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#1 of 22 Old 11-20-2006, 11:46 PM - Thread Starter
 
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Hi there...I'm 7 weeks pregnant and planning a vbac homebirth. Ds was born via csection due to the fact that the cord was wrapped around his neck. The two births will be 30 months (2 1/2 years) apart. The first csection was low transverse double (i think) closure. We found backup midwives who have agreed to work with us, however they don't think a vbac homebirth is a good idea. I also talked to our pediatrician today and he said that he doesn't hink a vbac homebirth is a good idea either. They're both concerned about uterine rupture. We are 15 minutes from the hospital (but could potentially run into HORRIBLE traffic making it much longer unless we had an ambulance or police escort or something).

Soo...my question how do all of you feel about a vbac at home? How many of you are planning a homebirth? Thanks
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#2 of 22 Old 11-21-2006, 12:46 AM
 
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I have never personally VBACed at home but would LOVE LOVE to.

I had a c-section becuase my baby was breech.
Since then I have had 4 VBACs.
My first VBAC was just 14 short months after my c-section

If you do some research (which I am sure you have) you will find the UR rate is extremely low! .07%!
You would be more likely to get an infection from the hospital then have a UR.

It boggles the mind that docs and even midwives are still throwing UR scare tactics around. I mean, what else can they find wrong with you?
Will your baby be too big? You pelvis too narrow? Maybe you are over weight?
UGH.

I think you need to look for a new midwife. A homebirth is so much safter than a repeat c-section or even a hospital VBAC where they can force so many interventions on you.

Also try this group for some awesome "no sugar coated" advice

http://health.groups.yahoo.com/group/ICAN-online/


Good Luck!
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#3 of 22 Old 11-21-2006, 12:48 AM
 
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Well...I have had 4 sections. The next baby WILL be a homebirth. There are just no other options for me.
In YOUR situation I wouldn't even consider hospital VBAC!

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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#4 of 22 Old 11-21-2006, 01:15 AM
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I'm planning a UBa2C in late January. There's no way I'd even attempt in a hospital with all their interventions and policies. You're much more likely to rupture in the hospital.
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#5 of 22 Old 11-21-2006, 01:43 AM
 
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I'm planning an HBA2C in January.. I have read so much on the whole topic and really feel good about my decision (my mother is another matter.. see vent post in HB forum). Two good books I read were Silent Knife and Vbac Companion..
http://www.plus-size-pregnancy.org/f...reansand VBACs
also has some great links to research info on rupture..

Best of luck to you in your decision!!
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#6 of 22 Old 11-21-2006, 01:48 AM
 
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I had an HBAC with my daughter and it was very healing.

ITA with roadfamily6- find another midwife!
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#7 of 22 Old 11-21-2006, 01:58 AM
 
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Personally, I would not have a HBAC. That's me. The reason for this is that changes in fetal HR are the most consistent marker of UR, and most subtle changes in HR are hard to identify with intermittent monitoring. Realistically, a crash section is very iffy in saving a baby in the case of true UR, whether you're in the hospital or not. My issue is the early identification of signs of UR.

Where did the 0.07% UR rate come from? The research is fairly consistent in showing 5-10 UR/1000, which would be 0.5-1%. That's ten times the rate the PP cited, and to me, that makes a difference.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#8 of 22 Old 11-21-2006, 03:01 AM
 
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There are only two midwives in my town and the one botched my DS's delivery so I won't be seeing her again and the other refused for me to do a HBAC, but I had an emergency c-section with the vertical incision so perhaps thats why.

If you're serious about it I would hunt around for a midwife who can work with you and also talk with them about the risks for your particular situation.
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#9 of 22 Old 11-21-2006, 03:37 AM
 
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read, read, read, and get to ICAN as soon as you can. The books "Silent Knife" and "Open Season" by Nancy Wainer Cohen are still very relevant today, check them out too! I HBA2C almost 2 years ago (12/1) with a 10lb 4 oz whopping baby girl and it was awsome! HOMEBIRTH ALL THE WAY!
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#10 of 22 Old 11-21-2006, 03:51 AM
 
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If it was legal for mw's to do HBAC's here I would have one. But since it isn't, I am going to the hospital.
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#11 of 22 Old 11-21-2006, 10:16 AM - Thread Starter
 
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Our homebirth midwives are 100% supportive of vbacing at home. But, we have to have back up midwives (cnm's with hospital rights) just in case. The closest hospital pretty much doesn't take homebirthers unless it is an ABSOLUTE emergency (like uterine ruptrue) and they aren't big on vbacs so we are seeing midwives from another local hospital in case we need to transfer for something less emergent like exhaustion or something like that. These midwives are really good and super supportive of homebirths. It seemed more like she legally had to tell me she doesn't support a vbac at home. But, even after saying that she said they would be happy to work with me and be there to support me in pregnancy/in the event of a transfer. My homebirth midwife also called there and the cnm said they'd be happy to support us.
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#12 of 22 Old 11-21-2006, 11:27 AM
 
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I am having a vba2c at home in April. After doing a lot of research I feel very comfortable with my choice.
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#13 of 22 Old 11-21-2006, 04:06 PM
 
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We're planning HBAC in february for our second child. It has been three years since my daughter's birth, but <gasp> I have a single layer closure and still stubbornly insist upon out of hospital vbac. Maybe thats because I actually want to have a vbac rather than another surgery. True rupture is very very very rare. The statistics for UR are based upon any type of scar issue during labor, even harmless "windows" that affect neither baby nor mama and are often not treated in any way, merely allowed to heal on their own. Also, UR rates are only recorded for hospital births, where more often that not, laboring vbac moms are given pitocin or induced with no regard to the fact that those interventions are very likely to cause rupture. The important thing is that you are well prepared for a vaginal birth and confident in your abilities, that you have a good, well educated support system. I agree with other posters that "Silent Knife" is an excellent book. Also, continuous electronic fetal monitoring is not the end all and be all of labor and delivery safety. Often times it is inaccurate, uncomfortable, and just plain unneccessary. It is likely to make laboring more unbearable for mom and to cause extreme reactions by hospital staff to normal fluctuations during labor. There is just no way that one person monitoring you from a computer screen far away from where you are while simultaneously being responsible for half a dozen other patients as well is going to be able to give you as high a level of care as one woman devoted to your labor every minute of it and who stays beside you the whole time can.

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#14 of 22 Old 11-21-2006, 05:11 PM
 
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Quote:
Originally Posted by maxmama View Post
Where did the 0.07% UR rate come from? The research is fairly consistent in showing 5-10 UR/1000, which would be 0.5-1%. That's ten times the rate the PP cited, and to me, that makes a difference.
The research that I've seen says that 0.5-1% of women experience any type of rupture or scar separation at all, and about 1/10 of those cause problems for mother and/or baby, or about 0.05-0.1% of them so maybe that's the difference in statistics.

I have already had one hospital VBAC and am planning another one for February. I am seeing a group of midwives who are very pro-VBAC and I think I'll be able to avoid a lot of needless interventions. I thought about a homebirth and/or birth center but went with the hospital mainly because my husband wasn't comfortable with birthing outside the hospital. Also, I figure if I was at home, my husband of course will help out but I'd be tempted to do the laundry, help with the cooking/cleaning, and the kids will want me to play with them, and I think it will make the first couple of days easier if I have to stay at the hospital where there's nothing to do but watch TV and read books/magazines. But that's just me.

Minta
mom to 2 and 1 on the way...
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#15 of 22 Old 11-21-2006, 05:25 PM
 
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DH and I will be ttc in January. I'll be having a homebirth VBA3C. I was naive enough to try for a hospital VBA2C, and you couldn't pay me to put up with the pressure again. I ended up with a scheduled section, and I can't even imagine the fight I'd have had on my hands if I'd actually gone into labour.

Of course, I have no option, anyway. The OB I had last time was actually comparatively VBAC-friendly, and he was a nightmare. I can't get a licensed midwife (ie. one with hospital privileges), because they're not allowed to attend a VBAC after multiple sections.

I have a small percentage chance of rupture vs. a very high percentage chance (like 100%) of another section. Since I still can't feel my bladder from my third one, I don't think I want to roll the dice again.

Besides, if I have to spend my first few days post-partum in the hospital again, I will probably, in all seriousness, kill myself.

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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#16 of 22 Old 11-21-2006, 05:48 PM
 
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Well, DD was a UBAC. So obviously *I* choose HBAC! LOL


I will NEVER NEVER NEVER birth in a hospital again. EVER. Oh, alright, maybe there is some weird circumstance where I would consider it, but in a healthy, normal pregnancy? He** no! lol. NO.


I did my research during my second pregnancy and was COMPLETELY comfortable with my "risks" of HBAC (roll eyes). Education is your key to comfort. Educate YOURSELF, don't ask your OB, your midwife, your pediatrician (sidenote: I don't understand why you would discuss your birth choices w/a pediatrician - that's not his/her department, yk?). Everyone has their own agenda and beliefs. Their answers are going to be colored by that. The only way you're going to be able to make your own decision and take responsibility for yourself is to do your own research.


Good luck in your decision!

K
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#17 of 22 Old 11-21-2006, 08:58 PM
 
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p.s. here's a link to a sight that has a collection of different studies regarding uterine rupture. They are mainly in relation to whether a single layer or double layer closure is more safe, but it still has a lot of different info on various uterine rupture rates.
http://www.collegeofmidwives.org/new...r_study01b.htm

Mom of three spunktastic kiddos, supported by super-partner while dabbling in midwifery and organic farming. Biting off more than I can chew since '03.
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#18 of 22 Old 11-21-2006, 09:27 PM
 
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You might also as WHY specifically the various care givers you've spoken to are all against a homebirth? Ask them to ignore UR for a moment and explain why, in your specific case, they are against it. Is it a standard policy? Was your incision/closure not actually a lower transverse incision with double closure?

Maybe UR was just the first thing that came to their minds and if you ask them to explain in more detail (and provide them with current scholarly research on UR and the safety of homebirths and vbacs) they might realize that they could be more supportive. Alternatively, you might find that they are not really as vbac or hbac supportvie as they might seem at first glance and you really do need to seek another care giver to get the birth you want.

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#19 of 22 Old 11-21-2006, 10:05 PM
 
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The research that I've seen says that 0.5-1% of women experience any type of rupture or scar separation at all, and about 1/10 of those cause problems for mother and/or baby, or about 0.05-0.1% of them so maybe that's the difference in statistics.
yes, that is the numbers I recall. Just that 0.07% is an average of those who face serious problems during a rupture.

I assume we are all intellegent women here and each one of us needs to decide which risk we are willing to take. For me I would risk a home birth if UR rate is even 1% like you mentioned. Did you know you have a 25% chance of something going wrong in the OR during a c-section?
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#20 of 22 Old 11-30-2006, 02:29 AM
 
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I have had 2 prior VBAC's...one hospital and one home. I LOVED my homebirth. I am planning my 2nd HBAC for March/April 07. I would never be comfortable VBACing in the hospital again.

Too much pressure and negativity. I LOVE LOVE LOVE my homebirth midwife and trust her completely.
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#21 of 22 Old 11-30-2006, 11:27 AM
 
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I had a HBA2C and what I learned about ruptures is the following:
- heartbeat of baby will change upon impending rupture, make sure your hb mw is familiar with this and does dopler or fetascope through out labor (mine was supposed to be every 15 minutes or so, but I honestly don't remember how often they did it)
- you have 30 minutes from rupture to c/s to save the baby and yourself (or at least that is one stat) I have also read 17 minutes is optimal. Hence the reason hospitals have banned vbacs were there is not staff on call 24/7 to do ER c/s.
- get a copy of your OP report from the hospital and read it, it will state clearly single or double layer surturing, know for sure
- time wise you are fine. I was 23 months from c/s to my hba2c!!!

What I did as a precaution -
1) pre-registered at the hospital, like any other mom in town, except, I did not state I was planning a hb, I used a docs name from out of town so he was not in their system and I was marked "red button" which would call the on-call OB if I came in
2) drove the route to the hospital and timed it several times - 4.5 miles from my door to the ER door, about 14 minutes
3) had a plan with my mw, she would call the ER enroute and that should make everything ready at the hospital. My mw was from out of town, so I wanted to make sure she had the L&D no., ER no. and map.

All these precautions just set my mind at ease and I had complete peace birthing at home after I took care of my worries.

About the only reference I can remember that addressed this issue with my vba2c status was http://www.plus-size-pregnancy.org/
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#22 of 22 Old 10-05-2013, 02:47 PM
 
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It makes me heartsick to see so many of you downplaying the risk of uterine rupture. My niece-in-law just attempted VBAC after a caesarean two years ago. Unfortunately, her uterus ruptured at home with midwife present. They live 10 minutes from the hospital. They could hear the heartbeat before leaving for the hospital but the baby was dead when they got there. My niece-in-law ended up with a total hysterectomy, therefore all future dreams of having a child are gone. They baby was four days early and was over 8 pounds. She had a semi-traumatic birth the first time after laboring at home for some time with no results.
If you really think uterine rupture is not a risk, go ahead, but be sure you are not just building a home delivery up in your mind. Statistics show many more deaths on home births than in the hospital. So much of the data is twisted to encourage moms to stay at home. It is the long term with your child that is important, and please do everything you can to bring the baby into the world with the least trauma possible. This is the hardest thing we have ever done, and seeing and holding a dead baby that we all were so excited about is certainly something that will never leave me. Heartbreaking.
Now that we have gone through this, I am hearing so many families who have had the same experience. Please please please protect your baby by being in the hospital for your VBAC.
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