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Forum: VBAC: Vaginal Birth After a Caesarean

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  #1  
April 25th, 2011, 12:36 PM
WhoaMomma!'s Avatar Danielle
Join Date: Nov 2008
Location: Northern Virginia
Posts: 8,446
Hello ladies!

I've posted here before, but it's been a LONG time, so allow me to introduce myself again. I'm Danielle (28) wife to Billy and Mommy to Claire (20 months). My DH and I are TTC#2 and are hoping for a VBAC after a very traumatic failed induction turned ER CS.

Despite our birth experience, I really love the midwifery practice we used. They only have about 20 c/s a year out of hundreds of births, so we were just really unlucky They have cleared me for a VBAC, and I don't really want to switch. HOWEVER, they only accept VBAC patients if the c/s was performed by their practice or if the mom has had a successful vaginal birth since the c/s (per hospital rules). So because they don't do that many to begin with, they don't get many VBAC patients a year. I think last year they had 9, 7 of which were successful or something like that. I'm just wondering if I should go with a practice with more experience dealing with VBACs or if it's good enough that they obviously handle deliveries well or they wouldn't have so few c/s to begin with? Thoughts?
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  #2  
April 25th, 2011, 12:50 PM
Sk8ermaiden's Avatar Platinum Supermommy
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Location: Houston, TX
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Personally, if I really liked and trusted my provider, that would be a big thing to consider.

I would ask them all the VBAC questions, and see if they give the right answers. No, that is not many VBACs per year, but it is a good success rate.

Why were you induced? Was it because of something that is likely to occur again?
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  #3  
April 25th, 2011, 01:31 PM
NutMeg76's Avatar Platinum Supermommy
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  #4  
April 25th, 2011, 01:59 PM
WhoaMomma!'s Avatar Danielle
Join Date: Nov 2008
Location: Northern Virginia
Posts: 8,446
The hospital does not allow midwives to attend births after 42 weeks so the practice routinely induces patients at 41w4d if they haven't gone into labor before then. They leave a cushion so that if it doesnt work they have time to try other things before hitting the deadline. I was a first timer and didn't know any better. This time I will be giving an LMP that is 7 days before conception. That way I will be left alone until 43 weeks. They won't induce again but I would be offered a c/s or transferred to OB care at that point.

Forgive me if this is stickied somewhere, but what are the questions I should ask?
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  #5  
April 25th, 2011, 02:22 PM
Sk8ermaiden's Avatar Platinum Supermommy
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Location: Houston, TX
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Oh gosh, I don't think we have a sticky. Some I can think of are:

What is your VBAC success rate? (Obviously you know this.)
Do VBAC patients have to follow extra rules? (ie, IV, heplock, continuous or internal monitoring) Or the more telling way to phrase it would be, "How is a VBAC birth treated differently than a non-VBAC birth."
Would you ever induce a VBAC? How?

I am not sure, I hope others have more!

The LMP thing sounds good unless they want you to have an early scan, or you start measuring ahead.

Do you know what OB they would transfer you to? It might be worth interviewing him too, just in case you are referred to him.
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  #6  
April 25th, 2011, 03:10 PM
WhoaMomma!'s Avatar Danielle
Join Date: Nov 2008
Location: Northern Virginia
Posts: 8,446
I already know they will not use pitocin or prostaglandins on a VBAC patient. I do know the OB practice but there are 6 docs there. I guess since I know their standard procedures I should just ask the "how is it different" question.

Also the practice doesn't believe in dating u/s or growth u/s. I'm under the impression that the midwives want me to have the best possible chance. They just also have to follow hospital rules.
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  #7  
April 25th, 2011, 04:24 PM
Sk8ermaiden's Avatar Platinum Supermommy
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Location: Houston, TX
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Definitely. It really sounds like you have a supportive group there. I would ask about policies. I would also ask them their honest opinion of your VBAC chances if you get transferred to the OB group. There is always the chance that you go late or something risks you out of midwifery care, and it will be good to know if the OBs will give you the best possible shot too.

The "measuring ahead" thing wasn't about growth U/Ss, but about fundal height or at your anatomy scan. I think you have to be measuring 4 weeks ahead before a midwife will generally order an ultrasound to check? So that will cut you down to 3. Also, if you get the anatomy scan, I think I have heard that if it is more than a week off your due date, they will often change your due date. But even with these things, I think your plan is a good one - and one I plan to use too with my backup doctor!
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  #8  
April 26th, 2011, 08:30 AM
*Candi*'s Avatar Candi
Join Date: Jan 2009
Location: Ontario Canada
Posts: 8,645
I'm kind of in the same boat Danielle... i have to switch midwives because the hospital they use is over an hour away, but there are local midwives who practice at the hospital thats only 5 mins away. So I need to figure out all the same things.

Maybe we will get lucky and can be VBAC buddies
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  #9  
April 27th, 2011, 06:49 AM
*~Ginny~*'s Avatar RN - Student CNM :)
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Location: Virginia
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I didn't have anything to add because Sk8terMaiden has done a good job answering your questions. Good luck, Danielle. (and Candi, and me for that matter )
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