Worried about unsuccessful VBAC.

[yeaimemi]

I haven't really been getting any answers to these questions so I figured I might come here. I had a c-section with my daughter on April 25th, 2010. I got pregnant again when my daughter was around 9 months old. I have roughly 2-3 more weeks before this baby is born (August 20th). Acacia, my first, came on her due date so I'm not sure I should be worried about Teagan, my second currently baking, being too late. But, of course, each pregnancy is different.

Teagan is estimated 7lbs 2oz or 8oz.. I can't remember. A month ago she was 6lbs estimated, 70th percentile. Now she's in the 67th percentile. Acacia was in the 90th percentile, coming out 9lbs 3oz. They say they gain a pound a week, so I'm worried Teagan will end up coming out 9lbs. I've heard of people having successful VBACs with 12 pounders, though. Acacia wouldn't come down, I wouldn't dilate past 4.5cm. I went into the hospital at 6am, around 9:30am they broke my water (I think I was 3cm dilated), they put me on pitocin & at 10am they put me on the epidural (which took about an hour & a half, because apparently my bones are "too close" together, so they kept messing it up). Then 7:30pm they sent me back for my c-section (roughly 13 & a half hours). Aren't you technically supposed to have 24 hours before they worry about infection? I could have dilated more by that point..

I keep thinking it was because a.) they broke my water too soon, b.) they gave me pitocin & the epi too soon & c.) I was stuck lying in a bed rather than walking around & letting nature take it's course. I was only 3cm dilated, I don't know why they didn't just send me home to labor longer? If they hadn't broke my water, I could have had much more time to dilate. But I'm worried, what if it was because Acacia was just too big? What if all the interventions weren't at fault?

I want to stay at home as long as possible, I want my water to break on it's own, or they can break it around 8-9cm if I haven't yet. I don't want any medications.. Or, well, I DO, because I have a super low pain tolerance.. but I'm too afraid that'll stall my labor. I want to be able to walk around, & do things like get in a tub or shower, etc.

I'm just worried.. am I going to have the same problem with Teagan not coming down? Was it all the interventions that messed up Acacia coming down? (They say they use the amniotic fluid to get into position, & if they break it too fast baby gets "stuck".) Or, in the case of what happened to my friend 3 days ago, get all the way to 10cm, station 0 but just cannot push the baby through & have to have an emergency c-section? (She was pushing for 3 hours.. that baby would not come out).

I just really want to do what's best for me & Teagan, & I honestly don't want to see another OR again. Esp if I go without meds. I'm not sure if I can handle being in such active labor & getting a needle stabbed into my spine for the c-section. I'm just really worried. I was thinking positively, but since it's getting closer to home.. I'm getting really freaked out!

[ablepearl]

You can do this.  Absolutely those interventions stalled and prevented normal labor.  What position was your friend pushing in?  Did she also have a lot of interventions?

[AlexisT]

Generally, babies stay on the curve. It's closer to half a pound a week, not a pound, BTW. If she's 67th percentile now, chances are she will be at birth--which is, IIRC, under 8 lbs. A healthy sized baby, but not enormous.

You can't say the interventions "absolutely" prevented anything. We don't have perfect hindsight. It's possible. It's also possible Acacia was malpositioned from the get-go and you wound up with the interventions because you had a problematic labor to begin with. Most interventions are not 100%, and the only way to know is to rerun the whole thing without doing them... which we can't do. Honestly, I'm not a huge fan of Monday morning quarterbacking labors--sometimes it's appropriate, but all too often, it's a series of judgment calls with no clear answers that may well have been reasonable at the time, and it winds up with the mom blaming herself for letting it happen.

[cairomama]

This can help when baby won't come down:

http://www.spinningbabies.com/techniques/activities-for-fetal-positioning/walchers-trochanter-roll

[akind1]

I go back and what-if my first labor all the time - it's usually not just one thing, it's a whole network of things that can affect the process.

I think you *can* birth this baby, I'd work as much as I could the next few weeks on good positioning techniques. I need to do some myself (but I have almost 2 months to go, so am being lazy about it :S ) so much about how labor progresses hinges on baby being in a good spot.

Most women I've spoken with have said that contractions without pitocin are SO much different than contractions with pitocin, so you may find yourself perfectly capable of handling drug free contractions - the few doctors I've spoken with are very reluctant to use it with VBAC's. which is probably one of the few perks of being a VBAC mama!

[parsley]

I think going back of the "what ifs" is very common among VBACs I've talked to.   Hugs.  And, remember you can do this!

I'm wondering if you feel like you have a supportive birth team to help you deal with pain, the unexpected, avoiding interventions, etc...  From the reading I've been doing, it seems like having a doula can make a huge difference in preventing interventions and that prevention can lead to a successful VBAC.  How's your team?  Do you have a doula?  Do you think you might be able to hire one even now? 

[yeaimemi]

Sorry for the delay.. I've been really busy these past few days. I'm just going to answer everyone in the same post so I don't post a 100 times lol.

You can do this.  Absolutely those interventions stalled and prevented normal labor.  What position was your friend pushing in?  Did she also have a lot of interventions?

That's what I keep thinking.. I'm hoping that it really truly was all the interventions. I don't want to be wrong this time around. I don't want to be stuck with a baby almost coming out, & realizing she can't.. & then go to get an emergency c-section. I'm not entirely sure what position it was.. probably normal propped up on the bed position that they usually do.. She didn't really explain. She went from 2:30am to 10am before she got her epidural, & she progressed pretty well with dilation.

Generally, babies stay on the curve. It's closer to half a pound a week, not a pound, BTW. If she's 67th percentile now, chances are she will be at birth--which is, IIRC, under 8 lbs. A healthy sized baby, but not enormous.

You can't say the interventions "absolutely" prevented anything. We don't have perfect hindsight. It's possible. It's also possible Acacia was malpositioned from the get-go and you wound up with the interventions because you had a problematic labor to begin with. Most interventions are not 100%, and the only way to know is to rerun the whole thing without doing them... which we can't do. Honestly, I'm not a huge fan of Monday morning quarterbacking labors--sometimes it's appropriate, but all too often, it's a series of judgment calls with no clear answers that may well have been reasonable at the time, and it winds up with the mom blaming herself for letting it happen.

I'm so relieved. I'm not entirely sure where I heard a pound at.. & the lady that does my non-stress tests every week said the same thing. I kept getting told that once you have one big baby, they all come out big babies. 8lbs is a big baby, but not as bad as 9lbs. I certainly hope she is a little bit smaller, that'll help me in the long run.

I wish I could honestly say that it was the interventions, cos then at least I'd feel like I have some control. I'm sincerely hoping with all the research I've done, & looking back on that day, it was that which caused my labor to stall. That's the only way I feel confident that it could go differently this time.. but, again, it could have honestly been me. I've read that breaking your water too fast could cause the baby to get stuck in the wrong position, which may have been what happened to Acacia? I'm certainly hoping..

This can help when baby won't come down:

http://www.spinningbabies.com/techniques/activities-for-fetal-positioning/walchers-trochanter-roll

Thank you, I'll keep that in mind.

akind1

I go back and what-if my first labor all the time - it's usually not just one thing, it's a whole network of things that can affect the process.

I think you *can* birth this baby, I'd work as much as I could the next few weeks on good positioning techniques. I need to do some myself (but I have almost 2 months to go, so am being lazy about it :S ) so much about how labor progresses hinges on baby being in a good spot.

Most women I've spoken with have said that contractions without pitocin are SO much different than contractions with pitocin, so you may find yourself perfectly capable of handling drug free contractions - the few doctors I've spoken with are very reluctant to use it with VBAC's. which is probably one of the few perks of being a VBAC mama!

That's what I heard, too. Normally induction labor feels so much more intense than on your own, because they give you pitocin. This time around I told my OB I don't want any of that. Let me go naturally. I don't understand why they didn't just send me home. I've heard of women sticking at 3cm, & being sent home to labor for longer. I don't understand why I couldn't have. This time around I'm staying home until my water breaks, I bleed, or I just cannot handle the pain anymore. I think I'm sticking to my guns about no medications.. I don't want them messing me up.

I think going back of the "what ifs" is very common among VBACs I've talked to.   Hugs.  And, remember you can do this!

I'm wondering if you feel like you have a supportive birth team to help you deal with pain, the unexpected, avoiding interventions, etc...  From the reading I've been doing, it seems like having a doula can make a huge difference in preventing interventions and that prevention can lead to a successful VBAC.  How's your team?  Do you have a doula?  Do you think you might be able to hire one even now? 

I'm trying so hard to keep a positive outlook. I don't want to be negative on this. I really don't want my labor to go wrong again. But it's so hard to do with my mindset, esp after hearing terrible labor/delivery stories.

I honestly don't feel I do have a supportive birth team. I was looking for a doula or a midwife, but all of the ones I could find were either way too far away, wanted actual money not insurance (which I don't have..), or I'm too far along, they won't take me. That was 2 to 2 & 1/2 months ago.. I know I'm waaaay too late to find one now.. I've got 11 days left before she's expected to arrive. My OB feels I should have a repeat c-section, but he knows he cannot force me, so he's going along with my VBAC & letting me do it my way.

[AlexisT]

The pound a week is how much you gain. Half for you, half for baby. And it slows down at the end, so a 42 week baby is not necessarily a pound heavier than a 40 weeker. The percentile is more important, IME--I'm monitored for growth and that's what they pay attention to.

[parsley]

It sounds like you are in a really difficult situation, but I bet there are still some things you can do to feel more confident and in control.  Is you partner on board with your VBAC plans?  Will he or she stand up for you to drs and nurses and help to make your wishes clear?  Have you written a birth plan?   Have you gone over that plan with your ob? 

I read on another thread recently the very useful suggestion of going in and having a consult with an anestheseologist to help women be aware of their pain medication choices.  This was in the context of what happens if I have a repeat c-section but the advice may be useful for you as well. 

Also, I read somewhere on the Doulas of North America website (www.dona.org) that they have a fund to provide doula care to women who can't afford to pay the full price.  I really recommend trying to find a doula agency near you and giving them a call.  You can use the search function on www.dona.org to find certified doulas in your area too.  Maybe they can still help you find someone and help you feel more in control of your birth plans. 

Hope this doesn't sound bossy- just trying to remind you that there are choices you can make and actions you can take.  I ended up with my c because I lost track of that along the way...  Good luck!

[akind1]

OP - also look at doulas in training - maybe DONA has a list of those too? - as they need to attend (if that's the right word) so many births for certification purposes and may do yours as a courtesy since they are in training. Other doulas will also work with you price. I don't think any insurance covers doulas; not so much that doulas don't accept it, but that insurance wouldn't pay them anyway  - that's my hunch.

it's not too late! the hospital I'll deliver at offers free doula services, and they come when you arrive so there isn't really any chance to meet them beforehand or anything. I hired my own this time, as it was really important to me to know and actually have a doula (there supposedly were none available when I had my first). So doulas can work with you and still be of help at this stage.

[Ms. B. Sprout]

I've done your worst-case scenario -- I labored for 35 hours in my VBAC attempt (with a malpositioned baby) and still got a repeat c-section. I got to 10, baby would not come down, and I had to get my epi for the c/s during nonstop-peaking contractions.

It was not the way I wanted things to go, but it was also not the end of the world. It took some time to process things, but I am still glad I tried.

Statistically, you are very likely to have a much better experience than me! Sending you all my best wishes for a great birth!

[roadfamily6now]

Since when is 8 pounds a big baby??

[BrusselSprouts]

Originally Posted by cairomama 

This can help when baby won't come down:

http://www.spinningbabies.com/techniques/activities-for-fetal-positioning/walchers-trochanter-roll

Thank you!!!  41wks +2 here  for a VBAC hopeful :)

[cairomama]

Walcher's seems to work best after water is broken, so if you do it with water in tact and it doesn't work, do it again after water breaks.