[hjshan]

I am 32 weeks pg and would really like a vbac. My doctor thinks I'm a great candidate and is all for it (she had 2 vbacs herself). The problem is there are only 2 hospitals in the county and neither one allows vbacs - actually refuses to do them - therefore my doctor is not allowed to do it. Even if I was to present at 9 cm, hospital policy requires emergency C-section. I am a registered nurse that worked in L&D before having my son a few years ago and am not completely comfortable with non-nurse midwives, therefore in my community that rules out home birth. If we drove 45-60 minutes to Santa Cruz and I changed my OB (one with hospital priv's in SC), I could maybe do it. My questions are: do you think it's safe to commute that far? should I just go with what is planned (scheduled C/S)? am I crazy to change providers this late? will recovery really be that much easier (2 yr old son - nursing and cosleeping, etc...)? I get such mixed messages from everyone... please give me your honest feedback.
Thank you...

 

[hjshan]

Thanks for your reply. As a nurse (L&D) I really want all equipment and monitoring necessary to catch a problem early - I am not afraid of a C/S - I just don't want to end up under general with a baby in danger and bleeding out (UR) due to lack of montitoring. Also, pain control is an issue I don't want to deal with in labor - if I need medication, so be it. My doctor's view is definite IV, monitoring and epidural - just in case - I agree. In Monterey county there are a couple midwives, however they are not certified nurse midwives, therefore to the best of my knowledge they don't have physician backup/support - just drive you to the hospital and get the on-call doctor. Santa Cruz, next county up the road, is a different story. I'm calling around again today - once my decision is made, I just need to find a new OB.

My main reason for wanting a vbac is recovery ease and comfort for my older son. With a 2 yr old and a new baby - I NEED to be able to carry my babes and move around. Simple everyday stuff - getting DS out of tub, into car seat, nursing at night, moving his sleeping feet out of my face/hair/small of my back at night, etc... how can anyone go a week without picking up their older child???

I really wish I felt more comfortable with homebirth - it really would be the best situation for my family and recovery. I just worry about the lack of medical backup, lack of options available at home (emergency supplies, pain control and monitoring) and lack of certified nurse-midwives in my area.

 

[hjshan]

Well, I'm a registered nurse and I have seen hundreds of births. While I was in nursing school there were 2 midwives going to nursing school (in my class) so that they could legally practice (certified, insured, etc.) in CA. I feel like the medical training has some major benefits and community respect. I have seen many necessary C/Ss, women hemmorhage, hung many blood transfusions and unfortunately seen fetal deaths occur - this is simply reality - hospital or home things can happen. I feel that having all/any life saving services available (even though MOST mamas and babes DON'T need them) is really smart. Also, I am not against pain medication if that will make things easier, more enjoyable or progress. One of my last deliveries as a working RN was a mom who went overterm and tried to deliver at home - she was not monitored and the baby ended up with major brain injuries (life long!) due to lack of O2 and placental age. The baby spent it's first 2 months in the NICU. The mom and midwive felt things were progressing fine, the husband (scared to death) stepped in and forced her into going to the hospital. This mom didn't want a C/S as she was being RUSHED into surgery AND begged for us to dim the lights - hmm... I feel the health and wellness of our children is so much more important than anything else - she and her baby were lucky to live. I, as a nurse, believe a complete team approach is best - if things are normal then a nurse midwive is all that is needed, BUT should complications arise - give me and my baby what we need - prepare for anything. I admit to being a bit biased - sorry.

 

[hjshan]

Thank you for all your suggestions and replies. We have finally made a decision that I feel really good about - we are changing doctors, driving the 45-60 minutes to Santa Cruz, plan on having a vbac at a great birth center and I just found/hired a doula. My DS is welcome to stay in the room the entire time or only at night (big issue for us) and my insurance will cover most of this (another big/huge issue).

I'm sorry if I came across as being closed minded or judgemental. Coming from a family of physicians and myself being educated/trained as a nurse, I put a very high value on education and credentialing. With non-certified providers I feel like something may be lacking in their knowledge base (I'm most likely way off - not the 1st time). If delivering babes is your calling why not do that but also go through the schooling necessary to be certified? I've read the satistics and I agree, most births are much smoother with a midwive (cert or non) however, I still couldn't have enough life saving equipment and support. I will not take any chances with my kids.

Anyway, it was a hard decision for me. I had a lot of very conficting information being presented. Depending on who asked, I was either called irresponsible for even risking the <1% chance of problems to being crazy for wanting a hospital setting - almost to the point of accusing hospital workers of wanting to do harm. I guess like everything else in parenting, there is 'no one' way to do anything! Thanks again.