for several women who have had HBACs from the Twin Cities ICAN chapter.
  • imageSquirrel29:
    I have no idea where you are in WI but I know that Dr. Hartung in Hudson supports HBACs and has been back up for several women who have had HBACs from the Twin Cities ICAN chapter.

    Thanks for the info.  I will see where exactly he is located :)

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  • I don't know how to quote...  But Hartung is located in Hudson, he is with Hudson Physicians and his office is located in Hudson hospital.  Best of Luck!
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