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VBA4C

post #1 of 32
Thread Starter 

Just wondering...how many people here (who obviously really support VBAC and natural birth) would consider a VBA4C?

 

I've just found out that I'm pregnant with our 5th child.  I know it's very early to think about this, but I can't help it.  I've tried harder than anyone I know to have a natural birth (3 times at home, once at a hospital) with all of my babies.  I've never succeeded even with very supportive doctors and midwives. 

 

I have very large babies (9lb 6oz with the first and progressing up to 10lbs 11oz.)  No diabetes.  My babies like to gestate for a long time. 

 

I've gone to great lengths to find support of any kind here in a state with a bad reputation for birthing.  I dream of a successful homebirth or even vaginal birth in a hospital.  It's such an emotional rollercoaster though.  After fighting hard for it 4 times and ending up with C/S anyway (usually after long and uneventful labor), it would be kind of nice to let myself off the hook and just enjoy this pregnancy.

 

I do understand there are risks with multiple C/S as well as risks of vaginal birth after C/S.  I do think it's healthier for the baby to be born vaginally.  I just am starting to seriously wonder if I really am someone who cannot get a baby out.  It's so frustrating to have tried so many times and have gone through so much emotionally, physically, and financially for my right to VBAC.

 

Would YOU put yourself through it again if you were me, or would you just resign to a scheduled C/S for once without all the aggravation?


Edited by jr'smom - 9/26/12 at 3:41pm
post #2 of 32

If I were in your position and with your history, I would schedule a repeat c/section.  I think there is certainly a time and place for VBACs, but this isn't one I'd be willing to attempt.

post #3 of 32
Thread Starter 

I appreciate your opinion, rnra.

I realize there is no one right answer here, but discussing it helps me work through my own emotions.

post #4 of 32

Even with that history, I would try.  It would take alot of time and work and probably involve a hotel room or home rental next to a hospital (university !), and I would also strongly consider co-care with an RCS scheduled for 43 weeks.   I guess my reason for trying would be the same reason I'm going for my first VBAC this time, I don't want to have another CS recovery.  I would want to avoid the two weeks of zombiehood that a drug reaction gave me, and honestly, planning a CS would give me anxiety, I feel much more at peace with trying for a natural birth.  Even knowing it could become a RCS, its comforting to know I'm trying.  You need to decide what's worth it for you, and what is the most peaceful plan for you.  

post #5 of 32
Check out ICAN. You may find stories of women trying to vbac (successfully or unsuccessfully) after multiple c-sections and their opinions of whether it was worth it to them. I've only been to one meeting in my area, but that night there was one successful hba3c.
Here is a birth story of a hba4c.
http://blog.ican-online.org/2011/04/30/cam-birth-story-sarahs-hba4c-an-incredible-feat/

I think if it were me, I'd try it if I could find a REALLY good, trustworthy care provider.

A tough situation for sure.. Wishing you the best!
post #6 of 32

I agree with the PP who said to check out ICAN. They have a forum online and they also hold virtual meetings, theres actually one tomorrow night at 9pm. 

 

As for your descision, you have to weigh the benefits and the risks and make your descision from there.  I am planning a HBA2C for this coming April and for me, the risks of trying the homebirth greatly outweighed the risks of having another section and like someone said before the whole aftermath of it. 

post #7 of 32
Thread Starter 

I appreciate you ladies weighing in.  I've been in contact with ICAN the last 2 pregnancies.  I've read wonderful stories of VBAMCs.  I've researched and contacted ANY provider who even has a reputation for supporting VBAC within a 2 hour radius of where I live.  It is doubtful I could find a midwife who would support me in a HB. There is no such option as a midwife supporting a VBA2+C in the hospital.  There are no birthing centers. The woman I used for #3 wanted me to cocare with a physician, but I couldn't find a physician who would agree.  I paid the midwife $4K out of pocket and she ended up dropping me when I was 10 days "late."  On her advice, I had to walk into a hospital and ask them to do a C-Section (she accompanied me posing as my doula) because I had no other option. To rub salt into the wound, my health insurance company went out of business and we ended up with a $30,000 bill from the hospital (that we are still making payments on!)

 

The physician I found for my 4th agreed to not schedule a C/S and just "see how it goes at the end."  (He was the MOST supportive doctor I could find.  Even the doctors who reportedly were VBAC advocates would only take patients with 1 prior c-section.  I went armed with the study about how VBA3C+ is safe but still no one would take me)  I ended up having bronchitis and pleurisy for the month before my due date.  I broke 3 ribs from coughing.  I couldn't get a normal breath without excruciating pain which made me acknowledge that I couldn't tolerate labor anyway.  We scheduled a RCS 2 days before my EDD.  My only baby born before the EDD and she was 10lbs 11oz. 

 

My biggest struggle in this isn't whether I should try for a VBA4C for my safety or the baby's.  I readily acknowledge I prefer this.  I just don't have the support.  ICAN was not able to point me to providers who would support me either.  I'm not willing to try unassisted. 

 

My plan for now is to make an appointment with the physician from the 4th birth at around 12 weeks.  If he will take the wait and see attitude with me again, then great, but I'll be surprised.  I'm not 100% sure he would have been completely supportive of the hospital VBAC in the end because it never came down to it.  But he at least he is the ONLY one to humor me. 

 

I also plan to meet with a physician whom I know advocates VBAMC, BUT does not deliver anymore.  (He and another doctor in his practice were sued.) I just want to ask his opinion on how hard I should push for my right to VBAC and see if he can lead me to someone who can support me.  Last time we talked (for guidance the night before I walked cold into the hospital for a CS for #3) he did not know of anyone who could help me.

 

So my biggest struggle is how much should I torment myself trying to find support and wishing for what can never be?  It's not like I haven't exhausted my resources in the past.  The only option I see is traveling to a state with a better birthing climate.  I am not willing to go to that extreme.  With 4 kids at home, one of whom will likely still be nursing, I need to be near them. 

 

I guess I'm just looking for everyone to say, "You've got no choice, just plan the RCS and be done with it this time.  In YOUR case there is nothing else you can do."  Or slap me in the face and say "You're just making excuses.  You'd be crazy not to keep looking under every rock you can find for a way to do your VBA4C!"

 

I think in writing all this out, I already realize that I have to keep trying to find support because I won't rest if I don't try anyway.

post #8 of 32
Quote:
Originally Posted by jr'smom View Post

I paid the midwife $4K out of pocket and she ended up dropping me when I was 10 days "late."  On her advice, I had to walk into a hospital and ask them to do a C-Section (she accompanied me posing as my doula) because I had no other option. 

 

How in the world can a midwife call herself a competent, responsible, ethical provider of maternal/newborn care if she dumps you off at a hospital and does not even acknowledge her role or transfer your care?  I get aggravated when midwives push to be recognized as reliable care providers and then they sneak around asking their patients to lie so that they can hide if things aren't going ideally.  I've heard of this many times.  Being a provider of care means owning your title which includes accepting responsibility for the outcomes/circumstances that arise--good or bad, and taking necessary steps to ensure you are well taken care of.  

 

Imagine receiving care from a regular OB/GYN for the majority of your pregnancy when suddenly a serious problem is identified and it is in your best interest to be seen by a high-risk perinatologist.  Rather than working with the perinatologist to review your prior records and transfer care, the OB/GYN accompanied you to the high-risk appointment and told you that he/she expected you to introduce him/her as your friend.  Would you tolerate or accept that?  If not, why is it okay for a midwife to do the same thing?

 

Your midwife's request to pretend she was a doula is completely unethical in my mind.  There would have been absolutely nothing wrong with her escorting you to the hospital, stating she was your midwife and that you planning for a homebirth, but you are now at 41 weeks, 3 days and would like to be evaluated for a repeat cesarean.  Then she could accompany you to speak with the attending physician and inform him/her about your prenatal care.  I'm not saying it's irresponsible for her to provide doula services in the event of a hospital transfer, I'm saying that it's irresponsible for her to pretend like she is simply a bystander in the whole thing.

 

Sorry for the slightly off topic venting.  For the record, I am not in any way anti-midwife.  I just feel that midwives need to take more ownership of their role and responsibilities.

 

Good luck with your decision.  It's a tough place to be.  I hope you are able to find a care provider who can assist you in making a choice that you can feel comfortable with.

post #9 of 32

If you've given previous births a try, you know if you "need" the labor process. I had a scheduled C-section with my twins, and an after 36 hour labor c-section with my daughter. I felt much better after the trial of labor, and felt that she was ready to be born, as labor had started.   Certainly part of my "feeling better" might be not having been pregnant with twins. 

post #10 of 32
Thread Starter 
Quote:
Originally Posted by rnra View Post

 

 

Sorry for the slightly off topic venting.  For the record, I am not in any way anti-midwife.  I just feel that midwives need to take more ownership of their role and responsibilities.

 

 

 

It was a very uncomfortable situation.  It seems most (or all?) homebirth midwives in my area are "underground."  It must be the birthing climate here. Using a midwife was the best prenatal care I've had of the 4 pregnancies, but I could never face that in the end again.  It's even worse than I mentioned.  She actually copied my records for me to present at the hospital removing any information that would identify her and CHANGED my EDD to a week earlier!  Originally, she said I should tell the hospital that I was from out of town and went into labor here. I wouldn't do that.  I'm not sure why she felt she had to protect herself-but she clearly felt that way.  She is a well respected naturopathic practitioner in my area but does not advertise being a midwife anywhere.

post #11 of 32
Thread Starter 
Quote:
Originally Posted by Red Pajama View Post

If you've given previous births a try, you know if you "need" the labor process. I had a scheduled C-section with my twins, and an after 36 hour labor c-section with my daughter. I felt much better after the trial of labor, and felt that she was ready to be born, as labor had started.   Certainly part of my "feeling better" might be not having been pregnant with twins. 

 

I think it's best for the baby to choose their own birthdate.  I have to admit though that the birth I felt the best after was the last one.  The one we actually scheduled (2 days ahead of time) and I showered and got ready, we went in and immediately started the process.  I was never on IV pain meds after the surgery...just oral.  I was unhooked from the IV and out out of bed the next day.  I didn't even need pain meds by the time I went home.

 

I only labored with the first 2 and they were both over 24 hours of active labor.  One with pitocin.  Neither with an epidural. They were tough recoveries both for the fact that I checked myself out of the hospital after 2 nights (less than 36 hours after the births) and because of the emotional turmoil of having an unexpected CS.

 

If the doctor I used with #4 agrees to "let" me go into labor before doing the CS, I will definately do that.  If he agrees (like last time) to just wait and see and possibly attempt VBAC, then my prayers will have been answered.

post #12 of 32
Quote:
Originally Posted by jr'smom View Post

She actually copied my records for me to present at the hospital removing any information that would identify her and CHANGED my EDD to a week earlier!  Originally, she said I should tell the hospital that I was from out of town and went into labor here. I wouldn't do that. 

jaw.gif

post #13 of 32

http://www.facebook.com/groups/183444955077965/ Come join this group if you haven't already!

post #14 of 32
Thread Starter 
Quote:
Originally Posted by ajlinder89 View Post

http://www.facebook.com/groups/183444955077965/ Come join this group if you haven't already!

 

Thanks!

post #15 of 32

you should ABSOLUTELY research your options!!

i have had 2 vba4c's. my 1st was a hospital vbac with my 8th child & i recently had a hba4c(homebirth) delivering a 12lb4oz boy. i never had any complications with my vbacs. ( my bub did get stuck but that was due to his size & not vbac related).

regarless of whether you decide on a vbac or rcs do your research. if you don't know your options, you don't have any! research the pros & cons of both, ask lots of questions so you can make an informed decision about whats best for you & your bub.

good luck!

post #16 of 32
Thread Starter 
Quote:
Originally Posted by gez15673 View Post

you should ABSOLUTELY research your options!!

i have had 2 vba4c's. my 1st was a hospital vbac with my 8th child & i recently had a hba4c(homebirth) delivering a 12lb4oz boy. i never had any complications with my vbacs. ( my bub did get stuck but that was due to his size & not vbac related).

regarless of whether you decide on a vbac or rcs do your research. if you don't know your options, you don't have any! research the pros & cons of both, ask lots of questions so you can make an informed decision about whats best for you & your bub.

good luck!

 

I've done the research many times over.  If there were ANY kind of option for support (provider) I would opt for a VBAC in a heartbeat.  I'm concerned about getting in the same situation as I did with #3 (homebirth midwife dropping me and having no option but to present to a stranger for a c/s.)  There's no guarantee I could find any midwife to care for me anyway and there are definately no OBs who would take me. (Except possibly the one I used last time.  I'll check with him. It's not like he was super positive, but he was the only one who would even take me and not automatically scedule a RCS.)

 

Your success certainly gives me hope.  Thank you! 

 

I am actually feeling more optimistic.  I'm going to wait until I'm 12 weeks and then contact my last OB.  Hopefully he will take the same attitude about a possible hospital VBAC. (You have no idea what a miracle that would be in my area.)  Then I will ask my previous underground midwife (yes, the one who dropped me and falsified records) if she will take me on.  If I go into labor before 41 weeks I will attempt a HBAC.  If I run into trouble during the HBAC, I will have my OB as a backup.  Otherwise I will likely agree to do a RCS at 41 weeks.  This would honestly be a very good scenario for me in my area.  (And an expensive one...(very high deductable and no MW coverage.  Last time it was $4K out of pocket just for the MW.)...but who cares.


Edited by jr'smom - 10/7/12 at 10:21am
post #17 of 32

Hi there! I have had very similar labors/deliveries. Four kids, three labors, four c-sections.  The labors in which I DID make it to 10 cm, I pushed for hours and babies never descended.  I kind of feel like at this point, I need to realize that there really MIGHT be something anatomically wrong & I'm not able to vaginally deliver my babies.  That does give me a sense of closure, in that my c/s were truly necessary.

 

With that said, I don't think I'd be opposed to trying again.  Why not?  It's not any riskier than going for another c/s, mom/baby's bodies both get to experience all the physiological changes that need to take place during/after birth, and I'll never have to wonder if it *could* have happened the way I wanted.  However, I had a hell of a time finding an OB who would accept a VBA2C.  I found a great OB who actually let me make the call on whether or not to try for a VBA3C, but I did decide at that time to go with RCS.  I was pretty back & forth on it.  IF I was unable to find an OB who would accept me, I had on the back burner that I would simply not fully disclose all my birth history.  I never had a single pregnancy complication, had healthy babies....  If they were going to treat me as a VBAC patient in the hospital, they're going to be monitoring for the same things whether I'd had one c-section or three.  So why not just go in & tell your OB that you've only had one or two c/s?  He might find out you're a liar only if he has to cut into your uterus or if your medical records are online.

 

Good luck with your decision!

post #18 of 32
Thread Starter 
Quote:
Originally Posted by FlipMom23 View Post

Hi there! I have had very similar labors/deliveries. Four kids, three labors, four c-sections.  The labors in which I DID make it to 10 cm, I pushed for hours and babies never descended.  I kind of feel like at this point, I need to realize that there really MIGHT be something anatomically wrong & I'm not able to vaginally deliver my babies.  That does give me a sense of closure, in that my c/s were truly necessary.

 

With that said, I don't think I'd be opposed to trying again.  Why not?  It's not any riskier than going for another c/s, mom/baby's bodies both get to experience all the physiological changes that need to take place during/after birth, and I'll never have to wonder if it *could* have happened the way I wanted.  However, I had a hell of a time finding an OB who would accept a VBA2C.  I found a great OB who actually let me make the call on whether or not to try for a VBA3C, but I did decide at that time to go with RCS.  I was pretty back & forth on it.  IF I was unable to find an OB who would accept me, I had on the back burner that I would simply not fully disclose all my birth history.  I never had a single pregnancy complication, had healthy babies....  If they were going to treat me as a VBAC patient in the hospital, they're going to be monitoring for the same things whether I'd had one c-section or three.  So why not just go in & tell your OB that you've only had one or two c/s?  He might find out you're a liar only if he has to cut into your uterus or if your medical records are online.

 

Good luck with your decision!

 

That helps a lot.  I appreciate it!    I really identify with you.  During the two labors I did have, my babies never descended.  Not at all. No head molding...nothing. I wonder if having the thought that I MIGHT not be ble to birth my baby will affect a VBA4C attempt.  (If I can get support for it anyway.)  I chalk up the first two c/s to my water breaking before the baby was ready to be born (2 days past EDD in both cases.)  My water didn't break the 3rd time and 10 days after my EDD, I just did the RCS. I did the RCS with the 4th 2 days before my EDD because of my broken ribs.  I just don't know. 

Lying to my OB won't be an option because he performed my 4th c/s.  I don't want to go to anyone else because he has the best natural birth reputation around.  I guess I'll just see what he has to say. 

I'm still toying with contacting the underground HB midwife for cocare and hopefully be able to attempt the VBA4C at home.  I wouldn't tell my OB about this. 

I would be willing to do the RCS at 10 days past EDD again. (For multiple reasons--the most predominate being my fear that if my pelvic opening is small, I may never go into labor and the baby will perish.  Yeah, I guess all this has really messed with my psyche.)  I'm pretty sure I can get my OB to agree to wait until 41 weeks and since I know I ovulated early, he will calculate my EDD 3 days later than I have (making his 41 week calculation really 41w 3d according to my charting.) (And I'm really sure about my O date.  I used OPKs, felt O pain, and got a BFP at 9dpo.)

 

Wow!  As I read my own thoughts, I realize I have a lot to overcome mentally to have a VBA4C!  No wonder I was asking if I should take the "easy" way out. But, I really don't want a RCS.  I really want a vaginal birth more than anything.

post #19 of 32

Go for what you really want.  You will know you tried for what you really wanted, and that always makes everything better for me.

post #20 of 32
Wow our stories r so similar. I just found out today that by some miracle i too am expecting again( my biological 4th child, 7th pregnancy, 5th c/s if thats what i choose to do)
I have a fantastic OB who is very vbac friendly. His partner's are not. They r the cause of my last unnecessary c/s. My option is to deliver
Local with an OB and people i dont know or trust AND have a RCS or stick with who i know and wing it. I will schedule an RCS to cover my OB and save
Him from his partners drama. I assume i am only having 1 baby so i will prob go full term or beyond so Im guessing sometime mid to late July since my EDD is July 8.
Best of luck to both of us
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