I am expecting baby #4 in April and had a VBAC with #2. Was great, felt so pleased that I was able to do it. Ended up with another section with baby #3 and will schedule a section with this one as well. Loved that I was able to have one vaginal birth though - it is a totally different experience and the recovery is much different than that of a c-section.
I will be trying for a VBAC as well and have come to somewhat of a dilemma.
There are two VERY supportive providers in my area:
One is a solo practice OB who is skilled in both breech VBAC, as well as traditional and rotational forceps delivery. He has a 89% VBA1C success rate among data collected by my local ICAN group; that number increases to 92% if you remove the breech attempts. He has a 57% breech VBA1C rate among the data collected by my local ICAN group.
The other is a midwife practice (6 delivering midwives) that allows VBAC waterbirth, is backed by an OB who does family-centered cesareans (if necessary), will do ECVs in triage for breech, but is not as skilled with forceps deliveries (does not even use rotational forceps).
I have chosen the midwife practice, even though I know it will be a toss up on which midwife will be on call when I deliver. During my last labor, I enjoyed laboring in the tub so much that just the option of laboring in the water (even if I don't have a waterbirth) pretty much made my decision for me. I have already decided that if this baby is breech, I will be switching to the solo OB practice. But, now I'm getting scared that I might end up with a RCS if malpositioning ends up being an issue in my upcoming birth, and the backup is unable to successfully deliver with forceps. I have not posed this question to my ICAN group because I'm afraid there are strong feelings towards one or the other provider as many of them have delivered with one or both.
So I came here in hopes of some input...knowing that laboring in water is very important to me, would you guys stick with the midwives and hope that a forceps delivery isn't in my future. Or would you go ahead and switch to the solo OB, knowing that water laboring (and definitely waterbirth) is out of the questions and IF a RCS is the ultimate outcome, it would be your standard, run-of-the-mill c/s??? As I said before, I will absolutely switch if baby is breech, but otherwise, I'm just not sure.
Any input is greatly appreciated.
Was your previous baby breech? (And if so, do you have any structural differences in your uterus that would make a repeat breech more likely?) My input would be to stick with the midwives and look into the optimal fetal positioning stuff on spinning babies. Also, remember that there are lots of ways to help a breech baby turn before labor (positioning, homeopathy, acupuncture, moxabustion, etc) I agree that water makes a HUGE difference and personally, I wouldn't want to birth anywhere that it wasn't an option even if the dr's numbers were good. just my 2 cents.
Will spinning babies help with overall positioning, not just breech?
I am hiring a doula who has attended over 50 births and had 3 VBACs of her own..I'm hoping she'll be helpful regarding what to do during labor to help with optimal positioning.
I really don't want to give up the option to labor and birth in the water, but I'm worried about regretting that decision if I end up with another c/s because the back-up OB couldn't deliver with forceps.
I would feel better if I knew there was something I could be doing to make sure baby was positioned well!
spinning babies has lots of great info on encouraging "optimal fetal positioning". Also, being in water can support baby's position to move into a good position to birth. In all honesty, forceps deliveries aren't all that common. As a doula I've seen an occasional vacuum assisted delivery, but never forceps so I personally wouldn't be too concerned about the ob not delivering with forceps. Also, being able to move in labor and to deliver in positions other than flat on your back will do far more to prevent a repeat c/s than the ability to have a forceps assisted delivery.