When to go to hospital

[NaturalMama311]

I'm REALLY hoping for a VBAC in a few weeks (EDD Jan 26) and I'm wondering when I should go to the hospital once I go into labor.  With my first DD was breech and I had really low fluid level so she couldn't flip over.  I had a scheduled c/s so I never actually went into labor.  Since I am attempting a VBAC my midwife said I should come to the hospital as soon as I go into labor - no laboring at home for any amount of time because of the risks associated with VBAC.  They are very closely affiliated with an OB group (share an office) so I'm wondering if that's just the policy because of the OB's. 

They also told me that I have to be constantly hooked up to fetal monitoring as a VBAC patient.  I wasn't happy about that AT ALL and considered switching to a new MW but they assured me that the leads are long enough that I can still walk around the room, be on a birth ball, etc.....the only thing I can't do is labor in the tub.  But there is only one tub in the L&D unit so it may not even be available. 

So I would like to labor at home for a while so I can avoid being hooked up to monitoring as long as possible.  I know the uterine rupture risks are very low.  WWYD?  Should I try to labor at home for a while before going to the hospital?  My worst fear is that my labor stalls once I get to the hospital and I end up with a repeat c-section.....I DO NOT WANT another c-section!!!!!  Is it really risky to stay home for a while?  And how do I know when I should go to the hospital? 

[TiffanyToo]

Originally Posted by NaturalMama311 

I'm REALLY hoping for a VBAC in a few weeks (EDD Jan 26) and I'm wondering when I should go to the hospital once I go into labor. 

I wish you a wonderful VBAC!! I would suggest that you hire a doula she will help you identify these sign posts provide you comfort measures and provide reassurance to you and your family.

As well I would suggest you read up on the emotional sign posts of pregnancy. Try here~> http://www.angelfire.com/nb/doulaamanda/Labor.html
this to give you and those supporting you clues, cues as to what stage you are in and how important it is or is not to get to the place your birthing your baby at. With my VBAC I did not go to the hospital until I could not walk, talk, or focus on anything but the contraction. As well they were close together and were lasting a good while.

They also told me that I have to be constantly hooked up to fetal monitoring as a VBAC patient.  I wasn't happy about that AT ALL and considered switching to a new MW but they assured me that the leads are long enough that I can still walk around the room, be on a birth ball, etc.....the only thing I can't do is labor in the tub.  But there is only one tub in the L&D unit so it may not even be available. 

When you arrive at the hospital who will be managing your labor? Will your midwife be there most of the time or will the OB's be a big part of the management team? Who's orders prevail? If you can not get the direct answers from your midwife call the hospital. Talk to the L & D nurses they can help you better understand just what exactly the standing orders are, who will be the most militant on keeping/enforcing them and if there are any VBAC friendly nurses who you should be asking for when you arrive. I would also ask the nurses about the continuous fetal monitoring (CFM)  if that is standard practice or if that can be negotiated to intermitant about 15 minutes every hour, when you arrive. If they say you must have CFM I would spend as much time in the shower and on the toilet laboring as you can, that usually gets around that arbitrary rule. Best wishes!

[cairomama]

My c/s was for breech, no labor. For my VBAC, I planned to labor at a hotel near the hospital for as long as possible (I was 2 hours away from the hospital), but my labor was really fast and I was 8cm when I got to the hospital. If I wasn't far dilated, I would have gone to the hotel. 

I have been a doula at 3 VBAC labors. They have all been long and had rest periods. This is not allowed in the hospital. It is not allowed to be long or take breaks. The earlier you go in to the hospital, the lower your chances are. However, you need to do what you feel comfortable with. Also, even if you are in early labor and you feel like something is wrong you should go in.

That said, I think about it this way, if you can be distracted or are interested in doing things that you can't do at the hospital like eat, drink, shower, walk, etc., then it is too early to go. There are leads on the EFM and wires and you can move around the bed, but not much, so if you don't go in until you don't want to move that works better.

[kdaisy]

I had a similar situation.  I had no labor with my first either.  My MW practiced at the hospital and EFM was a given for VBACs. 

I really wanted a homebirth.  I hired a doula and planned on laboring at home as long as I could.  Baby came early and my doula was out of town unfortunately.  But I ended up laboring until 9 cm at home.  Once I got to the hospital, the EFM was a no issue, I barely even remember it!  (Here is my story.)

I would labor at home as long as you are comfortable...and hire a doula to help you gauge how far along you are.

Good luck!

[CookAMH]

I personally plan to approach my labor as labor, regardless of being a VBAC. Meaning, I do not have extra concern with what could come in labor to make me go in asap. As a result, since we are planning a hospital birth right now (considering home birth), I plan to stay at home as long as possible no matter what I am told.  If my water breaks, I know to check the color.  The impact that being a vbac DOES have on my labor and decisions is that I don't want to go too early so I have warned my husband that I plan to labor at home until I am very serious with contractions for a while - and he might get nervous but he needs to trust me.