Deciding between 2 birthing center - Mothering Forums

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Old 02-17-2005, 05:03 PM - Thread Starter
 
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Hey there,
I have called both places and asked many questions. Everyone was really receptive and nice- VBAC friendly places. So, here are the two main differences between the places. BC #1 is close-by and small, which are plusses. In the negative, they require a hep-lock, no IV, but do continous monitoring. They don't have underwater monitoring supplies, so no tub or shower. Ugggh
BC #2 is further away - 1 1/2 hour drive and also fairly small and intimate. They do monitoring too, but have one of those systems where you aren't literally hooked up. You can walk anywhere, outside, use the tub, etc.
They both have about the same stats for successful VBACs - 70% or so that try are successfull at vaginal birth.
Oh, another difference I forgot. BC#1 doesn't use any induction tools but Pitocin during VBAC. BC #2 doesn't use any induction tools at all for VBAC. What are the plus or minuses of haveing Pitovin available to me for a VBAC?

Any thoughts??? Both have MD and OF staff on call, but I would have midwife and/pr family physician and nurse attended birth.
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Old 02-17-2005, 05:15 PM
 
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Old 02-18-2005, 12:20 PM - Thread Starter
 
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My husband works at a residential school where he is a Math teacher. Not a good place to have a home birth. Plus, I really dig the birthing center with Baby #1. There was no intervention up to the C section so it felt very freeing and I loved having them clean up and feed me and rub my feet ( you get the picture ). I hated to leave.
Of course, there will be more interventions now that I am trying a VBAC, but I am Ok with that. I guess my real choice between the two places is distance of the place versus monitoring choices. The pitocin issue I am wondering about too. I don't like Pitocin, know about the horror stories associated with it, but is having it as a tool help stave away a possible c section? Or- do you think it ups the chances of another c? Just wondering. One place forbids its use during Vbac, the other uses it if necessary with caution.
I feel good about both places, love the midwives/family physician soooo much. Of course, protocols are protocols. I have never been monitored, so I have no sense of what that is like.

- Kerri
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Old 02-18-2005, 12:36 PM
 
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I wouldn't want to attempt a vbac anywhere with only 70% success rate. That's really not that good, especially for a birthing center.
both the continuous monitoring and the pitocin increase your odds of having another cesarean.

Like the previous poster said, you need to go with where you feel the most comfortable. For me, that would not be either of your two birthing centers.
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Old 02-18-2005, 11:37 PM - Thread Starter
 
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What should the success rate be? I was under the impression that 70% success rate was really good. Aren't the success rates for a vaginal birth without a previous C section like 85-90% What are the rates in your area? I live in NH and would birth in VT, which according to the birthing centers have a very low rate of first time c sections and a high rate of VBAC. The birthing center I went to before had about 3 out of 4 women having a successful VBAC, with the other 1 having a successful C birth. they have never had an infant death due to VBAC or maternal death either.
Whoa, please send the info if you have it. I am just floored that figures should be higher than that.
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Old 02-19-2005, 04:19 AM
 
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#2 sounds appealing.

I'd prefer a birth center with midwives that also do homebirths as well as their birth center births. No inductions. If Pitocin is available, chances are they'll use it and it will create more issues and restrictions.

I don't know about rates for VBACs. I guess a good question would be to ask what happens with certain scenarios: if you go over your due date, if your water breaks, but no labor starts, if you're GBS positive (or can you waive that test??), if your labor is longer than what they think is "normal", or what reasons would indicate a transport (meconium, "stuck" at a certain dilation for so many hours, etc.).
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Old 02-19-2005, 07:22 AM
 
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I know I am struggling with the monitor thing. Have to monitor and be laying down at the hospital with my generally cool OBGYN. It makes sense to me, but laying down IS counter intuitive. My first birth was in water and great. Second was at a hospital, laying down and monitored ( my water broke early both times, probably will here too) and it went badly. I am trying to accept my situation and make the best of it in the context. I just probably won't have a water birth perfect birth experience again. But I like reading your post to see that they probably ARE options for me out there. I will explore too. I agree with people here who say you need to go where you feel ok. I know I am pretty scared about the VBAC and trying to focus on why I wan tto do this and how to make it all ok for myself and not tripping myself out about the birth I REALLY want but probably can't get at this point based on my own level of paranoia. I like the idea of the surgery room being thisclose just in case. For me, it feels better and I can RELAX and allow the bab yto do their thing.

Now, I have been hearing form my doula friends and such that the recent VBAC studies seem to indicate that induction might be part of issue cases. This makes sense to me- you don't want to stress the uterus. I won't take castor oil, which is what I did for #1, because it just seems like it would bother my body as much as get things going. My plan in this area is to put lots of emphasis on visualization and other ways to get labor going and avoid drugs of any kind in that arena. In my case, since my water seems to break early and cause doctor issues, I want to focus my birth plan around compensating for the induction drugs. Just my thoughts on the matter.

Anyway, I look forward to keepign on this thread! I think it will help me too! Thanks!

Nikki
#3 VBAC planned Sept. 17 due
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Old 02-19-2005, 01:44 PM
 
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Quote:
Originally Posted by Mama Coltrane
What should the success rate be? I was under the impression that 70% success rate was really good. Aren't the success rates for a vaginal birth without a previous C section like 85-90% What are the rates in your area? I live in NH and would birth in VT, which according to the birthing centers have a very low rate of first time c sections and a high rate of VBAC. The birthing center I went to before had about 3 out of 4 women having a successful VBAC, with the other 1 having a successful C birth. they have never had an infant death due to VBAC or maternal death either.
Whoa, please send the info if you have it. I am just floored that figures should be higher than that.
at the hospital #1 was born (cesarean) the overall c/s rate is 30% and the vbac success rate (those few women who even bother to attempt vbac) is around 80% - I was under the impression that is pretty much average for the US, but I may have been mislead by my OB. at The Farm, where DD2 was born, the c/s rate is less than 2% and the vbac success rate is 98%.
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Old 02-22-2005, 10:29 AM - Thread Starter
 
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Cool. thanks for the stats. The Farm is its own special place that would no doubt have better rates than anywhere else, but 80 % is really good. I will check with the centers again and see what the reasonings behind most of the failed VBACs were. I feel like I am researching like crazy, but I am a very thorough person and I want the best chance possible this time for a VBAc
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Old 02-22-2005, 03:25 PM
 
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I would not go anywhere that offers a vbac woman Pitocin -- that is a recipe for disasterous out comes. Pitocin or any other induction medication increase your risk of a uterine rupture. It should never be given to a woman who has had her uterus cut open.

I would also choose a place that is going to allow you to move in your labor. You need to move in labor to move and work you baby down the birth canal.

70% vbac rate is good IMO, better than the hospital. I would expect the BC1 on your OP to be lower than 70% by your discription.

1 1/2 hours is not too bad, but labor in a car won't be easy, especially since you won't be able to move much during the ride there.

I opted for a homebirth b/c birth centers were not open to my a2c/s status and the hospitals rules and regulations were not acceptible to me. Yes, I paid out of pocket, $2200 for my midwife. Worth every penny to hold my dd immediately and nurse her within minutes of birth, to see her alertness (my dh even noticed the difference). I was prepared to take cash out on every credit card I have stashed away for emergancies to pay my midwife, fortunately my dh had just taken an equity line of credit out on our house.
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Old 02-23-2005, 09:46 PM - Thread Starter
 
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Yahoo-
Just found out that I can move around completely during labor. They are buying a monitor that isn't attached by wires. You can go in the tub, shower, all over the place with it. If they don't have it in house By August, I am going to rent one.
I'm talking to the doc about Pitocin and opting out of that. I agree that it puts me more at risk for a c section.
Well, I am feeling better about all of this. I am opting for the Buirhting Center that is 15 minutes away and I am laboring at home for a long time.
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