Help me get my VBAC

[Laranna]

Well, it's still early days yet but I have my first OB appt on Wednesday and I need your help to be prepared to convince the OB that I WILL BE having a VBAC.

I had a c/s with DS due to placenta praevia, but I did go into labour naturally with my waters breaking at 36+6. Fingers crossed this time, the placenta is putting itself in a nicer position for us Bubs is due mid-Jan so there will be 20 months between the two births.

What sort of info can I arm myself with to convince my OB that I'll be having a VBAC?

This is the first OB I'm seeing. I also have another appt the week after with a different one JIC this one is not agreeable

[Sequoia]

Who are your OB appts with Laranna?

[Arimeh]

Grab a copy of silent knife. Thats the best info you will get.

And of course, don't forget there is more risk of rupture with a first time mother being induced than a mother going for a VBAC - yet they do that every day

[Laranna]

Sequoia, I'm seeing Dr Charles Armstrong on Wednesday and Dr Vincent Lee the following week. Both deliver at Mercy Hospital.

Thanks Arimeh. Will definitely get a copy.

[Tobily]

Well, it's still early days yet but I have my first OB appt on Wednesday and I need your help to be prepared to convince the OB that I WILL BE having a VBAC.

I'm going to be blunt and I hope you don't mind If you have to convince your caregiver - OB or midwife - that you're having a VBAC you are with the wrong caregiver.

You need to find someone who already believes that vbac is a safer option all things being equal than another caesarean.

If you go with someone that has to be talked into it, the odds are very high that you'll have the rug pulled from under you late in pregnancy or in labour - because you are going to have an already jittery caregiver who doesn't wholeheartedly believe that vbac is safe.

It happens to women all the time - if you want this vbac, you have to seek out people who will fully 100% support you. Not because you've convinced or coerced them into it, but because they already believed before you even walked through their door that VBAC's are ok.

Good luck.

[Arimeh]

I have to say that I totally agree with Tobily.

My OB believes anyone should be given the chance for a VBAC, so I don't have to convince her that I should be allowed to - she just asked which way I was going this time - no more said about it after that.

[Laranna]

Tobily, that's exactly why I have a couple of appointments with different OB's. I have no idea yet what their thoughts are on VBACs which is why I booked in with a couple to start off with.

I would have loved to gone back to my OB I had with DS. She said next time I would have a VBAC. But, she is not taking patients at the moment as she is on a break.

[Ryatha]

I agree with the others about finding an ob who will support you without the need to be convinced. I changed from an Ob to a midwifry program when I was 19 weeks as I realised that even though my ob supported me, the hospital didn't and would make it hard to accomodate my wishes during labour. In fact my new midwife finds me information that will be useful for my VBAC and is encouraging me to do everything I can to ensure my body, baby and mind are ready to go in a few weeks.

Goodluck finding the right caregiver!

[Jennifer13]

Laranna, as your preferred ob is not available, why don't you call her or her office and ask who she is referring patients to instead?

When I wanted to get in to a particular ob a good friend of mine had used (and had confidence in their natural birthing philosophy since my gf naturally delivered twins with him), he was no longer taking ob patients. The receptionist gave me who she and the ob recommended seeing as an alternative over the phone (and also told me there were a couple delivering at my hospital she would avoid, although she didn't name names).

[Laranna]

Thanks Jennifer, have done that and the appts I have so far are with the two they recommended.

[BeautifulMadness]

Couldnt agree more. You shouldnt have to convince ur OB for a VBAC. They should ask you what you are aiming for. When i had my 1st OB appt the frist thing he asked me was are u going for a natural or a c/s again. Everyone i had believed in me having a successful VBAC.

I'm going to be blunt and I hope you don't mind If you have to convince your caregiver - OB or midwife - that you're having a VBAC you are with the wrong caregiver.

You need to find someone who already believes that vbac is a safer option all things being equal than another caesarean.

If you go with someone that has to be talked into it, the odds are very high that you'll have the rug pulled from under you late in pregnancy or in labour - because you are going to have an already jittery caregiver who doesn't wholeheartedly believe that vbac is safe.

It happens to women all the time - if you want this vbac, you have to seek out people who will fully 100% support you. Not because you've convinced or coerced them into it, but because they already believed before you even walked through their door that VBAC's are ok.

Good luck.

[Fleur]

Laranna I am guessing you have had your Ob appts by now - how did you go?

I am hoping to VBAC next month. My GP made an offhand comment at one of my first appts when I told him DS2 had been CS - ' Oh, you'll probably need one this time too...' I don't know whether I was more annoyed that he had said that, or that he obviously didn't know what he was talking about!
Thankfully the hospital were much more supportive (I go to my GP to get my BP etc checked & that is IT - any birthing questions go to the mids!)
However due to his ill-considered remark I was prepared for a fight... I read everything I could get my hands on, and learnt a few numbers, stats etc... I had my mind set that I could do it, I wanted to do it, and I knew why.. I was so ready to argue for it..and then i never needed to

There are fantastic articles on here, and I would recommend reading just about anything relating to labour & birth -(I cleaned out the library!) it doesn't necessarily have to relate to a VBAC to be useful to you. This time around I know more than I ever did before & I find it a really empowering feeling.

Good Luck!

[Laranna]

jasp, thanks, the appt went well and my OB is happy for me to have a vbac although as my dates have changed slightly, he is going to be on leave and being xmas/new year time, he does not know who his back up will be at the time and therefore can not guarantee that that ob will support a vbac....he suggested I see another ob but is happy to have me as a patient if I get stuck, so will just see how it all goes. I'm seeing another ob next week.

I guess I was just after some info to go in as informed as I possibly could be rather than have no argument ready should I needed one. If I had come across an ob who was anti-vbac I would not have continued any appts with them and would look for someone else.

I guess the other side of the coin is that I am feeling anxious myself already about being able to have a vbac...

[Fleur]

Good to know everything is going well so far heres hoping your next Ob is as supportive.

I hear you about being anxious about a VBAC.. and I have had 2 previous VB, so it's not like I don't know I can do it
I think it's just that with all the hoo-ha around it you start to doubt kwim? When you have Obs who won't support VBAC, and GPs who make ill-informed comments, and even the Drs at my hosp who are supportive but have these 'requirements' like turning up as soon as labour starts, having a canula inserted, being monitored etc etc... it makes you nervous, sure.

Sorry for the mini-rant

Anyways what has helped me heaps is reading all the birth stories on here.. there are some great VBAC stories which are very inspiring and make me feel like I can do it too
Hopefully I will get to post my own in a few weeks

[Laranna]

So true jasp. I look forward to reading your VBAC story in a few weeks!

I saw my second option OB today and he was all for a VBAC. Although he did outline the risks of which I knew, he was quite happy to support me in having one. He even mentioned that he delivered a baby by successful VBAC just this morning He did say however, that I would need to be monitored while in labour and that I'd be hooked up for 45 minutes every hour. Is this normal for VBAC's? Also, he mentioned that I won't be induced due to risks so if for some medical reason they need to get the baby out early, it will be a c/s. And the other bit of info was that they have a time limit of around 8 hours, if I haven't progressed by then it will be off for a c/s.

Are these normal conditions for a VBAC? What can I start doing now to prepare my body (and mind) to succeed in a VBAC?

[Arimeh]

They can be "normal" conditions - but that doesn't mean they are necessarily the best conditions. Nothing like being on a timer to hold up a labour

My OB (as everyone knows) is very pro-VBAC and has no conditions attached. She said to me that other OB's prefer constant monitoring, but she believes that the woman is the best judge of what is happening, so if you want monitoring you can have it, but she understands why you wouldn't.

You can say no to the constant monitoring though - you might get a lecture though about how irresponsible you are being....... hehe

[Laranna]

Yeah true Arimeh...Unfortunately I don't have your OB I am planning on not going in to the hospital until the very last minute
My OB seems to think me having a quick labour this time is possible since with DS my waters broke and bang my contractions started 5 minutes apart straight away. Since I had placenta praevia with him, the midwives had to give me an injection to slow labour down until the OB showed up to do the c/s. I feel positive about the OB being pro-VBAC, now just have to calm the nerves and believe in myself

[Fleur]

Yeah, 'normal' conditions as far as I know... and I totally agree that they may not be the 'best' conditions.
The Ob that I saw at hosp & discussed it with outlined their reasons like this:

1. Monitoring - apparently the earliest indicator of rupture or other problems is change of fetal heart rate. I asked if I could have intermittent monitoring so that I could still use the shower etc - she said in her opinion it wasn't worth the risk of being in there for 1/2 an hour then coming out & they can't find a heartbeat. So yeah that made me stop & think - in the slight chance that anything did go wrong, after hearing that I would never forgive myself kwim? But I still don't think I'm convinced that it's absolutely necessary to stay hooked up 60 minutes of every hour. I will think about this one more.

2. Timing - the time frame I was given was, after I reach 3-4cm, they would like to see roughly 1cm/hour (so about 6-7 hours) for first stage, and for second stage, 1hr to feel the urge to push and 30 min to push (or was it an hour? can't remember )
- AFM this is fine, DS1 was a 3hr labour from when my waters broke and 5 min second stage - I figure if it's not happening for me within their 'time frame' there's probably a reason & she said this is basically why they set these 'limits' - that is, if it's not happening in that time there would be a problem.
SO this is fine for me; but I don't think this would suit a woman who has never laboured before, say who had an elective CS due to breech etc, and i don't know if they change their time frame for these women? Is the outline she gave me for someone like me who has had 2 prev VBs, or is it for everyone? in which case it would be a bit unfair.

Going to the hosp as soon as labour starts is basically so they can begin monitoring you staraight away. Again, with a 3hr labour behind me, I won't exactly be dawdling anyway - but I WILL be making sure things are well underway, kwim?

Induction is a tricky one, I was told firstly that there would be no induction, then that there may be ARM if it's deemed suitable, possibly synto. The problem I have is that I really don't know if I want any of that or if a repeat CS would be better. I will be talking to the Ob more aout the risks of each option... in the meantime I am going to be doing everything I can from about 37-38 weeks to bring this bub on before dates!

I was walking a bit, don't seem to have as much time as I would like , I am taking RLT & tablets, will start EPO soon, also read a bit on optimal positioning & am no longer slouching in the couch I do think a lot of it is mental prep, I still feel a bit nervous about it & wonder am I missing something? The thing is neither my CS nor yours was due to anything other than circumstance - there is NO reason to think that we cannot have a VB this time - so really all I am doing is trying to make tht as good an experience as I can, and trying to avoid induction. I'm not sure what else I can do?

good luck... if you come up with anything else let me know ; )

Sorry for the MONSTER post