VBAC Hunterdon Cty. , NJ or surrounding area - Mothering Forums

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Old 08-05-2010, 10:42 PM - Thread Starter
 
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Quick first time post..I am 33 weeks and not getting a good vibe from my Ob about my request for VBAC. Can anyone suggest a practice that supports VBACs and perhaps a doula? Thanks.
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Old 08-09-2010, 05:58 PM
 
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Have you looked into Midwifery Care Assoc. on 31 in Pennington?

No doula rec aside from to certainly get one.
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Old 08-09-2010, 06:23 PM
 
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Have you looked into Midwifery Care Assoc. on 31 in Pennington?

No doula rec aside from to certainly get one.
I have been told wonderful things about these ladies from my ICAN group ( I believe there is a new HUnterdon group also, but we always love new people at out somerst group if you want to joing us. I used Princeton Midwifery Care (they have am East Windsor and an Lawrenceville Offices) and had a successful VBAC with them in May.

For doulas (my doula is due with twins in Nov or I would rec. her) I love Patrice London.
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Old 08-09-2010, 06:38 PM
 
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Don't have any recommendations for you, as I am in Bergen Co. But I posted a near identical post a few weeks ago (at week 27) and just wanted to send my encouragement to you. And if you have that vibe, like I did, absolutely look elsewhere!!! If they are hesitant now, they don't typically get more enthusiastic come L&D. I have since decided (now at week 29) to go with a midwife practice (supported by docs and delivery in a hospital). I now plan to drive 45 minutes to my visits and the hospital they practice in for my delivery. And that's worth it for a chance at the delivery I desire. Good luck!
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Old 08-10-2010, 11:00 AM - Thread Starter
 
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Thanks for ideas and support. Unfortunately I called a couple of midwife offices and they won't accept me at such a late time. Still working on it! Thanks!
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Old 08-10-2010, 06:48 PM
 
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Well I am sure you aren't giving up but at the very least attend ICAN meetings pronto (one in Manville next Monday). And hire a doula without a doubt.

I have a friend who used Amy Wright Glenn. She loved her.
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Old 08-10-2010, 06:59 PM
 
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I'd also question my provider on their reason and bring up the latest release from the ACOG and see what they have to say.

http://www.ican-online.org/
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Old 08-10-2010, 11:16 PM
 
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Me again! Have you tried Avalon in Morristown? I think that's about 35 miles for you...I am traveling 35 miles from the opposite direction to work with them (granted my NJ geography is not great). First appointment with them today. Fell in love! Night and day compared to leaving my formal OBGYN 2 weeks ago with my hopes for a VBAC minimized & even questioning myself as to why it's so important. Now, I am so excited! And the Morristown Hospital L&D looks amazing...check it out online...wireless monitoring, tubs, all private rooms. Avalon took me at 29 weeks, and they were talking tonight about a gal, who I believe they said they took at week 36. And if it makes you feel better, there practice has doctors affiliated with them too. I hope this helps.
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Old 08-11-2010, 11:26 PM
 
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Princeton Midwifery Care took me at 33 weeks with my son.
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Old 09-04-2010, 01:14 AM
 
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Have you been able to find a midwife practice or ob that will support a VBAC yet. Let me know and I will ask a few docs that I have worked with in my area if they could do a referral or give some recommendations. I am a doula and I know when they are not encouraging now, they are not going to be later. Best Wishes and Congratulations...early!
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Old 09-04-2010, 01:49 AM
 
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everyone has given great recs. i have friends who have used all these mentioned-specifically 8 births with Pam & Louise in Pennington (Midwifery Care). But none of them were ever going for VBACs-they were all homebirths.


Just make sure you know who the back up OBs are & what their stances are on each labor/birthing situation. in my case, my water broke & i didn't end up delivering until 45 hours later. no midwife would have touched that with a 10 foot pole once they knew i was past 24 hrs.


we took a bradley class this time around & it met at Avalon's office in Caldwell. There were 5 couples, 3 of us going for VBACs. the 2 vbacs were both using Avalon, birthing at Morristown Hosp. i used my same ob, birthing at Newton Hosp, & spent my entire pregnancy in a partnership with her for my goal of a vbac. i also hired our instructor as my doula. i am the only one who got my vbac. they both said that the back up ob's to Avalon were not supportive at all. they had never even met them. and avalon (along with many others) does not use induction as an option. if you go past their "deadline", you don't have a choice-you are getting a section. no option for pitocin. they both went past the desired "date".

i ended up needing pit 30 hrs after my water broke to get things going but it worked & no c section.

Stephanie~hippie.gifwife to Dov, mama to Ella Irie (9/24/07) & Kaya Raine (2/1/10)~our vbac.gifbaby, born 45 hours after PROM!!!
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Old 09-04-2010, 01:32 PM
 
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Hmmm..... that's interesting. One of the most horrible bait and switches I ever witnessed happened at Newton Hospital (plus one of the doctors there attempted to committ insurance fraud against me by causing a car accident when I was pregnant but that's a whole other story ). They only had 5 VBACs there last year (Morristown had 91). But I'm really glad that you did have your VBAC!!! I just heard from a woman who had a VBAC at St Barnabas and nearly fell off my chair. That's a good reminder to ask the tough questions about your midwife's stance/policies on VBAC and what restrictions her back up doctor might have. I've heard back from several women who had great VBACs with Avalon but it's certainly possible that things are changing. Sadly, VBAC policies do change. Induction IS a no-no for VBACs (not that providers won't do it but it's not a great idea because it increased the chance of uterine rupture). A little bit of pitocin after natural contractions have started is generally considered okay, especially for a prolonged labor. You ALWAYS have a choice though. No one can force you into a c-section that you don't want. Even the hospital where I work (not terribly VBAC friendly) has had women refuse c-sections.

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Old 09-04-2010, 05:42 PM
 
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Just make sure you know who the back up OBs are & what their stances are on each labor/birthing situation. in my case, my water broke & i didn't end up delivering until 45 hours later. no midwife would have touched that with a 10 foot pole once they knew i was past 24 hrs.
Not exactly sure what you mean by that but I delivered at 44 hours past PROM with Pam and Louise. Pam said they just like labor to be established by the 24 hour mark. She was very patient and stayed with me in the hospital for over 24 hours. And I was a VBAC.

Taryn-31 Crunchy Conservative Catholic SAHM with DH-32
DS 7.5, DD 5 (vbac), DD 2.5 (vbac), and DD 12/30/13 (vbac)

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Old 09-04-2010, 11:37 PM
 
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"Hmmm..... that's interesting. One of the most horrible bait and switches I ever witnessed happened at Newton Hospital (plus one of the doctors there attempted to committ insurance fraud against me by causing a car accident when I was pregnant but that's a whole other story ). They only had 5 VBACs there last year (Morristown had 91)."

wow...i would love to hear those stories!!!???!!! PM me if you don't mind sharing!!!

Morristown's rate of VBAC is 11% and Newton's is 5%. It does suck that Newton's comes in that low because they truly are trying to support VBAC but they have had a rough couple years with the demographics shifting & women delivering there after having ZERO prenatal care at all & very poor nutrition etc. The higher # of repeat c sections are coming out of the hosptial clinic there which also has a very high # of drug addicted teen mothers. (a whole different issue but still impacting their #'s) I don't think Morristown takes those cases. They are going to be one hospital system shortly though & maybe we will see a change in certain aspects?

Anyway-Morristown & Avalon are amazing. I am just speaking from what happened in our Bradley class to the other 2 trying to VBAC. They were both really unhappy with being dumped off onto the back OBs & how things went down.

"Induction IS a no-no for VBACs (not that providers won't do it but it's not a great idea because it increased the chance of uterine rupture)"
I thought there was a new shift developing on this? I got the stats from the VBAC forum here & I thought it actually only turned out the it increased the rate of rupture by some miniscule %??? I can't recall the actual incriment right now Anyway-the risk of rutpure if far less than the risks associated with a c section/surgery...I am not saying pit is the answer or ideal, but in some cases, it is necessary & I would rather have that option than the other. I sat with a breast pump for 12 hours, walked, crouched, etc for a day & couldn't get labor to keep a pattern. After 30 hrs of that-I needed something. Had I been at Morristown, I wouldn't have gotten my VBAC.

"Not exactly sure what you mean by that but I delivered at 44 hours past PROM with Pam and Louise. Pam said they just like labor to be established by the 24 hour mark. She was very patient and stayed with me in the hospital for over 24 hours. And I was a VBAC."

Pam & Louise are AMAZING. That is wonderful you got your VBAC with them!!!! I love them. They wouldn't take me because I was a VBAC with GD but my 3 best friends home birthed with them 8 times all together. I just know that 2 of them lied about when their water broke because it was close to the 24 hr mark & nothing was happening. They knew they would have to go to the hospital at that point & didn't have any say in who the back up OBs would be.

For a VBAC, I am just saying that since that stuff can happen-it's important the OBs are supportive too & you know who they are...that's all.

Now...I wish to God I could name some Mine is leaving OB & only doing GYN as of 12/31 because she is so sick of the nonsense, insurance BS, lawsuits in NJ. GGGGRRRRRRRRRRR.

Stephanie~hippie.gifwife to Dov, mama to Ella Irie (9/24/07) & Kaya Raine (2/1/10)~our vbac.gifbaby, born 45 hours after PROM!!!
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Old 09-06-2010, 12:12 PM
 
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It was just an awful, awful situation where they were super supportive of VBAC with this mom for the first 32 weeks of pregnancy. I thought she found a real gem of a hospital!!! I was so excited to learn about Newton. Then they told her no going past 40 weeks. At 36 weeks, they told her the baby looked too big and she had to schedule a c-section around 39 weeks or she would not be able to continue seeing them (completely unethical). At her next appointment, they told her that at her age (which was about 30!!!), her risk of fetal demise with this VBAC was significantly increased.

The problem is that it was a bait and switch. There was no way to know until almost the end of her pregnancy. Like I said, I am THRILLED that you got a VBAC there!!! Maybe you got the 1 good doctor there (which is really what you need). Unfortunately, another situation just played out again last night. Doctors were super supportive of VBAC up until close to the end. Mom fought really hard for her VBAC as she approached 24 hours PROM but had to endure the doctor calling her selfish and complaining that he was missing his wife’s birthday party and pulling the dead baby card. Berating and belittling a mother in labor is not my idea of VBAC supportive.

I honestly don't know about Newton's vs Morristown's demographics but I work at a very suburban hospital that still gets it share of uninsured, drug users, etc. As a level III NICU, I have to believe that Morristown is getting it's fair share of these patients since many of them may need the NICU. But who knows!!! I’m a little wary when hospitals have excuses about their low VBAC rates. The real issue is whether women who WANT to VBAC, CAN have a VBAC. Pam and Louise attend at a true inner city hospital. The hospital has a clinic as well to serve the area. Yet, the hospital still maintains one of the lowest epidural rates, lowest c-section rates and highest VBAC rates in the state (those rates are all relative to the state, of course!!!!). Now that I've written that, I have to mention that one of the hospitals with the lowest c-section rates and highest VBAC rates is Cooper Hospital in Camden where I am quite willing to bet they get plenty of uninsured patients without prenatal care, proper nutrition, etc.

That's really a shame about the other women you knew hoping for VBACs with Avalon. This is the first time I've heard stories like that!!! Obviously, I can't comment without know what happened but I do know a woman whose VBAC turned into a CBAC with them but she had serious complications in labor so I believe her delivery was handled appropriately.

That's odd about your friends not knowing P & L's back up doctors. Up until about a year ago, they were backed up by 1 doctor whom all their patients met. He was very comfortable with P & L's running the show with their patients. They are now backed up by the on call physician group (actually the group has doctors and midwives) at the hospital but they are still running the show when it comes to their patients. My dh actually served in the military with one of the back up doctors so I am comfortable with them. Plus, that doctor was on call for my friend’s labor and I don't even think he ever stopped by the room for her VBAC. He just let Pam handle it (even with pitocin and well over 24 hours post-PROM). To me, that is a good doctor-midwife relationship. Hopefully it doesn't change! I don't blame your friends for lying about when their water broke. I wouldn't want to lose my homebirth over that reason either!! The good thing is that they knew the "policy" up front and could "work around it" (so to speak!).

As far as induction goes, it is still not a good idea for VBAC. When I say induction, I am talking about the use of cervadil or cytotec. Those 2 drugs are typically coupled with pitocin to augment labor once contractions get going. This can increase the risk of rupture to 1.4% (according to the 2004 NEJM Landon study). A totally spontaneous labor has a 0.4% chance of rupture. So I guess it depends on the way you look at it. I would consider a castor oil induction or a foley induction before another c-section but I would NEVER agree to cytotec. A VBAC candidate is not without options when a medically indicated induction is necessary. A low dose of pitocin is considered safe for VBACs after labor has begun but in the past, providers would routinely increase the amount of pit at specific intervals (which is not safe).

My labor started and stopped for a week. P&L were quite aware of this! By the time I delivered I had been in labor for 41 continuous hours. We talked about pitocin but decided against it. Pam was more concerned that I would become exhausted than anything else. As long as I was okay to keep going, she was okay waiting.

Unfortunately, VBAC is not easy in this state!!! I totally agree that it is so important to know your midwife and her back up doctors. One of my old midwives was very encouraging of VBAC but she still had to adhere to the semi-strict policies of her back up doctors. There are a couple doctors in this state who are very supportive of VBACs and natural birth as well. In fact, I'd go with certain doctors before many midwife groups in this state (but that goes back to the fact that a midwife's scope of practice can be limited by her back up doctor). I really wish this state would recognize midwifery as an independent practice!!!

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Old 09-06-2010, 05:25 PM
 
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Sending best intentions for a lovely VBAC

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Mom to Liam 9/06, spirit baby 3/09, and identical twins Mateo and Sebastian 10/11namaste.gif

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Old 09-06-2010, 06:00 PM
 
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"I would NEVER agree to cytotec"
i think the jury is in on cytotec & that we all agree...never, EVER. vbac or not.

yes-i am referring only to pit being a viable alternative. after missing 2 nights of sleep i needed something to get things moving. i was extremely uncomfortable, could not rest & was still not in a labor pattern that i felt good about. at that point, even my doula agreed we needed something else.

newton has a specific "clinic" that all of sussex cty/dingmans/surrounding areas use so i think they do get slammed there. i am not making excuses & don't feel anyone there is either. i know the nursing staff very well & none of them want c sections for their patients.

"I thought she found a real gem of a hospital!!! I was so excited to learn about Newton."

I think you mean the OB/GYNs practicing out of Newton right? It's not like the hospital decides or the hospital pulls a bait & switch?? There is a huge difference between the nursing staff at a hospital & the OBs that work out of the hospital. It stinks when a hospital takes the wrap for the Drs that work there. Those nurses work so hard & take so much crap from the Drs. (like many nurses ) Newton L&D has a wonderful staff of very caring nurses.

anyway-with the acog shift-things might get better here!!!!!! and now the small newton hosp will be part of morristown & "one" health system which is good. neither of their vbac rates are great...and their initial c section rates aren't too hot either. nj is a pain in the a$$ place to be sometimes!

[I]That's odd about your friends not knowing P & L's back up doctors[/I]
Maybe since they were planning homebirths it just never happened or everyone figured chances are, we won't need to anyway?

My only point in all this is that if you are planning a vbac with a midwife, you should hire a doula AND just make sure the OBs you might end up dealing with are who you would want to be involved. You don't always just end up dealing with your midwife, so it's good to be covered in case.

I think with a doula, knowledge, empowerment & the right caregiving TEAM, anyone can vbac-even in NJ!!!

Stephanie~hippie.gifwife to Dov, mama to Ella Irie (9/24/07) & Kaya Raine (2/1/10)~our vbac.gifbaby, born 45 hours after PROM!!!
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Old 09-06-2010, 08:34 PM
 
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yes-i am referring only to pit being a viable alternative. after missing 2 nights of sleep i needed something to get things moving. i was extremely uncomfortable, could not rest & was still not in a labor pattern that i felt good about. at that point, even my doula agreed we needed something else.
Ahhhhh, I think we are talking about 2 different things here. I think you are talking about pit augmentation not induction. An induction is starting contractions not helping them along. I wouldn't suggest inducing with pit but using a little to help an established (but perhaps not regular) labor pattern along is another story.


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newton has a specific "clinic" that all of sussex cty/dingmans/surrounding areas use so i think they do get slammed there. i am not making excuses & don't feel anyone there is either. i know the nursing staff very well & none of them want c sections for their patients.
Oh, I don't think you are making an excuse! I'm just wary of hospitals that think they can explain away their low VBAC rates/high c-section rates. I would be hard pressed to suggest that any L&D nurse *wants* her patient to have a c-section but that doesn't translate into being supportive of VBAC. The hospital where i work does allow VBAC and I know women that have VBACed there but I wouldn't call them particularly VBAC supportive.

Quote:
I think you mean the OB/GYNs practicing out of Newton right? It's not like the hospital decides or the hospital pulls a bait & switch?? There is a huge difference between the nursing staff at a hospital & the OBs that work out of the hospital. It stinks when a hospital takes the wrap for the Drs that work there. Those nurses work so hard & take so much crap from the Drs. (like many nurses ) Newton L&D has a wonderful staff of very caring nurses.
Well, yes and no. Newton is so small that there are so few doctors attending deliveries there. Trust me, I know how much crap nurses can take. When it comes down to it, the doctor makes the call. Nurses don't have a ton of power when a doctor decides to do a c-section or berate a patient over a VBAC. Unfortunately, I've been in situations where doctors have berated patients. But after that patient leaves, *I* still have to work with that doctor (in one case, I helped the patient call the patient advocate heheeee)

Quote:
anyway-with the acog shift-things might get better here!!!!!! and now the small newton hosp will be part of morristown & "one" health system which is good. neither of their vbac rates are great...and their initial c section rates aren't too hot either. nj is a pain in the a$$ place to be sometimes!
Here's hoping it gets better!

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Maybe since they were planning homebirths it just never happened or everyone figured chances are, we won't need to anyway?
The doctor used to visit their office once a month so there really is no reason they should not have met him. But that still didn't guarantee he would be there. Like I said, I wouldn't want to lose a homebirth over the "24 hour rule" though!

Quote:
My only point in all this is that if you are planning a vbac with a midwife, you should hire a doula AND just make sure the OBs you might end up dealing with are who you would want to be involved. You don't always just end up dealing with your midwife, so it's good to be covered in case.
ITA!!!!

Quote:
I think with a doula, knowledge, empowerment & the right caregiving TEAM, anyone can vbac-even in NJ!!!
This is true. My hope is that women don't have to fight for a VBAC. Women deserve to be supported while giving birth. As much as I dislike care providers flat out refusing to support VBAC, I think the bait and switch is worse. When you know what you are up against, it's easier to plan how to get the birth you want. When you find out in labor that your doctor is going to pull a 180 and call you selfish for wanting a VBAC (after he has promised to support you for 9 months), I have a real problem with that. Obviously, no one can predict what will happen during any labor so even the best laid plans can go awry. Most women in NJ wanting a VBAC, work hard or travel significant distances for that VBAC. They deserve to know that everything was done to support their wishes.

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