Feeling dejected about my VBAC

So I had an appointment with my OB this morning and have come away feeling rather deflated, disappointed and my confidence in achieving this VBAC has taken a dive :(

For the most part everything is good. My OB will not use any prostaglandins, syntocins or anything else to induce or speed up labour, supports natural third stage, will wait for cord to stop pulsing, etc. He is happy for me to VBAC but there is a BUT or two...

1. All through our previous appointments we had agreed on intermittant monitoring. I insisted I will be moving around and he was happy to monitor intermittantly. Today he turns around and says he wants constant monitoring. I said to him that I understood they need to know what's going on but I WILL be moving around and will not be tied to the bed. He said I'll be monitored. :wall:

2. Time limits. He said I can "trial" labour for up to 6 to 8 hours. I asked to be checked and if baby and I are both well, I'd like to continue labouring longer. He disagreed and their policy is 8 hours max. This is now freaking me out. No pressure! He asked me if I knew how far I dilated last time. I said I didn't know because I never had a VE. All I know is that my labour started at 37 weeks with SROM, then contractions 5 min apart. C/S was due to placenta praevia.

These two things have just got me doubting myself now in my ability to achieve my VBAC. What can I do to get around this? What can I do to make sure my labour moves along quickly and I birth my baby in under 6- 8 hours and how do I avoid the constant monitoring? My plan of attack is to labour at home as long as possible and head into hospital when contractions are about 3-4 minutes apart.

I'm not worried about labour pain or the process of giving birth or even rupture. I'm just worried that I won't get my VBAC and I really, really, really want it.

Hey babe :hug:

If it makes you feel better, my midwife also said the thing about the 6 - 8 hours labouring thing, and that if there was no sign of anything happening, she would transfer me to the hospital.

But you know what? When I was in labour, I did not even think about her transferring me because I wasn't progressing - too busy asking for the transfer myself ;)

Have faith in your ability of your body to do the job its supposed to do. Your OB won't do anything without your consent - so believe in that as well. If you are progressing nicely and go over the 6 - 8 hours - BUT ARE STILL PROGRESSING - then I very much doubt he would whisk you off unnecessarily. Take your RLT because that is supposed to help with powerful contractions - I had a special mix made up from a homeopathic clinic, and I so believe that is the reason I dilated as well as I did (considering it was my first ever labouring experience!!!). I can give you the name of the clinic where you can get them from as well if you like (or Lulu could probably help out as well??)

As for the monitoring - double check with him exactly what he means - I had monitoring too, but I wasn't tied to anything, they just checked the baby every few hours - and her heartbeat never wavered.

Have faith honey. Thats all I can say. You can do this.

If you need to chat - on the phone or whatever - I'm here for you mate.
xxxx

Hun, I'd be looking for a second opinion. If he isn't being supportive of some of the fundamental things you want (which will improve your VBAC chances, as opposed to lying in a bed and having to give birth in 8 hrs), then I can only imagine how much less supportive he is going to be when you're actually in labour. The hospital sounds a bit restrictive too.

Since your first c/s was due to placenta praevia there is no real indication of how you'd do if you were labouring naturally anyway. (You are in exactly the same situation I hope to be in within the next year or so, I wish you all the best and hope you get the VB you want and deserve!).

ARGH! Why do they always do this to women right at the last moment? I'm sure it's a conspiracy to get you on side and make like they are supportive then at the last minute they do this :hug: Maybe you can play along with what he says for now, but when the time comes the midwives on duty may be happy to let you move around and have only intermittent monitoring and if they feel you are progressing well they could let you go past his time limit. After all good progression doesn't mean fast progression. It is unrealistic to expect that you can get to a certain point by a certain time because otherwise all labours would be only 10hrs long LOL. Don't forget that you can refuse any intervention and they cannot do anything without your permission. Of course this is best done in a way that wont get them offside and make them narky at you.

And do you have a doula? If not, I would suggest getting one if you are able too as she would be better placed to be your advocate during birth to avoid some of their intervention.

Are you at Mercy by any chance...?

Staying at home as long as possible is the best idea - if you're already in established labour by the time you get there, they are very unlikely to 'do' anything to you.
also, make sure your DH (or other support person) is well briefed and able to assert your preferences.

I was induced. Our OB wanted me to go straight on synto with AROM. We refused. He was a bit put out, but couldn't do anything about it. We waited several hours before starting Synto. He wanted constant monitoring, but middie let us do intermittent so I could move around. (until baby's heartrate started dropping...)
DH was great at questioning everything and sticking up to doc (he's a nice doc, actually, we were happy with him, just had a difference of opinion on a few things).

I would check what monitoring means too. I was attached to the ECG from about 6cm on, but I could still move around. Not very far, but i could stand and squat and pace a bit. I actually found I didn't want to walk around, I lay down and tried to sleep through my contractions. It worked for a while. ;)
Drink your RLT and have some accupuncture if you can. I really think that helped me with a speedy labour. Try not to stress about the time limit. The 6-8 hours will be active labour, not all the pre labour too, so technically you have around an hour for each cm. Try not to go into hospital until you think things are really moving along so you are not on the clock too soon. They won't check every hour though, my ob said every 3 to 4 hours was standard. I would assume it also doesn't include pushing, so you can add a couple of hours to that... they won't rush you off to surgery at 9 or 10cm just because it has been 8 hours. And most importantly, they can't give you a c/s unless you sign the piece of paper. Stand firm if you think it is not necessary.

I honestly hope that you don't need to worry about any of this when the time comes. Just focus on staying comfortable and let things progress. Once you are in labour you can't do any more than try to relax and go with it... you will know what to do. :D

I would say that is standard procedure. Don't feel disappointed, you will find that when you get there they will check you and baby and then you will be able to move freely with checks inbetween> As far a 6-8 hours that is flexiable too as long as you are progressing smoothly..believe me if you are'nt you will find that you start to feel concerned about your babys welfare. I was given around 10 hours and my Ob was willing to let me go longer except bubs got into distress, he then tried to reach her with forceps before he took me to surgery. i think they tell you these things because they want you to be reasonable??? afterall it is their neck on the line as well, but at the end of the day they get to go home if something does go wrong, its the family who has to pick up the pieces.
Good luck, don't worry too much it will work out, just remember when you get there to tell them you want to be able to move freely, these days they don't hook you up unless you end up having an epi or something like that.

Hi Eluned,

I'm so sorry that your OB is backflipping at such a critical time but natural birth is something humans and other mammals have perfected over hundreds of thousands of years and I consider it quite arrogant of your OB to think he knows better... Your body knows better.. As for getting your Vbac... Get a copy of The thinking womans guide to a better birth and check out the section on constant monitoring as it gives you scientific reference to show that there is no benefit to constant monitoring over intermittant monitoring.. Copy this page and take it to the OB... As for the time limit.. If you are not at the hospital he can't really be counting... Get yourself a very experienced doula and stay home as long as you can.. You can trust them to know how far and how well you are progressing by observing you and then wait until the doula says it's time to go and you should've then had an easier labour in the comfort of home than watching the clock under stress at the hossy... Make sure your Doula knows what you want and let her/him advocate for you on the day and let you get on with birthing your baby... As Arimeh said
"Your OB won't do anything without your consent "... Good luck Hun... Is it too late to find another more supportive OB (contradiction in terms if you ask me though...) You can do this...

Do you have extra support like a doula at all??

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These two things have just got me doubting myself now in my ability to achieve my VBAC

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Don't doubt yourself. Your problem is the OB!!

My advice to get around the time frame is to stay at home until you can't cope any longer regardless of the time between contractions (within reason of course). How far away from the hospital do you live?? Look at hiring a birth pool for pain relief so that you can cope for longer with the pain. If you go to hospital with the 6 - 8 hour thing worring you then most likley your body will slow down the labour process because you don't feel 'safe' in that environment.

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I asked to be checked and if baby and I are both well, I'd like to continue labouring longer.

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Definatley do this even though he has said no, he can't make you have a CS. If you know you and the baby are ok then don't let them talk you into anything. If you say no all he can do is wait for you to say yes.

As for the constant monitoring, keep on at your OB about intermittent monitoring and if that doesn't work, got to the toilet LOTS when you get to the hospital and get in the shower on one of those trips. They can't stop you from going to the toilet. Also refuse to get on the bed. If they want to monitor you closley they can do it while you stand or sit on the fit ball or lean against the bed. But stand your ground, they might get p!ssed at you but that is their problem not yours.

If you don't have the extra support of a Doula or an IM then make sure you get your DH/P fired up to fight for you in hospital. Let him deal with all the backlash that the MW's might give you if you refuse stuff. You can refuse stuff, it is within your right cos they can't do anything to you that you don't want them to!!

Another good thing to do is to give your birth plan to the hospital MW's a couple of weeks before your due date so they can put it in your file. That way when you ring up and say you are coming in they have already had time to look at it and they might be a bit more accomodating about the VBAC conditions.

You can still get your VBAC with his conditions. Just smile and say ok now and be prepaired to be firm and stubborn later in hospital. It is not ideal but don't let it get you down. You can do it, your attitude is what matters most!!

:hug: and :hug: My turn to reassure you that you are totally capable of achieving this. Don't let this small hiccup shake you. You body will know what it is doing, it did it last time, you just had to have the intervention cause of pp...

Sorry, have to run to get DS from day care... Just know I am holding your hand through this. xoxo

:hug: A support person like a doula and staying home as long as possible both sound like really great ideas to me. xo

Have you done much reading about vbac? The book I always suggest is Silent Knife.

If you are feeling uncomfortable with your dr, it is never too late to seek another one who you feel comfortable with. Youmust not lose track of the fact that YOU are the boss of your dr, not the other way around. Without you he would be out of a job! YOU'RE THE BOSS!!! Get the service you want or get someone else who will give you the service you want!

The conditions dr's place on vbac are actually the conditions which cause repeat surgery, have you considered hiring a midwife instead? What about hiring a doula? You can get a student doula at no cost I believe, if money is an issue.

How do you get around the monitoring and the time limit? Refuse the monitoring :D The time limit? Refuse surgery unless you are absolutely certain that you need it and have sought a second opinion. This brings me back to my point from before ... YOU ARE THE BOSS!

Whatever you choose I hope that you are treated well, and that you feel confident to make the decisions for yourself without being pressured by care providers or family and friends. Only YOU have to deal with the outcome. Lots of love to you xxxx

I second, third and fourth staying home as long as possible.

Have a look at your top sig - YOUR thoughts will help change your mindset. It's a temporary dip in confidence caused by the ob (that really SUCKS btw), but try your bestest to visualise what you want.

When you do go into labour, please continue to take your remedy - a part of it is to ease your fear/anxiety so it's good to take whilst you pace/rock/walk (little sips are fine)....and do that shake thing that Mel is talking about ;)

Thank you so much everyone for your replies and support. My confidence took a real kick after seeing my OB today. He has been a good doctor up until today when he started backfooting.

With the monitoring, he said I would have the belt attached and it would be on constantly. At our other appointments he said it could be on for 20 minutes, off for 20 minutes and that I'd be able to move around.

Mel - thanks hun. I'm on the RLT already as well as a Lulu remedy. What's the name of that clinic for the RLT special mix?

Trill - sure feels like a conspiracy. This OB is all for a VBAC but on his terms it seems. The midwives at the hossy are actually very happy to support me. As for a doula, I've been looking into this. I've just got to get organised and book one.

marcellus - yep I am at Mercy. Have you had experience there? The AROM was another thing he mentioned - he said that if I'm say 3-4cm and my membranes are bulging, then they will burst them to help get things moving. But I'm not concerned about that (should I be?). Our difference of opinion is the time limit and monitoring.

berrme - thanks, the time limits don't include pushing. The OB said if I've been pushing for say about an hour and nothing is happening he will use vacuum if baby is low enough other wise if baby is too high he said ceasar :rolleyes:

lilmiss - will check out that book. It may be too late to find another OB, however, my OB is going to be on leave in the last two weeks of December and his back up OB is the OB I wanted but couldn't get into, go figure. Anyway, he is very pro-VB and VBAC so I'd be quite happy to go into labour while my OB is on leave!

ruf - thanks hun xox

Lulu - thanks, I've been taking the remedy and it has been working well so far.

I know I can say no to things, it's just I am a bit worried I won't speak up for myself when push comes to shove. I do know my body can do it. Just had a bit of a freak out what if can't moment after seeing the OB today. And I feel a lot better now I have read all these words of support from you lovely ladies. Thank you so much xox :hug:

Hon - google the Meher Clinic ;)

Speak up to DH (will he be there with you?), let him know how you are feeling right now and why. Ask him to be your champion (for want of a better word) - if you can't get a Doula in time have you got a GF you can ask. Or maybe someone that can cheer you on over the phone?

Yes, DS born at Mercy. The middies will look after you very well there during labour and will respect your wishes. They were all super excited to have a vag birther (6 caesars and me...!). (I'm guessing there will be at least a couple absolutely ecstatic to have a VBACer!)
So, stay at home as long as you can. And, make sure your hubby is totally on-board and ready to stand up for you. Note - your OB probably won't be there most of the time, so you'll mostly just have the middies, who you'll probably find are very supportive of natural birth.

the AROM was ok, we were just hoping to go into labour with only that and no synto, whereas he wanted me to get both straight away.

You're going to do good!

Sorry to hear that you are not getting the answers you hoped for from the ob. I had a similar experience when I had DS where i was supposed to go to the birthing centre but ended up booked in for induction because he was so late. I had to have constant monitoring and it couldn't be negotiated. I asked for the wireless monitor so that I could go anywhere. I ended up wearing it in the bath and it wasn't a problem. Can you at least ask for a wireless one?

Hope things work out for you.

An hour to push? That is a joke too. The midwives were absolutely blown away that as a first time VBer I got my baby out in 30 minutes. I wanted him to take a bit longer, but maybe it was worth all the tearing to get him out that quickly so I didn't have to argue with scalpel weilding obs. :rolleyes:

Like Marcellus, I found the midwives to be very supportive of VB and VBAC. Your ob shouldn't be there for too much of the time, so fingers crossed that your middies are more relaxed about the 'rules'.

Do they have telemetry monitoring?? You are attached to the monitor (CTG machine) all the time BUT you can move around freely. I had telemetry monitoring for DS vaginal breech attempt and for DD's VBAC. With DS I was in the shower for the entire labour until his heart rate dropped.

As for the time frame - just stay at home until labour is well established or until you feel you need to be at the hospital. You may be surprised at how quickly you will labour :hug:

One of the hardest things to conquer is the the controlling attitude of Drs. If you doubt yourself and cave in to ridiculous medical demands you will not achieve the birth you desire. It is possible to meet in the middle though and stay safe without confrontation. Stay at home as long as possible. Wait until the contractions are strong,very painful and less than 4 minute apart. When you arrive at hospital don't tell them when you started labouring, tell them a very short time only! Buy yourself a birth ball and sit on it as often as possible, particularly in the last 2 weeks of your pregnancy. Do not sit in any recliners chairs or have any long car trips with the seat reclined. Take your birth ball into hospital with you (if they don't supply them) You can sit on it, pelvic rotate on it, lean on it on your knees etc, stand upright, go on all 4's, stay as active as possible whilst still being continuosly monitored. Ask if the monitor can be removed for the occassional shower, long sit on the toilet etc as long as the midwife listens to the baby's heart rate after every contraction.They are more likely to 'allow' you to labour past their time frames if you have the monitor on and all is ok. Be as calm and relaxed as possible to enhance dilatation. Keep the room dark, minimise noise ie no phones or TVs. Only have your partner with you. Make sure he has an understanding of normal birth. Stay positive and visualize your cervix opening and you baby being born normally. Good luck!

:hug: you CAN do it, we're all cheering you on :hug:

Stay at home, go in to hospital when YOU are ready, take someone supportive with you who will back you up, be confident, be strong, you have every right to labour & to continue labouring if everything is going well, no-one can force you in for a CS just because you are taking a little longer than they would like.

I had a similar 'time-frame' and I just told myself we would see what happened when I got in there - no point fighting a fight that may not need to be fought KWIM? On the day I never thought about it anyway.

Big :hug: thinking of you & sending lots & lots of VBAC vibes :lol:

Just wanted to give you a :hug:...

Use your strength and determination to show the ob wrong!

Meanwhile I will :pray: you get the VBAC you want and deserve!

Aw thank you so much ladies for being so reassuring and supportive. It might just be pregnancy hormones but you've got me all teary!

I've spoken to the midwives at the hospital and they only have 1 wireless monitor so it really depends on if it's being used on the day as to whether I'll get to use it. The midwife I spoke to was really enthusiastic about me having a VBAC so I hope they are like that on the day too.

DH will be there with me as my support person. He fully understands what I want and he knows he'll have to speak up when necessary. Tonight we had our physio-led labour class. At the start, I felt like bursting into tears because the physio talked about movement and positions tonight and I started off thinking I won't be able to do that! But after getting into and actually practicing some positions and movements with DH, I can see it being really beneficial.

Thanks again girls, your words are more support than I ever imagined!

Sweetie, I was going to suggest you ring the hospital too, and find out about wireless monitoring, but you are one step ahead.

So pleased you found some support from the midwives too. They will be the ones with you on the day.

We can do this hun! I know we can. :hug:

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The midwife I spoke to was really enthusiastic about me having a VBAC so I hope they are like that on the day too.

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I knew it! :)

Hi Eluned,

:hug: Why do they always spring this on us at the last minute? After you've already built up trust in your OB?

My VBAC was a week ago and there's a couple of things that happened with me that I thought I'd share.

With the monitor, there was only one telemetry monitor in the delivery suite at my hospital too. But out of the 7 women in labour that day I was the only woman who 'needed' monitoring so I got to use it. My midwives bent the hospital policy quite a bit when it came to 'intermittent monitoring'. Basically they would put me on for up to 20 minutes, then if bub's heart beat looked fine they would take it off again (and apparently that was enough to assure the OB that I was being monitored). I was only monitored every couple of hours and had a VE every 4 hours (I didn't know about the VE policy until I was in labour!).

With having an overall time limit to beat, I wasn't aware of one if I had one. There are certainly things you can do to help speed up your labour and maybe help you beat a time limit. My first mistake was to leave too early for hospital. I should have waited a couple more hours until I was definitely in active labour. But the midwives didn't time my labour from when I arrived (7 hours 25 minutes), they timed it from when they considered me to be in active labour (2 hours 30 minutes). I found that being monitored made my labour slow down (it was a telemetry monitor but for some reason I always sat down when it was on), so my midwives kept sending me off for walks to speed things up again. So mistake number 2 was that I didn't stay upright and moving. Mistake number 3 was that I got dehydrated (which could have meant an IV and catheter), which again slowed things down and they got me drinking lots and going to the toilet (handy if you need to get off a wired monitor).

With the AROM (although I think someone else raised it), my waters hadn't broken and my birth plan said I preferred SROM. The OB and my midwives were against using syntocinon, but suggested AROM after 6 hours which I let them do. I went from 5cm to 10cm in 10 minutes after having my waters broken (mind you I had just been for a huge walk up several hills prior to having AROM).

The 1 hour cap on pushing sounds a bit strict to me, I think no limit would be better or at least 2 hours. It took 1 hour exactly of pushing to birth my VBAC baby. It's worth reading up on positioning and how to push effectively. I'm sure what the others have said is true, that if you have gone over the time limit but you're still making progress then they should let you continue.

I hope you feel a bit more confident about your VBAC now, there's been lots of great advice posted.

:bellyrubs:

Suz, thanks so much for sharing your experience! I'm finalising my birth plan and will give it to my OB when I see him on Wednesday. Everyone is right, I just have to realise I do have the ability to say no. I am planning on staying home as long as I can (although DH is a bit nervous about something going wrong). I'll have to remember to ask the OB about the VE's as no one has mentioned this yet. Ob wants to do a strep B swab on Wednesday (never had this with DS) so that will be my first experience of being checked out down there.

I've been attending physio-led classes on positioning for labour and went through pushing techniques there and have also got a couple of good books which talk about it too. So that is helpful, just have to remember it on the day!

I am feeling more confident about my VBAC now thanks to all the lovely ladies here who have replied :) Just a little bit nervous about it all getting closer now. It's getting more real.

marcellus - the midwife I spoke with when I had my pre-admission interview was all for vbac although she did say that they don't have many vbacs at Mercy because not many obs there support it. I'm seeing Dr Lee who supposedly is pro-vbac but his backup is Dr Thyer who I know for sure is very pro-VBAC so in some ways I'm hoping I go into labour when Lee is away so I can have Thyer :)

Hi there everyone,

I was hoping it was ok to jump on this thread as I have just seen an OB and was told it was best to have a c-sec in a few weeks. I am feeling very depressed about my VBAC and feel as though no one understanding or supporting me.

I am almost 37 weeks now and have had some complications with my pregnancy - GD (under control with insulin and good blood sugar levels for weeks now) and the previous c-sec and the Dr tells me my bub will be approx 10-11 pounds by by due date (2nd Jan) so these are all the reasons for the VBAC he tells me. Also the risk of scar rupturing but I know this is a small % but he said it's bigger for me because of my "monster" baby.

Bub is fine and healthy, lots of amo fluid left, healthy placenta etc. I don't feel huge at all. Is it possible to have a monster bub and not feel it? I know ultrsounds are not 100% accurate but still 97th percentile is what he kept telling me - off the scale.

The OB even said book in on the c-sec days so there will be more staff and no sleepy people working on me if I had an emergency c-sec!! implying care I receive during the day is better than at night.

He just kept telling me what his (the hospital) advice is and wasn't listening to me. I felt all my power draining away and couldn't really stand up for what I believe in.

He has made me really worried now and I don't know what to do. I can't move to private hospital as no health insurance and lack of $$

Would really appreciate some help and advice.

Would a midwife or doula help me at this stage or is it too late and am I "too complicated"?

Thanks

HL

I hope that someone can come in and offer you some practical advice for your options.

unfortunately the trend by many OBs is to fein support for a VBAC with a clause of performing a scan to 'make sure everythings ok' towards the end. And most of the time, come the final weeks a 'problem' appears.

This happened to a close friend who was advised that her baby was a monster baby (they told her he was already cracking the 4kg mark. so she was scheduled to have her baby by c-sect the following week as there was 'no way' that he would of fit through her pelvis. At 38 weeks her c-sect was performed and bubs weighed in at 2.8kgs. waaaay waaay off their 'guesstimations'.

I really hope that you can find some answers and peace with whatever decision you come to. Even if you could find a doula etc to be there to help guide you through the birth of your baby by c-section if it comes to that (there are some doulas that specialise in this area apparently!).

If you have maintained really good diabetic control there is no reason your baby will be "too big". Even if your baby is on the upper end of the normal size scale (> 4kgs), plenty of woman have normal births with this size baby. If you are really determined for your vbac, no Dr can force you to have a C/S. It is clear that he will try and make things difficult but hang in there and stay positive. The private hospital system is not your answer either. Most private hospitals don't support vbac and if they say they do, mostly it is only a token response to make women feel they are being given a choice. I would suggest a private midwife as a support during labour ( as long as they are experienced and comfortable with vbac).Thanks for listening and good luck.

Hi there Cassius 2,

Thank you for the post.

I am all fired up because I have decided to hire a private midwife and doula and get their support. I have just spoken with a brilliant doula who has inspired me and made me remember what I can do, what us women can do and how much medical intervention is not necessary.

I am feeling very positive!!! Let the journey begin. It really reminded me that at any time the path can change, just need to make a choice.

She also said that all the factors re: the so called "risks" I have are overblown and not necessarily true.

Thanks for the support Belly Belly women!!! Power the the ladies!!

GL happylila - it really sounds like you have the right support and attitude. I wish you all the best with your VBAC!

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I am almost 37 weeks now and have had some complications with my pregnancy - GD (under control with insulin and good blood sugar levels for weeks now) and the previous c-sec and the Dr tells me my bub will be approx 10-11 pounds by by due date (2nd Jan) so these are all the reasons for the VBAC he tells me. Also the risk of scar rupturing but I know this is a small % but he said it's bigger for me because of my "monster" baby.

......

He just kept telling me what his (the hospital) advice is and wasn't listening to me. I felt all my power draining away and couldn't really stand up for what I believe in.

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Oh boy... I got so mad reading this :shakehead: I feel for you I really do, I'm soooo glad you have decided to get yourself a doula / midwife (are you having one? or both?)
...not because I think you should realllly have a VBAC (although there's no reason not to) but becasue you need someone who will listen to you and talk with you not at you, support you and help you make the right decision for you, on your terms.

FWIW my VBAC baby was 10lb8 (4770g) ...oh, and I didn't rupture ;)

My sister was another one who was advised she might need a CS due to the fact that she had a monster baby. I saw her four weeks later & remarked that she didn't look that big to me, and she said she didn't feel it either. Her bub was 6lb12, I think just under 3kg. So I would trust your instincts on that one ;)

:hug: wishing you all the best for the birth you want :) good luck