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Hoping for a VBAC & questions

621 Views 6 Replies 6 Participants Last post by  SettingSail
I'm 28 weeks along with #2 and my doc is completely willing to do a vbac as long as this one is not breech as well. I'm really excited about this because we live in the boonies and our hospital isn't supposed to officially do this, blah, blah, blah. But I have some questions.

I've never been able to go to birthing classes. The hospital offers 1 every 4 months (I think?) and DH has been officiating weddings during every class during both pregnancies. Do I need to go to one, or can someone recommend resources (videos) that I could access? I do not a very methodical person, so I don't know how much I would do learned breathing techniques, etc.

Where do I find info on what the laws really are in my state (Iowa)? How do I know that my labor is far enough along that they will deliver me? With DS they scheduled the c-section and the nurse told me that I was registering some "pretty strong" contractions when we were prepping for surgery. I didn't feel anything (but I wasn't comfortable!).

I think that will get me started. I know there were more questions swimming in my mind, but I've lost them!
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I do not, unfortunately, know of any videos, but I have personally found books on the Bradley Method very worthwhile, and also Birthing from Within. Someone else will be able to point you towards a Hypnobirthing video, I imagine.

I do not know of laws in any state specifically governing VBACs. Google "Iowa state law" and you'll probably be pointed towards an official government website for your state where you could do a search of the statutes. (I know it works for Texas, Hawaii, & Virginia, so I'm imagining it'll work for Iowa too.)

How do I know that my labor is far enough along that they will deliver me?
This question, unfortunately, I am not sure I understand. If they have said they'll "allow" you a VBAC, then there should not--in theory--be any issues. You may be one of those lucky women who doesn't feel her contractions until her water breaks--my two female cousins are like that. A lot of women describe their contractions as mere tightenings, and my cousin Margaret has mistaken labor 3 out of 4 times for stomach upset and/or a backache.
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As far as knowing laws in Iowa, I am not sure that each state has its own laws. However, you can look up EMTALA which is a federal law at or check out ICAN's VBAC Advocacy section.

As for attending birth classes, I really didn't learn a darned thing in the birth class I went to that was sponsored by the hospital. All they really taught was how to be a good patient. Blech!

I also, don't know of any videos off hand. But tons of reading material, on the other hand, I do have experience with! My recommendations would include "Natural Childbirth After Cesarean" (Crawford & Walters), "The VBAC Companion" (Korte), "The Thinking Woman's Guide to a Better Birth" (Goer), and "The Birth Book" (Sears). There are a few more that you could check out, but these are definitely ones to look into.
Regarding my "labor far enough along" question. My doc said that if I show up at a certain stage in labor I am considered a critical patient and it's against the law to transfer me to another hospital (million dollar fine for the hospital, I guess). My hospital is 25-30 minutes away, and there's another hospital that's at least 60 minutes from us who officially does VBAC. I'm not sure if she's suggesting that they would tend to transfer me to that hospital if I was early in labor. I need to start asking more questions again, now that the time is drawing near (edd 11.14). She did say that she would be glad to deliver me at that hospital if I wanted to avoid red tape. But I'd really rather be in the closer hospital for numerous reasons.

Thanks for the book recommendations and helpful comments. I'd rather read the books, too, in all reality. I was just wondering about something less committal for my dh/coach.
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I'd be asking this Dr. a lot of questions. Your Dr. is willing to do a VBAC at a hospital that doesn't do them? That sounds odd to me. I'd be concerned that some hospital bureaucrat will stop this Dr. at the last minute. But hey I'm a skeptic.

Do I understand this right? You are going to turn up at say x cm at this nearest hospital (which doesn't do VBACs) when they can't transfer you? You have an arrangement with your Dr. that this is how you'll be able to VBAC at this closer hospital? I'd really want to be able to trust my Dr. on this one because the hospital CAN refuse to do a VBAC, even if you're crowning! C/s can be done at the last minute. Babies have been pushed back up and c/s done.

It's due to ACOG recommendations that some hospitals ban VBACs, it's because they don't have anaesthetists (sp?) on call 24/7 at the hospital. It's a malpractice issue more than anything.

I did a hospital birth class for my first baby, and it was more about preparing me to be a good patient than anything else. I think reading a few books and reading the birth stories on MDC were more helpful.
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Your doctor is right. According to the Emergency Medical Treatment and Active Labor Act (EMTALA), the hospital cannot transfer your or refuse you care once you are in active labor. Defining active labor is a bit tough. 4-5 cm with contractions is a usual indicator. If the hospital does not treat you, they can and will be fined majorily. In a former job, I was a consultant that traveled doing training for hospital administrative personal about EMTALA compliance. Hospitals are petrified of EMTALA violations.

The difficulty I see you possibly having is that once you are admitted, the hospital will want you to have a c/s. It is your right to refuse all treatments and procedures, including a c/s. If they force you to have a c/s against your wishes, they can be sued for medical battery. Once you are in a hospital, they can be very "pursuading", so you need to be ready for a fight. If your doctor is on your side, it may be easier, but it probably will not be easy.

Good luck. Keep us posted.
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There is also "the birth partner" by Penny Simpkin. Its a really good read and has sections just for the dad to read.

With regards to your hospital not allowing vbacs, I would really do some phone calling and research to know what youre going into. If your hospital wont allow vbacs then what is it your Dr plans to do? If you go in early, are kept for being in "active labor" whats going to happen when your Dr is not on call and they find in your chart you are a vbac mom? I would try to find out if there is another hospital in a reasonable distance your Dr can be at or just find one that is vbac friendly and hopefully you will get a caring Dr.

They arent going to deliver you of anything- You are going to give birth
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