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-   -   Help me decide? (http://www.justmommies.com/forums/f501-vbac-vaginal-birth-after-caesarean/2685857-help-me-decide.html)

SkyBaby October 14th, 2013 09:14 PM

Help me decide?
 
He is sort of "supportive" of my attempting a vbac, in the sense that he is at least willing to let me try again. This is where he started to confuse me a little. I was just in to see him today for a regular prenatal and I just wanted to fact check what he was telling me. He was telling me that between 24 and 28 weeks, the csection is generally scheduled if that's the birth the mother chooses, so my next appointment, 4 weeks from today, I have to make a decision one way or the other on my next appointment.

He was telling me how 39 weeks is typically kind of the "sweet spot" health wise because he thinks the risk of uterine rupture and other complications increases in general if the mom doesn't have her scheduled csection until 40 weeks, as in right on the due date. He continued to say how much safer it is to have the scheduled csection at 39 weeks instead of waiting the full 40 weeks.

My feelings on this are pretty much I feel like 39 weeks is kind of jumping the gun. I kind of feel 40 would be the better option for me, psychologically especially. I feel like waiting would give me the best odds at having my vbac. What if I go into labor naturally at 39 weeks 4 days or something?

I was starting to get really nervous talking about it during the appointment and was very relieved when my OB told me after seeing me get the deer in headlights look that I didn't need to make a decision right then.

I could also see with all of the OB's talk of csection at 39 weeks being the "safest option" that he was starting to sway DH, too. I was too nervous to bring it up on the 45 minute drive home so we haven't talked yet, but I know what he's going to say. He is very medically oriented, given his own medical background and sees birth as a medical thing in general and not as a natural process. He is supportive of me laboring on my own first if I do go into labor after I showed him the amount of risk we're dealing with. He wasn't at first, but the data changed his mind.

What are your thoughts on this? I've read all the stickied articles and studies and data on this board, and I'll admit what my OB was saying did seem to be consistent with what I had read, but I'm not sure if he was trying to word it so I would just choose the csection or if he was being entirely honest.

If you read through my jumbled thoughts, God bless you, but if you want to skip all all that, my point is, suck it up and schedule the csection at 39 weeks and just hope I go into labor naturally a little before then, or give my body and my baby a little more time and schedule at my due date at 40 weeks? Is there really an increased risk of rupture and other complications if I choose to wait to the full 40 weeks?

HorseGal October 14th, 2013 10:49 PM

Re: Help me decide?
 
I'm a hopeful VBAC this time as well. I can tell you from what I have learned that there is only a 1% chance of you rupturing. Especially if you have a low transverse cut "bikini cut", which is usually whats done now and what I had done.

Here is what the class I took at my hospital told me.

If your c-sec was due to "less likely repeatable" reason, where it wasn't due to having small hips or failing to progress etc. Then your chances for a successful VBAC are high. My hospital has an 80% success rate. They told me they treat patients like any other mom except VBACs are required to have continious monitoring, must have an IV line put in and should come in earlier and labor longer in the hospital. All just to be on the safe side. From what it sounds like, they reason for the extra measures is because if you do rupture, it's likely to be a large one. But it is still very very rare.

So your decision should be based on what YOU feel comfortable with. It sounds like your DR is pro c-section, but that doesn't mean you have to be.

Memi October 16th, 2013 07:12 AM

Re: Help me decide?
 
To be brutally honest it doesn't sound like he's supportive of your VBAC at all. It sounds like he's already switching bait and trying to get you to schedule an unnecessary early c-section. Even having a c-section scheduled for your exact due date is bogus to me coming from a "supportive" OB on this topic. Your body has got to have the freedom to do its thing! If it were me I would continue to push back, stand your ground and fight for your VBAC. Truthfully I'd also demand that he be on my side and readdress what it is YOU want in this birth experience. If you're not high risk and baby is fine thent here is no reason for him to be talking about how risky a VBAC is to you when he initially said he was on board. No factors have changed in the game so he needs to get back on board.

This was my *biggest* fear when looking for a Dr. to do my VBAC - that I'd find one that said oh yea, no problem...but towards the end or even on my delivery day they'd completely switch their tune and push me into an unnecessary c-section again anyways. My son was born 3 days after his EDD and I had a 100% natural, safe and successful VBAC. What if my providers had pushed me into a c-section on my exact due date? Then I would have been robbed of that experience I wanted so badly! Consider the factors and fight for what you want as long as YOU are comfortable with it!

SkyBaby October 16th, 2013 09:03 AM

Re: Help me decide?
 
Quote:

Originally Posted by HorseGal (Post 27728204)
I'm a hopeful VBAC this time as well. I can tell you from what I have learned that there is only a 1% chance of you rupturing. Especially if you have a low transverse cut "bikini cut", which is usually whats done now and what I had done.

Here is what the class I took at my hospital told me.

If your c-sec was due to "less likely repeatable" reason, where it wasn't due to having small hips or failing to progress etc. Then your chances for a successful VBAC are high. My hospital has an 80% success rate. They told me they treat patients like any other mom except VBACs are required to have continious monitoring, must have an IV line put in and should come in earlier and labor longer in the hospital. All just to be on the safe side. From what it sounds like, they reason for the extra measures is because if you do rupture, it's likely to be a large one. But it is still very very rare.

So your decision should be based on what YOU feel comfortable with. It sounds like your DR is pro c-section, but that doesn't mean you have to be.

My OB told me I have a small pelvis, but I don't think so. She was poorly positioned and at 9 pounds. Not huge, but not tiny either. I was also on my back the whole time, both labor and pushing. I think he said officially my reason for a csection is failure to progress, but that's only because I got the epidural. It took me 28 hours to go from nothing to dilated to 4-5 but in the hour and a half I had to wait for the epidural, my body took off and went all the way to 7. To be honest, I did need it to sleep (28 hours of hard work on 2 hours of sleep doesn't help anyone). The epidural stopped my progress and I wasn't having anymore contractions or maybe I was but they were too weak, so "needed" the pitocin. The typical cascade of interventions. My DH says my labor stalled before the epidural, but no I was in pain and dilating right up to that point.

I'm not going in right away. There's no way I could focus enough to get through that being in a hospital. Hospitals are anything but relaxing. I'm going to be in a hotel room near the hospital, within 10 minutes. If all goes well, I wont show up until I'm well into transition. DH is ok with that, too.

My OB left it completely up to me to schedule either at 39 weeks or 40 but that his suggestion was 39 weeks. Because of that, DH is adamant about me scheduling at 39 or 39 and a few days. I really wish DH didn't have a medical background sometimes lol.

Quote:

Originally Posted by Memi (Post 27731316)
To be brutally honest it doesn't sound like he's supportive of your VBAC at all. It sounds like he's already switching bait and trying to get you to schedule an unnecessary early c-section. Even having a c-section scheduled for your exact due date is bogus to me coming from a "supportive" OB on this topic. Your body has got to have the freedom to do its thing! If it were me I would continue to push back, stand your ground and fight for your VBAC. Truthfully I'd also demand that he be on my side and readdress what it is YOU want in this birth experience. If you're not high risk and baby is fine thent here is no reason for him to be talking about how risky a VBAC is to you when he initially said he was on board. No factors have changed in the game so he needs to get back on board.

This was my *biggest* fear when looking for a Dr. to do my VBAC - that I'd find one that said oh yea, no problem...but towards the end or even on my delivery day they'd completely switch their tune and push me into an unnecessary c-section again anyways. My son was born 3 days after his EDD and I had a 100% natural, safe and successful VBAC. What if my providers had pushed me into a c-section on my exact due date? Then I would have been robbed of that experience I wanted so badly! Consider the factors and fight for what you want as long as YOU are comfortable with it!

My OB left it up to me to schedule at all or to decide if I want to do it at 39 weeks or 40 weeks. He fed me the usual garbage of things getting more dangers and blah blah blah. He's not the one I have to really convince though. Trust me, I'd rather not schedule this at all and only have the csection if I need it. He did my csection with DD and his personal thing is he prefers to be the one to deliver his patients, even if he's not the OB on call.

It's my DH that's standing firm on this and he who will be the hardest to convince. I really wish he doesn't have a medical background sometimes. He wants to blindly trust the OB's suggestions and not look at it from any other way. DH told me "All that matters is a healthy baby." None of my other family are supportive of me even trying. They all think both me and the baby are going to die. At least DH is fine with me going into labor and trying again if I am lucky enough to go into labor before the csection. He is adamant about scheduling the csection at 39 weeks and a few days. That's the longest he will "let" me wait. He's the tougher hurdle here.

Memi October 16th, 2013 07:25 PM

Show him the facts. The rates. The hard numbers. How rare uterine rupture is and how much major surgery increases the complication risk for both mom and baby. Then have a conversation that going thru all of that is not medically necessary.

SkyBaby October 17th, 2013 01:43 PM

Re: Help me decide?
 
Quote:

Originally Posted by Memi (Post 27734885)
Show him the facts. The rates. The hard numbers. How rare uterine rupture is and how much major surgery increases the complication risk for both mom and baby. Then have a conversation that going thru all of that is not medically necessary.

I'm going to try that within the next few days. I'm going to compile all the websites I can find with real statistics and show him those. I'm being careful with what I read. I'm not going off of the mom's-sister's-best friend's-cousin stuff. I'm going to show him the real facts. I just hope he gives me the time of day.


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