FRUSTRATED!
I never thought it would be so darn hard to get OB's more on board with me wanting a VBAC!
My last labor was REALLY long and hard. I had all back labor, got the epidural too early, got ZERO sleep, and started running a fever. After 2 1/2 hours of pushing and me passing out in between every contraction, we decided on a c-section. My daughter was 8lbs and 13 ounces. She was sunny side up.
I knew I wanted a VBAC or at least a TOLAC for this baby, so I lost 21 pounds (+35 pounds of baby weight) and have been more active. I have now had 3 OB opinions and a midwife practice's opinion, and no one thinks I am a good candidate. The last person gave me a study from 1997 saying my chances of a successful vbac as 30-35% and everyone seems to think my odds are even less! I do not understand. I get the fact that I have a smaller pelvis, and I do realize that we have larger sized babies (9+lb babies are normal in my husband's family---and all the women are petite!), but I still lost 21 pounds, I am eating a bit better, I am more active, I now know what I should and should not do in labor, and this baby may not be sunny side up! My doctor told me that I can have a TOLAC if this baby is smaller. We will evaluate if I am dialating around 37-39 weeks and do a growth ultrasound, and that is when they will let me know if I am allowed to go through with my plan or if I have to do the RCS. If my "odds" are 60+% they will allow it. Otherwise it is a no go.
I like my current doctor and I love the hospital we will be using (home birth is not an option for us), but I am unsure how to fight for my right in all of this. What can I print off to show them? And how do I get my extended family to understand and support me (my husband is fine with whatever)....they all think I am being stupid and endangering the baby.
P.S. The hospital I am using has a REALLY high VBAC rate (I have now heard 95-100%). I found out I have one of the best VBAC OB's around here (from the other opinions---they did not understand why I was seeking other opinions when she is my doctor). Apparently both the hospital and doctor only fully support VBAC's when something went wrong with the baby (placenta issues, distress, breech) or if the new baby is under 3500 grams). I am just so frustrated!
Re: FRUSTRATED!
Is that right? 3500 grams is 7.7 lbs - that's how much the c-section baby has to be, or the VBAC baby? Either way, that is a really insane requirement.
Do you have hospital-based midwives in your area? Have you talked to your local ICAN branch? I'm sorry you are being given such a hard time, a lot of us on here had similar stories with our births that ended in a c-section...my first son was also OP, but my second was lined up correctly and I had a VBAC no problem.
I don't think it matters what you tell your current provider, if they don't want you to have a VBAC, they won't let you have one. You could always try to show up at the hospital pushing, but it's not the easiest/best thing to do.
I would keep on looking, or seriously consider home birth - I know you said it's not an option for you, but sometimes it's the only option that will allow a woman a decent chance to VBAC.
DS2 - Oct 2010 (my VBAC baby!)
Even if your doctor only likes VBAC when the prior baby was the problem, I feel like you ARE one of those situations. You had an above average baby sunny side up. From what i have read on here, all bets are off with a sunny side up baby. Plenty of people have VBACed after that- with larger babies even.
Sorry this has become so frustrating for you. It isn't fair. It sounds like you might be stuck with the doctor, but to suggest you have to be dilating by 37 weeks doesn't sound VBAC friendly on any scale. I'd ask for a more up to date study AND ask them why they think you wouldn't have been able to birth that baby had he been in a more desirable position.
I don't understand why doctors don't count c/s for OP position the same way they do a c/s for breech position. Your baby's position was causing problems with delivery. That is not a reflection on your ability to deliver vaginally. Cesarean rates increase significantly when the baby is in the OP position. Furthermore, when doctors attempt to manually rotate the baby, the cesarean rate drops significantly. This shows that OP position causes women to need c-sections who otherwise would have been able to deliver vaginally.
I am 4'10" and I weighed 90 lbs soaking wet before each of my pregnancies. I got the "your pelvis is too small" spiel too. I figured with my size, if anyone really did have a pelvis that was too small, it would be me. My first baby was OP position and I had a c/s after 2 hours of pushing with no progress. My OB told me that I was not a good candidate for VBAC because of my pelvis. I found a new doctor and had a fast uncomplicated VBAC with a baby who was 2 ounces larger than my first child.
Some stuff for you to print out:
OP position significantly increases c/s rate:
https://www.ejog.org/article/S0301-2115(07)00071-1/abstract
https://journals.lww.com/obgynsurvey/Abstract/2008/02000/Manual_Rotation_in_Occiput_Posterior_or_Transverse.9.aspx
https://www.ncbi.nlm.nih.gov/pubmed/12738150
https://www.ncbi.nlm.nih.gov/pubmed/11755548
https://prepforbirth.com/news/wp-content/uploads/2009/10/1671-dystocia-nulliparous.pdf
VBAC odds after a prior cesarean for failure to descend/CPD:
This study finds an 80% VBAC success rate for a c/s during the second stage:
https://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1998.tb09939.x/abstract
This study finds a 75% VBAC success rate after a cesarean for failure to descend:
https://journals.lww.com/greenjournal/Abstract/2001/10000/Should_We_Allow_a_Trial_of_Labor_After_a_Previous.22.aspx
WOW! Thank you sooooo much! I have not had a chance to read these yet, but I hope to tomorrow! Thank you, thank you, thank you!