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Not a good candidate for a VBAC...agree?? - Page 2

post #21 of 39
A failed induction is not a contraindication for a vbac in subsequent pregnancies.

I suggest contacting ICAN to find a vbac friendly care provider.
post #22 of 39
Poor candidates for VBAC include:

1) women who through injury or illness have a deformed pelvic opening, the size or shape of which prevented the baby entering or exiting the birth canal (not you).

2) women who have had classical (belly button to pubic bone) T-shaped (hip to hip and bellybutton to pubic bone) or J-shaped (done to free an wedged breech or preemie) incision, or a woman who had a premature baby delivered by high transverse incision (side to side still, but the fundal part of the uterus is cut because earlier in pregnancy it is all lower in the pelvic cavity and there isn't "enough" low transverse area for a surgeon to cut enough to get the baby out) (not you)

3) women who have already suffered severe anal or vaginal prolapse following 4th degree tearing at a previous delivery (please note, pregnancy does as much to weaken the pelvic floor and ligaments as birth, but in a woman where prolapse has already occurred minimising damage may become a priority) (not you)

4) women who have placenta praevia (placenta over the inner os of the cervix) or placenta accreta (placenta growing into the previous section scar) (not you as far as i know)

5) women who are post-dates with a baby showing clear signs of distress (it is DANGEROUS to induce a VBACing woman, and to augment her - many of the US studies with high uterine rupture rates included cytotec - to put that in perspective a NON-VBACing woman who is induced with cytotec has the same risk of rupture as a VBACing woman who is not in any way induced or augmented - cytotec is dangerous). (not likely to be you - post dates is normal, the average first baby of non-induced women is born at 41.4 weeks gestation, true distress because of postmaturity is NOT common)

Please be aware that aside from women whose pelvis's are so deformed the baby can't get out (possible causes - past pelvic fracture, polio, etc.) all of the above are poor candidates but even that in itself does NOT MEAN THEY CAN'T VBAC it just means the risks are higher for them and their babies.

Your labour was induced before your baby wanted to be born. The doctors cannot make the baby be born except surgically your body and baby aren't ready. Labelling you "failure to progress" is akin to labelling a 3 week old baby with "failure to walk" - until your uterus is ready for labour (there is a massive increase in receptivity to certain hormones at the end of pregnancy - when the sensitivity is high enough labour can progress normally) it CANNOT work the way it's supposed to. Doctors cannot predict with accuracy who will be receptive and who won't. The Bishop score is a crude tool for a sensitive job.

You are an EXCELLENT candidate. Find care givers who care and you will do great.
post #23 of 39
I have the failure to progress label too! I never got past 6 and that's with starting labor on my own, water breaking on it's own - painful strong contractions for 8 days! AND.. I'm being give a chance at a VBAC. No one ever told me that I wasn't a good candidate! I'm seeing the same midwives (out of a hospital) that I saw last time!
Sounds like you should find someone else to handle your prenatal care and delivery!
post #24 of 39
I totally agree with all of these posts. and awesome that you got to 9cm in a hospital! the stress of all the people in and out, the clock, the fingers, the time... it's awful, isn't it?

My first vbac ended in c after a glorious 'bradley-style' labor because, in my opinion, it wasn't failure to progress, but my 42w 10lb 3 oz babe was posterior and asynclitic. His head was literally stuck, and they even tried manually going up there and grabbing him. *ouch*!

My second vbac attempt was only 15mos after my second c, so I was a bit concerned about a vba2c so soon after the last c... but I swore I would not consent to surgery unless it was medically necessary. I had a sweep done at 38w (btw, I had lots of sweeps done with DS above, and it didn't do much... ) and that night I labored at home expecting it to peter out, and finally gave in and went to the hospital - arrived at 10cm +3, and delivered via vba2c 35 minutes after we pulled up.

Positioning was sooooo important to me this time around. We didn't know my first DS was posterior or asynclitic, or over 10lbs, but with the last pregnancy, I made sure before pushing that everything was aligned as it should be.

Keep researching and get your confidence up. Challenge everything. Good luck!!!
post #25 of 39
I haven't read all the previous replies but I think in the end what really matters is do YOU think you are a good candidate?

If you do then go for it and don't let anyone talk you out of it based on airy-fairy concepts of who can and can't VBAC. If you have a serious medical issue that needs to be considered then by all means do but "not a good candidate because I just don't think you are" is a little silly.

If you do decide to go ahead with a VBAC I think it is ESSENTIAL that you find someone who supports you and believes in you and believes in the birth process. I made the mistake with my second baby of using an OB who "allowed" me to "try" a VBAC...I thought that was all I needed and ended up with another c-section. This time around I'm using a group of midwives and I feel SO much better about it. The difference between midwife care and OB care really is night and day. Keep in mind that if you go to an OB you are going to have a surgeon delivering your baby...they really do see things differently most of the time. (Of course there are exceptions to every rule...there are plenty of great OBs and plenty of medical type midwives).

Oh and as an aside I firmly believe that in the case of an induction that leads to c-section the Dr should have to take FULL responsiblity for that c-section...no taking the easy route and blaming the mother's pelvis or just her general inability to give birth!
post #26 of 39
Like all the PP already stated, you are an excellent candidate for a VBAC and do not let anyone tell you anything different.

Quick background on me:
Went into labor on my own. AROM at 1-2 cm. Epi. at 3 cm. All back labor. Spiked a high fever. Progressed to 10 and pushed for 3 hours with no progress. Baby was also posterior.

Was told by my former Dr. that I would never deliver vaginally....my pelvis was too small.

Will be having my 3rd VBAC late Oct./early Nov.

You CAN do this Mama!!
post #27 of 39
I was induced because the 37 week u/s showed a big baby. He wasn't,but that's another story.

Anyway, very similar story to yours, with a posterior baby, failure to progress, labored flat on my back for 12 hours. Everyone telling me it was the shape of my body and big baby that made birth impossible for me.

I did a LOT of research and found a new hospital and doctor,since a midwife is not an option in my area. Was told constantly that my body would not support a vaginal birth.

I labored at home as long as possible with a doula. Showed up at the hospital fully dialated with baby nearly crowning. STILL got lectured by the staff for my dangerous behavior of not being in the hospital and accepting the interventions. Delivered naturally my 8lb boy 30 minutes later with no complication or drugs! Then got lectured the whole way to the recovery wing about my reckless behavior of trusting the process and my body.

Even with an example before them of a relaxed, uncomplicated pregnancy and uncomplicated delivery, I still couldn't get any support from the hospital. But who cares? I knew, my doula knew, and my husband knew we were making rational, sound decisions.

IF you want to labor and trust your body, then you have to study up on the facts and be assertive. Try to find a supportive provider, but never give your power away to make good decisions for yourself.

Just as a note, I did have a backup plan in case of complications. I knew as many of the signs of labor problems as I could, and made sure my doula and husband knew too. So if there was any sign that more medical help might be needed, we had a plan for getting that help. I made my peace in case another c/s was needed. I just made sure that it was a final resort, and not a first convenience for the doctors.

Know thyself and trust thyself. Hang in there!
post #28 of 39
I agree with everyone here!

GO HAVE A VBAC!!!!!
post #29 of 39
I think you'd be a fine candidate for VBAC. Anecdotal evidence, I know, but I labored more than 60 hours with a posterior baby before he finally decided to come out.(incidentally I was also induced!)
I had a CS with baby # 3 for breech, CBAC with baby #4(failed induction by an OB who let me "try" a VBAC) and VBACed baby #5 after 2 C-sections and 92 hours after spontaneous ROM. The last time, I can honestly say, I did it MY WAY and I felt like superwoman, lol!
Find a supportive care provider and go for it, if VBAC is what you want!
post #30 of 39
I have 3 quotes for you

"I've come to realize that a God who is big enough to so perfectly form little eyes and ears and a little round nose and a heart and lungs and every single part of a little person is certainly big enough to work out the details of their coming into the world."
-Vicki in Mars, PA

"Always listen to experts. They'll tell you what can't be done and why. Then do it."
-Robert Heinlein

"Of course the game is rigged. Don't let that stop you - if you don't play, you can't win."
-Robert Heinlein
post #31 of 39
Hugs to you mama! Congrats on the new babe-to-be.

Find a supportive care provider, ask as many questions as you can irl and here, and trust yourself... from your story it sounds like there is no reason for you to have a surgical birth.
post #32 of 39
Thread Starter 
Thanks again all!
I had an appt with my mid wife tonight and I think I will look into other options/seek a second opinion.
She told me that I have to talk more and negotiate with the OBs about what they are comforatable allowing me to do.
She also said that her gut told her that there was some reason that my son didn't fit...so it is her gut instinct telling her that I am not a good candidate for VBAC.
She also mentioned that she has seen 4 uterine ruptures and I have to bring up the risks associated with a c/s.
post #33 of 39
Sounds like your HCP had a case of failure to wait....

I too had an induction that led to a section...and was told I was not a good candidate for a vbac...of course that was by the doc who performed the section...


I found a supportive loving wonderful hcp, I read, I went to a therapist, I meditated, I labored and I pushed my baby girl out of my vagina...It was the very best day of my life

I encourage you to listen to your intuition and to get clear about what you want and then find the right birth team to make it happen

sending light and congrats on your new wee one
post #34 of 39
Quote:
Originally Posted by lisat77 View Post
She also mentioned that she has seen 4 uterine ruptures and I have to bring up the risks associated with a c/s.
No way. Isn't the risk of uterine rupture (even with a previous c/s) less than 1%? How long has she been practicing, or how many babies has she delivered, that she has seen 4 ruptures?!

Also, why do you have to debate it with the OB's? Isn't the midwife your care provider? : I would definitely see if you can find someone else.
post #35 of 39
Four uterine rupture rings warning bells for me too! Though she may be refering to a decade or so ago when inducing vbac mamas was more common... the UR rates were through the roof (relatively speaking) when mamas had classic incisions and induced vbacs.

If she has had that sort of experience I don't blame her for being very hesitant... but it's also not a health attitude in today's birth climate, and not an attitude she needs to be putting onto vbac mamas. She may do better (for herself as well as for the women she attends) if she only attends very low risk mamas until she regains her own confidence in birth.

Hugs to you, and happy birthing!
post #36 of 39
I just wrote this is another thread, but there are only 4 reasons for a c/s on the papers they use here. I was marked at FTP despite getting to 10 and pushing for 1.5 hrs. Like someone else mentioned, my baby was asynclitic and was not moving, even w/ some forcep help. I went on to have 2 VBACs, the first one was 18 mos after my c/s. I've planning on VBAC #3 in Jan/Feb w/ the same OB who did my c/s. I was even induced w/ my last VBAC, but my body was much more ready to go. I had a forced induction w/ my oldest, as in I was only like 1cm and he was still -3 station, nowhere ready to come out. W/ Ilana I was 4cm, 0 station I think, and was contracting on my own, it was an entirely different process!
post #37 of 39
Quote:
Originally Posted by keeptryst View Post
I have 3 quotes for you

"Always listen to experts. They'll tell you what can't be done and why. Then do it."
-Robert Heinlein

"Of course the game is rigged. Don't let that stop you - if you don't play, you can't win."
-Robert Heinlein
Side note I love these 2 quotes!!! I'm going to keep them in mind now with my VBAC pursuit!!
post #38 of 39
Quote:
Originally Posted by lisat77 View Post
Thanks again all!
I had an appt with my mid wife tonight and I think I will look into other options/seek a second opinion.
She told me that I have to talk more and negotiate with the OBs about what they are comforatable allowing me to do.
She also said that her gut told her that there was some reason that my son didn't fit...so it is her gut instinct telling her that I am not a good candidate for VBAC.
She also mentioned that she has seen 4 uterine ruptures and I have to bring up the risks associated with a c/s.
*sad sigh* I hate hearing this from a midwife. My midwife fed me the same lines. The fact is that she really doesn't know whether your baby would have fit b/c you didn't push.

My midwife said the ob "checked" my pelvis during surgery and said I had an oval shaped pelvis and a thick sacrum which would never allow the passage of a baby. The 2 other midwives said I could have a trial of labor but I couldn't labor as long, I needed to wait a year to get pg again and I had to go into spontaneous labor by 41 weeks.

My one midwife has seen 2 UR. One was in a mom who NEVER had a c-section or uterine surgery. The other was in a vbac attempt when mom got pg withing a year of her c-s.

Ask your midwife if the URs were all in VBAC attempts and whether pitocin or labor induction agents were used. That will increase your risk of UR.
post #39 of 39
Quote:
Originally Posted by lisat77 View Post
Thanks again all!
I had an appt with my mid wife tonight and I think I will look into other options/seek a second opinion.
She told me that I have to talk more and negotiate with the OBs about what they are comforatable allowing me to do.
She also said that her gut told her that there was some reason that my son didn't fit...so it is her gut instinct telling her that I am not a good candidate for VBAC.
She also mentioned that she has seen 4 uterine ruptures and I have to bring up the risks associated with a c/s.
She said that your son "didn't fit"? Didn't fit where? You weren't fully dilated! There was no fitting or not fitting, you weren't ready to push. Even if you ignore the fact that the labor wasn't something you and baby created, she's missing something big in there, to say something like that.

I'd run screaming from someone who had seen 4 ruptures....I don't want that person touching me!
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