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Discussion Starter · #1 ·
I was given the name of an OB by a Doula. She said she's known of at least 1 case of this dr. overseeing a successful VBA2C. I called today but I had to make an appt. to speak to the dr. Anyways, how do you find one without having to make an appt. with each and every dr.?
 

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Why do you need one? You know that if you want a vaginal birth, regardless of previous surgery, you have a very poor chance of achieving it when you hire a surgeon and even less for a VBA2C. If you want to birth vaginally you don't need a surgeon, you either need a midwife (and all midwives should support VBAC because it's the evidence based safe choice) or you need to freebirth or you need to go to hospital in strong labour with a doula in tow and say no to all interventions. To hire a careprovider who's supportive of evidence based care you need to avoid surgeons because they don't practice this way. If they did, they'd all support VBAC and no one would ever be induced on dates and they wouldn't accept healthy women as clients in the first place. Steer clear of the people who do the surgeries and you won't get surgery, by and large <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> To hire a CP who supports VBAC ask nitty gritty details of percentages of clients. I just hired a MW with a 100% VBAC rate <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> Find a surgeon with those stats? I don't think so! The only way to get the right CP is to interview each one and be totally upfront about what you need.
 

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<div>Originally Posted by <strong>JanetF</strong></div>
<div style="font-style:italic;">Why do you need one? You know that if you want a vaginal birth, regardless of previous surgery, you have a very poor chance of achieving it when you hire a surgeon and even less for a VBA2C. If you want to birth vaginally you don't need a surgeon, you either need a midwife (and all midwives should support VBAC because it's the evidence based safe choice) or you need to freebirth or you need to go to hospital in strong labour with a doula in tow and say no to all interventions. To hire a careprovider who's supportive of evidence based care you need to avoid surgeons because they don't practice this way. If they did, they'd all support VBAC and no one would ever be induced on dates and they wouldn't accept healthy women as clients in the first place. Steer clear of the people who do the surgeries and you won't get surgery, by and large <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> To hire a CP who supports VBAC ask nitty gritty details of percentages of clients. I just hired a MW with a 100% VBAC rate <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> Find a surgeon with those stats? I don't think so! The only way to get the right CP is to interview each one and be totally upfront about what you need.</div>
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I'm sorry, but I have to say that I find this reply sort of offensive. As a mama who need an OB (and one who handles high risk, at that) because I have preterm labor issues and preemie babies, I think that it's inconsiderate to take that sort of tone and not think that perhaps she really does NEED to see this sort of care provider. I don't know of any midwives (and I'm friends with several) who would even consider taking my care on.<br><br>
ETA an answer to the OP <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br>
I found my new OB by asking around to mamas at my playground, and asking midwife friends who I trusted. I then called the office and asked for a phone consultation with the doc. I spoke with the CNM who works with him, and she pretty much answered all my questions and I was very happy. But I did follow up witht he talk with the OB as well, and ask specific questions like what is the VBAC rate, percentage of pactice, what sort of interventions they'll use, etc. I had a list of questions ready beforehand so that I wouldn't forget anything.<br><br>
Also, check out the ICAN website, I think there's some great info there <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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Discussion Starter · #4 ·
Homebirth is totally out of the question... First, my insurance won't cover it. Second, my DH has only agreed to support me with a VBAC if I have the care of an OB in a hospital. It is most important to me to have my husband's full support.<br><br>
I have contacted a few midwives in the area and they won't take me because I've had VBA2C. They have said I needed to contact an OB.
 

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I would talk to your local ICAN group if you have one. They usually have the inside scoop on which OBs are really VBAC friendly and which only pay lip service. I also got some good leads through my local LLL group.<br><br>
The problem is a lot of OBs will say they are and then back pedal as your due date approaches. I switched OBs at 30 weeks with my last pregnancy because of this. Like you, my DH was only comfortable with a hospital VBAC, and truthfully, so was I.
 

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You should definitely check with the local ICAN chapter. Other mamas know who is supportive from their own experience. Have you tried asking to talk to the dr. briefly over the phone? Then if you feel like it is a possibility, you could then make a follow up appt. to see if you still feel that way after talking to him/her in person. I agree that many OBs will SAY that they are VBAC supportive, but only if you meet every single criteria they have. Ask around, and go with your gut.
 

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I also agree with talking to your local ICAN chapter and watching out for OBs who position themselves as supportive until the end when they suddenly change. I've found that for myself, while I found a team of providers who claim to be supportive of VBACs, what "supportive" means is very different to each of them (especially as we get close to the actual event) and that ultimately I've found it to be in my best interest to assume that they aren't going to be terribly supportive, educate myself and my partner really well, hire a good doula, and be ready to fight for my VBAC. I wish I could see a midwife instead of an OB, I wish I was brave enough to try for an unassisted birth, and most of all I wish that I could just trust that a provider I hire is going to have my best interests at heart instead of her/his own convenience/liability/whatever, but the lesson I've learned is that I have to take care of myself and look out for myself. Sadly, with the climate around VBACs these days, I feel like many of us have no choice but to lower our standards (in terms of support) and be ready to fight, which sucks, frankly, but all we can do is make the best of what we have.
 

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Where did I say "women with high risk pregnancies shouldn't have Obs"? The OP hasn't mentioned any major health concerns, she's just planning a birth! That's a normal part of women's wellness cycles regardless of previous surgery.<br><br>
As other posters have said, surgeons who support <b>not</b> having surgery are pretty rare. If your dh wants you to have a surgeon, he probably doesn't understand how inappropriate this is and how unlikely you are to avoid surgery if you hire someone who does it for a living. Lots of reading on midwifery care will help with this problem and if you really want to birth in a hospital, you're safer without your own surgeon and safety is enhanced by having a doula. They're pretty easy to find and will also help a lot with dh understanding what appropriate care for pregnant women is. Good luck! Remember ultimately it's *your* birth, not your husband's and not your CP's so *you* have to totally happy with where and how you birth! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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Over the last several months I've been pondering the same question. I've joined the ICAN list, I've looked up every resource on the sticky at the top of the forum, I've googled every term known to man on the topic.<br><br>
What I have found is not really all that encouraging I'm afraid. Turns out even moms with no history of c/s are having a hard time getting a natural birth with their OBs. For one example of that, there's a thread about how birth plans are (not) followed going on right now.<br><br>
But I'm too optimistic to say you can't find one, I hope you do! There are birth stories here and elsewhere depicting successful VBACs in hospitals - it surely can be done, with lots of information, lots of determination, knowledgeable support givers and clear knowledge of your rights.<br><br>
I do find it disheartening that so many OBs give moms a line of bull. Too many times I see moms tell their story about how their doctor gave them a yes only to find a reason to say, Oh, sorry we can't go that direction now! I read a post recently (was it here?) by a mom who said her doctor started backpedaling outright near the end of her pregnancy by saying, so are we done with that VBAC nonsense yet? But most times the doctor is much more subtle, they don't say no outright, they simply create doubt and find flimsy reasons to do the interventions we know increase the risk of surgery.<br><br>
I think asking your prospective care provider how many VBACs they attended last year, how many ended in vaginal births, to see what they say or don't say, is a good idea. It also seems to be critical to understand how to refuse consent for interventions you don't truly need, knowing that you will need support who can do that for you when you are in the throes of labor, and weighing how disruptive you feel that resisting the pressure from the staff is going to be for you.<br><br>
Have you seen this document? It might be helpful in educating your support givers too. <a href="http://birthpolicy.org/primer.html" target="_blank">http://birthpolicy.org/primer.html</a><br><br>
Articles I have read explain that due to the conventions of tort law, doctors are bound to apply the "standard of care" to each and every woman who seeks their care. "Standard of care" is arrived at not by examining evidence, but by consensus in the medical industry - sort of an industry-approved version of "But everyone else is doing it!!!" Has nothing to do with research or being better for patients.<br><br>
So once an intervention or procedure becomes common, it becomes necessary for the doctor to apply it or be in violation of the "standard of care". They can't do that because it would make them vulnerable to losing lawsuits, losing their malpractise insurance, and bring down the disapproval of their superiors, peers and their professional organization.<br><br>
So you are going to be subject to the "standard of care" under the name of hospital policy, not because research shows those procedures are helpful or necessary, but because the doctor is in a CYA situation that makes it extremely difficult for him/her to address your need for evidence-based care even if he/she believed in VBAC or natural birth. That makes it very hard to get what you need from the OB, even though <i>they</i> work for <i>you</i> - their priorities are different from yours in many ways.<br><br>
I hope you find the info you need to hire an OB you feel comfortable with. It stinks that we are in such an adversarial atmosphere during one of the times in our life when we need peace and loving support the most.
 
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