[bryonyvaughn]

When you're struggling to find a VBAC supportive HCP have you ever lied (like flipping the order of birth histories) to make it appear you've already had a VBAC?

Being a UCer I don't have to deal with searching for a supportive HCP I can trust. I just wonder what you do when know one's on your side and you know what your doing is in you and your child's best interest. I don't like the idea of lying to someone who is supposed to be "on my side" but I just don't know what good solutions I could come up with if I weren't a UCer.

The only successful VBACers I know IRL are UCers plus one friend who labored at home for 3 1/2 days and got to the hospital 20 minutes before her 2nd DD was born. Around here you really have to drive at least 45 minutes to find a hospital that supports VBACs in theory.

~BV

 

[mm72873]

I would chime in...but I don't know what a Ucer is...

Mir

 

[meatloafkend]

hahaha, I also don't know what a UCer is or any of the other abreviations. Please enlighten me

 

[arlecchina]

uc is unassisted childbirth, mothers delivering their own babies

 

[Robinna]

UC is unassisted childbirth.

I would lie if I felt I had to. I feel lucky that I'm not in that position.

 

[AlexisT]

Realistically I couldn't lie, since I had 1 birth and it was CS...
Hospitals here are supposed to let you VBAC (I heard one doesn't) but it has to be in the consultant led L&D ward.

 

[JanetF]

I'd lie in a heartbeat. The risks of any birth are mine to decide, not a bunch of strangers who'll never see me again and birth is, after all, as safe as life gets

I have friends in the US who've lied and said they've never had a c-sec at all. New state, new CP, if no one looks at your belly they won't know. In a climate like we have at the moment I support "by any means necessary" to get a baby birthed safely.

 

[bryonyvaughn]

Quote:

Originally Posted by meatloafkend hahaha, I also don't know what a UCer is or any of the other abreviations. Please enlighten me

Sorry. I get annoyed when my US Marines bil & sil speak in acronyms. I didn't mean to do it to you.

• VBAC = Vaginal Birth After Cesarean section
• HCP = Health Care Provider (midwife, general practictioner, ob/gyn, etc)
• UC = Unassisted Childbirth i.e. no professional birth attendant
• IRL = In Real Life i.e. people I know by name and face rather than screen nick

BTW (oops! By the way) I really appreciate everyone's honesty. I get so tired of dealing with medical prejudice against fat moms, fat babies, natural birthers, etc that I opt out of a lot of it. I can't imagine dealing with the pressure birth attendants fearful of birth let alone prejudice against VBACers.

~BV

 

[Ruthla]

I'd like to know how you plan on having a HCP provide prenatal care and NOT see your belly or your c/s scar?

Do you mean, like if you had a vaginal birth and then a c/s lying about it and saying you had the c/s first and then a vaginal birth?

 

[CaraNicole]

i'm pretty sure i am going to lie if i have to for the next one...i want a water birth at HOME...dh is so not thrilled... i wonder how i am going to pull that off...ds was born by LS CS... do what you gotta do!

 

[ckhagen]

I would if I ever had no other choice.
My OB was such an incredible surgeon (really, she missed her true calling... plastic surgery), that even I can barely find my scar. Not to mention she did not write an operative note for my surgery. I could definitely get away with lying as far as them not being able to tell. I definitely wouldn't WANT to... but if I had no other choice I would.

 

[wifeandmom]

Quote:

Originally Posted by Ruthla I'd like to know how you plan on having a HCP provide prenatal care and NOT see your belly or your c/s scar?

I've had three c-sections and I could certainly get away with lying. My scar is literally *right* at the top of my pubic bone, which is covered with pubic hair. And I'm not an overly hairy person or anything. It's just *that* low.

Would I recommend lying about previous sections? Probably not, but I wouldn't rule it out completely.

The problem could become what happens if you rupture? They aren't really looking as close for a rupture in a woman without a previous c-section since the chances are so incredibly low compared to VBAC moms (1 in 15,000-ish to 1 in 200-ish).

I would say mom better arm herself with a lot of knowledge on the signs of impending rupture so she could 'come clean' so to speak should the need arise.

Also, if something DID go wrong, any chance of suing for malpractice would basically be out the window, so it'd definitely be a choice you'd have to be 100% confident in and willing to accept the responsibility for ANYTHING that might go wrong, even if it really was the fault of whomever was seeing you.

How very sad it is to think that women actually have to contemplate lying in order to birth vaginally. I wish I knew what the answer was to this whole mess.

 

[oregongirlie]

Quote:

Originally Posted by bryonyvaughn I really appreciate everyone's honesty.

Well, being honest about lying is a start.

If you ever needed to sue for malpractice, this lie might not be a good one to have told.

 

[bryonyvaughn]

Quote:

Originally Posted by wifeandmom ...The problem could become what happens if you rupture? They aren't really looking as close for a rupture in a woman without a previous c-section since the chances are so incredibly low compared to VBAC moms (1 in 15,000-ish to 1 in 200-ish)...

While the 'risk of rupture' card is frequently played on moms wanting to VBAC, I always thought the true risk of rupture correlated far more closely with Cytotc and Pitocin than with previous c/s. Did I get that wrong? It's probably been 8 years since I've read Obstetric Myths vs Research Realities.

If that was indeed the case, I could understanding someone lying about c/s history to get in a setting without cytotec/Pit but would be scared to do so if I were being pressured to induce or augment labor... especially if I had multiple c/s, surgical abortions, D&Cs, fetal surgeries, etc.

The reason I asked brought this up is sometimes my clients will tell me one thing but when I look at their urine or test their blood I know things don't add up. I'll explain the discrepancy between their story and test results, offer possible reasons for the test results, and wait for them to 'fess up. I don't do it to be mean but if they want me to help them I can do a much better job working with reality than an illusion.

I use the Golden Rule as a moral standard and realized if I were in a VBACing situation, I'd be sorely tempted to treat my HCPs differently than I like my clients to treat me. I was struggling with the idea of my being a big old hypocrite. Hearing your replies I think my Golden Rule dilemma is evidence that I'm far more open, accepting, and supportive of my clients than most HCP are toward VBACing moms.

That's all. Just me working through my moral quandaries on the VBAC board. While I quoted only wifeandmom, I thank you all for your input. It's help me.

~BV

 

[AlexisT]

I don't know about pitocin, but VBAC does contraindicate being induced with prostaglandins--it significantly increases the rupture rate. I forget the stats, but I believe a repeat CS is safer than that type of induction.

The problem is that there is a risk of rupture with VBAC; unfortunately, that risk can be overstated and used to justify needless intervention. On the one hand, you want them to know you did have a CS so they're paying attention (uterine rupture being so much rarer in non-CS women that they don't think it's happening), on the other, with the restrictions on VBAC, you don't want to be setting yourself up to fail.

 

[rmzbm]

I would be upfront. I also will NOT be seeing an MD - so no worries, LOL!

 

[mom3b1?]

Nope, I"ve never lied to a Doctor, Nurse, or MW about my medical history.

I do plan on lying about my "due date", but not to the MW I might hire. I will tell friends and family that I'm due at least a month later than I am, so they won't be fussing at me to get an induction when the baby takes longer than what they consider "usual" to finish gestating.

I get HUGE. I am tiny, overweight, but short and small boned. I usually measure much larger than my dates would indicate. So, people really freak when they see me anyway. Friends, family and strangers try to comfort me by telling me how cruel my doctor is not to induce me and get it over with, which just upsets me. My first two were induced, and it was extremely traumatic. With my third there was no doctor, and I wanted it that way. The birth began naturally as God and Nature intended, two days shy of 44 weeks.

I"m just going to tell t hem "Marchish" and then they won't be able to say a thing to me about that, though I can't hide the size I'll be.

Kiley

 

[mom3b1?]

While the 'risk of rupture' card is frequently played on moms wanting to VBAC, I always thought the true risk of rupture correlated far more closely with Cytotc and Pitocin than with previous c/s. Did I get that wrong?

I've forgotten a lot since my last birth, but not that! Yes, you are right. Induction is the biggest risk factor whether or not you have a previous c/s. C/s does increase risk a bit, but nothing to the extent that induction does. There was a time I could rattle off the relavent percentages in a heartbeat.

Now that I've UBAC'd I don't worry so much.

Kiley

 

[wifeandmom]

Quote:

Originally Posted by bryonyvaughn I've forgotten a lot since my last birth, but not that! Yes, you are right. Induction is the biggest risk factor whether or not you have a previous c/s. C/s does increase risk a bit, but nothing to the extent that induction does. There was a time I could rattle off the relavent percentages in a heartbeat. Now that I've UBAC'd I don't worry so much. Kiley

Two women, both being induced, one with a previous c-section and one without have *very* different rupture risks.

Every study I've seen agrees with this. A woman *without* a scarred uterus, induction or not, has a MUCH less likely chance of rupturing. I'd be interested to see reputable studies that claim otherwise.

I've yet to see *any* study that even came close to saying a non-induced VBAC had a rupture rate anywhere close to the 1 in 15,000 or less chance of rupture in an unscarred uterus. Certainly the risk is sometimes given as less than the 1 in 200 commonly given for the overall risk, but I've just never seen any reputable VBAC study showing non-induced rupture rates as low as rupture rates in non-scarred women.

 

[bryonyvaughn]

Quote:

Originally Posted by Ruthla ...Do you mean, like if you had a vaginal birth and then a c/s lying about it and saying you had the c/s first and then a vaginal birth?

More along that line is what I was thinking. I was interested in any other "fudges" folks felt obliged to tell to get what they considered optimal care given their circumstances.

Quote:

Originally Posted by wifeandmom ...How very sad it is to think that women actually have to contemplate lying in order to birth vaginally. I wish I knew what the answer was to this whole mess.

Dittos and sighs, my friend. Dittos and sighs.

Quote:

Originally Posted by AlexisT I don't know about pitocin, but VBAC does contraindicate being induced with prostaglandins--it significantly increases the rupture rate. I forget the stats, but I believe a repeat CS is safer than that type of induction.

I understand your point completely but it just makes me crazy when doctors use that as justification for repeat c/s rather than as justification not to induce. (I realize you're not justifying it, Alexis; I just had to micro-vent.)

Quote:

The problem is that there is a risk of rupture with VBAC; unfortunately, that risk can be overstated and used to justify needless intervention. On the one hand, you want them to know you did have a CS so they're paying attention (uterine rupture being so much rarer in non-CS women that they don't think it's happening), on the other, with the restrictions on VBAC, you don't want to be setting yourself up to fail.

It was just the beginning of last month I was at a Henci Goer talk and learned there were isolated cases of women being taken to court and ordered to undergo c/s. I knew many docs would give moms false encouragement to VBAC, only to insist on repeat c/s at term when no other HCPs would accept them. I just didn't realize some had persuaded judges to be hostile to VBACing moms too.

I *assumed* (and, yes, I realize "I assumed" could be among the most common last words ever spoken

) moms informed enough to pursue VBAC would be informed enough to know the risks of induction.

Quote:

Originally Posted by mom3b1? Nope, I"ve never lied to a Doctor, Nurse, or MW about my medical history.

I haven't either BUT I wouldn't consider it a moral badge. I feel no need to lie since I'll only go to doctors if I think they'll be able to help me. I've mastered the art of smiling sweetly and nodding while thinking, "This doc is an idiot."

Quote:

I do plan on lying about my "due date", but not to the MW I might hire. I will tell friends and family that I'm due at least a month later than I am, so they won't be fussing at me to get an induction when the baby takes longer than what they consider "usual" to finish gestating.

Here, here! My past dates babies have averaged EDD+23d.

I've learned how to avoid lying by misleading with carefully placed facts. (How's that for moral high ground?

)

Q: When are you due?
A: I'm expecting this baby the middle of January. Wouldn't it be neat if it shared it's sister's birthday?
DD's birthday is Jan 24th. EDD is calculated for Dec. 16

Quote:

Originally Posted by mom3b1? Two women, both being induced, one with a previous c-section and one without have *very* different rupture risks. Every study I've seen agrees with this.

I agree.

Quote:

Originally Posted by wifeandmom A woman *without* a scarred uterus, induction or not, has a MUCH less likely chance of rupturing. I'd be interested to see reputable studies that claim otherwise.

Are you claiming a woman w/o a scarred uterus given Cytotec and Pitocin is less likely to have a uterine rupture than VBACing mom w/o the Cytotec and Pitocin?

I admit I gave away my copy of Obstetric Myths maybe eight years ago and haven't read a copy since but I got the impression it was the other way around?

Does anyone have references for this sort of study? I'm giving a talk next month as part of my Anat & Physio final and would like to know. I live near a university and, given the journal reference, can easily get copies of the articles.

BV, who needs to get better at googling