VBAC - Last pregnancy was "high risk" - Mothering Forums

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#1 of 3 Old 06-02-2012, 12:33 AM - Thread Starter
 
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So, I had my son (only living child) in November 2009 at 42w and 1d via c-section.  I have had 2 miscarriages at 5 weeks and 12 weeks (baby stopped growing at 10 weeks).  I REALLY wanted a natural birth and even did hypnobirthing classes, but due to my labor not starting and me being 2 weeks overdue I had a c-section.  My son has a heart defect that required immediate care after his birth, so I had to be in a hospital.  I had doctors breathing down my back and scaring the heck out of me.  I had absolutely NO pregnancy issues, but my pregnancy was marked as "high risk" because of my son's heart defect. 

 

I am currently 7 weeks pregnant.  I REALLY want to have a natural birth, preferably a home birth.  However, I live in Arizona and no one will touch me because of the laws against having a home birth after a c-section.  So, I really feel like "damaged goods" and don't want to have to go through such an invasive and "in your face" atomsphere as a teaching hospital (where I delivered my son).  To make matters worst, I'm apparently "elderly" because I'm over 35 (I was 36 for my pregnancy with my son)!  Which I think is ridiculous because I take care of myself better than most women in their 20s and am very healthy.  So, that made doctors in my face even more!  I just want a stress free pregnancy and have the chance to enjoy it.  The midwive's out here have a policy that they don't take on VBAC patients at their facility, but will work with me at the hospital.  So, it looks like I'm stuck in a hospital unless I just go into labor and not go to a hospital.

 

Does anyone have any advice as to what I would be asking regarding VBACs?  I saw posts about the way you get stitched up and I don't have a clue the method that was used on me.  Does this matter?  What are the risks with a VBAC?  What are the stastics of something really horrible happening because you had a c-section?  I need as much advice as possible, I have just started my research on this topic.

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#2 of 3 Old 06-02-2012, 02:45 AM
 
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Best luck!
I had a great hospital VBAC at OHSU in Portland Oregon. It was very high tech (Dd was a preemie, and failed BPP and NST so extra monitoring was helpful), but was also the most wonderful and easy birth. 4 hrs of labor, 4 pushes, zero pain, zero recovery.

That said, please don't have an OOH HBAC. I know that this is an unpopular opinion here, and if you understand the risk and want to do it anyway, thats your right. However, Ruptures do happen, no matter how healthy you are. I have 2 friends that lost babies due to HBAC and one with a very disabled baby. While this can also happen in a hospital, you still have a fighting chance, unlike OOH.

The risk of rupture is 1 in 200. Even though the rate of death and HIE (brain damage) is lower than that, it is still not something that can be properly handled OOH. You do need CEFM (ask for wireless so you can use the tub!) to watch for problems.

Where you birth really matters with VBAC, I wouldn't go to a small rural hospital either! You may need to travel to go to a big hospital that does VBAC (I traveled 2 hours), but it's worth it.

Here's a great link that covers both USA and UK guidelines for VBAC::
"http://guideline.gov/syntheses/synthesis.aspx?id=25231"

Some things make it less likely, but I had most of these factors and still had a great VBAC, so don't be discouraged. From the link:
"There is agreement that factors associated with unsuccessful VBAC include: induced labor, no prior vaginal birth, advanced gestational age (≥40 weeks), advanced maternal age, high maternal BMI, high birth weight, previous cesarean section for a recurring indication, and non-white ethnicity."

(I'm sure some others will accuse me of "fear mongering", but INFORMED consent and the ability to choose depends on knowing the facts. I would feel irresponsible not posting this. )
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#3 of 3 Old 06-20-2012, 11:31 AM
 
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 I too got tired of the "well I'm going to stick my fingers up your vagina when I want to and you can sit still or it will hurt more" attitude.  My options are also limited because of laws, but I have found midwives who will do HBAC and hospital VBAC with me, I suspect you will have similar choices.  

 

You sound like you need to get "in" with the home birth community in your area.   I found more midwife options by asking people at my (family centered, no-sunday-school, half of them home school their 5 kids) church and my ICAN group.  Even if those aren't "your kind of people", consider looking up a homeschool group, church with big families, or ICAN near you.  Basically, where there are big families, there is someone who has had a home birth.  

 

Once you have one midwife who does home births, ask for other recommendations.  The world may be small but at least up here in Oregon there are ALOT of  birthing choices.  Even among home birth midwives, there are some who do VBAC, some who don't, some who are certified, are nurses, are naturopaths, are licensed, are not certified, are not licensed. In Oregon, you can pick any one and its all perfectly legal, plus you can still transfer to a hospital from a home birth at the drop of a hat during labor.  The unlicensed midwives tend to not advertise except by word of mouth (up here, many midwives who were licensed dropped out of that when the state made it very expensive to hold onto), so they might be hard to find for you but worth looking up.

 

As to research, I am still in the process but I LOVE the internet.  I also recommend the book "Obstetric myths versus research realities" by Henci Goer, which deals with medical research in the area of pregnancy and explains alot of the more technical jargon so you can dive into reading studies on your own.  Also, anything on the ICAN website, and read up on the medical research on ACOG's website.  Pubmed is excellent for finding medical journal articles as well.  

 

For myself, any blog reading was out until I'd exhausted the above, and even now any website advocating UBAC (a birth where you blissfully plan to be completely unassisted) is off my reading list.  Not that I would turn down a UBAC if I just like poof could give birth at the bus stop without any warning, I think every CS mama I know has fantasized about that! 

 

And if you end up like newsolarmomma2, and want to be at a hospital, that's all up to you too.  I'm undecided, but the benefit to your current HBAC plan is that you automatically have a plan B.  Plan A is HBAC, plan B is VBAC.  Every midwife I have talked to says we will have a transfer to hospital plan, and if its premeeie then duh, they'd go with you to the hospital.   But you can at least try your plan A out on your own turf, as it were, and you sound more comfortable there.

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