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Discussion Starter · #1 ·
<p>I look at this site and see so many people driving for hours to find somebody to allow them to VBAC, or deliver a vaginal breech.</p>
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<p>I had a VBAC with #3--so part of my discussion is that I had a VBAC myself.</p>
<p>I plant the seed at the first prenatal----most are shocked that it is even an option--then I get some to just up and get their records---and have made less than kind comments about me recommending such a dangerous thing---I have been called VBAC Quack etc.</p>
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<p>I have over 90% success rate when I lived in a "more progressive city"--so it just kills me to hear that the mother does not want to try----I have to respect their wishes--and I always say they have lots of time to think it over and read about it---I certainly don't expect a decision early on----many need time to mull it over.  But---I am I think dealing with "family" who play a huge role----"my family would like to plan it",  "My family thinks it is unsafe",   "My family...."</p>
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<p>Last month I had to do 3 sections on excellent VBAC candidates because they did not want to VBAC----and I have another to do next week--who is also an excellent candidate---but "I don't even want to consider it-----I don't want to labor---and even if I come in at 8 cm---I want to be sectioned"     Arrggghhhh!!  Yet I can't make her feel bad about her decision-----that would be demeaning to her!  </p>
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<p>I always say I will respect their wishes--and the final decision is up to them  but really do put VBAC in a positive light---and the fact that I did it myself----I would think is a good convincing point.</p>
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<p>Ironic isn't it-----you all want it--- and I can't give it away!!!   There are no doulas or midwives here at all.</p>
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<p>You want somebody to do a vaginal breech, and although I did a few last year---there were still some who didn't want to do it.</p>
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<p>You want non-intervention birth--and I get asked about how quickly they can get an epidural at the first visit!   I spend their whole pregnancy trying to dispel the fear of labor--and I often spend 30 mins at every visit.</p>
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<p>Oh well---back to the labor floor----got a baby coming---she's been fully dilated for 4 hours---and just now starting to get an urge---epidural at 6 cm---she is so glad she chose to get the epidural---and she IS going to get a vaginal birth!!!!</p>
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<p>Does your local ICAN group know you?  lol   Many women near me travel an hour or more for a VBAC, especially a low intervention VBAC.  :)</p>
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<p>I live in an area where many woman are more than happy to sign up for the repeat c-section.  I wonder about that a lot but I think in many cases their 1st labors were so horrible that they really don't want to repeat that.  :(</p>
 

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<p>Good point about ICAN.  Also if there are any local mothering/birth groups....  I go to a mothering/birth circle once a month and they often have speakers like chiropractors to teach attendees about options for birthing, parenting, etc.  This might be your mission, obdoc!</p>
 

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<p>I'm driving over an hour and a half to get my water VBAC after 2 successful, uncomplicated VBAC's, one a water birth because "standards have changed". If I knew doctors in my state who are as open as you seem to be to allowing women to let their bodies work naturally I would be referring everyone I knew.</p>
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<p>My only question is, when women are insisting on RCS, do you point out that there are as many risks involved for them and for their baby as there are with VBAC? Have you recommended hypnobirthing, alternative childbirth classes? Maybe if you put together information clearly outlining the pros and cons to both VBAC and RCS, more women would choose to at least attempt VBAC, especially if they knew pain meds were available (although I disagree with meds too but for some I suppose it's a valid choice). </p>
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<p>I'm glad there are OB's in some part of this country that aren't so adamant about VBAC's being unsafe and more trouble than their worth, I wish more OBs and hospitals here would give birth the respect it deserves!</p>
 

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Discussion Starter · #6 ·
<br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>VBACmama4</strong> <a href="/community/t/1350298/doesnt-anybody-want-to-vbac-where-i-live#post_16944047"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style=""></a><br><br><p>I'm driving over an hour and a half to get my water VBAC after 2 successful, uncomplicated VBAC's, one a water birth because "standards have changed". If I knew doctors in my state who are as open as you seem to be to allowing women to let their bodies work naturally I would be referring everyone I knew.</p>
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<p>My only question is, when women are insisting on RCS, do you point out that there are as many risks involved for them and for their baby as there are with VBAC? Have you recommended hypnobirthing, alternative childbirth classes? Maybe if you put together information clearly outlining the pros and cons to both VBAC and RCS, more women would choose to at least attempt VBAC, especially if they knew pain meds were available (although I disagree with meds too but for some I suppose it's a valid choice). </p>
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<p>I'm glad there are OB's in some part of this country that aren't so adamant about VBAC's being unsafe and more trouble than their worth, I wish more OBs and hospitals here would give birth the respect it deserves!</p>
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I had a VBAC myself--so I paint VBAC in a VERY positive light--and ICAN doesn't EXIST near me---and since most women are on welfare---I can barely get them to go to ANY class---and we sure don't have ANYTHING on hypnobirth etc etc.   I spoke with Bonnie Mathison about this(she is the CHILBIRTHSOLUTIONS founder-----she looked---and sure enough---NADA!!!</p>
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<p>And---hate to say it---but we have such a big drug problem here that I KNOW in my soul that many women HERE want that C. Section because they will get narcotics after the birth--and they always seem to need WAY more than the average woman--and I am stuck with that---they can sell half of their pills--and of course I can't tell them that they don't need as much pain pills although I do tell them that the amount I give them is ALL THEY GET---period--spread it out.  They get twice as much as a non-drug user just so they can't complain to the Medical Board that I don't meet their pain needs. All I have had to do with such a complaint is show the board their positive drug screens and the amount they got---end of story---but believe me----the population I deal with is NOT as a whole into taking care of themselves---let alone their fetus!</p>
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<p>I DO tell them that we can make them comfortable--as I full well realize that a C. Section is typically the culmination of a crappy labor---I think it is a "given" that if you ended up in the OR---you didn't have a great time-----this manages to get a few---but well under 50% go for it.</p>
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<p>That is very unfortunate. I live less than 45 mins from Baltimore, MD which is the national capitol of the world (it seems) for drugs, crime and poor health care so I can completely understand what you're saying about women who don't care about their baby or themselves beyond making sure their prescriptions are filled. The only suggestion I'd have in that situation is to offer information sessions in your office and make them a mandatory requirement prior to allowing any patient an RCS. If they still decline there's nothing you can do, of course, but that is how things are best accomplished in the Baltimore area. People on welfare have to sit through financial counseling, are required to register with the workforce exchange to find a job, etc. The fact that these things are required doesn't mean everyone does them, a lot of times they just don't do it and their benefits get cancelled, but at least it makes them accountable for their decision. If I were you I'd be very frustrated too! </p>
 

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Discussion Starter · #8 ·
<p>The "information sessions" are pretty well each prenatal visit, literature--even advising them to go to MOTHERING (although it doesn't do much to garner any respect for docs)---and I often spend 30-40 mins on a prenatal visit---so they get lots of reinforcement.  After 5 pm---forget it---these women are not working---I am --and I have 3 children to get home to---and I am on solo call--so I am not doing anything AFTER 7-6 hours unless it is a call to the hospital for a delivery-----enough is enough.  Haven't taken a day off since August 3rd 2011---although I am taking ONE day on April 17th!!!!   Yippeeee --- a day away!!!</p>
 

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<p>Could you offer some informational/educational events to get the word out?  My local hospital offers free seminars on water birth, vbac, avoiding c-section, etc.  Or...could you start an ICAN chapter since there isn't one nearby?  If the 'once a cesarean always a cesarean' thing really is that pervasive where you are, it may take more than a few prenatal visits to change the culture...</p>
 

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<p>I'm trying for a VBAC in my area. There is only one Doctor in my whole county that does it, and thank the Lord he is in my city. I'm sorry you are having a hard time getting women to have one. It is kind of a nerve racking decision though. I still go back and forth as to if I really am going to go through it. I am more nervous giving birth this time then with the first. Because the first I just knew I would go through some pain for a bit, and then have an epidural. This time I am going without any medical intervention and the thought of how long it could take and how long I'll be in pain for really scares me. And before I didn't really look into the whole tearing or episiotomy thing, and I kind of freaked myself out about that. I feel like I already have a scar from a c-section do I really want my vag to look like Frankenstein's face. I'm sure a lot of women feel the way I do. Maybe if you just tried to understand their reservations and make them comfortable about the things they are scared of you might have better luck. </p>
 

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<p>I'm trying for a VBAC in my area. There is only one Doctor in my whole county that does it, and thank the Lord he is in my city. I'm sorry you are having a hard time getting women to have one. It is kind of a nerve racking decision though. I still go back and forth as to if I really am going to go through it. I am more nervous giving birth this time then with the first. Because the first I just knew I would go through some pain for a bit, and then have an epidural. This time I am going without any medical intervention and the thought of how long it could take and how long I'll be in pain for really scares me. And before I didn't really look into the whole tearing or episiotomy thing, and I kind of freaked myself out about that. I feel like I already have a scar from a c-section do I really want my vag to look like Frankenstein's face. I'm sure a lot of women feel the way I do. Maybe if you just tried to understand their reservations and make them comfortable about the things they are scared of you might have better luck. </p>
 

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Discussion Starter · #12 ·
<p>"Maybe if you just tried to understand their reservations and make them comfortable about the things they are scared of you might have better luck."</p>
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<p>Why the assumption that I don't understand their reservations? </p>
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<p>@Princess, I'm sorry to hear that you're feeling scared about your possible VBAC. This is kind of off topic for the post but if you need any info on natural pain management I know a few good methods that a lot of women swear by. I had a 4 day prodromal labor with my 1st VBAC (which is not typical, please don't let that scare you, I've only met maybe 2 other women who had prodromal labor at all) and I found a birthing tub helped dramatically, as did massage, relaxation, changing positions.. I've had friends who have tried hypnobirthing (or the Mongan Method if you'd like to google it) and I've also had friends who were terrified of pain but found that they responded to it remarkably well and their labors went quickly. The better you can relax the smoother things will go.</p>
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<p>Also, tearing heals MUCH better than episiotomy, unless you have a major tear, in which case your doctor will probably do the episiotomy anyway. Because of the type of skin in that area, they usually heal pretty smoothly and there are ways to prevent major tears. Perineal massage especially with oils, taking your time while pushing rather than attempting to push the baby out in one motion will allow your skin to stretch naturally, and again, changing position can all help to prevent severe tearing. I had 7-10 stitches with each VBAC (this will be my 3rd) and each time I healed in just a few weeks and I have no extreme scarring or pain at the site. </p>
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<p>I wish you great success in your TOLAC, it's an incredible feeling to realize that you really can do it, and if it ends in another C/S at least you can say that you really did try :)</p>
 

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<p>I wasn't planning on responding to your post in response to my suggestion about starting a potential support group or required information session because it seemed pretty clear to me that you were only concerned enough to complain about your clients but not take action to further encourage them.. however, "marryme" above said basically what I would have said. I never said you had to be the one to give chair the support group or start the ICAN chapter, but offering it at your office, even if it's during the day at some point when you are willing to be there, would get a better response than just bombarding women at their OB appointments with info and pressure. I personally tend to tune out an overzealous doctor, especially when confronted one on one in the office under a paper gown or when I'm in a vulnerable position. Maybe they're not listening because you're not presenting the information in a way they want to hear. Make sure you're tone isn't one of condescension and that you're not making them feel inferior. Treating them with respect, even if you don't respect them as it seems you don't, would probably open a few more ears. </p>
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<p>I have 3, soon to be 4, kids as well and I know that when you are off the clock it's family time, but if you don't want advice from women who are in a position of your would-be clients, then why post here asking questions? Sometimes when you're dealing with people who are already tough to convince, approaching them with an alternative to sitting in on your office lecture might be appealing. Having other women in a group setting who are not doctors and are not using medical information to convince them could be just the support they need to change their mind. Having other women tell them how it actually FEELS to give birth and how incredible it is to accomplish something like that might give them reason to consider it. </p>
 

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Discussion Starter · #15 ·
<p>If you know of somebody who is willing to start up a group in this area---I have the space---is there anybody?????  40 miles north of Knoxville!</p>
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<p>Lot of space.</p>
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<p>Evidently---there is nothing I can do right!  Me being a woman who has given birth and had a VBAC gives me no insight??</p>
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<p>So I am VERY happy to welcome anybody in the area who wants to take it on---doulas, midwives--ICAN    Free meeting space---any takers???  message me if you are interested!!!</p>
 

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<p>It's not your insight that is lacking, it's your attitude. I never said you can't do anything right, promoting a safer and healthier option for women whose birth you will be attending IS right. Attempting to educate and inform them about the risks vs. benefits of RCS as opposed to VBAC IS right. Being an OB with the attitude that a woman's body is made to labor and birth IS right, and rare in my experience and unfortunately the experience of many other women. But the way you respond to a post in an internet forum is enough for most people reading to get a clear picture of your bedside manor, which is more than half the reason why women switch providers, and again if you don't show respect for people who have placed the life of their child in your hands, you won't get a good result. </p>
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<p>As far as your statement that there are no sources of VBAC info immediately available in your area, here are some I found in a ten second Google search that might be worth referring to or even contacting yourself and perhaps setting up a partnership with:</p>
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<p>Knoxville chapter of ICAN:  <a href="http://www.eokhq.com/profile/KnoxvilleDoulaBeautifulBirths" target="_blank">http://www.eokhq.com/profile/KnoxvilleDoulaBeautifulBirths</a> (even though it's a distance ICAN is phenomenal at locating resources and engaging women to learn more about their VBAC options)</p>
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<p>If you feel that is too far away here is the page from ICAN's site giving info on starting your own chapter: <a href="http://ican-online.org/chapter/search" target="_blank">http://ican-online.org/chapter/search</a></p>
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<p>Bradley Method providers in your area: <a href="http://www.birthsource.com/scripts/article.asp?articleid=366" target="_blank">http://www.birthsource.com/scripts/article.asp?articleid=366</a> (historically most Bradley instructors are very supportive of VBAC for healthy women)</p>
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<p>If your area is so bad, have you considered moving to an area that has more women seeking your style of Obstetrics?</p>
 

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Discussion Starter · #18 ·
<p>I said 50% choose NOT to VBAC----not to leave me---actually it is very rare for someone to transfer out of my practice and it is pretty well always because they are moving away----I guess because I respect their wishes--they DO stay with me---- and get their C. Section, which I try to make as pleasant an experience as possible---baby to mom right after cord cut---baby stays with mom/dad all the time,  no eating restrictions, --as much as you can do for post op anyway.</p>
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<p> I think you are reading into my sentences and making some erroneous assumptions--- and then judging me based on that.</p>
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<p>I can't remember a mother in some years that has transferred out due to any personality issue----I actually ENJOY talking with women.  We offer same day counseling referrals for substance abuse---but even though 35% of moms are addicted to drugs---it is very difficult to get them into a program--and this is actually a nationwide finding---not just here.  So --when was the last time you had an OB rub your back, or get you a drink, or bake you bread--or bring you breakfast and flowers from her home--which I do very often----how is THAT "bad bedside manner"??</p>
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<p>I wonder if you had such a bad experience with a doctor that you cannot conceive of any doctor helping you to breastfeed or knitting a hat for your baby while she waits for you to deliver.  </p>
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<p>I do give out LOTS of literature and internet resources (and mothering.com is on the list of resources--as is ICAN).  Where did you get the idea that I give out no information?  I use Google all the time to get information for patients.</p>
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<p>Anyway---the offer is out there for free space to anybody interested in starting an ICAN chapter or Bradley classes----I'll provide the snacks.  I cannot do it --I am on call 24/7,  so if a mother comes in I would have to bow out---and that happens often.</p>
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<p>There is an ICAN group IN Knoxville.  I don't think 40 miles is unreasonable for travel.  Have you ever made contact with the ICAN leader in Knoxville?  If she is the nearest chapter, women probably contact her for suggestions.  Years ago I was a regional coordinator in that area (that position is vacant right now unfortunately), and I had a heck of a time when women in your state contacted me.  The VBAC providers were few and far between.  Sometimes finding the VBAC supportive providers is random.  I met one at a church party. I met another one when I was visiting a local health clinic for a course I am taking.  I met a few by attending a meeting for the local holistic moms group (that's another idea if there is one of those near you).  I would love it if doctors emailed me to let me know they are happy to support VBAC.  I pass names around among local doulas as well.</p>
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<p>The drug situation is very unfortunate.  I live in NJ and the inner city hospitals are the ones that do the most VBACs. </p>
 
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