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VBAC
Homebirth - better chance for a successful VBAC?
When my daughter was born, I had a cesarean due to her being a surprise breech.
When I met with my doula last week (I'm now 15.5 weeks), she said that if I was comfortable with it, I should look into homebirth as an option for my VBAC. I have started reading resources and it seems like the risks are not much, if any, greater than hospital births (for low risk moms). Obviously, a HUGE piece of the puzzle is me feeling 100% comfortable with my decision to have the baby at home.
I'm wondering if anyone has any insight or information on whether a homebirth VBAC has a greater chance of being more successful than a hospital VBAC. I am nervous because even though my hospital and miwifery group has an 80%+ VBAC success rate, I am going to have to wear a continuous fetal monitoring device (likely wireless, but still). I am worried about that and other kinds of hospital-ly things inhibiting labor and therefore making the VBAC less likely.
I'm also talking with local midwives and going to an ICAN meeting this month, but I want to hear your insight if you have any! Thanks!
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Re: Homebirth - better chance for a successful VBAC?
I'm choosing a out of hospital birth at a center with midwives who also do home births. VBACS have to be at their center due to proximity to the hospital and they get to charge their facility fee, essentially though it is the same as a home birth.
Iris has posted articles on the safety of VBACs in the hospital vs. at home but I don't recall seeing anything comparing general success rates. For me the VBAC friendly hospital claims a success rate of 80% while the midwives' rate is closer to 90%.
I think it depends a lot on what the hospital and the your provider's policies are. I could go to the hospital but they won't induce vbacs or use pit at all if labor stalls and I would be "on the clock". I'd also be given a 41 week limit at most as opposed to a 42 week limit. I figure if it can't happen naturally with the attentive and patient care of the midwives and my birth team then it wasn't meant to happen. At least I will know if they transfer me that everything possible was done (since the hospital won't do anything medicallythat they can't due for failure to progress) and that I had the support.
I'm not sure on the success rate of homebirth VBACs vs hospital VBACs, but I can tell you that the likelihood of medical intervention is obviously going to be polar opposite between the two. With a homebirth, there is no OB or staff constantly coming in suggesting various meds/procedures to advance your labor. The pace at home is set by you and your birth team, not working against the clock like at the hospital.
Iris (moderator of this board) may have this information posted somewhere
And I think you will get a ton of information on this from the ICAN meeting. I know that both the Denver and south TX groups were VERY informed on both homebirth and hospital birth options/information/resources!
I had a hospital waterbirth VBAC with a midwife group in Denver, CO, and I wouldn't change anything about the experience. Yes it was annoying to have the on-call OB come in to discuss the risks of VBAC, but honestly it was nice to feel "comfortable" and safe. I think those are the two most important things to consider. Where will you feel the most comfortable and safe for the birth of your child? The answer to that question will likely end up being the best option for you and baby.
This time, I am in a completely different birthing environment as we've since moved back to south TX. My doula here has also spoken with me about homebirth, and while the idea seems fascinating and wonderful... I just can't seem to get over the fear of not being in the hospital if an emergency were to occur (VBAC or non-VBAC related). I realize that most homebirth transfers are non-emergency, and the midwife is more than qualified to identify issues before they become emergent. But it just doesn't fit with me like I wish it would
I would be 100% okay with a birthing center, but the ones close to me no longer accept VBACs (regardless of prior vaginal birth or succesful VBACs). The birthing centers here are all located less than 1 mile from the hospitals, so I'm not as worried about emergencies per se.
Sorry this got so long LOL. GL to you!
~Sweet Girl *8/18/08* c-section ~ Sweet Boy *12/2/10* VBAC ~ Sweet Boy *8/14/12* VBAC~
VBAC Birth Story 2VBAC Birth Story
This woman had an HBAC, and is a statistician: https://vbacfacts.com/2008/09/06/homebirth-vs-hospital-birth-for-the-number-cruncher/
DS2 - Oct 2010 (my VBAC baby!)
Thank you guys so much for your input.
Unfortunately, to my knowledge, I don't have a nearby birthing center that accepts VBACs (I think we only have one). I love the idea of that - it seems like a great combination of both worlds.
Babyike, if I remember correctly from previous posts and based on what you're saying, I think you had your VBAC where I delivered last time and where I'm probably going to deliver this time. I love the group, the care, feel very comfortable there, etc. and I am excited about finally (hopefully) getting my waterbirth. My doula was just presenting homebirth as an option. I think the way you phrase it is a great summary of her biggest concern - the medical intervention aspect is going to be night and day in a hospital vs. at home. (Also, the one thing I don't love about this facility is that if you do need a cesarean, you just get one of the on call docs from the huge pool and will never have met them. I got pretty lucky last time but it would be nice to have a more familiar relationship with my potential surgeon).
One of the things that (strangely) sticks out in my memory most from my reading of Ina May's Guide to Childbirth is the sphincter rule (I think because I grew up with Wayne's World!). If I'm scared/very anxious/worried about the distance to the hospital from our home (a 15 minute drive), it's going to be way tougher to birth
Thanks again for your comments, guys. I am not too anxious about this, mostly just like thinking and talking about it.
ETA: thanks for the link. I will check it out. Only two comments had posted before I starting writing my novel here, ha.
80% vbac success rate sounds good to me! some things that eased my fears about my hospital vbac was that there were OBs and midwives staffing, thus they had to be there no matter what and i wouldn't have been subjected to arbitrary timelines. they did require CFM but otherwise seemed to be pretty hands off. and the hospital tour was very family-centered and appeared accepting/supportive of natural birth. there were of course the stupid hospital rules and stuff to follow, and although i think the interventions unraveled my psyche and interfered with me able to go natural, it did not impact the vbac.
but you have to have your baby in the environment where you will be most comfortable, where you body will be able to do what it is meant to do. and if that means home birth, then go for it!
My Wedding Bio!
If you ever want to PM me with questions/etc I would be happy to share any and all info/experiences/opinions (all are good) I have about my VBAC with UC-CFM. To be honest, if we hadn't found a group here (TX) that I felt comfortable with, DH had already agreed that we could fly up to Denver at 36 weeks and wait it out there LOL! GL!
~Sweet Girl *8/18/08* c-section ~ Sweet Boy *12/2/10* VBAC ~ Sweet Boy *8/14/12* VBAC~
VBAC Birth Story 2VBAC Birth Story
Thank you so much! That is awesome. I will definitely keep you in mind as things get closer. I am actually really excited about birthing there. Last time, even as they were sewing me up, both the OB and the midwife were saying "you are so going to rock a VBAC next time." They are VERY supportive and I just love the environment. Glad to hear it was so good for you, too. Also glad to hear you found a place more nearby that works for you!