Overweight & advanced maternal age influence on success?

anitaflora · May 2012

I just got my BFP Fri so it's still a little early I guess to be thinking about my L & D options. But I'm curious if anyone can give me input on how much obesity and age impact VBAC success.

If I decide to go that route, I will need to look into a hospital about an hour and a half from where I live. I'm not comfortable with HBAC and the hospitals near me have very low success rates and do not allow midwives to deliver.

As to why I had a c section with DS, it eventually was because he wasn't fitting. But I think if I hadn't had an epidural I would have had more success in the window of time I had. And I only got the epidural because I originally went to the hospital thinking my water had broken normally when in fact it was a "high leak" I guess it's called. When I went on at 8 am they didn't realize that had happened until about midnight. So then I asked them to break my water fully to get things moving and then finally things started to progress. But by 3 am I was done with trying to manage the pain so I got an epidural. Which caused everything to slow down etc. etc.

Sorry this is so long but just wanted to give some background. And I'm sorry this isn't like a nice and formal intro post - don't know if I'm breaking any board etiquette but I hope not!!

Oh specifically I will be 39 this month and am about 45 lbs overweight (officially obese BMI).

Thank you in advance for any input!!

Cornflakegrl · May 2012

Congrats on your pregnancy! It's never too early to start thinking about this. Finding the right practioner is key. Do you have a local ICAN group? They're a great resource for locating a VBAC-friendly provider who delivers at that particular hospital.

The VBAC calculator does factor in both age and BMI into its prediction of success, and some practioners will use the number. https://www.bsc.gwu.edu/mfmu/vagbirth.html But it's just a prediction, and women with low percentages do have VBAC's. A 40-50% chance is so much better than a 0% chance, right?

I'm curious - Did your OB explain how he/she was sure that your DS wasn't fitting? Were there any signs of distress with your baby?

cchill01 · May 2012

This was posted the other day in someone's success story. Her doctor said, the two biggest factors in getting a VBAC are attitude/support and knowledge. If you have a truly supportive provider and a good attitude, I think you can definitely make up for things like AMA and BMI. I am 4 months shy of AMA and I'm at the top end of overweight, but I'm not worrying about that. My provider has a success rate of over 95% and I refuse to be one of her handful of VBAC failures.

anitaflora · May 2012

Thanks for the encouragement ladies!

I think the nearest ICAN group is either DC or Baltimore, both are about an hour and a half from me. But I will definitely contact both and see if they have any resources for me.

I am weighing whether or not my chances of success will be worth the inconvenience of my care being so far away. I have a toddler at home now so that all factors in. But when I think about how important it is to me for so many reasons, I kinda think it would be totally worth the temporary inconvenience.

I think the other thing that worries me is that this would be my second and due in winter. If I go into labor super quickly what if I don't have time to get there?

Oh, regarding why baby wasn't fitting - I know he didn't come down far enough. I don't remember if he was in distress. But I do know I didn't feel like I was able to get in very many good pushes I felt like. And I think if I had a little more time and no epidural things would have been different.

Thanks again for all your support and good luck to you cc!

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