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I have transferred my care to a midwife/OB practice 3 hours from home and LOVE the midwife I saw the first time around. This time I saw an OB and had a different experience. While i've been told multiple times that I'm a good candidate for a VBAC, SHE said that she thinks I have a 60% chance or lower of having a successful VBAC since I already tried pushing my 7lb 14oz baby the first time around and had no success. I was finally feeling confident and now I don't know what to think. Is she right? I pushed for 3.5 hours after a 4o hour 41 week induction. I had an epidural, an episiotomy, pushed on my back and 3 vacuum attempts. I really thought that Lucy getting stuck was due to the fact that I didn't walk and didn't open up properly. Now I'm just getting closer and today was a big let-down. She said she loves doing VBACs and is more than willing to give it a shot, but I'm not a good candidate. WTH?? Can anyone give me a boost?
 

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Hmmmm....how much can you avoid that particular OB?


From the way you describe your first birth attempt, you are right--it was the conditions imposed that created the eventual csec scenario. NOT you/your body!

Do you have a doula? Can you maybe labor with support in a hotel room near the hospital, rather than going in too soon? Of course, if you're 3hrs away from hosp, you may arrive pushing anyway--2nd babies are often pretty fast.

Also, MANY VBAC moms have pushed out babies as big or bigger than the one they got sectioned for. Have you visited ICAN--I bet they have a link to a beautiful slide show on this very topic.

stay strong, don't let her predictions run you down.
 

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I had a similar experience my vbac. My OB was very supportive of my vbac but mentioned that because my c/s had been because I couldn't push my 8lb 15oz baby out after 2hrs (with epidural, on back, etc), that the chance of a successful vbac was 20%. That was the only slightly negative thing she mentioned though, after that she never once mentioned a c/s or anything and was supportive of the natural birth I wanted. I had a successful vbac and my baby was 8lb 14oz, just the tiniest bit smaller than my "CPD" baby. I believe the fact that I walked around more and changed positions made the difference. I'm sure I could've pushed out my 9lb 3oz baby this last time too if he hadn't been truly malpositioned. I don't put much stock in the "big baby" scare most people get. I firmly believe mom and baby's positions are what really makes the difference.
 

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I've dealt with a lot of roller coaster opinions about this too. One OB gave me a bad VBAC vibe... one seems willing... one seems supportive... the NP is even more supportive... the L&D nurses - eh, they varied on the whole thing... but one day I was up and one day I was down; depending on who I talked to. I stopped talking to people about it.

I have done my research and planning, I have opened my eyes to all the possibilities and have accepted them, I want to make informed decisions when the time comes, and just try my best overall.

Be confident that you will make the right choices for the right reasons.
 

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My OB told me she'd advise I "never ever have a vaginal birth" psh, baby #2 was 10oz bigger, with a bigger head! Focus on your baby being in an optimal position, and believe in yourself. You CAN do it!
 

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Did you get a chance to discuss all those factors from your 1st birth with the new OB? What was her reaction? She may be supportive of VBAC (in theory) but is she supportive of the things you know you need to do in order to get a different outcome this time? Does she think you will be able to change those circumstances in a birth that she is covering? Will you be happily encouraged to walk freely, sit on a birth ball, take a shower (or better, sit in a tub!), squat on the toilet, etc. while laboring? Will you be supported to try other pain relief than epidural if you want to? Will you be able to push in ANY other position besides on your back - preferably more than one position, if it is helpful?

She may have been trying to helpfully manage expectations - or setting you up to fail - hard to know. I would probably try to engage on the details above...and do NOT let her comment undermine your confidence in yourself.

Remember, its hard for any OB, with so little experience of normal birth, to make a fair judgment about what's possible or likely. She's just not probably the best source for this particular kind of opinion!
 

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Did she give you REASONS you're not a good candidate for VBAC? Such as a vertical incision, single-layer closure, etc? It really kills me that medical professionals (supposedly scientific minded people) will just make statements like this without supporting or explaining them.

I would check your local ICAN chapter to find a TRUE VBAC friendly care provider in your area. If your provider doesn't support you and believe your body can do it, you are probably not going to have any success with them.
 

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If that's just a small preview of what you'll be up against if she's on duty when you go in to deliver, I'd stay home/at hotel as looong as possible.
 

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The textbook answer is that the "best" candidates for VBAC are those where the issue was nonrecurring and not potentially due to the mother- like fetal distress for instance. Although it could recur there is no reason to think it will, and if it does it is a baby issue, not mom. So if someone's section was done for true CPD then theoretically that would recur so it makes them not as good of a candidate. That's assuming there really was CPD and you couldn't do anything to change the situation--- and of course it probably wasn't and you can do plenty to make a better outcome so no worries
 

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I've not had a section (only due to the fact I was at home with a supportive midwife...) I pushed for around 6 hours with dd, around 8 with ds.

Here's what I see you had working against you:

1. it may have just taken you longer to push...
2. you were induced
3. you had an epidural
4. you were on your back

-Angela
 

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Ditto everyone else and I would avoid this OB at all costs. Her lack of faith in you and birth in general can be dangerous for you as you've already seen...here you had lots of confidence and now she's making you doubt yourself!! There's absolutely NO way for her to make a percentage chance prediction on whether you'll be successful, that's just silly.

Don't give her that power. Trust yourself, trust your body, and read lots and lots of positive VBAC birth stories. Educate yourself and do your best and the let go, and I bet you'll be able to be happy no matter what the outcome of your next birth may be. ((hugs))
 

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My DS was over 11lbs and was born by c-sec. My OB is very supportive of VBAC but she did warn me that I only had a 50% chance of success in having one this time. We know that this baby is going to be just about as big. We are still going for it. We have discussed different labour positions and she is quite fine with letting me do a VBAC. I know that the epidural and labouring on my back were probably the cause of the c-sec so I am going to do things differently this time. She even said the baby could be positioned differently and in such a way that it helps the baby come out better.
 

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My OB has always been supportive of my VBACs. I was induced w/ my oldest as well and pushed for 1.5 hrs and we used forceps etc to no avail. He was asynclitic and not coming out. He was only 7#3oz. I had my first VBAC 18 mos later to a 7#8oz baby. This will hopefully be my 3rd VBAC, I see no reason why you would have low VBAC chances. I was induced w/ AJ and they broke my water early (he was -3 station) and when the water came out, he came down crooked and just wasn't coming out.
 

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I really don't see why you aren't a good candidate. It sounds to me like you are a wonderful candidate, and had too many interventions the first time around.
Don't let this OB shake your confidence. My first VBAC attempt failed because the OB I had scare-mongered me. I had a successful VBA2C three years later because I had amazing supportive people on my side.
You can do it too.
 

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Even if you believe her stat of only 60% chance of success, then that's still a much higher chance of having a vag birth than if you scheduled a section, right?!


My first labor before my C section doesn't sound as hard as yours, but I was given a "70% success rate" quote. While it would obviously suck to have to endure an episiotomy, long labor, etc like you did, and THEN have a C section too, I would still risk it to go for a more than 50/50 chance of success. I decided that I would be more upset to not try and always wonder what might have happened than to try for VBAC and "fail" (and in the end, 9lb 6oz posterior baby flew out! Same weight and similar position to baby #1, just less intervention and more confidence. But who knows exactly why it was different really. It just was!)
 
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