39 weeks and midwife "not confident": ( - Page 2

[MNHall]

My VBAC baby was not engaged on the Monday that I had my appointment. I had her on Saturday!!

I agree with the others that said it's too early to determine that things won't happen!

[Rands]

I updated the thread but I didn't know how to say that I updated in the title...the update is at the bottom of the original post.

[ShwarmaQueen]

So basically you have 2 more weeks till you're 42 wks? I think you still have plenty of time. You could looking into Evening Primrose Oil (orally and vaginally) but honestly you're still ok, as far as going into labor on your own. Hang in there!

[mamatolevi]

i was induced with pit at 41w5d and had a 10#8oz baby vba2c. It was a fabulous birth. You CAN do this.

You don't have to be sectioned or induced just b/c of dates. Wait it out; you'll go into labor on your own.

[Rands]

At my hospital they will not induce with pit...there is a slight option for them to augment with it if you are further into labour though. I think my options for induction, if need be, are foley cathedar or ROM.

[Serenyd]

Originally Posted by kitkat5505

None of my babies engaged prior to labor, and I've heard that for 2nd+ time moms that it is common not to engage until labor. I also don't think a cervix check means anything. My MW for my last birth didn't do any cervix checks until I was almost 40wks and asked her to strip my membranes, and then not again until I was pushing during labor. I've had friends be 5+cm for days or weeks before going into labor and others who've been 1cm or less and gone into labor in a day. All cervix checks do is cause stress and worry.

: nak

[mamatolevi]

Originally Posted by Rands

At my hospital they will not induce with pit...there is a slight option for them to augment with it if you are further into labour though. I think my options for induction, if need be, are foley cathedar or ROM.

Personally, b/c of how differently pit is usedin vbacs v. unscarred mothers, I don't see the difference between pit induction v. pit augmentation at that point. The dose for my pit inductin was 2mu/min w/increases only if labor didn't start or progress. They never got over 6mu.

Even knowing the risks of pit induction for a VBAC, I would insist on pit before AROM. At least if it doesn't work, you can still go home and try again later. AROM puts you on the clock and once you're on that clock, they'll either use pit to get you going or send you to the OR.

Say they do a foley cath, you get to 3cm and it falls out. but ctx haven't started yet or aren't progressing how they want them to. they will either do AROM or augment with pit. If they do AROM, and nothing gets started, or starts too slowly for their comfort, (b/c you're on the artificial labor clock) they'll probably do pit anyway.

From what you've been posting here your best bet is to not let them do any more cervix checks till you're at least 41 and a half weeks. that way you can stop worrying about it and just gestate. If they're worried about the baby they can do NSTs and US.

[Rands]

How's this for bad...apparently I have an OB consult TOMORROW (my due date) with the doctor who did my first c-section. The midwife says it's just to discuss my options should I get to 42 weeks and not go into labour on my own....

[kltroy]

Ugh. Just hang in there and stand your ground if this doctor is hostile to the idea of a VBAC. If you get to 42 weeks you do, legitimately, have to decide if you want to keep waiting or try to evict the baby. And honestly if a NST came back looking bad and there is a true concern about how the baby is doing for whatever reason you could be faced with a decision too induce too.

So I would try to make this as productive a visit as possible. Ask what your options would be in either situation, what the risks are associated with each option, what the benefits of each are, what alternative choices there are. Bring your husband if you can. Remember, you don't need to make a decision about what you will do during the visit - the best scenario would be that you have a discussion w/ the doctor and at the end leave with some numbers and references, telling the doctor that you will let your MW know once you have taken some time to think things over. Then do follow up w/ your MW so that she can document your plan, should it become necessary. Then hope and pray you don't need it!!

[saimeiyu]

I'm just going to tell you. If I had your midwife, I would be *so* gone if at all possible.

I don't understand why you are still getting cervical checks if all it's going to do is stress you out. It doesn't mean anything at all. Nothing. It will not give you any clues. All it is is a risk. How much bacteria do you *really* want to shove up there before you go into labor? It doesn't particularly matter until your water breaks, but if they're this free with it before labor, when it can tell you *absolutely nothing* of value, I'd worry about whether or not they can keep their hands out of there in the event that your membranes rupture and you don't give birth two seconds later. No matter what they tell you, you *can* tell them "thanks but no thanks, no cervical check today." You might have to be quite firm.


I think your body isn't what will prevent you from having a VBAC when it comes down to it, though. I think your body works just fine and it's silly to worry about your dilation and effacement before your body even begins the work of it. (which is what the first stage of *labor* is all about.)

As for the OB consult... Well, take it or leave it. I wouldn't personally step anywhere near the OB that gave me my section, but if that's your backup OB, you might as well meet them. It's probably standard procedure for your midwife. I think a supportive midwife would *at least* wait until 41 and a half weeks before sending you over to him, though. I don't see a reason to burden you unnecessarily by telling you on your *due date* that you're broken. How many people go by their due date? Nuts! Then again, a supportive care provider wouldn't be checking your cervix at 39 weeks and telling you she's "not confident", and telling you that you're gonna get sectioned at 42 weeks. Baloney.

[Rands]

I know...I am pretty shocked by all of this because these midwives say they're very pro-vbac. My midwife from my first pregnancy certainly was...but she is on mat leave. I moved out of Toronto around 34 weeks and tried to find a midwife in my area or a pro-vbac ob and could find neither. The closest hospital to me has a vbac ban. It's very difficult to get a midwife in Ontario. You have to call literally the moment you find out you're pregnant.

The OB that didn't my section was pretty good. She encouraged me to do the c-section but she wasn't forceful and made it clear that she would prefer to do a vaginal birth if she thought it was possible. I guess at least with this appointment I can get a feel for what my options are.

I am not sure why I'm seeing her tomorrow though. The midwife had said 41 weeks for a consult but that this is when the ob was available to see me.

[Mamatoabunch]

Can you just refuse the OB visit. Here in NM, when I last did prenatal care w/ my 10y/o, the state required a OB visit in late pregnancy for VBAC moms. I refused, signed a waiver. If there is an emergency I don't care who I get since a emergency to me would a c/s and I figure they all know how to cut.

[Rands]

At this point talking to the OB is not something I care enough to fight. I'm sure I'll have enough to fight during labour or if I go late. I'll go in and see what she has to say and how she feels about VBAC. If she gives me any feeling that she's against it I'm telling my midwife she's a no-go and that if we have to cross that bridge it will have to be with a more vbac friendly OB...

[spu]

I kept telling myself, suddenly, things could start at any moment in time... and just because things are not happening at 39 weeks doesn't mean a whole lot... Everyone 'gets going' differently. Some people know two weeks before, and some people know hours before.

Hugs and calm vibes to you mama. Good luck tomorrow - keep us posted. Play the 'medically necessary' card and don't let them scare-tactic you. Ask for ultrasounds, biophysical profiles... daily/every other day, whatever... and if everything is fine, ask why they would recommend major abdominal surgery for you, not statistically speaking. Keep it about you, your medical records, your situation, your baby... make them be as specific as possible.

[Rands]

Thanks for the support. I'll definitely update tomorrow. I am not easily bullied and I'm well-informed and knew I was doing a vbac since the week after my home birth ended in c-section. I will stick to my guns unless the baby or myself become at risk!

[saimeiyu]

Good for you. I certainly hear you on the lack of HCP front. We'll be keeping you in mind. I hope everything goes well and look forward to the update.

[mamatolevi]

Is there any way you can have this consult with a different OB?

edited:
ah. I just saw your later posts. Just stand your ground and make them show you the studies. or just nod and smile a lot. whatever gets you through it.

You've got plenty of time to go on your own.

[1littlebit]

Originally Posted by Rands

How's this for bad...apparently I have an OB consult TOMORROW (my due date) with the doctor who did my first c-section. The midwife says it's just to discuss my options should I get to 42 weeks and not go into labour on my own....

i'm not saying do this.. or thats its a good idea.. but i won't lie to you, i wouldn't go. not a chance in flipping he!!.

i would post in FYT and ask for vbac midwife recommendations. they will probably be able to recommend someone. and if you haven't done so get in touch with ICAN in your area and ask them about midwives and OBs they recommend for vbac.

[tuffykenwell]

Originally Posted by Rands

Thanks for the support. I'll definitely update tomorrow. I am not easily bullied and I'm well-informed and knew I was doing a vbac since the week after my home birth ended in c-section. I will stick to my guns unless the baby or myself become at risk!

Rands keep in mind too that the midwifery guidelines for Ontario say 43 weeks is the point at which they *have* to transfer care to the OB so even at 42 weeks you still have some jiggle room.

Have you considered seeing an accupuncturist? I did accupuncture inductions for both of my girls and I am not sure if they did anything really but they made me feel like I was "doing" something instead of just waiting and I figured if they even helped ripen my cervix a bit I was better off for it.

Good luck...I have had 2 successful vbacs and I understand the stress of going post dates as a vbac but try to be strong and stay positive. My email is [e-mail] if you want to chat about stuff or just need someone to say you can do it

Steph

[Rands]

Well today was a disappointment. I did refuse an internal exam. Basically the OB said she'd be scheduling me for a section at 41.5 weeks if she had it her way. She put the whole "you make babies too big for your pelvis that's why the first one never came down and why this one isn't engaged yet" blah blah blah. She wants to book me for induction at 41.5 weeks. She said if the cervix is ripe she'll try foley cathedar (because I suggested it--she said she's not really comfortable with it), then she'd do ROM, or pitocin if I'm "ripe" and the head is low. SHe says 9 of 10 OB's at the hospital would be opposed to letting me even attempt a VBAC if I got that late.

So this afternoon I researched and called the most VBAC friendly hospital in the area. I convinced the birthing department head of my story enough that she went and found the head OB of the hospital and told him my story. The doctor said to have my midwife call tomorrow and schedule me an urgent consult with him in the next few days. Hopefully speaking to him will be more positive. The plan will be that if I go late enough that my midwife wants to transfer me, hopefully she will transfer me to this VBAC friendly OB instead of the other hosptial and OB's....