provider options

[shanniesue2]

Just to clarify.  I am not pregnant, and have only just gotten to the point where we are talking about when we might want to start trying again...  But one of the things that is on my mind is finding a VBAC provider.  There are 3 fairly decent options, I think.  One is a very reputable homebirth midwife.  Another is an OB who has a very good VBAC rep (apparently he prides himself on his VBAC rate, and I have heard nothing but good about him from local ICAN group ladies).  And a third that I found out about yesterday are CNMs at a different hospital who attend VBAC.  I have heard very good things about all three provider options.

The situation with my son's birth was that it was a very long labor.  25 hours at home before we opted to transfer.  Another 6 at the hospital with pitocin and a spinal block.  DS never descended and I never made it past 8 cm.  I was at 8 cm for about 13 hours.  There was no fetal or maternal distress.  I was just completely exhausted and couldn't go any longer.  And although my OB.GYN told me she thought there looked like plenty of room, the OR-report is says CPD.  I think there may be something to that because my pelvis is slighty torqued.

Anyway, I keep going back and forth on whether or not I want to try for another homebirth.  On one hand, I think that because of the torqued pelvis, positions are going to be pretty important... so a homebirth might be the best option.  On the other hand, because of the torqued pelvis, the same thing might happen where I labor forever and can't deliver vaginally and I don't want to deal with the emotional fall out from a home birth turned transfer turned cesarean again.

The hardest part about my son's birth was not the cesarean birth, but rather the huge let down from not having the homebirth that I had dreamed about for 9 months.  I don't really want to go through that emotional trauma again.  so I'm nervous about getting my heart set on a homebirth and then having it not happen.

Anyway, having 3 good options for VBAC provider, what are your thoughts?

[LisamommyRN]

I want to preface by saying that this is based totally on my own experience, and you can take it if it makes sense to you, and forget about it if it doesn't.

I had a similar experince to you with my first son (long labor, "FTP," no distress). And then again with my second. I am now looking for a provider who will attend a hopeful VBA2C. The emotional fallout of trying and "failing" to have a vaginal delivery is preferable to the regret I would feel if I didn't try. I would be forever wondering if it could have happened. (I wonder about this with m first two babies, too, but I have comfort in the fact that I did the best I could in each situation.)

So my thought is go for th VBAC!

But that's just me.

Hugs to you!

[shanniesue2]

Oh, I'm going to try for the VBAC... its mostly just trying to figure out which provider I want to try with.

[Bmorefarmgirl]

I was going for a home birth with my first too. It was a huge loss to end up with a c-section, mine coming at 33 weeks due to severe preeclampsia. The home birth atmosphere has changed a lot in my state in the 2.5 years since my son was born, with several midwives being prosecuted and/or having their licenses suspended. Between that and the risks of a vbac and getting pre-e again, I was not comfortable trying for a home birth this time.

I really respect the midwifery model of care and found a practice that didn't even bat an eye at my history and is supportive of vbacs in general. I, personally, would not choose an ob for my care. I just feel they are way too legal/risk minded. I feel that with the midwives I chose, I am getting all the information I need plus the full support and staff of a hospital and nicu if needed, but they are letting me make my own decisions for myself when appropriate and, as long as things are going well, letting my body do the work it needs to do. I have never felt that type of respectful relationship with any medical doctor.

I feel like I have found a good middle ground, and that's the best I can ask for in this situation.

(I'm due in November, btw.)

[womenswisdom]

No real input on which provider, but a couple things in your post stuck out at me and I wanted to point them out. You had a "stall" at 8cm and have a known "torqued pelvis". These are both indications of fetal malposition, such as posterior or asycliticism. I would suggest that you find a good chiropractor to work with before and during your next pregnancy to help make sure that there are no structural issues contributing to another malposition. A good prenatal massage therapist (one who will actually work on structural problems rather than just relaxation) can also help to release tight ligaments. It's also important to pay attention to your alignment and other factors that could influence your pelvic floor and abdominal muscles. I came across this post today and it might be a good starting point: http://www.alignintegrationandmovement.com/1/post/2012/09/pregnancy-how-to-get-your-body-ready-for-birth.html. Along with www.alignedandwell.com.