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My midwife just broke up with me...afraid of my VBAC

post #1 of 34
Thread Starter 
Hi there,

I'm 20 weeks pg. I had a failed homebirth with DS 2.5 years ago. 3 weeks overdue, FTP, went to the hospital, progressed, but DS would not drop no matter what. He was born 11lbs. There was suspected undiagnosed GD, but he, nor I, showed high glucose numbers after birth. Midwife was given a talking to from the OB, though, for letting baby get so big.

Anyway, after a ton of odd behavior and half told stories, finally was able to get MW on the phone last night (we were supposed to see each other in person, but she had a birth to attend) and she tells me she can't, in good faith, continue care with me. Apparently, she had a VBAC mama who just almost had a catastrophic rupture at home and one of my MW's consulting OBs was super pissed because he told her not to let this mama go so overdue. In addition, a year and a half ago, she almost lost her license over a VBAC where she lost the baby(I think the first babe she's ever lost)...again, perhaps undiagnosed GD and went overdue.

So...she admits a lot of it is her, but she is also still wary. She says that she wants to believe in VBACs, she wants to believe in the body doing what it should at the time it should, but, obviously, in light of a couple of bad expereinces, she's re-evaluating things.

This sucks . Although she was never the perfect midwife, we had a good and honest relationship, she was the best we could find for us, and, well, she just knows our story so well already...I feel like she knew for a long time she wasn't going to be able to do this, but couldn't bring herself to say it, and that, more than anything is what I'm upset about. Here I am at 20 weeks, essentially providerless (she's promised to stick around for prenatals until I find someone new).

When I asked her what she would do, she said she would work her ass off for a VBAC at home and basically, tell her to f%^k off! She doesn't want me to lay down for a section. She said there is on OB she feels really good about and she already talked to him about me in case I decide to go that route and he said he'd take me on. She also mentioned a couple of other HB midwives in town who she feels like would take me on (one was under investigation a year ago for a breech gone really bad).

I have no idea what to do. The OB gets lots a great press...his partners are all super pro VBAC and natural birth, but regardless, I'd have to have the babe in a hospital which just mortifies me. i'd have to have EFM. The time after the c/s last time was awful. I was there for a week with an infection among other things. I also don't revel the thought of my care provider being a man. Just a personal thing.

I think I'm also just feeling so deflated. I was feeling super positive. Like I could do this, I had no doubt, and I woke up this morning just wanting it to find an OB and schedule a section(obviously not now).

So...I guess I'm looking for some sort of support, thoughts...My c/s was fine, besides DS being really big and hard to get out. My uterus is fine, my vitals are all normal and healthy. My sugars have been checked and I'm totally not GD. I'm eating pretty healthy, feeling much more in touch with this p/g. I've been pretty nauseous and tired, so the exercise hasn't been as much as I'd like. I am pretty darn overweight/obese.

No idea what to do. If you've gotten this far, at least, thanks for listening!
post #2 of 34
I couldn't read and not post, I'm so sorry you're going through this right now. I've been in the works of prepping for a VBAC (mostly mentally) for 4 years now (not pregnant yet). Your body knows how to birth, I'm sorry you're care provider is afraid/wary of that process. I hope that you're able to find someone that is supportive of you and an encouragement to you.

post #3 of 34
I had been following your post about your birth team on the BT board. Sorry to hear that she ended it with you leaving you pretty much high and dry. I guess you don't really have an option besides getting out there and interviewing providers. Probably not something you wanted to be doing at 20 weeks, but better now than later. I'm glad that at least your MW was honest with you, even if it's not what you wanted to hear -- honesty is something I've struggled with with my MW and it creates needless uncertainty and strife.

I hope that this at least gives you the opportunity to go out and find someone who isn't tainted by the trauma of your prior birth, and who isn't afraid of your VBAC. As far as the doc v. midwife thing, I can totally understand why you wouldn't want to birth in a hospital even with the world's most supportive doctor and nurses. My hospital experience almost makes a DIY section look reasonable.
post #4 of 34
Just an FYI - and I'm definitely not trying to scare you out of a VBAC, I am sure you can do it if you find a supportive care provider. But as far as the hospital vs. home birth goes - you mentioned that you are quite overweight/possibly obese. In the unlikely event that you do require an emergent c-section for any reason, it takes OBs additional time to 'get the baby out' when the mom is obese, because of the extra layers they have to go through and difficulty manipulating the pannus (skin roll). If you are attempting a homebirth and need to be transferred to the hospital, that extra time could cost you. I know a hospital birth is not what you would prefer, but it might be the safest thing for your baby. I would discuss this at length with whatever care provider you choose. If you do end up going with a hospital birth, they should have telemetry monitoring units available so you aren't strapped to the bed.

Best of luck to you in finding a new care provider!
post #5 of 34
I had to respond. I'm a plus size VBAC mama, if I were in your shoes I'd interview all the available choices including the male OB. I'd choose who I felt best with. Then work on growing a smaller baby, eliminate all/most sugars and processed food and make sure I was walking about 40-60 minutes a day.


I can certainly understand your midwife's perspective and I think it's wonderful that she's so honest. The consequences of an uncomfortable provider are far reaching and could have lead you to a repeat c-section because of ftp again. If you can find a midwife that feels good about you birth and her abilities you're going to have a positive experience. So as much as this is a pain right now I'm happy that it's getting out of the way so that there is no unnecessary fear being brought to your birth. Good luck and I look forward to an update!
post #6 of 34
Thread Starter 
duplicate
post #7 of 34
Thread Starter 
Quote:
Originally Posted by Right of Passage View Post
Then work on growing a smaller baby, eliminate all/most sugars and processed food and make sure I was walking about 40-60 minutes a day. !
I think this is whats killing me, I'm doing ALL that and have been for quite a while(walking has taken a back burner the past week or two). And we just had the u/s and baby is measuring a bit on the small side.
I'm also doing chiro for positioning, acupuncture, weekly yoga...am about to order hypnobabies. I'm not just sitting around waiting for this VBAC to find me. I'm working for it for sure!
post #8 of 34
Thread Starter 
I'm just obviously a bit tired and drained today. I really, honestly, do appreciate your thoughts and input. I don't mean anything to sound like I don't.

We had a great ultrasound that showed a beautiful and measuring a wee bit on the small side, but in no way scary small. Its a girl . Yey!

I've read the research, I've read the studies. I KNOW that being a big girl adds an element to this, but based on what I've read, I can't quite tell what it is...last p/g I was chugging the milk and having lots of treats. This time, I can only stomach a sweet or two a week and milk is limited...just not appealing. My body is handling things so much differently and I've gained a whopping 3 lbs so far.

I just need someone, with enough perspective, to tell me what the huge fear is. I need risk described to me in numbers backed up by studies, not possibilities and singular experiences. I need to be able to take those numbers and make my own decisions about what kind of risks I take. Can any of you do that? Can anyone show me studies that add the size element to it? I'm not massive, just big. Totally mobile and healthy otherwise.

This is my birth, hopefully my VBAC and last I checked, its still my right to decide how I'm going to do this.

I am feeling liberated from the situation with my midwife now. I'm pissed and it still sucks, but at least I'm out of limbo. At least she was finally honest with me. At least its a fresh start and I talked to some friends this morning who have good things to say about a couple of the names she gave me. Its a pain to start calling and interviewing and scheduling again, but, I guess I needed a new project. .

Again, thanks for your help, and I'm serious about those studies. Think I might head over to ICAN to see what kinda info those ladies have too.
post #9 of 34
Hi, I guess I'm forum crashing, b/c I don't have the experience of a c-sec. But I wanted to say that if your instincts and your spirit are set on a hb, then I would do whatever is possible to make that a safe and healing experience. I wouldn't necessarily move to an OB just b/c the MW backed out. Especially b/c it seems that she did it to keep her reputation/relationship in the medical network.
post #10 of 34
Have you checked out the website plus-size-pregnancy.org? Theres alot of great info there, a whole section on vbac and many vbac success stories. Good luck with everything!
post #11 of 34
Another thing to remember about hospital births - if you don't want an epidural, you can say no to ANYTHING. No to the EFM. No to a section. No to ANYTHING.

In your shoes, I think I'd meet with the pro-VBAC OB practice and see if that is a bearable solution. If so, I'd wait until active labor to go to the hospital, and then I'd say no to everything except periodic EFM to see how the baby's doing.

For this kind of scenario, you might want to hire a real bulldog of a doula. But when it comes right down to it, if you speak English and are not high on drugs, stating loudly and clearly that you do not consent is going to get most hospital staff to back off. They have no interest in being sued. You just can't equivocate.
post #12 of 34
Thread Starter 
Quote:
Originally Posted by Smithie View Post
Another thing to remember about hospital births - if you don't want an epidural, you can say no to ANYTHING. No to the EFM. No to a section. No to ANYTHING.

In your shoes, I think I'd meet with the pro-VBAC OB practice and see if that is a bearable solution. If so, I'd wait until active labor to go to the hospital, and then I'd say no to everything except periodic EFM to see how the baby's doing.

For this kind of scenario, you might want to hire a real bulldog of a doula. But when it comes right down to it, if you speak English and are not high on drugs, stating loudly and clearly that you do not consent is going to get most hospital staff to back off. They have no interest in being sued. You just can't equivocate.
True...but why would I want to fight so hard? The hospital is 5 minutes from my house. What are they/the ob really going to be able to give me that a midwife couldn't besides a big fat pain in my a##? I'm not trying to be defensive, I'm just seriously asking.

My first c/s wasn't an emergency, but believe me, big fat belly and all, they were able to get in there fast and pull that baby out, I was pretty amazed. If I was further from the hospital, I might be concerned. But I feel the intimidation factor alone, the fighting, the...well, all that stuff, is just as risky as not being 20 feet from an OR, KWIM? Its not condusive to a good honest focused labor, for me at least.
post #13 of 34

Just Had To Post

because of my history I just had to say something here. I am supposed to weigh 145lbs. dd was emergency c/s and I was 255lbs. My weight may have been a factor in the reason for c/s but I wouldn't let that stop you from having a birthplan that is right for you in your heart. I went on to have a natural vbac at a hospital at 235lbs. I never felt high risk. I think that's bs. Doctors just would rather section women, imo. what worked for me was natural induction with castor oil at home one week before my due date. I was scared to let ds get too big and be told I had to have a c/s. I labored at home with family and waited till almost transition to go to the hospital. There was no time for interventions or any other crap. When I got to the hospital I got my room and had the baby. I think I got the best of both worlds this way. I got to labor at home and had the security of a hospital in case something went wrong. I mostly showed up at the hospital so I could be served for a few days pp. This way I could concentrate on the baby.
post #14 of 34
I started seeing a hospital based MW, but decided against it because the OB in her practice wouldn't be comfortable with me going past 40 weeks and I told her I would not consent to a cesarean. I just got an encouraging e-mail though from a HBMW that is supportive of me no matter what route I take & she honestly believes that having a VBAC at any hospital around here is unattainable so I'm considering going with her or UC.
post #15 of 34
Sorry you are going through this.

If it were me, and the male (yeech, I only go to female OB's too) OB & practice were truly pro VBAC and not bait and switchers I'd go with him, and just stay home until I was in transition. (hospital 5 minutes away I am very jealous.)

I like this plus size preg site
http://wellroundedmama.blogspot.com/...o-gallery.html

This is about macrosomia talks some about obese Moms (we are still at a greater risk for big babies *even if* we watch our preggo diet) - might have to register to see it though...
http://emedicine.medscape.com/article/262679-overview
post #16 of 34
Oh goodness! I'm so sorry to hear this! Wow, that stinks! It sounds like you've got a lot going for you otherwise though (walking, eating good, smaller baby possibly via u/s)! So, add that to your list of positives, for sure!

Now, I know a lot of VBAC women are against OB's and hospital births, but I had a good experience and I'm looking forward to an even better one with an OB in the hospital! I did switch OB's after my c/s, because I did feel like that doctor let me down and was knife happy. But my new OB was about an 8 out of 10 for a VBAC supporter. She actually suggested it to ME! I did agree to things like constant monitoring and an IV (because I was GBS positive and that felt like the right decision for me), but I got to be up, moving and mobile!

Now, I've decided to switch OB's again, not because my OB was bad, but I've since found who is considered the most VBAC friendly OB in town. I actually met with him today and he's amazing! He made me so confident in him. His first words when I said that DS was a c/s and DD was a VBAC were "I LOVE VBAC's, way to go mama, that's awesome!!!!" Then, with things like rolling his eyes when I said I hit that magic 2 hours of pushing point with my son (the c/s) and his reaction was the eye roll and saying, "well, some women just take longer to push...and maybe that's you! I have no time limit on pushing, I just pushed with a woman for 4 hours last week!" So, IMO, I'd meet with this OB and see the feeling you get from him. Maybe you'll be pleasantly surprised and confident in going with him! It's at least worth a try!
post #17 of 34
Hmmm. I would still look for the most hands-off provider...You are more likely to have a successful VBAC at home. Milk puts on the pounds- it isn't really necessary for a grown adult to drink it(possibly laced with growth hormones from the cow?) I know some mws will help clients hb even with previous surgery IF the conditions that caused the first section don't repeat. Sounds like you have that part under control. Some midwives don't do babies over 10 lbs. I have known of a couple of 12 lbers and a 13 lber born at home, but they were not expected to be quite that large...Once you are in the hospital, the staff can pretty much do what they want, if they feel the need to- even another c/s. That happened to someone I know. She told them she didn't consent, would not sign the forms, as they were wheeling her into the OR, and they cut her open anyway...That doesn't mean that would happen to you, it's just the way it was there, then. Hope your situation improves...
post #18 of 34
I'm not plus-sized, but I can relate in a lot of ways. My homebirth was transferred to hospital due to breech presentation and I was cut. I have spent the last two years avoiding dealing with the inevitable which is that I must give birth in the hospital this go around. I am finally coming to terms with never getting my homebirth and I am beginning to be ok with it; when you have your heart set on something and you spend so much time and effort trying to make it happen it can take time to come to terms with the loss of the dream. Breech homebirths are illegal in NJ and so are homebirths after c-sections so that's why I'm in the position I am in now.

I am now trying to focus on all the wonderful positives I have for this birthing event: I have a wonderful team of doctors who are incredibly supportive of VBACs and have no problem catching my baby in the tub, I still can do my waterbirth, I don't have to have constant monitering and be stuck in bed, I get the same wonderful doula who attended my first birth (and who is about to be officially licensed as a midwife), I still get to do my hypnobabies natural birth, and the hospital is very supportive of natural births, VBACs, and has low c-section rates.

I can have a wonderful birth. So can you; whether it is at home or in the hospital. Obviously your choices are more limited for homebirth care providers, but you can still find one if that is what your heart desires. But, if you can't and you do go with the OB practice that your midwife suggests, please know you can still have a great birth experience in the hospital (just make sure you get a doula!). I understand the grieving process of not having the birth you want, but try and focus on the fact that this is a new birth experience and you can still have a great one. Don't give up!
post #19 of 34
how does one work on growing a smaller baby?

(honestly wondering)

Quote:
Originally Posted by Right of Passage View Post
I had to respond. I'm a plus size VBAC mama, if I were in your shoes I'd interview all the available choices including the male OB. I'd choose who I felt best with. Then work on growing a smaller baby, eliminate all/most sugars and processed food and make sure I was walking about 40-60 minutes a day.


I can certainly understand your midwife's perspective and I think it's wonderful that she's so honest. The consequences of an uncomfortable provider are far reaching and could have lead you to a repeat c-section because of ftp again. If you can find a midwife that feels good about you birth and her abilities you're going to have a positive experience. So as much as this is a pain right now I'm happy that it's getting out of the way so that there is no unnecessary fear being brought to your birth. Good luck and I look forward to an update!
post #20 of 34
OP - I can only identify with you so very much. Though my midwife didn't leave me, I too had a second c-section because my baby couldn't engage in the pelvis (cord wrapped around her arm several times, occiput posterior, head cocked backward). I was 41 weeks 6 days. My water broke first and labor didn't come until some herbs and castor oil later. My baby too was 11lbs. even. Neither of us showed diabetes. I was around 244lbs. at delivery.
There are some things you can do to help keep baby on the more "normal" size, but it sounds like you are doing what you can. My first baby was 8lbs.13oz. at 38 weeks even. I was not overweight then, and had only gained 35 pounds during the pregnancy. Sometimes it is just genetic. Aside from totally giving up on your diet being healthy, or true CPD, there is not reason to think that your body will grow a baby it can't birth.
I hope you keep your head up mama and follow your heart. (((HUGS)))


Quote:
Originally Posted by trekkingirl View Post
because of my history I just had to say something here. I am supposed to weigh 145lbs. dd was emergency c/s and I was 255lbs. My weight may have been a factor in the reason for c/s but I wouldn't let that stop you from having a birthplan that is right for you in your heart. I went on to have a natural vbac at a hospital at 235lbs. I never felt high risk. I think that's bs. Doctors just would rather section women, imo. what worked for me was natural induction with castor oil at home one week before my due date. I was scared to let ds get too big and be told I had to have a c/s. I labored at home with family and waited till almost transition to go to the hospital. There was no time for interventions or any other crap. When I got to the hospital I got my room and had the baby. I think I got the best of both worlds this way. I got to labor at home and had the security of a hospital in case something went wrong. I mostly showed up at the hospital so I could be served for a few days pp. This way I could concentrate on the baby.
I just have to give you a . I like this story!

Quote:
Originally Posted by rainbowmoon View Post
how does one work on growing a smaller baby?

(honestly wondering)
Keeping yourself healthy. Exercise. Take a good look at diet. I suggest Nina Planck's book Real Food for Mother and Baby. Otherwise just trust the wisdom of your body. It wouldn't be advantageous of evolution/nature to allow us to start growing babies our bodies can't birth. Sure, there will be a fluke every now and then, but it's not something to worry about IMHO. Two of my grandmothers gave birth to 12 pounders at home with no complications.
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