hbac vs hospital vbac

[marrymeflyfree]

Hi everyone!

I'm ~10 weeks pregnant with #3. #2's homebirth didn't happen; transferred after a long pushing phase and ended up with a c-section. That was just 8 months ago. Given the short time between, I'm tentatively planning a hospital birth. We have a really wonderful CNM who is very non-interventive, very normal-birth-oriented, and highly recommended by both our homebirth midwife and our crunchy family doc.

Soo...if I go ahead with the hospital thing, we're in good hands. But something has been nagging at me since my last appointment with her. I was asking some questions about what this hospital's policies are for vbac's, yadda yadda. She gave the old 'show up to push' advice. (Curiously, she never actually answered the question, though...) I'm totally on board with that, but it begs the question that if I'm hospital birthing because of the additonal, albeit minor, risk...but showing up basically just to push the baby out...then what's the point of doing it in the hospital in the first place? I'd be there essentially just long enough for them to mess up my mojo by doing all the admissions BS, wanting to stick a hep lock in me "just in case", blah blah blah, and likely get in the way of the unique specialness of those first few precious hours, etc, etc, etc.

*sigh*

Our first baby's birth was so peaceful and awesome and respected and completely un-messed with. The second..not so much. I'd be at the same hospital, too. They weren't terrible, all things considered. But it's the little things that get me down about the prospect of birthing there again. That horrid bed that seemed designed just to discourage co-sleeping or side lying nursing. The terrible flourescent lights that were either full on or completely off. (I believe there's a special spot in hell reserved for nurses who come in and throw those lights on, then leave without turning them off when the post-c-section mom is stuck in bed 8 feet away from the switch.) Agh, so many little and big things. It was just such an impersonal and cold experience.

I've been spending the last few weeks trying to wrap my brain around the prospect of being there again, trying to warm up to it, prepare for it, figure out how to make it better, and accept it. And then she tells me to show up ready to push and I just can't help but think...then what's the point? Why bother? Why put myself through all that just so their staff can watch DH catch? Is the benefit of the high tech stuff being available on the off chance it is needed worth the hassle and interruption and angst?

I'm still gathering facts about all of this vbac stuff...I know so little about the stats, about what happens in a rupture scenario, etc. I need some clarity on the facts, and writing this out here is giving me some clarity on my emotions. I feel as though I've not truly processed the loss of my homebirth and the unexpected c-section, and the prospect of being back in that hospital is really bringing it all to the surface. The circumstances will be very different, of course, but I don't want to go in there with those images and emotions still in mind and heart.

Thanks for reading. If you've hbac'd after a fairly recent cesarean, what led you to that choice and did the low possibility of UR weigh on your mind? I'm out of my element with the hospital thing...what can I do to make it a better experience?

[MyFillingQuiver]

I understand just what you are saying!

Last June, I had a VBA2C in a hospital. My OB (whom I really liked for an OB, and who went out on a limb to basically "tell" the other OB's at the hospital that I "would" be doing this) told me to pretty much come in while pushing.

Well, things didn't go that way, and at 41 weeks, he advised me to come in and have AROM and get things going, as the other OB's were getting antsy and were pushing for me to have 2 x weekly NST's and schedule a c-section for the end of the week-42 weeks. So, I agreed to the AROM. So, basically, I turned a natural event of "come in while pushing" into a medically managed birth...

Things went really well, but I feel the same as you. If the whole idea is to "have me monitored" for complications of VBA2C, then where is the benefit of doing that in the 3 pushes I give to birth a baby? There wouldn't be time! We also live 1 hr from the hospital in another state that allowed the VBAC.

So, I've opted for a homebirth. To me, my MW is so much more thorough in my prenatals, that she's much more likely to find an actual issue during pregnancy..so, I'm sure that's how birth will go, as well. Her intuition, along with mine, and allowing me simply to birth in my own environment, schedule and terms will mean abnormalities will be seen better than by me going through labor on my own at home, with none of her support, and then driving an hour in transition to the hospital...sheesh!

I'm now 33.2 weeks, and just as with my last delivery, rupture is the furthest thing from my mind. I realize and know it's a possibility, but it's not my focus. That's something I didn't think was possible after all the fear mongering and VBAC ban that led to my unecessary forced RCS.

I know you will make the decision that's right for you, and I understand both avenues for VBAC. Blessings, and KUP on what you decide!

[keeptryst]

I loved this post by one of the mamas here on her blog, about the effects of fear around birth:
http://www.attached-at-the-hip.com/2...s-of-fear.html

[AustinMom]

haven't read the respones, but I'd say this. Yes, there is a slight chance of uterine rupture, that is unknown in a truly unmedicated, un-augmented birth, it could actually be no more than a non-scarred uterus.

The chance of rupture is highest in labor, so if you are choosing to birth in a hospital only becuase of uterine rupture fear, and you labor at home and show up pushing, your basically doing it for no reason, yes. I would see it more risky (if you are worried about UR) to labor at home alone, un monitored and then go to hospital pushing. It would seem 'safer' to labor at home with MW who monitors your status and then either birth at home or then move to hospital.

Me, I'm HBACing in Sept, it is 2 yrs since my CS, but even if it was 8 mo or so, I'd still HBAC, I feel the UR stuff is MOSTLY all hyped up and makes moms scared for not that big of a reason, if you truly have skilled attendants.

I think the recommendation is 18 months between births, so if it has been 8 months since your CS, and you are a little over a month and half prego, then that would be about 16-17 months between births, not that huge of a difference. So personally, I wouldn't worry, I'd go with what your gut is telling you and birth at home.