I am planning to have a vaginal birth for this second baby -- my first was an emergency c-section and pretty dramatic. There are very few providers in my area that will do VBACs but I found one midwife and a group of physicians that will support VBAC's. The HBAC seems like a great idea, but I am honestly scared of the risks associated with home birthing. Anyone out there done a VBAC at home? VBAC in the hospital? Pros & cons? Thanks
HBAC vs VBAC?
i had a planed c/s with ds1 due to a birth defect and then an UHBAC with ds2.
You are much more likely to get your VBAC in a homebirth then at a hospital. If you state allows midwives to attend VBACs then all the better!
The midwife will be right there and you can always transfer if something comes up. it's not as if you would go to the hospital at the first sign of a contraction anyway.
How long has it been since your last birth? do you know if you had a single or double layer suture?
I had a natural hospital vbac w/ my second child. First was scheduled breech c/s, so there was no reason to believe a vbac would be unsuccessful. That said, I did heavily consider a hbac, but did not pursue it b/c I had never given birth vaginally before. Dh and I were comforted by being in the hospital w/ midwives. We are also both outspoken & able to stand up for ourselves, so were not afraid of the hospital. It was a wonderful experience, no problems at all. For this baby, I would like a homebirth for a few reasons, one of which is that I know I can do it. I was never afraid during labor, just in pain, which was okay. My suture is single-layer, which is not as great, but it has proven itself to be effective. Mainly, I would like to avoid the hospital b/c the whole thing is a hassle, esp w/ two kids now.
It was a tough decision for me. I live in a state where it is illegal for midwives to attend homebirth so I found a midwife across state line that delivered babies in her home. I had shadow care with an unsuspecting OB through which I founrd out I was GBS+ in the urine. Being a diabetic also, I decided it would probably be safest for the baby if I delivered in a hospital (so I would get antibiotics and baby would be observed for low blood sugar problems ect.) My OB was lukewarm on VBACs so I hunted around for a tried and true supportive VBAC OB. Was directed from my tribe site here on mothering to a nearby ICAN chapter, which is where I found the OB and switched at 34 weeks preggo. I got a great doula (really recommend doula) and was determined to stay out of the hospital until I was really in labor.
The downside to the hospital birth for me was being on the monitors continuously but I really didn't feel like moving around a whole lot anyway. I was allowed a clear liquid diet during labor (had to sneak drinks during the first birth.. that sucked)
I think the most important thing is to find out if your provider is *really* VBAC supportive or just does lip service to it until you are too late to switch. I'd find out if they have any "rules" ie baby can't be more than 8 pounds, have to go into labor naturally by the 39th week, have to be on an epidura, ect.. I'd ask how many VBAC moms do they do a year and how many of them deliver vaginally (should be over 70%) I'd want to know if there are any conditions that would cause them to want me to do a RCS instead (some docs don't like GD or low/high amniotic fluid or preemie VBACers) If you have a nearby ICAN chapter they might be able to fill you in a little about your OB/MW track record.
There are other great entries in this same blog: http://www.nurturingheartsbirthservices.com/blog/?p=1751
I think that there are some other articles about this on the ICAN site, as well as VBAC forums on mothering. Ultimately, I think the most important thing you can do to plan a successful vbac (based on what I've picked up in ICAN meetings) is to pick a care provider you can trust. If Your care provider tells you that they are supportive of vbac, but then says that they recommend an epidural or induction- my redflags would raise. I'd interview a home birth midwife and share your concerns, as this was a regret of mine last time. I just ruled it out without interviewing because of some fears I had- that now I know could have been easily relieved had I talked to the right person.
Best of luck wherever you choose!!