Feeling conflicted about VBAC - need advice! - Mothering Forums

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Old 04-30-2005, 04:37 PM - Thread Starter
 
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I've just written my update at the end of the thread!

I just found out that the placenta previa I was diagnosed with (at 18 weeks) is now, at 24 weeks, far enough away from my cervix (3.5 cm) that it will probably be fine for me to try VBAC.

My dd was born via C-section due to being breech, and because I could not push during labor for fear of bursting a rare lymphatic tumor (cystic hygroma - not cancer, actually a birth defect) in my neck.

So far the hygroma hasn't appeared (hopehope that it won't!) so I'm considering VBAC. But I'm so nervous about it. I guess I might as well also mention that I have a plum sized cyst on my ovary but I don't think that would make any difference...

Anyway. I'm thinking I might let my OB schedule the C for 39 weeks but go ahead and try VBAC if I go into labor before then. I know, wishy-washy! I just can't decide! I'm sorta scared, but this pg is soooo diff from the 1st that I actually feel a strange confidence that my body can do it.

I just heard a nightmare birth story from a friend that nearly threw me off track totally. I would love it if you would share your stories - both successes and otherwise, and if you have suggestions for preparing for VBAC I'd like that too (books, etc).

I really don't know where to start. The weird thing is the feeling I have of indifference... It could go either way and I'd be happy as long as my baby and I were healthy... but I would much prefer a natural birth with less recovery time... My earlier C was a great experience, I had a wonderful, advocating OB who let me attempt to nurse on the operating table. But she decided to go traveling for a couple of years.... (OT!)

Thank you so much for reading this far and for any help you can offer.
much love,
alison (and I'm sure Liam will appreciate this, too!)
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Old 04-30-2005, 04:41 PM
 
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I have had a VBAC and it went really well; drug free, hospital birth.

It was an awesome feeling

One of the major pluses was being able to return home quickly and not be recovering from a c-section, especially since my other child was 2 at the time.
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Old 04-30-2005, 05:33 PM
 
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my vbac story

sorry about the pop-ups and banner ads, I need to find a new free host since Ivillage quit hosting personal websites

don't listen to anyone who has anything negative to say about childbirth, or your plans. Just absolutely refuse to discuss it with them if they can't be positive and supportive!! Seriously, that made a huge difference in the success of my vbac.
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Old 04-30-2005, 06:14 PM - Thread Starter
 
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thank you for sharing - i'm in TN too but far east, and thinking of finding a doula to assist me...
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Old 05-01-2005, 11:58 PM
 
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Go to www.ican-online.org they have a lot of great info. I just have to say it was such an empowering experience for me, I would pick vaginal birth anytime. You can read my story from the link in my sig.

What exactly are you scared of or unsure of?

FYI the rupture rate according the the New England Journal of Medicine's study in December 2004 for Spontaneous labors was only .4%. So please don't let the dr.'s scare you about rupturing!
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Old 05-02-2005, 12:39 PM
 
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I ended up with a c-section with my DS because the docs pushed me to agree to a Pitocin induction. All the interventions created a slippery slope which led straight to the OR.

I vowed that I would never let that happen again.

Well...when I got pregnant with DD I learned just how hard it is for women to get the chance to deliver vaginally these days! I went through 3 OBs and finally found a CPM who trusted birth.

I think it's extremely important for women wanting to deliver vaginally to learn about natural birth and get in touch with their bodies.

We're DESIGNED to give birth. Only in America are women told their bodies are inadequate and that they need assistance to deliver their babies.

I think it's an absolute necessity for hospital VBACs to have a strong doula with you to run intervention with the staff. If planning an HBAC select a midwife that has confidence in your body and follows the midwife model of care.

I posted a version of my DD's birth story on the birth story thread. Let me see if I can hunt it down.


Here it is:

http://69.20.14.30/discussions/showt...highlight=hbac

--Kari
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Old 05-02-2005, 01:57 PM - Thread Starter
 
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Thank you!
Fortunately, my doctor strongly advocates VBAC. She actually brought it up to me and has been encouraging me to consider it. I guess she's one of the few who really care. She would rather not perform a repeat C-section if I continue to do well.

I guess my fear is that, although the risk of rupture is low, the consequences are terrible. I see the VBAC vs. repeat C kind of like a plane crash vs. a car accident. Yes, you are more likely to get in a car accident (i.e., more likely to have complications with C) than a plane crash (uterine rupture with VBAC), but if you do get in a plane crash the results are usually fatal. I just love my dd so much, I'm willing to endure almost anything to see her grow up. I know that a scheduled C-section has risks, too - but it seems more controlled. I don't know. This is why I'm so conflicted!

Your birth stories are really giving me confidence... thanks for sharing them....
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Old 05-02-2005, 05:40 PM
 
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do a bit more research then. UR is not usually fatal for either mom or baby. so you take a really small chance that it's going to happen, and an even smaller chance that if it does happen someone dies.

You really have to feel comfortable with your decision, you have to KNOW it's the right thing to do, and you have to trust your body to give birth (or your doctor's surgical skill, depending on your choice).
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Old 05-02-2005, 06:04 PM
 
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I HBA2C, but I'll start from the beginning sort of...

With my 2nd child I decided for a repeat c/s, I didn't have all the facts. But in the end it was what I needed. I had very bad scare tissue from the 1st c/s being horribly done the 2nd c/s repaired that. My focus w #2 was also not on natural birth but on breastfeeding. I so longed to breastfeed and suffered major depression for almost 2 yrs after the horrible c/s and treatment of #1. So, I set out my course to bf and decided I didn't want a repeat of #1. A few points along the way, I was really wanted to go into labor before the sch date. I even tried inducing labor herbally to do so, not smart, but... I felt like I couldn't change my mind b/c my parents were flying in from overseas and already had their tickets etc.

W #3, I was fired by my OB at 30 wks and decided this was my opportunity to get it right. I had wanted a hb when I first found out I was pregnant w #1. It took a while to find a hb mw around here, but I did find her. We had 6 wks together before the birth.

My HBA2C was incredible, really. I was so empowered by birth and was on a birth high for at least 3 mo, then it faded a little. Breastfeeding was a snap, dd is such a happy baby, I want another hb.

Either way you go vaginal or c/s there is a healing process you body must undergo. I felt great emotionally after my hb, but my physical body took a long time to start to get better. It didn't help that I had an undiagnosed UTI for 2 wks before I go treatment -- ouch. Anyway, all it all I'd still do it again. Being able to get out of bed with no hands holding on to my sleeping baby at the breast is far better than having a my stomach cut open and require assistance for 2wks while I got some of my ability to rise out of bed or a chair by myself.

As for rupture and fatality -- in a hospital setting it should not be fatal for you or your baby. For me the risk was greater being a HBA2C, but I knew that if I got a c/s w/in 30 min of rupture we would survive and if it happened in 17 min or less her survival without problems would be greater. I live 3.4 miles from the hospital and it takes about 14 min if you stop for all the lights.

I realized that if I ruptured I would lose my uterus and not have anymore children, but I trusted God would see me through what ever happened. In a hospital, some ruptures can be repaired and you can continue having babies and c/s.

The biggest reason I had a HBA2C was a little bit of information no one wants to tell c/s woman... Each pregnancy after your 3rd c/s carries a greater and greater risk of uterine rupture during the pregnancy. I sat at 24 weeks pregnant with this information thinking to myself, if I made it past 24 wks and my uterus ruptured I would survive, my baby might survive and I would definitely lose my uterus. If it happened before 24 wks my baby would die. I could live with the risk of losing my uterus, I could not live with the risk of losing a baby that way.

I spoke to my OB about this information I had read. He told me that he only recommends 3 c/s and that I should have my tubes tied this time (they tried to get me to do this the last time). I said that I could not be having my tubes tied for religious reasons and asked what my risk are for having more children, he never answered me. I received a letter in the mail 3 wks later terminating me from their care for reasons of non-compliance. They stated I refused a GT test, when in fact it wasn't due until my next appt. which they canceled and left me with no prenatal care for amost 2 mo in my last trimester.

I feel God was leading me to greater things and wanted me to begin healing from my horrible experiences with hospitals and c/s.

I love Ina May's Guide to Natural Childbirth -- it was so empowering to read about woman giving birth naturally. I had it checked out until I gave birth!
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Old 05-02-2005, 07:12 PM - Thread Starter
 
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wow, thank you for sharing your experience. I think one of the best decisions I've made so far has been posting in this forum...

Ok, I'm going to get Ina May's book...

I feel certain that the doc who did the 1st c did a wonderful job putting me back together, I healed very well and very quickly. I'm so amazed that you all overcame your fears, or had the strength - whatever it is, that made you choose H/VBACs. I'm a pretty neurotic individual, but I'm getting better...

So many of you (I've read other posts from other threads, too) had such awful experiences with doctors. I think for some of you this may have encouraged you to have VBACs, but maybe others were freaked out or miseducated because of their docs. I've been one of the lucky few with incredible, young (i do think this made a difference), truly caring female (i think this made a diff, too!) OBs who really treat me with respect, and I feel like it would be a travesty if I didn't VBAC considering my doc is so supportive. It's like I'd be throwing it away after so many of you could have used an OB like mine!

Time for me to do some reading. I was about 50/50 when I started this thread, already I'm about 65/35 pro VBAC...
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Old 05-03-2005, 10:32 AM
 
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ITA with getting ina may's guide to childbirth. and the book birthing from within.

i think the more research you do, the better. listening to birth stories is also very important b/c you'll see what obstacles other women have overcome.

good luck to you!

i would post a link to my vbac story but i don't know how.... hmmm, gotta figure that one out.
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Old 05-03-2005, 12:16 PM
 
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I just thought I would add my experience too!

I had a c-section with my first because he was breech and we couldn't get him to turn. I had a c-section with my second after a very long labor in a Free standing birth center for many reasons: he was large, big head, cord next to his head, posterior position, and heart decelerations. It was a tough labor, but I still preferred the 2nd experience to my first. (Going through labor, painful as it was, made me feel ready for my son's birth. I think it was better for him too.)

Here I am now, pregnant with my 3rd, and planning a vba2c. I will admit that I had a hard time for the first half of the pregnancy--I was feeling pessimistic about my chance to actually have the vbac. (I'm also in a hospital setting now, with midwives, but it's VERY different from the FSBC.) Then I did some reading, and it helped me to become optimistic again--it was the Ina May Gaskin book already suggested. (Wonderful book, fantastic and inspiring birth stories, and excellent info. Slightly OT, but I'm going to be seeing her speak tomorrow at a conference I'm going to, and I'm VERY excited!) I would also suggest Birthing from Within, which is a fantastic book and useful for working through fears. It also might help to do a lot of research on vbacs and csections, which will help you realize that the risks aren't as bad as some people think. (And that the risks of csections are often downplayed.)

It's wonderful that your ob supports you in having a vbac--this is very important! I also have an ovarian cyst, which I have been told will not affect my ability to have a vbac. (It's 6.1 cm, and hopefully not growing.) Good luck!!
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Old 05-03-2005, 02:27 PM
 
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I think a supportive caregiver, whether OB or midwife, will make a huge difference. I've had two c/s, both for breech presentation. And, if this baby is again breech, I'll probably have the repeat c-section. But, my OB is being quite supportive of my wish to VBA2C if the baby's presentation is okay. If I'm breech a couple of weeks before due date, I'm going to wait until labour begins before consenting to a section, though. Both my babies turned very late...my son during labour, and my daughter in my 40th week.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
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Old 05-04-2005, 03:24 PM
 
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Quote:
Originally Posted by mamasarah
ITA with getting ina may's guide to childbirth. and the book birthing from within.

i think the more research you do, the better. listening to birth stories is also very important b/c you'll see what obstacles other women have overcome.

good luck to you!

i would post a link to my vbac story but i don't know how.... hmmm, gotta figure that one out.
Ina May's Guide to Childbirth is great and I absolutely adore Birthing From Within and the keepsake journal that goes with it. The journal is on sale at their website for $9 right now. :-)

I had a horrible experience with my first pregnancy. I was induced at 36 weeks for toxemia and after only 6 hours, the OB lied to me and said DS was moulding (I was only 2cm dilated 100% effaced) and that he had to do an emergency section to ensure that he didn't suffer brain damage or a damaged skull as a result. I didn't find out it was all a lie until this pregnancy when I brought up wanting a VBAC and the other OB at the practice told me the reason I was told I needed a cesarean made no sense. Then he looked back in my chart and it said the baby was too big (barely 5 lbs at birth, what a load of crap) and that he wasn't even engaged. So he was nowhere near moulding! I was so pissed. But then he told me it would be like taking a revolver with 100 chambers, putting a bullet in and pulling the trigger. Could I take the chance that I wouldn't shoot my son's brains out, even though it's only a 1% chance that I would. I got up and walked out. I thought that was highly inappropriate and instead of terrifying me into scheduling a repeat section it made me want a VBAC even more. So now i have a new OB who is being much more supportive of my VBAC decision and hopefully things will go much better this time around.

Good luck with whatever you decide to do!
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Old 05-04-2005, 03:39 PM
 
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Jillene -- it's stories like yours that make me wonder how any woman gets out of the hospital with a vaginal birth. Doctors make me sick! (But glad you found one that isn't such a BLANK!)


Birth in the US has become ridiculously entangled with 'cover my butt' syndrome. It puts the woman being treated with this CMB syndome at an increased risk for unnecessary interventions and c-sections.
I'll climb down now...
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Old 05-04-2005, 04:34 PM - Thread Starter
 
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:LOL I love you guys.

I'm about 90% there. I think I'm going to do it!!!! I'm feeling more confident every day. I know this sounds silly, but I just *feel* that my body can do it!!! Now let's all hope the baby will co-operate and turn around when he's supposed to... and that I don't get that silly hygroma thing in my neck... I had it a month earlier in my pregnancy with Abigail than I am now. (I was about 19 wks, I'm at 25 now).

I am beginning to think that my ambivalence is more about my fear of disappointment if I get my hopes up for a VBAC and then can't do it. Yeah. That sounds about right.

I'm calling a local doula right now. Or should I say *the* local doula...

Thanks again, you ladies are really helping!!!!!!
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Old 05-04-2005, 04:39 PM
 
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Quote:
Originally Posted by jillene
So now i have a new OB who is being much more supportive of my VBAC decision and hopefully things will go much better this time around.

Good luck with whatever you decide to do!
There are some out there who definitely support VBAC. My family doctor and the OB were both behind me having a VBAC last time...until the baby was breech (again!). I'd never heard anybody suggets that a vaginal breech birth was practical until I came here.

But, they're both a lot more hesitant about a VBA2C. Fortunately, the OB isn't the "this is just the way it is" type. My family doctor's attitude was basically "you'll have to have a c-section again next time, so you might as weel accept that now", whereas the OB is much more supportive of my desire to avoid the section.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
Loving my amazing dh, James & forever missing ribbonpb.gif Aaron Ambrose ribboncesarean.gif (11/07) ribbonpb.gif

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Old 05-04-2005, 04:41 PM
 
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Originally Posted by daekini
I am beginning to think that my ambivalence is more about my fear of disappointment if I get my hopes up for a VBAC and then can't do it. Yeah. That sounds about right.
I've had some of that, too. Then it occurred to me that if I "fail" to VBAC, all that happens is another section. If I don't even try, then I get the section for sure! I'd rather have the possibility of VBA2C than no possibility at all...

Besides, if I try VBA2C and don't succeed, my body will still be ready for the baby when it comes. I don't think it was with my scheduled c/s for dd.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
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Old 05-04-2005, 05:14 PM - Thread Starter
 
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OMG!

I just spent the last 45 minutes talking to the doula that I may use.

She sounds great. I didn't realize when I called her that she is also a midwife, but she takes a couple of doula clients a year.

She seems really experienced and is emailing refs to me. I want to ask about people's experiences with doulas - should I go over to another forum?

I think that I need labor support in addition to dh - he would have a hard time being an advocate for me, and if I started crying for meds he'd be dragging the anesthetist in ASAP rather than help talk me out of it...

I still sort of feel like I'd wait up to 40 weeks. I don't want to be induced! I don't want any meds! But I also don't want to wait too long b/c I'm afraid of the rupture risk increasing as weeks pass by...

Mark and I are going to meet with Belinda in the next couple of weeks. Maybe she'll really tip the scales for me!
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Old 05-04-2005, 05:17 PM - Thread Starter
 
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I've had some of that, too. Then it occurred to me that if I "fail" to VBAC, all that happens is another section. If I don't even try, then I get the section for sure! I'd rather have the possibility of VBA2C than no possibility at all...
Well said, mama... never thought of it that way.

:
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Old 05-04-2005, 06:13 PM
 
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Just to reassure you, the rupture risk does not increase as the baby grows, or as you pass your due date. The chance of successful VBAC goes down slightly past the due date, but this data is also confounded by how many women have scheduled cesareans once that due date has come. It is no less safe to labor with a 41 week baby than a 38 week baby as far as risk of rupture goes. More labors start spontaneously after the due date than before, so putting an arbitrary date out there decreases the chance of success.

I attended a VBAC this morning. This mom actually didn't follow that most-babies-after-the-due-date rule, though. Her first baby was a cesarean for breech at 34 weeks when her water broke and she was in good, active labor on arrival to the hospital. This time, her baby was head down. Her water broke at 36 wks 6 days, at 1:40 this morning. She started having contractions at about 4 am, was complete a little before 7 am, and after pushing for a fair while, birthed her baby girl at 8:28 am.
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Old 05-04-2005, 06:48 PM
 
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OMG!

I still sort of feel like I'd wait up to 40 weeks. I don't want to be induced! I don't want any meds! But I also don't want to wait too long b/c I'm afraid of the rupture risk increasing as weeks pass by...
No VBAC woman should ever receive labor inducing drugs, like pitocin. The risk of ruputuring the uterus is too high when meds are involved, the meds put too much unnatural strain on the uterus.

As far as I know there is no great risk of a uterine rupture with post due babies than with any other time of delivery. The worry is that a post due baby will undergo stress and be in meconium or the placenta gets to old and quits providing for the baby -- seriously rare event.

Here is why a hospital VBAC was out for me --
- Required continuous EFM monitoring, not intermittent.
- When on the EFM you are not allowed to move b/c it moves the baby and throughs the EFM off the heartbeat area. (Was not allowed to move w first baby b/c water had ruptured and was on continuous EFM.)
- Unable to move, meant for me less ability to manage and work through my labor contractions. I was also on Pitocin which causes contractions to be one on top of the other with no breaks for breathing or preparing inbetween.
- Unable to manage contractions, makes you want pain meds.
- Pain meds knocked me out, except w the contractions hit, so really wasn't effective except to put me out for seconds inbetween contractions and then come to in sheer pain.
- IV pain meds obviously a mistake, I had an epidural. A VBAC having an epidural is a mistake b/c an epidural can slow down labor and then the hospital staff want to bring it back with labor inducing drugs. VBACs should not have labor inducing drugs, so they will then say c/s.

As for my first experience, not being able to move did not allow me to work my baby into position for birthing. I was not willing to risk being set up for failure, so I decided on a homebirth.

I really do believe a lot of hospitals routine procedures and protocols (which you doctor really has no control over), set VBACers up for failure. There are some woman who can birth without moving, I'm not one of them. I am a primal hip swaying mover in labor.

If you haven't read it read A Thinking Woman's Guide to a Better Birth by Henci Goer.
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Old 05-31-2005, 06:33 PM
 
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Alison,

Just thanking you for starting this thread. It has been very helpful to me as I find myself in a similiar situation. I think I am now reconvinced to get to work on trying for a VBAC.
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Old 05-31-2005, 08:08 PM - Thread Starter
 
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That's wonderful to hear!!!! I didn't know you were expecting - congratulations!
Really, though -
Thanks to everyone who has offered up their experiences and knowledge. If anyone else has more to add... feel free to keep it coming.

I'm definitely going to try to labor for a VBAC. I'm really nervous/excited - I find it sort of sad that when I talk to the doula I feel very positive and excited, but every time I leave the OB office I feel like giving up because they just fill your head with risks. Not that they have even ONCE discussed ANY risks associated with a repeat c-section. In fact, I won't be able to have a doula assist with labor because the philosophies are in such conflict that there could be some problems with working with both an OB and doula in this case. It really sucks, and at this point in my pg I don't feel comfortable switching providers - everything else has been really great, my OB actually suggested VBAC from the start. The doula I've been talking to is offering pain coping/birthing classes to prep me and is offering her support in other ways.

This has been a real learning experience for me.
thanks again...
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Old 06-01-2005, 01:24 AM
 
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http://www.cochrane.org/cochrane/revabstr/AB003766.htm

This is the Cochrane database abstract on continuous labor support during labor. It is an analysis of several studies involving over 12000 women, that found that doula-type support improved outcomes for moms and babies. The Cochrane Database is a well-respected source of evidence based findings.
I'd be uncomfortable working with a doc not willing to acknowledge such evidence.
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Old 06-01-2005, 02:00 AM
 
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You are right Alison. My thanks should have been to all those who responded as well.

I have lots of reading to do and no doubt I will have some questions along the way but its nice to be headed down that road again. Hopefully I can get some time to call my doula tomorrow and chat with her too. It's nice that your doula is willing to work with you and around any conflicts which might arise between her and your docs! The more support the better.
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Old 06-01-2005, 09:49 AM - Thread Starter
 
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Quote:
Originally Posted by doctorjen
http://www.cochrane.org/cochrane/revabstr/AB003766.htm
I'd be uncomfortable working with a doc not willing to acknowledge such evidence.
The truth is, I'm really not comfortable with the fact that she's not supportive of using a doula. Well, actually she doesn't have a problem with people using doulas and has worked with them in the past, just isn't sure about my situation. She wants to monitor things pretty closely and feels that the doula would be so limited that it wouldn't be "worth it" in her words. At this point I'm just going to set my teeth and refuse epidural etc and pray that I can do it with the support of dh. I have this feeling I'll be begging someone to call my doula, though.


She didn't even want me to write a birth plan. She said it would be like guaranteeing I'd not get the birth I wanted - like carrying an umbrella and then it doesn't rain. I wouldn't use her again. I just don't feel comfortable switching right now when I'm so confident I can VBAC, and she supports it. Many of the other OBs around here wouldn't even consider it.

Do I make any sense at all?
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Old 06-01-2005, 10:01 AM
 
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I think it is a little strange that your doc doesn't want you to have a doula. Most practitioners jump with glee. they are such an asset to labor and the results of doula-attended births are great. It is scientifically proven that they help. As for me, I am definitely having a doula this time with my VBAC. I plan to stay home for a long time with the doula to avoid some of the EFM at the birthing center. Maybe you can talk to your doc again about the importance of a doula to you? Or, you could just hire her anyway?
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Old 06-01-2005, 11:31 AM - Thread Starter
 
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I could hire her anyway - the doc didn't say NO, but she was very negative. I'm going to make a copy of that article and give it to her. Maybe that would make her more supportive of it.

The negativity is what keeps me from having the doula at my son's birth - I'm the peacemaking type, always in the middle of everything, and I'm afraid that I'd be very stressed by the conflict between the two. I know that the doula wouldn't be the problem - I'm pretty sure that the doc would be negative during the labor and I don't want to be in the middle of it. I guess I'm taking the easy way out at the moment, but it may not be so easy at the labor.... I'm feeling so confused! It's like I finally made the decision to VBAC, and now I have to deal with this.

My doula is so supportive. When I talked with her she said that she is just pleased that I still wanted to VBAC and she is going to help prepare me for that. To be honest I'm not sure that she wants to be in the middle of that confict, either.

I don't know what I'd do without the support of my loving dh. He's reading up a storm and asking me to find books so he'll know how to help me. After all the poor decisions I've made in my life I can't believe that I made such a perfect decision to spend my life with him.

Thanks so much for all of your support, too - And thank you Leah for reviving this thread!
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Old 06-01-2005, 11:33 AM - Thread Starter
 
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Quote:
Originally Posted by daekini
I don't know what I'd do without the support of my loving dh. He's reading up a storm and asking me to find books so he'll know how to help me.

BTW, anyone have any suggestions for dh to read???
we have "husband coached childbirth"...

Also, is there anything out there geared toward VBAC support for partners?
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