HBAC if you have a great hospital option?

[CookAMH]

No decision needs to be made for ages since we're not pg yet, but I think about it often and wonder. I think I have an option for an awesome midwife in a hospital that is supportive of VBAC and natural childbirth. What factors to consider as a result if one ends up staying home? The birth of my son at a FSBC went great until I pushed too soon, he wasn't moving down, turned posterior some, and I thought things weren't moving along. I believe now, looking back, I needed to give more time. It would have been pretty intense and hard as the cxt hurt so much, but I believe if I had received encouragement to keep going, I could have.

The main factors for me is 1) the environment in which I want to give birth (home is SO different), 2) not having to worry about a birth plan as far as requests go of what NOT to do to me or my baby, 3) which environment will truly be supportive and safe, and 4) is my husband's comfort level (which is very important to me, and I respect). I agree it needs to be where the woman is most comfortable, but my husband is my greatest physical strength and I need him support me without fear of something happening to us.

[HeatherB]

While a supportive MW in a supportive hospital is a good thing, there's no comparison to being at home. All studies on homebirth show it is as safe or safer than being in a hospital. You've got the issue of interventions being at hand. What are hospital restrictions like? Will they "let" you go IV-free, labor in water, birth in water, have intermittent monitoring wherever you want, labor as long as you need to, birth wherever and however you want to, etc.? Those are all things you'd have a lot of freedom with at home.

Privacy and comfort are big things, too. A hospital is not home, no matter how nice it is. If you want to wander around in the nude, can you do it? Would you feel comfortable? How would you handle your DS in a hospital versus at home? Another benefit of being at home is NOT driving in a car in labor! At home, you'll have your own kitchen, food, and drink available. What are the hospital rules?

There are many, many differences. Thinking over them and finding out the exact rules of the hospital may help you clarify your wishes and needs. I know there are some people who truly want to be in a hospital, and that's fine. But I also think that home is, in most cases, a calmer, more peaceful, more enjoyable place to be.

Hope this helps a bit!

[shenanegans]

Well if a problem arises at home you know that you have a hospital you feel comfortable transfering to. I would stay at home.

[ShwarmaQueen]

There's no way I could labor naturally in a hospital- I screamed, yelled, grunted, groaned, and cried. I wouldn't have felt unhindered at a hospital, no matter how 'natural birth' friendly they claimed to be. And I truely believe that it was a major factor of my successful VBAC.

[cairomama]

In order to help your husband get on board with homebirth, you could have him meet with the midwife and talk about the potential problems and hers plans for handling them. Also, write a transfer plan in case of problems so he feels that bases are covered. Also, he might like to talk to other husband's who have experienced homebirth. It would be great if you found someone who was reluctant at first and ended up loving it. There are also greats books and statistics that he could read about the safety of homebirth and VBAC if he would be willing to read.

Since you aren't pregnant, yet, you have lots of time. If homebirth is what would make you feel most comfortable there are ways to bring him around. If after he meets with the midwife, talks to other husbands, reads stats and/or watches some video clips about homebirth and VBAC, if he is still uncomfortable, then you could go with the hospital. I think, though, that is he does all of that, he will be comfortable with homebirth.

I would start doing all those things now since the longer he hears the message that homebirth is safe, and the longer he has to process it, the more likely he will be to get it.

[SalmonBayDoula]

I think it is "easier" to have the birth you want at home, if you are looking for low-no interventions, no pain meds, any position, eating and drinking at will, not so much attention paid to progress and time, etc. I have been to beautiful hospital births with fantastic providers. but at the end of the day, you meet a lot of new people as the shift cycles through, and it is not your space. and I think that really matters.

Good luck wherever you choose. only you can decide what is the right decision for your family!

Sharon

[AlexisT]

Originally Posted by HeatherB

All studies on homebirth show it is as safe or safer than being in a hospital.

These studies normally exclude women with a prior Caesarean section, or if they aren't, there are so few in the study that it's impossible to draw any statistical conclusions.

There are no studies, as far as I know, comparing HBAC to hospital VBAC. I don't think one will ever be done. Does this mean HBAC is unsafe? No, it just means we have no good evidence.

[thorn]

for ME, having a good hospital option, there was no question that is what I would do. I realize that the risk of rupture is very rare, but I wouldn't have been able to make peace with a rupture if I had been at home.

I don't live in a homebirth supportive state, and there is no way I would be able to transport and get a c/s fast enough for my own comfort.

I have had two hospital vbacs with minimal interventions.

[veganbaby]

For me HBAC was my best optional. At first my husband was uncomfortable, but he became very involved in our search for a midwife. He also researched the safety of home birth. Now he is a big advocate for home birth.

[HeatherB]

Originally Posted by AlexisT

These studies normally exclude women with a prior Caesarean section, or if they aren't, there are so few in the study that it's impossible to draw any statistical conclusions.

There are no studies, as far as I know, comparing HBAC to hospital VBAC. I don't think one will ever be done. Does this mean HBAC is unsafe? No, it just means we have no good evidence.

Still, if home birth is safe, and the risk of rupture in a VBAC is very low when not interfered with, it's pretty safe to infer that the risk of HBAC is also very low. I would certainly recommend it with an experienced, skilled, and trustworthy care provider.

[CookAMH]

Thanks for your thoughts.

Originally Posted by SalmonBayDoula

I think it is "easier" to have the birth you want at home, if you are looking for low-no interventions, no pain meds, any position, eating and drinking at will, not so much attention paid to progress and time, etc. I have been to beautiful hospital births with fantastic providers. but at the end of the day, you meet a lot of new people as the shift cycles through, and it is not your space. and I think that really matters.

Good luck wherever you choose. only you can decide what is the right decision for your family!

Sharon

I hope to be at one of the next ICAN meetings soon! I joined the yahoo group this week.

[MyFillingQuiver]

I understand how difficult that decision can be! I posted very similar questions and sentiments, oh..about 6 months ago or so!

I had 2 hospital vag births, a c-section for a transverse baby/nuchal cord on u/s, and then a forced repeat, totally un-necessary, due to a VBAC ban. With our 5th, I was determined to stop that pattern of completely pointless and dangerous surgery.

I found a provider via ICAN. He is an OB about an hour away, and practices at a hospital that is supportive. There are only a handful of OB's at this smaller hospital, but they have great anesthesia coverage, and my OB is located IN the hospital-so even when he's seeing patients, he can monitor mama's in labor from his office.

So, given my questions and fears that had been bred into me via scare tactics to discourage VBAC, I felt this was safer. I had a great VBA2C last June at the hospital with my OB. I went overdue, and allowed him to break my water to get my labor started. They used wireless machines for me to walk and be free for movement, and he was born in a few hours after AROM. It was GREAT!

Now I'm pregnant again, and feel much more educated and confident about the process. I realize that continuous monitoring is not needed, and that I don't need interventions or induction tSo have a safe birth. After MUCH deliberation and prayer, we decided on a homebirth. What a HUGE change (albeit it took many hospital births, a loss, etc., to get us here) for my DH and I, who grew up totally mainstream.

I'm 30 weeks now, and love my MW. She does all my visits in my home, and is truly supportive and encouraging, without sugar coating what risks there are-she's just confident the risk is extremely rare, and we'll deal with whatever comes with knowledge and experience.

I credit ICAN with being instrumental in helping me get off the end-to-fertility train I viewed as the c-sections I didn't need. I view the hospital and OB as a great stepping stone I needed for me, and don't regret it. However, I'm thankful I'm where I'm at, and looking forward to a hands-off, natural and peaceful blessing of birth in August!

Blessings to you, and please PM me if you'd like to chat more about it. It was one of the biggest struggles and considerations for me!

[roadfamily6now]

Originally Posted by HeatherB

While a supportive MW in a supportive hospital is a good thing, there's no comparison to being at home. All studies on homebirth show it is as safe or safer than being in a hospital. You've got the issue of interventions being at hand. What are hospital restrictions like? Will they "let" you go IV-free, labor in water, birth in water, have intermittent monitoring wherever you want, labor as long as you need to, birth wherever and however you want to, etc.? Those are all things you'd have a lot of freedom with at home.

Privacy and comfort are big things, too. A hospital is not home, no matter how nice it is. If you want to wander around in the nude, can you do it? Would you feel comfortable? How would you handle your DS in a hospital versus at home? Another benefit of being at home is NOT driving in a car in labor! At home, you'll have your own kitchen, food, and drink available. What are the hospital rules?

There are many, many differences. Thinking over them and finding out the exact rules of the hospital may help you clarify your wishes and needs. I know there are some people who truly want to be in a hospital, and that's fine. But I also think that home is, in most cases, a calmer, more peaceful, more enjoyable place to be.

Hope this helps a bit!

I could not agree more.

Great hospital or not, it is still NOT your home.