would this make you switch providers? - Mothering Forums

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Old 01-29-2009, 10:36 PM - Thread Starter
 
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My OB today told me she NEVER lets a VBAC mama go past 40 weeks. Since she doesn't induce, it would be a rcs, which I DO not want. :
Should I try to convince her to let me go past, as long as we do fetal non stress tests, etc, or should I think about switching? I'm 29 weeks now and our fees are already paid by my husband's work, so It would be kind of a hassle to switch now, but if switching is the only way to VBAC, I am going to do it.

I am determined to VBAC since this is probably our last baby, and i want to experience birth, like I should have the first time!!!!
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Old 01-30-2009, 01:03 AM
 
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Yep, I'd switch providers. A truly supportive VBAC provider will likely want to keep an eye on you and the baby with nonstress tests or biophysical profiles after 41 weeks or so. Also, if you're nearing that 42 week mark, a truly supportive VBAC provider will talk with you about foley bulb induction or even a membrane sweep if you really want to avoid an automatic cesarean at 42 weeks. Some VBAC providers will even consider a very gentle pitocin induction; VBAC moms differ on whether they would accept the pit or just for the cesarean...
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Old 01-30-2009, 01:05 AM
 
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My doctor told me on my first visit that he NEVER lets pregnant women go past 38 weeks. The more I went there and the more we talked I guess he realized that I was aware of the 'dangers' of a VBAC and that I did my homework. He agreed on letting me go 40 weeks and in the end he cancelled the repeat c/s and gave me a chance with a very slight induction with pitocin and eventually ruptured my membranes. So, there are doctors who do change their mind but I must say that I was very lucky to have such a support system (another OB, who was more open to VBAC, doula and a head nurse who had a VBAC before) backing me up.

If she won't listen to you or not give you a chance at all..I think I would switch and I know that is easier said than actually done.

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Old 01-30-2009, 01:22 AM
 
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I'd ask her for a citation for proof that this is the most accepted medical model through the ACOG. Here's a link to the study *I* am thinking of, but it's eight years old, http://findarticles.com/p/articles/m...36/ai_77377549

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Old 01-30-2009, 02:35 AM
 
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I'd talk to her again...then depending on what she says...consider it. My doctor at first was saying we'll schedule a c/s for 40 weeks...but this was before she realized that I wasn't just wanting to "try" a VBAC, I "WANTED" one more than anything. So then her statement was we'll go up to 41, but if you still haven't had her, we'll access with u/s and testing and so on to check on baby.

If you do switch, which may be a good idea if your doctor is behind what she initially told you...don't worry about the money situation...it will work itself out. I'm sure you will owe them something for the prenatal care visits, but they can't keep your money that is owed to you!!!! And like you said, it will be worth it to get your VBAC!

Me (30), DH (31), DS (3.5 yrs - 5/07), DD (1.5 yr - 2/09) via VBAC!!! DS (newborn - 11/10) via natural VBAC! 2 angel babies - 06/06 & 04/08
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Old 01-30-2009, 02:57 AM
 
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yes, i would switch.

Christine, mom to C(7.5) - E(5) - J(3) - B(10 mos)

Doula, childbirth educator, Co-leader of ICAN of Atlanta

 

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Old 01-30-2009, 05:14 AM
 
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I switched at 30 weeks because my doctor talked about scheduling a c-section even though we talked at length about VBACs.

I found a great midwife whose attitude toward birth and VBAC was more supportive. I gave birth in a hospital with her and successfully VBAC'ed.
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Old 01-30-2009, 01:54 PM
 
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I wouldn't continue seeing a doctor that didn't practice evidence based medicine. I also wouldn't continue seeing a doctor that told me what she would and would not "let" me do with my body. I would switch now because I don't feel like it's worth fighting about during the last weeks of pregnancy or during labor.

I know it's hard to switch. With my 1st VBAC I switched providers when I was about 25 weeks, after the hosptial I was supposed to go to changed it's policy and wouldn't "allow" a trial of labor. I went with a great group of midwives that worked with an OB and had a relatively intervention free hospital VBAC. It was completely worth the stress of switching. For my next baby, and this one due in April, I decided on homebirth, which was way better than the hospital.
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Old 01-30-2009, 07:02 PM
 
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Not sure what others have said but yep, I would absolutely switch. Your red flag obviously went up and a blatant statement like that from your DR shows that she does not have a lot of faith in nature to do what it needs to when it need to. Which means she is probably high intervention too. SWITCH. I went over 42 weeks with my VBAC attempt and that last week was stressful HELL from all the pressure from DRs I was getting to be induced. Eventually I got scared (was told "fetal death" would occur) into an unnecessary induction which turned into an unnecessary c-section. My son was born very healthy-no meconium or any sign of "suffering" from his 42 week gestation.
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Old 02-01-2009, 02:56 PM
 
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The word "never" certainly would worry me. That tells me she's not adapting her medical care to individual patient circumstances.

And the word "let" isn't so fabulous either. That may be a sign she doesn't really consider you part of the decision-making process about your own medical care.

She COULD have said: "I'd be concerned about waiting past 40 weeks for X and Y reason, so at that point I may recommend a repeat c/s" which would still be total B-S but would at least indicate that she is operating rationally and leaving some room for discussion.

Definitely ask around and see if you can get any recs on VBAC friendly care in your area (a local ICAN chaper or the MDC tribal area could help). A consultation with an alternate provider is just an initial step - you can always stay where you are if the alternative isn't any different. Are there any midwives around you? They are much more likely to have patience with waiting for a VBAC.
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Old 02-01-2009, 03:30 PM
 
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Yes. Switch. Yesterday.
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Old 02-01-2009, 09:36 PM
 
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IMO a truly VBAC supportive OB wouldn't talk about RCS. Unless it was an emergency.
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Old 02-01-2009, 09:53 PM
 
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IMO a truly VBAC supportive OB wouldn't talk about RCS. Unless it was an emergency.
Yeah that. Mine has never brought up a repeat c, not even when my son was in a very bad transverse lie for so long. Switch, you'll be glad you did and it will be very worth the hassle.
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Old 02-01-2009, 09:55 PM
 
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I'd switch too.

Good luck!

Jen, L&D RN, CBE, CLEC who loves to knit.gif! I adore my modifiedartist.gifDP, treehugger.gifDD 10/98, & sweet new babygirl.gif5/10!!!
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Old 02-02-2009, 04:09 AM
 
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not to derail the thread, but what does a woman do if she can't switch... or like say she got fired at 30 wks by the *only* OB anywhere close that 'allows' vbacs at all... ?? No midwives...no vbac friendly docs anywhere within hours... I've made up my mind to freebirth now and I'm comfortable with that, but I know many women would not be and I just wonder what their options are.
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Old 02-02-2009, 05:31 AM
 
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Originally Posted by elephantine View Post
not to derail the thread, but what does a woman do if she can't switch... or like say she got fired at 30 wks by the *only* OB anywhere close that 'allows' vbacs at all... ?? No midwives...no vbac friendly docs anywhere within hours... I've made up my mind to freebirth now and I'm comfortable with that, but I know many women would not be and I just wonder what their options are.
I would do it by myself.

For the OP, I would switch providers.

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Old 02-02-2009, 11:43 AM
 
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not to derail the thread, but what does a woman do if she can't switch... or like say she got fired at 30 wks by the *only* OB anywhere close that 'allows' vbacs at all... ?? No midwives...no vbac friendly docs anywhere within hours... I've made up my mind to freebirth now and I'm comfortable with that, but I know many women would not be and I just wonder what their options are.
If you are not comfortable with UBACing, and you have exausted every midwife outlet ( including traveling midwives), you can always try the farm.
Farm won't work, LOOK FOR A FAMILY/GENERAL PRACTITIONER.
Don't run to a surgeon first, gp/fp can catch babies too, and sometimes they tend to be more on the crunchy side. There are even those who do it at home ( shhhhhhhhh don't tell anyone ).
If after all that and no go, then take an OB, BUT, get OB to sign stuff, before you go into labor, make it clear that you WILL NOT ACCEPT BULLYING. You wouldn't take crappy advice from an accountant would you, make it clear you won't take crappy advice from the OB. Have OB SIGN a birth plan, turn this into a legal issue. I know it sounds more stressful than something you would want to go through but it will be less stessfull than being pushed into an OR again.

I pray all mamas will someday get the care they need, not what drs. want to provide.
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Old 02-02-2009, 12:41 PM
 
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If you are not comfortable with UBACing, and you have exausted every midwife outlet ( including traveling midwives), you can always try the farm.
Farm won't work, LOOK FOR A FAMILY/GENERAL PRACTITIONER.
Yes I had a relatively old school family practice doc attend my hospital VBAC - it was fabulous!

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Old 02-02-2009, 04:03 PM
 
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OP: I think I would talk seriously with my OB about my desire for VBAC and her "rules." I did that with mine (I told him if he did not support my VBAC then I would be switching) and, after the conversation, he did change his tune given that he knew I had done my research, knew the risks, etc and still WANTED to VBAC. If OB is still demanding/you do not have a good feeling, I would switch.
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Old 02-05-2009, 06:51 PM
 
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I did switch providers for that. It was especially important for me because what she'd calculated as 40 weeks, I had calculated as 39 weeks. DS was born at 38 weeks, so I turned out to not matter, but we couldn't have known that.
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Old 02-05-2009, 07:35 PM
 
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Yes! I would def. switch.

My MWs induce VBACs at 42 weeks (naturally first), much better than a RCS at 40!

Taryn-31 Crunchy Conservative Catholic SAHM with DH-32
DS 7.5, DD 5 (vbac), DD 2.5 (vbac), and DD 12/30/13 (vbac)

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Old 02-05-2009, 07:39 PM
 
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Yes, I would switch.
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Old 02-05-2009, 08:45 PM
 
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not to derail the thread, but what does a woman do if she can't switch... or like say she got fired at 30 wks by the *only* OB anywhere close that 'allows' vbacs at all... ?? No midwives...no vbac friendly docs anywhere within hours... I've made up my mind to freebirth now and I'm comfortable with that, but I know many women would not be and I just wonder what their options are.
If there were absolutelyno midwives that would come to me (some will cross state lines!), I would go to them. I would do whatever it takes, including getting a bus ticket (I don't own a car) and riding across the country to have a VBAC.
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Old 02-05-2009, 09:06 PM
 
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If there were absolutelyno midwives that would come to me (some will cross state lines!), I would go to them. I would do whatever it takes, including getting a bus ticket (I don't own a car) and riding across the country to have a VBAC.
I don't think most people would have the finances to do this... and what about your other kids? I personally would have no one to watch them for that amount of time. Great if one could manage it, but I'm glad I would prefer UC over any midwife I have met because I simply could never be able to afford one.
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Old 02-06-2009, 12:49 AM
 
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I don't think most people would have the finances to do this... and what about your other kids? I personally would have no one to watch them for that amount of time. Great if one could manage it, but I'm glad I would prefer UC over any midwife I have met because I simply could never be able to afford one.
Bus tickets are cheap. I'd take my kids with me. We'd stay in a motel. I'd sell all of my stuff to afford it if I had to. I'd do anything to not have another hospital birth.
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Old 02-06-2009, 01:03 AM
 
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Bus tickets are cheap. I'd take my kids with me. We'd stay in a motel. I'd sell all of my stuff to afford it if I had to. I'd do anything to not have another hospital birth.
Not to beat this to death...but.. that sounds like pure hell to me... then I could go take my kids and a newborn and live in a homeless shelter b/c we would be completely destitute. If anyone were as zealous as all that, why wouldn't they just UC? Who's to say you wouldn't be traumatized by this long distance midwife and end up being transferred anyway? How could you really know or trust this person?
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Old 02-06-2009, 01:06 AM
 
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Not to beat this to death...but.. that sounds like pure hell to me... then I could go take my kids and a newborn and live in a homeless shelter b/c we would be completely destitute. If anyone were as zealous as all that, why wouldn't they just UC? Who's to say you wouldn't be traumatized by this long distance midwife and end up being transferred anyway? How could you really know or trust this person?
Because I'm not comfortable with UC. If you are, then that is your choice. This is mine. I'd rather run the risk of being traumatized by a midwife than be definitely traumatized in a hospital.
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Old 02-06-2009, 01:17 AM
 
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Because I'm not comfortable with UC. If you are, then that is your choice. This is mine. I'd rather run the risk of being traumatized by a midwife than be definitely traumatized in a hospital.
Fair enough... though as it stands my choices are 1)non vbac friendly hospital(no friendly ones exist anywhere near where I live), 2)UC or 3)selling everything I own and abandoning my lease to travel to a midwife in one of my surrounding states

I guess for a lot of women those would all be pretty crappy choices, but for me the choice is clear.
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Old 02-06-2009, 01:22 AM
 
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Fair enough... though as it stands my choices are 1)non vbac friendly hospital(no friendly ones exist anywhere near where I live), 2)UC or 3)selling everything I own and abandoning my lease to travel to a midwife in one of my surrounding states

I guess for a lot of women those would all be pretty crappy choices, but for me the choice is clear.

I wouldn't abandon my lease or sell everything I own. I would just be gone for a few weeks, maybe a month tops. And I sold a LOT of my stuff to fund my HBAC. I had some collectibles that were worth money. I sold superfluous electronics I don't need anymore. I sold a lot of my clothes. I sold off some of my fabric stash. I made a lot of mama cloth and sold it. I raised all the money for the HB pretty much singlehandedly. I could do it again.

All of this is just speculation anyway because I am lucky engouh to have lots of midwives in this area, so I don't need to travel.
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Old 02-06-2009, 01:30 AM
 
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I wouldn't abandon my lease or sell everything I own. I would just be gone for a few weeks, maybe a month tops. And I sold a LOT of my stuff to fund my HBAC. I had some collectibles that were worth money. I sold superfluous electronics I don't need anymore. I sold a lot of my clothes. I sold off some of my fabric stash. I made a lot of mama cloth and sold it. I raised all the money for the HB pretty much singlehandedly. I could do it again.

All of this is just speculation anyway because I am lucky engouh to have lots of midwives in this area, so I don't need to travel.
oh, well I'm divorced and living well below the poverty level right now and don't have much as it is so I guess it is all relative.
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