Is a second VBAC still considered a VBAC?? - Mothering Forums

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#1 of 36 Old 03-08-2007, 11:54 AM - Thread Starter
 
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Help!! I just found out Im pg with #3. We moved to Maine in 2005. Previously lived in PA and had a wonderful OB who fully encouraged and supported my VBAC with #2. It was a great experience and I did it with absolutely no problems!!

So here is the kick in the gut. There isnt a dr in the entire state that does VBAC's up here!!! : I am waiting to hear from the midwife if this would be considered a VBAC or a normal delivery. My c-sect was 6 years ago, my VBAC was 3 years ago.

I am fuming mad to say the least and dont know what I will do if it comes down to them telling me I HAVE to have a C-sect. :
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#2 of 36 Old 03-08-2007, 12:45 PM
 
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Yes, its still considered a VBAC but since you had a successful one in the past few years its very possible you can find a provider to take you on.
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#3 of 36 Old 03-08-2007, 12:50 PM
 
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I am fuming mad to say the least and dont know what I will do if it comes down to them telling me I HAVE to have a C-sect. :
Don't forget, they can TELL you whatever they feel like, but you don't HAVE to do anything you don't want too. Granted, they don't have to keep you as a patient though. Have you considered a homebirth or UC?
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#4 of 36 Old 03-08-2007, 02:19 PM
 
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The doctor my midwife is umbrella'd under considers it to still be a vbac, but gives his blessing for hb so, if I ever have another, I can have the hb I so desire/

Amydidit is right, they can tell you anything they want...you can also do your own research and don't have to do what they tell you. They work for you, remember that...I think hb is the way to go. good luck mama

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#5 of 36 Old 03-08-2007, 02:22 PM
 
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Don't forget, they can TELL you whatever they feel like, but you don't HAVE to do anything you don't want too. Granted, they don't have to keep you as a patient though. Have you considered a homebirth or UC?
f your VBAC went that well I'd say HB or UC would be an awesome option for ya, seein' as how you are all confident now, right?!?
And as dumb as it is, yes. 2nd VBAC is considered VBAC. Where is the "proven pelvis" crap here, where I ask you, where??? Sorry, it just has me irked!:

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#6 of 36 Old 03-08-2007, 02:29 PM - Thread Starter
 
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Yes : it is. There is only one hospital in the state of Maine that will deliver VBAC. (I am an hour and a half away) I am sick and incredibly : I cant believe this. I guess coming form PA where VBACs are greatly encouraged, I just cant fathom a state so set against this. Never even crossed my mind I couldnt do it again.

And I PROVED I can birth that way too! grrrrrr.

I would absolutely consider a HB but am pretty sure my insurance would not cover it. There are a ton of Midwives in this area (Go figure, must have a need cause no one will do freakin VBACs!!!)

So so sick over this.
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#7 of 36 Old 03-08-2007, 04:32 PM
 
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Sadly, it IS considered a VBAC with all the inherent "risks" (for the provider, that is). I vote for seriously thinking about a hbac or UC as well.
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#8 of 36 Old 03-08-2007, 05:00 PM
 
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For a home birth, the cost is really reasonable usually. I priced out midwives (although they arent allowed to attend VBACs in SC) and it ended up costing about the same as my after insurance costs for the OB and they had really reasonable payment plans. (I ended up actually paying a blanket price for OB services that included birth and even though they kicked me out of their office ON MY DUE DATE they refused to give me back the money...and even tried to charge me an outstanding $55 ... grr)

Even if you do feel you need to go the hospital route, they are legally unable to do anything to you against your wishes. Contact ICAN, and get as much information about your rights as you can. I homebirthed my last (UC) but we had a packet prepared for if we went into the hospital, that included a birth plan, a statement of intent, and a copy of the law that says they cannot section me or do anything to me without my consent, but that they have to treat me within my requirements. (doctors dont have to do this, they can just kick you out, but hospitals are required to take care of women in labor, no matter how obstinant and demanding you choose to be)
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#9 of 36 Old 03-08-2007, 05:35 PM
 
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yes and it downright pisses me off

I am preparing for my 5th VBAC and I am still considered a VBAC patient and I cannot use a midwife here in Alaska for an out of hopsital birth because they are forbidden to take on any patients with previous uterine surgerys.

UGH!!
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#10 of 36 Old 03-08-2007, 05:36 PM
 
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so technically I am a VBAVBAVBAVBAVBAC
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#11 of 36 Old 03-08-2007, 07:43 PM
 
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This stuff really annoys me. I really don't see why my birthing career should be forever defined by having had surgery once. I had surgery the first time and I didn't the second time. No biggie. Changing the model of care should elicit a more evidence based response.
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#12 of 36 Old 03-08-2007, 11:37 PM
 
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so technically I am a VBAVBAVBAVBAVBAC
Me too minus one and facing the same problems - hospital policy here is now "once a c-section, always a c-section." My OB has told me that if I show up too late to assemble a surgical team then they won't give either of us any crap about doing a VBAC (8ish cm - or less and moving really fast), but other than that I will have to refuse while in labor or just stay home. She's willing to work with me as much as she can (said she would send me home or walking if I wasn't close enough but water hadn't broken yet). I've been to the ICAN website and read about filing complaints, but I worry that doing that will throw up red flags and I'd rather just slide under their radar than have to refuse, plus I've kind of waited too long now trying to decide.
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#13 of 36 Old 03-09-2007, 09:57 AM - Thread Starter
 
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Me too minus one and facing the same problems - hospital policy here is now "once a c-section, always a c-section." My OB has told me that if I show up too late to assemble a surgical team then they won't give either of us any crap about doing a VBAC (8ish cm - or less and moving really fast), but other than that I will have to refuse while in labor or just stay home. She's willing to work with me as much as she can (said she would send me home or walking if I wasn't close enough but water hadn't broken yet). I've been to the ICAN website and read about filing complaints, but I worry that doing that will throw up red flags and I'd rather just slide under their radar than have to refuse, plus I've kind of waited too long now trying to decide.
Thanks to some suggestions, I am just going to labor at home until I am at the verge of having to push, go to the local hospital and deliver. I was wondering about that, what would happen if my water broke and I went into labor and couldnt make the hour and a half drive to the VBAC hospital. They cant MAKE you have a c-sect if you are on the verge of delivery I assume.

I actually read somewhere that VBAC's are losing out in the medical field and that more and more doctors refuse to do them. I just dont understand that at all. I guess I am very grateful I had such a pro VBAC doctor for my second son. He didnt even want to talk about another c-sect unless it was medically necessary. I loved him!!!
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#14 of 36 Old 03-10-2007, 12:03 AM
 
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Technically in our state...FL....you are still a VBAC but you are a lower risk VBAC. A VBAC with a proven pelvis which allows for some providers to take you on.

For example...I am having a HBAC but I didn't have to have an OB sign off on my birth this time but I did for my first.

I HIGHLY recommend an HBAC. I have now had 1 hospital and 1 HBAC. I liked my HBAC so much better. I am planning my 2nd one for the next couple of weeks.
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#15 of 36 Old 03-10-2007, 08:07 AM
 
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For example...I am having a HBAC but I didn't have to have an OB sign off on my birth this time but I did for my first.
.
That's horrible! As if you are some school kid needing permission. It is just infuriating the kind of treatment pregnant women are getting.

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#16 of 36 Old 03-10-2007, 10:18 AM
 
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Thanks to some suggestions, I am just going to labor at home until I am at the verge of having to push, go to the local hospital and deliver. I was wondering about that, what would happen if my water broke and I went into labor and couldnt make the hour and a half drive to the VBAC hospital. They cant MAKE you have a c-sect if you are on the verge of delivery I assume.

I actually read somewhere that VBAC's are losing out in the medical field and that more and more doctors refuse to do them. I just dont understand that at all. I guess I am very grateful I had such a pro VBAC doctor for my second son. He didnt even want to talk about another c-sect unless it was medically necessary. I loved him!!!
Right - the same laws that don't let them turn away those who can't pay also don't allow them to turn away anyone in active labor. Then they can't make you have a c-section (technically they could by court action, but it seems highly unlikely that they would or would have time to if they really tried). I feel more confident because my doctor is with me on the VBAC issue and is against the hospital's policy, but either way I would still have the same plan of action I think. If she weren't, I might be slightly more likely to drive the 45 minutes to the possibly VBAC-friendly hospital (there it is the doctor's choice, but only a few choose to do them).

I too had a doctor with my second that pushed VBAC as the first choice and barely mentioned a repeat c-section. He's my OB hero :-). Sadly, that hospital also doesn't allow VBACs anymore.
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#17 of 36 Old 03-10-2007, 01:56 PM
 
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Isn't Maine the state where Christiane Northrup (the author of Women's Bodies, Women's Wisdom) practices? I would think that she and the doctors working with her would be very pro-VBAC.
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#18 of 36 Old 03-12-2007, 06:39 PM
 
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birthing career should be forever defined by having had surgery once
It's totally not fair, but from the medical perspective that "one surgical procedure" has left us all with a permanent scar. And even once that scar has been "proven" by a successful VBAC it's still there...and still a medical liability (from the hospital/doctor perspective). It stinks. But there it is.

OP- I'm soooo sorry! The positive birth culture in my current home town is one reason we decided to have our VBAC babe sooner rather than later...we know that we'll be moving to a much more "medical" area in the next year or two and we just didn't want to risk it. Having proven your pelvis and scar by having a VBAC might make you low risk enough for a more holistic/moderate care provider? And maybe you could use a care provider during pregnancy but then go with a hb or uc at the end...so the insurance would at least cover the prenatal and you could claim a "couldn't make it to the hospital in time" sort of thing?

Good luck...I hope this works out for you!

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#19 of 36 Old 03-12-2007, 08:06 PM
 
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It's totally not fair, but from the medical perspective that "one surgical procedure" has left us all with a permanent scar. And even once that scar has been "proven" by a successful VBAC it's still there...and still a medical liability (from the hospital/doctor perspective). It stinks. But there it is.
Yep. Most are completely willing to give you a csection, whether it is neccessary or not, will downplay or completely gloss over the risks to you and baby, then fail to tell you anything at all about the impact it will have on the rest of your birthing career. Don't you just love "informed choice"? :

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#20 of 36 Old 03-13-2007, 12:50 PM
 
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I had my 2nd VBAC(HBAC) in FL, and besides the fact that my MW felt more comfortable w/ me having a "proven pelvis", she was still supposed to have OB back-up, etc. We didn't bother w/ that, though.

I knew someone(yes, first person - not "a friend of a friend" ) in FL that was forced(b/c she didn't fight it) to have a c/s w/ her 4th baby eventhough she had already had 2 VBACS in the same town. I was like over my dead body would I let them cut me just b/c they don't "allow" VBACs anymore, but you can't make someone care about their rights. :

Add me to the list of those that are pi$$ed off about the state of birth, particularly VBACs, in our culture.
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#21 of 36 Old 03-13-2007, 10:19 PM
 
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There are 2 hypotheses as to whether a vbavbac is safer or less safe than a vbac.
1) The scar and pelvis have been tested as safe, so it's safer.
2) The scar has had more stress put on it, so it's more likely to rupture, so it's less safe.
I'd love to see some studies addressing this.
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#22 of 36 Old 03-14-2007, 01:01 AM
 
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REALLY?!?! I moved from Maine, had my first baby there... attended by a midwife, and at the very end by my doc. I loved the hospital - they were working towards the baby-friendly designation at the time. They all seemed quite progressive there. Have you checked many different hospitals? We were 45 minute drive away at the time, but it was well worth it in the end.

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#23 of 36 Old 03-14-2007, 08:58 AM
 
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2) The scar has had more stress put on it, so it's more likely to rupture, so it's less safe.
I've never heard that line of thought. I would have to dig them up and dust them off, but there is a LOT of research done on the risks of VBACS, going from 1 VBAC after multiple cesareans, multiple VBACS after sincle cesareans, etc. The amount of research material out there is HUGE and goes against the ACOG reccomendation of not doing VBACs (ACOGs reccomendation is the reason why insurance companies wont cover hospitals and doctors who VBAC...which is what the real issue is in a lot of places)

If there is a hospital near you that refuses to do VBACs I would STRONGLY urge you to give that information to ICAN. Even if you do it anonymously or wait till after the birth, it will give them more ammunition to change the way things are.
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#24 of 36 Old 03-14-2007, 02:21 PM
 
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And as dumb as it is, yes. 2nd VBAC is considered VBAC. Where is the "proven pelvis" crap here, where I ask you, where???

What does a 'proven pelvis' have to do with the fact that a woman with a prior c-section will ALWAYS have a scar on her uterus?

Fact is, once a woman has a c-section, her uterus is never the same as an unscarred uterus. Never.

And there isn't adequate research available to assess whether or not a scar that's upheld during a VBAC already is better, worse, or the same in terms of rupture risk in subsequent VBAC attempts. Women can and do rupture during a second VBAC attempt, but again, there simply aren't any research stats on how often this happens compared to a first VBAC attempt, making it impossible to know with any certainty what the real risk is.

Unfortunately, with the VBAC climate as it is currently, I do not anticipate any wide scale studies looking at the issue either. When you figure you'd have to look a lot of women with a minimum of three pregnancies (one section and two VBACs), that alone is a limiting factor considering the average number of deliveries per woman isn't 3 or more.
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#25 of 36 Old 03-14-2007, 03:02 PM
 
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Help!! I just found out Im pg with #3. We moved to Maine in 2005...
So here is the kick in the gut. There isnt a dr in the entire state that does VBAC's up here!!! :
How "midcoast" are you?? I live in Ellsworth, and the Blue Hill Memorial Hospital is VERY supportive of VBAC!! It's only about 45 minutes from Belfast.

Maine Coast Memorial in Ellsworth usually will do them, as well, except that the major VBAC OB here in town passed away in December and they haven't gotten a replacement yet.

I'm going to Blue Hill for mine, and I even have complications and they're all for my VBAC.
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#26 of 36 Old 03-14-2007, 03:55 PM
 
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i am sorry you are going thru this, it is not fair.

i too had to find a hospital willing to do another vbac with me. i went 1 hr away. i was beyond frustrated considering i CAN give birth vaginally. thankfully, the ob was pretty laid back. i got to the hospital @ 6 cm and ds was born 4 hrs later. but that was at a vbac friendly hospital (of course they had vbac guidelines though). the thought of delivering somewhere that did not allow vbacs really freaks me out. i hope you can find a solution.

it seems to me, i read somewhere about once you've HAD a vbac, your risk is almost that of an unscarred uteri. anyone read the same thing? (my ob believed that as well.)
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#27 of 36 Old 03-16-2007, 05:14 PM
 
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Man that stinks. I'm sorry you're having to deal with these people. The 2 closest hospitals in my area are very anti-VBAC. In fact a friend of mine had a cesarean, moved here, had a VBAC, then wanted another VBAC at the same hospital. In between babies, the hospital changed their "policy" and told her she couldn't have another VBAC in the same hospital. It's insane.

The other hospital changed their "policy" 3yrs ago while I was pregnant with my 1st DS. My OB knew I wanted a VBAC, but she didn't bother to tell me they were in the process of becoming a no-VBAC hospital until they'd already done it, which happened to be when I was 7 or 8months pregnant.:

I was so upset. I happened to find a wonderful midwife that I didn't even know lived 15 minutes away from me. We had a HBAC with DH catching his DS. It was tough, and my longest labor so far, but I'm so happy we did it.

I hope you can find a solution to your problem.


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#28 of 36 Old 03-17-2007, 06:14 AM
 
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Man that stinks. I'm sorry you're having to deal with these people. The 2 closest hospitals in my area are very anti-VBAC. In fact a friend of mine had a cesarean, moved here, had a VBAC, then wanted another VBAC at the same hospital. In between babies, the hospital changed their "policy" and told her she couldn't have another VBAC in the same hospital. It's insane.
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That's exactly what happened to me. Had my last VBAC 2-1/2 years ago, same hospital, same doctor (doctor still on board for VBAC). Their policy is about a year old now, was new when I got pregnant this time. And the hospital where I had my first VBAC, where they were VERY supportive of VBAC, has stopped doing them altogether too. Both hospitals say it is because they don't have 24-hour anesthesiologists, but that doesn't make any sense to me. What do they do with the non-VBAC emergency c-sections and other emergency surgeries? Oh yeah, they call the on-call guy.
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#29 of 36 Old 03-17-2007, 03:36 PM
 
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To the OP: I would at least check with midwives in the area and ask them about insurance coverage! Most seem to be accepting insurance the same as docs, hospitals, etc. The midwife we used for our HBAC, which was my second VBAC, delivers at two area hospitals AND for homebirths. She accepted me since I had had one successful VBAC, but her policy is not to accept VBAC patients if its their first one... UGH!

I too am angered about the c/s defining our entire birthing lives - my first baby was c/s after a cascade of interventions beginning with my OB stripping my membranes without discussing it with me. It was my first baby and I was still six days prior to my due date! :

Anyway, I LOVED my homebirth and highly recommend it! If we could not afford it or couldn't find a midwife on our insurance, I would seriously get a loan or use a credit card check if I couldn't save enough or work out a payment plan with the mw.

Someone mentioned a study on subsequent VBACs and safety, etc. I seem to remember seeing something about that on this site that mentioned after one successful VBAC your risk level is almost as low for c/s, rupt, etc as if you'd never had a c/s; check it out - you'll have to click on the Research link on the left and then look for it under VBAC but it is there:

http://www.homebirth.org.uk/

Wishing you all the luck in the world!!
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#30 of 36 Old 03-20-2007, 07:45 PM
 
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That's exactly what happened to me. Had my last VBAC 2-1/2 years ago, same hospital, same doctor (doctor still on board for VBAC). Their policy is about a year old now, was new when I got pregnant this time. And the hospital where I had my first VBAC, where they were VERY supportive of VBAC, has stopped doing them altogether too. Both hospitals say it is because they don't have 24-hour anesthesiologists, but that doesn't make any sense to me. What do they do with the non-VBAC emergency c-sections and other emergency surgeries? Oh yeah, they call the on-call guy.
OMGoodness, that's exactly what an OB that delivers at that hospital told me! What a lame excuse. Obviously it doesn't hold water because of the other emergency surgeries that you mentioned. It's like they're flat out admitting that their hospital should not be in business because they can't handle having a woman in labor after business hours.

The other hospital in my area obviously can't handle more than one woman in labor either because when we were trying to get help for my DS because his cord was threatening to prolapse, a nurse told us that they were about to start a cesarean and it would be an hour before they were done. Either she was lying or this brand new, multi-million dollar facility can't handle more than one woman in labor at a time. In fact we were told the same thing by another hospital as well. All 3 local hospitals have major issues. Sometimes I wish we'd sued.


Julie
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