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-   -   32 weeks pregnant, VBAC candidate.. so many restrictions. UPDATE! post 1 (http://www.justmommies.com/forums/f341-home-birth/2311981-32-weeks-pregnant-vbac-candidate-so-many-restrictions-update-post-1-a.html)

MamaRN April 25th, 2011 05:09 PM

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

So I called a local birthing center run by midwives that a friend had her son at almost 2 years ago, 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 (portable unit that 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!

MamaRN April 25th, 2011 05:32 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions... HELP!
 
ETA: I just emailed a homebirth midwife in my area and explained my situation and asked what her thoughts are.

Eeeek!:sneak::eek:

Sk8ermaiden April 25th, 2011 05:36 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions... HELP!
 
Oh Kim, I am sorry to see you facing this problem. I wish our hospitals were more evidence based!!!

All I can say is that all you can do is try. I don't think your history would keep you from a homebirth, but there is a good chance the midwives will be booked. It NEVER hurts to ask.

Another option that might be good for you is a monitrice. If you can get a doula who can also do cervical checks and monitor heart tones and blood pressure, then you could labor at home until the last minute and then head in. Sometimes you can even get an apprentice midwife for that.

Are you on your local ICAN list? They would be your BEST source of info for the options in your area.

Also, I know this is homebirth-oriented, but you might want to post it in the NCB board too - most of the homebirthers hang out there too and it is quite a bit more active than this board.

I hope you find an option that gives you confidence and peace and also that you have the best birth possible, regardless of where it happens.

Oh, and EEk!!! I will wait anxiously to hear what you hear back!

beckiethedoula April 25th, 2011 07:43 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions... HELP!
 
I really hope you can get your VBAC!

I second the idea of finding a monitrice or apprentice midwife to doula for you and laboring at home as long as possible!

And if you're really aiming to birth at home I hope you find a midwife who will help you get it! (And I hope your husband would come around!)

Good luck! I'll be thinking good things for you!

MamaRN April 25th, 2011 08:30 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions... HELP!
 
Thanks Ladies!

So is a monitrice an apprentice MW? Hmmm, where do I find one?

I am not in my 'local chapter' of ICAN, there actually isn't one super close to me (I looked them up today). There is one about 2 hours from me and one I think an hour or so from me, and there's an email contact for the group leader. Is that how I get involved in the group?

I was thinking the midwife would probably be booked up, even if I was a candidate. And, I am not sure what the out of pocket cost would be but given DH's reluctance to consider it anyway I know that a large out of pocket cost would be enough to deter him completely. But he repeated again tonight that he is supportive of us being at home as long as we can before heading to the hospital.

I'm not 100% set on a homebirth, honestly. It is something that has always interested me, but practically I am not sure it will work, I have a small 1 story house and DD has NEVER spent a night away from home without us and that would stress me to no end to send her to MIL or my moms (both houses are not toddler proof and actually dangerous and I am not comfortable with her being there without me or DH) but alternately because there is no where for me to get away and birth where she won't hear me and be affected, (our 1 and only bathroom shares a wall with her crib) I don't want her to be scared either, and she is too little to understand (will just be turning 2 at the time I am due).

Basically I just want the CHANCE to have a VBAC, and with the conditions my hospital and OB's are imposing on me, I don't see how it's possible.

I'm looking into a birthing center about a half hour away that a friend used attended by MW's that is across the street from a hospital should anything go wrong, so that is an option, and also looking into seeing if anyone can recommend a good OB at the two major teaching hospitals in town, so I could maybe get a second opinion and see what their VBAC policies are too.

I'll keep you posted on that and what the home birth midwife says!

Sk8ermaiden April 25th, 2011 08:39 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions... HELP!
 
No, a monitrice OR an apprentice midwife. A full-fledged midwife will not provide that service for you because they are too busy and charge too much. And apprentice midwife often will, and to find one, you would probably want to ask a few midwives if they know any.

A monitrice is a doula who also provides the additional services of cervical checks and fetal heart tones. I think to find one you would want ICAN, or you could possibly email doulas and ask if they know any.

As for ICAN, this looks like the group you want. ICANofEMASS : ICAN of Eastern Massachusetts

They do not look very active. :( Yes, by all means email the leader! She might be a wealth of information (hopefully.)

Most birth centers in the US will not do VBACs, and most of the very few that will require a prior VBAC for you to qualify. :( They might have some good recs for you too though.

I really do think a good doula (monitrice or not) is your best bet. Someone to come to your house and also transition with you to the hospital. Someone who will likely know when you are strongly into active labor and ready to go. Also, if you have a good, experienced doula, they will likely be able to really recommend some OBs to you.

Please keep us (me!) posted on all the developments.

beckiethedoula April 26th, 2011 11:14 AM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions... HELP!
 
I know the birth centers around here "allow" vbac.... so talking to your local birth center is a great idea!

Let us know what the hb midwife says! And good luck again!

Martha83 April 26th, 2011 03:04 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions... HELP!
 
I dont have any extra advice...just wanted to say I'm interested in what the MW has to say as well as the birthing center! :) KEEP US POSTED :)

MamaRN April 26th, 2011 06:21 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions. UPDATE! post 1
 
Thanks everyone! Thank you for all those resources Kellie. :D I posted an update in the first post.:):)

Sk8ermaiden April 26th, 2011 06:25 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions. UPDATE! post 1
 
NP. Just wish I could figure out something as good. My plans are just falling apart. :(

MamaRN April 26th, 2011 06:50 PM

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

Originally Posted by Sk8ermaiden (Post 23745632)
NP. Just wish I could figure out something as good. My plans are just falling apart. :(

Oh no! Are there no other options other than where you delivered your DD? Are you not a candidate to try for HBAC, or is that something you've decided not to do?

Sk8ermaiden April 26th, 2011 07:06 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions. UPDATE! post 1
 
Do you mind if I just point you here? It is long and I am really emotional about it right now and I don't want to take over your thread.

MamaRN April 26th, 2011 07:07 PM

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

Originally Posted by Sk8ermaiden (Post 23746144)
Do you mind if I just point you here? It is long and I am really emotional about it right now and I don't want to take over your thread.

Not not at all. I'll check it out!

sodagirl April 27th, 2011 01:05 AM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions. UPDATE! post 1
 
Sounds like you found a pretty cool solution :D !!!!
And this: VBAC: making a mountain out of a molehill | Midwife Thinking is a good read :)

navywifey2003 April 27th, 2011 12:51 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions. UPDATE! post 1
 
It sounds like you have found a great alternative!

HappyHippy April 27th, 2011 12:57 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions. UPDATE! post 1
 
Hope everything goes well!

Martha83 April 27th, 2011 01:59 PM

Re: 32 weeks pregnant, VBAC candidate.. so many restrictions. UPDATE! post 1
 
YAY...that's a great update...I'm glad there is a middle ground that makes you comfy! YAY...


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