Another VBAC thread I know there are a few of us here! « Back to Group Discussions

[JuicyPakwan]

I am so happy today!  I finally got my 20wk ultrasound and it shows a wonderfully healthy baby and a placenta that is plenty far away from the incision site so my homebirth is officially on!!  The placement of the placenta was a sticking point for my midwife and now it has been officially resolved I feel like I can finally start to prepare.

[MissE]

Still planning my 2nd VBAC...I have no doubt in my mind that it's not happening. I have a few questions for my OB when I go back on Monday and I'm still not so sure about the doula.

Someone was talkign about a VBAC consultation. I believe it was WCM? I have never been to such a consultation. What is it about? You said the midwife sent you there? Is the midwife not convinced you can VBAC? What is the holdup? Is she worried about scar rupture? Distress?

[activealli]

Im planning a home vbac. This will be my first vbac attempt. I have to have a home vbac because vbacs are banned at every hospital within over 100 miles. My daughter is due exactly a year from my first EDD but feel great so far.

[Monkey Keeper]

2nd VBAC here too!  (3rd vaginal birth overall)  I am really, really at peace with this one unlike the last one where VBACing was incredibly, overarchingly important. I feel like I am in a good mental place. Last time I would have been destroyed if a complication had arisen where  a c/s was the best route. This time, I will be fine if that's the case. Maybe it's because this is my last?

[JuicyPakwan]

I am so glad to connect with some women who are in a similar place.  I admit however I feel like a vbac cheater as I don't have the same issues alot of women trying to vbac face. I have a supportive midwife, husband and family and have successfuly birthed before.

I had my first 4 at home/vag, baby 5 was with CNM's because  I felt uncomfortable with a home birth and my intuition played out correctly she was an emergency c-sec pretty much the minute we got to the hospital she was severly distressed and I was only 3 cm dialated and they got her out just in time. However this time I feel so good about a homebirth again so that is what we are planning.

MonkeyKeeper - That is really good you have more peace about the birth this time.  I think I would be really unhappy about another c-sec but it really has to do with the recovery which completely sucked!

[Monkey Keeper]

Originally Posted by JuicyPakwan 

I admit however I feel like a vbac cheater as I don't have the same issues alot of women trying to vbac face. I have a supportive midwife, husband and family and have successfuly birthed before.

I think it is a very different ballgame for those of us who have a "proven pelvis". My 2nd was my c/s, and i knew from the moment she was born I would VBAC the next one, as did my provider. 

I did fight hard for my VBAC, so I know what other mamas are going through--my DS was an unstable lie from 33w till the end, and I also went post dates and had polyhydramnios. I really had to be confident that he would come on his own and calmly respond to objections. I won't lie--it was stressful and frustrating and emotional. But I would do it again.

I agree with you on the recovery thing. While my c/s recovery was a breeze for a c/s, I had virtually NO recovery with my VBAC. I cooked dinner for my family plus my mom and FIL the day after he was born and picked up my girls from school 2 days after. Don't get me wrong--I'd rather recover from a vag birth any day (well, at least one like my son's--it's a toss-up comparing my DD1's recovery and my c/s recovery since i had THREE packs of sutures in my nether regions!). But I feel like I will *know* if a c/s is the right route this time as opposed to my last birth where I would have fought it tooth and nail even if it WAS the right choice. It definitely feels a lot better this way!

[activealli]

Agreed. The hard part for me is that I was never allowed to labor with my first since I was high risk and they didnt want to risk my water to break with the severe polyhydramnios (related to my sons diagnosis of down syndrome and complete intestinal blockage) so its all a big mystery to me as to how Ill labor. The first question everyone asked when I tried to find someone who would take me as a vbac is why I had a c/s in the first place. I imagine if I labored and for some reason (failure to progress or something like that) it may change the game.

PS- Just talked to a medical biller yesterday. I thought I was going to have to give up on my vbac due to finances, but found out my my insurance should reimburse me about half of it and I should be able to use our health savers account (tax deferred and we already saved money in that account) for the remaining. So, looks like Im still a go!

[activealli]

Ps- has anyone else seen the vbac portion of "More business of being born"?

[amysue]

I had a CS 12 years ago due to pre-eclampsia at 34 weeks.  I'm now type 2 diabetic and my OB isn't talking like she wants me to VBAC.  My sugars are well controlled (until the last 2 days ) and my blood pressure, etc is good.  I am on blood pressure meds, but it is staying down and is actually lower than when I wasn't pregnant.  As long as everything/everyone is healthy, I don't see why I can't and I can't find anything online why I shouldn't.  If I have a complication that requires a CS, fine, but I'm not scheduling one just because the placenta could start to deteriorate or some other reason.  If that happens, we'll deal with it then.  My CS recovery was pretty easy, I drove the 45 minutes to my Dr. Appt (left baby with my mom) with no problems.  I'm thinking that since I'm older and diabetic now I probably won't heal as quickly. 

[JuicyPakwan]

activealli - That is great you are going to be able to fund your vbac.  It is so frustrating that finances have to figure into that decision but they do.  We have to pay our midwife out of pocket while our insurance would pay 100% for a hospital birth which makes my finance conscious dh twist a little.  While my ob backup is really nice the restrictions they have in the hospital will be a no go for me.

amysue - I am glad you are able to look at your risks objectively and plan accordingly.  It seems so many providers are so focused on the risks they aren't looking so much at the things that are going well.

About c/s recovery I had heard so many women say it was no big deal and honestly my scar healed quickly and without infection.  However the nerve damage caused long term pain it took me a good 6-8 weeks to figure out the constant pain I was in wasn't from the incision anymore but from nerve pain which, while reduced, unfortunately became permanent and the drugs weren't so helpful with that type of pain so my memories of the first few weeks are blurry from the drugs and pain filled.  The first 15 weeks of this pregnancy my scar area was so much more painful than usual it has disapated some now and I am hoping some of the long term pain was from adhesions and that they will be broken up by this pregnancy?  The abdominal ultrasounds are so physically unpleasant thankfully the tech is understanding and quick.

[border stories]

I will be aiming for my second vbac too.  My dd was my first vbac four years ago.  her two older brothers were born via c-section.  I am toatlly nodding with MonkeyKeeper - Last time for me it was distressingly important that I vabc, this time I am all chilled out and feel calm about what ever happens.

I have midwives booked and am planning a home vbac (here in the UK) there is no way I am able to labour in hospital.  Too many associations make me fearful and unable to labour.

[crystal_buffaloe]

I just realized that I never posted here. I'm going for a primary VBAC -- and I agree that things would be/feel different if I had a "proven pelvis"!

I'm waiting on the follow-up ultrasound due to some kidney issues to make a decision on where to give birth, though right now I'm leaning hospital even if things come back normal. My very tentative plan is to labor at home until pushing with a montrice and then make a mad dash to the hospital, though I haven't totally ruled out homebirth (if that u/s comes back normal!)

[WindyCityMom]

Originally Posted by MissE 

Someone was talkign about a VBAC consultation. I believe it was WCM? I have never been to such a consultation. What is it about? You said the midwife sent you there? Is the midwife not convinced you can VBAC? What is the holdup? Is she worried about scar rupture? Distress?

I had to have a VBAC consult (two parts, one down, one to go).  I see a hospital based group of CNMs.  The first consult is with one of them and they go over the consent form.  The second is around 30some weeks after all third trimester tests have been run, with the OBs that the midwives work under.  They go over the risks, etc., and make the final decision as to whether or not they'll let you VBAC (or VTOL, Vaginal Trial of Labor.. so unsupportive sounding...).  From what I was told you need perfect 3rd trimester tests, low transverse scar, and no other health issues.  I'm guessing maternal weight gain might risk you out since such a huge emphasis has been put on it with me this time around... I'm not really sure.  the OB consult is essentially a scare tactic fest.  Not looking forward to it...

I'm also risked out of a vaginal birth if I go past 40w6d.  Really.  I'm guessing this baby will end up a homebirth.. they are just making it right nextdoor to impossible for me...

[JuicyPakwan]

That sounds so frusterating!  What a way of keeping the pressure on you until the very end.

[crystal_buffaloe]

Originally Posted by MissE 

Someone was talkign about a VBAC consultation. I believe it was WCM? I have never been to such a consultation. What is it about? You said the midwife sent you there? Is the midwife not convinced you can VBAC? What is the holdup? Is she worried about scar rupture? Distress?

I also have to have a VBAC consult. I'm seeing my family practice doctor for the pregnancy, who can't do c-sections, and I guess it's hospital policy that I get the "full picture." We won't have it until after the follow-up ultrasound because of fluid found in one kidney at our 20-week scan. However, we've been in contact with the MFM (maternal-fetal-medicine specialist) who'll do the VBAC consult already (I think) because of the kidney thing, so I don't think it will be a scare fest -- though I do predict there will be talk about risk. I warned DH that there might be scare tactics just so he won't be off guard and I let him know that if there's any "OMG your baby will die" going on, that we're just going to calmly ask for the medical literature/what studies/actual numbers. I'll let you guys know how it goes when it actually happens. My doc has said that she thinks I'm a good candidate for VBAC, but that it's my decision if I want to transfer care to an OB after the consult.

[JuicyPakwan]

I am resurecting this thread to see how everyone is doing in their plans and such. 

I had an appointment with my midwife this morning that went well.  I have an appointment with my ob on the 16th which I don't look forward to I would really prefer just to see my midwife as the ob, nice as she is, leaves me feeling stressed out since she goes over the risks each time.  I doesn't shake my confidence but it is unpleasant to hear doomsday vbac stuff from her.  I am hoping after that appointment when they check the scar integrity that it can be our last.

[MissE]

Good luck JuicyPakwan. HOpe everything goes well.

Still the same old, same old over here. I jotted down some stuff for my birth plan yesterday and didn't know what to write when I got to the "In case of repeat c/s" point. I'm blanking, totally. I sure do hope I won't need a c/s but there's always that small chance. My OB hasn't talked about risks at all, she's treating this pregnancy and birth like I never had a c/s (but I also had a VBAC before). I will go back in on Thursday for a checkup.

[crystal_buffaloe]

I posted some of this over in the weekly chat, but I'm in search of a new care provider. Mine is actually my primary care doc (family practice) and I have a pretty good relationship with her. Most likely we'll stay with her after the pregnancy and she'll be the new baby's doc, but I had to have the VBAC consult (hospital policy) and the MFM told me that CFM was hospital policy and wanted to schedule a c/s at 39 weeks or 40 at the latest and told me I "needed to talk to my doctor" -- when I met to talk with my doctor, she said that she had to find a back-up OB to schedule the c/s with at 41 weeks and that basically her hands were tied with hospital policy there (we never even got to the CFM part). I do know that she thinks she gave me a few extra days with EDD, since the 8-week u/s was saying EDD of 9/20 and she went with EDD of 9/23 by ovulation (my chart) instead of the u/s or by LMP, but anyway, since I think the induction with DD at 41+5 pretty directly lead to the primary c/s in the first place, I am fairly adament about finding someone who's not going to be on my case until at least 42w, and if I am making things awkward for anyone by refusing or not showing up for a scheduled c/s, I want it to be the person who is actually denying me my human rights and not my primary care doc who is just acting as an intermediary with her college. So. I'm hopeful that if she can't find an OB in part because of unfriendly hospital policies, well -- I'm willing to drive/look for my own OB/switch hospitals.

Anyway, I heard about some hospital CNMs about an hour away through an old VBAC thread here on MDC and called and made an appointment with the one mentioned by name, but got a call back saying that they could no longer take VBAC patients (apparently there's a relatively recent hospital-wide ban -- I wish I'd known about them with my first pregnancy -- there are virtually no hospital midwives in my state).

I got a rec from a homebirth midwife in my town for an OB/DO about 40 minutes away and made an appointment with her for Tuesday. Her partner (also a DO) was also recommended by name in an MDC thread, and those are the only 2 OBs at the hospital (it's pretty small). I found this video after I made the appointment, and it makes me wish that I'd made the appointment with the partner, but I'm thinking the homebirth midwife wouldn't have recommended the other one if she weren't good, too. Anyway, the 12-13% c/s rate makes me feel hopeful.

The name that has come up the most, though, has been an OB at the other hospital in my town (and actually, it has a higher c/s rate than the one I would have been at with my primary care doc, but apparently they have some somewhat friendlier practices). He was recommended on ICAN (and recently had a VBA2C go to 42+2 or 3). One of the other VBAC mamas in our DDC is actually using him, too. I have a consult with him on Wednesday.

I have an appointment with the nurse practitioner at my regular doctor's office on Thursday for the 1-hour glucose screen. So that means I'll have doctor's appointments on Tues-Wed-Thurs next week. I'll let you guys know how the consults go.

I still have not hired a doula -- nor actually 100% ruled out a homebirth -- but even if we did plan a homebirth, I would want shadow/back-up care, just because I'm afraid I'll go to 42 weeks and be risked out, and I know that I'm going to want NST starting at 41 weeks.

[MissE]

CB:i'm wishing yiu all the best on your doctor marathon next week and hope things will work out for you. What you posted sounds good, the doctors sound good by letting you go for so long so there's a good chance that everything works out in the end. I could not imagine getting the runarounds like you do. I would freak out. You are handling that situation very well.

[crystal_buffaloe]

Haha! MissE! I am really, really, really hoping this is all for naught and I will go into labor sooner than I did with DD. I am sending baby bean strong subliminal messages about this. I am really not one of the women who starts complaining at 37 weeks ... I just seriously don't want to go to 42 and start up all of the "Your placenta could be deteriorating" and "risk of stillbirth" drama ... with DD we had the added drama of "She will weigh 10 POUNDS!" but since she came out at 7 pounds, 4 ounces fully cooked, I will just ignore that last one.