I NEED your help for a friend who is 38 wks!!

[JENinOR]

A friend of mine who is in Indiana is trying for a vbac. She recently learned (through a doula she hopes will be able to take her on) that the hospital she is planning to deliver in "is the worst for supporting natural birth" and her doctor says this particular hospital "is better if she ends up needing an emergency C-section". Her (hopefully) doula mentioned that there is a premier(not sure what this means?) hospital, and has great labor rooms to support natural birth, but she would have to change doctors to go there.

Her doctor "says" he will support a vbac, but is recommending that she schedule a c-section at 40 weeks, because it is more of a medical risk for her to labor for a long time and then get a C-section, than to just schedule a C-section. Also, he said her baby's head is measuring big, and since the baby had trouble descending last time, he is worried about that this time. He is concered she may have CPD! Um, whatever!

Also, once she gets to the hospital, they insist she immediately get hooked up to a heart monitor and an IV, and she had to convince the doc. to let her not immediately have an epidural needle in her back. She want's to labor without drugs and not be confined to a bed to increase her chances of an VBAC.

What do you think? What are her odd of VBAC with this doctor and at this hospital? What are her options? What would you do? HELP!

Thanks SO much!
Jenny

[loveandgarbage]

tough call. if it were me, i'd take my chances with the original doc. i had a vbac with a doc who told me i was making a mistake to have a vbac because my baby was going to be as large as my first (ended up being 8 lbs), and was also not going to "let" me go more than a couple days over 40 weeks. i was blessed with a fast labor, and showed up to the hospital when i was already 9 cm dilated, and had my baby soon afterward. i think one of the keys to a vbac is waiting until the last possible moment to go to the hospital, as long as you think everything is progressing normally. BUT if your friend feel extremely uncomfortable at that hospital/with that doctor, than why not change? i just don't think it's 100% necessary to vbac success.

[maotmsmi]

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Edited by maotmsmi - 5/21/11 at 3:02pm

[ericswifey27]

classic case of doc saying he supports a vbac but setting up the mama for a repeat c. Barf.

You could strongly suggest that she contact a homebirth midwife- this may be "out there" to your friend depending on her opinion on hombirth, but it may not be too late for the homebirth option if she's open to it , as it is a viable safe option to avoid a c-section. My sis was 30 something when she made the switch so it's definitely a possibility- but even if she is absolutely set on a hospital birth, homebirth midwives are a GREAT resource for finding out which doctors truly are VBAC and mama friendly, and which ones are talking out their arses, ykwim?

[murphysaangel]

If it were me I would be thinking about switching and at least interviewing/talking to other providers in the area that attend at other hospitals. It's late in the game buut I certainly wouldn't want to have to fight for everything I believe in while in labor - it's probably part of that OB's plan because he knows how hard it will be to resist interventions when you're vulnerable like that. Plus, 40 weeks is early! If it were at least 41 she'd have a week longer to let that baby cook. It sounds as though the Dr. doesn't really want to allow the VBAC; he's just going to placate her until it gets too late and then he'll push a repeat c-section no matter what the circumstances are. If she really wants this VBAC she'll need to get far away. Maybe you could post something in the Indiana tribal area to get more info about that doc and other area providers and hospitals?

[Xerxella]

I'd listen to the doula. They've definitely BTDT.

[lisa_nc]

I would switch. My relationship to my doctor is not as important as my relationship to my uterus and my child. I sometimes doula and I KNOW what hospital not to go to. The last two clients that birthed there had unnecessary cesareans. For what it's worth.

[courtenay_e]

It's statistically more difficult to break up with your OB than it is your highschool sweetheart. That said, if she has the gumption to do it, I would say that it will make it a lot more likely that she will get the VBAC she says she is looking for. Of course in the midwest it can also be a challenge to find a provider who truely IS willing to support her through a VBAC. I would say to definately look to the natural birth community in her area...to the ICAN list, to the doulas and childbirth educators in the area, and to ask them who they would recommend. You will likely hear the same one or two names from many of the sources, if a provider in your area such as she would be looking for does exist. I would do it today, though, as she is at the point where few people will accept the "risk" of taking on a late term patient.

[JENinOR]

Thank you all so much for sharing your experiences and insight!

Well, T (my very pregnant friend, lol) did get her doula and is having her first meeting with her Sunday, although they have been talking on the phone. This doula is AWESOME and really knows her stuff. All of my four boys were born at home and I have suggested homebirth to T, but she feels safer in a hopital, so that is where she needs to be at this point. She keeps finding out not so great things about her doc though, ugh! T says she is going to basically tell her dr. she wants a heploc and only intermintent monitoring with a doppler. I am so proud of her! She is yet to see how that is going to go over. Her doula is recommending that she labor at home as long as possible and T had planned this already, so that's in the game plan.

Also, there is a birth clinic with midwives as care providers that the doula recomends and T may call Monday and see if they would take her this late in the game. The clinic only does VBAC in the hospital though? THe doula says it's a great hospital and a hospital is where T would rather be so that works, but why is this? Is this accross the board protocol with Birth centers? I called a few VBAC supportive Drs. for her and it seems as though 36 weeks is the cutoff for switching care providers. Is it possible for her to just show up at the preffered hospital in labor? Would they admit her?

So any last insights or things she should know to increase her odds of a VBAC in a hospital setting??

Thank you!!

[JENinOR]

Originally Posted by courtenay_e

It's statistically more difficult to break up with your OB than it is your highschool sweetheart.

Interesting...I'm in the it's my vagina and my baby group though!

[maotmsmi]

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Edited by maotmsmi - 5/21/11 at 3:02pm

[rainashine]

I'm in the Indy area and will looking at a vbac next time too. From what I understand, the only birth center here risks out vbacs. Their back up hospital will take those patients and you can still birth with a CNM. I would suggest she calls a chiropractor in her area for recommendations. I live North if Indy but still in the metro area and my (a woman with three natural births behind her) chiropractor has given me some suggestions.

[courtenay_e]

Originally Posted by mommyjenn

Interesting...I'm in the it's my vagina and my baby group though!

Heck, yeah! I'm just letting you know that it might be hard emotionally for her to do it. I would in a heartbeat, and would KEEP doing it until I found a practitioner I trusted...but I have always been the kind of person who doesn't do well being told what to do just because "those are the rules" even though there are no statistically good reasons to do whatever it is.

Many hosptial based midwives are allowed to catch VBAC only if they do it in the L&D unit, because of the protocols that are typically followed for VBAC. I know that one of the Alternative Birth Units in our area doesn't allow VBAC because if they did they would have to allow constant fetal monitoring, and they feel like it's a slippery slope...if they allow it for VBAC with the admin they have now, it wouldn't be long before it was every woman who had to have it...and then would good would it be to have an Alternative Birth Unit?! However the midwives have the call on the births they handle in the regular L&D, and they tend to be more lenient when it comes to protocols, etc...so especially if your friend's doula says that the new hospital is a better place to VBAC, it might definately be the place to go...the doulas tend to be in the know. and they don't benefit from it financially, so the only reason for her to tell your friend this is that it will benefit your friend.