Not a good candidate for a VBAC...agree?? - Mothering Forums

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#1 of 39 Old 09-03-2008, 04:13 PM - Thread Starter
 
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Hello,
First, I'd like to introduce myself.
I'm new here, this is my first post.
My son is turning 2 this Saturday and I am 12 weeks pregnant with #2!
I had an unplanned c/s with my son.
Here's just a bit a background.
I saw a midwife throughout my first pregnancy, she is in a group practice with a few obs.
I had hoped for a low-no intervention vaginal birth. I was opposed to induction. Here's my story ~

I was sent to the hospital for an induction at 41 weeks 2 days because I had slightly elevated blood pressure @ my 41 w 1d appt.
My bp dropped before I left the doctors office but I was still told, you need to go over today and start your induction.
I was given 2 doses of cervadil (sp?) and my water broke (after I was at the hospital for about 10 hrs). Then I labored for a awhile and decided to get an epi at about 4 cm. After the epi, they began to administer pitocin.
At that point I had been at the hospital for over 12 hours and thought that I would need some rest if I was going to get to 10 and push.
I progressed throught the night, was checked at about 6 am and was 9 cm.
I was told they would be back in about an hour and I would likely e ready to push at that time.
Then I stalled. I never progressed past 9 cm.
I had a c/s at 2:30 pm after laboring for ~32 hours.

I had a really hard time after my section. It was exactly what I didn't want...
Later I learned that my son was in the posterior position.

The reason for my c/s in my chart is 'failure to progess.'

At my first prenatal appt. I was told that I wasn't a good candiate for a VBAC since I was 'failure to progess.'

I'm dissapointed. My midwife said that we can talk more...
I guess I'm hoping that I'll be allowed to labor and see how it goes -
My hope is that if this baby is not posterior, I may have a successful VBAC.

Has anyone been in this situation?
Did you attempt a VBAC? How did it go?
Is my midwife's determination of 'not a good candidate' pretty typical for my situation?

Thanks in advance,
Lisa
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#2 of 39 Old 09-03-2008, 04:27 PM
 
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By the sound of it the real reason for your section was an un-needed induction.

Find a homebirth midwife.

I see no reason you can't birth normally.

-Angela
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#3 of 39 Old 09-03-2008, 04:31 PM
 
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I'm not a medical professional, but I'm quite familiar with vbacs. IMO your "failure to progress" had more to do with your induction and epideral than actual anatomical disfuntion. If you would have gone home I'm pretty certain that you would have had your baby naturally in a few days. That you made it to 9cm with all those interventions I would think you would be a great candidate for vbac! GL...
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#4 of 39 Old 09-03-2008, 04:35 PM
 
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I have a hard time believing if you'd gone into labor naturally, been able to move around, change positions, etc that you wouldn't have *progressed* just fine.

My DD2 was posterior and after 19 hours of labor I'd gone from 3 (where I was when I started labor, I checked myself) to... 3. Yep, no change. My midwife suggested I get on my hands and knees, so I did. Within a few minutes my water broke, I could feel DD turning herself around and I went to 10 within an hour. DD was born shortly after that.

I couldn't have done that if I'd been in a hospital. She would have been born by unnecessary c-section for *failuer to progress*, just like you.

So no, I don't agree that you're not a good condidate for VBAC.
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#5 of 39 Old 09-03-2008, 04:35 PM
 
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I had a very similiar first birth, with a bunch of nasty docs/nurses. However i made it to 10 (after a LONGGGGGG time and refusing a section for a LONGGGGGGG time) and just couldn't push him out. He was wedged in weird. I was told that the chance of me VBACing successfully was next to none. I decided that I WOULD VBAC, read everything i could etc. I started taking evening primrose oil at 36 weeks to soften my cervix and drinking buttloads of red raspberry leaf tea. I went into labor at 37 weeks 5 days. I labored at home for as long as possible (it wasn't real painful either, nothing like pit contrax!) and then head to the hospital. The second i got there, everything just stopped. I seriously did not progress at all that night. The next morning they started pit and i progressed to 10 and delivered 32 minutes after i began pushing and had my successful vbac. So, it CAN be done. I have no doubt had i stayed home that everything would have been fine though and i think going to the hospital stalled my labor. Every baby is different, every delivery is different.
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#6 of 39 Old 09-03-2008, 04:39 PM
 
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Yeah...that's the standard answer/excuse by care providers when their unnecessary interventions didn't work. The failure was theirs, not you or your body's.

I completely agree w/ pp.

From what you've said, I think you're an excellent candidate for a VBAC.

Ditto to the recommendation of finding a homebirth midwife.

- Kim
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#7 of 39 Old 09-03-2008, 04:41 PM
 
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The fact that you got to 9 cm was great. I bet if they had just left you alone for a bit longer you would have gotten to 10 and had that vaginal birth you wanted. I got to 10 and was pushing, but baby was posterior also. I too was labeled as failure to progress. Really, FTP is a catch all reason for a c-section. How much more progressed can you be than pushing short of actually having the baby? KWIM?

You are an excellent candidate for a VBAC. Get your medical record and see a real midwife (not a MEDwife). My midwife wanted to be sure I met a few criteria to make me a low risk patient.
1) Low transverse incision on the uterus. This is called the Bikini cut to most people.
2) MW preferred double stitching on the uterus, but said a single layer would be fine too.
3) no postpartum infection. I did spike a fever right out of surgery, but it was quickly gone so I was good.
4) I need a u/s around 20 weeks to check for placenta placement because a c-section can make it more likely for the placenta to be low or on the incision, which can be dangerous.

I fit all these criteria, so I am planning a HBAC in March, probably the same time as you, right?

W (26) and C (27) parenting G (11/06 ) and D (2/09 ) plus a new one (3/11)
Sometimes the greener grass is actually AstroTurf, a false promise and nothing more.
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#8 of 39 Old 09-03-2008, 05:02 PM - Thread Starter
 
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Thanks all.
I have 1 low transverse incision scar.
I'm not sure abouot stitching? I'll have to check on that.
Yes, I am due 3.16.09

Any recommendations for midwives/doulas in SNJ or Philadelphia?

Thanks!
Lisa
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#9 of 39 Old 09-03-2008, 05:08 PM
 
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Check out ICAN too, and see if there's a group in your area. I've learned a lot about VBAC since finding my local group.

Mom to DD1 (10/07) and DD2 (3/11)
geek.gif I blog about our life with food allergies and eosinophilic disorders.
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#10 of 39 Old 09-03-2008, 05:41 PM
 
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Absolutely disagree! You are a perfect candidate!

I'm telling you, medical birth intervention (and all its resulting 'joy') is the perfect way to make a women feel inadequate and broken!

You CAN do it mama!!!

Blessed helpmeet to my man, mama to Cody, Sarai & newly born Rebekah
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#11 of 39 Old 09-03-2008, 05:49 PM
 
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Our birth stories are pretty much identical. I FULLY agree with the previous posters, I believe the FTP would not have happened had we not been rushed into a delivery using induction/augmentation meds.

I am preparing for a VBAC, my new doctor feels very positive about it. I have also done lots of reading, and feel even more strongly that my body is totally capable of having a normal birth.

Kudos to you that you are exploring other options!
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#12 of 39 Old 09-03-2008, 06:03 PM
 
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Sounds like you are fine for a vbac. Like others have said "FTP" is a common 'diagnosis' and excuse for a c-section. If the practice you are with now isn't supportive of vbacs, find one that is supportive.

Not exactly the same situation, but I was told I had "CPD" with a 9lb 6oz child and, after pushing for two hours, I ended up with a c-section. With my second child, I had a 9lbs 10oz child and pushed for 2.5 hours. Perhaps if I'd had the extra half hour with my first, I'd have pushed her out as well. It sounds like if they'd waited just a little bit longer, you may have dilated to 10.

I recently changed my username, but I still say "Hello" to all those who know me in real life! Hi P, S, T and K!
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#13 of 39 Old 09-03-2008, 06:15 PM - Thread Starter
 
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Not sure if I would have made it to 10 under the circumstances....
I went from 6 am until 2:30 pm with no furhter dialation. I waited as long as I could/was allowed. I went from 2-9 cm in about 6.5-7 hours and then nothing for the next 7 hours.

I may have (probably would have?) made it to 10 cm if I didn't get the epi and didn't lay on my back from midnight until 2:30 pm the next day.
After my water broke my contractions were getting strong and painful and my body was telling me to move, I kept calling in the nurses to see if they would let me out of bed because I felt so much better off of my back.
I went into the bathroom twice for about 8 minutes each time but they wanted back in bed and on the monitors so I listened got back in bed and took the epi.
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#14 of 39 Old 09-03-2008, 06:26 PM
 
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lisat77, go to different people.

Listen to this. I was 42 weeks 3 days when DS was taken out of me. I had been in labor for 96 hours (90 hours at home, 4 at the hospital after a forced transfer, 2 with an unwanted epidural that made me forget I was pregnant, flat on my back). I barely got to 8, but the DOCTOR changed it to 9 on my chart.

Why? Because he said that i would be a GREAT candidate for a VBAC, and he wanted to make sure nothing in the records would cause someone else to say "hmm". Oh and he said I had been in labor 48 hours. Yep, he halved it.

If I can be a great candidate per the medicos (and I am, even without his say so), then YOU are too. You DID get to 9, despite having a baby that was NOT ready for labor, that had NOT started labor, and having a BODY that was not ready for labor! And you did it all in the hospital!!!!!

You're obviously a fabulous candidate, despite what these silly doctors and their midwives are saying, or rather most likely, what their malpractice insurance companies are telling them to say....


Find someone else!
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#15 of 39 Old 09-03-2008, 06:41 PM
 
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FTP is really FTW (failure to wait). It has nothing to do with a woman's ability to give birth & everything to do with her ability to give birth the way the "care" provider thinks she should. It says more about them than it does about you.

I never got past 1 with ds1, since I was on their stupid clock for having broken water & wasn't ready to be in labour. I got an FTP/CPD diagnosis. I gave birth to ds2 after 20 hours of labour which started *3* days after my water broke. I know I could have birthed ds1 if it weren't for their rules and stupid expectations.

You got all the way to 9cm. You are a great VBAC candidate. Find someone else to attend your birth.

mom to all boys B: 08/01ribboncesarean.gif,  C: 07/05 uc.jpg, N: 03/09 uc.jpg, M: 01/12 uc.jpg and far too many lost onesintactlact.gifsaynovax.gif

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#16 of 39 Old 09-03-2008, 06:52 PM
 
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I labored for 70 hrs, pushed for 4.5, birthed my babe just fine with absolutely no medical intervention, would have for sure been failure to progress if I'd gone to the hospital before the last 7 hrs of labor and had a different ob/no doula. Labor can take awhile, and every woman labors different. Failure to progress is complete bs, especially after an induction. Go for the vbac, mama!
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#17 of 39 Old 09-03-2008, 07:42 PM
 
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I labored for 29 hours with my first baby. Went into spontaneous labor but arrived at the hospital only 2.5cm dilated. I had the whole 9 yards - pit, stadol, and an epidural..... and then had a c-section when I wouldn't progress past 4-5cm. Oh, and I had a midwife! She told me I would never birth vaginally and I should just schedule c-sections.

I met with 2 of NJ's best vbac midwives 2.5 years later who were completely unphased by FTP diagnosis. After 41 hours of continuous labor (following nearly a week of prodromal labor), I pushed my second baby out. The one midwife sat in the hospital with me for 17 hours and never let me know that I wasn't progressing. She just knew what to do to get me (and my cervix) moving when it was time.

You can click on my VBAC story in my siggy to read more. They don't do hbacs since it's illegal for them in NJ but there are Philly midwives that can do them since it's fine in PA.

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#18 of 39 Old 09-03-2008, 07:43 PM
 
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I agree with what others have said: you sound like a perfect candidate to me. I had a 32 hour long labor with my succcessful VBA2C.
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#19 of 39 Old 09-03-2008, 08:06 PM
 
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I was sectioned for a combination of failure to descend and CPD (DS1 was posterior with a very large head, and I do have a narrow pelvis, so it was only partly B.S.). I labored for 46 hours in the hospital, I, too, got everything I didn't want (epidural, Pitocin, stuck in bed, etc.) I was told I wasn't a good candidate for VBAC either. 4 years later, I had a wonderful, successful HBAC.

I see no reason you can't have this baby vaginally. My advice would be to stay out of the hospital this time, though.
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#20 of 39 Old 09-03-2008, 09:40 PM
 
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I second what others have told you. You are an excellent candidate and need to find a provider who will support you.

I have a similar birth story to yours and I am planning a hospital VBAC in Feb.

Good luck. Fight for yourself, learn all you can and make it happen.
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#21 of 39 Old 09-04-2008, 11:44 AM
 
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A failed induction is not a contraindication for a vbac in subsequent pregnancies.

I suggest contacting ICAN to find a vbac friendly care provider.
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#22 of 39 Old 09-04-2008, 12:09 PM
 
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Poor candidates for VBAC include:

1) women who through injury or illness have a deformed pelvic opening, the size or shape of which prevented the baby entering or exiting the birth canal (not you).

2) women who have had classical (belly button to pubic bone) T-shaped (hip to hip and bellybutton to pubic bone) or J-shaped (done to free an wedged breech or preemie) incision, or a woman who had a premature baby delivered by high transverse incision (side to side still, but the fundal part of the uterus is cut because earlier in pregnancy it is all lower in the pelvic cavity and there isn't "enough" low transverse area for a surgeon to cut enough to get the baby out) (not you)

3) women who have already suffered severe anal or vaginal prolapse following 4th degree tearing at a previous delivery (please note, pregnancy does as much to weaken the pelvic floor and ligaments as birth, but in a woman where prolapse has already occurred minimising damage may become a priority) (not you)

4) women who have placenta praevia (placenta over the inner os of the cervix) or placenta accreta (placenta growing into the previous section scar) (not you as far as i know)

5) women who are post-dates with a baby showing clear signs of distress (it is DANGEROUS to induce a VBACing woman, and to augment her - many of the US studies with high uterine rupture rates included cytotec - to put that in perspective a NON-VBACing woman who is induced with cytotec has the same risk of rupture as a VBACing woman who is not in any way induced or augmented - cytotec is dangerous). (not likely to be you - post dates is normal, the average first baby of non-induced women is born at 41.4 weeks gestation, true distress because of postmaturity is NOT common)

Please be aware that aside from women whose pelvis's are so deformed the baby can't get out (possible causes - past pelvic fracture, polio, etc.) all of the above are poor candidates but even that in itself does NOT MEAN THEY CAN'T VBAC it just means the risks are higher for them and their babies.

Your labour was induced before your baby wanted to be born. The doctors cannot make the baby be born except surgically your body and baby aren't ready. Labelling you "failure to progress" is akin to labelling a 3 week old baby with "failure to walk" - until your uterus is ready for labour (there is a massive increase in receptivity to certain hormones at the end of pregnancy - when the sensitivity is high enough labour can progress normally) it CANNOT work the way it's supposed to. Doctors cannot predict with accuracy who will be receptive and who won't. The Bishop score is a crude tool for a sensitive job.

You are an EXCELLENT candidate. Find care givers who care and you will do great.
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#23 of 39 Old 09-04-2008, 01:36 PM
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I have the failure to progress label too! I never got past 6 and that's with starting labor on my own, water breaking on it's own - painful strong contractions for 8 days! AND.. I'm being give a chance at a VBAC. No one ever told me that I wasn't a good candidate! I'm seeing the same midwives (out of a hospital) that I saw last time!
Sounds like you should find someone else to handle your prenatal care and delivery!

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#24 of 39 Old 09-04-2008, 01:36 PM
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I totally agree with all of these posts. and awesome that you got to 9cm in a hospital! the stress of all the people in and out, the clock, the fingers, the time... it's awful, isn't it?

My first vbac ended in c after a glorious 'bradley-style' labor because, in my opinion, it wasn't failure to progress, but my 42w 10lb 3 oz babe was posterior and asynclitic. His head was literally stuck, and they even tried manually going up there and grabbing him. *ouch*!

My second vbac attempt was only 15mos after my second c, so I was a bit concerned about a vba2c so soon after the last c... but I swore I would not consent to surgery unless it was medically necessary. I had a sweep done at 38w (btw, I had lots of sweeps done with DS above, and it didn't do much... ) and that night I labored at home expecting it to peter out, and finally gave in and went to the hospital - arrived at 10cm +3, and delivered via vba2c 35 minutes after we pulled up.

Positioning was sooooo important to me this time around. We didn't know my first DS was posterior or asynclitic, or over 10lbs, but with the last pregnancy, I made sure before pushing that everything was aligned as it should be.

Keep researching and get your confidence up. Challenge everything. Good luck!!!

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#25 of 39 Old 09-04-2008, 02:38 PM
 
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I haven't read all the previous replies but I think in the end what really matters is do YOU think you are a good candidate?

If you do then go for it and don't let anyone talk you out of it based on airy-fairy concepts of who can and can't VBAC. If you have a serious medical issue that needs to be considered then by all means do but "not a good candidate because I just don't think you are" is a little silly.

If you do decide to go ahead with a VBAC I think it is ESSENTIAL that you find someone who supports you and believes in you and believes in the birth process. I made the mistake with my second baby of using an OB who "allowed" me to "try" a VBAC...I thought that was all I needed and ended up with another c-section. This time around I'm using a group of midwives and I feel SO much better about it. The difference between midwife care and OB care really is night and day. Keep in mind that if you go to an OB you are going to have a surgeon delivering your baby...they really do see things differently most of the time. (Of course there are exceptions to every rule...there are plenty of great OBs and plenty of medical type midwives).

Oh and as an aside I firmly believe that in the case of an induction that leads to c-section the Dr should have to take FULL responsiblity for that c-section...no taking the easy route and blaming the mother's pelvis or just her general inability to give birth!
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#26 of 39 Old 09-04-2008, 02:56 PM
 
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Like all the PP already stated, you are an excellent candidate for a VBAC and do not let anyone tell you anything different.

Quick background on me:
Went into labor on my own. AROM at 1-2 cm. Epi. at 3 cm. All back labor. Spiked a high fever. Progressed to 10 and pushed for 3 hours with no progress. Baby was also posterior.

Was told by my former Dr. that I would never deliver vaginally....my pelvis was too small.

Will be having my 3rd VBAC late Oct./early Nov.

You CAN do this Mama!!
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#27 of 39 Old 09-04-2008, 03:41 PM
 
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I was induced because the 37 week u/s showed a big baby. He wasn't,but that's another story.

Anyway, very similar story to yours, with a posterior baby, failure to progress, labored flat on my back for 12 hours. Everyone telling me it was the shape of my body and big baby that made birth impossible for me.

I did a LOT of research and found a new hospital and doctor,since a midwife is not an option in my area. Was told constantly that my body would not support a vaginal birth.

I labored at home as long as possible with a doula. Showed up at the hospital fully dialated with baby nearly crowning. STILL got lectured by the staff for my dangerous behavior of not being in the hospital and accepting the interventions. Delivered naturally my 8lb boy 30 minutes later with no complication or drugs! Then got lectured the whole way to the recovery wing about my reckless behavior of trusting the process and my body.

Even with an example before them of a relaxed, uncomplicated pregnancy and uncomplicated delivery, I still couldn't get any support from the hospital. But who cares? I knew, my doula knew, and my husband knew we were making rational, sound decisions.

IF you want to labor and trust your body, then you have to study up on the facts and be assertive. Try to find a supportive provider, but never give your power away to make good decisions for yourself.

Just as a note, I did have a backup plan in case of complications. I knew as many of the signs of labor problems as I could, and made sure my doula and husband knew too. So if there was any sign that more medical help might be needed, we had a plan for getting that help. I made my peace in case another c/s was needed. I just made sure that it was a final resort, and not a first convenience for the doctors.

Know thyself and trust thyself. Hang in there!
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#28 of 39 Old 09-04-2008, 03:51 PM
 
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I agree with everyone here!

GO HAVE A VBAC!!!!!
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#29 of 39 Old 09-04-2008, 06:25 PM
 
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I think you'd be a fine candidate for VBAC. Anecdotal evidence, I know, but I labored more than 60 hours with a posterior baby before he finally decided to come out.(incidentally I was also induced!)
I had a CS with baby # 3 for breech, CBAC with baby #4(failed induction by an OB who let me "try" a VBAC) and VBACed baby #5 after 2 C-sections and 92 hours after spontaneous ROM. The last time, I can honestly say, I did it MY WAY and I felt like superwoman, lol!
Find a supportive care provider and go for it, if VBAC is what you want!
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#30 of 39 Old 09-04-2008, 07:16 PM
 
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I have 3 quotes for you

"I've come to realize that a God who is big enough to so perfectly form little eyes and ears and a little round nose and a heart and lungs and every single part of a little person is certainly big enough to work out the details of their coming into the world."
-Vicki in Mars, PA

"Always listen to experts. They'll tell you what can't be done and why. Then do it."
-Robert Heinlein

"Of course the game is rigged. Don't let that stop you - if you don't play, you can't win."
-Robert Heinlein
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