Hospital or home for a VBAC?

[whitneyg]

I am totally on the fence on this one.  I have come up with a thousand arguments for each and can't seem to decide.  I had a very intervention-heavy experience with my daughter, which leaves me with both a "no thank you hospital" and a "what if I need the hospital" feeling about the next baby's place of birth.

What are your thoughts?

[WaitingForKiddos]

I was in the same place making our decision. For me, going to a hospital and not wanting to be subjected to a load of interventions would require me staying home to labor as long as possible with just my husband and myself. A home birth would mean that I would be monitored lightly (doppler) early on during active labor and my birth team (an ob and a midwife) would be with me. What I kept thinking is, while the hospital felt...I dunno...more 'safe' for the 'what if's' it left me alone during that time of labor when I'd likley experience a uterine rupture if it was to happen. If I was at home, I would be monitored, watching for signs of rupture, and would, hopefully but likely, be able to transport to a hospital. So, stay home and labor and be alone in that window of 'danger' or stay home and birth and be watched during that window. We are staying home to labor and birth.

[babycatcher12]

I had a HB after 3 C/S. For me I knew that there was no way I was going to get a "fair shake" at having a natural birth at the hospital. I knew that I would be strapped down and watched like a hawk any sign of (real or imagined) danger and I'd be off for another c/s. (My view is a little tainted because 1. I'm a L&D nurse and 2. I had a bait and switch right after I moved here). 

I totally trusted my midwife who told me right from the beginning..."I will not risk you or your baby". I knew that if she felt uncomfortable, or if I did, that I would go to the hospital and the only reason I would go is if I needed a c/s. 

[siren]

I am there with you, sister!  While I wasn't necessarily wanting to do a homebirth, I have gone back and forth between birthing center and the hospital-- my first birth was very very intervention heavy and I had pre-eclampsia to boot so 30 hours of heavily interventioned induced labor with magnesium ended in an emergency c-section.....  It left me with a very sour taste in my mouth for the hospital, any kind of interevention, etc... I couldnt stand the thought of being immobile during labor and being out of control......I don't want to be in that position again-none of it....

It is such an individual decision..... and this is my current thoughts and experience--hope it helps.

I really like my OB. We live in Germany now and they are very much about natural birth. He fully supports my decision for VBAC if everything continues to go smoothly... and I do not intend to allow one intervention near me unless something is wrong.  He was very matter of fact  "why wouldnt we do a VBAC?" ... that is... if Pre-e doesnt come back....

However, for me... if it comes down to him having to induce or the re-surfacing of pre-e... I am going to opt for the hospital c-section again due to the high rate of unterine rupture in induction during VBAC, and the danger to the baby and me with pre-eclampsia. I am not willing to take the chance for me or the baby's health to do the birthing center (in my case).

I would say-- do what is best for you and baby, and do not feel pressure from either camp... if the reason for the interventions is something that is not recurring  in this pregnancy, then talk to your OB or mid-wife about the homebirth option.... Whatever you decide, it is you who has to be at peace with the idea.... I definitely had a far from desired birth experience for my first little one, but I was still able to breast feed, and he is a smart, beautiful healthy little boy-no problems whatsoever...  So I can live with a few days in the hospital again if necessary... It is not a reflection on you as a mother whichever way you decide...  

[babycatcher12]

I would say-- do what is best for you and baby, and do not feel pressure from either camp... if the reason for the interventions is something that is not recurring  in this pregnancy, then talk to your OB or mid-wife about the homebirth option.... Whatever you decide, it is you who has to be at peace with the idea.... I definitely had a far from desired birth experience for my first little one, but I was still able to breast feed, and he is a smart, beautiful healthy little boy-no problems whatsoever...  So I can live with a few days in the hospital again if necessary... It is not a reflection on you as a mother whichever way you decide...  

Yeah! 

[Simonsez2u]

I agree with PP it is such an individual decision and you should not feel pressured by either party.  Personally, I decided to go with a hospital VBAC.  I was just more comfortable with that decision.  I learned a lot from my first birth that was "intervention-heavy." This time around I researched everything I could about my options, hired a doula, and was very vocal about what I wanted during my birth experience.  I was attended by a very supportive hospital staff who respected my desire for a natural birth and VBAC.  I think knowledge and support where the key components of a really very nice hospital experience.  Good Luck in what ever you decide!

[justKate]

Agreed.  It really is so personal.  For me, there are certain things that I know will interfere with my labor at home that have made me choose a hospital VBAC for this baby.  I don't think there is a right or wrong answer--only what feels right or wrong to you.

[waluso]

I went through the same internal struggle, and have decided on a home vbac. I have a great midwife and I know she will have me transfer if necessary, and I live close to the hospital. I also know that I will automatically be on the defense as soon as I walk into the hospital and that certainly won't help labor progress. So after a lot of research and discussions with DH, we decided that being at home will be the safest and best option for me. But I also agree that it is very personal and depends on where you will feel most comfortable and safest.

[Meleroo]

We also struggled to have a homebirth or a hospital VBAC.  We weighed all the research.  I cried because I felt that somehow I should choose the hospital but that the hospital felt wrong.  As we weighed the statistics and even the realities in living in a pretty small town with no NICU and a pretty small paramedic force.  My husband said to me finally, "If all the studies and certificates are weighed in this decision why do your feelings and emotions not deserve some weight too."  I don't think you can just base your decision on studies or just on emotions but you have to weigh both things.  Ultimately, a homebirth is our first choice.  A lot of things still need to line up and we are pretty aware of plans B,C,D E....Z but that is our first choice and we are doing our best to prepare for it.  Best of luck in your decision making.

[Lisa1970]

I think you should do what feels right to you. One point someone made is if they had a hospital birth, they would be at home as long as possible with no monitoring or outside help. But at home, they could have light monitoring and help as soon as they want. I am someone who had complications from my vbac. AND if I had not opted for a hospital birth, I would have been better off. You see, myVBAC doctor would not admit his vbac patients until they were basically ready to give birth. This means, while I was in labor and feeling I needed help, or at least be checked, he refused. That left me at home, in extreme pain, laboring for about 40 hrs before I gave up. The vbac OB was refusing to check me, see me, or even speak to me. The labor and delivery said they were just going to do whatever the doctor ordered. And since the doctor told them they were not allowed to check me or run any tests or anything, I was left out in the cold, with no clue what was going on. I finally ended up at a different hospital with an on-call doctor and an emergency c-sect. I still wonder if I really needed the emergency c-sect, as I did not have anyone to evaluate me who was vbac friendly. But that is what I got stuck with when I was forced to be home alone, with just my dh, and my vbac doctor refusing to see me because I was not actually giving birth at the time. It was scary and traumatizing. If I could do it over again, I would have a midwife at home and a back up doctor who can handle things if I end up at the hospital.

[Altair]

I'm in the same boat.  Had a HB-turned c-section transfer with my first, and am wanting to attempt a HBAC with my second.  I can't say the risks don't keep me up at night.  One of my biggest emotional reactions is knowing that in the particular hospital I would go to (b/c my HB midwife could maintain care there) I would be separated from the baby after birth (even a vbac) as a matter of policy.  That is such a non-starter for me. 

[Arete]

Yes to waluso's point about the hospital being a stress in and of itself.  I found the hospital to be such a cruel and uncaring place (and I'd be back at the same one again), that even with the best, most supportive team on earth, the very walls would oppress me like a tomb.  Chances of successful vbac: slim to none.  So unless there is a VERY compelling reason not to, I will try homebirth.

[justKate]

Quote:

Originally Posted by Altair  

One of my biggest emotional reactions is knowing that in the particular hospital I would go to (b/c my HB midwife could maintain care there) I would be separated from the baby after birth (even a vbac) as a matter of policy. 

Wow, even after a vaginal birth.  Crazy.