Feeling so lost! Help me decide where to VBAC

[BarnMomma]

As of now, we have two options for a VBAC.

One is in a hospital that is 40 minutes away. It would be with the OB/mid wife practice (2 of each) that we're currently with. The hospital talks a good game, each room has showers and tubs, birthing balls, bars, stools, and encourages movement and freedom of position during labor. It's the most progressive hospital around or so it claims. HOWEVER, being a VBAC there is a good chance that I will still be forced to watch a clock and if they insist upon fetal monitoring they might not even allow me to take it off to USE the tub. So I might end up with C-sec quicker there just becasue of the hospital setting. And I'd be 40 minutes away in some random town alone at night becasue my husband would need to be home with our young son.

Other option is to hire a local midwife who our doula suggested because she does home VBACS. We are 5-10 minutes from the hospital where I was forced into a C-sec with my son. Pro's being however that the recovery ward was 100% fabulous and I feel like if i HAVE to endure another C-sec then I want to recover there.

But a home VBAC still has me nervous. I can't shake the fear of uterine rupture and not making it to the hospital on time. And at the the same time I want to be nowhere near a hospital becasue I find them to be unwelcoming, germy, and I'd rather be somewhere I'm comfortable. I feel very scarred from my first hospital birth experience. And I hate that no-children-allowed thing all the hospitals have going on now. Not see my son for 6 days? Sure. That will go over SO well. I've never been away from him for more than 5 hours.

I wanted to birth at a birth center that I visited but they won't allow VBAC and the hospital the midwives there are affiliated with has a very low % of vbac and high c-sec rate. And again, it would be an hour away.

So here I am at indecision city.

I'm scared either way. I furious all over again that I even had a c-sec to begin with. I don't know what to do.

Has anyone had a home VBAC? Complications? I'd love to hear all stories and outcomes.

[liberal_chick]

Well, I vote for the HBAC (homebirth VBAC) b/c it is what I had.

I talked to the people at the hospital (which is about 5 miles away) and they said, even when everyone is on duty, it would still take 20 minutes to get me into the OR if there was an emergency. That sealed the deal for me. We could call ahead to the hospital in case of emergency at home and still have to wait 15 minutes for an OR once we got there.

My HBAC was easily one of the most amazing experiences of my life. I was in labor a long time, like 30 hours, and didn't get past a 4 until after over 20 hours of labor. I know I would've been sectioned for "failure to progress" at the hospital and/or put on pitocin at some point. By staying at home, I was able to just hang out with my dh and sister (who was my labor support) at home. We walked at the park, went out for pizza for lunch, dealt with the internet service guy, , instead of being trapped at the hospital. MIL came and kept ds1 occupied (he ended up being asleep in his bed during heavy labor and when ds2 was born. he woke up and baby was here; it was an amazing moment.).

And, honestly, the whole time I was in labor the words "uterine rupture" never entered my head.

[cc91709]

hope this helps

I too am deciding where would be best. I read a sad story about a woman attempting a HBAC however; she knew something wasn’t right before anything happened. She was on the operating table when her uterus ruptured and still had bad consequences; this was two hours after she knew something wasn’t right. While I was deciding I realized that no matter where you are if it’s going to happen it will. Because of this story I have decided to do mine at home with a good backup plan ( car ready and hospital on speed dial) I feel as though the hospital isn’t necessarily the safest place, its just another place. I’m not trying to scare you, remember it’s a very low chance you’ll even have that problem.

[GOPLawyer]

Assuming you have the standard low, horizontal scar, there is about a 99.5% chance that your uterus will NOT rupture. Pretty good odds IMO.

Hands down I'd go for the HB. Now that I've had the care of a MW, I can't ever imagine seeing an OB. Interview w/ the MW. See if you click w/ her.

[lotus.blossom]

What were the circumstances of your first labor/birth?

I chose a HBAC for my second. My first I never progressed past 6cm with a OP acynclitic baby. It wasn't even a question that I would homebirth the second. I had little other choice. But it didn't work out for me and I had a transfer and c/s. Come to find out my pelvic structure plus my babies coming down OP and acynclitic (yes, despite ALL the tips and tricks) just makes it impossible to birth vaginally. I pushed for 5 hours at home and he was soooo stuck. If I have a 3rd it will be in the hospital for sure (my HB midwives will not see me again) and I would like to attempt a
vba2c but am not even sure if its possible.

If you do choose a hospital, you could just labor at home for most of it with a doula so that when you get to the hospital you don't have to be strapped down for too long.

[iris427]

I think the HBAC sounds like a good option. Your odds of rupturing are very low--less than 1%. Even if one does occur, it is likely to be small and you would have time to get to the local hospital for a cesarean. You are much less likely to have another cesarean if you deliver at home, and you said yourself that you are not comfortable delivering in a hospital.

I think you should meet with the HB midwife and see what she has to say. She may be able to reassure you as to some of your fears. And if you don't like her, you can always stick with your current practice and deliver in the hospital.

GL!

[BarnMomma]

Ok this is great. THis is what I need to hear. By all means, keep the stories and opinions coming. I'm showing my husband your replies as well because he is as on the fence as I am.

[sept15lija]

I've chosen HBAC and am waiting to go into labour presently! I am so excited about our choice. DH was a little unsure but after some talks and also watching some videos and hearing real-life stories (my midwive's office has a home birth information night - and the mom who came to talk was a HBAC - yay!!) he now worries about going to the hospital, lol. I am not at all worried about a uterine rupture, I know it's a possibility, but I feel in very good hands with my midwives and my doula.

I just REALLY don't want to go the hospital. Like you, I have a young son, and I can't imagine being separated from him for any length of time, especially when he can't visit me at the hospital. Making this decision early in my pregnancy I had the same feelings as you, anger all over again at my (IMO) unnecessary c-section. Heck, I'm not the only one; my midwife thinks it was unnecssary too (I had a c-section for suspected macrosomia - not so much, he was 7lbs10oz - and also because my bp had gone up a bit...and my OB at the time basically pressured me into it).

Good luck in your decision!

ETA: Also my midwife mentioned that even if I do need a c-section, the anesthesologist and the OB are on-call, so we'd have to wait for them. What's the difference in calling them from home and driving the five minutes to the hospital and meeting them there, or waiting there for them? That sealed our decision.

[kellij]

I'm too nervous about not being in a hospital. One of the very few drs here that does a vbac is at a hospital that is currently reviewing whether or not they will continue to allow vbacs. Apparently a uterus ruptured and a baby died a couple of months ago. Clearly, I think that is the worst nightmare for all of us. I don't want to have to question whether it would have made a difference if I was at the hospital if something were to happen. I'm hoping to be left alone as much as possible and be given as much time as possible, but I'd rather be right there in an emergency situation. I think I'll be able to relax more knowing I'm closer, than that I need to catch whatever might happen and rush in.

On the other hand, I'm not phobic about hospitals. I didn't have anything super-traumatic or horrible happen to me, I just would really prefer a vaginal birth and think it's best for my baby and me. So I'm okay with the trade off of being at a hospital. Oh, and I'm a vba2c. I might feel differently if I'd just had one c-section. My parents will be able to watch our kids for us and they love spending time with them, so I'm also okay with that.

[azmomma]

Originally Posted by kellij

I'm too nervous about not being in a hospital. One of the very few drs here that does a vbac is at a hospital that is currently reviewing whether or not they will continue to allow vbacs. Apparently a uterus ruptured and a baby died a couple of months ago. Clearly, I think that is the worst nightmare for all of us. I don't want to have to question whether it would have made a difference if I was at the hospital if something were to happen. I'm hoping to be left alone as much as possible and be given as much time as possible, but I'd rather be right there in an emergency situation. I think I'll be able to relax more knowing I'm closer, than that I need to catch whatever might happen and rush in.

On the other hand, I'm not phobic about hospitals. I didn't have anything super-traumatic or horrible happen to me, I just would really prefer a vaginal birth and think it's best for my baby and me. So I'm okay with the trade off of being at a hospital. Oh, and I'm a vba2c. I might feel differently if I'd just had one c-section. My parents will be able to watch our kids for us and they love spending time with them, so I'm also okay with that.

You have to do what YOU feel is right for YOU! I personally would not feel at ease at home. My sister-in-law has had all 3 of her kiddo's at home and I think that is awesome FOR HER. One of the biggest things I have been reading about online, in books, on message boards...you probably want to steer clear of pitocin because that can a-cause uterus to rupture b-slow down labor because of most likely epidural that will follow. You don't have to birth at home to stay away from pit. Also, another HUGE thing to keep your labor progressing is to BE CALM AND RELAXED as much as that is possible while laboring. I have read several places that if you tense up or are stressed etc. that sends chemical reactions to your brain literally shutting down the chemicals i.e. oxytocin that help keep labor going. Where will you be able to out your MIND most at ease. That may be at home, it may be at a hospital. One other thing to really consider is a midwife AND a doula.

Here's my situation briefly (that I feel comfortable with - doesn't mean you will, but you can take what you will from it): Just decided on VBAC out of the blue at 26 weeks. Now approaching 29 weeks and just met my new doc for the first time. I am choosing a hospital that has 75% VBAC success and doc who is VERY well known for VBAC success and his natural approach. He is the only doc in the practice with 2 midwives supporting him. He WILL NOT use pitocin at all. He will use epidural though. He also HIGHLY encourages a doula. I am interviewing my first doula tomorrow. I think it's super important to have a doula with you so that she can be there with you 100% of the time you are in labor/delivery not just physically but emotionally as well. Hope that helps.

[azmomma]

Originally Posted by BarnMomma

As of now, we have two options for a VBAC.


But a home VBAC still has me nervous. I can't shake the fear of uterine rupture and not making it to the hospital on time. And at the the same time I want to be nowhere near a hospital becasue I find them to be unwelcoming, germy, and I'd rather be somewhere I'm comfortable. I feel very scarred from my first hospital birth experience. And I hate that no-children-allowed thing all the hospitals have going on now. Not see my son for 6 days? Sure. That will go over SO well. I've never been away from him for more than 5 hours.
.

Okay here's how I look at it...as silly as it may sound make a chart of pro's for home and pro's for hospital. Sure germy, unwelcoming...but may save your's and your baby's life if need be.

What I would REALLY look at is the difference between the two hospitals. Look at (a)do either/both of them have an anesthesiologist (sp?) on staff 24/7 ready for an e-c/s? Is there an on-call doc there 24/7 that will also be there in 5-10 minutes...or at the other hospital...immediatly? (b) What are the NICU's like at each hospital...which is BEST for your baby should they need that type of attention. Hopefully you, nor myself, nor anyone else will need to use these measures...but something to think about. So if you have your homebirth but need medical attention is THAT hospital going to be your best option vs the hospital you can do your VBAC in?

Also, if you end up going to the hospital 40 min away...is there a possibilty that you can get a babysitter (well known of course i.e. family) to stay with your son at a nearby hotel? At least you know they are taken care of just minutes away and your hubby can be with you???

One other thing to really keep in mind: what are your biggest fears? What setting will you most be at ease (you may be "stressed" at both, but which is the less of two evils for you)? I've stated in this thread in another post that anxiety/stress can slow your labor.

Just some things to think about. It's a rough decision I know...Just make sure you do what YOU feel most comfortable with.

[jesbentink]

Your story sounds so familiar to mine, and so many others I am sure! I had a c-section with my son april 07 due to a forced induction at 41 weeks, pushed for 4 hours(I was complete) and then had a c-section for no other reason but I had been pushing for a long time. I interviewed several OB's. One even had the nerve to ask me what my drive was behind wanting a vaginal birth...???WTH!?! I got pregnant when my son was 15 months old(my 2 births were almost 2 years apart). The OB that did my c-section told me that she would let me "try" a VBAC but would not let me go past my due date. That didn't work for me! I did some looking around and found a nurse midwife about 45 minutes away and started going to her, then I fell in love with the idea of a water birth but was not allowed to do so in this hospital where the CNM worked because of their rules about constant monitoring for any VBAC Mom. She was actually the one to suggest(under wraps) a home birth. I found a lay midwife about 30 minutes away who was wonderful! She attends mostly for amish around here. I kept seeing the CNM that was 45 minutes away but not very often and only for insurance purposes. Anyway, I was quite nervous but after all the reading and research I had done up to this point I was terrified to go back to the hospital so my decision was easy. I went to 41 weeks again and I had a 2 and half hour labor right in the middle of the sun shiny day! It was so awesome! I had prepared for so much and gotten all the supplies that people suggested and never really had to use many of them. I definitely vote for the HBAC all the way!

[solinox]

I'll vote for HBAC. I had an HBA2C for my last birth. I always make sure a good backup transfer plan is in place before my births, so I know that there will be no delay in getting things done if we need to transfer. I make sure my midwives have an established OB to call, and know that if we needed to transfer for an urgent c/s (cord prolapse, uterine rupture, etc.), an OR would be getting set up while we were en route to the hospital. This makes me feel that the call-to-cut time would be comparable or even faster than if I were in the hospital already, plus I get the advantages of the midwives attention and lack of intervention.

[BarnMomma]

This is great. Please keep sharing!

[CookAMH]

This is really helpful for me too as my DH and I have been discussing these options off and on for a future baby.

[tanyachap]

I could have written your post myself. I totally understand where you are coming from and how you probably feel about HBAC and hospitals. I am due 2/7 and full term as of now. After much thought, I have decided to go for HBAC. I personally see my chances for successful VBAC at a hospital to be no more than 40%. The constant monitoring, being in bed, having a big boy are all bad factors that work against me, which will all make me labor slowly and feel nervous. The chances of complication during of HBAC are really really low and you are 5-10 min away from a hospital. I would take these chances. By contrast, we are 15 min away from one hospital, which I don't like, and 25 min from a more progressive hospital. Still, I would rather give HBAC a shot. I hope I will post my success story in a couple of weeks

[BarnMomma]

UPDATE:

So we spoke with a midwife who does HVBACS. She has a OB back up at the close hospital but he doesn't support HVBAC so she couldn't call up and accompany in case of an emergency. We'd need to go ourselves to be admitted through emergency. The hospitals she wants to back up with are far away (25-45min) and places I don not want to be stuck at for 6 days should I need a C-sec.

So now we're considering a midwife with whom we met last year. I really liked her but I didn't call her this year becasue I know she no longer had a back up at the hospital closest to us. Now that seems to be a non-issue.

So now the options are, stay with the ob/midwife practice and attempt a hospital birth, or use one of the two midwives knowing we will be treated like garbage if we need to be rushed to the ER. (midwives said that would happen...said they don't look kindly upon homebirth and the emergencies involved)

Again, we're kind of leaning toward having this hospital be the back up despite the unkind welcome we'll get because it's close, and I've recovered there before and the care was top notch. (labor and delivery another story, but recovery was aces)

[MamaMereMere]

So, I don't want to sound insensitive, but how did your birth go, now that its a year later or so? I am hoping to HVBAC (though not yet pregnant) and also just started a local ICAN Chapter. 

[Mamatoabunch]

I have had 8 HBAC, my last 7 actually unassisted. No complications.

[CookAMH]

Originally Posted by CookAMH 

This is really helpful for me too as my DH and I have been discussing these options off and on for a future baby.

Just an update from my earlier post from a month ago, we have decided on HBAC. I will admit one factor in the midwife we chose was that she would accompany us to the hospital in the event of a transfer. We do not, however, have an OB backup and didn't feel compelled to get one. We are very happy about our choice!