Thoughts of cancelling cesarean... - Mothering Forums

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Old 06-24-2014, 05:23 PM - Thread Starter
 
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Question Thoughts of cancelling cesarean...

I am 36 weeks pregnant with my 3rd child. I have been unable to find a VBAC supportive OB in my area due to gestational diabetes, controlled by glyburide. My first C-section was completely unnecessary and I was pushed into it because the OB thought the baby would be too big. My 2nd, I was told that I would be supported if I went into labor before 39 weeks, but I didn't. I am educated on the risks vs. benefits on going past 39 weeks with GD, as well as VBA2C vs. RCS. I just can not fathom having another cesarean just because the OB's and their insurance companies are scared of litigation. As of now, I have all my NSTs and AFIs scheduled up until I am 39 weeks, and I am scheduled for the C-section at 39+1. The hospital in my area, but not the one my OBs go through, is a VBAC eligible teaching hospital. It is also a level 1 trauma unit with the best NICU in the state, if anything were to go wrong.

I am seriously considering cancelling my scheduled C-section the day before I am to have it, and just show up at the hospital in labor. I recently started taking EPO as well as drinking RRT and taking the red raspberry supplement. Is there any advice that from others?
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Old 06-24-2014, 06:11 PM
 
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I've seen horrible cases where legal action was taken to force the mother into cesarean in similar situations...I wonder if speaking with a lawyer to plan this would help to protect you. Are homebirth midwives closely regulated where you are? It might not be too late to switch care providers if they'd take you.
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Old 06-25-2014, 08:37 AM - Thread Starter
 
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Originally Posted by JamieCatheryn View Post
I've seen horrible cases where legal action was taken to force the mother into cesarean in similar situations...I wonder if speaking with a lawyer to plan this would help to protect you. Are homebirth midwives closely regulated where you are? It might not be too late to switch care providers if they'd take you.
Getting a court order for a cesarean is rare and looked down upon by ACOG. The OBs in the practice I go to wouldn't do that. They do not participate in VBACs due to hospital policy. I will be going to a different hospital that does. It also takes a while to get a court order and by the time I get to the hospital, it will be close to delivery time.
Midwifes are strictly regulated around here. There is one group but I am not considered a candidate for their practice due to being on Glyburide.
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Old 06-25-2014, 03:01 PM
 
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Have you considered it's not because they fear litigation that the OBs won't support your VBAC? They are human and their job is to get women and babies through pregnancy and birth alive and healthy. Maybe they are afraid of your baby being hurt or dying in a shoulder dystocia, or of the baby dying before your body goes into labor at 40 weeks, or of trying to keep you alive and save your baby after a uterine rupture.
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Old 06-25-2014, 03:48 PM - Thread Starter
 
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Have you considered it's not because they fear litigation that the OBs won't support your VBAC? They are human and their job is to get women and babies through pregnancy and birth alive and healthy. Maybe they are afraid of your baby being hurt or dying in a shoulder dystocia, or of the baby dying before your body goes into labor at 40 weeks, or of trying to keep you alive and save your baby after a uterine rupture.
Shoulder dystocia is caused by having either a large baby, the mother having a small pelvis, or the baby being turned wrong. It does not cause death and I also have none of those issues at present. I also do not have any signs of a weakening or failing placenta and uterine rupture is very rare with the type of incision I have. At this time, there is no medical reason to have a cesarean over a VBAC. The OB I go to has a policy in place not to allow them due to the recommendations from ACOG of having 24/7 OR staff. I am more at risk of myself or my child having complications from the repeat section than if I were able to have her naturally. Also, I did ask my providers why they don't do VBACs and was told it is due to hospital policy and litigation. I am aware of what the doctors are supposed to do but I am also aware that they have their hands tied on some practices. This is something I have been educated on and I am not going into this ignorant or blind.
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Old 06-25-2014, 04:23 PM
 
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So, ACOG used to recommend against what you are suggesting because they medically believed the research supports the safety of RCS vs VBA2C (without a previous vaginal birth), but now says it's reasonable although the rupture rate may be higher- but old habits die hard. Shoulder dystocia is not just from a bigger baby, but also because in GD the shoulders tend to be disproportionately be bigger. But regardless, if you are not worried about 'burning bridges' with your current practice, I say go for it. I guess it's more of an issue of the gap from 39-? weeks of pregnancy- would you feel comfortable forgoing the NSTs and AFIs for what could be considered the riskier part of pregnancy (one could argue that the longer pregnancy continues, the higher the risk of stillbirth, and GD is a risk factor for stillbirth). You could go to the VBAC hospital claiming something like decreased baby movement, get evaluated with NST, then check out to return in labor, I guess (I know, it's deceitful, but you are being forced into a corner). It sounds like overall you are pretty comfortable with the idea; what you are proposing certainly sounds reasonable IMO.
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Old 06-25-2014, 05:46 PM
 
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Originally Posted by crcollins515 View Post
Getting a court order for a cesarean is rare and looked down upon by ACOG. The OBs in the practice I go to wouldn't do that. They do not participate in VBACs due to hospital policy. I will be going to a different hospital that does. It also takes a while to get a court order and by the time I get to the hospital, it will be close to delivery time.
Midwifes are strictly regulated around here. There is one group but I am not considered a candidate for their practice due to being on Glyburide.
This happened to me. Feel free to ask me about it if you feel it will be useful to you in making your decision.
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Old 07-05-2014, 01:43 PM
 
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Originally Posted by Katie8681 View Post
Have you considered it's not because they fear litigation that the OBs won't support your VBAC? They are human and their job is to get women and babies through pregnancy and birth alive and healthy. Maybe they are afraid of your baby being hurt or dying in a shoulder dystocia, or of the baby dying before your body goes into labor at 40 weeks, or of trying to keep you alive and save your baby after a uterine rupture.
If that's the case, then they are ignorant OBs who are ignoring the evidence.

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