I get frustrated that more Docs don't support VBAC

[luvymommy]

A friend of mine was considering VBAC after her OB suggested it.  However, after meeting with the other doctors with the practice, she got the impression she would end up with a c-section so she decided just to go ahead and schedule it 1 WEEK EARLY.  Not only is it safer to attempt VBAC but it is medically recommended to never schedule a c-section a week before the due date because that puts the infant at risk for lung issues.  Sigh.

Below is a link to my blog - my most recent post is on VBAC.  There is an awesome video I found and included with the blog post about one mother's experience with VBAC. Also, I've included a few links to articles that support the importance of improving maternity care and the safety of VBAC compared to repeated cesarean. If you'd like, feel free to comment.  I just get so disheartened with our maternity system sometimes.  

http://sweetnaturalchild.blogspot.com/

[labortrials]

Hopefully she has time to think about it?  Docs insist that it is safer to do ERCS w/o labor, but you're right . . . then you don't know if the baby is really ready to be born or not.  I'd recommend sharing the NIH VBAC Consensus info with her as well as the C/S vs. VBAC info at Childbirth Connection at the very least.  "The Business of Being Born" might be useful too in changing her attitude about women's health.

[MsFortune]

It sounds like your friend's doc supports VBAC but your friend does not want it. 

[akind1]

I find that is the case with nearly all my friends; most docs are more than happy to do a RCS, so unless a mama is adamant about a VBAC, the doc is happy to oblige with a RCS, usually the week before the "due" date. I have a couple friends that are bothered by the fact that the docs won't "take" the baby any earlier than 7 days before the due date.

All I can do is try to educate, but it a hard thing, especially since I do understand, to a point, not wanting to go through a long labor just to end with another c-section (which is what most of them fear the most). For me, I want to go into it knowing I have done everything in my power to assure a VBAC success; that way if it does not work out, at least I know I tried.

[AlexisT]

Actually, the ACOG recommendation is not to do it before 39 weeks--not that 39 weeks is a problem. 37-39 week babies were shown to have a higher level of issues and ACOG issued a statement against elective induction or ERCS prior to 39 weeks (barring medical issues). This assumes, of course, that dates are accurate. The danger with a 39 week scheduled delivery is that baby may not really be 39 weeks. 39 weeks for elective repeat is the standard not just in the US, but elsewhere.

It is true that failed TOL is the worst scenario. In order of outcome, it's successful vaginal, CS without labor, CS after labor. There are studies supporting this. But, I'm not sure that would be applicable to anyone who went into labor and then went straight to the CS. All the women I know who had lengthy labors and wound up with a CS anyway describe the experience as akin to being run over by a truck. I would think that length and difficulty of labor prior to CS would be a factor.

[ablepearl]

I definitely agree, there is most liekly a difference in a woman waiting for labor to start and going directly to the hospital for surgery and a prolonged 'failed' TOL.

I too recommend BOBB and the book Pushed for woman in this situation.