Doctor won't allow VBA2C, hospital has a De Facto ban. But do I really need their permission???

[momma2libby]

Hi all! I'm preg with number 3, due end of February. I had been seeing a wonderful VBAC supportive doc up to this point. He is an hour away and due to circumstances and no support to help watch my two older children at the time of the birth, I am having to switch to someone closer. No one at the local hospital will do a VBAC. I am with the most 'vbac friendly' of the docs but that doesn't mean anything. He quit doing VBACs 9 months ago due to hospital pressure. He has agreed to let me go to 42 weeks if I want, and if I go into labor before then, I can just come in and have a c-section.

Well my plan is.:

While I'm supportive of HB, it is simply not something I feel comfortable having 2 previous c-section. Please. No flames. This is my choice, and yes I've done the research. The local HB midwife has said that she can come by in active labor and act as a doula, but also can monitor vitals, the baby's heartrate, and let me know an appropriate time of when to go into the hospital. Once it's time to go to the hospital, I'll bid my MW goodbye and just tell staff "Ooopsie daisy, looks like I'm about to have this baby". I have a friend who works in L&D at the hospital and she said that if I come in almost ready to push, they can't/won't do anything, esp if I refuse to consent. I mentioned court ordered c-sections, and CPS and she assured me that wouldn't happen. They've had a woman come in before dilated to an 8 screaming that she wanted a repeat c-sec and she told her it was too late, the baby was coming out the old fashioned way.

So anyone else show up pushing, or almost ready to push? I've tried using google to find similar stories but I can't find anything.

[BettinaAuSucre]

that is kind of my plan. to stay home and labor as long as i can, until i dilate to 8 then head to the hospital. I am planning my 3rd after 2 cs and hope for a VBA2C.

I will of course seek a doula or MW to prevent any health problems. But i hear that your best chance of a VBAC is to labor at home. one small monitoring fluctuation and the hospital will immediately deem that a reason for a cs.

[GOPLawyer]

My situation was a little different (preterm labor @ 30 weeks...a planned HBA2C w/ a vert. incision). I had about 3 hours of labor at the hospital and just flat out refused a c/s. They were *dying* to give me a c/s but there was nothing they could do.

It wasn't the ideal birthing atmosphere but it CAN be done!

[peachsara]

I know of a mama who was planning a HB after 2 C/Ss. Pushing wasn't progressing so she ended up transfering to a hospital that banned VBAMC. I think she conveniently forgot to tell them about her previous C/S and delivered naturally with no problems. Most of the staff was freaking out afterwards, though.

Since you have a friend in L&D that can assure you that you won't be forced into anything, you might have a good chance at a vaginal birth. But, with some hospitals, I wouldn't risk it.

[peachsara]

Originally Posted by BettinaAuSucre

that is kind of my plan. to stay home and labor as long as i can, until i dilate to 8 then head to the hospital. I am planning my 3rd after 2 cs and hope for a VBA2C.

I will of course seek a doula or MW to prevent any health problems. But i hear that your best chance of a VBAC is to labor at home. one small monitoring fluctuation and the hospital will immediately deem that a reason for a cs.

Do you currently have an OB?

You do know that you have an awesome VBAMC option around you, right? Definately your best chance for a hospital vaginal birth, vbac or not.

[Kirsten]

I would stick with the original doc/hospital. You have until February to find childcare for your older kids! And it would just be for 24 hours or less! Neighbor, school friend's family - there must be SOMEONE!

[mamatolevi]

Originally Posted by Kirsten

I would stick with the original doc/hospital. You have until February to find childcare for your older kids! And it would just be for 24 hours or less! Neighbor, school friend's family - there must be SOMEONE!

I agree. You do have a lot of time to research your childcare options. Even a nanny or babysitter service to sit your kids for 24-48 hours would be better than losing a supportive provider/hospital. And if your employer offers a pre-tax dependent care spending account you can be reimbursed for the expense.

What about schoolmates? There are bound to be other moms that would take the kids for you when you go into labor.

Or maybe a couple of college students?

[mamatolevi]

Originally Posted by peachsara

Do you currently have an OB?

You do know that you have an awesome VBAMC option around you, right? Definately your best chance for a hospital vaginal birth, vbac or not.

I've used that dr for my VBA2C; he's awesome AND an ICAN member. If you're even remotely close to atlanta (say w/in 4 hours) he's definitely worth it.

[BettinaAuSucre]

Originally Posted by peachsara

Do you currently have an OB?

You do know that you have an awesome VBAMC option around you, right? Definately your best chance for a hospital vaginal birth, vbac or not.

who who who?!?


i dont have an OB yet bc i dont have medical insurance. We are signing up before TTC but that process takes at least 90 days.

[peachsara]

http://www.dr-joe-tate.yourmd.com/in.../site.home.cfm

Definately worth meeting with. He is a really strong advocate for vaginal birth for women and doesn't routinely induce, give episiotomies, etc.

[prancie]

Stick with the original. Make it work! There has to be someone, even if a relative flies in from elsewhere. I mean, who is going to help you postpartum anyway?

[perditafoster]

I'm in MS and one of our local private hospitals has recently banned VBACs. I was talking to my doc about it and he said that under no circumstances should I even attempt to show up there, even if I am pushing the baby out. He said that according to the hosp's policy, no nurse or doc would even be able to touch me. They couldn't even give me a room; they would either transfer me or put me in a closet to have the baby!!!! JK about the closet thing; obviously, I would transfer. Well, I wouldn't go there anyway since there are two hospitals within one mile of that one that are vbac-friendly. Anywho, I don't know what the policy is at your hosp, but it is apparently crazy strict at this one in my town! Good luck on finding a solution...

[alllyssa]

What about including your two older children in your prenatal visits and in the birth? How old are they?

[mamatolevi]

Originally Posted by perditafoster

I'm in MS and one of our local private hospitals has recently banned VBACs. I was talking to my doc about it and he said that under no circumstances should I even attempt to show up there, even if I am pushing the baby out. He said that according to the hosp's policy, no nurse or doc would even be able to touch me. They couldn't even give me a room; they would either transfer me or put me in a closet to have the baby!!!! JK about the closet thing; obviously, I would transfer. Well, I wouldn't go there anyway since there are two hospitals within one mile of that one that are vbac-friendly. Anywho, I don't know what the policy is at your hosp, but it is apparently crazy strict at this one in my town! Good luck on finding a solution...

If that hospital accepts any federal money they CAN NOT transfer you or refuse to treat you.

[DocsNemesis]

What she said. They can't legally refuse to treat you, ever. The worst they can do is be complete $%*es to you and possibly try to get a court order for one, but they can't make you leave.

[perditafoster]

Oh, the hosp that has a ban is a private hosp. There's a great public one across the street though. Just a bummer that such a nice hosp, since it really is a nice one, won't allow vbacs!

[AlexisT]

It doesn't have to be a publicly owned hospital. If they take money from HHS (ie Medicare and Medicaid) they are subject to EMTALA. The number of hospitals that do not participate in either of these is vanishingly small--it's almost exclusively the Shriners and the military.

[fyrebloom]

I just did this on friday (although to a very vbac friendly hospital). I showed up in transition LOL! I was there for an hour and a half, maybe and was pushing a baby out. They can't refuse to treat you if you show up in active labor, but doing a late transfer like that is hard. The car ride is hard, the getting through the hospital is hard and you do run the risk of not making it or of progressing too slow and possibly getting wheeled off to the OR anyway, esp if this is your first vaginal birth since pushing can take a LONG time. Personally I would rather go to a vbac friendly hospital then fight with a vbac-ban hospital, esp with having an untried pelvis. I think walking into that situation might very well be asking for a repeat section. Rather then hiring a midwife to act as doula why not use that money for a sitter? A doula is def not money wasted by any means but in your case it might be better spent on child care so you can go to a hospital that is safe. Just my 2 cents.

[momma2libby]

Thanks for all the replies. My daughters are 3.5 and 18 months...too young to be at the birth without someone else watching them. DH's mom is driving up from where she lives (11 hours away) to watch them. There are so many variables in that. I know that first time labors are long but she is over 60 and can't make the whole drive in one sitting. I cannot fathom leaving my dd's over an hour away with a hired babysitter for 1-3 days...or even one of their friend's parents. I have been looking/asking/hinting for 6 months now for a sitter and no one has offered. Only family here is a crazy mother, and sister in law who owns a crazy (inside the house no exceptions) pit bull. I don't feel comfortable leaving them there. When I go to have the baby in the in town hospital, I can have a friend watch them during the day for a few hours and dh can go home and night (until mil gets here). He can't feasibly do this if I am over an hour away. And said friend is willing to watch them for a couple of hours for a few days but up to 3 consecutive days is too overwhelming. You know I'm not a dumb lady and I have seeked my resources and like I said in the OP, "due to circumstances and no support to help watch my two older children at the time of the birth, I am having to switch to someone closer". If I had a neighbor willing to watch them (that wasn't on drugs or over 80) believe me, I would. I'm not willing to leave my children in the hands of someone not capable of watching them, or someone I am not comfortable with on the chances I happen to go into labor this time.

[GoestoShow]

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Edited by GoestoShow - 12/17/10 at 9:12am