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VBAC
WWYD- (very long note) Doc avoiding discussion and seems reluctant for VBAC
Hello ladies,
I am wondering if it is too late to get a different doctor, whether or not we should, or what advice you might have for this situation.
With our first child I was a week and a half past due so they induced with pitocin but it really didn't help. I did everything without pain meds at first. They had to break my water for me. I was in labor 25 hours without much progress then the doctor said we had to do a c section because the baby was starting to stress so they gave me a spinal and did the csec. According to the doctor, our daughter was difficult to get out even then, she was up by my ribs and didn't want to budge.
We stuck with the same OBGYN and conceived 8 months after delivery of our first baby. We are now due Sept 1 and have brought up a VBAC a couple of times with the OBGYN and she has an attitude problem. She gave us a speech about my uterus potentially rupturing and malpractice suits, yatta yatta. She said I am not a good candidate because we didn't wait long enough in between pregnancies. If we had waited three years she would be more comfortable with it. She said we wont make a decision now and can discuss it when I am 39 weeks. She said would rather schedule a csection than let me go full term or past my due date. She said if I do go into labor to contact her immediately and go to the hospital instead of waiting for close contractions because it would be safer to bring me into surgery than let me deliver naturally.
We explained we would like to have a few more children and continuing to have csections is not conducive to that family plan. She responded by going on another speech about people making bad decisions to have large families and we should consider stopping after this one because multiple csections are not recommended and most doctors will not let me try for a vbac after two csections. Then she lectured me on putting this baby at risk so we could potentially have another.
Hopefully that is enough background. Basically I am concerned that she is stringing us along to our 39th week only to refuse to let us try for VBAC. I'm upset because I feel like she is pushing me into a corner and I really want to have a VBAC if possible. I was able to deal with the pain the first time and I am hoping this child progresses better than the first.
Do any of you know of someone who had a ruptured uterus from trying a VBAC? Any suggestions on what to do?
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Re: WWYD- (very long note) Doc avoiding discussion and seems reluctant for VBAC
It sounds like your OB is not very VBAC friendly. If she won't even discuss it til 39 weeks, when it's too late for you to change providers, and she won't even let you go to your due date, the chances of you getting a VBAC are really low. If you really want one, look into switching care providers.
The risk of uterine rupture is still very low even for VBAC, even for babies with close spacing. The risk increases with medications like pitocin or with epidural but it is still small. I don't have any stats to quote but I'm sure you can find them on ICAN or on the board FAQs. I don't know anyone personally who has had one but we were discussing this at my ICAN meeting this week and the leader has seen a handful of them. However, the outcome was good in all cases. There was also a mom at the meeting whose babies will be about 15 months apart and she is planning a home VBAC. So there are providers who will take you on.
Good luck!
Thank you for your reply, the knot in my throat just got a little smaller
I googled ICAN and there is a meeting group in my area on Monday. I am going to go to that and chat with some of the people there and see what doctor they used. I still have 12 weeks to my due date so hopefully I can switch providers without a problem.
Thanks again!
First, her response about making bad decsions to have large familes is entirely none of her business. To me that signifies a lack of professionalism that I wouldn't be comfortable with and would look to swtich just because of that. Lurk a bit on this board, I have found a ton of resources (links to legitimate research), and experiences that really give you a good idea of what the risks really are. Is it possible to switch to another practice or a midwife?
I also had a c/s with my first in 2009, we wait 2 years before getting PG again. My OB who did the c/s said as she was stitching me up "you'll be a great VBAC candidate" she said this again at my 6 week PP visit. At my first visit with her when I was 8 weeks PG, all of a sudden she isn't so positive about it and continued to be, I could go into specific details but I wont write a novel here. I left a few of my appointments feeling so unsettled about how negative she was being about the possibility of having a VBAC I started looking elsewhere and 2 weeks ago switched to a Midwife practice that will do VBAC's in the hospital. My final decsion was when I walked out of the MW practice for the first time I felt so supported and actually positive about the possiblity of having a VBAC, the MW I met with said "when you tell us you want a VBAC we go into it assuming that is what will happen and we will do everything we can to make that happen while keeping you and baby safe and healthy."
I switched providers at 14 weeks. I know people who switched much later. Your doctor is not educated in nor is she positive about VBACs (a reasonable option for you). The fact that she mentioned malpractice suits to you is unprofessional but certainly shows her stripes.
Good luck and the ican crew will likely be able to help you find a different option!
I second (or third, or whatever) all of this. Find another doctor if you possibly can -- don't wait until 39 weeks to make a decision on VBAC. Every pregnancy is different so you have a good shot of a successful VBAC, but you NEED a supportive doctor.
The risk of rupture is less than 1/2 of 1% as long as you are NOT induced. That's from a New England Journal of Medicine article, which I read after my OB, who was initially VBAC friendly, scared me. I found a new OB.
I see too many red flags to suggest continuing with this OB if you truely want a VBAC.
Hopefully your ICAN chapter will have some good resources for you. I would definitely switch.
Checking out ICAN is a great first step, I'm sure they will be able to point you in the direction of a truly supportive provider. No offense, but she sounds awful - good for you for looking for someone else!
Good luck!
DS2 - Oct 2010 (my VBAC baby!)
Ugh...that's a tough one. It does sound like your OB could have approached the topic with more tact. I can see her concerns about your kids being close together & the strength of your uterine scar.
My OB, who is very VBAC friendly, told me that I am an ideal candidate b/c I never went into labor with DS. He was breech, I had a scheduled c/s. She did say that if I had labored and pushed and didn't really progress w/ DS, she & I would be having a very different conversation and VBAC would not likely be her recommendation.
I would see another provider to discuss VBAC and get a 2nd opinion.
Your doctor is equally uninformed on VBAC. I labored and didn't progress. DD was malpositioned with the cord wrapped twice around her neck. My MW told me I was still an excellent VBAC candidate.
OP, I hope your local ICAN chapter can help you find a supportive provider. I would not hesitate to switch. Good luck!