Advice..what would you do?

[kittymac]

Okay, here's my dilemna. My goal and biggest wish is to have a HBA4C.

Two months ago, I found a mw who was willing to help me. She is very nice, but several things have changed.
She is about 45 minutes away by car, but since I take public transit, it takes me 2 1/2 hrs to get there. She told me from the beginning that she wanted me to go there for appointments, so I deal with the inconvenience.

Now, however, she told me that she thinks I am too far away, and won't come here for the birth. She said she found an OB at Mt Sanai in downtown Toronto who will let me have my VBAC there. She would come with me, but would only be an unofficial support person.

I really wanted to avoid being in a hospital if at all possible. She would like me to meet the OB and discuss it, but I kind of feel that with all this backpedaling, what'll it be next?

Thing is, I really don't know that I can find another mw. I contacted several before I found this one. So, these are the options I think I have.

1. go to the hospital she suggested and try to birth there.
2. labor at home with a doula till ready to birth then go to local hospital
3. have an unassisted childbirth

Sorry so long. Are there any other options anyone can think of? What would YOU do if you were me? Thanks for any advice.

Shelley

[Stayathomemommy]

oh my gosh,,,,,,,whats her reasoning for backing out on you?? thats horrible on her part. she made a commitment.

i would work really hard to contact every known midwife and beg!! then i would talk with the DR. she is talking about if you cant find a mw and then worst case, stay at home for as long as possible and if the birth goes well enough stay at home and have it unassisted but if you feel like you need help you know you can go into the hospital with the doc and mw who you have already met??

[Emmy142]

Is the climate changing with VBACs in Canada? I had previously thought that they were much more supportive of VBACs then the US but recent postings it seems that the climate is getting much uglier.

I agree with the above poster, I would be calling every MW in the book and if they won't take you, see if they can recommend someone who will or if they can recommend another resource. You might want to call around and talk with some Doulas and see if they know of any MW who might work with you.

If none of those pan out, I might meet with the OB and see for yourself what you think of the doctor and the hospital. If you don't like the OB then I would probably do number 2.

I'm so sorry that your MW backpedalled on you. How awful!

[scatterbrainedmom]

you should call all the midwives you have already talked to earlier and tell them about your midwife backing out. one may be willing to take you on to "spite" the other one.

my mw will not take on clients that smoke, but made the exception about a year ago. there was a mw that was notorious for backing out half way through, fatalities, etc..so she took on the smoker after the other mw dumped her.

[misseks]

Hi I'm in Vancouver, so I just wanted to say that Canada does seem t be more supportive of VBACs than the US, but maybe not VBA4C...

My two cents is that you should meet this OB, find a supportive doula and labour at home until/unless you think need to go to Mt Sinai. At least if you meet the OB you won't be walking in to emergency and not have a contact there. But, I would definitely keep salt in your ears while s/he blah blahs about all the dangers.

Sometimes I think that the problem with docs is that they want so much to help that they forget that sometimes doing less is more. LIke parenting...you need to guide, but not push. KWIM?

I'm sending lots of hugs and support your way. If I were closer, I'd come advocate for you!

Kate

[kittymac]

Most dr's in the larger areaas of Canada are fine with 1 and sometimes even 2 cesareans.

I think they need to educate themselves more on VBA2+C however. Statistically, I'm not really at much more risk than someone who has only had one cesarean.

As for midwives, Ontario is one of the only provinces where midwifery is recognized. Unfortunately, they are pretty heavily regulated. Many won't even take on a woman with 1 section. I'm not giving up, but it sometimes gets really discouraging. :(

[Natabimic]

omg, that's just messed up but I know the feeling when I was attempting a vba2c i had a midwife all the way up to 32 weeks and she told me that no one would clear me for a vbac and that she wouldn't do it unless she had a doctor's clearance, etc.. so she even gave me a referral to an OB who first did his career as a plastic surgeon and now advertises his tummy tucks while performing c-sections.. :o and "hey at least you'll get a nice 3-D ultrasound" oh yea way to go I get a nice 3D ultrasound and a big ole scar on my uterus :thumb :irked: but whatever, I know the feeling and all I can really tell you is I regret the choice i made, on the first sign that something was hurting me on my incision site i went to the hospital and got sliced, I wish I would've waited just an hour more before making the decision to go to the hospital, my advice to you is ( from a very frustrated and hurt self here) you won't lose anything with going to the doctor, and meeting him, if you feel at the end they're both going to turn on you and suggest a repeat cesarean, stay home the longest you can with a doula and then either show up at the last minute if you don't feel comfortable with the idea of birthing at home, or if everything is going smoothly and you're already at teh pushing stage, might as well stay home and finish birthing at home, kwim?? my thoughts are with you, sending you lots of good midwives who will stay by your side vibes...PM whenever you want to talk.. :wink

[MuhajibahMama]

Have you contacted the Riverdale Community Midwives? I don't know for sure what their position is on VBA4C, but I know they support HBAC and they will take out of area clients. They just attended my HBAC and I am in Mississagua.

[cathicog]

Most dr's in the larger areaas of Canada are fine with 1 and sometimes even 2 cesareans.

I think they need to educate themselves more on VBA2+C however. Statistically, I'm not really at much more risk than someone who has only had one cesarean.

As for midwives, Ontario is one of the only provinces where midwifery is recognized. Unfortunately, they are pretty heavily regulated. Many won't even take on a woman with 1 section. I'm not giving up, but it sometimes gets really discouraging. :(
I would do what the pps said about finding a mw(I would plan a homebirth with one), then meet the OB, just to say you met him, and to cover *your* backside, then prepare for a UC *if* you are comfortable with that, and you are prepared for a homebirht. If you have a doula, she could help you at home before you go(if you want to still go to the hospital-but I am sure you know they will probably plan to send you to OR the minute you get in the door), and if the labor goes really fast, everything is usually fine. Just make sure you get a doula that has actually assisted at a birth before and is comfortable with that. I know they aren't really trained to catch, but they should at least know what normal is, if the birth is fast. I know a couple doulas who *have* had to catch, since the labor was only about 45 min long, start to finish! :)

[GatorNNP]

I can tell you what I would do because a similar thing happened to me. My homebirth MW lost her OB backup and without it for legal reasons could not attend me at home (without risking loss of her insurance) I would not have asked her to do it, although her partner was like just do it anyway. I hired her to be my doula and she came to my home for early labor, then we (my doula, mom, sister, husband, and son 23 mos) went to the hospital. Then a couple close pals arrived after that to the hospital. They were my support team and I can honestly say it was very homey. I felt pretty comfortable with the situation. The OB was supportive ( my new MW ended up taking a couple days off for thanksgiving!) and the nurse was supportive. I think what made the biggest difference was all the familiar faces and they all new my wishes as far as birth plan. So I would say bring your doula to the hospital.

[Storm Bride]

re: VBAC in Canada. My OB told me, in the course of a conversation about something else - "overdue" babies, I believe - that the US is "more conservative" (ie. intervenes earilier and more aggressively - interesting use of the word "conservative", imo) than Canada, but that we usually follow the US lead. So, if we're currently more VBAC-friendly, don't count on it lasting. My OB and FP were very supportive of my desire to VBAC, until dd turned footling breech. But, they weren't supportive of a VBA2C...that extra cut caused them to treat me like a ticking bomb.

[kittymac]

Thank you for all of your replies. Last week I actually went to see my family dr. He has been very supportive of me having a vbac, but he does not deliver babies.

I explained my situation and asked him what he would do. He made some phone calls and found an OB in my hometown who he says is willing to let me go for a VBA4C. Apparently, all I have to do is sign some informed refusal papers or something and they will be all for it. I am meeting with them on the 22nd of Feb.

I kind of have mixed feelings about it. On the one hand, it's good to have someone who it seems at least is going to support me. But I am scared of a hospital birth. I am so afraid I'll have tons of interventions pushed on me.

I am seriously thinking of seeing the new local OB and keeping my options open.

Then hiring a doula and laboring as long as possible at home. I will prepare myself for an UC in case I decide to go that way, and if not I'll leave for the hospital when I am pretty far along. At least I know if I have a local OB support, they can't try to force a cesarean on me once I arrive....or I hope not anyway.

Does this plan sound logical?