Questions about VBAC

[Shuli]

This is my second pregnancy, but my first birth (my twins were c-section). I am 36 weeks and by this time last pregnancy one of the babies was in distress, both transverse, so that was that.

Now I have one babe in there and am going for VBAC (baby is in perfect birthing position). What can I expect hospital wise? Will I have to fight them not to rush me to another cesarian? Will they give me the time I need to birth this baby? If pushing goes longer than normal I don't want to have to beat them off with a stick to get a vaginal birth.

Anyone BTDT who can help?

Thanks

[cairomama]

To give yourself the best chance for VBAC success, you should make sure you have a supportive provider. Don't just take his/her word, ask for their c-section rate, VBAC attempt rate, and VBAC success rate. Ask local doulas, natural childbirth educators and the local ICAN group about the providers' reputation.

Ask the provider what their requirements are for VBAC labor. Many providers require continuous monitoring and iv. You can negotiate intermittent monitoring or a heplock instead of an IV. Many want you to go into labor on your own by 40 weeks or have a repeat c-section or induction. Some require an early epidural in case you need an emergency c-section. You can have a safe induction even if you are a VBAC using a foley bulb. You can use pitocin, but it is best to be avoided. As long as you and baby are healthy, you should be able to go to 42 weeks AT LEAST before they start talking induction/repeat.


If you don't get the answers you are looking for or the good feeling of trust you need, please switch providers. It is never too late to switch. I switched 4 times.

Have a beautiful birthing time!
I think the fewer interventions, the better chance of VBAC. My midwife had a very good reputation among the doulas, especially for VBAC. He required continuous EFM and a Heplock in the forearm (instead of IV). I agreed to monitoring because he did not make me lay on my back, I had freedom of movement. There are telemetry units where you can walk the halls and be monitored, but I decided not to go to the hospital until I was past the point of walking. I labored on my hands and knees and a bit on the birth ball. I was only in the hospital for 2.5 hours when she was born. I had no pain medication or augmentation. My water broke at 10cm. I listened to Hypnobabies the whole time which really helped. Everyone was supportive and encouraging. I think that made a huge difference.

[moorishamerican68]

Questions About VBAC

Shuli,

The first thing I would strongly recommend is that you get a written birth plan. I am 35 wks and planning for a VBAC next month also. My birth plan is already in place and has been approved by my midwife and doula. I am working with a midwife and doula but delivering at a hospital because of state restrictions I cannot have a homebirth. Anyways, the only way to ensure that you will get something remotely close to what you want is to put it in writing - do not rely on just conversations that you have had with your dr./midwife, etc. , especially if you will be in a hospital setting.
If you do not want any medical intervention, vaccines, other unnecessary procedures put this on your birth plan. I can email you privately a copy of the birth plan I am using if you need an idea to get started. But I would NOT step foot into a hospital without one if I were you!!

I personally would hire a doula if you can afford it. she will be there to make sure your wishes are carried out.

The best and only advice I can recommend is lfor you to not run to the hospital at the first sign of labor. Labor as much as you can at home because once you enter the medical establishment you will be on their "clock" so to speak and will get pressured to accept medical intervention to move the laboring process along. I think from my research that is how many women end up with unnecessary c-sections. if they feel you are taking too long, they will offer you epidural, pitocin, etc. and as you know these drugs (interventions) slow down the natural birth process. The interventions just snowball until they cause you and/or the baby to be in distress... by then a c-section seems attractive and the only option.

If you haven't already, I would strongly suggest you also watch the videos "the business of being born - by rikki lake" and "orgasmic birth"... the first one will open your eyes as to how the medical establishment has brainwashed us women into doubting our ability to birth and the second one will likely empower you and keep you focused in the outcome you DO want.

I hope this helps you. I am on the same boat and am so determined to have my VBAC... so do feel free to message me privately... at the very least we can encourage each other to that end.

ari

[Fay]

A hospital VBAC is absolutely possible, but you will have to voice your wishes often and loudly. You can get a doula-in-training to advocate for you for free, or you can hire a more experienced doula to support you. You will need plenty of support for a successful VBAC. Ask your health care provider questions about his/her experience with VBACs, ask direct questions and don't accept BS answers. The fewer interventions you get, the higher your chance of VBAC...practice your "NO, thank you!" before you get to the hospital. The later you arrive at the hospital, the higher your chance of VBAC...most OBs will only allow a max of 24 hours for a trial of labor, but for most cases it is perfectly safe to labor a lot longer than that, especially since you've never had a vaginal birth before.

I enjoyed a successful unmedicated hospital VBAC in 2007 -- it was a dream come true! Best wishes for a happy VBAC!

[MNHall]

I did a hospital VBAC and the main thing for me was an OB that knew my wishes! She actually was the one who suggested a VBAC, so I knew she was on board! Unfortunately I went into labor on a Saturday, so I had one of her partners, whoever was oncall. BUT, being that they were partners, they trusted eachother's judgement and had similar believes. So when the on call OB came in and heard I was a VBAC he said, "so your OB was okay with this, right?", I said, "yes", he said, "well then, let's birth a baby!!!"

So, supportive provider, YES! In addition, a supportive nurse. My nurse was not afraid of a natural VBAC and if she would have been negative or hesitant, I would have requested someone else! It's my birth, I want a nurse that trusts in me, ya know!

AND, I had a doula! Oh my, a doula was the BIGGEST confidence booster. With going into labor, trusting my body, getting through those contractions, and staying strong with my desires! I highly recommend a doula! Granted, a doula will NOT fight the OB in their decisions, that had to be me saying what I wanted to the doctor. But I had someone by my side that knew what I wanted and was there to help support me through it! I didn't meet with her for the first time until 35 weeks, commited to her at 36 weeks, then did our before labor meeting with her at 37 weeks, 2 days.....which was 2 days before I went into labor! A doula is a WONDERFUL support for natural and for VBAC!!!!

[kltroy]

I had a really great unmedicated hospital VBAC. For me the main thing was making sure that I had a supportive doctor who knew that I trusted my body 100% was willing to let me work with it. The other thing was a well documented birth plan (as it turns out, the doctor I *had* been seeing for my prenatal care was out of town for the birth so I got the on-call doctor - who ended up being excellent. So having my birth plan in my records was important since the on-call doctor was basically going by my doc's notes and by what I told him). The third thing was that even the best laid plans are irrelevant if nobody remembers them. So my mom, who was acting as my doula, was great about tactfully reminding everyone in the room of the most relevant part of my birth plan AT THAT INSTANT IN TIME. (For example, I wanted to catch my baby -- nobody cares about this detail until about 1 minute before the baby is born and then everyone needs reminding, otherwise the moment would have passed and we would have all thought "darn we missed it!")

Best of luck with your birth!

[catspage]

The doctors changed shifts while I was in labor. For me, it was really the support of my wonderful nurses who talked the new doctor out of giving me a repeat c/s. He wanted to section me right away.

If you can afford a doula or get a support person, I would recommend it.

[GOPLawyer]

What you will have to deal w/ varies depending upon the doctors, nurses and hospital you use. It's impossible to say w/o knowing them.

That being said, I would highly recommend a doula. Statistically, you will have a better shot at a VBAC. I wouldn't go to the hospital w/o one.

[3tammuz]

Write out a birth plan and discuss it with your OB/have him/her put it in your hospital chart. I found discussing the plan gave us time to sort out the parts that we did not agree on, OB could not do, I had time to process/understand hospital policy, etc.

A doula can be very helpful. My sister was in exactly your boat (twins, both breech when she spotaneously went into labor at 35 weeks = CS; three years later, she VBAC'd her son). Her doula really helped focus her and got her through the long, hospital labor.

Be strong and confident in yourself and your body's ability to give birht naturally!

B'sha tova.

[fyrebloom]

Shuli,
Congratz on the singleton! I just VBACed a singleton last week after having a section with my twins. A few things. Make sure the hospital is vbac friendly. If not find another one. If you have no vbac friendly hospitals in the area then prepare for that circumstance. It's by far better to not have hospital policy get in your way from the start. Stay home as long as humanly possible. The less time you're at the hospital the better. ACOG guidlines say that CFM must be used the entire time for active labor and statistically speaking the more FM that's used the more likely they will section you. Best to labor at home until the last possible min so that when you get there you spend less time on the monitors. Also monitors help to keep you immobile. Being immobile makes it much harder to cope with labor and is more likely to cause a prob with the baby due to compression. Staying mobile I think really helped me succeed because if I had been strapped to the bed for that whole time I'd have given in to more intervention (namely I'd have certainly been screaming for an epidural!) and more intervention means a greater likelyhood of a RCS.

I just posted my birth story and luckily there was no fighting about the vaginal delivery they were really awesome and supportive and minimally invasive. Not all hospitals are going to be like that and some will be openly hostile to VBAC moms. Best to know the score before you step foot the door and avoid the fight altogether. Be prepared to use the magic words AMA and I'm happy to sign a waver if needed. Best of luck and I can't wait to hear your birth story!

[smallbutfeisty]

Another pregnant one interested in VBAC... since so many of you suggested getting a doula, can anyone give me an idea of how much a doula would cost? I know that they will all vary, and regional differences will matter, but any ideas you can give if this is viable for us would be appreciated!
Thanks so much!

[kltroy]

I think the going rate is anywhere from $400-1000, but you can often get a doula in training for less or even free. If you have a friend or family member who can act as a doula for you and as BTDT with birth (esp. natural birth) this can work too. I had my mom, a CNM who no longer practices, act as my doula and she was fabulous!