Preparing for VBAC before BFP?

[Jennifer1970]

Hi everyone, my 4 month old DD was delivered via c-section. I suspect it was unnecessary. I was induced because my water broke and then got put on the clock. They wouldn't let me eat or drink anything and made me push before I was ready. She got stuck and I had no more strength to keep pushing. I've since learned that the hospital has one of the highest c-section rates in this state and is known for being over-medicalized.

We'd like to have another and I'd like TTC late summer or early fall. Is there anything that I can do now (like see a midwife) that would increase my chance of having a VBAC?

I don't even know if I will be considered to be a good VBAC candidate. My last pregnancy was deemed "high risk" simply because of my age (I delivered at age 39). I'll be at least 40 by the time I conceive again (if I can conceive again). Would my age keep me from having a VBAC?

Just to give you a feel for how VBAC unfriendly my hospital was (and they claim to do VBACs), after my c-section I asked the doctor if the incision was such that I would be a candidate for a VBAC and she laughed at me. And then when I went in for my 6 week post-partum visit the nurse practitioner tells me that I'll have the choice of a scheduled c-section or a VBAC for my next birth. Talk about bait and switch! I'm willing to bet that no one at this practice ever has a VBAC.

[ann_of_loxley]

I would absolutly suggest preparing for a VBAC before a BFP! - It gives you time to heal emotionally (a big important factor!) and physically (they recommend you wait at least 2 years before getting pregnant again after a c-section. Pregnancy takes a lot out of your body and a c-section is major abdominal surgery!) and do lots of research ...because the best way to be is confident and prepared. That way they can't push you around or throw a bunch of scaremongering crap at you! lol

[Jennifer1970]

I was told I only needed to wait a year after my c-section, not 2 years. Regardless I don't want to wait a full year. I'm almost 40 and my fertility is probably limited due to age. Every year I wait, the harder it will be to get PG.

[MNHall]

My c/s story sounds a bit like yours..other than the fact that my water didn't break, so I took a lot of responsibility for being uneducated about birth in that I signed up for a very unnecessary induction just because I wanted to meet my baby. But, I did have my water broken at 2cm, even though my baby was still high. I got to 10cm, and started pushing, with a high baby. Pushed for 2 hours, just trying to get him "down"...exhausted myself and thought I had no other choice.

I left that practice. I felt like they were just a business...get patients in and out, make money, get them on the schedule.

So, find a supportive provider now! Whether you want an OB, a midwife, if you're interested in a hospital birth (hopefully there's a different one around you!) or a homebirth. But preparing before a BFP is a GREAT GREAT GREAT IDEA! I'm actually doing that myself!

I had a c/s and a successful VBAC, but I wanted more. I had a provider that was willing to let me VBAC, as long as things were going appropriately. Like under 40 weeks (although I worked her up to 41, this is when I had a scheduled c/s, just in case), and I had to go into labor on my own, monitoring in the hospital, blah blah blah. I was okay with it, but now I want more! So, I've already found who I think is the best of the best, and I'm just TTC!

As for how long to wait...it seems like 18 months from c/s to VBAC is a good idea to find someone to support you. Granted I have a friend that did a VBAC 14 (almost 15) months later...and another who is currently allowed to do one 17 months later, but it seems you get less resistance when you've got 18 months between the 2. Mine were just under 22 months and I never heard anything negative about them being too close to have a VBAC! So, IMO, I'd want them at least 18 months, so you'll have one less thing for a provider to give you a "red mark" against you!

As for age...well, I know over 35 is considered AMA...but high risk to the point of no VBAC...I've never heard of that. Granted, I'm sure someone would try to pull that on you if they weren't a true VBAC supporter, but if they truely support VBAC's, I wouldn't think age would matter. (that's not from experience or from actually hearing it from a professional though, so maybe someone else knows better!)

It's GREAT to prepare now....educate, edcuate, educate. And find that provider that believes in you and believes in vaginal births! Have support, support, support too!

[springfever]

Read the books Silent Knife, and Ina May's guide to childbirth! I have read many books about VBAC and childbirth and those are by far my favorites. Also research keeping your baby in a good position, like www.spinningbabies.com www.plus-size-pregnancy.com also has really good info on avoiding malpositions and c-sections (even if you aren't plus size).
Also these forums are great! Good luck with conceiving and having a VBAC!

[mollikins]

plan #1 would be to find a new care provider. Having a doctor laugh at you when you ask a question about the surgery they just performed is absolutely unacceptable.

plan number 2, I agree that waiting till your DD is about 9 months old before TTC again would be a good idea as far as decreasing resistance to a vbac among any care provider. Rupture rates are slightly higher when the interdelivery interval is less than 18 months.

Definitely do some reading and research. Your 'advanced maternal age' (I hate that term btw) does have some impact on how likely you are to be successful with VBAC, but as long as other factors are favorable it should in no way prevent you from trying.

Overall, your best bet would be to find a care provider (midwife or OB) that you are comfortable with and trust, and start asking questions.

Good luck!

[Jennifer1970]

Thanks for the advice ladies. I've just made an appointment for about a month from now with a midwife who practices out of the hospital that has the highest VBAC rate and lowest c-section rate in this state. I felt a little silly making the appointment since I'm not pregnant or due a pap. I gave the reason as "pre-conception." I hate to waste their time but I've got good insurance. I want to ask about conceiving over age 40 and whether I'll be a good candidate for a VBAC and if I'm a candidate for a VBAC, how long do I need to wait to TTC?

[jess152]

We met our midwife while we were TTC#2. It was a great feeling to know I was doing all I could to prepare for a VBAC. It was nice getting to know her, in advance of the delivery.

I don't imagine your age would be a deterrent. Isn't 'advanced maternal age' 30 anyway? It's ridiculous.

Another one to read is Pushed by Jennifer Block. It made me feel very validated in my feelings about c/s. Lots of info you can pass on to your DP or friends or family that may think you are 'high risk'.

[mamalade]

Hi Jennifer-
Am reading through the posts and wondering if you met with them yet. How did it go? I am doing the same thing at the moment...

[MNHall]

Oh, I'd love to hear too Jennifer! I hope it went great!

I also met with my new provider before my BFP. For starters, I wanted to see for myself how great he was (I had heard from a number of people how incredible he was with VBAC support and natural birth support, so I wanted to ask my own questions and see if it was really true..yes, yes it was!) AND, I wanted to be established before my BFP, so I didn't call and say, Hi, I'm pregnant and want to switch to you, and find out he was "full" for new patients due at that time (this had happened with a friend in a previous practice, so I just didn't want to chance it). So anyway, once i was pregnant, I just got to call and say, hi, I'm a patient and I'm pregnant!

I hope your appt was great!

[SelenaJean]

I hope your appt went well with the midwife! I also prepared for a vbac before my bfp. I joined my local ICAN, read books and interviewed my midwives. I figured it would be easier to find someone in advance than feel the pressure of needing someone right away once I was already pregnant.