VBAC or HBAC? - Page 2

[AlexisT]

FWIW, even on the NHS (which has a VBAC rate over 30%--what the US had in 1995 or so at the height of VBAC) OBs/GPs/midwives refer to it as trial of labor. My NHS OB (who, I later found out, is a big VBAC advocate and lectures on it) told me I could "attempt VBAC" the next time. This is accepted medical terminology and doesn't necessarily reflect any personal bias on the part of the practitioner. It's not a VBAC until the baby is born.

JohnsMama, that's actually a fairly good protocol for VBAC! Many hospitals require continuous EFM for VBAC. I'd say any hospital permitting ANY intermittent monitoring is pretty supportive.

The thing that always comes to mind in these threads is that HBAC has to be an option in the first place (home birth needs to be available and an appropriate option). For those of us who can't HBAC (I can't--high risk pregnancy), it is important to know that you CAN have a hospital VBAC if you plan appropriately.

[HappyMommy2]

I started out looking into a hosp vbac. There were so many restrictions and rules (no water, CFM, etc.) at the most vbac-friendly hosp, that I figured the only way I could have a successful vbac was to have it at home.

I was prepared to fight. But I just didn't think that fighting for my rights while in labor would lead to successfully opening up and pushing out a baby!

I had an amazing and wonderful hbac.

Good luck mama!!

[John'sMama]

Originally Posted by AlexisT

The thing that always comes to mind in these threads is that HBAC has to be an option in the first place (home birth needs to be available and an appropriate option). For those of us who can't HBAC (I can't--high risk pregnancy), it is important to know that you CAN have a hospital VBAC if you plan appropriately.

You're right, VBAC in a hospital is definitely possible and the odds of success are increased with the more VBAC friendly the staff, OB/midwife are; there were a lot of people who responded to my original thread with positive, successful hospital VBAC stories. Although I think I could probably have a VBAC here, I'm confident there are many hospitals that are more proactive with VBAC. Good luck to you!

[womenswisdom]

Originally Posted by John'sMama

Unfortunately, IL doesn't have birth centers. Disappointing b/c yes, they do seem to be the best of both worlds!

Unless it is a hospital-based birth center, there is no difference between a birth center and a homebirth other than you have to drive to a birth center. Everything that is available at a freestanding birth center is generally brought to your home by the midwife (I'm sure there are individual exceptions). They can't do any "procedures" in a birth center that they can't do at home. It's just an illusion that somewhere other than your home is safer because we are culturally conditioned that you *go* somewhere to give birth.

Anywho, I did choose HBAC even though there is a truly supportive OB in my area. I felt that the benefits of homebirth outweighed the risks and felt that I would actually be safer with a midwife in constant attendance during my labor as opposed to intermittent monitoring by a machine and seeing the nursing staff once an hour or so in the hospital. I wanted to labor in the way that was most supportive of physiologically normal birth and that includes freedom of movement (and a labor/birth tub, not available in the hospital), freedom to eat and drink as I wish, the comfort of being in familiar surroundings with people I trust, and freedom from unnecessary interventions or the fight that comes with refusing them. Although my backup OB is very vbac supportive, he's not there for the labor, the nurses are. And there's no way to know what kind of nurse you're going to get. I also wanted my baby to be treated with respect and as a person, which I don't see happening very often as a doula at hospital births. All in all, it's a very different environment in which to give birth, not only because it's a physically different space, but because of the attitudes of the people who are around you and what they believe about your ability to give birth normally.

In the end, I had a short labor, pushed for 1.5 hours and birthed my baby girl in a pool of warm water while supported by my husband. My midwife caught my daughter and unwound her from her (> 2' ) long cord wrapped twice around her neck and around her body and leg without drama. She handed me my baby immediately and that was that. I pushed out my placenta, got out of the tub, nursed my baby then ate some cereal. No drama, just my birth day, surrounded by people I chose and trusted who believed in me.

[courtenay_e]

I am glad to hear that you are more sure of your home birth choice now that you have talked to an OB.

As a birth professional who has attended numerous VBACs in and out of the hospital, for the sake of lurkers, I think it is important to know that WITH the right care provider, a doula, a good amount of information, truely informed consent, and a strong voice, a woman is very likely to have a VBAC in the hospital.

She is also very likely to have a successful VBAC at home.

The difference I have seen the most is that the women in the hospital have to fight a LOT more to get the "perfect birth" because they are constantly battling the idea that something is going to go wrong.

A woman having a home VBAC with an appropriate provider (every midwife has her "thing" that freaks her out...some get the willies when they think about hemorrhage, others hate breech, still others are freaked out by VBAC...find the one who is not freaked out by VBAC and you're on a good path) just plain doesn't have as many battles to fight. Baby is born and typically? put to the chest and left there. Mom is attended and typically? They look at her, evaluate her needs, are quiet and helpful, and supportive, and expect that everything will be well. there is no "you're a ticking time bomb" assumption. Rather, they look to the mother for her needs, as opposed to following protocols that protect their own legal needs.

A mother who is confident in the research that shows that homebirth (including VBAC) is as safe or safer than hospital birth who wants a home birth and whose pregnancy is normal and healthy should have a home birth. It will tend to be significantly more peaceful, calm, and supportive.

But again, that doesn't mean that with the right circumstances, a successful VBAC cannot be gotten in a hospital setting. In my area, it just tends to be more work to get there.

[shenanegans]

That is great. I am sure your HBAC will go great.Glad you found a good CNM. I am pregnant with #2, my son is 2yr 7mo born in Japan by "emergency" c-section. It was the last thing I imagined would happen. I am now back in Canada and really hoping to get in one of the birthcenters in my city. I put my name on the waiting lists on the day I got my faint positive pregnancy test. It is all covered by our nationaly medical insurance but since there are only 2 full birthcenters (the other you can get a midwife and do a mome birth) the supply vs demand is vastly out of proportion so getting a spot is kind of like winning the lottery. I asked at one center about hiring a midwife privately for a home birth if I don't get a spot and she said its not really possible as all of the midwifes are registered with the provincial midwifes organization and they can't work out side of that. ugh. I will have my first doctors appointment on Dec 3rd. I really hope I won't be there for long. I have only met him once before, he seems like a nice guy but it will be interesting to hear their policies. If they don't work for me I will find another Dr. asap. Fingers crossed for the birthcenter!!

[ruma]

I have had both an unmedicated hospital VBAC and a HBAC. HBAC is MUCH easier. My hospital VBAC baby was 7 lbs. and my HBAC was 9. I highly recommend a birthing pool. It is amazing how uncomplicated child birth can be at home. Good luck!

Ruma

[*Christa*]

My hospital VBAC turned into a CBAC. This time I am going for a HBA2C. I had a very supportive hospital/doc too, but I still felt the pressure & the ristrictions. My CBAC was needed due to an infection, not because of anything the hospital did (other than vaginal exams) & there was only 2 of them.

[tracymom1]

I would never have been able to VBAC at the hospital. Now that I know what a long, all-natural birth feels like, I know with absolute certainty I would have hated being continuously monitored, unable to labor in the water, NPO, getting cervical checks every time someone came in the room. I NEEDED peace, quiet and familiarity in order to do it naturally. I had a 16 hour labor with 3 hours of pushing and no tearing at all.

I know many women who had successful VBACs in the hospital, but I just can't imagine having all the restrictions placed upon me durning such an intense time.