Where to start when HBAC is not "legal" in your state?

[thehappydeer]

Hello!

I just found out an am expecting my second little one. I'm really interested in having an HBAC but I live in Washington and apparently midwives are not legally allowed to attend here.

So, are my only options unassisted birth or birthing in the hospital? Does anyone have experience with HBAC in a state that frowns upon it? Who should I talk to and what questions should I ask of providers?

I have been to the ICAN website and found helpful info about hospitals in my area, but not much about attempting and HBAC.

If its helpful here's a little background about my first birth. I began labor at home with my first and transferred to the hospital for a CS when my midwife arrived and found my daughter was breech. As far as I know I'm an excellent candidate for a VBAC.

Thanks for any input you may have!

[HappyMommy2]

You should be able to find some great crunchy folks in WA! Keep trying mama, and ask around! My HBAC was amazing.

[GOPLawyer]

I would ask about this in the Finding your Tribe area. I'll bet there is a person or two who, um....disagrees w/ the law.

[liberal_chick]

I had a HBAC in Arkansas this year where it is illegal for midwives to attend VBACS.

My first step was to contact local midwives to see if they'd attend me "under the table." Some will do it, but I found since my first (and only) c-section was done at 30 weeks that none were willing to do that for me. When they turned me down, I asked if they knew any unlicensed midwives who they trusted that I could talk to. I got lots of references that way, including the midwife that attended my HBAC.

I did also have concurrent care with an OB just b/c they don't treat transfers well at my local hospital. Also, b/c my midwife was unlicensed, she was unable to do any tests or ultrasounds, so the OB was good for that. Our insurance covered the OB's fees (all but $7, IIRC) and we paid the MW's fees out of pocket. Well worth it!

[kltroy]

Don't just go to the ICAN website. Rather, join your local mailing list and try and get to a meeting face-to-face. It is VERY helpful, and I am sure someone within that group will know who to contact. If it's not "legal" it will probably not be publicly available, but you can find out by speaking with someone directly.

[prancie]

you should be able to find a lay midwife through the grapevine that will attend your birth. There are always those people around!

[onyxravnos]

Midwives can't do VBACS in my state either. For me i ended up doing a UBAC at home with a doula as that was the right choice for me.
(would be happy to talk about it whos/hows/whys/whatever if you would like to PM me )

there are several main options:
1. Try to have the birth you want at the hospital
2. Go to another state that allows midwives to assist you: California does for example or of course there is The Farm.
3. Bring a midwife from another state that does allow it to you. ( I have two or three traveling midwives email addresses if you would like them PM me)
4. Find an underground midwife, they exist everywhere but are sometimes hard to find. start sooner rather then later if this is what you want as they book up quickly.
5. Unassisted birth at home - which of course doesn't mean you couldn't have some knowledgeable people around to help.

[kltroy]

One other option would be a birth center birth - Washington has many, and IMHO they are a really great compromise.

[CookAMH]

Do a search in our local tribe site (http://www.mothering.com/discussions...splay.php?f=97). There are many m/w who will attend a HBAC and I will be looking into that myself next time I am pg. Don't worry, you will find someone. I actually didn't know it's "illegal" in our state, I had that much info that hombirth midwives are out there for HBAC.

[babycatcher12]

There are traveling midwives who will come to you, so that might be an option. I second the idea of checking with your local ICAN chapter. There is usually someone who will at least talk to you about your options. I'll bet that you can find someone who is willing to "take the risk" of *allowing* you to HBAC. (I hate that we have to be allowed to do anything). Grrr.
Good luck to you!

[CookAMH]

Originally Posted by kltroy

One other option would be a birth center birth - Washington has many, and IMHO they are a really great compromise.

I actually don't think VBACs are allowed at birth centers. It's either at home or in the hospital.

[SalmonBayDoula]

I am one of the co-leaders of ICAN Seattle, please go to our website and join our local yahoo group. there will be women who can help you with resources. HBACs are NOT illegal in WA! You will have options! We have a very active yahoo group with lots of knowing women!

www.icanseattle.wordpress.com

See you there!
Sharon

[thehappydeer]

Wow thanks everyone for your helpful replies. It feels so great to have this input and support!

[DocsNemesis]

Er....who told you HBAC was illegal here?? It isn't.

It IS illegal for a VBAC to occur in a birth center in Washington, but not a homebirth. I interviewed 3 different homebirth midwives for my VBAC, so I'm sure of this.

Anyway, I think its idiotic that birth center VBAC's are illegal but at least we still have the option of homebirth or hospital. I just had to transfer care to an OB due to pre-e, but my homebirth midwife was really nice and I liked her a lot. I just can't see her anymore I do like my OB too though, though delivering in a hospital is bleck for me.

I'd definitely check with ICAN and the local tribe and ask for suggestions on the peninsula for midwives. I live near Seattle so I probably had a lot more choices, but hopefully there is someone out there!

[CookAMH]

Originally Posted by DocsNemesis

I just had to transfer care to an OB due to pre-e, but my homebirth midwife was really nice and I liked her a lot. I just can't see her anymore I do like my OB too though, though delivering in a hospital is bleck for me.

What hospital will you be at?

[DocsNemesis]

Evergreen. Its actually a really nice hospital and I like a lot of their practices, but some of the policies don't work well with what I want. Since I'm a VBAC, its policy to do continuous fetal monitoring, no eating, etc. It probably won't be an issue though, I'm seeing a very quick labor/delivery here!

[thehappydeer]

Oh My, I sincerely apologize for spreading around my misunderstanding. My midwife told me after my last birth that she would not be able to care for me when I had my second baby. She said she was working with other midwives to change the regulations reguarding home VBACs, and that I'd need to go to an OB. Maybe I really didnt understand what she meant. maybe SHE doesnt/wont attend HBACs, maybe its her insurance policy that regulates this?

[DocsNemesis]

That's very possible. I know my former midwives couldn't take me back after I had my cesarean due to insurance regs (they were both a birth center and homebirth midwives...I wanted a homebirth but even so, they couldn't take on VBACs).

[milkybean]

Originally Posted by thehappydeer

Oh My, I sincerely apologize for spreading around my misunderstanding. My midwife told me after my last birth that she would not be able to care for me when I had my second baby. She said she was working with other midwives to change the regulations reguarding home VBACs, and that I'd need to go to an OB. Maybe I really didnt understand what she meant. maybe SHE doesnt/wont attend HBACs, maybe its her insurance policy that regulates this?

From what I found...there are serious problems with the malpractice insurance companies that cover midwives. So it's not even a health thing, for us, at all.

I do wish that the midwives in this state would be a bit more open and honest about what the full truth is, not just THEIR truth. Encountered that while pregnant with my 5 year old; one midwife would say "that's the law" and another midwife with the exact same credentials would refute it. It gets really old.


I will likely be going to Oregon, should I get/be pregnant, for midwifery care. That is, if it's still as open as it was a couple years ago! I woudln't mind going to CA, but I don't think my childfree brother would agree to me using his house, and I'd have to lock my NICU nurse, 100% brainwashed, stepmom out of her house if I wanted to be at my dad's!

[CorasMama]

Originally Posted by kltroy

One other option would be a birth center birth - Washington has many, and IMHO they are a really great compromise.

none of the birth centers in WA can do vbacs

Originally Posted by DocsNemesis

Evergreen. Its actually a really nice hospital and I like a lot of their practices, but some of the policies don't work well with what I want. Since I'm a VBAC, its policy to do continuous fetal monitoring, no eating, etc. It probably won't be an issue though, I'm seeing a very quick labor/delivery here!

Actually, the woman who did the tour I took at Evergreen said "I can't imagine [shudder ] why you'd want to eat during labor, but we aren't exactly going to stop you."

I was recently at Evergreen for monitoring after falling downstairs, and the nurses were really wonderful. I mean exceptionally wonderful! Made me jealous that I can't deliver there (I need to be closer to Children's, because baby needs to transfer immediately.)