I'm 39+2 with my third baby. My boys were both born by c-section. The first due to fetal distress after a failed induction and the second after 24+ hours of active labor with no dilation or engagement (attended first by a HB MW, then a family practice Dr.).
I've got a long list of reasons *not* to VBAC, but have still managed to find an OB who is on board and truly supportive. Unfortunately, the hospital environment he is in is much less supportive. We both feel like we've fought a battle to not have had my c/s at 39w just because I'm diabetic.
I'm a T1 diabetic, well-controlled with no complications, both my boys were large (one 9lb 2oz and one 10.5lbs) and that whole FTP thing. We were doing great and #3 is doing well by all accounts, but she has become persistently transverse. Until about a week ago she was unstable in her position switching between breech/transverse and oblique with an occasional foray to head down. She's not moved from the transverse position (except to oblique) in the last several days. I've tried Webster (several times), acupuncture, moxibustion, everything I could find on spinningbabies including writing Gail to no avail.
At the advice of another supportive OB, I scheduled an ECV yesterday. When my husband and I showed up, the OB that was scheduled to do it was less than supportive. He gave it less than a 40% chance of success (which as I understand, the success rate is much higher with transverse than breech, so that was just a lie), played the giant, dead baby card and all in all had nothing positive to say. He said he'd try it, but didn't really see the point. My feeling (having never had one) is that an ECV's success is pretty dependent on the commitment of the provider doing it, so we chose to leave.
I have an appointment with my OB today. I'd really like a chance at an ECV to at least try an labor on my own. I've had prodromal labor for several weeks now. Strong enough contractions that when I go in for NSTs they don't understand why I haven't transitioned to active labor yet. They are also picking up steam to where they are waking me up several times a night. Clearly, these haven't helped baby girl make the turn.
Writing this out, it looks like I should just assume I'm in labor, baby hasn't turned and have a 3rd c-section :(, but I'm so close to the situation and having a hard time finding people who have a voice of reason, I thought I'd put it out there for any other thoughts.
Thanks for reading!
I hope you get more answers than just from me. I would guess that an ECV is better now than later; can you request a different (more supportive) provider? Can your regular OB do it for you?
There is the school of thought that if the baby is persistently something or other, it's for a good reason...
Support, Hugs, You'll make the right decision for your family...
I hope you're doing OK.
Thanks Bekka. I don't know if my OB can do it, it's definitely one of the questions I'll ask today. The rule appears to be that whoever is the main OB on call in L&D is in charge of making the decision and doing the procedure. I thought about checking in every 12 hours to see who it is, but they are pretty adamant about the fasting rule. And while I have no qualms about fudging when I last ate, if I'm always showing up, they're gonna figure it out. :)
We didn't schedule it earlier since she was still moving and changing position and they didn't want to risk early labor, but the jerk we saw yesterday went on about how it was too late now.
I think the only good reason for her position is that I've got some apparent ligament damage on the lower side where her head stays. I started going to the chiro too late to solve it although he's done good work to help it along. It always is much more uncomfortable when she's mobile, making me think it's constricting my uterus enough that she doesn't have the strength to move. It's also why I thought an ECV would have a good chance of success. I've been assured that cord length isn't an issue and that they are confident by the number of ultrasounds I've had (due to diabetes) that they would have noticed had it been an issue.
But, at some point I start getting nagging worries about rupture with all the contraction activity going on...
I posted Eleanor's birth story over in the Cesarean forum. We did get my OB to try the ECV but it didn't work. He was surprised at how mobile she was, but still couldn't get her anywhere other than breech or transverse. My water broke about 7 hours before my scheduled rcs. The surgery took quite a long time due to the number of adhesions and scar tissue from my previous c/s. My OB felt it quite likely that the tight band of scar tissue that made it difficult for them to get to her was also the reason she couldn't turn, especially since she was 10+ pounds, it just wasn't going to happen any other way. As much as I really wanted a VBAC, I'm at peace with this birth, healing well and enjoying getting to know our newest family member.
I'm sorry you didn't get your VBAC but am so glad to hear that your baby is hear and happy and you've made peace with your journey. I think it's pretty common that we get those bands of scar tissue. I know a mama who was trying to have a VBA2C in our ICAN group and she labored forever (ok, a few days that felt like forever) and ever with our most friendlly VBAC doc here and she had a band of scar tissue like you are talking about...she spent a ton of her labor literally upside down on an ironing board trying to get her babe's head in the right position to apply pressure to her cervix...b/c she just wouldn't dilate. The head was caught in a hammock of tissue and wouldn't move to where it was supposed to be. Obviously she ended up with another c/section...but she was glad that she gave it her best shot. It feels good to know you made the right decision and it sounds like you did. I wouldn't want to have a breech baby with a provider who isn't comfortable doing one. And wow, what a plump baby!!
I feel very blessed that my 3 c/sections went as well as they did and my scar tissue wasn't too bad. Maybe you will heal better this time and get another shot at VBAC. It took me 3 tries before I was successful. Maybe you can see a chiropractor to help break up some of that scar tissue. Congratulations on the birth of your baby! Thanks for updating!!