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VBAC
somebirdseatseeds
member
Sort of a failure to progress question...
somebirdseatseeds
member
in VBAC
My c/s story in a nutshell:
I was induced at 38.5 weeks with DD because the doctors were worried about her size (she was 5 lb 6 oz when she was born - but she is still tiny today - 18 lbs at her 1 year check up - so she is just a small girl). I was induced with pitocin, dilated to a 1 coming in, and never got past that. They tried the foley (sp?) bulb induction and still did not progress past a 1. By the next morning once I was back on pitocin, DD stopped tolerating the contractions and her heart rate started dropping with each one. So we had a c/s. I was started on pitocin at 8 am and it was stopped at 5 pm so I could eat/sleep. It was restarted at 5 am and by 8:30 am we knew we were going to have a c/s.
My question/concern:
I had my first appointment on Friday with my same OB. I have to switch because the hospital she delivers at does not support VBAC. She did her residency at the hospital that I will probably end up delivering at this time. She said that she is pro-VBAC and used to perform them all the time. She is going to hand pick my doctor to make sure I get a good one. She said she would send me to her best friend that she went to school with, graduated with, and has the same pro-VBAC feelings.
She started discussing all of the risks of VBAC, which I knew, but then started talking about my cervix. She said that I am a good candidate because of where my scar is and for the reason for the c/s in the first place (DD's heart rate dropping). However, she said I might not be a good candidate (but I can still try) because I never progressed past a 1 even with the foley bulb induction. She said that it would be way easier if we had a magic ball that could tell us if this/then that would happen, but she said that because I never went past a 1, there is a chance I may not go into labor and progress successfully in this pregnancy or future pregnancies.
Has this happened to anyone and still had a successful VBAC? Do you think that what she is saying can be possible - that my cervix might just not dilate? I told DH that we are made to have babies and that I really didn't put too much stock into what she was saying. He basically said that maybe I'm one of those special cases where what she is saying is true, where I would have died in child birth back before there were hospitals/doctors everywhere like in cowboy times or whatever.
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Re: Sort of a failure to progress question...
I am no expert, but I would have to say that your body knows what to do if you got to a 1. If there were an issue with your cervix, I would have to think that it wouldn't have dilated or effaced at all. There are too many unknowns with a induction for you to judge what your body is capable of doing "naturally". I am in a similar position, although I know the reasons why I stopped dilating (at 2): a 20cm fibroid in the contratcile portion of my uterus (my contractions couldn't get strong enough) and a malpositioned baby. I had a very long and hard labor. Even with all of that my doctor admits that I do still have a chance at a VBAC, even though it is a very very small chance (maybe even less than 1%). I'm debating on what to do, but feel like it would be nice to at least give my body a chance. I don't think it is fair for you to say that your cervix might just not dilate... because it did!
Give your body credit for what it DID accomplish, and try not to focus on what didn't happen (I know it is very very hard). I say go for it and GL with your future pregnancies!
While I have heard that those who dilate fully and then have a c-section tend to be considered better candidates for vbac, I would say in your situation it might not be applicable. You were induced early, when your baby was still quite small; your body might have known you weren't ready and that is why it didn't respond to the induction method. If you went into labour naturally I bet you would have more success. I don't have any research to back this up but it seems possible to me. I wouldn't worry about it.
See the post just below this for more motivation.
I agree with pp. Your body and baby were probably just not ready. This is not uncommon in an induction.
My best advice is to interview your new provider and stay positive. Like your doctor even said, none of us has a crystal ball. And no two births are the same.
My c/s was from an induction for questionable reasons as well at 38.5 weeks. I had 2 days of cervidil and 1 day of pitocin. From the time I started pitocin to the c/s for FTP was 16 hours. I stalled out at 7cm and did not progress for several hours so they said it was time for a c/s. DD was basically still swimming around in there, not ready at all to come out.
My vbac, I went to 41wk2d. I went into labor naturally and never had pitocin, so he was trying to come out. Still, my progress stalled out again. I was mentally preparing myself for another c/s. My doctor said lets wait and see. He poked around on my belly and suggested specific positions for me to lay in to help baby come down. And eventually I progressed. Slowly. Very slowly. And after 29 hours of labor, he came out. So yeah, my body DID know how to dilate. It was just taking its own sweet time about it.
And, FWIW, I don't think you would have died in cowboy times. You would not have been induced, baby would have been trying to come out, and the pressure of baby's head is a huge part of what makes you dilate. (And besides, the biggest killer of childbirth in olden days was childbed fever. So if you ever get stuck in a time-vortex and end up birthing in the wild west, make sure they wash their hands really really well, ok?)
I will let you know in about 16 weeks! I failed to dilate or efface at all during my first labor-- water broke first (PROM) at 39 weeks, they gave me 18 hours to go into labor on my own, didn't happen, so pitocin was started, 10 hours later, still zero progress, unbelievable pain for me, DS's heartbeat would not recover between contractions, so I had a c-section.
My doctor, as is everyone in Vancouver, is very pro-VBAC. (IMO, they actually want women to VBAC --> less expensive for our "free" healthcare.) Anyway, she finds it "curious" that I did not dilate or efface at all, but that my water breaking and induction (and the restrictions placed on me) contributed to my c-section as well. Maybe DS and I just weren't ready for the big show. She said we'll try this time, I have to go into labor on my own and we'll see if I dilate this time around.
I thought that maybe I didn't dilate because I had scar tissue from cryo years ago, but I had about 5 people up in there during my first labor and I asked every single one if they felt anything and all said no. Did you have anything like that?
Honestly, I have been doing a lot of scouring the internet for similar stories to mine and successful VBACs, but haven't come up with anything yet. Maybe one of us can be the first!
Thanks ladies! It has helped reading your responses. I will meet with the new doctor and see what she says. I wasn't worried about VBAC until my doctor said something about not dilating and you helped calm me down a little.
NicholeeK - I've never had problems before so I don't have scar tissue. I've also been trying to see if there are any stories of success with situations similar to mine to no avail. Good luck on your VBAC! You should definitely come and post your birth story here to let everyone know how it goes.