VBA3C in NEPA (Long)

[DBassett]

First, I'm begging that people not flame me for managing to get bullied so many times.  I have social anxiety problems and fighting for myself is EXTREMELY difficult because I have panic attacks.  I am at a point in my life now where I am getting better at being very vocal and I can actually afford a doula this time so I plan to get the extra support.  DH is great but also socially awkward and does not do well with confrontation either.  He too is becoming more vocal as we get older. I wish we had this strength before.  Though to be fair, one should not need to fight to give birth.

c/s 1 was physician failure to wait. I was 16 and really didn't realize that I could tell the doctor no.  I was admitted 2/12 at 11pm without actually being dilated. I should have been sent home.  They kept me though b/c I was 9 days late .  I walked the halls and at midnight I was at 1cm.  I was given something to help with the pain (against my will) so I could sleep.  Idk what it was, nobody ever told me.  In the morning, I walked more.  At noon, my water was leaking.  Doctor broke my water without warning me.  Over the next 4 hours, I progressed 3 more cm.  At 4pm, I got an epi I didn't ask for.  I was in pain, they offered it, I was unsure.  They pitched it like it was perfectly safe, and to avoid argument, I agreed.  3 hours later, OB was telling me that "I failed to progress" and "needed" a c/s.  So, to recap: I was in labor less than 24 hours.  My membranes were ruptured for less than 7 hours.  There was no fetal distress.  There was no medical indication for the c/s.  The doctor abused the fact that I didn't know any better.

That dr was no longer delivering babies so I (mistakenly) went back to the same practice with ds2.  OB lied to my face the entire time and last minute refused a TOL.  (He was one of the butchers on the Amber Marlowe case if any of you are familiar.  I didn't know that then though.)  He told me through the whole pregnancy that I'd be allowed a TOL.  At 40 weeks, he demanded that I scheduled a c/s.  I didn't think I could switch practices so late so I stuck with him but was hesitant to schedule.  He insisted that I'd have a TOL as long as I went into labor at any time before the c/s.  

Aug 28th, I went into the hospital (Wilkes-Barre General) at 7:30am to register for the c/s.  We hung out in the pre-op room for awhile (surgery was scheduled for the afternoon).  I watched a bit of TV and started contracting hard!  I was pretty excited!!!  OB came in, asked how I was doing, I told him I was contracting.  He saw the contrax on the monitor (very close together, regular, and STRONG) and all he said was, "yeah you are!" and then he left.  I had no idea where he went.  I thought he disappeared to maybe go get some stuff or maybe a nurse (b/c they do all their exams with nurses present).  Instead, a nurse came in and started to prep me for the OR. I could barely speak between contrax at this point so I'm not sure if they ever actually heard anything I was saying.  I had already signed the consent forms (under false pretenses) so I think he figured he had me. 

I switched practices (and hospitals) for #3. Most of the OB's agreed to a TOL but I ended up in the hospital from awful contrax and got an OB that I had seen once before (earlier that morning for contrax that were only slightly changing my cervix).  I asked for something for the pain because I hadn't slept in 24+ hours and I needed some rest if I was going to birth this baby.  I wanted something minor, to just take the edge off.  I tried to ask as many questions as I could and they said the risk to the baby was very small and that it was generally considered safe.  I was desperate so I figured it was worth the tiny risk.  When I started hallucinating, I asked AGAIN if they were sure what they gave me was safe for the baby.  I had no idea that they'd given me an opiate (stadol).  I would have never consented if I knew that.  I couldn't sleep because I was too busy staring at a pink ice cream house that we were all sitting on and yelling at DH to stop laughing at me.  He thought the ice cream house was hilarious because he was half asleep and I guess I was babbling.  So, the dr comes in like an hour later and honestly a lot of it's a blur.  Baby had moved out of the birth canal and they didn't know why.  His heartbeat was great (though it took them a while to find because he moved).  There was no reason to believe anything was wrong with him but then dr started talking about a c/s and said it was up to me.  I was scared from the drugs, I was loopy, and I was so tired so I ended up consenting before I realized what was going on.  Oddly, even trying to recount that experience made me feel a little high- like a flash back I guess.  There are only bits and pieces of the memory which is a clear indication that I was not in any state to consent to anything.  I do remember being given the option to go home though and dr telling me that the baby looked great so I don't think I needed the section.  I was just off in lala land.

This week, I was told that the practice is probably going to drop me because I'm refusing a section.  I didn't need any of them in the first place and my pregnancy is going great so why would I consent to a c-section? I'm angry and I'm not having another one.  

I'm not opposed to homebirth but hubby would like my first vbac to be in a hospital just because he's nervous.  We've had this conversation for 7 years now and he's just scared of me or baby getting hurt.  Ultimately, he wouldn't stop me from having a hb but I love him and don't want him to spend the whole time I'm laboring freaking out so the plan was to walk into the hospital in active labor.

Problem is, the OB that told me I'm going to be dropped said, "they're just going to section you anyway".  He backpedaled when he saw the look of horror on my face but that's going to stick with me.  Ilove geisinger for everything except birth I guess.

Anyway, MTH said that if I can find a physician to attend, they'd allow me a TOL.  I'm not sure if I believe it b/c I've read some bad experiences.  Anyone know if they really are VBAMC friendly? I'm nervous since they recently changed ownership to Commonwealth Health.  It might not be fair to assume all Commonwealth Health facilities are as bad as General but my most traumatic births were there so it's hard not to.

Does anyone know of anyplace that won't automatically try to section me?  I'm in the Wilkes-Barre area but I'll travel a bit if I have to.  I was entertaining the idea of Pennsy but I read some less than stellar stuff here and I'm not sure now.  I mean, it looks gorgeous but has a high c/s rate?  I'd love to hear that that the bad experiences were the exception and not the rule though. ;)

I just want to find a place that I'm not going to have to fight tooth and nail.  I'm tired of fighting but I'm determined to do this.  I KNOW I can do this.  I think my first DS gave me enough evidence to know I can do this.  I mean, I wasn't progressing super fast but I think if I had been left alone I would have had him within the next 24 hours.  3cm in 4 hours for a first labor?  I think that's pretty average.

If I have to travel to find a good hospital, I think I'll probably leave when early labor starts, grab a hotel room near the hospital and just relax with DH until things get really going.  The kid will have school so my parents will likely be watching them but they'll be ok with that.

My only concern with travel is prenatal care.  Ideally I'd like to be seeing the person who's going to catch the baby instead of continuing prenatal care here and then showing up somewhere else where they have no idea who I am.  Traveling for prenatal care will be costly though.  I mean I can probably travel to appointments when they're still once a month, maybe even twice a month but when they get to be every week, that's going to kill me in gas money so I'm not looking forward to that.

I'm sorry if my thoughts aren't coherent.  Preggo brain is messing with me and it is after 5:30am. lol

TIA for any help and I know my request is a difficult one.  OB's in this area are pretty anti-vbac so finding someone to help me vba3c may be impossible but I'm trying to stay positive.

ETA: I'm sleepy and typed vba4c instead of vba3c lol.  I clearly need to go to bed!

Edited by DBassett - 8/18/12 at 3:18am

[harli]

First of all no one should flame you.  IMHO women should be able to trust their doctors to take care of them and not have to fight them.  ((((hugs))))

I spent a lot of time researching the hospitals in the area (WBG, MTH and Wayne Memorial in honesdale).  But admittedly I have little knowledge on VBAC's in the area.  For that you may want to join our local ICAN group.  They would probably be able to give you specific doctors names that may be able to help you.

MTH supposedly does VBAC's.  I'm not sure about VBA3C though.  However, here is my experience with MTH and the OB's at Physicians Health Alliance.  For the prenatal care they were BAD.  I was forced to see every OB in their office and as a result NO ONE knew my name or anything related to my health at the end.  No one had read my chart before any of my appt's and since I was seeing them all for the first or second time they couldn't remember anything about my medical history.  My care was severely compromised because of that.  Without going into great detail they also put my well being far behind their own superiority all the while prescribing wrong med's and giving bad advice.  The office staff is also incredibly rude and even hateful at times.

When it came time to deliver.  I was talked down to and belittled the entire time.  Not just by PHA staff but by MTH staff as well.  When I hit about 7 cm's I had an urge to push and told the nurse it was time.  She examined me and very condescendingly told me I still had hours to go.  I decided to push anyway.  DD was born 12 min's later.  By the time the Dr.(a prominent DR. at the hospital would be glad to give his name out to anyone who wants to pm me) got to the room DD's head and shoulders had already been delivered.  The Dr. put her on my chest, as requested and then insisted that he suspected a 'uterine rupture' and that he needed to examine me.  (FTR I have never had any uterine surgery of any kind so why he suspected uterine rupture I have no idea.  There is also nothing noted on my medical records stating that something was wrong and that is why he suspected it).  I was still in labor la la land, heard the words, 'uterine rupture', knowing it could mean death, and not knowing what the exam actual was (thought it was just a vaginal exam) I ok'ed the exam.  What the Dr. did in actuality was something called a manual removal of the placenta. 

He waited less then a minute after birth and then stuck his arm all the way up inside of me, to a few inches below my ribs and scraped out my placenta with his fingers.  It was the most excruciating pain of my life.  I screamed, tried to kick them off of me and the nurses reaction was only to hold my legs down for the 'good' Dr to do his exam.  The ordeal took my completely normal, powerful delivery of my DD, basically by myself, to a rape case. I still to this day have no idea why he did this to me, nor why he felt the need to do that procedure to me.  They also lied about it on my medical records, with the dr. conveniently leaving that part of my records blank and the nurse saying I delivered my placenta naturally.

After hearing about this happening to several other women with different dr's. I visited the vice president of the medical board and told her my story.  She said she would have to talk with the dr.  to find out more.  She came back with some really lame reasons from the dr. for the procedure (like, to protect me from retained placenta 30 sec's after delivery and to protect me from hemorrhage, when the procedure actually causes hemorrhage and uterine infections) .

The only logical explanation I can come up with for the procedure was that the hospital beds were all full that night, which isn't hard since there are only something like 12 delivery rooms and that he was busy and needed to leave asap. 

I have also heard from several other medical professionals that MTH is a less then stellar place for L&D.  The most recent medial person I've talked to stated that she is absolutely amazed MTH is even still allowed to deliver babies with all the horror stories she has heard.

Even if you can find a DR at MTH to deliver you I would be very leary of trusting them.  The hospital is very intervention happy and has a high c-section rate. although admittedly I think it's lower then WBG's.  I wouldn't put it past them to tell you one thing and then do another.

I live east of you.  I'm about, 30 min's from MTH, 45 from WBG and 30 from Wayne Memorial.  So I'm not very familiar with delivery options to the west of you but out of the three hospitals your best bet would probably be Wayne Memorial.  I've heard really great things about delivering there for natural birth.  They also have some fantastic midwives that work out of there as well.  They even have done water birth's there.  You should look into them.

There are also several homebirth mw's in the area.  You should at least interview them.  Bring your hubby along and ask questions regarding, "what would you do if...." That really helped ease my Dh's HB fears.  I delivered my third baby at home with a local HB MW. 

How far along are you?  Have you considered making it look like your going along with the c-section plan and then just showing up practically pushing the baby out? 

PS I'm very sorry for this long novel. 

[harli]

MTH is also good at saying what you want to hear and then not following through. They tell everyone they do skin to skin, etc but they don't.  Be very cautious of anything they say.

[jenmidwife2b]

I would really look into Wayne Memorial if you are needing a hospital to deliver at for your vbac. And if at all possible, hire a doula. They can make a world of difference for your birth experience!

[DBassett]

Harli,
Sadly, I only asked not to be flamed because it happens a lot for both the fact that I've been bullied so many times and my choice to vbac.

Nobody here has ever flamed me but I'm just overly cautious now I suppose.

You said a lot so I want to respond to all of it.

First of all no one should flame you. IMHO women should be able to trust their doctors to take care of them and not have to fight them. ((((hugs))))

No, nobody should be flaming me. It's happened a lot over the years for this topic though. Recently, I was told that I was selfish for wanting a vbac and berated for "risking" my baby's life.

I spent a lot of time researching the hospitals in the area (WBG, MTH and Wayne Memorial in honesdale). But admittedly I have little knowledge on VBAC's in the area. For that you may want to join our local ICAN group. They would probably be able to give you specific doctors names that may be able to help you.

Unfortunately, I tried to get their help and they are taking their own sweet time gathering me resources. It's only been a few days yet so I'm hoping the person I contacted was just busy.

I live east of you. I'm about, 30 min's from MTH, 45 from WBG and 30 from Wayne Memorial. So I'm not very familiar with delivery options to the west of you but out of the three hospitals your best bet would probably be Wayne Memorial. I've heard really great things about delivering there for natural birth. They also have some fantastic midwives that work out of there as well. They even have done water birth's there. You should look into them.

Thank you for the recommendation. I've been considering Wayne Memorial. I need to look into them.

There are also several homebirth mw's in the area. You should at least interview them. Bring your hubby along and ask questions regarding, "what would you do if...." That really helped ease my Dh's HB fears. I delivered my third baby at home with a local HB MW.

It's not so much that he has home birth fears. He's just afraid that we will be one of the low percentage of people who have a problem. He's jaded because we've had a really tough life. It's been one bad thing after another for us so he's got that mindset that "with our luck we'll need to be in the hospital". I think the only thing that will make him feel better is seeing something work out for us for once.

How far along are you? Have you considered making it look like your going along with the c-section plan and then just showing up practically pushing the baby out?

I'm only 12.5 weeks- which is another reason I'm so annoyed that the OB was even talking c-sections with me. My plan last time was to show up practically pushing but it was very stressful on me so I'm hoping to avoid that if I can. Worst case scenario, that's what I'm going to do though.

Jen, thanks for your recommendation too. I'm planning to hire a doula. I've been looking around at the ones in the area and trying to decide which one(s) to meet with so I can hire the one who is best for us.

Any awesome feedback on a particular doula?
Edited by DBassett - 8/19/12 at 7:38pm

[DBassett]

A couple of people in my local (errr...the closest one anyway) ICAN chapter have recommended the midwives at the Reading Birth Center.  One said she delivered at the hospital with the midwives for a vba2c.

Anybody here have any insight regarding that suggestion?  Like I said, I am willing to travel if necessary.  I still plan to contact Wayne Memorial too.  I think I'm going to talk to a lot of hospitals and a lot of providers before everything is all said and done. :)

[jenmidwife2b]

I'd recommend Abigail Zeiger from benebelly.com.

[DBassett]

Thank you for the recommendation Jen.  I'm emailing her now.

The Reading Birth Center told me that they won't assist and that it will "likely be another section".  Which is very disheartening to hear such negativity.  Because I actually labored with my first up until the point of the epidural, I have no reason to believe that I cannot do this.  I will not let the tiny risk of rupture stop me.  Nobody allowed me to labor after DS1 so I do feel very abused and violated and without a medical reason, I'm not about to let that happen again.  I am stronger now and will keep searching until I find someone who will "allow"  me a TOL.

I'm glad that I'm only 13 weeks because this looks like it's going to be a lengthy process.

I did call Wayne Memorial and they said they do VBAC's but I would have to meet with the doctors and discuss it with them.  I'll get to that at some point but I'm so jaded now that I'm just worried they will say no.

Some days I could cry thinking about how I may never be able to experience a vaginal delivery all because of one doctor's abuse.  I can't think like that though.  There is nothing wrong with my body.  I CAN do this.  There's sufficient evidence that my body will go into labor and progress naturally.  I just can't let them disrupt the process.  The whole thing makes me angry though, I should not have to fight like this to give birth.

[DBassett]

This is getting to be extremely frustrating.  Every place I've called so far keeps telling me, "you will have to have another section".  The risk of rupture is so low- why won't these people just let me try? I'm so tired of fighting.  I've been battling for a vbac for more than 6 years now.  SOMEBODY has to just let me freaking try!

Seriously, with the first vbac attempt, a doctor looked right at DH and said, "there is a risk of fetal and mommy death.  We don't want either of those things to happen".  I had had ONE section and they were trying to scare DH into agreeing to it so that HE would push me to consent.  Of course, he told me he didn't like that doctor.  Another doctor, one that I had had a previous bad experience with, looked right at me and said, "you're not a good candidate for a vbac".  Based on what? The sole reason for my section was that the doctor was in a hurry! She said that because I failed to progress once, there is little reason to believe that I was able to progress on my own.  First of all, that is utter BS and secondly, she wasn't there.  She can't tell me that I failed to progress- especially when I know that I wasn't given a fair amount of time to progress!  Pretty much every doctor in the practice was like that- except one.  In hindsight, I should have switched but I didn't know anything about any of the OB's in the area...since I was pretty much the first of all my friends to have kids.  The one that supported my vbac was lying.  I was doomed to have a repeat section in that practice.

With the 2nd vbac attempt, most of the doctors kept saying that the risk of rupture after 2 sections was double and that they weren't willing to take that risk.
Now the same freaking practice is saying that if it had been 2 sections, they'd allow it but since I've had 3, they won't.  And a lot of the other places I've called are saying the same thing- vba2c is ok but not after 3.  I could cry.

I'm glad that I still have quite a bit of time to find a provider but I'm sick of this.  Every time I try to vbac, I'm told that if the previous doctor hadn't sectioned me, we'd be in business.  This is quite possibly one of the most unfair things I've ever experienced.

I talked to DH about a hb again and he's still not budging.  He said that he's aware that part of his uneasiness is probably because of society (and he's not proud of that) but he has too many "what if"s.  He said meeting with a mw won't change his mind.  I feel awful but I'm actually starting to get mad at him b/c a hb may be my only way out of this downward spiral. Birthing my child the way I want should not be this hard.  It's not like I'm looking to give birth in a dirty alley while having a crackhead catch the baby! I've made a perfectly reasonable and educated decision.  It should be respected!

[budwana birth]

DBassett,

It is rediculous that you are going through this experience.  I know this may be a huge stretch to propose, but would you travel into NJ for the right care provider?  As you may have seen on this board, I often sing the praises of Dr. Judy Banks- my go-to person for many moms who have situations others consider high risk.  Her office is located in Florham Park and she works out of Morristown.  I bet that is a hike for you, but if your life allows, maybe it is an option to consider.  The midwives at Hunterdon Medical Center (All Women's Healthcare) are phenomenal as well, and they may be closer for you.  While I am not familiar with the CPs up in the Northwestern part of NJ, if you're open to the travel, maybe someone else on this board has a recommendation.

[DBassett]

It is ridiculous isn't it!?!  I just looked at where those places are and they're about 2 hours away- so that's not too terrible.  Someone else had suggested them too so hopefully that's a good thing. :)

[Sunday Moon]

I had a successful VBAC at MTH last November.  My OBGYN is Dr. Wilcox and he made sure that all doctors and nurses I came in contact with were aware of my wishes.  I can't say enough about him!  One nurse mentioned c-section during my labor and when I told Dr. Wilcox (sadly he wasn't on call that night) he was annoyed it was even brought up.  He sincerely was my greatest cheerleader throughout my pregnancy.

nak so I can't type too much now but PM me if you are interested in seeing him.  I must be a rare one that had a good experience at MTH!  I even kept my son in bed with me (DH went home to be with our older son the second night and no way was I getting in and out of bed all night to nurse) and no one told me to put him in the little basinette.  No one really bothered me much during L&D either!

[DBassett]

I think it's hit or miss with MTH from what I've heard/read.  Some people love their experience there but with a vba3c, I'm very worried about all of the horror stories I've been told from up there.

Wayne Memorial may be a no go.  I had my appointment today with a midwife there and while she didn't say no, she didn't seem pro-vbamc.  She said things like "after 3 sections, the risk of rupture is huge".  There is no evidence anywhere that it's "huge".  The only research that has been done has shown low risks so her verbage has me worried that she's one of those people.

She said the practice has a meeting this Friday and she will discuss it with them and give me a call.  I'm expecting a no.  She was nice and seemed sympathetic to the abuse that I've been through but seems to feel it's "too risky"...

ACOG has this whole page about informed consent- which is amusing.  People want to quote ACOG at me and say that ACOG only supports vbac's after 1 or 2 sections even though ACOG does not specifically advise against vbac's after more than 2 sections.  They also don't seem to care that ACOG fully supports informed consent.

Another humorous thing is that my insurance company (Geisinger) sent me a booklet today that went on and on about the importance of informed consent and how, as a patient, you are entitled to certain rights such as refusing any medical treatment that you disagree with.  My insurance thinks I should have a say in the matter but the providers do not.  Interesting...

[jenmidwife2b]

I'm sorry you are going through all of this. I currently have several moms in my practice who are vbacs. A few are vba1cs, one is a vba2c, and another is a vba3c. I had a mama birth at home with me a couple years ago who was a vba7c. Vbacs after multiple sections should have additional monitoring, and yes your risk of rupture does increase a bit with each section, but not enough to state that it is a "huge" risk after three. I'm sorry your dh won't budge on the homebirth option, as it is looking more and more like that may be your only way of truly guaranteeing that you have the option of a trial of labor. You may have to labor at home until you are in transition and then transfer to the hospital as late as possible in labor to increase your chances of a successful vbac, but without being monitored during labor I'm not sure how safe of an option that would be for you realistically. It is a thought though, if your dh is set on you birthing in a hospital and you are committed to having a vbac.

[DBassett]

Honestly, I think if there is absolutely no other option, he will be fine with a hb because he is not the type of person to force me into an unsafe position where I will be bullied into a section but if I just give up on trying to find a hospital that will "allow" it, I'm sure he'll feel slighted because I didn't at least try to stay within his comfort zone.

I'm still searching just in case I can find a vba3c friendly place.