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32 weeks pregnant, VBAC candidate.. so many restrictions... UPDATE! post 1


Forum: VBAC: Vaginal Birth After a Caesarean

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  #1  
April 25th, 2011, 04:35 PM
MamaRN's Avatar Platinum Supermommy
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UPDATE!

So I called a local free standing (but associated with the hospital across the street) birth center a friend used almost 2 years ago with a good experience, and I spoke to a very nice midwife for awhile this morning. While I am not a candidate to deliver at the birthing center itself, I am a candidate for a VBAC at the hospital itself (across the street) attended by the midwife, and although they do monitor a little more closely there, I will be allowed to be on telemetry ( a portable unit you can put in your pocket) to move around the entire labor, with periods of taking it off so I can use the tub. Going post dates are not a problem for the midwives as long as baby is OK and I am too, so no arbitrary CUT date at 40 1/2 or even 41 weeks if I still haven't gone and things look OK. Births attended at this hospital by midwives have an 80% success rate with VBACs vs. something like 30% at my hospital. The midwives are very supportive of VBACs and do all they can to help mamas get them.

I got copies of my records today from my practice and have an appt. with the midwife on Monday at 4 pm to review the records, be assessed and discuss things more, but the midwife I spoke to today said it sounds like I am a good fit for their practice and are looking forward to meeting me.

I still haven't heard back from the homebirth midwife I emailed last night but in all honestly this seems like a more practical option for me anyway.

************************************************** **************


Hi Ladies,

So I am 35 years old and pregnant with my 2nd baby. I had a miscarriage last June due to an SCH (subchorionic hemorrhage) and I had one early with this pregnancy but it has been resolved for some time.

My daughter will be 2 years old on June 25th and I am due June 20th with a boy. With my DD, I had pregnancy induced hypertension which started at 28 weeks, and turned into Pre-eclampsia at 36 weeks. I was induced at 36w5d and after 26 hours of labor and every intervention possible I ended up with a crash c-section. The cord was around my DD's neck 3 times and her heart rate dropped. At that point I had an IV with pitocin, a foley catheter, an epidural (which did nothing for pain control but paralyzed me from moving) an internal fetal scalp monitor, an oxygen mask.... I felt so out of control, and it was everything I didn't want, but in the end I just wanted a healthy baby and we did, thankfully, get her. (after 5 days in the NICU and 5 on the regular PP unit.)

This pregnancy started out rocky with the SCH and my previous loss from it, and later a placenta previa which also resolved, but now seems to be going smoothly. My blood pressure looks good, baby is head down, I'm not anemic, amniotic fluid levels are good, no gestational diabetes... etc.

I have been given the green light to try for a VBAC IF my blood pressure stays good, baby looks good, I don't go past 41 weeks, amniotic fluid and placenta look OK, etc. Alot of IF's.

However, I had my 32 week appt at my OB today and we have been discussing a VBAC ( I see a few different OB's and a midwife at a large practice, whomever is on call is who delivers.) While he is on board with me trying for a VBAC, he said I have to be on continuous fetal monitoring (even though studies have shown repeatedly there is NO difference in fetal outcomes with CFM). The hospital has telemetry monitors and he said in early labor if they can get a good reading I can use one to move around. I called the hospital and they said their tele units can go in the tub also. (I'd like to be able to move around in labor and use the tub). However, once I am in active labor they want me on the monitor next to the bed which will limit my mobility and keep me out of the tub.

The nurse I spoke to at the hospital was very nice, she said it really depends on what provider is on when I go into labor as to how relaxed they will be, if they will let me get in the tub and walk around.

My OB wants me to call right away if I think I am in labor, or if my water breaks as they 'need to watch VBAC patients more closely'. I would like to wait as long as possible at home so I can use my awesome tub, eat and drink, and move around.

I just feel like with all the restrictions (you also can't eat in labor but can drink at the hospital) that I will end up with another section, and I really don't want one. There is one other hospital I could go to locally but my sister had her baby there in January and their practice has a similar attitude towards VBAC.... 'allowed' under certain conditions but not encouraged and they put the fear of God into her and she ended up choosing a repeat c-section.

DH and I have discussed it and he is comfortable with us being at home as long as possible. I did a little research today and there are homebirth MW's in my area but I don't know if I am a candidate with my history, and it is so late in the game I don't know if they could even fit me in if I were, and DH isn't really comfortable with the idea, but isn't 100% opposed (he said he's 98% opposed, LOL).

I guess I'm just looking for thoughts or advice.

If you've gotten this far, bless you
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Last edited by MamaRN; April 26th, 2011 at 05:47 PM.
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  #2  
April 25th, 2011, 06:30 PM
NutMeg76's Avatar Platinum Supermommy
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You live in a metropolitan area and only have 2 choices of OBs? Or are those the only two you know about?

I would find about about the attending physicians at the hospital. What are THEIR views on VBAC. If it is promising, you can always 'fire' your doc that is on-call when you go into labor if you don't like what they are doing.

Have you joined the ICAN group on Yahoo groups? If not you should, they will have resources for you in your area.

I would be very nervous about giving birth with doctors like that.
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  #3  
April 25th, 2011, 08:12 PM
queenofthecastle's Avatar Platinum Supermommy
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What about a free standing birth center?? You would have a hospital-like feel but the freedom of a home birth.

I noticed that you were from Boston, so I did a google search for you and found one for you. I don't know about Bostons stand on VBAC's in a birth center but that might give you a starting point.

Definitely check out ICAN. Our chapter has been SO helpful with my pursuit of a VBAC!!

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  #4  
April 25th, 2011, 09:23 PM
Christy72's Avatar Birth doula mommy of 4
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I would find a new care provider and to be honest homebirth would not be out of the question. I had a CNM who would let me home birth with pregnancy induced hypertension and GD and I was a VBA3C. My surgical records ultimately risked me out, but just because you had pre-e before doesn't mean you will this time. At this point in your pg there is nothing wrong with you. You and baby are healthy. Look for a more caring and supportive care provider. Join ICAN, they can help you.
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  #5  
April 26th, 2011, 05:20 PM
WhoaMomma!'s Avatar Danielle
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If all else fails: repeat after me "no thank you I will not be doing that". Ultimately they can't force you to do anything you don't want to do. And definitely look into hiring a doula. I'm sure my hospital is going to insist on CEFM and they do have the telemetry ones that go in the tub but I wore them for my induction and they were AWFUL. I will not do that again and I know theyre not going to like it but that's too bad. The key is to not be upset. Don't yell or whine or plead. Just say very matter of factly "no thank you I will not be doing that" and then tune out their scare tactics and sign their waiver. But yeah IF you can find a more supportive provider that'd be the best option.
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  #6  
April 28th, 2011, 11:45 AM
NutMeg76's Avatar Platinum Supermommy
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Yay! That is an awesome update! Way to go taking your health care into your own hands and going for what you know is right. Good thing the doctors played their hands early so you knew when to bail on them!
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  #7  
April 28th, 2011, 11:51 AM
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Just keep in mind that while a hospital birth may be more "practical" it does put more stress on you than being at home with a midwife. Even with the most supportive midwife in a hospital there are policies that have to be followed. At home you are free to do what you want when you want to do it.
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  #8  
April 28th, 2011, 06:58 PM
queenofthecastle's Avatar Platinum Supermommy
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I'm SO happy that your getting a opportunity on a VBAC!!! GL and please KUP about the birth. Feel free to ask more questions!!
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  #9  
April 29th, 2011, 02:42 PM
MamaRN's Avatar Platinum Supermommy
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Quote:
Originally Posted by kruff79 View Post
Just keep in mind that while a hospital birth may be more "practical" it does put more stress on you than being at home with a midwife. Even with the most supportive midwife in a hospital there are policies that have to be followed. At home you are free to do what you want when you want to do it.
Yes, I know, but my husband isn't really comfortable with the idea, and the homebirth MW I emailed never got back to me. I'm really more comfortable with not doing a home birth too. I would have preferred a free standing birth center birth, but am OK with a hospital birth that is supportive of a VBAC, and I have the right to refuse any hospital procedures if I choose.
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  #10  
April 30th, 2011, 10:49 AM
NutMeg76's Avatar Platinum Supermommy
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A VBAC in the hospital can be great. I had 4, two were good, one was really junky because I didn't have a supportive provider and one was full of interventions because I didn't know better.

My best was the one I had with midwives, of course there was no monitoring for that one, but I do know they were very open to finding ways to get me off the monitors and would not have used any interventions other than the required monitoring occasionally. They are home birth midwives mostly and do VBACs in the hospital because of state law.

That said, if I get pregnant again, I will birth at home with a traveling midwife. I don't think there are any midwives here that are like the ones I had in NJ, so it is my only choice. Unless there are complications I won't go back to an OB. Hospital yes, OB no.
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