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Discussion Starter · #1 ·
I don't want to be a downer here, but I'm having a change of heart over my VBAC options. I was all ready to switch to a midwife and then I had the 20-week anatomy scan. There is some question over the baby's heart and I have a fetal echocardiograph scheduled in 2 weeks to see if there really is a problem. If there is a problem, then I am not going to switch. I feel secure and safe with the care my baby and I would get if there is a problem. And I am at peace with sacrificing a largely intervention-free birth for a more medical one in return for that security.

Now, assuming all is well and it turns out the baby's heart is fine and healthy, do I still want to switch at this point? I really don't know any longer. I still believe that a natural birth is best for mom and baby whenever possible, which is most of the time. But this anxiety over the baby has made me feel less determined and committed to switching practices and hospitals (there are no midwives at my current hospital). My current OB would want me to have an epidural, and where I was largely against it before, I am not so sure it is all that important to me now. Can anyone relate?
 

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Wow. I hope that everything frm teh tests come back fine and that this is just a scare and nothing serious. (((hugs)))

I do think that things lik ethis can tend to have us focus on the *big picture* which, for me, is a healthy baby in the end. yes, I want a VBAC, and yes, I'm willing to fight for it, but the ultimate goal for me is a healthy babe. This will be my 4th birth, and each one was different - none we what I had planned, LOL! I jsut think that even the best laid plans can go awry when we're talking about birth


I am curious why your OB will expect an epi though. that seems odd to me - I know most push it becuase no doc understand why a woman would "want" to go thorugh pain, but I've never heard of any actually forcing them. That would be one thing I'd really have a hard time with.
 

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I can understand that ... you can only make the best decisions you can with the information you have at the time, and do what your gut tells you to do.
 

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Discussion Starter · #4 ·
Quote:

Originally Posted by Knittin' in the Shade
This will be my 4th birth, and each one was different - none we what I had planned, LOL! I jsut think that even the best laid plans can go awry when we're talking about birth

This is a great reminder - there is only so much we can plan!

Quote:
I am curious why your OB will expect an epi though. that seems odd to me - I know most push it becuase no doc understand why a woman would "want" to go thorugh pain, but I've never heard of any actually forcing them. That would be one thing I'd really have a hard time with.
My OB's practice is very conservative and wants the epi as a precaution. She has had deal with a few full-scale URs, one in triage. She wouldn't force anything so I could still discuss it with her. Still, no one wants to fight what their doctors want. I know the downsides and feel that having the epi could make another cesarean more likely though. I would just have to make sure not to have one too early to help mitigate some of those risks. On the other hand, I don't want to rule it out entirely - I think there are instances when an epi can help.
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The epi can definitely decrease your chance of a c/s, but for a labor that isn't progressing, it can be helpful in some cases. I would be concerned that your doctor is using the UR as a reason for the epi. One of the benefits of NOT having an epi for a VBAC is that in the event of a UR you can feel if something is not right. I have heard from women who have had UR that a pain that was different than labor pain and that would not go away was the first signal they had that something was not right. The fetal distress comes later. So not having an epi and trusting in your body can help you in the event of UR.

It sounds like this doctor does not expect VBACs to be successful and wants women to have the epi already in place to make it faster to get to the OR. Also, just because the doctor "requires" it does not mean you have to have it. If it were a true emergency, then GA is often used. You might want to ask yourself why the doctor recommends an epidural for ALL VBAC patients when 99.6% (based on UR rate for spontaneous labor, not induced or augmented) of them will NOT rupture.
 

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hugs mama...I hope your test shows a happy, healthy baby!

About switching...it's important to remember that sometimes the person can be more important thatn the job title (be that title OB, Family Practitioner, or Midwife). If you are comfortable with your OB and feel that she can and will support your decision to VBAC then don't move to a different practice just to get the midwife "job title".

If, on the other hand, you really feel deep down that she will not work with you and wont actively support your VBAC then maybe switching is a good idea. Depending on the type of heart complication, a vaginal birth is not necessarily out of the question, and a midwife attended VBAC at a hospital woth a good NICU should be as safe as an attempt with an OB.

If you do decide to stay with your current care provider you can discuss options. As a PP mentioned, in a true emergency GA is most likely the course they'd take if you don't have an epi or spinal already in place. Perhaps you could tell your OB that you're comfortable with this scenario and agree to a heplock as a "partial measure"? And if you do stay, remember there are lots of women out there who do VBAC with a spinal or epi...it doesn't knock a VBAC out of the water!

Either way you go, please consider a doula or well-informed support person...VBACs can be emotionally tough (even when you're not worried about your babe's heart) and if you think your OB might not be 100% on board then a doula is even more important to help you stay focused!

hugs again and prayers for your babe!
 
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