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Old 09-21-2006, 04:18 PM - Thread Starter
 
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I'm relatively new here. Long time lurker, second time poster.
A bit about me: I have one DS, 4.5 yrs old. Married several years. I enjoy candlelit dinners and long walks on the beach. : But seriously. I have a question I have been struggling with for several months now.

I went into labor w/ DS on a Monday, on Friday they finally did a c-section. DS was facing up and his head was tilted (acynclitic?) so that he wasn't bearing down on my cervix correctly. I dilated to 6 centimeters (I was 5 when I came in that morning around 1 a.m.). Then the nazi nurse said the baby wasn't handling labor well anymore and moved me to the OR. Crappy nurse, crappy doctor, crappy birth experience.

I put DS to breast as soon as I came out of the meds, and did my best to breastfeed. My supply ended up being too low. I went through fenugreek, an LLL consult, no formula, and several crying jags (both mine and DS's). I was only able to give him about 2 ounces each feeding and supplemented with formula. This went on until we weaned at 16 months. DH tried to be supportive, but freaked and was a major reason we gave DS formula in the first place.

I'm older, wiser, and expecting a new baby in March. I'm also in law school, and it turns out DS is on the autism spectrum. So, in short, busy life. Baby's due March 16th. I can only miss about 3 weeks of school without violating bar association attendance requirements. I'm looking into this, but, either way, I'm worried.

See, I can try for a VBAC, but my doc would only want me to try this if I go into labor on my own by my due date (since 'failure to progress' was the 'diagnosis' for DS, she advised I have a 50% chance of success with this one). If I choose a c-section, doc wants to schedule the birth for the 7th, the weekend before spring break. I could take that extra week to work on making this breastfeeding experience completely successful (by which I mean this baby gets nothing but breastmilk).

I am seriously torn about this birth. I want a VBAC, but I also want to maximize my chances of breastfeeding. I know a bit more now (and plan on learning even more before the birth) about both. What can I do to increase/ensure success?

There’s one more thing: DH may be going back to Iraq next April. I’m pretty sure stress was a major reason I wasn’t as successful at breastfeeding as I’d like to have been. How do I handle this birth decision?

I don't know what to do. What do I need to know to make this decision? What would you personally choose? I'm seeking educated opinions here to help educate and inform my own decision. Thanks if you made it this far. I’ve x-posted this in VBAC, Breastfeeding, and the BBB board for the most information/education.

TIA,
eva
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Old 09-21-2006, 04:24 PM
 
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Get rid of the OB. Find a midwife. FTP is a BS diagnoses. Get someone who will actually support your VBAC. A section will seriously reduce your chance of breastfeeding successfully.

-Angela
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Old 09-21-2006, 05:21 PM
 
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I find it nearly impossible to believe that you had this problem as a result of a section. The stress you describe, maybe. Most mothers who have sections BF successfully, I know many & myself have, I even had oversupply. I am sorry I don't have advise but the tone around here re: sections is REALLY getting to me lately. One has nothing to do with the other. I mean, maybe for some woman it can for certain reasons, but AS A RULE moms who have sections BF just fine. My point is just that it DOESN'T have to be either/or. You can have a surgical delivery and BF. The fact you had low supply before would make me worry that it would happen again though...but moms have this problem with natural deliveries, too. It's not so uncommon. Again, no advise...but please don't go right to formula just b/c you have a section! Good luck!

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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Old 09-21-2006, 05:28 PM
 
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Wow, Eva. I'm sorry things are so complicated and stressful for you during a time that should be nothing but joyful.

If I were in your shoes, I'd choose the VBAC and seek out good LCs and LLL groups near you. Seriously, you'll have the best chance at a successful breastfeeding relationship if you can avoid the c. Think about it: you'll be able to nurse right away, without waiting for the stitches for the meds to wear off. Plus, you won't have the extra pain and healing from the surgery. All you'll have to focus on is your baby.

Angela made a good point. Are there any midwives near you? You'd probably have a better chance with a midwife. You shouldn't let your OB pressure you about due dates, since we all know they're pretty much arbitrary. Consider a doula as well.

Re: law school... can you sling your babe and wear him to class? You can BF quite modestly in a wrap (although honestly I haven't tried it... I've seen my friends do it...)

Good luck, mama!
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Old 09-21-2006, 05:29 PM
 
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There's no reason you can't nurse right away after a section. They can't tell you otherwise if you want to. I nursed in the OR.

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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Old 09-21-2006, 05:31 PM - Thread Starter
 
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I find it nearly impossible to believe that you had this problem as a result of a section. ...but please don't go right to formula just b/c you have a section! Good luck!
Thanks. I don't think the supply issue was a direct result of the section. I think it was a combination of factors (stress, long labor, school was starting up again in a few weeks, no support from family or friends because they'd never breastfed or seen it done, and, of course, the pain of it all!). Also, last time, my breasts didn't change at all before birth. This time, I've felt fuller and tingling and it's like they're getting ready for the new one. So, hopefully, that's a good sign.

I'm just wondering if I should go ahead with a section this time to allow myself more time to recover and start breastfeeding on the best track. I know I'm taking a chance either way; I just want to know which chance to take. Does that make sense?

eva
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Old 09-21-2006, 05:34 PM
 
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Thanks. I don't think the supply issue was a direct result of the section. I think it was a combination of factors (stress, long labor, school was starting up again in a few weeks, no support from family or friends because they'd never breastfed or seen it done, and, of course, the pain of it all!). Also, last time, my breasts didn't change at all before birth. This time, I've felt fuller and tingling and it's like they're getting ready for the new one. So, hopefully, that's a good sign.

I'm just wondering if I should go ahead with a section this time to allow myself more time to recover and start breastfeeding on the best track. I know I'm taking a chance either way; I just want to know which chance to take. Does that make sense?

eva
I understand.
What you have described sounds like an awful stressful situation & likely that did contribute.
You CAN nurse after a section - don't let ANYONE tell you different.
That said, PLEASE consider a VBAC anyhow. Not so that you can BF, you can BF no matter what you decide, but because it's better for your body and your baby.
Beyond that, plan to BF...you can & you will!
Good luck!

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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Old 09-21-2006, 05:36 PM - Thread Starter
 
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Also, although I'm told midwives are covered on my plan (an HMO), there's only one, Ann Jacob, here in Houston, TX on my plan, and I'd have to change provider groups to get a chance at getting to her. Not that I'm unwilling, but believe me, my HMO is no picnic already. I'm looking into the options.

Either way, the doc can't perform surgery if there's no patient, right? At the end of the day, she knows I'm not that gullible. Her DH went to law school here, and she's currently pregnant herself (her first). I think by the time my labor rolls around, she'll have a better outlook on it. She supports my desire for a VBAC, but she's like every other doc: worried about lawsuits.

I want to wait to go into labor on my own, but I just didn't know if I should forego one to ensure a great result on the other. And which one? Birth is huge, but I don't want to go through formula again.

eva
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Old 09-21-2006, 05:43 PM
 
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My advise is go for the VBAC. Then go on to BF. It doesn't have to be either/or - you can nurse after a section...but why have a section to begin with? Cuz the OB wants you to? That's the worst reason yet.

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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Old 09-21-2006, 05:50 PM
 
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Oh! You're in Houston! That's great news. I bet you can get a homebirth midwife covered... do some searches here.

-Angela
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Old 09-21-2006, 05:57 PM
 
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i wholeheartedly agree with RMZBM (marie)

I see no reason why you cannot successfully BF,
Also, you can VBAC too!

Good LUck!
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Old 09-21-2006, 05:58 PM
 
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If you go for a VBAC, the baby will truly be ready to be born and will have a much better chance of BF sucessfully. Even if you end up with another c/s, by waiting until you go into labor naturally you'll avoid the risk of a "not quite ripe" baby. Babies born before they're ready (even if they're at or beyond the estimated "due date") are more likely to have problems with sucking, breathing, or co-ordinating the two.

I'd definitely look into taking the newborn to class with you, if you won't be able to take a full maternity leave. Would you consider putting school on hold for a year so you don't have to worry about this, or is that not a realistic option right now?

Ruth, single mommy to Leah, 19, Hannah, 18 (commuting to college), and Jack, 13(homeschooled)
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Old 09-21-2006, 06:03 PM
 
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I'd be interested in who your OB is, or at least which hospital. There's a great variation in section rates at Houston hospitals. A few as low as ~27% Some as high as 40%+

I would homebirth. With a supportive midwife. Plan to be successful. As mentioned- take your baby to class with you to nurse. If that won't work- have someone bring babe to you on breaks to nurse. You CAN make this work

-Angela
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Old 09-21-2006, 06:40 PM - Thread Starter
 
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Putting school off for any amount of time (a semester or a year) is not feasible; DH works 3 jobs to take care of DS (who needs a lot of specific care because of the autism spectrum disorder).

We knew this wasn't the best time, but it's the best of the worst time to have another, KWIM? After I graduate, it'll be a few years before I could have another and then I'm 'high risk' because I'll be over 35. Bah!

Don't know about bringing baby to school, but I don't think it's out of the question. I also don't know about homebirth yet. I honestly think the only support on that I'd get is from the midwife. Seriously. Everyone else would be a PITA.

I'm so grateful for all the responses and help. Seriously. You guys are the only ones I can ask about this because everyone else says "midwife? whah? whaddya mean? are you speaking english?" : They seriously have no idea what it is to even consider anything outside of a hospital and a OB/GYN.

Thanks again for the insight. I'm going to talk more about this w/my peek-n-poke (OB/GYN) and look further into available midwives (if there are actually any available on my plan). If it's not covered by the insurance, we can't afford it right now.

eva

ETA: my doc is a Kelsey-Seybold doc, Purnima Rao, who is just lovely in all other ways as a doc, and she's only got privileges at Woman's Hospital of Texas (which is where the first crappy birth experience occurred). I've already told her I don't want to even see the nurse that attended me last time. Woman's hospital my hiney (can I say that here?).
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Old 09-21-2006, 07:16 PM
 
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oooo.... I'd run from Women's. They brag about their OVER 40% section rate.

:

-Angela
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Old 09-21-2006, 07:26 PM
 
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I would def go for a VBAC and stay away from hsptls if it were me! I plan to have a home VBAC for the next one.

And some women do have problems BF with a c-section. For me, with the meds/drugs from the c/s i think my body was messed up and didn't know if it should produce milk yet or not. DD wouldn't latch on because she was so tiny (another reason to not have a c/s). It was about 3 days before my colostrum came and longer for the milk. So much to my dismay dd had some formula. Maybe if she had been latching instead of me having to pump milk etc would have come more quickly.

I don't think anyone asked this, but.... were you trying to breasfeed on a schedule? This can greatly reduce milk supply as can tyring to get baby to sleep thru the night.

I would homebirth (hsptls have awful vbac success rates!) and just don't even tell people your plans if necessary. Then I'd take that 3 weeks and plan NOTHING but baby time. Just wear the baby, hold the baby and breastfeed on demand. You will go back to school full of milk I also 2nd the suggestion to keep baby with you at school or at least have someone bring him/her to you to breastfeed.

read all you can on here to learn about how bad unnessecary c/s are and how most are unnecessary. and btw.. Welcome to MDC!! :-)

Good luck! and hear is hoping your DH does NOT have to go back to Iraq!
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Old 09-21-2006, 07:37 PM
 
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I know I'm talking out of school here since my first isn't due for another 2 months and thus I have no direct personal experience with this, but wouldn't it be MUCH easier to physically recover (and get your butt back in school in 3 weeks) from a VBAC than another C-section? I'm sure there are exceptions, but of all the mamas I've known, I've never seen anybody be physically able to return to work or school that quickly after a C-section.
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Old 09-21-2006, 08:28 PM - Thread Starter
 
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I wish I could run from Woman's. But, it's the only place my ob/gyn is privileged. It's been hard for me to find a doc on my plan. I much prefer a woman (just my thing) and no independent practitioners take my HMO anymore.

I may not be able to bring baby to school (depends on the profs) but I have my handy dandy breast pump (Ameda PY) from DS, which did an admirable job last time (I had DS when I was in b-school). I had to return to school at 2.5 weeks after DS's birth and had the pump on hand knowing my situation.

I just keep doing the same thing, huh?

I'm doing research about VBAC and though I'm pretty sure I'm stuck w/ my ob/gyn, the positive is that she respects me enough not to take it personal when and if I have to ignore her medical advice.

eva
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Old 09-21-2006, 08:37 PM
 
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You can have both. Go for it.

I agree with other pp's who say homebirth. Wish I had tried that again the second time.

And start working on breastfeeding now!! Go to LLL while you are pregnant.(your son can go with you, kids are more than welcome!). Read books, lurk on the breastfeeding forum, and learn, learn, learn!! You can do it VBAC or not. Get the basics down, learn the myths, and know what to do and how to overcome. I had two sections and breastfed (and am breastfeeding) successfully both times. It's knowing what to do and how to contact help if you need it that counts. Support is so important. You have it here, you just need some IRL!

Good luck!
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Old 09-21-2006, 08:42 PM
 
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If Women's is your only hospital choice, have a homebirth. I doubt there's any chance of a VBAC there.



-Angela
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Old 09-21-2006, 09:11 PM
 
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Well, I'm one of those who are going to say have both! Try to get away from the hospital that has such a high cesarean rate. If, as it seems, you really CAN'T do that, GET A DOULA. FIND HER NOW, AND TALK TO HER OFTEN!

Then. Wait until you're in labor. Once you're in labor, go about life. Don't time every single contraction. Do life until you can ONLY do labor. Then, stay home. Stay home, stay HOME, as LONG. AS. YOU. POSSIBLY CAN. I mean as LONG as you can. Not at the first twinge, and certainly not while you are in any way still comfortable or conversational.

Take a Bradley Class. Start today by finding a teacher/couple and set up the class. Between the doula and the Bradley class (doulas make it 50% more likely that you'll VBAC successfully and Bradley moms have great stats, too...), you should be WAY ahead of the game.

Then, when you know that you're in VERY active labor and are getting ready to drive over to the hospital, call ahead to the L&D unit. Tell them you're on your way, with a doula, and want the most natural labor friendly nurse they have. Then, once you're there, if you don't like the one you have, even for a second, tell them you want another one. And keep telling them that until you find one who really supports natural labor and VBAC. YOU are paying their paychecks. You are the one who decides what kind of care you are given. Use your voice. Use it!

Now, also, read the spinningbabies web site, to be sure you do EVERYTHING in your power to be sure that your baby is presented properly, to be SURE that the head is where it's supposed to be to properly dilate your cervix.

I also HIGHLY recommend that you attend LLL meetings NOW, and as often as you can (certainly at least once a month), until you birth, and then KEEP going. Make THEM your friends (really, there are a bunch of us who make great friends...: ), use THEM for support, information, and HELP when going gets rough. Don't just go for a "consult," make them part of your circle of support pre- and postnatally. Did you know that the World Health Organization and UNICEF, AS WELL AS the AAP look to them for valid informaiton and current studies and stats?

Take up prenatal yoga. Continue postnatally. REally, sounds silly, but even fifteen minutes at two o'clock in the morning before I fall into bed does wonders for my stress level, my ability to make milk, to think rationally, and to take the stressful situations and keep the stress external.

I was not going to continue the mantra about homebirth, as it doesn't seem like an option for you...however! Check out what your total out of pocket would be for a hospital birth. THen contact the local midwives and see if they work on sliding scales. I bet you, after all's said and done, that you MIGHT find the amounts to be somewhat comparable. And, in my case, it would be wonderful for ME to scrape, beg, or borrow the extra couple hundred bucks to make it SIGNIFICANTLY more likely that you'd VBAC AND get your breastfeeding relationship!

That last little bit said, please, do all of the other proactive things, and one more. Please, trust birth. Trust your body, it was MADE to birth the babies that it grew! Trust your baby. If you give it the proper tools, it, too, was made to do the labor dance, and to HELP you give birth. Trust the process of birth. You CAN do it.

This doc has never given birth before, you're right. However, I wouldn't count on the fact that being pregnant will change her opinions about any of the process. It IS for her how it IS in her environment. The way everybody around her does things. Therefore, it is possible, but in my opinion from working with M-A-N-Y doctors with children, not likely that she'll change her ways. But, you're right. She can't cut a patient who's not there (*oh, by the way, a six week surgical recovery is NOT easier than a vaginal recovery! remember that!), and if you wait to go into labor, they can't refuse to treat you. But DO have a doula with you...for SO many reasons!

Hope some of that helps. You'll do great!

Mama to two awesome kids. Wife to a wonderful, attached, loving husband. I love my job-- I'm a Midwife, Doula and Childbirth Educator, Classes forming now!

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Old 09-21-2006, 09:20 PM
 
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Then. Wait until you're in labor. Once you're in labor, go about life. Don't time every single contraction. Do life until you can ONLY do labor. Then, stay home. Stay home, stay HOME, as LONG. AS. YOU. POSSIBLY CAN. I mean as LONG as you can. Not at the first twinge, and certainly not while you are in any way still comfortable or conversational.

!
If I did that I would be birthing in the car. LOL


Good luck to you.
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Old 09-21-2006, 09:34 PM
 
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If your can choose between c-section and vbac I'd go vbac again in a heartbeat. With my DD I had an emergency section and was in the hospital for 4 days. With my DS by vbac I was out in 24hrs. And I would have walked out on my own but hospital policy said they had to wheel me out. I healed up so much faster and was back to my self so much quicker with my vbac and that was with a level 4 tear.
If you end up with a c-section know your rights. They didn't but me out for mine just a spinal block and I was able to breastfeed within the first hour of birth. So my daughter was breastfeed by the start but what a start.:

good luck with your birth
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Old 09-21-2006, 09:39 PM
 
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With my last section I was home in less than 24. hrs. I'm still not advocating the section...but don't want anyone thinking they MUST stay a certain length of time if they have one.

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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Old 09-22-2006, 12:12 AM
 
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courtenay_e, you are a wise wise woman, and officially my new hero.
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Old 09-22-2006, 02:34 AM
 
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I don't have a lot to add, except that I personally will never have another scheduled section without labour. I've been cut three times - the first was an "emergency" in active labour. The second was when I let my doctor bully me into a scheduled section for breech at 39 w, 2d. The third was when I again let them bully me into another scheduled section - this time for an "overdue" baby and "high risk" (VBA2C) mom...oh, and "big baby".

I've successfully breastfed all three babies, with no long-term supply issues. However, with my dd - my no labour section - I did have short-term issues with milk production and it was absolutely awful. My milk just wasn't coming in. While it obviously doesn't affect everybody that way, I firmly believe the reason for the "slow milk" was that my body simply wasn't ready for my baby to be here.

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 09-22-2006, 07:12 AM
 
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courtenay_e gave FABULOUS advice. Definitely look into the option of a homebirth, and if it's not possible, definitely plan a VBAC and breastfeed.
And, as PPs have mentioned, try to bring your baby to class- I have a friend who was in grad school when our babies were born and she was able to bring him to class.
Good luck!
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Old 09-22-2006, 12:13 PM
 
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I agree with others - you should be able to do both. But I wanted to comment on something you said... You said your breasts never changed last time. Do you by chance have PCOS? I know that some PCOS women's breasts don't change (the milk glands don't form) and they suffer from true low milk supply (ie, there really is nothing that can be done at that point). I'm glad you're feeling some changes this time. LLL has an article on PCOS somewhere, that's a good read. I don't have experience with PCOS myself, but have talked to women who had it.

Mama to Tornado Boy (6/04), The Brute (11/06), and Mischief (05/09)... expecting in February '15
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Old 09-22-2006, 12:30 PM
 
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Quote:
Originally Posted by alegna View Post
If Women's is your only hospital choice, have a homebirth. I doubt there's any chance of a VBAC there.



-Angela
I agree with Angela.
You have to ask yourself what is more important - a provider that will be in your life for a very short amount of time or a birthing experience you will have for the rest of your life?

There is a female Dr. Johnson - I think her first name is Bina or Beena - she is at The Woodlands hospital - I think it's Woodlands Memorial. She is the only OB that my doula friend recommends for a VBAC. I know two women that have had successful VBACs with this OB at that hospital. If you are going to birth with an OB in a hospital this is where you should go.

Really, if you are considering a VBAC you need to run away from Women's. Their hospital policies are very anti-Women. So very sad but the truth.

If you are resigned to stay with this OB and therefor this hospital your chances are quite slim and likely impossible without a doula though it may even be difficult to find a doula that will grace the floor of Women's because of their practices and anti-doula ways

I understand liking/trusting your OB and that switching can be an issue but this is YOU, YOUR body, YOUR baby and you will have to live with yourself and this birth experience long after your OB has forgotten all about you.

Keri

 Keri wife and Mama to  Cory 17,  Brendan 15,  Kerianne 8,  Avery 7,  Lilia 3
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Old 09-22-2006, 02:22 PM - Thread Starter
 
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courtenay_e, I did exactly what you suggested w/ DS: I stayed home throughout my labor. I started Monday and went into the hospital on Friday. I had a regular doc visit that Tuesday, but since I had just started labor, it was just a visit. But, once at the hospital, they told me I had to stay and I believed them. It went downhill from there.

BTW, I didn't try to feed on a schedule, but thinking back, it may have turned out as less than on demand. I wasn't trying to do that, but DS's signals were hard for me to read at first b/c he cried about a lot of things (the sensory stuff, I've since learned).

I also don't have any symptoms of PCOS, though reading up on it I think a friend of mine may have that.... I think my breasts just didn't grow because they didn't know! This time, they're already revving up for the baby they know is coming.

I'm looking into another provider. The Woodlands hospital is on my plan, but Dr. Johnson (you were right, it's Beena) isn't, sadly.

If anyone knows of anymore names, throw them out and I'll look them up on my provider list. Never hurts, right? I'm near the middle of town, so driving anywhere isn't a big deal for me. At this point, I'd rather drive than end up at Woman's again (if I can help it).

I can't afford much in the way of outside help, like a midwife or doula, on my own; we just aren't in that position right now. But, I do plan on looking into sliding scale doulas, if there are any in my neck of the woods.

Thank you all so much for all the great advice. I am learning so much, and the encouragement you have each offered is overwhelmingly beautiful. Thank you!

eva
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