OB will only let me go to about 40 weeks and Q re doula

Re: OB will only let me go to about 40 weeks and Q re doula

• cecilyandgautam member

  December 2013

  Hi there! Having a 40 week cutoff is generally not VBAC friendly and definitely a way to get your c-section rate up because only about half of women go into labor by 40 weeks. Not wanting to induce a VBAC - I think that is more common but not the stance of ACOG. Sounds like you had reasons to deliver early last time. I don't know how likely those are to repeat in second pregnancies, but you may find that you need some one who is willing to induce a VBAC patient should those reasons arise again. 

  
  

  For finding a doula, your local ICAN chapter might have some recommendations. My practice keeps a list of recommended doulas - yours might as well. It's good to ask just to see how your Dr reacts. 

  

  
  

  
  

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• IBackBevo member

  December 2013

  @cecilyandgautam - Thanks for replying!  I think my Ob would be receptive to a doula.  She had info on one in her waiting room.
  
  I really don't want to change from my OB, but I also want a VBAC...so it is a bit of a conundrum.  
  
  I have been given different statistics on the likelihood of the pre-e repeating itself...there really is no way to know.  Honestly, I am prepared for the fact that if I do end up with pre-e and iugr, I was most likely end up with an RCS and I am okay with that.  BUT if I end up having a healthy pregnancy, I don't want to be pushed into a RCS just because I have not gone into labor by 40 weeks. I think I will probably talk to her again about it at our next appointment and let her know that I really, really want a VBAC if I don't end up with any complications.  If she seems receptive, I will probably stick with her.  If not, I may look elsewhere.
  
  I also have heard of women simply refusing a RCS at 40 weeks and saying they will wait for labor...legally speaking, they can't force you to get a RCS.  But that also puts you at odds with the doctor and isn't the best situation to be in.
  

  IF DX: DOR & Fragile X pre-mutation carrier
  2011: FSH 13.3 & E 99; AMH 0.54 2nd FSH 6.2 E 40's AFC: 8
  BFP from Clomid/IUI ~ Pre-e and IUGR during pregnancy ~ DS born 9/4/12
  Feb./March 2013: AMH less than 0.16 (undectable) and AFC = 4;
  BFP from supps ~ DS#2 due May 2014
  

  
  May 2014 January Siggy Challenge:
  
  

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• cecilyandgautam member

  December 2013

  It's good to check back in. The challenge with simply declining is that while the Dr can not force you, they can scare you and creatively interpret the data your body presents to make a very compelling and scary case. It's rare to find a practice that simply says "ok, you're the patient, we respect your wishes" when you decline what they recommend, or in this case when you go against what they "allow."

  
  

  The other thing to bare in mind is that complications do, of course, occur and you want a medical team you can trust in case that happens. Having a Dr who is eager to section you before labor even starts will make you hesitant to accept his recommendations and you won't really be in a position to know whether the risks he's cautioning you about are real. But if you find a truly VBAC supportive place, say a practice that has a VBAC success rate of at least 75% and a c-section rate of 20% or less, then you can have confidence in the Dr's recommendations when they say you need something for your safety or your baby's. For example, the practice I'm with has an episiotomy rate of 2.3% so I know that they aren't knife happy and if they were to recommend one, I would probably trust their judgement. I think you need to have that peace of mind that you're in good hands, so you can focus your energies on working through labor, rather than determining who's on your side and who isn't. 

  

  
  

  
  

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• ave1012 member

  December 2013

  I am considering VBAC for this pregnancy. My OB said that they will let me go a week past 40 and then schedule repeat if nothing has happened. They do not induce either. First pregnancy ended with emergency section under general anesthesia due to severe acute pre-e.

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