After the PROM at almost 20 wks got cleared up, I really haven't had ANY activity. These last few days have been totally different. I have been having several BH ctx a night, and even a few more than that some nights. It seems like she is about ready to come out, but with my history, and being dated by U/S this time, I expect to be 10 days late, give or take a few. Since this WAS a twin PG, it may be a little shorter than that. My last PG, also a lost twin in the first trimester, he came only 15 days late per my LMP. U/S seem to be more correct for me though.
Okay, so my BP has been pretty leveled out. I was concerned that it was going up more than it should, but my CNM MW wasn't concerned. I wasn't getting worse headaches or spots, and swelling has been very minimal if any. So, I relaxed about it, and life has been very good.
But, then, I went for my weekly check, and the MW told me that her overseeing OB was no longer there, and she is covering all the patients. I did ask about being induced to assure my husband's presence (he is a trucker, OTR p/t), but she said they aren't allowed to do that anymore. I know that an RCS is always an option, but I am pretty sure that I said no thanks to that. She asked if I wanted a courtesy visit with her new OB. No prob. She did talk to him about me, and when I went in, thinking this was just one visit, he tells me that she is unqualified to attend me, I am high risk (WTH???? after 6 VBACS??), and he is her boss. If I wanted a referral 1.5 hrs away, he could do that for me. I go very fast once I know it is really labor. It can be less than that for me to go from 2 to finish. And, I don't think my insurance goes any further east. I told him no, and he said that if I was staying with our NO VBAC hospital, he was it. This is the first time that I am told that I cannot plan a VBAC in that city. My MW and OB had both said to come late, but I didn't think much of it.
Long story short, although I made an appt a week later, I cancelled it 2 days before and fired him. I finally got a call back from the MW after a full week I had been calling. I know she is swamped, but geez. This is the same MW that attended me in that same hospital almost 4 yrs ago, when we were going UC, but ended up with 90 hrs of PROM and meconium with no OB back up. They said no problem to a VBAC, and I was only at a 2cm walking in at 8am(nervousness stalled things). By noon I was at a 4cm and not overlly in pain or anything, just regular ctx, but I told her to be back in an hour-hour and half. My DD was born 1hr27min later. The OB had gone to surgery, the MW went to pump for her infant. Their staff was excellent. I even bragged about that hospital on several groups and forums. Now they are adamantly no VBAC, with this OB anyway. I guess they need to pay for their new birthing suite, and figured ERCS are the best way to go. I didn't even get a chance to ask him if he was going to watch my 7 kids for 3-4 days while I am in the hospital, or pay the HUGE OOP costs that I would have, having surgery and recouping there for so long. He pretty much said that this hospital isn't safe to have a VBAC in, and nor is the MW competant to do it. What changed?
I tried to get into my friend's OB in the city an hour away, since that hospital DOES do VBACs (never knew that there was any hosp around that did), but I am too far along. They wouldn't take me on. So, if I feel like my BP has gone whack, or something else goes wrong before the baby comes out, I can walk into that VBAC friendly hosp, but will have to take whatever OB is on call. I can go so fast, and we are just too far away (and with my history of PPH and this being a lost twin PG), we will stay at the hotel near the hospital and see where it goes from there. I do have PPH remedies, so I may UC just fine. I have UCed several times before, but I was mostly planning a hospital birth for this one for the PPH thing alone.
Well, if you have gotten this far, thank you. I am just so to have this put on me at my advanced stage, and they should be ashamed of themselves. My DH was mad because we have already given so much money to these people that would do such a thing. And, the OB being onhery with me. Shouldn't it be a little more "the customer is (almost) always right", since I pay the premiums, copays, etc. And, he gets to send his kids to college because we do? It would have been really nice if the MW would have been more up front about the whole thing. She and the OB were trying to stay under the radar, about supporting VBAC in a no VBAC world, but if I had known that was the case, I may have looked for a more VBAC friendly hospital so I didn't have to fight for my birth (again). At least I would have had some choice. Maybe she thought we were planning a HB anyway, but if I had been, why would I have even bothered them every month, then every other week, to weekly visits???? I would have just UPed as we had done before. And, they knew all that. We felt that more than likely we would be planning a hospital birth. Now, I have been thrown into UP/UC world without really my choosing.
Thanks for listening. And, know that if you live anywhere near the Kansas City area, that Centerpoint Hospital in Independence is the only VBAC hospital around. Kymberli
FWIW, I think it is hard for doctors and MWs who want to support VBAC in the US. They need to be so careful, and can't say too much. The whole situation is completely crazy as far as I can see.
Happy to be a mommy and teacher to D , born 1-17-06 via and A , born 10-6-08 with a
Menorah Medical CenterOverland ParkKansasAllowed
Overland Park Regional CenterOverland ParkKansasAllowed
Providence Medical CenterKansas CityKansasAllowed
Saint Luke's South HospitalOverland ParkKansasAllowed
Shawnee Mission Medical CenterShawnee MissionKansasAllowed
University of Kansas HospitalKansas CityKansasAllowed
Research Medical CenterKansas CityMissouriAllowed
Truman Medical Center Hospital HillKansas CityMissouriAllowed
St. Mary's Medical CenterBlue SpringsMissouriAllowed
Centerpoint Medical CenterIndependenceMissouriAllowed
North Kansas City HospitalNorth Kansas CityMissouriAllowed
Again, I didn't limit my search to strictly the main area, I went a little further north, south, east and west, since I don't know exactly where you live.
ICAN created a database this summer, by calling around to all hospitals they could find with an L&D unit to determine if they allow VBAC's, Ban VBAC's or have a Defacto Ban on VBAC (means they don't ban them, but they don't have any OB/CNM who support them either, or they had really really really restrictive policies to which it was basically impossible to VBAC.)
These hospitals BAN VBAC
Kansas - couldn't find any in the area.
St. Luke's Northland HospitalKansas CityMissouriBanned
These hospitals have DeFacto Bans:
Kansas - couldn't find any in the area.
Saint Luke's East - Lee's SummitLee's SummitMissouriDe Facto Ban
Truman Medical Center LakewoodKansas CityMissouriDe Facto Ban
Here is a direct link to ICAN's web page that tells about the calls made, and what each of the three categories mean. At the bottom of the page, you can click on Allow/Banned/DeFacto, then once on the page, you can click on the individual hospital and read through the notes/comments from the callers who made the calls.
Anyway, it doesn't matter. My BP did get whack and I did go to Centerpoint, because I tried to get my care transferred, and couldn't. My friend had been there before, all the way from where she was, amazing. She has had 8 VBACs, many induced. I have never been induced. They were very kind to me, they kept me for about 80 hrs (but would have released me sooner if DH's work didn't mess him up). I requested to come home and they let me, even at 12 days overdue, BP issues but got better while there, baby looks great. I wanted to wait it out over the holiday weekend, and I am still PG, with snow coming again. We live an hour away in a tiny town where they don't clear roads. So, we may take a hotel closer to wait the snow out and see if labor hits. I don't think that I will feel comfortable at our house with bad roads to go into labor if there is snow. I don't think it is going to be a storm, as the weather channel hasn't said anything, but that we are expecting SOME. Mostly on Sunday.
They wanted me to be induced (two dr were okay with it), they were all okay with waiting since although my BP is bad, I don't need meds yet. And, of course, some were ok if I wanted an RCS. I had made that apt for Thurs, but I had gotten so much better, no pre-e and baby great, thatn I just asked to go home and the dr that took me on was totally okay with strict stipulations. STRICT bedrest, DH available at all times, etc.
I really had considered just cutting my losses and doing the RCS, but then I read the paper, and realized that unless there is med indication, I really don't want to go that route. I am very impressed with the dr I got. The nurses were more amazed that they let me walk out at 12 days overdue, 14 today. It doesn't seem labor is on the brink really, but I would think it would be considering all the things I have added up. It may just come on sudden.
So, thank you ladies. The dr did try to say that at a 7th VBAC, my risk is higher. Interesting that he would pick my number, but I cannot find anything online to support that. There surely hasn't been any studies on that. My friend has had 8, induced on some, so I think that proves something. Kymberli
And you're technically not overdue until tomorrow.
Momma to DD (12/04) and DS (11/09) .
I survived 16 mos! Ask me about breastfeeding a baby with posterior tongue tie, high palate, and weak oral motor skills- whew!
So, thank you ladies. The dr did try to say that at a 7th VBAC, my risk is higher.
The study's OBJECTIVE: To estimate the success rates and risks of an attempted vaginal birth after cesarean delivery (VBAC) according to the number of prior successful VBACs.
METHODS: From a prospective multicenter registry collected at 19 clinical centers from 1999 to 2002, we selected women with one or more prior low transverse cesarean deliveries who attempted a VBAC in the current pregnancy. Outcomes were compared according to the number of prior VBAC attempts subsequent to the last cesarean delivery.
RESULTS: Among 13,532 women meeting eligibility criteria, VBAC success increased with increasing number of prior VBACs: 63.3%, 87.6%, 90.9%, 90.6%, and 91.6% for those with 0, 1, 2, 3, and 4 or more prior VBACs, respectively (P<.001). The rate of uterine rupture decreased after the first successful VBAC and did not increase thereafter: 0.87%, 0.45%, 0.38%, 0.54%, 0.52% (P=.03). The risk of uterine dehiscence and other peripartum complications also declined statistically after the first successful VBAC. No increase in neonatal morbidities was seen with increasing VBAC number thereafter.
CONCLUSION: Women with prior successful VBAC attempts are at low risk for maternal and neonatal complications during subsequent VBAC attempts. An increasing number of prior VBACs is associated with a greater probability of VBAC success, as well as a lower risk of uterine rupture and perinatal complications in the current pregnancy.
I printed this out when it was released and sent a copy to the OB that told me, after 5 successful VBAC's, I should schedule an ERCS because my 'scar is getting weaker and weaker and could give out anytime'
I can't just wait on bedrest forever though. I am "16 days late" and it seems like labor can happen at any time. I am having lots of little signs that it will be soon. I live an hour from the hospital, back in a small town with bad roads. My DH can't take off work forever. Wed and Thurs is more snow, and this time it will be more significant than this last time while we were in the hotel last night and this morning.
We have to make some decisions tomorrow. Either go back home and wait it out, if they will even allow that this time. I more less got tricked to coming back in to my friend who said that she absolutely wanted to be with me, but her family at home were freaking out instead of figuring that maybe she might like a break from the 12 kids, and let her husband handle them for a while. Since he was neglecting them, she had to leave at 10pm, which left my DH with our 2 sons, which means the baby had to sleep, and he can't come up. She could have said earlier that DH will need to come up as she needs to get back to her family until I am established in labor.
Dr will be in very early tomorrow, and I have to make a decision on what we are doing. We can induce, which I am not crazy about the methods they are wanting to do. Or do an RCS. Or wait it out here. My other 5 kids are having a blast at my friend's house (which is also nearly 2 hrs from ours), but I feel like I am neglecting them by being here. By prolonging the pregnancy. If I have a VBAC, I can be home in 24 hrs. If I keep going overdue, then it can many more days (I have gone 23 days late twice and 26 days once), and still no guarantee on the VBAC or possible crash csection. Or do the csection tomorrow, and be in here until the dr will release me; when I feel okay or the 96 hrs insurance pays for. This sucks. I should have left well enough alone and not made a medical drama for myself. Just gestate at home until the baby came on her own. My BP isn't any different whether or not I am doing anything. It is up and down while on bedrest, it is up and down when I am active. And, although placentas don't normally just give out, being up is suppose to raise your BP even more and therefore less blood to the baby. Bedrest hinders labor setting in though. Ugh. Kymberli
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