ob pushing elective c-section

[coltynsmom]

Hello it's me again. 38 wks along and pregnancy is going great aside from slight swelling recently. Planning an HBAC but have been also seeing the ob that delivered ds1 for the testing and such. Ob ordered an u/s 3 days ago to check things out and is now very convinced that i need a c/s. (my 1st c/s was due to failed induction at 41.5 weeks) Her concerns are as follows: Baby is 8lbs 10oz, 26cm of fluid, placenta is stage 3, and placenta is anterior. Other than that baby is doing GREAT and there is no concern with him at this time. I of course do not "feel" I need the section and my midwife agrees that these reasons are nothing to panic about. I still feel confident about the HBAC. Just wondering what you gals thought or if i might be missing anything.

Also baby is currently sunny side up. Any suggestions on how to turn him? Have been doing pelvic rocks and avoiding the lazy boy. THANKS!

[TyrantOfTheWeek]

Visit the chiropractor for the Webster technique. That may help flip the youngin. Also check out this site:http://spinningbabies.com/

[*MamaJen*]

I don't know about the stage 3 placenta or fluid issues, but I would certainly not section for the "big baby on the ultrasound" doom warning. And as long as the placenta is just anterior and not previa, it's not a risk -- http://www.whattoexpect.com/pregnanc...-placenta.aspx
A lot of posterior babies turn during labor, especially if you stay active and moving during early labor. My son was sunny side up when labor started but he turned and came out anterior just fine. I had a little bit of back labor but it really wasn't bad.

[Paige, CPM]

Does your ob know you are planning a homebirth?

What is your ob's cesarean section rate?

Do you think that your ob is really supportive of vbac? What is he/his vbac rate?

Do you believe your first failed induction by her/him was necessary?

Why did he/she order an u/s n the first place?

U/s are very inaccurate towards the end of pregnancy. I wonder if you got an ultrasound elsewhere how different the results would be ( I bet different weight ) but also I want to know if the results of the placental grading would be different as I would not expect a grade III at 38weeks.

And finally why would your doc want to schedule a c/s instead of a gentle induction (foley catheter in cervix, for example)?

[coltynsmom]

Originally Posted by Paige, CPM

Does your ob know you are planning a homebirth?

What is your ob's cesarean section rate?

Do you think that your ob is really supportive of vbac? What is he/his vbac rate?

Do you believe your first failed induction by her/him was necessary?

Why did he/she order an u/s n the first place?

U/s are very inaccurate towards the end of pregnancy. I wonder if you got an ultrasound elsewhere how different the results would be ( I bet different weight ) but also I want to know if the results of the placental grading would be different as I would not expect a grade III at 38weeks.

And finally why would your doc want to schedule a c/s instead of a gentle induction (foley catheter in cervix, for example)?

not sure what my doc's section rate is but she has not been very supportive of vbac at all. that is why i looked into homebirth to begin with. she does know i am planning a home birth and she has acted like she was on board with duel care until now. she did and u/s to see how big the baby was and to check his vitals and give her final opinion on vaginal home birth.

i do believe that the failed induction and thus the c section was her mistake. there was no reason to induce other than i was 8 days over-due. babe was fine. can't induce because she won't do a vbac.

[Aka mommy]

Not sure about the other stuff, but Webster is great for turning posterior babes. Though my dd was 8 lbs 2 oz and born presenting posterior with a nuchal hand. She was my easiest delivery no less!

[Paige, CPM]

"not sure what my doc's section rate is but she has not been very supportive of vbac at all. that is why i looked into homebirth to begin with. she does know i am planning a home birth and she has acted like she was on board with duel care until now. she did and u/s to see how big the baby was and to check his vitals and give her final opinion on vaginal home birth.

i do believe that the failed induction and thus the c section was her mistake. there was no reason to induce other than i was 8 days over-due. babe was fine. can't induce because she won't do a vbac."

Ok, thats cool, sounds like her thing, her way of practice, doesn't sound like it has to do with you...I'd say don't sweat it and don't go back! The only thing is that if you think she was truthful about your grade three placenta I would get that rechecked with someone else just to get rid of that 'thought' that your placenta might be that far along in aging (i doubt it!).

From the little that we have conversed about, perhaps it is better to see someone else for backup next time, if there is another next time, or now if there is someone your midwife can set you up with.

Good luck and do let us know how it goes!

[babycatcher12]

Honestly, I'd say "thanks for your opinion" and then not see her again until after you give birth if at all.
An OP baby is no reason for a c/s. As PP have already pointed out...u/s in late pregnancy are very inaccurate for weights in late pregnancy.
A grade 3 placenta is somewhat normal for 38-40 weeks. And to be honest I doubt that it's really that far along in aging.
If she was truly concerned about baby's vitals and making sure all was well she'd have done a biophysical profile.
JMO. Good luck with your HBAC!

[cathicog]

ITA with pps and I would add:
1) for the best chance at a HBAC, you would probably be better off not seeing the doc again. Til After The Birth, if at all. She/he is apparently trying to sabotage your efforts at a VBAC, knowing you would probably NOT get one in the hospital she/he practices at....
2) Ultrasounds in the third trimester are notoriously inaccurate at guessing weight, in both directions. Amniotic fluid levels are constantly changing and if you were dehydrated, (with chasing around a toddler, it's easy to do) then the levels would be inaccurately low. All it would take to correct it is to drink more!
3) spending 15 min 2x a day or more on hands and knees can help turn a posterior baby. I second the spinning babies website. I would try to get the baby to turn before labor, to make it easier for both of you..(had 2 posterior labors, but both turned just before birth. Fortunately, they were also my two homebirths! )
If you can arrange to only see your hb midwife for the rest of the preg/postpartum, that would prevent your plans from being mentally sabotaged. You shouldn't need any more testing and the more you get, the more it undermines what should be a happy, easygoing time in your life. Especially if you go over 42 weeks, (still within normal limits) you can relax more without the pressure the OB is sure to put you under....there isn't anything that surgeon could do that your mw couldn't do- except cut you open again, unnecessarily... and I wouldn't tell the OB you are planning a homebirth, either. Most OBs aren't happy with VBACs. It's a rare one that encourages, truly encourages moms to have non-surgical birth...Have a happy birth, you have prepared long and hard, I am sure!

[coltynsmom]

thank you all very much. i would just like to add that i met with my mw today and she altered my diet a bit and also suggested i take nat mur and dandelion root for the water retention. i am also to drink 1/2 cup of cider vinegar in 2 liters of water as well as 1/2 cup of unsweetend cranberry juice. no sugar or white flour allowed and only 1 serving of wheat per meal. i am happy to do anything that might help!

not planning to go back to this ob by the way..thanks for all of your advice

[coltynsmom]

lol well i guess i don't have to worry about this doc anymore because i just got a call today that she "can't be held responsible for my pregnancy if i don't follow her advice." i guess i'm fired :-)

[laughingfox]

I'd have told her "You can't fire me, I quit!"

[emnic77]

Originally Posted by coltynsmom

lol well i guess i don't have to worry about this doc anymore because i just got a call today that she "can't be held responsible for my pregnancy if i don't follow her advice." i guess i'm fired :-)

Or, you could call her back and tell her that you're a grown woman that's perfectly fine being responsible for your OWN pregnancy.
Man, that sort of thing irks me.

[Comtessa]

Um... tell her YOU'RE not fired, SHE is. After all, YOU'RE the one who hired HER to be your care provider, and give you good sound medical advice... and, IMO, she's not living up to her end of the bargain. Why do so many MD's think that they are the decision makers? Don't they realize they are providing customer service just like any professional??

[coltynsmom]

i know! The whole pregnancy I was under the impression we would make the decision together in the end but she didn't even want to discuss it. I am even losing some water weight with the diet that my midwife suggested. Doc never said anything about nutrition. She just wanted to cut my baby out!

[ShwarmaQueen]

More motivated to HBAC than ever, now, right?

I'd send her a birth announcement, "Announcing XX, born lovingly at home, on..."

[born2birth]

Originally Posted by ShwarmaQueen

More motivated to HBAC than ever, now, right?

I'd send her a birth announcement, "Announcing XX, born lovingly at home, on..."

LOL - totally agree!

[coltynsmom]

haha. my sister-in-law still sees her so I plan on telling her to pass on the news after the baby is born.

[khaoskat]

Originally Posted by coltynsmom

lol well i guess i don't have to worry about this doc anymore because i just got a call today that she "can't be held responsible for my pregnancy if i don't follow her advice." i guess i'm fired :-)

A phone call is insufficient to terminate the patient client relationship on her part. Furthermore, she has to provide care for you for 30 days following the termination of her care on an emergency basis and refer you to someone who can provide services to you.

So, basically, she is stuck with you if you have to transfer in and cannot refuse to treat you.

[khaoskat]

I just wanted to say that I am in a similar situation right now. I see a 2 OB group. One seems very on board with the VBAC - no pressure to section/induce at 40 weeks - follow normal routine for patients after 40 weeks (nst, bpp, AFI, etc) till 42 weeks, then re-assess unless one of the tests shows an issue. No problems given my previous history of LGA on all my births (9 lbs 2 oz is smallest, 10 lbs is largest), and he does breech delivery. Oh, and he didn't move my EDD from LMP date to US date (2 week 3 day difference).

His partner on the other hand is starting to annoy the dog snot out of me and putting extremely undue stress on me right now after my appt. last week. He has ordered an US for this week, to determine baby size and position (umm...I just turn 37 weeks the day of the US/appt. this week). None of my kids have been in position and stayed that way this early..usually not until shortly before I go into labor...as a matter or fact DD2 ended up being an emergent C/S because she flipped transverse lay during delivery, stuck her arm out, and wedged her shoulder into the pelvic outlet. I get the vibe that he is going to tell me he will only recommend a repeat C/S at this point..... Oh and when I saw him last week, he seemed unhappy that I was not jumping for Joy that at just shy of 36 weeks I was 1 cm dilated (umm...ok, this is my 5th pregnancy to term....and I have walked around for almost 4 weeks with my last pregnancy at 1 cm dilated --- it is not a predictor of when you are going to go into labor).

I am not sure what I am going to do after my appt. on Thursday....I may refuse to go back to him, and just wait till labor starts, as I plan on HWBAC.