Military hospitals and RCSs/VBACs and midwife programs

ladybugpjb · September 2012

The subject line says it all. We are planning to TTC, and I'm thinking about my options for prenatal care and delivery. We are PCSing to San Diego soon, so I was looking at the website for the Naval hospital there, but I couldn't find answers to my questions.

1. How do MTFs usually handle women who have had c-sections - do they allow VBACs or should I just expect to have an RCS?

2. Will they consider me high risk since I've already had a c-section?

3. Related to "high risk" question - Do military hospital midwife programs accept women who have had c-sections?

Sorry if any of these are dumb questions - I really did try to search on my own. Also, I haven't researched VBAC vs. RCS enough to have a preference, but I don't want to set my heart on a VBAC if it's not even going to be a possibility. If any of you have experience with this, I'd appreciate the info.

ufsandra85 · September 2012

best bet is to call the hospital and ask your specific questions. I have found that is extremely helpful. BUT i have never heard of someone being high risk because they have had a c section

ladybugpjb · September 2012

ufsandra85:
best bet is to call the hospital and ask your specific questions. I have found that is extremely helpful. BUT i have never heard of someone being high risk because they have had a c section

Maybe "high risk" was the wrong term. The website for the hospital where I delivered DS (and used the midwife program) talks about the midwife program being about low-intervention and how they help with non-medication pain management. It doesn't say anything about VBAC, but I have heard of some hospitals that won't do them because they are high risk. And obviously midwives don't perform c-sections, so I wasn't sure if any of the military hospital midwife programs will do prenatal visits with a woman planning an RCS. Does that even make sense? I felt a lot more comfortable with the midwives than I do with doctors.

ufsandra85 · September 2012

oh ok

i thought you were talking about Perinatologist/maternal fetal medicine high risk

drcolleen · September 2012

DoD policy is that an OB has to be in house during a VBAC but it can be attended by a midwife or family physician (our on call OR team stays in house if laboring at night). As a family doc I do VBAC counseling but as a resident we would send patients desiring VBAC for a 1x visit to an OB for consent to VBAC. How patients are assigned and whether the midwifery service will accept VBACs is up to the clinic's policy so you'll have to ask.

hbbmama · September 2012

I would guess they take it on a case by case basis. I have a friend who just had a repeat c-section, but did some of her prenatal visits with a mid-wife, c-section was done by an OB. I know they do VBAC's at our facility, but again it will probably depend on the circumstances, the facility etc. Best bet is to call that facility. Good luck!

GreenFlamingo7 · September 2012

Change to Tricare Standard and pick your own hospital and midwife or other provider. Honestly, there is no real answer to your questions because you can't lump it all together like that. Asking the same question about "civilian hospitals" would turn up a zillion answers because it depends on the experience of that particular provider, their education and background, the policies of that particular hospital, etc etc.

ladybugpjb · September 2012

Thanks drcolleen and hbreivik. I'll give them a call sometime.

Nemesis3112 · September 2012

I delivered ODS at Camp Pendleton Naval. I was seen by a midwife until it was obvious that he was breach and not turning.I really liked my midwife and OB there,they are very helpful and really tried to meet all the things I wanted.

In 2011 I delivered LO at Camp Lejeune NH.They were VERY VBAC friendly.I was seen by a midwife right away until he too was breach.I was seen by two OBs and both really preferred me to have a VBAC but it just wasn't going to happen.The morning of my repeat c/s they check one last time and were prepared to let me go home if he flipped.I was very happy with my care.

MrsMoody2006 · October 2012

They cannot force you into anything, they may prefer not to do VBACs, but if you refuse to sign a consent for a c/s, they cannot perform one.

Military hospitals and RCSs/VBACs and midwife programs

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