HBAC thoughts: need some support

[ariabrea]

I know this subject has probably been done to death here, but I really need some support and guidance. I'm hoping you can help me with both.

Last spring, I had a homebirth transport (at 8cm and a great urge to push) due to a cord prolapse. My head midwife (2 CPMs at the house, plus one midwife apprentice who was an RN for 15 years) detected the prolapse and immediately called for an ambulance, telling them to have a cesarean team ready and waiting. We got to the hospital in 15 minutes and proceeded to do every test on me imaginable. After an hour, they decided a c/s was best. My boy had apgars of 1 and 5, meconium aspiration, and pulmonary hypertension. We were transported to our state's biggest hospital where we were in the NICU for a month. I've dealt with PPD and PTSD, and after almost a year I am finally starting to feel like my life is getting put back into place. He's in perfect health now, and we're beginning to think about number 2.

I know that the hospital where we transferred to has a no-VBAC policy, though I have friends who have gone there and had VBACs with "I'm not supposed to let you do this, but we're going to"-type doctors. I had a feeling this was one of those doctors (she was very respectful through the transport, and knew my midwives well and respected them. She knew the type of birth that I had desired. She did her best to get me into positions to allow me to birth vaginally. Why we waited a whole hour after arrival for the c/s though, I do not know.)

I just got off the phone with the assistant of the doctor who did my c/s. She just made me sound like the worst mother ever. She reminded me of the hospital's no-VBAC policy and "if you had a c/s, it was for a good reason, and you will need one again." I told her that I would just like to speak to the doctor on the phone to discuss my options, to which she told me that I only had one option (c/s) and there was no need to have that conversation. I pushed her a bit further and she finally took my information down, but I don't know if I'm going to get a call back.

I want to have a HBAC. I don't even know why I'm calling the hospital. They obviously don't want my business. I shouldn't need their "blessing" on a VBAC, but it would make me feel better, like I was doing the right thing. I'm just terrified that if I have to transport again, it will be an automatic c/s the minute I walk through those doors. I can't deal with that. Especially since the reason I needed a c/s was a such a rare occurrence that more than likely would never happen to me again. Honestly, I felt safer with my midwives, as they noticed the prolapse so quickly and got me to the hospital so fast, and it was the hospital that was slow with their care. The midwives called me every day when we were in the NICU. They offered me so much love and support, more than any doctor could even imagine.

I don't even know what I'm asking for here. I'm realizing that if I want a vaginal birth, it's going to need to be at home (the closest VBAC-friendly hospital is 2 hours away - my entire labor was 4 hours, so I'm a bit nervous of traveling. No birth centers in the area either.) But with such an emergency the first time around, I'm so nervous - so convinced that SOMETHING will go wrong. I wasn't scared at all during my labor and birth - I didn't learn everything that happened until after the birth and I was recovering - they allowed me to just concentrate on my labor and for that I'm glad. But now I'm so scared of birth. I'm scared of the hospital and I'm scared of something going wrong at home. Gosh, what should I do??

[CookAMH]

It's a hard call. For me, if I end up transferring, it's likely going to be FOR a c/s, so that isn't my worry if they will just automatically section me.

Your homebirth went as homebirths should go and you had good midwives who saw a problem and didn't hesitate.  I'm sorry the hospital delayed so much.  You are right it's unlikely to happen again.

I'm afraid you aren't going to get a non-VBAC hospital to back you.    Mine is so-so and it could be more ideal with a particular OB backing up, but that is hard to come by from what I have seen.

[Ms. B. Sprout]

I am so sorry your homebirth ended in transport, c/s, and NICU. What a tremendously difficult experience.

I don't have a lot of advice for you, except to say that your feelings are VERY normal. Do you have an ICAN chapter nearby?

[jenniro]

I am so sorry.  That must have been very stressful.  Sometimes we know things logically, like cord prolapse is unlikely to happen again, but emotionally it is a whole different thing.  Having a scarred uterus changes things, it changes how we feel about our bodies.  Maybe you've lost a little confidence in your body and that is why you are scared.  The midwives have confidence in your body  That stupid assistant has no idea what natural birth looks like, and she should be ashamed of herself for speaking to you like you don't have a say in what happens to your body and baby.  The feelings of grief you have at the loss of your birth are normal and completely understandable. 

It sounds like you want homebirth, and I am a little biased toward that because I am planning on a homebirth after 2 c-sections if/when we get preg with #3.  Even if something goes wrong at home, your midwives are more than capable of handling it, as they did last time.  Natural birth in the hospital is hard enough, but when it is a VBAC, it can be even more difficult.  All of this you already know, it's that logic vs. emotion thing, bleh.  I think your confidence has been shaken a little, but you are a strong mom that has been through the ringer and still came out the other side ready to have another baby, come what may.  You should be proud of yourself for everything you've done and continue to do to be a good mom. 

We are here to support you!