Mothering Forum banner

1 - 20 of 57 Posts

·
Registered
Joined
·
34 Posts
Discussion Starter · #1 ·
My LMP was 10/21. I had 3 days od mild spotting on 11/3, 11/4, and 11/5. I got a blatantly positive test on 12/3. The original due date was 7/28 with an estimated date of conception of 10/28. This all makes sense. The problem came when the original ob did a limited ultrasound...all of my pregnacies have measured small...(ie. normally measuring 20 weeks at 25 weeks pregnant). The new ob now says we have to go by the ultrasound measurement instead of LMP. My new due date is 09/3 with an estimated date of conception being 12/4 (the day after the positive test). This is physically impossible seeing as i couldnt have gotten a positive test before i concieved. The ob refuses to listen...because of this, she still hasnt given me the required rhogam shot and says if i am wanting to have a VBAC, they have to give me pitocin because they "cannot allow me to go into labor on my own"! This is getting ridiculous! The original due date puts me at about 32 weeks pregnant, and the new due date puts me at about 27 weeks pregnant. My 1st appt w the new ob will be tomorrow...how do i get her to listen and understand that this pregnancy is measuring the same as all my others and the new due date just doesnt make sense? Thank you ladies, and sorry it was so long!
 

·
Registered
Joined
·
373 Posts
I would say keep interviewing new care providers until you find one that listens.

Where are you located? What is your fundus measuring? You can do this yourself with a flexible tape measure- measure from the pubic bone to the top of the uterus (press down firmly at the top to find the actual top. After 20 weeks the fundus measures in centimeters exactly along with the number of weeks, in general.

I'd say you would have the best luck with a homebirth midwife (CPM), but it depends on the state you are in. California CPMs cannot do VBACs at the moment.
 

·
Registered
Joined
·
34 Posts
Discussion Starter · #3 · (Edited)
Fundus has measurer as follows starting from the 1st measurement: 22cm, 21cm, 19cm, 18cm, 21cm, and 35cm. Today it is at 27cm. Im in Fowler,CO. The nearest providers that take my insurance (and allow VBAC) are about 45 mins from me. There is one ob that listened to me over the phone, but she is not an option because she is 2 1/2 hours away. We are fully prepared for an unassisted home birth due to the distance of hospitals, but there is still the concern of no rhogam and possible complications...as well as the ob most likely putting me on bedrest due to what she will think is early dilation. I can't do bedrest if it is not really necessary...i have 2 todddlers at home, so it can be done, but not for long term.
 

·
Registered
Joined
·
618 Posts
I am RH negative, and DH is positive. After some research, and discussing it with my midwife, we opted to forgo the 28 week Rhogam shot. Evidence shows that it's not actually that necessary unless you have some sort of trauma (like a fall, or car accident,) where there is a chance that your blood may come into contact with the baby's blood. Evidence also shows that it's not really that effective unless given with 72 hours of said trauma, so just getting it at 28 weeks is kind of arbitrary. We opted to wait until after birth, and check the baby's blood type. I was planning on getting it after delivering if my babies were RH positive, but it turned out that there was no need, because my babies were both RH negative.

Anyway, the point of all that is that I wouldn't let the Rhogam shot be any sort of deciding factor in continuing to see this OB. What a frustrating situation to be in, though!
 
  • Like
Reactions: applejuice

·
Registered
Joined
·
3,442 Posts
Hmm.. It might be to your benefit to play along? Especially for a vbac? If you're 5 weeks more along than he is willing to believe, then you will completely Dodge any pressure to induce/schedule a c-section once you reach or pass your due date.

Sent from my SPH-L710 using Tapatalk 2
 

·
Registered
Joined
·
4,393 Posts
Hmm.. It might be to your benefit to play along? Especially for a vbac? If you're 5 weeks more along than he is willing to believe, then you will completely Dodge any pressure to induce/schedule a c-section once you reach or pass your due date.

Sent from my SPH-L710 using Tapatalk 2
But what if the opposite happens - if she goes into labor on her due date they will think that she is delivering 5 weeks early which would make the baby a preemie.
 

·
Registered
Joined
·
3,442 Posts
True, that's the other side of it. All depends how reasonable hospital staff would be. If they are "the chart says x weeks so we have to throw out all logic and have the baby admitted to nicu because our policies prevent anyone from thinking for ourselves" then... Problem. If they're willing to be reasonable to "I TOLD YOU I was further along, you idiots" and can recognize a healthy, full term baby who is transitioning well, then win!

Sent from my SPH-L710 using Tapatalk 2
 

·
Registered
Joined
·
34 Posts
Discussion Starter · #8 ·
True, that's the other side of it. All depends how reasonable hospital staff would be. If they are "the chart says x weeks so we have to throw out all logic and have the baby admitted to nicu because our policies prevent anyone from thinking for ourselves" then... Problem. If they're willing to be reasonable to "I TOLD YOU I was further along, you idiots" and can recognize a healthy, full term baby who is transitioning well, then win!

Sent from my SPH-L710 using Tapatalk 2

ROFLMFAO!!! All the hospitals here seem to be rather idiotic...but I love that response!
 

·
Registered
Joined
·
5,143 Posts
I would travel the 45 minutes to see someone else. An obstetrician who thinks you conceived the day before you got a positive pregnancy test and who thinks a syntocinon induction is acceptable practice for a VBAC has crossed the line from ridiculous to dangerous.

Also, regarding fundal measurements, 1cm/week above the umbilicus is textbook but, in practice, there is considerable variability. And if your babies measure small on USS there is every chance your fundus will measure small as well.


Sent from my iPhone using Tapatalk
 
  • Like
Reactions: Grace Wisdom

·
Registered
Joined
·
34 Posts
Discussion Starter · #10 ·
I would travel the 45 minutes to see someone else. An obstetrician who thinks you conceived the day before you got a positive pregnancy test and who thinks a syntocinon induction is acceptable practice for a VBAC has crossed the line from ridiculous to dangerous.

Also, regarding fundal measurements, 1cm/week above the umbilicus is textbook but, in practice, there is considerable variability. And if your babies measure small on USS there is every chance your fundus will measure small as well.


Sent from my iPhone using Tapatalk
That's kind of what I thought for the fundal measurement. The ob I previously saw, as well as the new one, are both in the 45 min zone. They are all in the same area and this is the best one we could find that takes the insurance. The good one is over 2 hours away. I would love to see her, but it isn't conceivable no matter how we look at it.
 

·
Registered
Joined
·
404 Posts
I just wanted to second what a pp stated about rhogam. If not having it is really worrying you,get a cfdna test. It measures small amounts of baby's blood from a sample of yours and can tell you what blood type baby has. You may not even need rhogam.

I'd also get another provider. Even if it's a drive,its worth it to be cared for by an ob/cnm who will hear you out and help you achieve the birth that you want.

I find it interesting that obs typically dont want to do vbacs partly for fear of uterine rupture,yet they'd induce labor which can cause even stronger contractions that surely can't help. I'm not an expert in vbac by no means,but just had that thought. Maybe someone else will chime in on those dangers.
 

·
Registered
Joined
·
34 Posts
Discussion Starter · #12 ·
I just wanted to second what a pp stated about rhogam. If not having it is really worrying you,get a cfdna test. It measures small amounts of baby's blood from a sample of yours and can tell you what blood type baby has. You may not even need rhogam.

I'd also get another provider. Even if it's a drive,its worth it to be cared for by an ob/cnm who will hear you out and help you achieve the birth that you want.

I find it interesting that obs typically dont want to do vbacs partly for fear of uterine rupture,yet they'd induce labor which can cause even stronger contractions that surely can't help. I'm not an expert in vbac by no means,but just had that thought. Maybe someone else will chime in on those dangers.
The ob kept saying over the phone that they don't induce, but that they use pitocin to "augment" labor. It's all confusing me because they induced me with my 1st in 2005 using pitocin. According to research I've done, it does increase the risk of uterine rupture by using pitocin...so, I don't get it. I guess I'm just going to hope this ob is more competent than the last once "if" she does an actual exam...the last one didn't do anything but the limited ultrasound, a urine test, blood pressure, height, weight, fundal measurement that measured below where the baby could be felt (he measured from about 2cm below my pubic bone to my belly button when you could physically feel the baby about 4 finger widths below my rib cage), and the baby's heart rate. They did basic blood testing also (for blood type and std check) but no pap smear, physical exam, palpitation, gestational diabetes testing, or iron count even though I have a history of chronic low iron during pregnancy. I have had major cramping for the last week or so, diahorrea, neaseua, major increase in fluid and consistancy, low back pain almost constantly, migraines that i cant get rid of, and can measure dilation about 2cm give or take (the amniotic sac is able to be felt via myself and my husband) so I'm hoping they can get their sh!t together this time.
 

·
Registered
Joined
·
5,143 Posts
Syntocinon shouldn't be used to either induce or augment a VBAC. And why is she talking about augmenting now? Why would she think you will need to be augmented? These are big red flags I think.

What makes her the best? Because she does not sound good to me. Who is the second best? Can you try them?


Sent from my iPhone using Tapatalk
 
  • Like
Reactions: Grace Wisdom

·
Registered
Joined
·
404 Posts
The ob kept saying over the phone that they don't induce, but that they use pitocin to "augment" labor. It's all confusing me because they induced me with my 1st in 2005 using pitocin. According to research I've done, it does increase the risk of uterine rupture by using pitocin...so, I don't get it. I guess I'm just going to hope this ob is more competent than the last

I have had major cramping for the last week or so, diahorrea, neaseua, major increase in fluid and consistancy, low back pain almost constantly, migraines that i cant get rid of
An ob or midwife(depending on your state) who are familiar with vbacs seems like your best option. Express your concerne about labouring naturally without pitocin to augment or induce unless serious progression issues arise. The wait and see approach. They can recommend many things,but ultimately its your say.

I'd definitely tell the new ob those symptoms and discuss the iron test and possibly diabetes test.

One of my family members just gave birth to get 1st,her dr wanted to induce her because bp was a few points high and wanted to augment labor with pitocin. Needless to say,she ended up with a csec,but wanted a natural birth. So often,the pitocin and epidurals can lead to more interventions,directed pushing, and csec. Her dr might've had a very high csec rate and already knew how it would play out. There are obs who want nothing to do with vbacs and those who are willing to work with you to try and achieve the birth you want. The drs preference on risk management determines a lot about how they view labor as a naturally bumpy process or a machine like process that needs constant fixing.

Id ask your new ob what her csec rate is and how may successful vbacs he/she has done. I don't see why a dr wouldn't let you labor naturally without pitocin to see how it goes. What's the harm in that?
 

·
Registered
Joined
·
34 Posts
Discussion Starter · #15 ·
Syntocinon shouldn't be used to either induce or augment a VBAC. And why is she talking about augmenting now? Why would she think you will need to be augmented? These are big red flags I think.

What makes her the best? Because she does not sound good to me. Who is the second best? Can you try them?


Sent from my iPhone using Tapatalk
Her stats are the best in the area (ie. VBACs, low infant/mother mortality rate, recovery time, etc.) and she has privileges at the only hospital that will accapt a VBAC birth and "fixing". She's talking about augmenting at 37 weeks if I am dilated at least 2cm at 36 weeks. Apparently, her clinic only allows VBAC with augmentation. I asked at the appointment today and was told it is the only way to insure that the labor will occur during a time when there are not many surgeries scheduled. Every ob or hospital I have talked to has told me pretty much the same thing...apparently here, they have to have a "full" staff for a VBAC because they consider it "extremely unsafe due to the high risk of uterine rupture". All bs for money if you ask me, but it is the entire f'ing area!
 

·
Registered
Joined
·
34 Posts
Discussion Starter · #16 ·
An ob or midwife(depending on your state) who are familiar with vbacs seems like your best option. Express your concerne about labouring naturally without pitocin to augment or induce unless serious progression issues arise. The wait and see approach. They can recommend many things,but ultimately its your say.

I'd definitely tell the new ob those symptoms and discuss the iron test and possibly diabetes test.

One of my family members just gave birth to get 1st,her dr wanted to induce her because bp was a few points high and wanted to augment labor with pitocin. Needless to say,she ended up with a csec,but wanted a natural birth. So often,the pitocin and epidurals can lead to more interventions,directed pushing, and csec. Her dr might've had a very high csec rate and already knew how it would play out. There are obs who want nothing to do with vbacs and those who are willing to work with you to try and achieve the birth you want. The drs preference on risk management determines a lot about how they view labor as a naturally bumpy process or a machine like process that needs constant fixing.

Id ask your new ob what her csec rate is and how may successful vbacs he/she has done. I don't see why a dr wouldn't let you labor naturally without pitocin to see how it goes. What's the harm in that?
At the appointment, the ob said that she is just as confused as we are with the due dates, and she doesn't trust anyone's ultrasound but her own. She scheduled me in 5 weeks for a full work up ultrasound to measure development instead of just size, as well as the diabetes testing, blood work, etc. the problem is that it isn't until the end of the month. Still did not do a pap or a vaginal exam, even with the symptoms and dilation. We did find out the baby is currently breech though, so I am working on that just in case I am right with how far I am.
 

·
Registered
Joined
·
3,442 Posts
paps really shouldn't be done during pregnancy. Wait till your 6 week pp appt.

Thats not "augmenting" what they want to do. That's straight up induction. And elective births prior to 39 weeks are against guidelines. If you can't switch hospitals/drs, then pretty much your only hope for a vbac is to play along, and let them believe your false dates. I've had 3 vbacs myself, all at home. You can do it! Your providers are not remotely supportive, but its doable especially since you "tricked" them into thinking you're not as far along as you are.
 

·
Registered
Joined
·
5,143 Posts
You're right. It's complete rubbish. Totally contrary to current evidence and best-practice standards and likely to result in more complications not less!


Sent from my iPhone using Tapatalk
 
  • Like
Reactions: Grace Wisdom

·
Registered
Joined
·
404 Posts
That's just awful that there aren't more options out there for your location. No birth centers or midwives who can attend a hospital vbac?
 

·
Registered
Joined
·
344 Posts
If you want a natural VBAC I would stay far away from those doctors.

I would ask around, find a doula, direct entry midwives, or natural home birthing minded people. They usually can put you in contact with a home birth midwife or a doctor that is the best for natural birth in your area.

ASK Ask ask and you can find some better options.

Your chance of a VABC under these conditions with these drs is next to none....
 
1 - 20 of 57 Posts
Top