Need some counter-arguments

[mizznicole]

I saw a Gyn today for a breast problem. I told her I was with a midwife practice for VBAC, and gave me the speech.

Honestly she was very tactful. She's pro-midwife and worked with them in private practice; she wouldn't have commented if it wasn't VBAC. However, she said that she would be "terrified" to VBAC outside of the hospital. She claims that ruptures happen very quickly even though they are rare. She told me to talk over how they would monitor me at the birth center.

I can understand her concerns...however, I'm not sure how well-founded they are. What would your response be?

[MNHall]

For starters, thank goodness this isn't your OB, just your GYN...and you already know you're with midwives that support VBAC! What would I want to say or what WOULD I say? LOL!!!! Gosh, I can only think what I'd want to say...but....

Since this is not your OB, I'd possibly say something just like, I've done my research and I've very comfortable with VBAC'ing and being in the care of my midwife. I know their practice and I'm also comfortable with how they will handle any situations that may arise. But I'm very confident and comfortable with the safety of a VBAC.

And maybe leave it at that. Sounds like this is one of "those" doctors and saying anything will probably go in one ear and out the other! I HATE to know there are OB's out there that are so against VBAC's, but obviously they exist and my feeling is, it's hard enough to convince anyone the safety of VBAC, but an OB that doesn't practice them would be talking to a brick wall!

One question though....this isn't the back up OB for your midwife is it?!?!

[elvispupy]

I'd probably say I was terrified of having a VBAC in the hospital, but that's just me

[MsBlack]

"Thanks for sharing that, Dr. I will take it into consideration as I make my way toward this birth" (big smile for her).

Really, her comments were a boundary violation...you hired her for a specific unrelated purpose, didn't ask her about your pregnancy care nor to hear her opinion of the care you choose. Sheesh! You really don't owe her any response at all. But if you like her well enough, and think she might be open to it, you could give her links to research on the ICAN website--maybe she will rethink her position! But I would only do this myself, if I thought she were open to it and ONLY for the fun and goodwill in it. No way I'd take on trying to persuade her outright, or let her engage me in argument about it.

[sgmom]

Originally Posted by elvispupy

I'd probably say I was terrified of having a VBAC in the hospital, but that's just me

I agree. Her comment about how quickly they can happen, leads me believe that her "suggestion" (as subtle as it might've been) was to labor/birth at a hospital so you could be monitored. And by monitored, I mean jump to any medical intervention when the machine sends a beep that's suggests something isn't "normal".

I'm having a similar fight with myself over the vitamin K injection (vs drops, or supplementing myself for breastfeeding). While the risks are very low, the few babies who do develop a blood clotting disorder can die very quickly (with little to no symptoms of anything being wrong).

I talked to my midwife on friday night about not wanting to induce come 42 weeks, and how we would handle that. She said that I would have to have an ultrasound to check the placenta and growth of the baby, and if necessary, NST's every day. When I told her that the only way I would agree to an induction is if the risks were high, and her response was "the risks ARE high once you past 42 weeks". My reply was "Yes, but that's according to the statistics. I don't care what the stats say. My body might work in perfect health until 43, or even 44 weeks. And the risks of stillborn are much higher at 38 weeks than they are at 42. So if the ultrasounds and NST's say that my baby is healthy, I'm not inducing."

She really had no response for that.

[jess152]

I was seeing a new doctor when I mentioned I was pg and delivering at home with a midwife. I considered her young and 'with it' and thought she'd be more open-minded, but she had the same reaction your's did. At my mention that I wouldn't consider it if we were more rural, like out on a farm somewhere, she replied with 'we are rural', in a community of 6000 people and 8-10 doctors. I felt comfortable with the risk and everthing went fine.

My rebuttal to her (like I needed one) was that a normal, uncut uterus can rupture as well with the onslaught of pitocin, and yet they administer pitocin on a regular basis and don't consider those women 'high risk'. I'm also 8 blocks from the hospital, so the 'decision to incision' time in case of a true emergent c/s at the hospital wouldn't be all that different if I showed up in some kind of distress needing a c/s.

I felt that she wasn't up on the latest studies released. I mentioned some of them and hope that she followed up, even just out of her own curiosity.

Doctors are trained to seek out the pathology. They'll find something treacherous about to happen, they are trained to!!

[writteninkursive]

Haha! Been there, done that!

My OB with my second gave me that charade... "ruptures happen so often and so quickly!" (despite that the consent form I signed clearly spelled out that it was always safer to have a VBAC than a routine repeat c/s!) As I stuck to my guns about VBAC, he changed his line into "your baby is going to be too big!" (she was a whopping 7 pounds, 6 ounces. WAAAY too big, lemme tell ya!), and when I was unconcerned with her size (I was tiny, no way was she gonna be a horse like my first!), he told me "she's in distress" and ordered NSTs every week for the last five weeks.

Stand your ground, Mama. I didn't. I was weak and let him convince me I should be done being pregnant right then (and as a result, my baby was born at 37 weeks and had respiratory distress at birth). I regret that decision every day of my life. Stay strong and gather a good support team!!!! I want to read your VBAC success story!!!

[smeep]

Originally Posted by elvispupy

I'd probably say I was terrified of having a VBAC in the hospital, but that's just me

I use that line ALL the time. I haven't had a section, but DS (my first birth so far) was born in a freestanding birth center. People often say something along the lines of how they'd be terrified to birth out of a hospital and I tell them I'd be terrified to birth IN a hospital, "but that's just me." Haha.

[TabithaB]

I use the line "terrified about going to the hospital" also. They will be pacing around my bed with a scalpel. (The VBAC rates are not too good here) and then I start rattling off statistics from the Illinois Department of Public Health on the two local hospital's c-Section rates for 2008. (credible source)