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This is one of the only things I am worried about. My mw's have told me that the dr's "require" continuous monitoring for vbac's. It isn't necessarily what the mw's like to do but they said it is their dr's. They did give me the suggesting of every 15 min or so to unhook it and go to the bathroom. They also said I could try to get on the birth ball etc if they can keep the hb on the monitor. This scares the crap out of me. I am planning on getting to the hospital at 8 or 9 cm if everything works as planned so that will help. But I do NOT want to be strapped to the bed. Any experience with this? I know I can refuse anything and I will have dh and a doula but just wondering how tough it will be.
Maybe I am just looking for support? Suggestions?
Thanks!!
 

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I did intermittant monitoring... 10 minutes every hour, then had 50 minutes to do whatever. This should be something ironed out beforehand. If "policy" requires it, call the hospital and talk to whoever is in charge... it will be "scare tactic, scare tactic, scare tactic...." then you can ask them for something you can sigh saying you listened to their schpiel and still don't want it, so you don't have to be hassled by it when you come in
 

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it is not hospital policy where i am (or if it is, my doc has a lot of weight), but aside from my hosital, i have never heard of a place that didn't require it for a vbac. hth
 

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My hospital requires it for VBAC (since it's the only really reliable way to track a UR, and that's the not so common event that scares the pants of hospital liability teams) but they use a telemetry unit. You can walk and even get in the shower or tub, so it's not a problem in terms of moving around. It is a problem in terms of making a repeat c/s more likely of course, but that's another story.


Maybe you could explore the telemetry option? Or a more frequent intermittent monitoring (say every half hour?) would still work for your backup doc/hospital? And I agree with pp...try to get the policy worked out and any necessary paperwork signed beforehand and copied to your file since you really don't want to be fighting an administrative battle at 8cm!
 

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They can try requiring all they like. It's your body and your birth and EFM doesn't help anyone. It just makes c-sec rates rise and that's what you're trying to avoid right? The women I know who have achieved a vaginal birth in a hospital (regardless of previous surgery) have some things in common.

1. Hiring a CP external to the system either a MW or doula to accompany them.
2. Refusing all monitoring and VEs. What your CP doesn't know can't hurt you.
3. Only going in to push the baby out, no earlier.
4. They were really lucky in the staff they got on the day.
 

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Yup...it's that whole "liability nightmare" pushing the rules onto VBAC mamas. Anyone can have a UR, but the malpractice suit is so much easier to lose (from the hospital's perspective) when a lawyer can argue that the hospital "should" have taken additional precautions knowing the mama's surgical history.

bleh.
 

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Here's what happened with me. I talked to my doctor beforehand about my birth plan and he said that as long as they got good heart rates for 20-30 minutes they would let me be on the monitor for 20 minutes per hour. I got to the hospital and they said nonono hospital policy is that you need to be on continuous monitoring. I said that's not what my doc said, they told me that the doc told them that he wants me on continuous monitoring. We went back and forth like this for a couple of minutes, and then the nurse came back and said OK, if you sign this waiver you can do whatever you want, I said OK. I did the monitoring for a while, heartbeat was good, and then I got off and sat on the birthball, tried the shower, whatever for a while. Then I started getting tired, and I got back in bed so they put me back on the monitor eventually. For me, it was more of a psychological thing, I didn't want to be stuck in bed, even though I was tired at the end so I spent most of the time in bed at the end anyway. This time, the midwives have told me that they do the telemetry and only 20 minutes per hour or something like that. it helps to have a doula who will stand up for you and whom you can bounce ideas off of, hopefully she will be an objective voice for you while you are in labor.

Good luck!
Minta
 

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I'm due in mid-December with my 2VBAC. With my first VBAC she was a preemie. i had the monitoring and the IV. This time however, we are not anticipating a preemie (another story)...

Anyhow, I am using CNMs. I met with one of the OBs as is the policy before one has a VBAC. I sat in his office for 45 minutes talking over the research about CFM and the rise in C-sec. He used a scare tactic that he nor the CNMs could cover me if I didn't (verbally) agree to the CFM and the IV. I haven't signed anything, just only given my verbal agreement to CFM.

Once i get to the hospital I plan to outright refuse the IV, unless if indications present that it is necessary. I"m not sure what to do with the CFM though, since it may be a tougher battle. I plan on arriving at the hospital at the point where I'm pushing the baby out. I"m just fed up with the medical system that doesn't allow for us women to birth the way we want to.

ONe more thing...the patient Bill of Rights, make use of it to refuse interventions.
Rachel
 

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I plan to request the telemetric unit. If the 2 that they have are both being used then I will only agree to intermittent monitoring. As far as it putting me at risk for a repeat C, I still have homework to do regarding heart tones, so I know how to react when/if someone says the baby is having decels and that they plan to operate again...
I'm happy with my team this time though. I have a better hospital and I'm going in informed and educated, unlike last time!
 

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Quote:

Originally Posted by JanetF View Post
They can try requiring all they like. It's your body and your birth and EFM doesn't help anyone.
Exactly! I was thinking of something along the lines of:

"You can 'require' all you want, but that doesn't override my autonomy and the legal right I have to decline any treatment I wish. You can put the efm belts on whomever you wish, just not on me thank you very much."

I'm sure all the minions of folks who want to argue that it "doesn't matter" if they're your legal rights or not and that it's not going to stop anyone. But quite frankly, it does matter that they are your legal rights and you have EVERY right to demand that they be followed. That being said there are women who have left one hospital and went to another. I know it's not "practical" and it certainly isn't anyway to give birth, but for me it's about being treated like an adult human being and making my choices accordingly - regardless of how difficult that make some l&d nurse or ob's job.
 

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It is hospital policy where I live. So if I have a hospital birth I will try to do it but if I can't stand the monitors on my belly or it restricts me too much I just know I'll take them off and they'll just have to cope with that. I couldn't keep the monitor on with my first baby - it was too uncomfortable. I know I annoyed one of the nurses so then i just demanded a different nurse. I have a wonderful personality change during transition where I don't care about anybody elses rules and wobetide anyone who tries to push me around. I wish I could be like that that everyday of my life! Without the pain, of course.
 

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I did. I was actually prepared to try to put up with nit, but the nurse was lax about it, and at some point the ob on call saw there was not a continuous strip so he sent someone with a release form for me to sign since I was "refusing monitoring". I hadn't been, but the form made it sound very achievable and I was going with no pain meds, so I signed and was no longer bothered. I chose some occasional monitoring but it was great to be able to keep getting up.

(I posted my story under the title "Mary's birth story").

Good luck!
Oana
 

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I called the L&D with my last. I found out the hospital requires it as part of their malpractice insurance stuff -- Malpractice Ins companies are dictating to hospitals how to handle patient care and that is passed on to docs and then mws.

I choose to have a hb b/c I could not see myself strapped down, arguing in labor with staff, etc. I had EFM continuous with my first, which ended in c/s. I think part of the c/s was b/c I was not allowed to "labor" to work my baby down. I worked hard swaying, walking etc to get my baby down at my hb. In the hospital I was told I had to stay flat on my back w the damn EFM, I wanted to sit in the rocker and was told only so long as the baby's hb was still detectable. It sucked and I was not going to subject myself to that again.

I thought about staying at home in labor for as long as possible, but upon researching labors and VBACing I decided that it was not safe to labor 'alone' b/c the hb of the baby would show signs of impending rupture (if that were to happen) and I would not know until it was too late. Now, I was also a vba2c so my odds were a smig higher.

I thought about hiring a doula to montior my labor at home, but very few doulas would admit to having the ability to use a dopler or fetascope back then. So, then I looked into hiring a lay mw with the thought I could go to the hospital and deliver. And well, then I just decided if I was going to go through all that just hire the mw and have this baby at home.

At 33wks I hired a mw and at 38 wks had my baby girl at home! Well, I was really full term, she was 9lbs 1 oz!!!


This time around I've hired a mw from the start and have not bothered myself w OBs or worries of hospitals etc. Which is a good thing b/c this pregnancy has been the hardest with me being sick until 6mo pregnant and just feeling like crap.
 
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