The need to pre-schedule a c-section for 42 weeks? - Mothering Forums

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#1 of 22 Old 11-18-2010, 08:57 AM - Thread Starter
 
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Hi All, 

 

I am having my third and I am due Jan 1st. My first was vaginal and my second was cesarean. I have been told this entire pregnancy that I am a good candidate. Recently due to DHs insurance changing we switched providers and hospitals. So I am now delivering at a birth center which consistently has the highest VBAC rates and lowest cesarean rates in the state. I am also now seeing a group of midwives that come HIGHLY recommended. 

 

With all of that said I was sort of surprised at my 33 week apt yesterday when my midwife said that I would need to pre schedule surgery for my 42nd week. It makes me so nervous! My son the eventual cesarean was born at 42 weeks and my daughter (vaginal) was induced at 41 weeks. 

 

The midwife could see the concern on my face and was very warm about it and said that "they" just want to be pro-active that I won't even need the appointment and that my baby will be born before then. On the way to the car I told my husband that when the scheduler calls I am just not going to answer the phone. He laughed and said "Don't!". 

 

I guess I don't know why I am surprised I have been told this entire pregnancy that VBACs shouldn't go past 42 weeks and that they won't induce a VBAC either.

 

How has everyone else handled scheduling the surgery at 42 weeks?


Sarah - wife, mom to Riley 7/9/03 and Jacob 7/15/05 and Hannah 1/5/11 a successful vbac.gif
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#2 of 22 Old 11-18-2010, 09:02 AM
 
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I'd be sort of inclined to not schedule just yet. 

 

If you get to, say, 41 weeks, then, okay, schedule.  But hold off until then.  And keep in mind that if you wind up with a medical need for an emergent section, they'll fit you in even if you aren't on the schedule.

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#3 of 22 Old 11-18-2010, 09:14 AM - Thread Starter
 
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Quote:
Originally Posted by MeepyCat View Post

I'd be sort of inclined to not schedule just yet. 

 

If you get to, say, 41 weeks, then, okay, schedule.  But hold off until then.  And keep in mind that if you wind up with a medical need for an emergent section, they'll fit you in even if you aren't on the schedule.



That is EXACTLY what I said to my husband. She mentioned yesterday they have been pre-scheduling so they aren't scrambling to try to fit people in at the last minute. I figure if I am at 42 weeks and have not had this baby but there aren't any "baby needs to be born NOW" problems that I can wait another day for them to fit me in.


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#4 of 22 Old 11-18-2010, 10:27 AM
 
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I wonder if this would give you a good excuse if you start getting pressure from someone like a back-up OB for going past 41 weeks. One of those "Well, we should start thinking about a c-section." "Oh, no need. I'm scheduled already." "Oh . . . Okay."

 

*shrug* That was my first thought.


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#5 of 22 Old 11-18-2010, 10:52 AM
 
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Hospitals like to know ahead of time how much staff they are going to need. I'd go ahead and schedule for 42wks 6days ;-)  Even if you schedule, it does not mean you have to show up for the surgery.


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#6 of 22 Old 11-18-2010, 11:27 AM
 
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Does anyone have good research to explain WHY a VBAC should not go beyond 42 weeks?

 

I would NOT schedule! I am stubborn like that.

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#7 of 22 Old 11-18-2010, 12:55 PM - Thread Starter
 
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Quote:
Originally Posted by roadfamily6now View Post

Does anyone have good research to explain WHY a VBAC should not go beyond 42 weeks?

 

I would NOT schedule! I am stubborn like that.


I have not researched it but they keep telling me because the longer you go in pregnancy the larger the baby gets blah blah blah. I would just HATE to okay the cesarean just because I am late only to birth a 7 pound baby or something.


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#8 of 22 Old 11-18-2010, 12:58 PM - Thread Starter
 
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Quote:
Originally Posted by LisaSedai View Post

Hospitals like to know ahead of time how much staff they are going to need. I'd go ahead and schedule for 42wks 6days ;-)  Even if you schedule, it does not mean you have to show up for the surgery.



Well "technically" just looking at my calendar right now. My 42 week mark is on a Saturday. I can easily make unbreakable plans for that day. Then that Sunday my daughter has First Communion class. VERY IMPORTANT ;) That Monday my kids don't have school so I have to stay home with them and I have my mother's group on tuesday which I am teaching a craft. So DARN! I can't schedule until 42 weeks 4 days anyway ;)


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#9 of 22 Old 11-18-2010, 07:06 PM
 
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My last OB had me schedule a "just in case" c/s.  At the time, I scheduled it to avoid confrontation.  And I was lucky in that I went into labor well before that date.  But, my husband and I had discussed that we could call in and tell them we needed to reschedule the c/s due to family issues.  Family issues being that we as a family did not feel comfortable with a c/s!

 

So, while I did schedule the c/s date last time, our plan was to reschedule, reschedule, reschedule.

 

This time, my OB has not brought it up, not even once.  I'm 38 1/2 weeks now, so we're not there and hopefully won't be.  But, he's not one to schedule just in case c/s's!

 

So, with all of this, I guess what I'd say is maybe schedule for that 42w6d mark, then see where things lead you!  And reschedule if you feel comfortable!


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#10 of 22 Old 11-18-2010, 07:16 PM
 
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If that would come up for me later in this pregnancy, I absolutely would not schedule.  They'll fit me in if I need it :)


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#11 of 22 Old 11-18-2010, 07:29 PM - Thread Starter
 
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The scheduler called today while I was at the grocery store. I deleted the message. WHOOPS!


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#12 of 22 Old 11-19-2010, 08:47 AM
 
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I would definitely not schedule! I also had all three of my babies around 41 weeks. When I had a VBAC, my OB and I had a deal that we would talk about a conservative induction at 42 weeks, if I made it that far, which I didn't. We never had a c/s contingency plan. Like you, I had a previous vaginal delivery and then a c/s. There was no way I was signing up for RCS. It would have had to be a medical necessity.


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#13 of 22 Old 11-19-2010, 08:10 PM
 
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Quote:
Originally Posted by soccerchic21 View Post



Quote:
Originally Posted by LisaSedai View Post

Hospitals like to know ahead of time how much staff they are going to need. I'd go ahead and schedule for 42wks 6days ;-)  Even if you schedule, it does not mean you have to show up for the surgery.



Well "technically" just looking at my calendar right now. My 42 week mark is on a Saturday. I can easily make unbreakable plans for that day. Then that Sunday my daughter has First Communion class. VERY IMPORTANT ;) That Monday my kids don't have school so I have to stay home with them and I have my mother's group on tuesday which I am teaching a craft. So DARN! I can't schedule until 42 weeks 4 days anyway ;)


And isn't Tuesday a recital for one of your kids? ;)

 

I like how you think, mama!

 


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#14 of 22 Old 11-21-2010, 11:19 AM
 
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I'm surprised that they're already trying to get it scheduled. I scheduled mine for 42 w when I was 41w 2d. The morning I was checking out of the hospital, 24 hours after my VBAC, I was supposed to be arriving for my pre-op appointment :)

 

I would tell them that it's causing you too much stress to think about scheduling it now.

 


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#15 of 22 Old 11-21-2010, 11:28 AM
 
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How about a "no, thank you?"

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#16 of 22 Old 11-21-2010, 11:33 AM
 
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You don't have to schedule anything you don't want to (which I bet you already know).


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#17 of 22 Old 11-21-2010, 12:34 PM - Thread Starter
 
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You don't have to schedule anything you don't want to (which I bet you already know).



Exactly! I am feeling so thankful that DH is on board with how I feel about all this and is supportive. I just do not see a point scheduling a cesarean 8 weeks out! I would maybe be a bit more understanding to "scheduling" if my 42nd week fell during the holidays but I will be 42 weeks on January 15th. Come on!


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#18 of 22 Old 11-21-2010, 09:37 PM
 
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Quote:
Originally Posted by roadfamily6now View Post

Does anyone have good research to explain WHY a VBAC should not go beyond 42 weeks?

 

I would NOT schedule! I am stubborn like that.

 

The 42 week "rule" isn't about VBAC as such. Most providers want you to deliver by 42 weeks, which is when the risk of stillbirth goes up. The difference is that for a woman who has not had CS they'll schedule an induction instead. Since induction is usually not possible with a VBAC it turns into an RCS.

 

I don't know if I would schedule or not. I think it would depend on whether I had strong opinions of any of the doctors I might have.


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#19 of 22 Old 11-22-2010, 09:13 AM - Thread Starter
 
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Quote:
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Quote:
Originally Posted by roadfamily6now View Post

Does anyone have good research to explain WHY a VBAC should not go beyond 42 weeks?

 

I would NOT schedule! I am stubborn like that.

 

The 42 week "rule" isn't about VBAC as such. Most providers want you to deliver by 42 weeks, which is when the risk of stillbirth goes up. The difference is that for a woman who has not had CS they'll schedule an induction instead. Since induction is usually not possible with a VBAC it turns into an RCS.

 

I don't know if I would schedule or not. I think it would depend on whether I had strong opinions of any of the doctors I might have.

Yes I have been told repeatedly that they will not induce me at all as that ups my risk for uterine rupture. 
 


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#20 of 22 Old 11-22-2010, 04:51 PM
 
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Quote:
Originally Posted by AlexisT View Post



Quote:
Originally Posted by roadfamily6now View Post

Does anyone have good research to explain WHY a VBAC should not go beyond 42 weeks?

 

I would NOT schedule! I am stubborn like that.

 

The 42 week "rule" isn't about VBAC as such. Most providers want you to deliver by 42 weeks, which is when the risk of stillbirth goes up. The difference is that for a woman who has not had CS they'll schedule an induction instead. Since induction is usually not possible with a VBAC it turns into an RCS.

 

I don't know if I would schedule or not. I think it would depend on whether I had strong opinions of any of the doctors I might have.



Actually, the risk of stillbirth does not increase until 43 weeks, and then typically only in high risk mothers, such as those with heart, liver, or kidney disease, or those with uncontrolled type 1 diabetes.


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#21 of 22 Old 11-23-2010, 07:05 AM
 
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FWIW, my OB would have induced me (Foley catheter and very low dose pitocin) if it came to that as a last resort post-42 weeks before c/s. It does increase the UR risk, but it is still very low. Subjectively on another VBAC support board, I would say that half of the OBs were willing to induce VBACs and half were not. 


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#22 of 22 Old 11-23-2010, 10:26 AM
 
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Scheduling at 42 weeks sounds very reasonable compared to what I've heard from other women (e.g., they have to go into labor by 40 weeks or the provider will do a repeat C.)

 

I'm the odd one out on this thread- I don't see the harm in scheduling that date. It may possibly reduce conflict with the provider (conflict with minimal benefit is not my thing.) It is less damaging to call at 41w6d and say, oops, I have a family emergency, can't come!, than it is to spend months refusing to set a date that you likely won't need anyway.

 


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