Torn between a home vbac or repeat c-section.... anyone had a home vbac? - Mothering Forums

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#1 of 11 Old 03-23-2012, 08:11 PM - Thread Starter
 
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Long story short, I had a very high risk pregnancy with my first son and it was very necessary to have a c-section for my first son. Until I found out I was high risk, I was planning a home birth. Since then I moved from vbac friendly portland, OR to santa barbara, CA, where vbacs are banned everywhere within 200 miles... I really dont want to have another c-section, especially if its not medically necessary. Not only because I cant stand another impersonal cold c-section, but I will have 1 year old son and an infant to care for, leaving NO time for recovery from a major surgery.

 

I did find a home birth midwife who is willing to try a home vbac. I am a little nervous, as I may lose the support of my back up MD and have no idea how Ill be treated IF I have to transfer or what exactly the risks may be of having a vaginal birth at home, and only 1 year after I had my first c-section.

 

Anyone have any experience here?

 


Active self employed momma to my amazing son with down syndrome born 8/24/11, wife to the most amazing husband ever, expecting baby #2 on September 5th, 2012, exactly 1 year from my sons original due date. Currently sharing our crazy household with 1 house rabbit, 3 exotic lizards, 1 guinea pig...

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#2 of 11 Old 03-23-2012, 09:03 PM
 
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What circumstances made your last pregnancy high risk?

 

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#3 of 11 Old 03-24-2012, 06:37 AM - Thread Starter
 
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Its a long story. At 28 weeks I was measuring 8 weeks too big. I went for an ultrasound and my son had a duodenal atresia, a blockage in his instestine. leaving him unable to swallow and process amniotic fluid. I had severe polyhydramnios (high amniotic fluid levels),  and found out I was in preterm labor at 28 weeks, and dilated to 2 cm. I was on an off bedrest, in and out of hospitals for the next two weeks, until they had to amnio reduction. At that time they found out he had down syndrome. The plan then was to keep me heavily medicated to stop contractions and did 2 more amnio fluid reduction to try and keep me pregnant as long as possible. This meant almost daily hospital admissions, perinatologist appts, and now additional screening for problems because of the down syndrome diagnosis. By some miracle we made it to 38 weeks. He was double footling breech because of all the excess fluid that was still building up on a daily basis, and still always in labor. I was a walking time bomb. Because of all the fluid, I was at a high risk for expelling the umbillical cord when my water broke, and pinching it once all the fluid drained. The speciality hospital that was equipped with the high risk NICU for his medical needs because of his intestinal problems was over an hour cross town, and in 2 months, he never flipped head down. It would have been a very high risk of death for me to stay at home, and hope by some miracle he flipped and didnt pinch the cord when my water broke. I was really not happy with a c-section, especially because I never got to see my son for hours afterward... he was rushed out of the room, but also because it was so cold nad impersonal. My regular perinatologist was out of town, so I had the doctor on call and was treated basically like a cadaver. My questions were not answered, no one would tell me what is going on, no one told me when they were going to start or what to expect, no one told me what happened to my son. I told my husband to stay with the baby, so I was all alone... for quite a while. It was really emotionally hard. My son was in the NICU for 19 days total, and had surgery 5 days after he was born to correct his intestinal blockage. This was, as you can imagine, just about the roughest birth you can imagine. Sitting in the recovery room, alone, husband had to go back home to take care of house, pets, and my parents in town, listening to other people love on their babies, for 2 days, until I told them they either discharge me or Im leaving AMA. I couldnt go to the NICU whenever I wanted because they were so busy with medical test and such, and had to coordinate hospital transport to take me down there, which often did not show up, or had to call many many times,and by the time i got there, they often sent me back to my room because they were sending my son to xray or something and I missed my window of opportunity.

 

I know its much riskier for baby and me to go through another c-section. I dont know if I can deal with my second and last child (my husband is getting snipped, we just want 2 kids), going to the NICU because of a surgery I didnt need, and being alone again. I will have no choice but to lift my 1 year old son because he will most likely not be walking or crawling at that point as he is 7 months now and neither sitting or rolling (we are working on it.... and so is his therapy team). I will have to care for a newborn and a baby the moment I get home, no sleep, no recovery time. My mom lives an hour away, but doesnt drive and my dad works full time. My motehr in law lives in town but works 3 jobs I will have no help. I know my husband will try to help, but he has a lot of work he has to deal with with our self employment that cant be put off o put on maternity leave. Im stuck!

 

My husband of course is listening to my mental debate on this matter, but I know he would feel better if I was in a hospital, even if that meant another c-section, with the big medical scare with my son, it kind of opened our eyes to the idea that big problems can happen. There is no medical or genetic reason why this pregnancy would be another high risk pregnancy. All the high risks associated with my first pregnancy were due to my sons down syndrome and intestinal blockage (a common problem with kids with DS). There was nothing "wrong" with how my body reacted to suspect that I would have problems on later pregnancies. I never had problems with high BP, sugar, no swelling of feet hanfs, healthy weight gain, etc etc. All ultrasounds on this pregnancy look like a "typical" pregnancy.


Active self employed momma to my amazing son with down syndrome born 8/24/11, wife to the most amazing husband ever, expecting baby #2 on September 5th, 2012, exactly 1 year from my sons original due date. Currently sharing our crazy household with 1 house rabbit, 3 exotic lizards, 1 guinea pig...

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#4 of 11 Old 03-24-2012, 06:42 PM
 
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How far along are you now? How has your pregnancy been going?


Do not go gentle into that good night. Rage, rage against the dying of the light. ~Dylan Thomas

 

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#5 of 11 Old 03-24-2012, 07:06 PM - Thread Starter
 
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4.5 months and as far as I can tell, everything is going fine. Ultrasounds have come back fine, less sick than the first pregnnacy. I will be going for a 18 week ultrasound, for a gender check and anatomy check, so Ill breathe a little easier after that. We are not worried at all about having another baby with down syndrome. All we know about is having a baby with down syndrome and he is seriously the most amazing baby ever (sorry, proud momma has to brag a little). BUT there is no genetic reason why I would be at any higher chance of having a baby with DS than anyone else my age (29 years old). We were just the 1:1000 who had a kid with DS (and we feel lucky about it). I could do without another high risk stressful pregnancy, and a NICU stay/surgery though.


Active self employed momma to my amazing son with down syndrome born 8/24/11, wife to the most amazing husband ever, expecting baby #2 on September 5th, 2012, exactly 1 year from my sons original due date. Currently sharing our crazy household with 1 house rabbit, 3 exotic lizards, 1 guinea pig...

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#6 of 11 Old 03-25-2012, 06:06 PM
 
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Thank you for the additional information. It sounds like you are making good decisions so far. I suggest you speak with your midwife about what happens in the event of a transfer.  Also what circumstances would your midwife transfer for? Does she have a Back Up OB that she works with?  Will she have any rights while she and you are in the hospital for a transfer or will all care be handed over to the OB or On Call OB?

 

 

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#7 of 11 Old 03-27-2012, 10:50 AM - Thread Starter
 
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All excellent questions. I have called three midwives/midwife teams and I am going to try to set up interviews ASAP. I know its a little late in the game as I know midwives can book up fast, but I am going to do my best. I have talked it over with DH and he is open to learning more about a hbac. He was open the first time around, as long as there were no complications that we knew about... then of course there were complications that knew about and consumed the last 3 months of my pregnancy. Ill keep everyone updated.


Active self employed momma to my amazing son with down syndrome born 8/24/11, wife to the most amazing husband ever, expecting baby #2 on September 5th, 2012, exactly 1 year from my sons original due date. Currently sharing our crazy household with 1 house rabbit, 3 exotic lizards, 1 guinea pig...

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#8 of 11 Old 04-09-2012, 05:39 PM
 
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I hope you're able to have a HBAC. If I get pregnant again, and I make it to 37 weeks (I had a random pPROM at 23 weeks this last time), then I'll probably be trying for a homebirth again. Until then, though, I'll be seeing an OB just in case my body decides to make my water break early again.

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#9 of 11 Old 04-13-2012, 05:10 PM
 
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Yours is a very hard choice to make. I too want to have a VBAC because of the awful experience of a c-section, so I know how you feel there. I did find a doctor in my city who will do a VBAC in the hospital so my choice is not as hard as yours to make. I personally don't think you would need to necessarily worry about a uterine rupture because the chances are very low, in fact your have a higher chance of other complications not related to a previous c-section then you do of getting a UR. The thing I'd be most worried about would be if you ended up having the same complications as your first and needing to go in for an emergency c-section. If I were you I would really research the complication you did have and how likely it would be to happen again, and also look into what could have caused it to happen. For example I had to have a c-section because of failure to progress in labor. And I read that petocin and an epidural can cause this to happen in a lot of women. I also found out that petocin and a c-section can cause your baby to be jaundice, and my baby was. So I've decided not to have any medical intervention. And if you think that having a V-BAC at home would be the best choice for you, I would just make sure you map out and plan how fast it would take you to get to the hospital in case of an emergency and if that would be enough time, and how fast you could get into surgery. Just research the whole thing up the wazoo, and way your pros and cons. Good luck. 

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#10 of 11 Old 04-13-2012, 05:10 PM
 
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Yours is a very hard choice to make. I too want to have a VBAC because of the awful experience of a c-section, so I know how you feel there. I did find a doctor in my city who will do a VBAC in the hospital so my choice is not as hard as yours to make. I personally don't think you would need to necessarily worry about a uterine rupture because the chances are very low, in fact your have a higher chance of other complications not related to a previous c-section then you do of getting a UR. The thing I'd be most worried about would be if you ended up having the same complications as your first and needing to go in for an emergency c-section. If I were you I would really research the complication you did have and how likely it would be to happen again, and also look into what could have caused it to happen. For example I had to have a c-section because of failure to progress in labor. And I read that petocin and an epidural can cause this to happen in a lot of women. I also found out that petocin and a c-section can cause your baby to be jaundice, and my baby was. So I've decided not to have any medical intervention. And if you think that having a V-BAC at home would be the best choice for you, I would just make sure you map out and plan how fast it would take you to get to the hospital in case of an emergency and if that would be enough time, and how fast you could get into surgery. Just research the whole thing up the wazoo, and way your pros and cons. Good luck. 

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#11 of 11 Old 04-13-2012, 05:39 PM - Thread Starter
 
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The likelyhood of me having the same complications with this pregnancy are about the same as getting struck by lighting multiple times. My son had down syndrome and an intestinal blockage that caused severe excess of amnio fluid. They were worried I would break my water and the sheer force of the excess amnio exciting my uterus would expell the umbillical cord, which then would get pinched. Also, he was breech because of the excess amnio fluid and had to have a hosptial birth where breech presentations means immediate c-section.  So it was somewhat of a "planned" c-section. I had lots of "preterm labor" but never had a chance to actually labor and attempt to deliver vaginally :( My son is amazing and I would do it over again if the same situations arose just to have him in my arms, but seeing as though this pregnancy seems normal so far and came back with a low genetic screening for DS, i dont see the reason to have another c-section. We came up 1:15,000 with this pregnancy and had been 1:1000 with my son.  We are not carriers for DS, just the 1:1000 lucky ones to be graced with an amazing kid with down syndrome. I go in for my 20 week ultrasound next week to confirm everything looks "ok", but as long as things look low risk and healthy, going to go ahead with the home vbac.

 

Thanks for the support everyone!


Active self employed momma to my amazing son with down syndrome born 8/24/11, wife to the most amazing husband ever, expecting baby #2 on September 5th, 2012, exactly 1 year from my sons original due date. Currently sharing our crazy household with 1 house rabbit, 3 exotic lizards, 1 guinea pig...

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