When to head to hospital?

planeNsimple · April 2012

So I woke up freaking about about a rupture. No idea why! My doctor said to go in just as I would in any normal labor. But I'm wondering what other doctors say to their patients. I know they want to monitor you closer during a VBAC to make sure everything is ok, so in my scared head that means to go in when active labor starts so they can make sure everything is ok. What are your thoughts?

cchill01 · April 2012

While I am concerned - odds are overwhelmingly in our favor.

I plan to act as if this is a normal labor. I will stay at home as long as possible. I want to be able to move around and get in the tub, or do whatever I think will help me progress. If baby is still moving (but not frantically) and I'm not in severe abdominal pain, then I'm going to assume we're both ok. I know there are cases where there are no warning signs, but the odds of that are even smaller.

I think the rupture issue has just been so hyped up, that it's hard to ignore it. But, the fact is uterine rupture can also occur in a unscarred uterus and I never thought about that before. There are also other life-threatening labor issues (like shoulder dystocia) that I really don't lose sleep over.

Good luck and let us know how you do!

selockar · April 2012

My Ob told me I could stay at home as long as I wanted. I only need to come in early if my water has broken and I'm not having contractions (she'll give me pitocin and move things along) or if I experience any abnormal abdominal pain. I really try not to worry about the chance of rupture. I feel like if I focus on the small chance of rupture I will be too scared to labor and push effectively. When the thought pops in my head I just go back through my list of reasons to do it.

Aloe0l · April 2012

My OB is more cautious as she actually had a patient that experirenced a rupture. I don't know the outcome however, but I do know it made them change how they treat VBACs (mostly to err on the side of caution) and they now recommend coming in earlier than you would if you were in regular labor. I can sympathize with her concerns, as I can't imagine what it must have been like for a VBAC advocate to actually have to handle a rupture.

However, it is just a recommendation. I do know that my OB will require internal fetal monitoring, which requires them to break my water. So, I'm hoping to stay at home at least long enough for my water to break on my own, or to where I don't feel I can adequately manage my contractions on my own anymore, whichever comes first. I also plan to hire a doula to help me with those decisions, as well as support me in the hospital.

Twizzle · April 2012

I haven't spoken to my midwives about this yet but I did ask a doula and midwife at an ICAN meeting recently about this. Both agreed that your chances of successful VBAC decrease the earlier you go into the hospital due to all of the potential interventions and not being able to labor as you like.

Despite the scary sounding name, uterine ruptures start with a very tiny tear. The women I spoke to said that as long as you are laboring naturally without medications, you are able to sense that something is not right if a tear happens and a rupture is beginning, with ample time to get yourself to a hospital. But you do have to be aware of your body and what's going on. They also recommended getting a stethoscope or doppler that you can use at home to check baby's heart rate while you are in labor for some extra reassurance.

I am probably going to try to labor at home for as long as possible but I am most likely going to hire a doula to be there with me for the extra reassurance.

Jen524 · April 2012

My doctor said to head in like anyone else in labor. I went in when contractions were 3.5-4 minutes apart and lasting almost a minute. I wanted to stay home longer, but I was GBS positive and needed to be on antibiotics. I was 6 cm and 100% effaced when I got there. I was ready to push in 3 hours after that. Staying at home as long as you can helps since you are able to move around and eat/drink. Now if I would have had any reason (i.e. pain that was not contraction pain or bleeding) I would have gone in right away.

nosoup4u · April 2012

My MW said to come in when labor was well-established. I had contractions for about 30-45 seconds every five minutes when labor started, but I could tell it was way too early to go in. I waited until things got "serious" - we left for the hospital right after water broke, and I couldn't talk through contractions anymore, and I showed up pushing.

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