[parsley]

Hi all, I am currently 4 1/2 weeks pregnant with #2. I am determined to have a VBAC this time and I'm trying to figure out what I can do to make it happen. I've been looking at the posts here but could also use some ideas and references to help me make sure that I am my own advocate.

With my first pregnancy I ended up on a slippery slope of over-medicating. My previous ob-gyn had moved out of town and I needed to start with a new provider. I made a really bad choice! At 6 weeks a different doc couldn't find the heart beat and diagnosed me with an ectopic pregnancy and prescribed meds for a medical abortion. After a round of panic, I pointed out to her that maybe the dates were early and she checked again, all was fine. I then began seeing my ob. She insisted on another round of genetic testing bc my husband had been the likely carrier and my previous doc had him do some of the testing. New doc bossed me into getting all the tests done on me. At 12 weeks, I was diagnosed with a low lying placenta and likely placenta previa and categorized as high risk, and told to not have sex for the rest of pregnancy. From then on I went to a special facility once a month for u/s. For the gestational diabetes test I had eaten breakfast on my way to the appt (bc I didn't know it was that day) and my level was one point above low. She insisted I do the long test the next week, all was fine. At 32 weeks, DD was still breach (though the low lying placenta had moved) and from then on she pestered me into scheduling a c-section. She told me a version wouldn't work. I began to have stress induced high blood pressure and at that point she diagnosed me as hypertensive and insisted that I couldn't wait to see if the baby turned during labor. I was exhausted and stressed at that point and gave in to a scheduled c-section at 38w,6d. That in turn lead to trouble with breastfeeding (in addition to the stress and discomfort that you all are familiar with).

So, when I spell it out here. First I think "what an idiot I was, why didn't I take charge of my own health?" (the answer of course is that the doc succeeded in scaring me into thinking she was right). Second, I can see lots of things that I can change to improve my chances. My plans at this point are to see a midwife practice at a great hospital (I live in a different city now), they are very supportive of VBACs, avoid too early testing and excessive testing (the midwives don't even want to see anyone before 9 weeks), and do everything I can to control my anxiety and stress (and my blood pressure). I'm doing prenatal yoga with a great dvd and will try to look for a class later in pregnancy.

Beyond that though, what can I do? I have a super short torso and I'm afraid that I'm going to have breech babies every time (though I don't even know if it's related or just my imagination). I've been thinking about a doula but I'm a very private person and my husband and I are a great team so it's hard to envision wanting another person involved intimately in this whole thing. If it can help me avoid a c-section though... it would be worth it.

I have plenty of time to make things work, so please pass along some suggestions to get me on the right path. Thanks so much!

 

[kltroy]

First, congratulations on your pregnancy! Sounds like you're doing all the right things. Basically, you can stack the cards in your favor, make the best decisions you can when you need to, and cross your fingers. I would contact your local ICAN group if you haven't already, and try and actually show up at some of the meetings. They're very helpful I found (in fact, I found them so helpful I ended up becoming a co-leader) - there is no substitute for talking to people face to face, hearing their birth stories (both good and bad) and getting support. As your pregnancy progresses, you may run into decisions that need to be made about prenatal testing, various health issues that may come up etc. I think the key is to TRUST your care provider. If you truly trust your midwives, then you will believe them if they say that something really should be done (ie some intervention that you hadn't planned on).

My first was breech and a scheduled c-section as well. For the 2nd pregnancy I did a couple things:

1. I MADE myself not worry about baby position until 29 weeks

2. I practiced good posture especially starting around then.

3. I went to the chiropractor when my hips were achy - about every 2 weeks after week ~20

4. I identified the one doctor in my area who would deliver breech babies vaginally, and I had a consult with him - he agreed that if baby was breech at term, I could have a vaginal birth with him.

5. If baby is indeed breech again (unlikely, but possible - I believe repeat breeches occur around 5-7% of the time) you can and should try a version. They often work, and are safe for VBAC moms. Again, DON'T WORRY about baby position until 29 or 30 weeks. Ideally if you get to that point, a version would be around 37 weeks. Even if you find a doc who will deliver vaginal breech, I would probably opt for the version first. The birth will be easier if baby is head down.

I would also make sure you have good dates on this pregnancy - my MW was happy to look at my chart dates, do a quick dating ultrasound, and pick whichever day was later. The point is, you want to buy yourself time, but you also don't want to think you're at 42 weeks and have baby really be 43 weeks, because of the increased risks. (As it turned out, our dates were only 1 day apart, and my baby went 9 days past EDD).

A doula is a good plan too. For now, I would simply enjoy your pregnancy and mentally switch your thinking from "I will try for a VBAC" to "I'm planning a VBAC".

Best of luck with your pregnancy!

 

[samstress]

congrats mama!

honestly, i think you've done the most important thing you can -- find care providers that support you. i also agree with the pp about contacting your local ICAN chapter (and to not worry about baby's position just yet).

you can have your vbac (and will) and you need to start telling yourself that right NOW. i started chanting positive mantras to myself very early in my second pregnancy "my mind is powerful, my body is strong" and continued throughout, right until the very end "i have faith in the birth process", "the body that grew this baby can deliver this baby", etc. also did lots of relaxation and positive visualization which i used during labor (it helped). do not underestimate the power of the mind.

read and listen to lots of positive vbac birth stories.

did you take a childbirth preparation class with your first? i took a lamaze class with our first which, i think, left me totally unprepared. with our second we took a bradley class and i absolutely credit our teacher as being an enormous reason why we got our vbac. she really helped to increase my confidence in my body and the birth process. she also made us aware of the many versions of normal, so i wasn't at all scared when things came up during labor (as i had been with our first).

remember ina may's words..."your body is not a lemon".

the mistake i made (which you've already avoided) is not choosing my care provider more carefully. he insisted that he supported vbac, but pulled a bait and switch as my due date drew near. the day i went past 40 weeks, he scheduled a c-section for me. i canceled it. with every day i went past my due date my doctor (and another doctor who actually called me) used their scare tactics by telling me i was putting my baby at risk to be brain damaged or stillborn.

i got my vbac despite the fact that i went 13 days past my due date, had a doctor who scheduled repeat c-sections for me on two separate occasions and gave birth in a hospital where the vbac rate was 4%. anything's possible if you want it badly enough.

looking forward to hearing your vbac story in february.

 

[parsley]

Thank you both for your support and advice! You are right. I am going to have a VBAC.

Great idea Kltroy about going over my dates with my midwife. So much of the craziness in my first pregnancy stemmed from a mix up with dates, seems like it would be very helpful to have it very clear for both me and my care providers. (I think this time it should be pretty straight forward though. Ovulated on day 14 of a 28 day cycle-- I've only been off the pill for a few months and my cycles haven't slowly meandered all over the place!)

Thanks too for the good news about how rare it is to have a repeat breech baby. Gives me some real hope! You are both right, I think, to not worry about positioning until later. But, I'm wondering how you think posture, chiropracter, etc... might help? Maybe that is something I should have in my head as I get further along.

Samstress, congratulations on your VBAC and on persisting in your plans. How frustrating to have your doc keep pushing you to a c-section after you thought he was going to be supportive.

You know I've been wondering about maybe taking a different class this time. Last time we took a general overview type of class that didn't focus in on only one method. It offered lots of good advice but it wasn't in-depth and I'm not sure how much I retained. I've been meaning to look into the Bradley method, so thanks for the suggestion about that. I'm pretty sure I'm want to be unmedicated as I hate being out of control way more than I hate pain. Some pain management techniques would help though

So, I totally get the idea of going to ICAN meetings but the thing is, I'm short of time (major work deadlines before baby #2) and am much more of a read-a-book than go-to-a-meeting type of person. Anyone have any book recommendations?

Thanks again for your advice!

 

[samstress]

Quote:

Originally Posted by parsley

Thank you both for your support and advice! You are right. I am going to have a VBAC.

that's the spirit!

Quote:

Originally Posted by parsley

So, I totally get the idea of going to ICAN meetings but the thing is, I'm short of time (major work deadlines before baby #2) and am much more of a read-a-book than go-to-a-meeting type of person. Anyone have any book recommendations?

Thanks again for your advice!

book recommendations about vbac or just birth in general?

silent knife comes to mind, but also i would just read a lot of books about natural birth. i was reading ina may's guide to childbirth in the weeks leading up to my son's birth. i used a lot of the stuff she talked about and i love all the birth stories. the book helped my confidence a lot.

as for the ICAN meetings, you don't have to attend a bunch (i only went to one), but maybe just connect with someone in the organization. i e-mailed the woman who leads my local meetings and had much correspondence with her before and after i attended the meeting. i just went to the meeting because i was interested in hearing other women's stories.

i would also check out the vbac facts website.

 

[ryan'smom]

Hi Parsley!! I second the Ina May book! I found it so helpful and actually caught myself quoting parts of it while I was in labor....great book. I know I read a few others, but that is the one that helped *me* the most.

Can't wait to hear how your appointment at Magee goes!! Good luck =-)

 

[labortrials]

I recommend joining the ICAN list on Yahoo groups. Seriously I get more from that group than anything! Also, your local ICAN group can be helpful in identifying the best care providers who really WILL support your birth choices (not just say they will now and then start chipping away at you in the 3rd trimester).

I'm not a super 'touchy feely birthy' type, but this time around "Birthing from Within" ended up really helping me. I even did some of the birth art stuff. "Born in the USA" (Wagner) really opened my eyes to the problems with our maternal care system, so if you like statistics and more science-based stuff, that'll be good for you.

You might set up a 'google alert' or something similar for VBAC. That was you'll catch a lot of blog posts that deal with this subject.

Oh, and regarding breech . . . I wouldn't worry about position too much until 32+ weeks. And a lot can be done to help resolve breech positioning. Sometimes the uterine shape can promote breech positioning but I don't think there's a link between short torso and breech.

 

[parsley]

Thanks a lot for the recommendations. I have to admit I haven't even read Ina May's book so thanks for reminding me to get that at the top of my list! Actually, as I read your replies I realized that I had only read books about pregnancy and babies during my first pregnancy (including what I like to call _What to Dread When You're Expecting_). But I didn't read a single book about childbirth. No wonder I ended up so unable to advocate for myself. I'm also going to check out all your recommendations.

I also just learned that the hospital where I'll be giving birth has *several* docs who will do a breech delivery (And, in NYC where I gave birth the first time there wasn't a SINGLE doc that did breech deliveries according to several sources!). I'm thrilled to have that back-up option if I do have a (unlikely) repeat breech.

Thanks again!

 

[ablepearl]

As a repeat breech momma, who has a short torso, I like to advocate seeing a chiropractor, the sooner the better. I don't know if there is a link between short torso and breech or not, but I do know a few women that have the same complaint. Regardless of that, the way your pelvis is CAN make a huge difference in fetal positioning. I had a c-section for breech, followed by two external versions at 37.5 weeks. With my fourth I FINALLY realized it was me and started seeing a Webster trained chiro at 23 weeks. She turned on her own at 36.5 weeks or so. The best $ I have ever spent! I would opt for either Webster trained or Bagnell trained.

I also agree that reading about birth, especially empowering natural births is a great idea during pregnancy. You can do this!

 

[bignerpie]

Quote:

Originally Posted by labortrials

I'm not a super 'touchy feely birthy' type, but this time around "Birthing from Within" ended up really helping me. I even did some of the birth art stuff.

Same here! Though I loved Ina May's book during my first pregnancy, I am getting a lot more out of Birthing from Within this time around. I didn't think I would like it because I am not at all new age-y or touchy-feely.

Add my recommendation for the chiropractor to the list. I am super short-waisted, and my issue is with posterior babies rather than breech. Keeping everything in line will make it that much easier for your baby to get in an optimal position. And as others have said, a Webster trained chiro should help if your baby decided to turn breech. I put it off until 28 weeks because I don't have insurance to cover chiropractor visits, and it is hard to come up with the money to pay for it. If you're able to go earlier, do it!

My husband and I were both happy to have a doula at my son's birth. My husband needed as much support as I did! This time, though, he doesn't think it's necessary, and I agree. But, we are planning a homebirth and will have a midwife and her assistant present. Most hospital-based midwives don't stay with you the whole time you're in labor, though. I know mine didn't. She actually went home for a few hours while I was in labor. So if you want someone with you without interruption, I'd say start looking for a doula.

 

[parsley]

Ablepearl and bignerpie, thanks for the very specific advice regarding a chiropractor. I'm going to add it to the list of questions for my midwife visit to see if she has any reccs. I haven't seen a chiropractor since I was a teen and no nothing about the field so it's really useful to have advice about a specific type of training to look for.

I have _BIrthing From Within_ on order as well as _Ina May's Guide to Childbirth_ and _ The Thinking Woman's Guide to a Better Birth_. I'm looking forward to them. Any other reccs?

We are leaning toward having a doula. One of my concerns is that if labor is long I want to have the option to have DH see DD for a while (hospital and house are close by). Having a doula seems like one way to make that work. Anyone have a sense of how soon in advance you should begin meeting different doulas and making plans?

 

[ablepearl]

http://www.plus-size-pregnancy.org/howtofindachiro.htm

 

[parsley]

What a great resource, ablepearl. Thanks!

 

[samstress]

Quote:

Originally Posted by parsley

I have _BIrthing From Within_ on order as well as _Ina May's Guide to Childbirth_ and _ The Thinking Woman's Guide to a Better Birth_. I'm looking forward to them. Any other reccs?

We are leaning toward having a doula. One of my concerns is that if labor is long I want to have the option to have DH see DD for a while (hospital and house are close by). Having a doula seems like one way to make that work. Anyone have a sense of how soon in advance you should begin meeting different doulas and making plans?

those are all great reads. i also read natural childbirth the bradley way, but was also taking a bradley class. i think the book's helpful even if you're not taking the class. i would also recommend the birth partner for your dh.

who will be with dd while you and dh are at the hospital? i'd hate for you to be without you coach/partner even if it is for a little while and even if you do have a doula. also, i would recommend laboring at home as long as possible.

that said, a doula is always valuable and it's probably never to soon to start looking for one, although, at 4 1/2 weeks, you still have plenty of time.

 

[labortrials]

Doula - YES! (Even though I'm birthing at home, I'm still gonna have a doula!)

Chiro - YES!

Other recs thus far - YES YES!!!

Regarding a chiro - you need someone who is trained in 'dealing with' pregnant women. Usually they are trained in Webster Technique and/or Bagnell. Often you find them through the ICPA, the pediatric chiro website. My chiro is amazing!!! Not only does he do the usual pregnancy adjustments but also he adjusts my pubis symphysis which normally is a DISASTER in pregnancy. I've had very little round ligament tension with this pregnancy, and I think it's because he's been so good a getting my pelvis re-aligned!!

Kmom's entire site contains quite valuable info. I still consult it on a regular basis, and it's not just for 'plus sized' women.

Oh, and good to be aware that possibly there IS a link between torso length and breech presentation. I wouldn't have thought of that, but now I can be aware of it in case any mamas start to experience this. A lot of women like the Spinning Babies website . . . I myself am spatially challenged, so I find it a bit difficult to follow.

Other good books to read, IMO:
Pushed (Block)

Born in the USA (Wagner)

My Best Birth (the Ricki Lake book)

BURN "What to Expect . . . "!!!!!

 

[samstress]

Quote:

Originally Posted by labortrials

BURN "What to Expect . . . "!!!!!

amen, sister!

 

[ablepearl]

I have trouble with the spinningbabies site too, although I still recommend it to other women.

I found this site very helpful when my daughter was still breech. http://www.suite101.com/content/turning-a-breech-baby-a7421

 

[bignerpie]

Quote:

Originally Posted by labortrials

A lot of women like the Spinning Babies website . . . I myself am spatially challenged, so I find it a bit difficult to follow.

The website confuses me. I bit the bullet and ordered the workbook. It is sooo much easier to follow. If you don't mind spending $15, or if you can borrow it from someone, I think it's worth it.

 

[samstress]

Quote:

Originally Posted by ablepearl

I have trouble with the spinningbabies site too...

Quote:

Originally Posted by bignerpie

The website confuses me.

glad it's not just me.

 

[Faither]

I did Hypnobabies with my first and they were very helpful. They have a VBAC track that might be very helpful. I haven't tried it yet, but plan on downloading in this weekend.

http://www.hypnobabies.com/store/shop.php?pid=18&sid=4&cid=4&start=0

They might have an mp3 track too. those are usually a little less expensive. Good Luck!