VBAC
VBAC = mandatory epi, constant monitoring...?
Hi, ladies. I had baby 1 c/s as he was breech and version completely failed. Baby 2 was breech until very end and by then when I considered changing to VBAC, DH, his family (who we needed to watch ds), and some of my docs (practice so if you do vaginal it's whomever is on duty that day) were not supportive. Wit not muc time to take vbac class/research and no support (and didn't know about doulas really), I went repeat c/s. I have actually had great c/s with great recoveries overall - last time was d/c 8 hours after surgery. BUT I wish I had tried the VBAC. I may not have a choice this time (i was originally scheduled to see the doc who said first c/s meant all would be c/s so I switched to my normal ob who delivered my others but that means waiting another 9 days b/c DH couldn't do the free appt time this week, drats). So I haven't talked to him yet but I know VBA2C is increasing so hoping it's a possibility - but I know one thing that pushed me away last time was that our hospitals policy is VBAC should come in sooner (% don't remember exact timing of contractions, but it was a lot earlier in labor) and would have an epi and constant monitoring = can't move around. While I understand monitoring baby and the idea of why they want an epi, I can't see being stuck in bed as setting up a successful vbac situation. Anyone else have similar policies to work with?
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Re: VBAC = mandatory epi, constant monitoring...?
As for the epi, I don't think that anyone can actually force you to have one...just know that if you need an emergency cs that you'd have to be put under. I didn't get the epi until I was 8 cm, because I wanted to give myself the chance to progress past the point where I stalled last time.
I was concerned about having to be put out if I ended up with a c/s, but my dr said that most emergency c/s aren't true emergencies. Meaning, they usually still have time. Since spinals only take a few min to take full effect, he said rarely is it such an emergency that they can't give you a spinal real quickly. of course, in the rare case that they truly only have a min to get baby out, I would be put out, but that it's too rare to let it dictate how I labor.
You're saying this in regard to her being a VBAC? Because unless it's an emergency-emergency, there's no reason to put someone under for a c/s just because they are a VBAC.
OP, I would look around and see if other practices/hospitals have better policies for VBAC. ACOG does support VBA2C. The mandatory epidural/staying in bed is a load of crap though, pardon my french. Is there an ICAN group in your area? They would be a good resource for finding someone. hth and good luck!
DS2 - Oct 2010 (my VBAC baby!)
Constant monitoring is fairly standard - even for non-VBACs. Mine wasn't wireless, but I could get up and move around the bed. Honestly, I found I had the most control sitting on the side of the bed anyway.
I went natural, because my epidural didn't arrive in time. There was no requirement for one. They did required a heplock, just in case.
Continuous monitoring was required, but they had a wireless unit so it was no big deal. Epi was not required, but I did end up getting one after about 10 hours because I was feeling urges to push too early and it was just too exhausting to fight that and contractions. When the anesthesiologist was putting it in, he said he thought it was good I was getting it because it would make it easier if I did end up having to have a RCS. However, in a true emergency, there wouldn't even be enough time to increase your epidural even if you had one. They would still put you under. I know of only one person who had a true emergency c/s, and she had general anesthesia even though she already had an epi in.
I personally felt better with having continuous monitoring but like I said it didn't limit my movement at all. See if you can get the hospital to purchase a telemetry/wireless unit.
"Just keep swimming, just keep swimming..."
I had my vbac with an epi. My hospital didn't require it but they strongly encouraged it. In my case, my first delivery had to be under general anesthesia. I had HELLP and my blood clotting numbers were too low for a spinal. So for this pregnancy, my main goal was to be awake no matter what. I knew the risk of a true emergency c/s was low but for me it wasn't a risk I was willing to take. I had the hardest time recovering emotionally from being knocked out for my first birth.
I had a doula and my intent was to go as long as possible without an epi. But when I wasn't dilating and my doctor wanted to administer pitocin, I decided I didn't want to do without without the epi.
In my situation, the epi was great. I was able to get rest, which I think helped me during the pushing stage. I also wasn't completely numb so I was still able to feel when and how I needed to push when the time came.
I understand the potential issues with getting an epi but I am very happy I made the decision that I did. And it is possible to have a successful vbac with an epidural.
But if it's something you feel passionate about avoiding, then you should consider switching practices.
It almost seems like something that could set you up for a failed VBAC. An epi increases the chance pg a csection. Hmmm
Anyway, if you don't want one, push not to have it.
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