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VBAC options

post #1 of 8
Thread Starter 
With my first son I had a failed induction 10 days before my edd. They thought he was closing in on 11 pounds and wanted him out. They gave me the options of immediate csection, induction, or waiting till he got bigger and doing a csection. He wasn't engaged and my cervix was showing no signs of being ready. I didn't respond to the cervadil, they broke my water, and 16 hours later offered pitocin. I wasn't allowed to eat, was only dilated to a 2, and only had 8 hours left according to their clock. They were also very concerned that his shoulders would get stuck since he was so huge. So we ended up with a csection and an 8 pound 14 ounce baby. Everyone was healthy, so that was good. I used CNMs for my prenatal care and had planned to use their birth center. When they got the results of my sizing ultrasound at 38 weeks they decided I was too high risk to deliver there and I ended up in the hospital. I don't really have a lot of negative feelings about my birth. It is what it is and I can't change what happened.


HOWEVER. This time, I don't want a csection unless it's absolutely necessary. I'm really fortunate in that I have lots of options. I can use the OB who did my csection. She is very vbac supportive and has had 3 herself. Or, I can use the same CNMs. Since I would be vbac they require me to labor and deliver and in the hospital rather than their birth center. Since they are employed by the hospital they have rights. My CNM with my first actually delivered Logan out of my tummy during the csection. My 3rd option is a homebirth with a midwife. Since my first csection wasn't an emergency and I healed well, I have already found 3 who would support my homebirth, even being 30 minutes from the hospital. I am only 2 blocks from the firestation and EMTs. My 4th option is a free standing birth center with CPMs. I haven't talked to them yet, but their website claims they are very supportive of vbac as well.

My #1 goal is to avoid unnecessary csection. I love the idea of being home for the birth and recovery. I love the idea of being released shortly after birth from a birth center. Our hospital is even ok. It's brand new (opened the weekend after my 2yo was born) and now has wireless AND waterproof fetal monitoring as well as a jacuzzi in every room. And no more shared recovery rooms. They didn't pressure me about the hep b vax or circumsision. The breast feeding rate is so high (well over 90%) that the formula companies don't even bother with the freebies. However, it was really fear and a lack of patience that resulted in my first csection.

So... any thoughts? I want to put myself in the safest situation possible for my current family. I really believe that part of that means avoiding a csection and the extra recovery from it if at all possible.
post #2 of 8
I think that it's a very personal decision and no one can make it for you. That said I weighed my options a hospital birth (that would be at minimum 1.5 hours away - nearest hospital that "allows" VBAC) or a homebirth. My first c-section was as result of a positioning problem, it was not an emergency. I am afraid that going to the hospital would automatically sign me up for a bunch of interventions and would ultimately inhibit my labor. At this point with the VBAC climate in my area I feel like I might as well sign my consent form for my c-section if I step foot in a hospital.

My midwife is an hour and a half away, and the nearest hospital is 20 minutes away. My husband and I looked at the statistics, my health, and we've decided that we are comfortable with a homebirth.

I hope you're able to come to something you are comfortable with, it is a hard decision to make.
post #3 of 8
Wow mama, sounds like you're in a great position! Lots of potential support. I think in your situation, I'd just weigh pros and cons to each situation, see who you click with, see who is willing and can give you everything you want! And assess things like your comfort level in the hospital, your comfort level in the birth center and your comfort level at home!

My reasons for picking one over and another would probably be different than yours, so I won't go into MY personal choices...but like the previous person said, do what you're comfortable with and take EVERYTHING into account. It sounds like you have some great options! YAY for that because you have no reason to automatically sign up for another c-section! Good luck!
post #4 of 8
Hi there - so GREAT that you have a good view about your first birth and good feelings/options this time around. I UNDERSTAND about wanting to avoid the c-section if at all possible. My first was all natural until they realized as I was pushing that he was breech - emergency cesarean I'm 20 weeks now - have a T incision from my first and am working HARD to avoid a cesarean. I'm more of a "red flag" than you b/c of the T incision - hard to find good/easy hospital support. That said - as others said - of course it is absolutely ONLY your decision and comfort level - I'd just say make it a researched choice and then go with your gut!! For what it's worth - in the LOTS of VBAC research I've done, I did read repeatedly that NOT going w/the same provider and institution is BIG in getting your VBAC. "If it were me" I honestly would feel that way...but again, it doesn't "really" matter what anyone else thinks - but personally I'd avoid the same setup - even if you personally feel good about how your first birth went. I'm sure you've done enough VBAC research to know induction/pitocin is absolutely BAD for VBAC's/possible rupture - so to avoid that. It sounds like your LUCKY w/your options. I hope you make a good informed choice and have a GREAT BIRTH!!!
post #5 of 8
Thread Starter 
Thanks for the ideas and support! I do feel blessed to be in a fairly open minded community. I have an appointment with a homebirth midwife to talk about my options, as well as 3 others who are willing to meet and talk if I would like to. I'm also going to schedule a time to visit the free standing birth center. My husband is very open to homebirth or the birth center, and really wants to avoid the csection as well. I don't know how many children I want to have, and I do know that a repeat csection will limit my future choices. It will also depend on what my insurance will cover. I'm willing to pay for a midwife out of pocket, but if I have to transfer then I will have an additional large copay for that. So if I can get any portion of it covered with the remainder going towards my out of pocket maximum, it would tremendously help financially. I've emailed them to get their first response in writing.

Thank you again!
post #6 of 8
My question would be "what would you suggest I do if this next baby is going to be '11 pounds'?" I wouldn't stay with a provider who is afraid of so-called "big" babies. IMO OB's are inducing so much that babies aren't "done" so we see lots of 6 and 7 pounders and think 8 is big and 9 is huge. My grandmother delivered 10 pounders at home. Several older ladies I've talked to about my 9lb 14oz VBAC baby have said they had a baby or two who was 9 lbs + at birth. There are OB's who will not "let" you VBAC if your baby is going to be x pounds.
post #7 of 8
Thread Starter 
Quote:
Originally Posted by LisaSedai View Post
My question would be "what would you suggest I do if this next baby is going to be '11 pounds'?" I wouldn't stay with a provider who is afraid of so-called "big" babies. IMO OB's are inducing so much that babies aren't "done" so we see lots of 6 and 7 pounders and think 8 is big and 9 is huge. My grandmother delivered 10 pounders at home. Several older ladies I've talked to about my 9lb 14oz VBAC baby have said they had a baby or two who was 9 lbs + at birth. There are OB's who will not "let" you VBAC if your baby is going to be x pounds.
Thank you for this advice. That question is at the top of my interview list. As well as "how far past the due date do you feel comfortable letting a mom go when all indicators point to a healthy mom and baby?"

I do know that I will be refusing any sizing ultrasound recommended at the end of pregnancy this time around. I was so incredibly positive about the baby's size and confident in my ability to birth a big baby, despite everyone elses negativity, until the midwives and consulting OB started doubting me too. Then I just cried.

My husband and I have a meeting with a free standing birth center on Thursday as well as a midwife on Sunday. I think I'll feel ready to choose a care provider early next week.
post #8 of 8
Hi! I just responded to your Tribal Area post as I live in Eugene. One thing I forgot to say was that Colleen, Carla, and Margie, I know all travel big distances for birth. Much bigger than 30 minutes.

You can do it!!! Good luck!!!
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