VBAC Check-In?

Sovvy · July 2015

I swear that I try searching but it pulls things from other boards and I'm just bad at it.

Anyways, how's about a VBAC checkin?

Sovvy · July 2015

I'm doing ok. I'm hoping someone has a good list of questions for VBAC providers that I can use for my next OB appt this week. My OB is in theory VBAC friendly but I am considering switching and I need to ask all my questions over again. The internet has some but any tried and true?

Other than this appt my stance is to just not think about it at all. It'll totally work. Totally.

RunnerMeg · July 2015

Here is a good list of questions from the files of an evidence-based VBAC facebook group I'm in. In addition to the questions below I am also asking these questions at my next appointment:

If a uterine rupture is detected, how quickly can a c-section be performed?
Will a dedicated OR be available the entire time? (I am interested in this because I had to wait almost 2 hours for my c/s with DS. However, he was not in distress, he just wouldn't fit).
Will you/the provider on call physically be at the hospital the entire time I am in labor?

What is your vbac success rate?

When do you test for GBS?

How late will I be allowed to go past my due date?

How will I be managed if I go past my due date?

Will you induce your TOLAC patients?

How? (Foley bulb with/without low dose pitocin?)

How early do you have your TOLAC moms come in to the hospital if they go into labor spontaneously?

Do you share call with other Ob/Gyns? Will they also be willing to care for me during a TOLAC?

In the event that I need a repeat C-section, is a gentle or family-centered cesarean offered at the hospital?

Do you have any rules about epidurals for your TOLAC moms?

Does the hospital have wireless monitors so I can ambulate in my room?

If all the monitors are wired can I still be out of bed but connected, maybe on a birthing ball or standing, if that is more comfortable for me?

What are your feelings on doulas? Do you know any you would recommend to me if I wanted to hire one?

What complications near the end of my pregnancy would possibly lead you to no longer recommend I have a TOLAC? (PIH, pre-E, GD, IUGR or fetal macrosomia, etc.)

What other stipulations or requirements do you have for your TOLAC patients either at the end of pregnancy or in labor?

MarleneG88 · July 2015

Love all those @RunnerMeg !!

I had my appt last Friday with a new doc and it was amazing! Can't wait for my next one. Other than that, just trying to imagine a wonderful vbac and keep in mind the feelings and determination I have On my to-do list is to start doing lots of research and reading lots of birth stories so I'll be very prepared in labor

RepeatPostPolice · July 2015

@MarleneG88 the mind is a powerful thing, I am envisioning success too when I imagine the birth.

My next appt is this Friday, with the 2nd of the 3 doctors in the office. I'm going to talk with her about vbac too, just to get a sense of how supportive she is compared to my OB.

laineylove78 · July 2015

As much as I'd like a VBAC I can't help but feel like it won't happen. I pushed for 3 hours and the nurse/doctor/husband saw her head but I couldn't push her under the pelvic bone. She was 8lbs 6oz which is on the bigger side but it's not like she was a 10lb baby. I also feel like maybe I just grow big babies and if this LO is measuring anywhere near what she was measuring I won't even try for it. I want my baby to be safe during deliver and not in distress because by pelvic bone wouldn't accommodate the largeness. Like I've said before it's a wait and see scenario, but I'm having a hard time being optimistic.

MarleneG88 · July 2015

@laineylove78 it was the same for me. My doctor said that makes my chances a little lower but they're still very good. I'm also just gonna see how everything goes and how baby looks when the time comes.

Sovvy · July 2015

Position has a lot to do with getting around the pelvic bone - both your position and baby's. If you're able to get off your back it helps immensely. That's another plus for med-free or a walking-epidural.

Sovvy · July 2015

@laineylove78 & @MarleneG88

Cailin+Deas+Rua · July 2015

My OB isn't being very supportive of a VBAC so I'm not sure what will happen. It's disappointing because the MW I had for my first was amazing and she's left the office. I know she would have been on my side. I have another appointment in 3 weeks and I'm hoping to talk with them again about it. They say my pelvic bone is too narrow and my first was only 6.5 pounds so they don't former it going well and they suggest c-section so that recovery is easier (surgery without exhaustion from labor rather than after hours of labor).

I still want to try though.

jeanbug12 · July 2015

@laineylove78 I make big babies too! My son was 9lbs 4oz, I pushed for 3+ hours and he just wasn't coming out so I had a c-section. My daughter was 8lbs 5oz, she was a VBAC and I pushed for abut 15 minutes! My RN that day told me "you could totally have a 10lb baby vaginally!" The biggest difference I think was that I was induced with my son and had an epidural, so he wasn't quite ready to come out yet and with out being able to move myself I couldn't help him get in a better position. With my daughter I went into labor naturally and didn't have an epidural, she was just ready to be born! You can do this!

RunnerMeg · July 2015

Hooray for big babies @laineylove78 ! I grow 'em big too! DS was 9lbs 14oz and 22".

@jeanbug12, very similar experience with my DS. Was induced and induction went well, I dilated to 10cm in 9-10 hours, but he never dropped past +2, station after pushing for over 3 hours. I got an epidural at 7cm, so was stuck in bed for pushing. So you didn't have an epidural with your daughter? Did our I've a doula or any other supper mechanisms?

I'm hopeful, that even if this baby is big, I can VBAC. My OB won't induce for a TOLAC so I have to go into labor on my own by 41w.

RepeatPostPolice · July 2015

Cailin+Deas+Rua said:
My OB isn't being very supportive of a VBAC so I'm not sure what will happen. It's disappointing because the MW I had for my first was amazing and she's left the office. I know she would have been on my side. I have another appointment in 3 weeks and I'm hoping to talk with them again about it. They say my pelvic bone is too narrow and my first was only 6.5 pounds so they don't former it going well and they suggest c-section so that recovery is easier (surgery without exhaustion from labor rather than after hours of labor).

I still want to try though.

If you want to try and they aren't being supportive then maybe it's time to start looking for another OB's opinion.
Another might tell you the same, but they may tell you differently.

@RunnerMeg if you don't go into spontaneous labor by 41w do they then induce? Or is it just an automatic repeat?

@jeanbug12 thank you for your vbac success story, it reinforces my determination

jeanbug12 · July 2015

RunnerMeg said:
Hooray for big babies @laineylove78 ! I grow 'em big too! DS was 9lbs 14oz and 22".

@jeanbug12, very similar experience with my DS. Was induced and induction went well, I dilated to 10cm in 9-10 hours, but he never dropped past +2, station after pushing for over 3 hours. I got an epidural at 7cm, so was stuck in bed for pushing. So you didn't have an epidural with your daughter? Did our I've a doula or any other supper mechanisms?

I'm hopeful, that even if this baby is big, I can VBAC. My OB won't induce for a TOLAC so I have to go into labor on my own by 41w.

Just determination

and a lot of fear of epidural from my first experience! My RN was amazing and I think she really had a lot to do with my success, she has just started at the hospital and had been at a birthing center for years, I really lucked out! I think a doula is a great idea, in hindsight, I didn't use one. With my daughter, I had my first contraction at 3AM and she was born at 11:40 so I really didn't labor that long. I had labored longer without an epidural with my son, but was so exhausted at the point I got one and wanted to sleep. Natural labor was much less painful than pitocin induced!

RepeatPostPolice · July 2015

The birth center we are going to use has volunteer doulas which I am so excited about.
I never went into labor with DD, so I have no idea what I'm in for but everything I've read indicates to me that even though it is painful, it's productive and therefore necessary to delivering. Not that I relish the idea of pain but it has a purpose and it's the body's way of working to get baby out so I'm willing to just deal with it. (I realize that may change entirely when I'm actually in labor but that's my
mindset going in...)

Sovvy · July 2015

Thanks for the questions, @RunnerMeg

RunnerMeg · July 2015

@repeatpostpolice -My OB won't induce for a VBAC due to increased risk of rupture. So if I don't go into labor by 41w, it's a repeat. Which I am okay with because, statistically, vbac chances success goes down after 40w and chances of fetal mortality go up.

RepeatPostPolice · July 2015

That makes sense, but I hope it doesn't come down to the wire for you. @RunnerMeg

RepeatPostPolice · July 2015

Eta double post.

RunnerMeg · July 2015

Ugh me too @RepeatPostPolice! I never went into labor with DS. He was finally born at 41+6.

RepeatPostPolice · July 2015

My intake nurse told me they don't let anyone go past 42w but I forgot to ask if that also applies to me being a vbac candidate, or if the cut-off is sooner like yours.

RunnerMeg · July 2015

@RepeatPostPolice (side note question - is this StephP? Like the new screen name

) - I know many midwives and practices will let someone go to 42w. There seems to be an equal number that only go to 41w. And some even more conservative OBs don't like patients going much past 40. The practice I was with when I had DS had a 41w cut-off. I talked extensively with my OB and she agreed to let me go to 41+4 since I agreed to come in for twice weekly NSTs and BPP. I appreciated her respecting my autonomy and decision making as a patient. Still ended in induction though lol.

jeanbug12 · July 2015

I had my VBAC at 41+5, I had to go for NST and BPP once I hit 41weeks. They also checks DDs size on US at 41 weeks, but they were way off they guessed she was about 7lbs and she was 8lbs 5oz when she was born 5 days later.

MarleneG88 · July 2015

My doctor also won't go past 41 weeks. She will induce with foley bulb but not sure if I want to do that, since I read that the success rate isn't that great. I will schedule a repeat for 41 weeks soon, just to have it ready. I'm also ok with this. My daughter came early, luckily, so hopefully this one will too

laineylove78 · July 2015

jeanbug12 said:
@laineylove78 I make big babies too! My son was 9lbs 4oz, I pushed for 3+ hours and he just wasn't coming out so I had a c-section. My daughter was 8lbs 5oz, she was a VBAC and I pushed for abut 15 minutes! My RN that day told me "you could totally have a 10lb baby vaginally!" The biggest difference I think was that I was induced with my son and had an epidural, so he wasn't quite ready to come out yet and with out being able to move myself I couldn't help him get in a better position. With my daughter I went into labor naturally and didn't have an epidural, she was just ready to be born! You can do this!

I do appreciate the support and I'm glad we have this check in to keep me optimistic.

As much relief as I felt from the epidural I do think it played at big role and my not knowing when to push. I'm petrified to not get one, however I think I'll have better chances of vaginally delivering if I'm not completely numb down there. Also the pitocin was ridiculous and caused back to back contractions that were unbearable. I think if I just let my body progress naturally I may have a chance. But again I'm worried about not dilating/effacing as I didn't at all on my own. Since induction isn't even an option I guess I'll go into labor or I won't.

kokoLeia2012 · July 2015

My ob 100% supports VBAC. And thats what i plan on this time. My last pregnancy was an emergency c and my first was a vaginal. So he said im a really good candidate for the VBAC.

Life is Exciting · July 2015

I'm technically due in February (feb 3rd), but I like this topic and was hoping you wouldn't mind if I comment.

I had a csection after being induced and having lots of other interventions (none part of my original birth plan) at 36 weeks when I had my son. In that case, it was due to dangerously low amniotic fluid. They don't know what caused it and have no idea if it'll happen again with this pregnancy. They said I can still try for a vbac if it does, but they would have to use alternate induction methods. I'll have to get more clarity on what that means at my 16 week visit in a few weeks.

When born at 36 weeks, my son weighed 6 lbs. I am very much hoping to go full term with my daughter, but am a little concerned that if I do, she'll be big (I'm imagining my son would have been at least 8.5 lbs if he had gone full term). Any thoughts on this? Do you think because she's a girl that she might be smaller?

RepeatPostPolice · July 2015

@Life is Exciting not sure whether sex plays that big of a factor in determining birth weight.

I had my OB appt today, heard the heartbeat loud and clear. Asked some questions, got some clarification. @RunnerMeg my doctors are the same as yours, they want to see spontaneous labor by 41w and they do not induce.
The only thing I'm a bit nervous about is having to fight the birth center on whether they administer pitocin. I'm hoping we can compromise on a hep-lock and observe labor before just shoving drugs in that I may not need. I'd rather drink my fluids too. We'll see, I don't want to bring it up now and stress over it when it may not even be necessary. @jeanbug12 was your vbac med-free?

Eta tag

jeanbug12 · July 2015

@Life is Exciting when I first got pregnant with my second and told my Dr I wanted to try for a VBAC, he told me "well, let's hope you are having a girl!" Because girls are usually smaller than boys. But not always. In my case, my daughter was about a pound smaller than my son, however I was a lot more careful with my diet during pregnancy and I didn't gain nearly as much weight with her. So, I think that had a lot more to do with it than sex did!

@RepeatPostPolice , yep, my VBAC was med free, I am hoping for another med free VBAC this time too!

RepeatPostPolice · July 2015

@jeanbug12 I'm going to pick your brain a little then if you don't mind. Did you have a hep-lock, or fully attached IV? What point did you go to the hospital in labor? Were you worried about labor stalling at all?

jeanbug12 · July 2015

I had my first contraction at 3 AM (on the day of my scheduled induction at 41 weeks 5 days). They were pretty intense and about 4 minutes apart right off the bat and so we called my parents around 5 to come watch DS and we got to the hospital around 6:30. My contractions were a little over 2 minutes apart when we got there. I had IV fluids going the whole time but they did take me off the monitor several times so I could go to the bathroom, I kept feeling like I had to pee but couldn't so I was back and forth a lot in the beginning, i finally asked them to in and out cath me for relief from that. I was also in and out of bed a lot, it would get up and squat at the foot of the bed with every contraction for a while and tried sitting in a rocking chair for a bit too. I didn't feel much like walking but I think they probably would have let me if I asked. I started pushing around 11:20 and DD was born at 11:40. I was pretty scared the whole time that something would go wrong, but it really all happened so fast I didn't have much time to stress about it during labor. Things really went smoothly for me and afterwards I felt like wonder woman!

RepeatPostPolice · July 2015

Awesome @jeanbug12 thank you for sharing! So happy your vbac went so well!

RunnerMeg · August 2015

Thank you for sharing your vbac birth @jeanbug12! Love hearing positive stories.

@repeatpostpolice - have you asked your provider about pitocin to augment labor? I would think the birth center would follow whatever your provider wants, so if your provider doesn't want any pitocin at all, you shouldn't have to worry about them slipping you any. My entire practice won't induce at all, but they are split about 50/50 on augmenting. Their practice is, if they use pitocin, whoever is on call and starts administration of it has to stay with the patient the entire time. My specific OB won't use it for augmenting. I would prefer not to have it. Pitocin contractions are horrible.

RepeatPostPolice · August 2015

@RunnerMeg the OB I met today said they give everyone pit in labor. @-)
I'm not sure if something got lost in translation there (she had a bit of an accent) but I am going to be sure to clarify that with my OB.
I don't want it either.

RunnerMeg · August 2015

RepeatPostPolice said:
@RunnerMeg the OB I met today said they give everyone pit in labor. @-)
I'm not sure if something got lost in translation there (she had a bit of an accent) but I am going to be sure to clarify that with my OB.
I don't want it either.

What?! Everyone gets pitocin as a standard? Ohh heck no! And I'm not super anti-pitocin, it certainly has its place. But to automatically just hand it out to everyone in labor?! No No!

RepeatPostPolice · August 2015

@RunnerMeg Yeah, right? It was my first time meeting her so I didn't want to go ape-shit but in my head I was thinking the same thing!!
I will definitely be clarifying that one with my OB, and letting the doula know that I do not want that anywhere near me. DH already knows

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