tips for a successful VBAC/ avoiding a repeat c/s???? - Mothering Forums

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#1 of 22 Old 02-11-2011, 02:40 PM - Thread Starter
 
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I am 38 weeks pregnant with my second child, due Feb. 20th.  My first child was breech, that was the only reason for cesarean.  This makes me a pretty good candidate for a VBAC, so I'm told.  I am really hoping for a VBAC this time around.  At this point, I know that this baby is head down, and he has "dropped"...so it's a waiting game.  I'm a little nervous because I do know that this baby is on the bigger side, definitely bigger than my last baby.  And apparently uterine rupture risk goes up with larger babies??  I'm looking for some advice on how to have a successful VBAC/avoid a repeat c/s.  If anyone out there has any advice or info for me I'd appreciate it! Thanks!

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#2 of 22 Old 02-11-2011, 10:33 PM
 
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I have never heard ANYTHING about the size of baby making rupture more likely, and I've read a good bit about VBACs.

 

It would probably prepare you well to anticipate laboring like a first time mom, since physically, you haven't labored before.

 

What else you can do

- read about and prepare for natural childbirth - too risky to get pit

have you done a birth plan?

visualize your labor take walks as much as you can!

 

Did you take any childbirth classes for your first one? I loved the book Natural Childbirth the Bradley Way and Ina May's Guide to Childbirth.


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#3 of 22 Old 02-12-2011, 05:45 AM
 
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I am also not aware of any studies showing a higher risk for rupture with a big baby.  Logically, it might seem that larger baby=bigger uterus and therefore a higher risk for rupture.  However, even ACOG says attempting a VBAC with twins is okay.  And your uterus would be MUCH bigger with twins!


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#4 of 22 Old 02-12-2011, 11:04 AM
 
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I agree with PP. I had a CS for breech and then VBAC. It was wonderful and the only complication was meconium. Try to get your hands on "Silent Knife" or "The Thinking Woman's Guide to a Better Birth" and read as much as you can. Try to find a local ICAN group and also a doula. Don't let OB pressure you. Once labor begins, just stay home for a bit. The less time you spend in the hospital, the better chance of avoiding a repeat CS. Usually they estimate the baby to be bigger than he/she actually is.

 

Good luck, mama!  


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#5 of 22 Old 02-12-2011, 12:40 PM
 
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Bigger baby does not equal higher risk of rupture as far as I know.  But I DO know that bigger baby = more provider fear of rupture! ;)  I delivered my 9lb, 5oz and 22.5" long VBAC baby in September--and I also had an estimated 31cm of amniotic fluid.  All was well!!  

 

Don't let your provider fear-monger.  Your body knows how to birth. And above all, be patient:  WAIT for labor to begin on its own, WAIT to go in, WAIT for the urge to push.  

 

YOU CAN DO THIS!


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#6 of 22 Old 02-12-2011, 12:58 PM
 
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I had a VBAC after 3 c-sections - he came at 37 weeks and was 7 lb 2 oz.  You've got to make sure you have the right health care provider and know exactly what you want to do.  Write it out.  Re-read it often.  Make the best choice for you and your baby.  Good luck!


Shannon, mum to ds1 (8/03), ds2 (6/05), dd (5/07), and ds3 (7/09)
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#7 of 22 Old 02-12-2011, 01:27 PM - Thread Starter
 
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wow, thanks ladies!!!  time will tell, I am trying to be as patient as possible!  Hopefully I will have good news to share soon!

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#8 of 22 Old 02-12-2011, 09:57 PM
 
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I remember when I was in the same situation as you. I had a C with my first as he was breech, followed a HBAC with a 8lb, 13 oz one. (I am 5'4). Just remember to be in the moment and accept your body as it opens to let out your beautiful child. I fought a bit with my third and it was harder. Really be in the moment and keep telling yourself, this is a once in a lifetime experience. After all, every birth is different.

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#9 of 22 Old 02-13-2011, 01:42 AM
 
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Never come across lit about big baby increasing risk for uterine rupture.  That is not listed as a risk when considering VBAC, and believe me if it were a risk, the ACOG would have it there.

 

Had a VBAC 3 years ago, it was AMAZING!  Totally worth it - listen to that voice that tells you this is possible -and- best.  It is what will get you through.  When fear/negative thoughts come in, replace it with the affirmations of that inner-guide.  My sister had a VBA2C, she went on an uncertain journey, but was open to this intuitive wisdom and fought mentally and emotionally through the process and it happened for her too!  I had to do less fighting through the process while in labor because I made up my mind even before the pregnancy.

 

Hypnobirthing was helpful for me in letting go of my fear - mentally handing fears back to those who were trying to keep me from trying, and replacing the space of those fears with affirmations.  A hypnotherapist could do that in a session, and you could probably do it yourself. 

 

It's never too late to change providers - find someone is comfortable with baby growing in you at least until 42 weeks, as baby is considered full-term (NOT PAST DUE) up until that point, and according to my former OB, studies show that 42 weeks is when morbidity and mortality increases, not before that.  Average gestation for 1st time vag birth un-interfered with is 41wks+4days.  Let baby pick his/her birthday, I promise it will happen on it's own!

 

No pitocin, NO Cytotec or "miso" (seriously, this could be dangerous), Don't let them break your water, stay home as LONG as possible... like show up to the hospital pushing is ideal, RELAX through contractions, use your shower/tub, if possibly hire a doula, and you will increase your comfort throughout labor and your chances of VBAC.

 

Wishing you blessing on your journey!!  


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#10 of 22 Old 02-13-2011, 01:14 PM
 
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You are making the right choice attempting a VBAC mama! I have had two VBACs, first was a small baby (6lbs 3oz) but second was 9lbs 9oz. Definitely never head of any concerns about size of baby upping risk of rupture.

 

As for best ways to have a successful VBAC - just try to have faith in your body, drink plenty of water and don't go to the hospital any earlier than you need to!!
 

Quote:
Originally Posted by newmom08 View Post

I am 38 weeks pregnant with my second child, due Feb. 20th.  My first child was breech, that was the only reason for cesarean.  This makes me a pretty good candidate for a VBAC, so I'm told.  I am really hoping for a VBAC this time around.  At this point, I know that this baby is head down, and he has "dropped"...so it's a waiting game.  I'm a little nervous because I do know that this baby is on the bigger side, definitely bigger than my last baby.  And apparently uterine rupture risk goes up with larger babies??  I'm looking for some advice on how to have a successful VBAC/avoid a repeat c/s.  If anyone out there has any advice or info for me I'd appreciate it! Thanks!




Laurie wahm (virtual paralegal) of 3 wonderful boys (11, 9, 5). 1st by c-section for breech, 2 by VBAC (one miscarriage between child #1 and #2).

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#11 of 22 Old 02-14-2011, 01:18 AM
 
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Going into spontaneously labor will greatly increase you chances. Then, practicing positive positioning throughout your labor will help speed your labor and help your baby get into the best positions. Then, stay home until you are in late active labor or transition. This means you will be having contractions lasting one minute or longer that are three minutes apart for an hour or two. Hiring a doula does significantly reduce c-section rates, so if you can hire one, I would highly recommend doing so. If you can't afford to hire one, there are usually volunteer doulas in the certification process who offer their services for free. Depending on what community you are in, it might be easy enough to find someone. Here is a link to a free doula listing: http://findadoula.com/.  If hiring a doula is not an option, I would recommend your birth partner read The Birth Partner by Penny Simkin.

 

As a doula, one other thing I tell my clients in their last weeks of pregnancy is to sit forward (as opposed to reclining) whenever possible. This helps your baby get into the best position for labor. Try to also avoid reclining during your labor.

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#12 of 22 Old 02-14-2011, 01:12 PM
 
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If you are planning delivering at a hospital, try to find one that has mobile telemetry if your OB (or hospital) "requires" constant monitoring for VBAC's.  Some do, some don't.  Not all hospitals offer mobile telemetry on labor and delivery but when I attempted a VBAC, my OB had me change hospitals to one that had it so that I could be mobile throughout labor, in the tub, on the ball and such. One of the last things you want to do is to be stuck in a bed in the least adventageous position for a successful vaginal delivery (on your back!)  Good luck!  We had a doula do some pre-birth work with DH and I (didnt have on at the birth, though)  She also recommended positions that help get baby in the right position prior to labor, as well as the suggestion not to recline as the previous poster mentioned.   For most, I think a VBAC is really about where you are mentally/emotionally.  Be strong and know you are doing the right thing smile.gif

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#13 of 22 Old 02-15-2011, 08:41 PM
 
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I can't stress enough how important a Doula is.  I think EVERY mama needs one, especially a VBAC mama, and if you are having a hospital birth, it's without question that you should have one.  If you can get one for free, consider getting two, as they are usually newer, unless you get lucky and find a tenure one that will Doula at a discounted rate. 

 

I'm so glad that baby is head down and dropped!  A LOT of pressure off worrying about another breech baby! YAY!  Yes you are the prime candidate for a VBAC, and it'd be a good idea to expect labor much like a first time mom, which can always vary.  Big Baby doesn't mean much, really anything.  Weight is usually due to fat, and that squishes.  Not only that, but your pelvis opens, and baby's head (the largest part) molds.  And no, it doesn't increase your chance of rupture.  Most VBAC mamas have babies bigger than their previous ones.  In fact, I now one mama who had a CS for CPD, as the Dr was looking at her pelvis during the CS said, 'there's no way you'll fit a baby any bigger than 6 pounds through there' (she had her CS for an 8lb baby).  Her second pregnancy, she had a homebirth of a 10lb baby.  Size really matters little.  :)

 

I think it's great that you are facing your worries, and asking for advice and searching out facts.  That's the first step.  You can do this!  You are a birthing mama going to have a baby normally, your previous baby just happened to be born by Cesarean.  :)

 

Much Love to you!

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#14 of 22 Old 03-25-2011, 01:08 PM
 
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I would recommend finding a VBAC support group.  We have a small one in my area, and it is a great way to get advice.  It also helps you work though your fears in an enviroment that is supportive and understanding.  

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#15 of 22 Old 03-26-2011, 12:07 AM
 
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Hope you and the baby are doing well.


Lisa DH Pat DS Liam DS Jamessigncirc1.gif

Missing DD Lily 6/17/10- 12/13/12

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#16 of 22 Old 01-18-2012, 08:23 AM
 
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I had a c-section with my first due to breech position and cord around the neck. I really struggled with the decision of a repeat c-section or a VBAC with my second. I chose VBAC and it was the most rewarding experience of my life. I wish more doctors would encourage this route. Our bodies are made for this. If you want to read my story you can see it here on my blog. http://kristydickersonblog.com/?postID=299&successful-vbac

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#17 of 22 Old 02-10-2012, 02:56 PM
 
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I'm 38 weeks, too! I'm preparing for a VBAC in the hospital and my biggest goal since my first birth experience was educating myself. I made a detailed birth plan stating my desires and reasons behind them and printed out several studies as well as the ACOG bulletin on VBAC. All of that is in a folder in my hospital bag, just in case I need it.

 

As some of the pp's have said, ACOG does not say that a large baby is a greater risk. Here's a quote about that from a study that I will link you to at the end (fetal macrosomia is the term for a big baby):

Evidence is insufficient to support induction for women with insulin-requiring diabetes, twin gestation, fetal macrosomia, oligohydramnios, cholestasis of pregnancy, maternal cardiac disease and fetal gastroschisis

 

Knowing what is safest for you and being bold and demanding the safest for you and baby is your best bet. The safest thing is a VBAC. The safest way to have a VBAC is completely natural. No pit, no cervical ripening, no stripping of membranes or breaking of water. Ability to move will help, as some others have said, laboring on your back is not the best. I have been working on my DH making sure that he understands what's safest so he can be a great advocate for me. He's reading the studies I'm printing out and making an effort to be come educated as well.

 

I've also been doing exercises to help prepare my body for birth. Bradley birth exercises, hip opening yoga poses and perenial massage are among them. Red raspberry leaf tea is also supposed to be good for VBAC moms (I take the tea regularly and have taken the extract for years).

 

My biggest fear with my current provider is that I will go post dates and he will pressure me into induction/repeat section. My info on these situations is this: A pregnancy is not considered overdue until 42 weeks (some providers will fudge this up to 41 weeks). From 37-42 weeks the chance of a stillbirth is 2-3 in 1,000 and after 42 weeks the chance only goes up to 4-7 in 1,000. If they try to induce me the risk of rupture goes up from around 1% to 40%. I will not be induced by any means. If I do truly go post dates I will consent to as many non-stress tests and ultrasounds they feel are necessary to check on the health of the baby. I would rather that than they cut me. If they induce and my uterus ruptures the chance of future pregnancy is greatly diminished (they may even have to remove it), and fetal outcome becomes a serious issue. 

 

They have also mentioned that if labor stalls or goes longer than 24 hours they will look at augmenting with pit or ripening my cervix. There's no basis for this. If my water is broken they can avoid exams and give me antibiotics and monitor my temperature to be sure I'm not getting an infection. If I do get an infection, then they can do an emergency section and I will be completely fine with that. But, until my fever is high and not coming down with antibiotics, I am not interested in any augmentation of any kind and there's no reason to do so. 

In the end, this is your birth and you are responsible for the outcome. They cannot give you anything or do anything to you without your consent. Be strong and demand what's best for your baby. An all-natural VBAC. 

 

Some resources:

The study from above: http://www.ncbi.nlm.nih.gov/pubmed/19191776

A terrific website with TONS of evidence-based info on VBAC: http://www.childbirthconnection.org/

ACOG Bulletin 115 on VBAC (take special note of the cautions on induction): http://www.childbirthconnection.org/pdfs/ACOG-VBAC-guideline-comparison.pdf

A guide to comfort in labor (the better you feel the stronger you'll be!): http://www.childbirthconnection.org/pdfs/comfort-in-labor-simkin.pdf

A VBAC study showing it's a reasonable and safe choice: http://www.ahrq.gov/clinic/tp/vbacuptp.htm#Report

A really good study on Uterine Rupture (note they recommend constant fetal monitoring as the only good indicator that you have one and time is of the essence): http://www.aafp.org/afp/2002/0901/p823.html

A really good study on macrosomia: http://www.aafp.org/afp/2001/0115/p302.html

Exercises for birth: http://patelife.blogspot.com/2011/03/bradley-birth-exercises.html

Yoga for opening hips: http://www.yogabasics.com/hip-opening-poses.html

A great study on management of overdue pregnancy (important to remember these numbers are for ALL women, not VBAC women): http://www.aafp.org/afp/2005/0515/p1935.html

 

 

 

One very big thing for me has been educating myself about what is normal during childbirth and what are the signs that something is not normal and what should be done in those circumstances. The WHO has some awesome publications about this:

Care in normal birth: http://www.who.int/maternal_child_adolescent/documents/who_frh_msm_9624/en/

Managing Prolonged and Obstructed Labor: http://www.who.int/maternal_child_adolescent/documents/3_9241546662/en/

Pregnancy, Childbirth, Postpartum, and Newborn Care: http://www.who.int/maternal_child_adolescent/documents/924159084x/en/

 

 

 

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#18 of 22 Old 03-29-2012, 05:34 AM
 
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Just thought I would come back and update the thread. I got my VBAC! The nurse said she hadnever seen a birth like it in her 25 years of experience. I was technically a first time birther and she said they expect things to follow the pattern of most first time births. Mine did not! I was 4cm dilated when I went in, my water broke in triage and I dilated 4cm in the next 45 minutes. It took another 45 min to get fully dilated and I pushed for 3 contractions (under 12 minutes). 

on my third contraction I pushed and they could see a sliver of her head. On the next push she came completely out! I tore (of course, not much time to stretch!), but It was an amazing birth. I am still feeling so strong and healed and empowered from it.

What I think helped the most:

1. Prayer: God is amazing!

2. Excercise: I stayed active through my whole pregnancy, exercising regularly, 5-6 times a week, 30 minutes of good, sweaty, heart pumping cardio. This has been shown to reduce labor length.

3. Kegels: I did 30 every time I peed for the entire last trimester.

 

With these three things my birth happened so fast that I don't think even the least supportive Dr could have had time to section me!

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#19 of 22 Old 05-06-2012, 10:10 AM
 
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wow fantastic, congrats!!!
 

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#20 of 22 Old 05-08-2012, 01:18 PM
 
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Congratulations on your VBAC!!

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#21 of 22 Old 05-16-2012, 01:39 AM
 
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 .

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#22 of 22 Old 07-05-2012, 09:48 AM
 
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Congratulations! Way to go, mama!

  reading.gif, mama to Amelie (May 2010), early loss (October 2011), and James (September 2012) vbac.gif

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