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Birth center vs hospital VBAC... perspectives please.

babyikebabyike member
in VBAC

apologies in advance for formatting, as i am posting from my phone.

so, the local birth center has started taking vbac clients on a case-by-case basis. since i've already had a vbac, the midwives think i'm a great candidate (yay!). i'm comfortable with their safety/transfer policies in place, but i do have one hangup.  the midwife did tell me that when they have to do a non-emergency vbac transfer, the result is often a c-section but this depends on the on-call ob and tthe reason for transfer.  my dilemma is that i already have a very vbac-supportive ob practice and hospital, and if i needed interventions for labor (pitocin, etc) i'd already be at the hospital so no transfer issues.

what are y'alls thoughts/perspectives on this?  i'm just looking for others' views on this since i figure "two heads are better than one" so to speak. thanks ladies!

~Sweet Girl *8/18/08* c-section ~ Sweet Boy *12/2/10* VBAC ~ Sweet Boy *8/14/12* VBAC~ 

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Re: Birth center vs hospital VBAC... perspectives please.

  • pepomntpatpepomntpat member

    Did they say why it was for a c-section primarily?  Is it due to the fact that they try everything they can to get LO out and know LO won't be positioned properly or is it more of a "punishment" for trying an out of hospital birth?

    Personally if you are comfortable with your current practice, I'd stick with them.  

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  • MAprincessMAprincess member

    I agree that I'd stick with the VBAC friendly OB and hospital that you have already VBACed in. I would have loved to have VBACed at a birth center but if the back-up hospital was not VBAC friendly, I think that would have been a deal breaker.  For me, I VBACed in a hospital with a high VBAC rate with a supportive midwife.  I did need pit to get the labor going.  It would have been upsetting to me that they would section me for no reason other than they were not VBAC friendly.

    Bottom line- I vote stick with the friendly hospital.

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  • babyikebabyike member

    Thanks ladies.

    @ pepomntpat - the midwife didn't give specifics, only said that was what she had experienced with non-emergency vbac transfers. She did say that they try to get their backup ob to be on-call as much as possible or other more vbac-supportive obs to come in. It just depends. This is the same hospital that I had my c/s with DD, so I'm obviously cautious after her statement today... They have a decent vbac rate, but there's no guarantee that I'll get a vbac supportive on-call if I had to be transferred.

    @ MAprincess - the ob practice and hospital I'm with for this baby, I did not use with my vbac with DS. So, while they have been supportive thus far, I am going off of the recommendations from my ICAN chapter and not personal experience birthing there. But, you both make good points about sticking with the supportive ob I already have. 

    My doula seems to be very supportive of switching to the birth center, but I want to feel good about the decision to switch/not switch providers at this point...

     

    ~Sweet Girl *8/18/08* c-section ~ Sweet Boy *12/2/10* VBAC ~ Sweet Boy *8/14/12* VBAC~ 

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  • iris427iris427 member
    I had the same dilemma when I was considering HBAC.  If I did have to transfer, there was no guarantee that I would get a VBAC-friendly doctor.  Ultimately I decided to take that chance because I felt that being out of the hospital gave me the best overall chance of having a VBAC.  My HB provider had such a high VBAC rate and low transfer rate that I felt good about my choice.  But I was having a primary VBAC too, so statistically my odds of success were lower than yours are now.  I would feel more comfortable being in a hospital for a 2VBAC because I would feel like it would be harder for them to screw things up for me, if that makes sense.  Either way, it sounds like you have two good options.  GL!
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  • babyikebabyike member

    imageiris427:
    I had the same dilemma when I was considering HBAC.  If I did have to transfer, there was no guarantee that I would get a VBAC-friendly doctor.  Ultimately I decided to take that chance because I felt that being out of the hospital gave me the best overall chance of having a VBAC.  My HB provider had such a high VBAC rate and low transfer rate that I felt good about my choice.  But I was having a primary VBAC too, so statistically my odds of success were lower than yours are now.  I would feel more comfortable being in a hospital for a 2VBAC because I would feel like it would be harder for them to screw things up for me, if that makes sense.  Either way, it sounds like you have two good options.  GL!

    Thanks for the feedback iris! It's a touch decision, but I am of course thankful to have such great options this time around. Your point about it being harder for the hospital to screw things up for a 2VBAC makes total sense. The hospital L?/D section is brand new, but my ob has a great VBAC rate from the previous hospital.  And this new hospital makes several VBAC-supportive statements on a few different pages on their website, so I think it's a fair to assume I'd have good support for a 2VBAC.

    The local birth center was where I would have wanted to be for my primary VBAC though, had we not moved out of state when pregnant with DS.  They have a super low transfer rate, and my doula has attended lots of VBACs there in the past.  Plus I'll get to have another waterbirth there, whereas that's not an option at the new hospital at all.  

    It definitely sounds like I need to get more detailed information before making a choice.  I did already make a first consult with the birth center in 3 weeks, so I have plenty of time to call/email them with questions.  Perhaps that appt will help!

    Thanks again! 

    ~Sweet Girl *8/18/08* c-section ~ Sweet Boy *12/2/10* VBAC ~ Sweet Boy *8/14/12* VBAC~ 

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    VBAC Birth Story    2VBAC Birth Story  


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