scared to death by VBAC.. help

[againstme]

Hi!

I just recently gave birth to me first child, a beautiful baby girl on February 4, 2012. My doctor insisted that I needed to be induced and after putting it off for about a week I was induced. It was not what  I expected, I had planned to go all natural but when I stopped dilating after 6 hours, I got an epidural. Three hours later I had not dilated any further and the baby still had not dropped. Her heart-rate starting dropping and off to the horrible C-section room I went. I developed a fever, my milk never came in, we ended up back at the hospital because she wasn't getting enough breastmilk.. needless to say, it was extremely difficult to start using formula and not being able to breastfeed after all the stress of the C-section.

NOW, I am pregnant again, should be about 5-6 weeks along with my second baby. I'm very excited but as soon as I saw a doctor, he scared me half to death with such things as uterine rupture, death of mom/baby, losing my uterus, etc. etc. He told me that VBAC is something I really need to think about and that his hospital (where I delivered my first baby) will not do VBACS. 

I'm getting ready to schedule an appointment with a different doctor I found online who seems to specialize in these type of cases because I do want a larger family, and I've read that C-sections have a limit. I want to experience a normal vaginal delivery where I get to hold my baby right then and there and not have to go through surgery... 

The reason for this post is, is there anyone who has been through a similar situation where the babies are not spread out enough... that's what I'm afraid of... that I did not allow enough healing time between pregnancies.. the previous doctor never mentioned I would have to wait a certain amount of time, but he was a douchebag.

[mandib50]

i completely support you in looking around until you find a VBAC friendly care provider who will provide accurate information and support you in your desire for a VBAC.

although it is not ideal to have your babies close together after a c-section, that by no means rules you out from having a VBAC.

[againstme]

Thank you :)

I have an appointment scheduled with a doctor here which I've read nothing but great reviews but not until August since strangely enough, they told me the doctor will not see me until after 9 weeks pregnant.

I'm not sure how to feel about this now since just yesterday I had to go to the ER due to bleeding at 6 weeks.... they found a subchorionic  hematoma, which could have caused the bleeding, so now my mind is focused and praying and not having a miscarriage. 

Thank you for your reply

[mandib50]

i will be thinking of you and hoping that everything turns out well for you.

[upstgeu]

I VBAC'ed my second surrogate baby 14.5 months after my horrible section with the first. That's just about the same distance between births that you will be at with this one. It CAN be done, I am living proof. Good luck!!

P.S I am now fighting for a VBA2C with my fourth surrogate baby (6th baby, total), as my last delivery in Nov. ended up in a repeat section.

[againstme]

Originally Posted by mandib50 

i will be thinking of you and hoping that everything turns out well for you.

thank you, I greatly appreciate your support :)

[againstme]

Originally Posted by upstgeu 

I VBAC'ed my second surrogate baby 14.5 months after my horrible section with the first. That's just about the same distance between births that you will be at with this one. It CAN be done, I am living proof. Good luck!!

P.S I am now fighting for a VBA2C with my fourth surrogate baby (6th baby, total), as my last delivery in Nov. ended up in a repeat section.

yea it's pretty much the same difference! How was your experience if you don't mind me asking? After going to the ER yesterday due to some bleeding I found out I have a subchorionic hematoma which has lifted the placenta a bit... I've read everywhere that people still have healthy babies but... I'm not sure anymore really. Did you have any complications?

[TanyaS]

I would highly recommend gathering local support as you plan your VBAC. See if there is an ICAN chapter near you. www.ican-online.org 

There is a phrase I have often heard that might be helpful for you.  

If you can't get ride of the fear... do it afraid. 

[fayebond]

I totally understand how you feel.  My cuties will be 17 and a half months apart. My story is in development but be encouraged, its not as scary as some people make it out to be.  I will pray with you, there is nothing a doctor could do about a miscarriage before I think  27 weeks, that's why they wait so long to see you.

I was told by my doctor, after the CS, that I'm a great candidate for VBAC, "healthy mom, healthy baby".  No complications, like you the reasons for my first CS were more doctor induced than actual medical necessity, and bonus points I'm "young and healthy."  She said that the ACOG recommends 6 months before conceiving the next baby, to be on the safe side.  So I followed her rules and come in all happy and preggers with baby #2.  Cue the screeching halt sound effects.  At the hospital, the OB, the midwife, the nurses, all are concerned.  "Oh, was it planned?"  was the most common comment (you'll have to imagine the worry lines everyone sported). 

Apparently the rules were changed for awhile  to 6 moths then they went BACK to what is apparently the usual (and really strict in my opinion) rule of 12 months.  At least your OB didn't say anything.  Mine gave me the rules and I followed them, only to show up and be told, oh, its a complicated pregnancy now, we're all worried now, its concerning... blah blah blah, its all the nice way of saying that they no longer could see me.  They see their own fears.  Y'all said, healthy mom, healthy baby.  Well, a healthy woman's body is designed to have babies. While I understand thier litigation fears, that's not my problem, my problem is getting good medical care. 

(this is the rant part so skip it if you want) I set up a few appointments anyway and finally got fed up with all the extra rules and exaggerated concerns.  But they stopped looking at me the person, and saw only potential problems.  "Your uterus is one centimeter smaller than the growth chart says it should be." (Its still within the range of normal according to the ACOG, so its not a big deal).  "Your BMI is getting close to the end of the normal range, you're almost obese, ad you're only 5 months along." (DH and I both laughed.   To me it felt more like a power trip, trying to gain some edge to use later to scare me more so I will stop asking them questions and just do what I'm told).  The final straw was when I said I wanted to start labor with minimal cervical checks because for me they are more painful than contractions and slowed down labor.  "Oh I'm fast you won't even notice." (DH doesn't get to just "be fast" with his apendages whenever he wants without saying anything!   Why should I have anyone else sticking stuff up there without so much as a by-your-leave?  No.  Not cool.  Its my body, you get to ask, and I get to say no if I want to, because its not consent if I don't have the real option to say no.  If you won't ask, or won't listen when I say no, that's not informed consent and that's not good medical care.)  And then I went to a home birth midwfie and she's just so different its amazing.  She talks to me like I'm an adult, and spent alot of time at each appointment with me so that we will know each other well by the time labor starts.  Health care where someone cares, who knew?  (end of rant, thank you internet for providing this great opportunity to yell out loud without having to actually waste my breath).

[Lynann]

Glad I dropped by this forum today.

My boys are 15 months apart. DS1 was a c/s due to legal NOT health reasons. (Florida law dictated the home birth transfer because of 24hr limit on ROM for LMs) and then at the hospital all the interventions (because I had been in labor over 24 hrs) caused me to stall and eventually got a c/s after 37 hours total of labor. The OB who did the surgery was very honest about I could VBAC the next baby, but our local hospital doesn't do them. Where I lived when DS2 was born I'd have to drive past 4 other L&D hospitals to get to one that "might" allow a VBAC IF the right OB was on call, as only 1 OB at that hospital will do them. I didn't like that idea so I went with a home birth CNM.

At my 6 week check-up after DS1 I didn't get to see the OB that did the surgery, some kind of mix-up when I called to make the appointment. The OB I saw was kind of horrified that I wasn't going to be using birth control. She did admit that as long I had 3 months between pregnancies then my scar would be fully healed, but they like to recommend 18-24 months between pregnancies. I was almost 6 months post surgery when we conceived DS2.

Finding a supportive CNM was one of the big keys for me. Also finding out as much as I could about what had happened to lead to the c/s with DS1. My CNM was great about this, helping me to piece it all together and finding out that she didn't have the same restrictions as a LM if my waters broke at the start of labor was a big one for me. She also recommended that I take vit C from 20 weeks onward to prevent PROM from happening again.

DS1 was born 40 weeks & 5 days, was 8lb 7oz and 19 inches long with c/s after 37 hours hard labor (I went straight to 2-3 min apart contractions)

DS2 was born 41 weeks & 1 day, was 9lb 8oz and 23 inches long with 7 hours total labor, only 3 of them hard labor & 20 min of no effort pushing.

If I can be of any help or encouragement please let me know, and feel free to PM if you need to. (I've seen a recent trend on here of some people posting horror stories to try and scare women out of VBACs and home births. If they try to high jack this thread then please be encouraged that positive stories exist out there too.)

[againstme]

Originally Posted by fayebond 

I was told by my doctor, after the CS, that I'm a great candidate for VBAC, "healthy mom, healthy baby".  No complications, like you the reasons for my first CS were more doctor induced than actual medical necessity, and bonus points I'm "young and healthy."  She said that the ACOG recommends 6 months before conceiving the next baby, to be on the safe side.  So I followed her rules and come in all happy and preggers with baby #2.  Cue the screeching halt sound effects.  At the hospital, the OB, the midwife, the nurses, all are concerned.  "Oh, was it planned?"  was the most common comment (you'll have to imagine the worry lines everyone sported). 

Apparently the rules were changed for awhile  to 6 moths then they went BACK to what is apparently the usual (and really strict in my opinion) rule of 12 months.  At least your OB didn't say anything.  Mine gave me the rules and I followed them, only to show up and be told, oh, its a complicated pregnancy now, we're all worried now, its concerning... blah blah blah, its all the nice way of saying that they no longer could see me.  They see their own fears.  Y'all said, healthy mom, healthy baby.  Well, a healthy woman's body is designed to have babies. While I understand thier litigation fears, that's not my problem, my problem is getting good medical care. 

I love reading rants and raves, that's what I feel like doing as of late..

This is exactly how I feel, the doctor that looked at me and said having a VBAC was something to carefully consider doesn't even do VBACS at the hospital he delivers out of. It's like this constant pressure to have a repeat C-section. As you've seen in my other thread, right now I have not only this on my mind but also the heartbreaking chance of a miscarriage. 

I'm still scheduled to see a doctor who seems to encourage VBACS but that's the one in August. In the meantime, I'm going to another doctor for my ER fu (which is not being treated as an emergency at all) 

I'm in better spirits today though..  but.. I never thought that making a family would be so complicated because of the care of hospitals/ doctors. 

Thanks for your story, can't wait to hear more of it!

[againstme]

Originally Posted by Lynann 

Finding a supportive CNM was one of the big keys for me. Also finding out as much as I could about what had happened to lead to the c/s with DS1. My CNM was great about this, helping me to piece it all together and finding out that she didn't have the same restrictions as a LM if my waters broke at the start of labor was a big one for me. She also recommended that I take vit C from 20 weeks onward to prevent PROM from happening again.

Thank you so much for your story,  I'm not even sure where to start to determine what could have led to the first C-section.. I have my own theory which is I've always had extremely irregular periods, I would get 2 or 3 a year. I always had a little fear that I would never be able to get pregnant but, one day when I was about to take hormones to kick start my period after not having one for about 6 months, I found out I was "3 months pregnant."  This was determined through an ultrasound, then 2 months later I had just one more u/s and was told be the woman that it looked like I was maybe 2 weeks behind what I thought I was, my doctor decided to keep my original due date based off of the original u/s so I think he induced me early.. 

He was the douchiest OB/GYN....

anyway! I'll be sure to PM you...  no one knows about my situation except of course my boyfriend, and my mom. So having someone who has gone through a similar experience lets me breathe a little.

[fayebond]

Hi again, I want to add, keep trying to learn more!  Its helped me so much to learn the actual ACOG guidelines, that was a big one in getting other people to understand how badly I want a VBAC.  I'm still learning myself.  Check out the UC forums, there's actually alot that those women keep track of and know how to do.  In the off chance that I'm on the floor again in active labor and no one is around, I don't want to feel like I have to get in the car because I have no idea what I'm doing. 

[againstme]

Originally Posted by fayebond 

Hi again, I want to add, keep trying to learn more!  Its helped me so much to learn the actual ACOG guidelines, that was a big one in getting other people to understand how badly I want a VBAC.  I'm still learning myself.  Check out the UC forums, there's actually alot that those women keep track of and know how to do.  In the off chance that I'm on the floor again in active labor and no one is around, I don't want to feel like I have to get in the car because I have no idea what I'm doing. 

do you have a good link or website that explains it? I'm just learning about these ACOG guidelines!

[upstgeu]

I have had a SCH with three out of four of my surrogate pregnancies, very common with IVF. I have yet to meet anyone who actually lost a pregnancy from one, but I know there are a lot of variables. I'm sure you will be fine, stressing about it definitely won't help, though!

As for my VBAC experience....it was AMAZING! If I never get to VBAC again, I will be ok with that...due to the fact that I have not only had two awesome vaginal deliveries with my own, but then the most incredible and triumphant VBAC with my second surrobabe! I have had the experience, both ways...so for me now, the most important thing I can do is deliver a healthy baby into his/her parent's arms be that by VBAC or section. I am totally at peace with it. :)
 

[Lynann]

My c/s had multiple causes.

1. STUPID LAW. Here is Florida if using a direct entry LM they have a 24 hour time limit for labor after the water breaks. My waters broke before labor (by about 20 min) so unknown to me I was on the clock for my home birth. When I was only 8cm at the 24 hour mark she had to transfer me to the hospital. I had started labor with no dilation, so I was progressing, just very, very slowly.

2. DS1 was acynclictic (at an angle rather than just anterior or posterior) and since there was no cushion from amniotic fluid he got cemented into that position and wouldn't move no matter what we did.

3. Continuous EFM forced me onto my back once we got to the hospital. Lying on my back basically stopped any further progression as it worked against DS coming out at the difficult angle he was at, and stopped him from putting pressure on my cervix.

4. Exhausted, and a long labor where the contractions had been 2-3 min apart from the start were wearing me down and the hospital staff insisted on pitocin to strengthen the contractions. DH was watching the monitor and could see that it was making them more painful but NOT more effective. After 8 hours of pitocin augmented contractions I finally gave in to the epidural. I had gone without sleep for nearly 3 days by this point and labored for 33 hours. The epidural gave me some rest, but also guaranteed my c/s.

5. Strangers constantly poking and prodding me contributed to dilation stalling. After going through the second night (with pitocin now) the on-call OB checked me just before the shift change. He said there was just a lip and I'd be pushing within the hour. Half an hour later the new on-call OB came in and checked me as soon as he came in the room and said I was only 8cm, which is where I had been when I got to the hospital. I never got any more dilated after that point.

I know that IF I'd been allowed to stay at home my son would have come out eventually. I may have had a marathon labor, but I knew in my heart that the hospital setting and interventions along with strangers checking my girl bits is what actually led to my c/s. There was nothing wrong with my body. My son was in a difficult position with no water cushion to help him move. He needed more time, and I needed privacy and to be left alone to focus on birthing and to stay relaxed.

With my wonderful VBAC birth my waters stayed intact until the first spontaneous push caused them to explode (all over DH's feet.) Thanks to The Pink Kit I had learned how to purposely relax my pelvic muscles, and DH had learned to do internal pelvic massage to relax that area in the weeks preceding labor. Also the hands off support of my CNM was exactly what I needed to allow my body to relax and dilate. I only had 1 internal check and that was after my body starting to push on its own. I still had a small lip so my CNM had me pant through the contractions for about 15 min so I could finish dilating. DS2 was a 7 hour total labor and 20 min of spontaneous pushing (no bearing down while holding my breath) and he had the added complication of his hand on his face, causing his elbow to come out with his head. He was bigger and longer than DS1 too. I knew my body wasn't broken and birthing DS2 proved that.

[fayebond]

Lyann, I am praying for EXACTLY that kind of VBAC.  To have someone only check me when its useful would be an absolutely awesome thing.

Againstme, the ACOG is essentially the American OB/GYN union.  To see thier VBAC updates in one fell swoop... http://www.acog.org/Search?Keyword=vbac

A bit more explanatory is the government's website for guidelines, http://guideline.gov/content.aspx?f=rss&id=23853  I used my hospital's research section to look up the study that's on that page, I lost the link but that was honestly where I started.  

My fav resource, though, is actually a book.  "Obstetric Myths versus research realities", by Henci Goer.  Its VBAC chapter has every research test you will ever need to read about.  The EFM chapter is useful as well (having EFM increases your chances for having a CS but has not been shown to improve outcomes for mom or baby, which is so fryingly infuriating).  Your local ICAN chapter http://www.ican-online.org/ will probably have a copy you can borrow, that's where I got mine.  I want to buy a copy but its like $40 so that will be something I save for.  :)  Yes its a medical reference book, I am that much of a geek... 

[Lynann]

Fayebond, I really can't praise The Pink Kit enough. Its a learn at home, birth skills package. It was developed by midwives in New Zealand. I didn't realise just how much tension I had in my pelvic area until I learned how to relax in that area. Also the pelvic massage that it teaches helped to relax the ligaments etc that I couldn't do without touch. I was so much more relaxed and loose for my VBAC. It also shows you how to find the shape of your pelvic outlet so you know what you are working with and then find positions that open you up more in the ways you need to be open. I was surprised when I discovered that squatting actually closed me, and raising one leg and turning away from that leg opened me up more.

Finding a CP that will be as hands off as you need is really key too. I talked about that a lot with my CNM. She was very comfortable to be as involved or uninvovled as I needed. Most of the time she was there during labor she was in another room, and she didn't get here until I was already in transition, as my labor moved really fast once I hit active labor. It is definitely worth the effort to find a CP who will be in tune with what you need.

[fayebond]

Thanks Lynann!  I have heard about the pink kit but now I simply must try it!  My CP right now seems pretty great, relaxed and helpful.  Several of my friends from church have had her attend them before and they all like her.  

[againstme]

thanks ladies.

well, thankfully the bleeding I had has stopped, I was spotting since Monday but today it is very very light and dark. I don't have an appointment for a doctor until July 25th even though I tried to schedule an emergency follow up but... just bullshit there. 

So wish me luck ladies! :)