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Discussion Starter · #1 ·
I was just hired as a doula for a client, having a VBAC (hopefully soon). Her Drs have told her that they want her to stay in bed. She would like a natural birth, and knows that having to stay in bed, will make this harder, although I told her we can do a lot of things "in the bed" <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> If the Drs won't bend on it. What I was hoping for though, is to find research that shows that there is no need to be in bed for VBAC etc. She'd like to have ammunition with her, as she approaches her Dr on this subject at her next appointment. Thanks for anything you can send my way! I knew you ladies would be able to help me!! My general searches haven't brought up much that she can take to the Dr.
 

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Not lying in bed really has little to do with VBAC. It is simply about having a natural birth... no animal or human left to their own devices lies in a bed for labor! (Exaggeration, of course... I'm sure someone has, but it isn't the norm.)<br><br><a href="http://www.lamaze.org/ChildbirthEducators/ResourcesforEducators/CarePracticePapers/FreedomofMovement/tabid/484/Default.aspx" target="_blank">http://www.lamaze.org/ChildbirthEduc...4/Default.aspx</a><br><br>
There's a link to get you started.<br><br>
People are so weird about VBACs. They are seldom any different from any other birth. They don't typically require anything special and do best when you just leave them freaking alone!<br><br>
*Sigh* sorry... feeling ranty...<br><br>
I hope your client gets a nice birth. Do the dr's have a reason from her medical history to want extra monitoring on her? Or are they just skittish about VBACs? Do you know all the details surrounding her c/s? It is hard as a doula when you don't know all their reasonings, but your client should demand to know why she deserves to be confined to bed. Is that something they do to everyone, or do they think that VBACs alone deserve that dubious honor?<br><br>
Have you been to a VBAC yet? (Sorry, I have no idea how much experience you have.) VBACs are exhilarating because they are usually such an emotional triumph for the woman. I love love love VBACs. Please know that VBACs usually go down (in a supportive environment) just like any other birth. She isn't extra delicate, she's not a time bomb, she isn't something for people to wring their hands over. (I'm sure you know this!) Let her know that you know she is strong and capable, and help her advocate for the best care from these dr's.
 

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Discussion Starter · #3 ·
Thanks for the link. this is my first VBAC, and my client knows this. I just want to be able to give her as much ammunition, for her own knowledge (she's an information person) but also that will remind her that this isn't anything to be scared or nervous about. She does have a real calm about her when talking about it. And her husband is very supportive. I'll be meeting him Friday to really see.<br><br>
As for the previous birth. It was a classic case of started out for a natural birth, ended up with pitocin and an epi, pushed and pushed, vac assistance, unable to get him out. Csection. From my understanding it was more about the babies position. He was average size, and the Drs have never mentioned anything to her about her pelvis. So, based on that.... I'm bring a lot of info for her about what she can do to try and get baby lined up, and its good to know her body has dialted completely once before!!<br><br>
I think the request to stay in bed is her Drs. The good news is that she called me last night after her appt and said she met with the female Dr there, and she didn't seem as adamant about staying in bed, told her not to worry. So, it sure would be nice if she were the one there for the birth!!
 

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In my area the request to stay in bed has much more to do with continuous fetal monitoring than it does "staying in bed". Are you sure the doc said she had to stay in bed or he said she would probably be in bed due to monitoring?<br><br>
Around here docs are very strict about it having all the belly bands on, the blood pressure cuff, the IV etc. when Mom is a VBAC. It is quite unfortunate but that is the way it is. All it does is help create more c-sections when women can't move and receive epi's but I'm sure you know that.<br><br>
If that is the case you would need an article for your client to bring to her doc proving continuous monitoring isn't helpful for VBAC. I don't have any articles off the top of my head but I know I've read some, maybe from Simpkin, that claim uterine rupture during Vbac only is a .05% chance. If that is the known risk and your client accepts that risk and still wants to be mobile she needs to tell her doc that and see what he says.<br><br>
Alicia
 

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If they do want her in bed for the idiotic monitoring thing, tell her to ask for a telemetry unit. Both hospitals here have them & I tell all my clients about them in case they decide that monitoring is the way to go.<br><br>
L
 

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I agree she has got to find a way to be able to move around.<br><br>
If I were her I would stay out of the hospital until its time to push. She can do whatever is needed at home to help labor progress. One of the best things my doulas helped me with at my births was really timing it so we were not leaving home until we were already at transition. They helped me identify the signs.<br><br>
I also agree with pps that the "staying in bed" issue is about all the machines that go "beep" being strapped on her. It may be very hard to avoid some of that equipment if it is required for VBAC patients by hospital policy (although technically/legally she can refuse to consent to any interventions and sign a waiver or form that says she's doing so at her own risk). But even if she consents to the CFM/IV/blood pressure stuff, she should absolutely call ahead or take the hospital tour to ask for what the nurses can do to allow her to move even with all the equipment. I've heard of IV's being put on rollers, IV's being taped up to allow women to go in showers, portable monitors being used, monitoring every 20 minutes rather than continuous, etc. If she pushes hopefully she can get some of these workarounds.
 

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Forcing laboring women to stay in bed is so barbaric. I'm so sorry you're dealing with this. He has to be concerned (unnecessarily) about monitoring. I've seen nurses hold on monitors for women who want to be on the ball or standing. Of course this requires either a dedicated nurse or a nurse who's willing to show you how to hold it on. OTOH she could just refuse continuous monitoring all together.
 
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