VBAC, informing OB about BH contrax

[CamoShades]

I am 29w3d with my second child, and I am planning a VBAC with an OB. Please don't suggest switching to a homebirth midwife or a birth center- or hospital-based midwife, because those are not options for me (due to insurance and husband reasons, as well as birth center policy reasons). I have found the most VBAC-friendly OB available to me, and I'm happy with what I've heard from her so far, though I wish I could go the FSBC route. OB was even giddy excited when I told her I'm using Hypnobabies -- she said she had dreams of teaching self-hypnosis to her patients when she was a young OB, but then realized it was too time-consuming -- which I thought spoke volumes for her thinking style.

So anyway, I've been having a lot of Braxton Hicks contractions since Saturday afternoon (so for about two days now). I've been drinking a lot of water, so I don't think they're being caused by dehydration. I hosted a family get-together at my house yesterday, and I was able to lie down and time them a bit once everyone left around 5 p.m. My hope, of course, was that they'd taper off with rest, but they didn't. I was having them about every five minutes, and they lasted for around a minute or minute and 20 seconds each time. When I went to sleep around 10 p.m., they were still happening rather frequently.

When I got to work this morning (a desk job), I noticed them starting up again. They haven't been quite as frequent at all times, but they've been going on all day, and they're happening about every five minutes as of late. Of course all the medical literature I read tells me to call my provider if I'm having more than four or five per hour, but I realize that's medical literature.

I know BH can increase with each pregnancy, and it's probably normal and fine. I am noticing some pelvic pressure from time-to-time, but I also have SPD which makes that whole area sore in general, so I'm not sure if the pressure is something to take into consideration.

I talked to my doula yesterday before I had a chance to sit down and relax, before the BH continued even with rest. Her advice was to sit/lie down and relax after my family left, drink more water, and time them a bit, which I had already planned to do. She said if it were her, she wouldn't call the OB at that point, unless I really felt like I needed to, for fear that it would be something they'd put in my charts (or they'd "discover" something) that could hurt my chances at a VBAC. I hadn't really thought about it that way -- duh, I knew I hired her for a reason, partially to remind me of what I already know and want! I e-mailed her with an update this morning, but she hasn't yet gotten back to me.

So do you think I should do anything at this point? Should I call the OB? I know there's a chance all these BH are dilating my cervix, but it's probably unlikely. And if I don't say anything now, what do I tell the OB next week Monday at my 30-week checkup? I don't want to lie, but I don't want anything minor to hurt my VBAC chances either. Because I AM having this VBAC, dammit!

[mediumcrunch]

I honestly can't see how a r/o preterm labor workup (sometime on the monitor, a cervical check and maybe a FFn swab) will impact your VBAC chances at all. Either you are at risk for preterm labor or are in preterm labor and it needs to be dealt with and keeping baby in a while longer is a priority at this gestation or you are not and maybe just have an irritable uterus and need to take some extra calcium and everything moves forward as planned.

I used to be a doula and personally, I would never counsel a mom to not call her health care provider if she was contracting consistently for days in spite of being well hydrated and resting. VBAC or not.

let me ask you this, if you were going to a FSBC and under the care of a LM or CNM would you call her and speak to her about these B-H?

[CamoShades]

Originally Posted by mediumcrunch

let me ask you this, if you were going to a FSBC and under the care of a LM or CNM would you call her and speak to her about these B-H?

Absolutely, and I know where you're going with this.

Thanks for kind of validating what I was feeling deep down (that I should probably call), and for saying that you don't think it would impact my VBAC chances. I wasn't sure about that, but since my doula was the one who brought it up, I figured she might be right -- even though I couldn't really figure out how it would.

And, to defend my doula, she did tell me to rest and see where it took me; I had been on my feet for the entire day (and the previous day), so I wasn't rested the last time I spoke with her, and I think she probably assumed rest would help. I know she had a client due any day now, so I am wondering if that's why she hasn't gotten back to me yet today.

[Juvysen]

I'm a homebirther/midwife-seeing type, but I'd call my provider in your situation. This is what you're paying her for, at this point! It's half the point of prenatal care - to have someone to ask about situations like this.

If it harms your chances of vbac then she may not be the right doctor for you... and it's time to find another one - OB or not. Kwim? you don't want to be nervous that anything you say during labor may affect your VBAC chances, too, right? Because what if that nagging "what the heck was that" you have was actually something important to share?

I'm not saying "omg, switch to a homebirth!" because that's ridiculous in this situation, but you do want a provider who you can trust, and that you can share your worries with and get her reassurances, you know? And most of all, you want to have a provider that has your baby's best interests in mind...

[skolbut]

Hey, mama. I was in a similar situation as yours, about the same gestation with my second. I had BH contrax pretty consistently from 5 months on, but one day they were pretty close and regular for an hour or two... then stopped... then up again. I called my OB and he told me rest and hydrate but I'm glad I called, because then he was aware and could get me in to the office asap if needed (I already had an appt that week). I went on to have a successful VBAC, so IMO go ahead and call. Especially if your OB is vbac-friendly, they shouldn't have a prob with a situation like this.

[GOPLawyer]

If your gut is telling you to call....then definitely call!

I had signs of preterm labor @ 28 weeks and hated to call my MW as I knew a trip into the world of OBs was inevitable (I was planning a HB) but I'm so glad I did. Long story short...DD was born two weeks later.

If this does end up being the start of something....your VBAC is not necessarily in jeopardy! At 30 weeks, I had a VBA2C. After 27 weeks, assuming there are no medical indications saying otherwise, a vaginal birth is generally safe.

[CamoShades]

Originally Posted by Juvysen

but you do want a provider who you can trust, and that you can share your worries with and get her reassurances, you know?

You are right. And I do have that. I think my doula questioning it was what made me question it, even though I didn't personally think I had anything to worry about concerning this and VBAC. In a way I wish my doula had been more supportive of having me call, but she has said she's never been at a birth attended by my doctor before, so she's uncertain what to expect from her, and I know she was just looking out for me because she knows what I want. I should have been more confident in the care provider I've chosen, since I DO know her. My doula is a homebirth/midwife-seeing type, too, so I think she's pretty leery of OBs in general. And to tell you the truth, I'm a cynic about the whole OB profession in general. I know you would think I should probably have taken my business elsewhere, but due to a lot of circumstances -- some are not medically related -- it's just not possible! So here I sit with the best option for my baby, husband and me, and I truly am happy and at peace with my decision. If I can't see a midwife and have a birth in a birth center (none within five hours of me "do" VBACs), I'm confident the doctor I have is my best option.

So I ended up calling my OB's office, and they had me go in to L&D. Of course my contractions were petering off by then, and I only had one the entire time I was hooked up to the monitors. The resident OB checked my cervix, and it was "nice and closed." Of course I felt stupid because nothing was going on, but the resident made me feel so much better. She actually sat down on my bed and told me she wanted to "get it through my head" that coming in was the right thing to do, and that peace of mind is everything. I have to agree with that part, because I know I would have sat here worrying/wondering until my OB appointment next week.

When the resident asked about my previous pregnancy, I told her I'd had a C-section and that I was planning a VBAC. She said, "Oh, good" and asked who my doctor is. When I told her, I barely had the doctor's name out of my mouth and she said, "Oh, good, that's who I'd choose, too. She's the best." She asked why I had a C-section, and when I told her breech, she said I was a prime candidate (which I knew) and she was confident I'd do it. I have to say, it was really nice to hear those things coming from a doctor.

skolbut and GOPLawyer- Thanks for your stories!

[khaoskat]

I am so glad that I am not the only one. although I don't feel (with my hands that my uterus is hard - it is not squishy soft, but it is not rock hard, it has a little give to it when I am feeling it).

But I am only 23 weeks right now, well almost 24.