First time VBAC ???

[AnnieNimIty]

My cousin is having her second baby and she asked me to help her get information on being prepared for a VBAC. I had both of my kids vaginally and knew that the place to start would be here with you ladies.

So, specifically she wants to know how to progress her dilation so that the Dr. will be more supportive, as well as what else to do to prepare for one.

Her Dr. keeps telling her to not get her heart set on a VBAC because she should think about what is best for the baby when the time comes. Which sounds like Dr. speak for "I will let her think whatever she wants to think, but do what I want..."

Also she is due soon. She really doesn't want another c-section.

Thanks!!!

[MaddieMay]

Can she switch doctors?  Also, I'd encourage her to hire a really good doula.  I'm planning on a VBAC any day now and I know without a supportive doc and doula, there's no way I'd be able to even dream about a successful VBAC.

[A_Random_Phrase]

Switching doctors sounds like a good idea. I would also labor at home as long as I could. I was blessed with a doctor who was willing to "try" and with a labor so fast that he had no chance to think c/s.

[texmati]

i would also consider switching dr's-- i just switched at 34 weeks. See if you can get in touch with teh ICAN group in your area.

[MsBlack]

Yes, ICAN is a great idea--

www.ican-online.org

There you can find MUCH info about VBAC and repeat csec.  Also, there will be links to local support.  Get support, and find a doctor who has a great VBAC rate.  There is nothing wrong with being prepared for all possibilities, including RCS--but it sounds like this doc does not really support VBAC and wants a lot of control over this mom and her birth.

[cricketina]

You might be able to find a local ICAN group on Facebook and get a lot of information about local providers/advice that way.  I know of a woman locally who switched from an OB to a homebirth midwife at like 38 weeks or something crazy like that.  She was able to birth at home, vaginally.  Hospitals around here are VERY anti-VBAC.  They're not prohibited, but they're not allowed either.

[A_Random_Phrase]

Some states don't allow midwives to attend vbacs or homebirth vbacs (that was my predicament).

[onyxravnos]

i would switch doctors ASAP (if she can't have a MW attended VBAC) 

 and prep her on saying NO ! Does she have a doula? I would get one right away.

[LisaSedai]

So, specifically she wants to know how to progress her dilation so that the Dr. will be more supportive

Haha. If only women had the power to progress our dilation ! We'd all have to start dilation at 38 weeks and go exactly 1cm each hour to make the doctors happy.

It is REEALLY hard to get a VBAC with an unsupportive provider. They can and will do everything in their power to force you to a repeat c/section. When you are in labor it is hard to think straight and the doctor will be throwing the "dead baby" card at you and your relatives With the doctor she has, it sounds like she'd have to get there with the baby crowning. Has she asked him if he has ever delivered a VBAC baby? If he has, it was probably by accident.

I second everything everyone has said- find ICAN, hopefully they can tell you who is a good VBAC provider in your area so you can switch. Doulas are great... especially if you can find one who has done VBAC births.

[TiffanyToo]

Originally Posted by AnnieNimIty 

So, specifically she wants to know how to progress her dilation so that the Dr. will be more supportive, as well as what else to do to prepare for one.

Here are a few resources:

http://www.askdrsears.com/html/1/T010900.asp 

 search MDC for emotional signposts of labor or try the book Natural Childbirth the Bradley Way.  BY Susan McCutcheon

Her Dr. keeps telling her to not get her heart set on a VBAC because she should think about what is best for the baby when the time comes. Which sounds like Dr. speak for "I will let her think whatever she wants to think, but do what I want..."

This some how supports her VBAC wishes? Gah I am so sorry how horrible for her!

Also she is due soon. She really doesn't want another c-section.

That is so awesome! Lets talk about things she can do to improve her ODDS of vaginal birth success. I get how hard it would for her to fire her OB and to find someone willing to support her VBAC. It is not so easy.

 How is her immediate support base for VBAC (spouse, BF, ____) does this person, get her desire and is willing to support and trust her?  JMO that is as important as the professional choosen to catch baby. What about other persons that live with her, extended family, close friends etc who might have a different agenda that could undermine? Is there someone who can make sure this person is not in the know or isolated out of the equation?

I would strongly suggest she hire a doula a professional labor support person who can help her, support her and work with her towards VBAC. Her chances of VBAC increase with hiring a doula.

 You might suggest she call the hospital she is birthing at talk to the L&D nurses they typically run the show. She might want to ask about how many VBACs her OB does, vs how many repeat c-sections. Is the OB part of a group?  If yes, ask what OB in that group is very VBAC friendly and which one is hostile. When she goes into labor call and ask who is on call. Try to wait out labor at home if there is a hostile OB on call. Ask about VBAC friendly nurses see about having that nurse assigned to her.

Have her find an online birth plan she can read through and think about the choices she has and decide based on that information what things she must have vs are casual and would like. Have her come here and post about what she is thinking will help too.

HTH if you have any questions please ask.

[AnnieNimIty]

Ya'll are wonderful and I am grateful for your input. I just found out that she is in contact with a midwife whose schedule matches hers to see what she thinks. Prayers and good wishes please!

Thanks again for this. I sent her the link for this thread. :D

[veteranmidwife72@y]

I am  a midwife.  My first vbac mother was at home, planned and back in 1981, If there is anything you my want to know about vbac's, i have been thru it all, even back when i was sneered for doing them, but really i was part of the early early stats that proved it was safe to have a baby after a section,

i would love to talk about this or answer questions.

214-414-6950 or see atexasmidwie.com.  out of all the vbacs i have dont over the years i amd so gateful woman sought me out and entrusted me to helping them do what they instinctually wnted to do. we did... very few transports are in my stats, maybe 3 at most.

I believe  we should share and train our doctors for the possinility of vbac birth. But i dont like they take away that sometimes occurs when your in thraws of laboring and things change. We also need to get rid of this trial of birth liner...

Even in the middle of labor if your doctor trys to switch avenues with your labor, you have to ask certain question and also request certain other things he must allow you to do,

I can post these thing if there is interest...

In closing, i am eternally greatful that i had midwives around me that taught that vbacs were safe and normal.

You can do it easily, much to your own surprise!

I have done many very wonderful healing successful home births withn woman who have that inkling, "I can do this" and they are right.

[mommybaker]

What certain questions and request should we make?  I am not able to have a midwife at my birth, but am having a really great labour and delivery nurse who is my best friend at the birth!

[rachelalfreda]

I was going through a midwife group (of 8) that delivers in a local hospital.  They were all very supportive of my "attempt of a trial of labor" until I got to about 30 weeks.  I had to meet with the OB to get "approval" and they told me this:
We'll support your "trial of labor" (and they listed all the benefits of VBAC's) but we will section you if:

• you go past your due date
• you don't progress

and

• you have to have the continual fetal monitoring
• you have to have an iv (just hep locked though, no fluid flowing) 

I left the office not feeling very great - they were saying how supportive they were but these rules were pretty restrictive in my mind.  I went VERY late with DS (42.5 weeks with a shady due date) so I am expecting to go late with this one too (especially since my mom went 1 week late with both me and my sister, I think I just cook longer.)

After reading Ida May's books and A Thinking Woman's Guide I started to think that I might never acheive a VBAC in a hospital environment.  I talked with the hospital midwives about not wanting the IV and Fetal Monitoring because it was so uncomfortable and it's not that effective anyway.  Their response was, "well the OB really likes to have it and we need to protect our relationship with them.  I know some of the midwives don't care, but others really like it.  I'll have to bring it up at our next meeting and see what everyone says."  I knew this was the beginning of the end, even though they are midwives they are practicing under the hospital paradigm. (This is just my experience, i'm not even TRYING to say that all hospital midwives are like this)

At week 33 I switched to a homebirth midwife, and haven't looked back!  I feel so much more relieved and relaxed - free to enjoy my pregnancy without a due date looming over my head and knowing that they trust my body to do what it can do naturally (without needles and monitoring.)

This has been my experience with my VBAC so far, but I wish your sister the best of luck!  I think the most important thing about VBAC's is to be educated with FACTS, not just what the dr's tell you (or midwives for that matter!)  Definately look up the ICAN people, they have great info.  They are very supportive and realistic as well.  And if she has to go through a hospital DEFINATELY get a doula!!  She'll need all the back up she can get!

[rachelalfreda]

Originally Posted by mommybaker 

What certain questions and request should we make?  I am not able to have a midwife at my birth, but am having a really great labour and delivery nurse who is my best friend at the birth!

It's not so much what questions to ask, it's what to refuse.  So much of what is done routinely in the hospital is completely unnecessary and sometimes harmful.  Read A Thinking Woman's Guide to a Better Birth and educate yourself on the hospital's routine procedures. 

When you take a tour of the L&D floor ask for a copy of the "dr's standing orders"  these are the things the hosptials do automatically and you want to know ahead of time what they are so you can decide what you want to refuse.   

Assuming that your OB is going to give you the space to be a "difficult patient" you should be good to go, but you will need a Doula for sure and someone there to run interferrence for you.  Nurses and Dr's are just trying to do their job, but it's your job to let your body do what it needs to do - so don't back down!

[Sage Green]

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Edited by Sage Green - 11/26/11 at 1:49pm

[tonttu]

I had a vba2c and I can only say , she ABSOLUTELY has to believe in herself , she can do it . Everybody told me , that it´s impossible to do , and that I´m playing with my life and that of my baby !

B....s...,the risk is soooo  much greater with a repeat c/s !

Tell your SIL to get all the information she can get her hands on , all the studies vbac versus rcs , the percentage of babies dying or having problems after uterine rupture with vbac (appr. 0,2 %) versus the the risk of mother and/or baby dying or having serious health problems after rcs (appr 1,7 %) and so on , all he successful vbac birth stories  she can get her hands on , a great supporter , not necessary a Doula (even though that´s ideal) but at least some strong-minded person , that will throw herself between your SIL and the doctor , somebody who keeps her focused on her goal of vbac .

She has to make sure , that everybody in the delivery room knows , that c/s is only an option if there is a definite need for it .

I was in really slow , gentle labor for 4 days with my vbac , then on tuesday late afternoon , my water broke (by itself) , then everything picked up and I dilated from 6 to 10 cm in about 1 hour and my son , who was still tossing and turning around inside of me , took a dive , I could literally feel that , and popped out .  I think , that "you have to dilate so and so quickly" is stupid , our bodies know . what they are doing and I firmly believe in my case my body knew , that it needed that loooong , gentle labor , so that there was not so much strain on my scar .

Plus , if baby and mother are doing well , there is no need to induce , after all , do doctors automatically induce a first-time mother , once she hits the 40-week mark ? NO ! 

So , tell her to find a really supportive doctor , not one that apparently just tells her , what she wants to hear and then does what he wants to do ( c/s)

and tell her , not to let anybody rush her .

After all , nobody has the right to say "we won´t allow that" , she is an adult and she can make that decision , and that´s why it´s important to get all the info possible .

It helps for her own sake , too

I read every piece of paper I could on women having vbac´s and I thought , if they can do it , so can I . 

And so can your sister-in-law

[SpicyTunaRoll78]

Bless you Annie, for being her advocate! You are so kind to help her achieve her goals! May we all be so lucky to have such a person in our lives! I'm also thankful to learn from all the info everyone is supplying on the site, too!