XP: In hospital natural birth with VBAC?

jalaiaa · February 2012

I would like to have a med-free VBAC but plan on delivering at a hospital. I spoke with my OB today and am feeling bummed. Essentially she said that if I want a natural delivery I need to stay at home as long as possible because if I come to the hospital it is essentially policy for them to do an epidural and continuous monitoring because it is a VBAC. She said if I show up at 8cm, they obviously wouldn't push an epidural on me so to try to stay home as long as I can. I plan on staying home as long as possible and laboring there anyway, but heck, I've never done this before, what if I think I'm almost ready and I show up and am only 4cm. I understand I can refuse the epidural and continuous monitoring, and I plan to, but by nature I'm not an adversarial person so I was hoping for more of a supportive situation.

If you had a natural birth VBAC was your OB ok letting you labor without continuous monitoring etc? Wondering if this is pretty much standard policy with VBACs or if it is my OB/hospital. On a side note, one of the reasons I chose her was that I heard she doesn't rush to c-section. With the boys she would have delivered vaginally even if baby B was breech (they were both transverse so I had to have a c-section anyway).

penguinem · February 2012

I just had a VBAC at a major medical center less than two weeks ago. I could have been natural but I chose to get an epidural at about 7 cms. I chose this because I felt it increased my chances of a positive experience; when I went in I knew I wanted to try natural but was open to the epi because my goal was to VBAC. A lot of hospitals push the epi because VBACing increases the risk of c section, and if you have to go suddenly and anesthesia doesn't have access already set up you will need to go under general anesthesia. That was the deciding factor for me; even though the labor was going well I was so scared of missing the birth altogether. As far as monitoring, I had to be on an external monitor per policy but it allowed me to be up, on the ball, etc. My baby was not in distress at all, but if that would have become an issue they would have done an internal. For me, I wanted to keep my OB and give birth at my hospital because that was my comfort. I felt supported but knew it may increase my chances of medical intervention. I decided to let go of my plan for a totally natural birth (with my first) and just focus on having a vaginal birth to get what I wanted and I was ok with that. I think if you are really unsure if your hospital will support you then you may want to investigate other options that meet your criteria. You can see my birth story several posts down "from a lurker"

Good luck! I turned everything over in my head the whole pregnancy; it can be maddening!

rbytsdy · February 2012

I went med-free in the hospital for my VBAC. I had a midwife and went to a hospital that offered wireless monitoring. So I was monitored the whole time but I could get in and out of the tub, shower, etc and walk around as much as I wanted. I did not get an epidural catheter placed or anything. I figured I would take my chances! Once they break your water, you have about a 0.5% chance of a cord prolapse but we don't make all vaginal--birthing mothers get epidurals for that reason!

nosoup4u · February 2012

I think continuous monitoring is standard everywhere for VBAC. Does your hospital have telemetry (wireless) units?

Having an epidural as standard for VBAC is bullsh!t, frankly. There's no reason for it other than making it easier for the provider. I would definitely push back on that one, and outright refuse it (or have your DH or whoever you're with refuse for you).

I had a med-free VBAC in the hospital, and my MW knew I wasn't planning on an epidural. Luckily, I showed up pushing, but they still strapped me to a monitor and put a saline lock in me (and did a really bad job, bc I was in the middle of labor). I remember my MW definitely pushed the "show up in when you're pretty far along", too.

Have you thought about hiring a doula, or even a montrice? A montrice is usually a home birth MW or nurse who acts as a doula at the hospital, but she's also qualified to do cervix checks. That way you could labor at home and be assured you're far enough along when you get to the hospital.

BeanieWeanie · February 2012

I was also going to suggest a doula. We hired one and it was great to know that someone with a lot of experience was there to see through any potential BS and advocate for us. As it turned out, I had to lay on my side because that was the only position that didn't stress the baby and it was excruciating not to be able to move so I got an epi since I was confined to bed anyway. Still, the doula really helped, as did going with a midwife who was supportive of my wishes too, even tho it didn't go as planned.

monksmama · February 2012

My Med-Free VBAC was two years ago, so I'm not sure if much has changed.

My OB (who was super supportive) also told me to stay at home as long as I could. His words were 'give us the least amount of time to ruin it for you.'

I got to the hospital at 2am in some serious labor. I was only at a 6 when I got there. I was given a non-negotible heplock (which sucked as they couldn't get it in right) and I was tethered to the monitor. I was able to sit/stand/lay/birth ball with the monitor on, but the problem was that baby didn't like it and kept trying to get away. Every time he shifted the nurse would have to come back in an readjust it, which he hated. So he would try to esacpe the monitor and throw me into another contraction. That was hell.

I kept having to 'use the restroom' just so they would take the damn thing off and leave me alone for a few minutes.

Luckily Babe was born at 4am after only 20 minutes of pushing so I was only stuck there for 2 hours.

After the birth the on-call OB and the nurses gave me a really hard time about the pitocin to deliver the placenta. I gave in and I do regret that as the after pain were intense and really served no purpose but to hurry up the placenta delivery so they could move on. I also tore pretty badly from his hand and elbow position during delivery and while they did numb the area prior to stitching, I did feel the end of the stitching and asked for more meds and was told 'oh, we're almost done anyway.' Then the gave me IV drugs I didn't want.

It was worth it and I'll VBAC again, but DH and I will be more forceful about what we want and don't want. And I'll still labor at home as long as I can.

shunt1983 · February 2012

i had one but the hospital is natural birth friendly plus my doc, was no 1 vbac doctor in the area, she got the hospital to get wireless monitors for this reason. constant monitoring is the standard because uterine erruption can occur at any point. you can still refuse the epi, just have tobe strong about it. bc at some point transition you will ask for it. when i asked for mine they knew i wanted a natural birth said your a 7 you were a 2 1.5 hrs ago youll be a ten soon. we can start fluids but youre awhile from getting it by then transition passed. telling you to stay at home until i wdnt do no one wants to be going to hospital in transition

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