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Are you on a time line for your VBAC?


Forum: VBAC: Vaginal Birth After a Caesarean

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  #1  
September 12th, 2010, 08:05 AM
MamaMandy's Avatar is it Spring yet??
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I'm curious if other VBAC mommas have been given a time line for "acceptable" progression for laboring? Such as, dilating a cm per hour, if your water doesn't break by a certain point they want to rupture it, moving through the stages, etc? My OB's philosophy is that if these things/stages whatever don't happen by a certain point, they aren't going to. I don't believe that. Yeah, sure, there are TYPICAL rates but I think just as every child develops at different rates, they will be born at different rates. I guess this is one of the fundamental beliefs where some doctors and some moms disagree? I'm guessing some of you ladies here feel the same and I am not a wing nut, anyway! Did you agree to a certain timeline, speak out & say no way, or just keep quiet on your plans?

I am feeling pressured, knowing I'm expected to literally perform a miracle on a schedule! I didn't sign anything agreeing that at point XYZ my TOL was over, so my plan is to take it as it comes, listen to my body & mommy instincts, rely on my doula/midwife in training to help me stand up for my rights and flat out REFUSE to let them section me for not fitting the mold. True necessity, of course, but for taking longer?! Ugh. But, I'm staying withthis practice, because the next closest hospital/providers are 2 1/2 hours away, one way! Makes the hour & 20 mins 1 way trip seem good!VBAC hospitals and providers are slim pickings here in Maine, and we are a very rural, wide spread state- from what I've heard most VBAC mommas home birth because of this state's overall stats. Thank God I have been blessed to find a doula who will help me through this, at no cost, because other than that I don't have a support person.
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  #2  
September 12th, 2010, 08:40 AM
Angel.Eyes4351's Avatar Mega Super Mommy
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No, my doctor hasn't given me any of these stipulations, but maybe I should ask specifically. But he has been very supportive so far for my natural, VBAC. But if this was my doc's point of view, I would be doing what you're doing.... trust yourself.... And unless there is some present danger to baby or me, say NO to a section! Sometimes I think they just want to free up the L&D room... ugh.
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  #3  
September 13th, 2010, 06:17 AM
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My Peri. didn't give me any guidelines when I had my VBAC.
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  #4  
September 13th, 2010, 08:42 AM
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I didn't have any stipulations as to a timeline. That actually benefitted me since my whole VBAC labor was 43 hrs. My doc kept coming in once every couple hours to check on me (didn't do cervical checks unless I asked) and to just reassure me that I didn't need a section.

Honestly... I'd just flat out refuse while in labor and make it clear that you're not going to be sectioned unless you have definite proof that something is amiss.
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  #5  
September 13th, 2010, 11:37 AM
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This is what I'm concerned with. I won't meet my delivering OB until I'm in my last trimester due to some insurance issues. I have no idea if they are going to have strict stipulations or not about the VBAC. It's one of my concerns and will probably be a deciding factor for me in choosing the VBAC
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  #6  
September 14th, 2010, 06:39 AM
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I labored for 17hrs with my VBAC baby (induction to birth). My doctor would come and check on me just to make sure baby was still tolerating labor well. The only thing that made him nervous was at the end I started to run a low grade fever but I was already in transission (7cm) so he just watched me closely.

Other than that no restrictions were really given. Overall though my hospital does not want you to go for more than 24hr with your water broken.
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  #7  
September 14th, 2010, 07:59 AM
The Purple Butterfly's Avatar Stacey
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Quote:
Originally Posted by Tiff F. View Post
I didn't have any stipulations as to a timeline. That actually benefitted me since my whole VBAC labor was 43 hrs. My doc kept coming in once every couple hours to check on me (didn't do cervical checks unless I asked) and to just reassure me that I didn't need a section.

Honestly... I'd just flat out refuse while in labor and make it clear that you're not going to be sectioned unless you have definite proof that something is amiss.
Same here. I had PROM at 35w0d. From the time my water broke to the first cervix check was like 20hrs! He wasn't born until 34hrs post PROM. I never felt rushed or that there was any time contraints. I'd be VERY concerned with a dr who does that.
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  #8  
September 14th, 2010, 12:33 PM
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Want to know the very true answer to your question?

99% of OBs have that same timeline in their head, regardless of you being a first-time mom, a VBAC, or BTDT mom. Blame the Irish (I cannot find a source but in the mid-20th century a group of doctors in Ireland are the ones who came up with "You will have your baby in 12 hours with NO PAIN")

Those "guidelines" are the reason many of us end in c/s in the first place (what do you think "Failure to Progress" is really? Failure to dilate 1cm every hour basically).

If you can't change doctors, you can decide when to go in. My labor, start to finish, was 75 hours long with ROM in the first hour. I would have ended in another c/s had I been in any hospital but luckily I went in at 9cm.
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  #9  
September 15th, 2010, 11:41 AM
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I'm wondering if my doc will agree to let me try a VBAC with our next baby.

With my son, my water broke at 7am, I labored for...14 hours (had the epi put in about half way through). We decided on a section because baby was in distress, I wasn't dilating, and baby wasn't dropping. When baby boy was born, his cord was in a knot (hence why he wasn't dropping and I wasn't dilating).

I wonder now what my odds are of being able to deliver naturally...what the odds are that a second baby would be born with their cord in a knot. KWIM?
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  #10  
September 15th, 2010, 02:49 PM
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I agree that a lot of doctors have a timeline they seem to go with whether they tell you about it or not. With my last pregnancy my water broke at 5am. I got to the hospital at 7am. The computer showed small contractions, but I wasn't feeling them. At 9am a nurse came in and told me she was starting me on pitocin (she told me as she put it in my iv... I would have objected/postponed if she would have asked or given me time to process before just putting it in). I thought it was rushed and ridiculous to give me pitocin after "not making progress" after 2 hours at the hospital. Like 30 minutes before that the nurse had just said that my contractions on the monitor looked like they were picking up although I still wasn't feeling them. The doctor hadn't even come in to see me yet.

Anyways, I wouldn't be surprised if the doctors I see this time have a time line I don't know about too. They have given me a time line of have the baby out by 40 weeks or c-section which I plan to fight for 41 weeks if needed.(I went to 40 weeks 5 days last time.) If I think baby is in position and everything seems good and I actually do go into labor on my own, I plan to stay home as long as I feel is safe. Like you said, stick with your instincts! Mommy knows best! Good luck!
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  #11  
September 15th, 2010, 06:50 PM
ImustBeNuts06's Avatar Platinum Supermommy
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I'm not sure. I haven't asked that specific question. Actually, I had to ask if there were rules about continuous monitoring (there are ) at my last appointment. I see my OB on Monday, I guess I should ask her about this....also if there is any other guidelines the hospital has put into place. BTW, the monitoring rule was the hospitals...not my OBs/midwife.

As of right now, my plan is to stay home as long as I feel safe and head to the hospital when contractions are close. That way I'm not stuck on the dreaded monitors during my entire labor and I will be free to move around at home.
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  #12  
September 18th, 2010, 12:26 PM
MamaMandy's Avatar is it Spring yet??
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Wow! Thanks for all the replies!

Nicole - Do they have wireless monitoring? My OB said not all hospitals advertise they have "mobile monitoring", but even the dinky rural one I'm delivering at has wireless and even waterproof tub birthing monitoring options. Worth asking, anyway! I was told to come in as soon as my water breaks (but I will prob. wait a bit & see if things kick in) or when the contractions are *steadily* around 5-6 minutes apart, and that's with an hour & 20minute drive. I think I will be ready to at least get to the right town by that point!

From the sounds of things, I guess I should be feeling lucky the doctors were
upfront about this arbitrary time line? If most docs do feel this way, that is. I met with the female DO at the practice last week & let her know I felt pressured to perform on demand! She did say that they look at the overall big picture, and it wasn't necessarily set in stone on a stop watch, but they do limit VBAC moms because every contraction stresses the uterine scar & they just do not feel safe with prolonged contracting that's not progressing. which, I do understand, even if I don't like it! I DID like hearing they only do episiotemies if there's a true blue emergency- as in NONE performed by ANY of their docs in the last year.
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Raising my kids with boundaries - NOT battle lines.

Children are not little adults, but they ARE people too!

There's a reason they are called dependents...

AP is not alternative to those who see no other choice

http://helpguide.org/mental/parentin...t_disorder.htm



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  #13  
September 18th, 2010, 03:05 PM
SugarNSpice's Avatar VBAC Mommy!!!
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I think any doctor that would put that kind of timeline on you is just setting you up for failure. Every mother and every labor is different and it is absolutely ridiculous to think that every mother should dilate 1cm an hour to be considered "normal". That is ludicrous!!!

I saw a midwife with my VBAC baby in 2007 and when I went into labor, I got to the hospital at 6cm dilated and I did not deliver until 8 hours later. It took me 8 hours to dilate those last 4 cm. But my midwife was totally unconcerned. Now, had that been an OB, he would have insisted on doing something to speed up my labor, which is flat out ridiculous when all I needed was time. In the end I had a beautiful birth and pushing was a peice of cake because my body was allowed to do things in it's own time.

I would run for the hills and find someone new if my OB/midwife/whatever EVER told me I would be on such a timeline. It's stupid and ridiculous.
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  #14  
September 20th, 2010, 12:28 PM
Jaci's Avatar I AM a Doula :)
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I'm very positive I saved a first time mom from the chopping block today by educating her on the "real" risks involved with a spontaneous ROM and infection. Because she knew the truth, she waited to go into the hospital for 10 hours and when she got there the pressure to get on Pit began immediately but she waited and waited. Finally she was having some contractions and progressing slightly when she agreed to a low dose Pit intervention (18 hours after ROM). It did what it needed to do and just a few hours later she pushed that baby out.

Guys, this all happened after her doctor said "Oh yeah, there is no timeline for your water breaking to delivery, NO PROBLEM." The same doctor bullied and pressured her the entire time (through the nurse, because the doctor didn't show up until 8 hours later) about getting on Pit. The doctor even called my client on the phone to yell at them. When she arrived she was fuming, assaulted my client on the table with an incredibly rough cervix check, yelled at her that she was going to write AMA all over my clients file, and left, never to return.
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  #15  
September 20th, 2010, 03:42 PM
~Lindsay~'s Avatar Platinum Supermommy
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If I remember right, I have to be continuously monitored. Also she wont let me VBAC at all if I develop pre-eclampsia again, and she will not induce me for any reason. If I make it to 40 weeks, we will schedule a c-section for 41 weeks. I am ok with all of this.
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  #16  
September 21st, 2010, 01:09 AM
ImustBeNuts06's Avatar Platinum Supermommy
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I asked my OB today and she said no time restraint. I told her my plans to wait until I am closely contracting. She said that was fine, to treat it like I would my other labors. She did tell me that the risk of rupture is greatest right before delivery....like when the contrax are one on top of each other. She still acted like everything was cool though, and did tell me that the risk was so minor. Out of all my OBs she is the one that seems the most "modern" about her beliefs. Meaning, she seems like the one that out of all of them would be opposed to vbac. Also, she was the one that did my c-section (it was a true emergency). However, she was totally cool and said I was a perfect candidate.

Mandy...I have asked twice about the continuous monitoring, but keep forgetting to ask if they offer portable monitors. Duh! My aunt is a labor and delivery nurse at the hospital, so I will have to ask her. The hospital is pretty modern and very up to date with technology, although they do not even have birthing tubs. So who knows?

Jaci...That is absolutely ridiculous that he treated her that way!!! OMG, I am appalled!!! I am glad you were able to share your knowledge and help her out!
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  #17  
September 24th, 2010, 05:17 AM
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Nope no time line here. I wouldn't allow them anyway. I get so frustrated when OB's try and tell women that they can have their VBAC if A. They are not overdue, and B. They go into labor naturally and C. Labor progresses at a perfect pace for the Doc.
IMO, they are just setting women up for a c/s.
I'll go overdue, my labor will progress on its own, and they will not come near me with a 10 foot pole with Pitocin, and they will not rupture my water unless I say.
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  #18  
September 27th, 2010, 04:23 PM
MamaMandy's Avatar is it Spring yet??
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Quote:
Originally Posted by Heather30 View Post
Nope no time line here. I wouldn't allow them anyway. I get so frustrated when OB's try and tell women that they can have their VBAC if A. They are not overdue, and B. They go into labor naturally and C. Labor progresses at a perfect pace for the Doc.
IMO, they are just setting women up for a c/s.
I'll go overdue, my labor will progress on its own, and they will not come near me with a 10 foot pole with Pitocin, and they will not rupture my water unless I say.
Ditto! I will not let them force me into anything. I understand why they have these guidelines in place, but my baby and I are not text books or statistics and just may not fit the mold. If they are so willing to say some babies are breech because that's what's natural for the uterus shape and sometimes nature shouldn't be interfered with by doing a version (resulting in a very unnatural c/s) then I guess they'll understand the every birth progresses differently concept! Write AMA all over my chart, label me a problem patient, whatever. Unless my baby or I are in danger, let my body do it's thing.
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There's a reason they are called dependents...

AP is not alternative to those who see no other choice

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  #19  
September 29th, 2010, 05:57 AM
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Because of when/how I developed pre-e with my first pregnancy, my OB wants to break my water by around 39 weeks if my body is showing signs of being ready for labor. With DD I was 3 cm and fully effaced for 3.5 weeks but I never progressed from there (I had a bad care provider then who didn't even catch my pre-e).

I'm guessing there is a 24-hour rule so if the baby isn't born within that time or there are other complications I'm guessing we will go for a section. I can't have any induction drugs at all and I have to have EFM the whole time. If I develop pre-e again I think I will just go for the section. I don't think my body can handle labor with my blood pressure really high.
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  #20  
October 3rd, 2010, 07:53 PM
NutMeg76's Avatar Platinum Supermommy
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Quote:
Originally Posted by Jaci View Post

99% of OBs have that same timeline in their head, regardless of you being a first-time mom, a VBAC, or BTDT mom. Blame the Irish (I cannot find a source but in the mid-20th century a group of doctors in Ireland are the ones who came up with "You will have your baby in 12 hours with NO PAIN")

Those "guidelines" are the reason many of us end in c/s in the first place (what do you think "Failure to Progress" is really? Failure to dilate 1cm every hour basically).

.
The unfortunate part of those guidelines is that those women in the Irish study had a woman with them trained in natural child birth, basically a doula. They did not have a million interventions and they were allowed to progress naturally. Because of the excellent support they had, they experienced less tress and didn't have all those hormones messing with the birthing process.

So the docs now use those guidelines for the 1 cm an hour, but DON"T follow the rest with proper labor support and keeping stress to a minimum.
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