OB says I have to have a c-section......... help - Mothering Forums
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#1 of 20 Old 11-15-2010, 12:44 AM - Thread Starter
 
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7 years ago I had a cs. For fetal distress( his heart was 95) and for herpes sores that were 6 days since outbreak.

Last week my midwife sent me to an ob. He said I have to have my airways looked at by the specialist. Then he started in about all the risk factors and why I should have another cs. I was so shocked. I mean I never even thought of it for this birth.

 

* previous cs, 7 years ago

* genital herpes

* diagnosed this pg with diabetes, my sugars have been fine since I stated to test

* over weight, but I have only gained 10 pounds this pg

* had or still have bacterial vaganosis

* baby is bigger than my last 3, according to the ultrasound

* headaches and vomiting everyday

* low iron. working on this

 

plus

I live in a small town with a small hospital. They don't have the staff to do a "fast cs"  if I needed one, it may take a while to get everyone there. and they want the best possible outcome for me and the baby.

 

It's DP first baby and I just feel like I am taking something away from him. My body is not broken but they make me feel like it is. I know I can do it I just need to find a way to convince them. My ONLY option is to go into the city. which is a ferry ride away and have My VBAC. From what I understand they will not induce for a vbac, and I could not just stay over in Vancouver waiting for the baby to come. We don't have the money and I have my youngest in school. it just wouldn't work. Unless I find a Dr that would be willing to induce me. I was induced 13 years ago with dd and her birth was great!!  I have thoughts of just not showing up for the cs and waiting to go into labor. But they would probably fly me to Vancouver if I show up in labor or insist on cs. I guess I could refuse to have one but what if something does go wrong??

oh and i had the air way test and the Dr said mine were fine, he was really surprise that they were great!  I was told that if the airway test was fine they would let me have a trial of labor. Now they are saying we should just book it.

It a cruel cruel thing to say to a mother at the end of of her pregnancy. Because I am so done. I really want her out! I feel it is clouding my judgment about the birth I want and have been thinking of and focusing on for, well years really.

 

anyone please anyone that can help, or give advice I would be so grateful

 

Elizabeth


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#2 of 20 Old 11-15-2010, 01:10 AM
 
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I can't give advice, but just wondering about the "airway test". Why did you have this?

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#3 of 20 Old 11-15-2010, 05:47 AM
 
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How long does it take on the ferry and do the ferrys run all night? If you really want a VBAC and can find a doc to support you in Vancouver, go for it. At the first sign of labor, head over to the city and check into a hotel near the hospital until you are ready to go to the hospital.

 

I travelled 2 hours in labor for my VBAC and it was worth it. My labor was fast and I was 8cm when I got to the hospital, but I still made it in plenty of time as baby was born 2.5 hours later. Yours may be fast, but it is pretty common for VBAC labors to have long warm up phases so you will likely have more than enough time to get there.

 

Your best chance for VBAC success is with a truly supportive provider.

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#4 of 20 Old 11-15-2010, 01:11 PM - Thread Starter
 
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I had the airway test because they were thinking because of my weight they may have problems if they have to put me to sleep for the c-section.

the ferry ride is 40 mins, about 20 to 30 to get there, it only runs every 2 hours and the last run is at 830 pm. We don't even have money for a hotel. yugg!!


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#5 of 20 Old 11-15-2010, 02:01 PM
 
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At least half of his list seems like good reasons to definitely not have a c-section.....

C section recovery can be harder and complications more likely if you are overweight.

C-section blood loss is normally twice as much as a vaginal birth, so if you have low iron better to have a vaginal birth.

BV is not a concern around birth, only a risk factor for preterm birth if you were symptomatic, but you're past that anyway.

Herpes only concern if you had an outbreak....acyclovir?

I definitely don't understand why headaches and vomitting would be a reason for section.

Usually, if I send someone for a consult because of high BMI prenatally (for airway) its with a anaethethics not obstetrics?

 

Anyway if your local hospital does VBACs just go there in labour, the OB can make a recommendation but that doesn't mean you have to follow it.  Talk to your midwife about it.


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#6 of 20 Old 11-15-2010, 03:02 PM - Thread Starter
 
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yes I am taking the meds for the outbreak.

thank you for the advice. I am going to see the ob tomorrow and hopefully get him to let me try to have this baby. I realize that if I go into labor with sores I will have a cs. but my due date is 2 weeks away and I feel I still have a chance to do this.

I am going to fight hard for what I want!


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#7 of 20 Old 11-15-2010, 03:16 PM
 
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We also live in a small town w/ no OB/hosp (150 miles to hosp/midwives) and first baby was footling breech.  When our midwife (in city) discovered baby was breech, she couldn't ditch us fast enough, especially after a host of her other issues (refusal at 35 wks to attend homebirth after agreeing to it months earlier, etc.).  Super stressor on top of everything else.  Since it's illegal for midwives in AK to knowingly attend breech birth, our safest (and only) option was the hospital (vs trying it solo at home).  I tried everything (ECV, moxa, pulsatilla, headstands in pool/on floor, chiropractor, etc.) to get baby to turn, feeling trapped, abandoned, cornered b/c of failing medical system.  My backup OB (to midwife) was out of state when I drove into the big city about a week prior to due date for other business; guess I'd been in labor 24+ hours and water broke and baby's foot poked out on arriving at hotel. We went to nearest ER and on-call doc did stat C/S. Baby never stressed/showed HR decels, etc. and was born just fine, no complications.  It really sucked to feel we only had one option b/c of other people's fears and submission to a top-heavy, doctor-centered healthcare system--at the hospital far from home, friends, family. Lucky for us it worked out as it did (great hosp staff and insurance covered most of it w/o headaches, fast/low-pain recovery--walking fine the next day): HEALTHY BABY and MOM to focus on for rest of life, in spite of missing the desired experience and some as-yet unnoticed slight side effects on baby from lack of going through actual birth experience, etc etc.  Thinking on it now, I'd go with the several other "rebel" mamas who advocate laboring at home as long as you can IF everything is going alright at the end of pregnancy (baby in good position, mom in good health) and throughout labor (w/ good helpers on hand).  [Get your own doppler/fetoscope to listen to baby, hire a worth-every-penny doula, know what staff/resources are available at your small hospital (you say they can't do "fast C/S"--think about it, if you go in to hosp. after labor is well established and you're fairly close to pushing, wouldn't they call OB in and you'd have time to continue laboring safely or have C/S should complications arise?).]  Research and understand EXACTLY what risks you are most likely to encounter w/ VBAC, and find out what travel/lodging expenses your insurance may cover should you find a VBAC supportive provider in Vanc. (in US ins. co's required to cover some/reimburse you costs if you live far from required facilities).  Here in rural AK, we're lucky to have a very affordable insurance policy (<$100/yr) that covers the cost of med-evac flights to Anchorage, should we ever need it.  See if something like that exists where you are (search with state/province + "medevac insurance").  

You mention other previous babies--all C/S? If not, your chance of VBAC success is greater than if no VB.  You also have the advantage of previous labors--you know what to expect, hopefully, you're in tune w/ your body and can gauge approx. where you're at in labor if you try the "just show up at ER in 2nd stage labor" plan.  You don't HAVE to do anything you're not comfortable with (like schedule C/S for OB's peace of mind), especially if you're well-informed, and the hospital/MD (in US at least) cannot abandon you if don't submit to their will (patient abandonment; it's called "battery" if they force treatment on you that you refuse).  Start here and follow the rabbit: http://www.vbac.com/ and look under right-side column "Mothers to Be".

Do you have any friends/family who could help w/ other kids if you have to go to city? 

My recent review of the uterine rupture study literature put my mind more at ease (http://emedicine.medscape.com/article/275854-overview --of the several thousand pregnancies in all the studies discussed, true uterine rupture occurred in a very small number of cases and usually in conjunction w/ other aggravating factors that arose earlier in labor (e.g., seriously stalled labor, traditional induction skyrockets your chances of rupture, http://www.nejm.org/doi/full/10.1056/NEJM200107053450101 ).  Scar dehiscence seems to be more what OBs call U.R. and from my read of it, the consequences are much less catastrophic should this occur.  Look at all your risk factors in success w/ VBAC and see what you can minimize, even at this late stage of game--we're malleable, tough creatures and positive attitude helps immensely.  Your BMI, perhaps your age, plus the GD (have you gone militant healthy diet and water intake?) are strikes against you from an OB perspective, but your physical fitness, overall good health, possible previous VBs, and optimistic attitude may counter some of them.  If the majority of evidence (that you thoroughly review and understand) suggests good chance of TOL and VBAC success for you, then TOL is plan A, with stat C/S as backup.  If the evidence isn't in VBAC favor, then consider the benefits of a scheduled C/S: you can plan around it for other children's care, it's less worry about chaotic outcome, you can be awake when they do it and get to hold your baby sooner (the grumpy anesthesiologist in my case wouldn't even consider an epidural/spinal and I was out cold, missing delivery, holding baby sooner, telling them NOT to clamp the cord, etc.). W/ a planned C/S you could even bypass tearing, extraordinarily long/painful/back labor, and all those other wonderful effects of vaginal birth.  It's all risks and benefits and you have to look realistically at the positives of both so you and your baby have the best outcome you can create.  Your body isn't broken, you just live w/ a broken medical system which may have contributed to your current pickle.  I know it's hard, but I'm focusing on all the positives I can after initial disappointment (not my fault almost no one practices breech deliveries these days and lacks a skill that was once more common). 

Realize that although it's tough spot, you DO have options--esp. if you're creative and willing to push the envelope for what you believe is safest and healthiest option for you and baby.  Here, care providers have to give you around 30 days notice that they are terminating your care and have to make sure you know your options for suitable alternative providers. Sounds like your OB isn't into VBAC at all, sees preg as pathological condition, and may do just fine for an emergency C/S--which is what you'd need should your labor go awry.  If you trust your body to labor on its own, just do it and stay out of hosp as long as you can (w/ tools and helpers at home to clue you in to fetal distress).  And READ, READ, READ all the data you can find (from reputable web sites and scholarly journals, typically addresses ending w/ dot edu, .org, and .gov).  You need to be able to speak and understand the terms your OBs use to stand a fighting chance.

We're expecting #2 in March and doing co-care w/ midwives and OB who support VBAC (rare here) at hospital w/ very good VBAC success rate (70-80% for last 12 mos).  Driving 300 miles/round trip for prenatal visits and for birth in winter in Alaska sucks, but it's in pursuit of the best long-term outcome we see possible.  Still disappointed that it's illegal for us to have baby out of hospital (birth center is <7 min. from hospital), but if all goes well, #3 (hopefully) can be born out of hosp.  The midwives can let us labor w/ them until labor is well established (6-8 cm, regular long contractions, etc.) then transfer to hospital, and they say they stay w/ us through birth--acting as a buffer between us and possibly pushy hospital staff for best chance of VBAC success.  Any "buffer" support (patient advocate, midwife/doula to go w/ to hosp.) you can afford, GET IT!  We have to arrange care provider for baby #1 so dad can come and we may go into debt a little bit more than w/ a typical hosp. birth, but we're going to give our VBAC the best efforts we're capable of.  Eat as well as you can, exercise every day, practice deep belly breathing/relaxation, practice squatting as much as Kegeling (http://mamasweat.blogspot.com/2010/05/pelvic-floor-party-kegels-are-not.html and http://sweetsprouts.wordpress.com/2010/06/24/keeping-your-body-in-balance-squats-and-pelvic-floor-strength/ ), and try to keep the big picture in mind when the little detail monsters come creeping.  Best wishes to you Elizabeth,  be strong, I'll be thinking positive waves your way!

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#8 of 20 Old 11-15-2010, 05:38 PM
 
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What would the local hospital do it an NON=VBAC lady needed an emergency c-section?

If you were not a VBAC, would your other "risk factors" still require a c-section?

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#9 of 20 Old 11-16-2010, 09:12 AM
 
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What would the local hospital do it an NON=VBAC lady needed an emergency c-section?

If you were not a VBAC, would your other "risk factors" still require a c-section?



I think this is a really good question! If someone came in needing an emergency c/s they wouldn't have any problems getting everyone together.

 

I know you said you don't have money for a hotel, but what about family or friends? Is it possible to stay with someone? Personally, I wouldn't want to be on the ferry during labor and if you had to wait all night for the morning ferry to arrive who knows how much time you would have. What about staying outside of Vancouver where hotels are cheaper? Do any of the hospitals in Vancouver have a place to stay until the baby comes on its own? I really hope you can find an OB that will work with you with an induction. Have you spoken with anyone yet?


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#10 of 20 Old 11-16-2010, 10:20 AM - Thread Starter
 
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Quote:
Originally Posted by sweetsadie77 View Post.

Usually, if I send someone for a consult because of high BMI prenatally (for airway) its with a anaethethics not obstetrics?



yes it was with an anaeththics.


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#11 of 20 Old 11-16-2010, 10:26 AM - Thread Starter
 
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I made a list of all the reasons to let me have my baby, my way! I will be sharing this at the meeting today. My midwife will be there. I was really struggling with this the last time I seen her, so I am sure my change of approach will be a little surprise. I hope she gets there early!! please keep us in your thoughts.

thank you for the great advice and links. I really feel that everything will work out the way it is supposed to. I feel this urge to fight for my baby. it is strong and I have to believe that a higher force is directing me to push for the vaginal birth.

I ;ll be back on in about 5 hours to update how it goes

Elizabeth


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#12 of 20 Old 11-17-2010, 05:40 AM
 
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ITA with sweetsadie77 that your risk factors make you a less attractive candidate for a C-section IMO. Other than an active herpes outbreak at delivery, none of the other reasons are compelling at all to me as anything that would preclude VBAC.


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#13 of 20 Old 11-17-2010, 10:35 AM - Thread Starter
 
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I am having a cs on friday. yes I am disapointed. But This what I have decided. It hurts a little.... plese wish me luck withthe next stage of my life, being a new mommy again!!


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#14 of 20 Old 11-17-2010, 11:57 AM
 
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Good luck on Friday and may you have a good recovery.  Enjoy holding that baby.

 

I am so sorry that it has come to this though, it seems like none of those reasons are really a good reason (unless you have an active outbreak).  So frustrating!

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#15 of 20 Old 11-17-2010, 01:59 PM
 
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Quote:
Originally Posted by corysmilk View Post

I am having a cs on friday. yes I am disapointed. But This what I have decided. It hurts a little.... plese wish me luck withthe next stage of my life, being a new mommy again!!



Is this your decision or theirs? If it is yours - I wish you the BEST of luck!!! If it is theirs - you do NOT have to consent EVER until you choose to, IF you choose to.


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#16 of 20 Old 11-17-2010, 10:30 PM
 
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Quote:
Originally Posted by smeep View Post



Quote:
Originally Posted by corysmilk View Post

I am having a cs on friday. yes I am disapointed. But This what I have decided. It hurts a little.... plese wish me luck withthe next stage of my life, being a new mommy again!!



Is this your decision or theirs? If it is yours - I wish you the BEST of luck!!! If it is theirs - you do NOT have to consent EVER until you choose to, IF you choose to.



I agree. I'm sorry. I see you are not due for 2 - 4 more weeks. What happened? Is everything okay?
My prayers and thoughts will be with you. HUGS!

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#17 of 20 Old 11-18-2010, 04:00 PM
 
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Best of luck and let us know how it goes.  You're in our thoughts.  Enjoy your new little love!

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#18 of 20 Old 12-09-2010, 06:40 PM - Thread Starter
 
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hi just an update. I did have the cs. I was a little out of it for the first day. but I feel ok. recovering nicley. and so glad to be a mommy to a littleone again. her birth was still a miracle!! she is everything I ever dreamed of and more. We are so happy she is here with us.

I am not having any regrets. well except that I got my tubes tied, but thats a whole other thread.

 

thank you


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#19 of 20 Old 12-10-2010, 12:35 PM
 
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Congrats on your little one!  And I hope the recovery continues to go nicely!

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#20 of 20 Old 12-12-2010, 12:32 AM
 
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Enjoy your baby snuggles :-)


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