VBAC - WWYD?

[Ninetales]

I'm not pregnant yet but I need some advice. This is literally keeping me up at night with anxiety and I keep going in circles and confusing myself.

I went through a birth center for my daughter's birth. It was a beautiful pregnancy but the birth went completely belly up. I had a very slow, painful labor which culminated in a hospital transfer where after pushing for four hours and not ever having her move down I consented to a section.

She turned out to be macrosomic and no one can tell why. I'm sure genetics played a part but this was extreme. We suspect malpositioning as well.

I intend to do everything in my power to have a VBAC when I do have another baby. However, I'm scared that I would have complications again and ruin our finances again. Because of the transfer I was on the hook for all our copays and deductibles as well as the 3800$ fee fir the birth center. It was a huge setback for us financially because we had expected insurance to contribute but due to a loophole they didn't have to. So our daughter's birth was about 5000$ out of pocket.

I love my birth center. But that is a lot of money. I'm so committed to the philosophy of natural birth and midwifery but the hospital will cost me less and is happy to take monthly payments indefinitely.

I almost feel guilty, like I need validation it's ok to make a decision based on finances. If money were no object or I were confident that we wouldn't have complications again I would go there again without hesitation. I just can't pay two bills again.

Advice? Reassurance?

[Alenushka]

Money is something you should take in account as well as safety. Obviously, the staff at the birth center did not have what was needed to help you and you child to survive this birth. The c-section is no the wort thing in the world and many case, it is the life saving surgery.

To me , any birth that end up with healthy baby and mom is natural and beaturifull thing.

I think money question is an important one. You have a child to feed. You have a roof  to provide for the child. Healthcare etc. And soon there will be 2 kids to provide for.

There have been many thing I wanted to experiece but I did not because of money. Because my kids needs are very important. Because our family needs are important .

So, I would not discount the money. If the hospital is nice enought to let you do payments (And many hospitals that), I would go with it.

$5 K buys a lot of cloth dieapers!.

[Kanna]

It's just one day in your life and that of your kid....and I think that kid will actually appreciate the things you can buy for him/her (College fund, good quality toys, books, good, warm blanket, etc.) more than he/she will be bothered about where you gave birth to him / her.

[Alenushka]

I actually talked about their birth stories with my kids this year. They really really do not care how they came about.

[Ninetales]

Oh, I know they don't care about any of it. It's me that it matters to. I just loved everything about my experience there, even though the birth didn't go as expected. I would be very sad not to go that route again.

I think that may be where I'm at in my head: reconciling that while it's what I want it may be better for my family to go the OB route. And have to mourn the loss of choice and rail against the unfairness of the health insurance system.

[Alenushka]

Oh....do not dwell on it too long and accepts it as "it is what it is".

Pregnant women are not that special as far as accepting limitations of our insurance system. Ask any mom with special needs child, like me. Oh, wait, my entire parenthood exprience did not go as planned. Yes, I grieved the loss of the 'normal child", but eventually a point came where the grieving was no longer productive and accepting, living my life as is and accepting "new normal" was a more functional way to live.

We do not have the kind of healthcare we all want. Our country is waisting 1 billion dollars a week on the wars and untold billions on corporate welfare.

[Beccadoula]

If you want a natural birth in the hospital - plan carefully, find a really good doctor that is open to you doing your own thing at the hospital, get a good, experienced doula, eat really...really...really well.  Pray.  I have a good friend who had a 20+ hour labor with her first (hospital), a36+ with the second (home and transfer) followed by a cesarean and a 4 hour labor with the third...she was actually in the car traveling to the hospital most of her labor and was only there 14 min. before her baby was born.  I personally have seen some very wonderfully nautural births in the hospital and I've seen some not so great ones - it really depends more on your choice of doctors, having a good nurse (you can go by the nurses station and find out who on each shift tends to be most supportive of intervention free birth and request them when you go in)...loving support of your spouse...and determination on your part.  Moms who say they aren't going to have any interventions and then agree to them as soon as they are suggested do not tend to have as good a time as the ones who are willing to wait it out and ask about alternatives - even stand up for themselves if they must.  That's just my perspective as a doula - what I have seen.  Whatever you decide, don't feel bad about it.  You have to do what is right for you in your situation.  No one else gets to define what that might be...and it may change again later when your situation has changed.  Birth Blessings!!!

[hildare]

i'm facing either a vbac or a c-birth in feb. 

here's something to think about:  if you are attempting vbac with an ob or a midwife backed by ob in the hospital, if you have the need, they will have an anesthesiologist and an OR available.  it would take less time and might "feel" safer.  a hospital birth can be a very positive experience, also. 

personally, i have multiple factors that make me feel as though if i do attempt a vbac (using the ob i like and who performed the cbirth surgery) i will want to do this in hospital.  i don't have the option of a birth center, but even if i did, i would choose hospital for vbac for myself. 

in your situation, i would probably elect to vbac in hospital.  finances are important, and i think you could arrange for a very positive midwife centered hospital birth.

will it be possible for you to have a midwife attend a hospital birth?  every place is different.  here, that's the only option.  if not, find a good, positive ob who is down with vbac.  write a birth plan and get a doula.  good luck!

is there an ICAN near you?  can you ask around for some positive hospital vbac stories that took place where you're considering going?  that might be a good way to feel things out.

[greenmulberry]

Originally Posted by Beccadoula 

If you want a natural birth in the hospital - plan carefully, find a really good doctor that is open to you doing your own thing at the hospital, get a good, experienced doula, eat really...really...really well.  Pray.  I have a good friend who had a 20+ hour labor with her first (hospital), a36+ with the second (home and transfer) followed by a cesarean and a 4 hour labor with the third...she was actually in the car traveling to the hospital most of her labor and was only there 14 min. before her baby was born.  I personally have seen some very wonderfully nautural births in the hospital and I've seen some not so great ones - it really depends more on your choice of doctors, having a good nurse (you can go by the nurses station and find out who on each shift tends to be most supportive of intervention free birth and request them when you go in)...loving support of your spouse...and determination on your part.  Moms who say they aren't going to have any interventions and then agree to them as soon as they are suggested do not tend to have as good a time as the ones who are willing to wait it out and ask about alternatives - even stand up for themselves if they must.  That's just my perspective as a doula - what I have seen.  Whatever you decide, don't feel bad about it.  You have to do what is right for you in your situation.  No one else gets to define what that might be...and it may change again later when your situation has changed.  Birth Blessings!!!

Edited: I posted an angry reply to this, but I think it was more my inner rage at not having a natural birth despite doing everything bolded above, than the advice that was making me so angry, so I edited.

OP, I hope you get whatever birth you wanted!

Edited by greenmulberry - 8/29/11 at 11:45am

[Morgasaursmom]

I was in a similar situation after I had my first boy.  I didn't get a trial of labor after discovering at 40wks he was breech.  So i had a C-sec, which went well, all was fine.  I had an extremely hard time nursing though, and was determined with our next child to have a natural birth.  Around the time we started trying I started looking into a more "natural" OB. 

Have you thought about the OB that your Birth Center is affiliated with?  I wasn't ready to deliver in a birth center (though now I totally would!)  and midwives in our area aren't allowed to deliver VBACS in the hospital.  Finances were also considered in our choice for hospital vs birth center.  I started seeing the OB that our local birth center recommended, who they refer patients to when they have issues.  My OB had delivered at least one of her own kids at the center and one at home, and was a big advocate for natural birth. 

I took the birth classes offered at the birth center, for woman wanting a natural birth but are delivering at a hospital.  They were AMAZING!  Everyone in the class was on the same page, instructor was incredible!  I also recommend a Doula.  I credit a lot of my success to her and my husband.  They did an incredible job during the birth of my second son. 

My labor was very fast, start to finish was about 5 hours.  Only minor issue I had was that my boy had a knot in his cord, and his heart rate started dropping at the end, so the OB (who ended up being a different OB than my primary, because she wasn't on call...) had to do an episiotomy.  I had a lot of tearing and needed stitches, but got to have my natural VBAC!

So I credit a lot to our local birth center and their resources.  My second son is now 6 months, still exclusively nursing.  I think the natural birth vs scheduled c-sec made a huge difference in our nursing success!

[Ninetales]

Actually, the only OB I'd really consider right now is the one who is affiliated with my birth center and is the one who did my section.  She's well known for being natural birth and VBAC friendly and I'm told she had her last child at the birth center herself. 

Originally Posted by Morgasaursmom 

Have you thought about the OB that your Birth Center is affiliated with?  I wasn't ready to deliver in a birth center (though now I totally would!)  and midwives in our area aren't allowed to deliver VBACS in the hospital.  Finances were also considered in our choice for hospital vs birth center.  I started seeing the OB that our local birth center recommended, who they refer patients to when they have issues.  My OB had delivered at least one of her own kids at the center and one at home, and was a big advocate for natural birth.

[Ninetales]

Hold up, Morgasaursmom, after a peek at your profile I think we may be in the same area and talking about the same place!  I went through The Greenhouse in Okemos, MI.

[starrlamia]

of course they dont. Why would they? That doesnt mean that how you birth is not important, and it doesnt mean that natural birth doesnt effect your children.

OP- How hard would it be to pay off the birth? I think going with your OB who is vbac friendly in a hospital is a great choice if money is an issue. I would think about what you want and talk to your doctor about it.

 

Originally Posted by Alenushka 

I actually talked about their birth stories with my kids this year. They really really do not care how they came about.

[Ninetales]

It would take years to pay off.  And that's assuming they worked out an amazing payment plan for us, which is understandably unlikely.  So it would be a credit card debt, which we're about to finally get out of.  There would be charges from the hospital too, but they're happy to take whatever you can afford to pay them.

[Beccadoula]

Originally Posted by greenmulberry 

Edited: I posted an angry reply to this, but I think it was more my inner rage at not having a natural birth despite doing everything bolded above, than the advice that was making me so angry, so I edited.

OP, I hope you get whatever birth you wanted!

Sorry I triggered you!  There is no way to promise the results will be good - even with good planning - I should have stated that.  Bless you!

[greenmulberry]

No Becca, I am sorry I got all angry. I really considered just deleting the post totally but I was worried that you already saw it and that it would be weird if it just vanished. I know you were just trying to be helpful.

This made me realize I am still not "over" my section. I usually stay out of this forum because it does get me all triggery to read about planning for childbirth, because I invested so so much of myself in a vaginal birth, I did everything "right", and it didn't happen.

Sorry about that and I don't want to derail the thread.

[myfairbabies]

Same boat, not pregnant yet, planned homebirth, big first baby, long long labor, poor position, cesarean. After a lot of study, I almost feel confident with the plan to have a montrice and hospital birth. We live 90 seconds from the hospital, so I would feel ok staying at home for as long as I needed since I would have the midwife to monitor me. If finances are no problem, we may pay for both (see an OB and not tell them our plans) and then decide in labor where we want to go, but that's a big IF. For me personally, if I lived any further from the hospital, I probably would just plan a hospital birth. It's a hard decision, good luck and I hope you find peace with whatever you decide!

[Alenushka]

Ultimately, I do not care either.  All I care is that they are alive and well. Epidural interfered with nothing.

Originally Posted by starrlamia 

of course they dont. Why would they? That doesnt mean that how you birth is not important, and it doesnt mean that natural birth doesnt effect your children.

OP- How hard would it be to pay off the birth? I think going with your OB who is vbac friendly in a hospital is a great choice if money is an issue. I would think about what you want and talk to your doctor about it.