Been told i cant have a vbac :(

Hi all, well had an experience with an Anethetist at redcliffe hospital the other week. I got told that due to my current weight 117.kgs and high BMI 42? and had a previous Emerg S/C due to my sons heart rate dropping whilst having contractions between 100 and 110 instead of being around 160 that I WILL NEED to have a C/S and i don't have a choice as normally history repeats in future pregnancies even though i got to 8cm Dilation last pregnancy. He was so rude and arrogant i felt like slapping him in the face. He told me it would be to risky to have a VBAC and selfish of me if i was to plan this anyway. GRRRRRR what would he know anyway he not an OB or midwife he just gives the injections. I then had a MW appointment and told her of my experience and she informed that if Adams Heart rate hadn't droped so low that she believes I would have benn able to have natural delivery as I had progressed to 8cm's in a short period of time and she believes that i will be able to have a VBAC.

So i guess what i'm trying to find out from you all is there anyone else out there that has had a high BMI and had Natural delivery or VBAC with high BMI. I really don't want to have S/C as I suffered with PND really bad last time as it took me a while to come out of recovery - more then 2 hours and lost that bonding period with adam and was really groggy for ages afterwards.

Would love to hear your thoughts, experiences and oppionions.

Many thanks

Bec xx

Were you a similar weight last time?
And have you actually seen the obstetrician?
In some cases anesthetists find emergency CS's in heavy people scary because it's harder to get the needles in to the correct spot in a heavy person, and contractions and urgency don't help - but I would have thought that if that were the case he should have had the courtesy to explain it to you in that way.

It's only selfish if you seek quite a few opinions from generally pro-vbac midwives and obstetricians and they tell you that you are taking unnecessary risks. Changing your decision based on the opinion of a single anesthetist is silly.

I think you should see another ob regardless! He sounds like a knob.

They can't make you do anything you dont want to do...regardless of if its their medical OR personal opinion.

If you really want a VBAC, you'll tell them to stick their BMI rot up their clackers and do what you want to do and not what they want you to do.

You'll find that a majority of women attempting VBAC's get this this talk. The your risking your babies life etc. Dont let them put the fear of God into you.

Keep faith in yourself and your body to do what she knows how to do. Refuse the section, stay at home as long as possible in labour (turn up pushing if you have to!) and in the mean time, avoid any negative attitudes like this - its a drain on you and you dont need that right now. Oh and TRUST YOUR INSTINCTS!!!

Stick to your guns hun!

You can do this!!

well, he's not strictly the expert on baby delivery, is he? :lol: so i'd definitely be seeking quite a few other opinions first :)

was your labour with your DS induced? i ask because i am overweight & was induced with my DS - his heart rate dropped & i had an assisted delivery. i managed to get the magical 10cm & was about to push when they got worried. i believe his heart rate dropped because he was being induced before he was ready. did they have an explanation for why your sons heart rate dropped last time? because if it was nothing to do with your weight, i can't see why you wouldn't labour well this time?

i'm in no way any sort of expert, but it's def worth getting other opinions. even if you don't end up with a VBAC, at least you will be comfortable in the knowledge that you explored all the options & gave yourself the best opportunity.

good luck!

I was in a similar weight range and had a vbac, with gd. He is an anethiatist not an ob so ignore him.

I don't think he's really qualified to know that sort of thing, so I would disregard him completely. Your midwife would be a better person to listen to.
In any event, isn't surgery more risky if you're overweight...? Doesn't sound very logical to me.

All the best for your birth - I hope it's a very positive experience for you

pffft what a loser ! I just had VBAC at ipswich hospital WITH an epidural and I weigh more than you! my little ones heart rate was dropping throughout the whole labour lower than 110 but was just monitored the whole time. Don't even take note of him! if you want to do the drive transfer to ipswich they were so supportive and never once said anything negative! Could not fault them at all!

Ignore him! He isn't a specialist in obstetrics and he is just giving you the standard talk. Go to caboolture if you can if Redcliffe isn't supportive. The are pretty supportive there. But for any VBAC mumma my advice is to get a doula. It may cost you but it would be worth it's weight in gold.

xx Bella

Not a VBAC but natural birth x 2 at BMI of 42.
My second labour was very quick which caused brachycardia but luckily I was able to push her out very quickly (<5mins) and avoided forceps and/or C/S (as despite being fully dilated my cervix was still high, go figure).
Also I would personally think the risk of elective surgery at that weight is higher than that of uterine rupture from VBAC. Especially coming from an anaesthetist. The one I saw as part of my ante-natal care was adamant that it was definitely preferred to avoid a C/S at my weight as the risks were high.

Hi everyone thanks for all your comments and support. When I fell pregnant with Adam I was 100kg and put 10kgs in 9mths. so was 110 when in labour, my weight had nothing to do with DS heart rate dropping - it was just everytime i would have a contratction his heart rate dropped, no other explanation. Yeah have a MW appointment this coming Wednesday so will know more then. Yes being bigger i thought would be higher risk of surgery aswell yes will be asking to speak with an OB not an Anethetist. Thanks for your support and encouragement. xxx

I was thinking overnight and I know what he is worried about. He is worried about having to anaesthetis you in a hurry for a general. Because of your weight it makes it harder to get a tube down your throat in an emergency and he is thinking worse case scenerio. It isn't for your benefit that he gave you that advice but for himself, because it would be out of his comfort zone to have to do that in a true crash section.

That being said, A- true crash sections are almost unheard of, with both Caboolture and Nambour having a 20min from decision to incision target time, and B- a babies HR dropping with contractions is very normal. It is only when they don't recover their heart rate quickly after the contrax that it is an indication that they may be starting to not cope, which they call late decel or prolonged decels. I can't be sure if that is what happened to you, but that has nothing to do with BMI.

Good luck love

xx Bella

bella is right, during a contraction lower heart rate is fine, midwife told me when I was in labour if it drops AFTER the contraction it means bubs is getting tired. I still don't see why you can't try for a VBAC, most real emergency c sections will be under a GA and having a VBAC you have to have a IV inserted anyway (if you want to that is) so access is already there just incase. Let us know how you go!

It's totally normal for bub's heartrate to drop during contractions, yeah. It's just how they come back up again that's important.

MHB, it isn't about getting access to veins. That is the easy bit. The anaesthetist is worried about getting a tube down Bec's throat to breathe for her if they had to do a rapid sequence induction. Which is a way of putting someone under a general when you have had no preparation at all. It is harder on people who are over weight(sorry Bec!). But that doesn't mean it can't be done well. My DH is an emergency specialist and spent 3 yrs doing anaesthetics and whilst it makes it more complicated they do it all the time in emergency if it is needed. It just makes them nervous. But making them nervous for a 1 in 1000 chance problem that actually may never be a problem even if it is faced, isn't worth not having a vbac for. He is thinking of his own comfort not Bec's. You can do it Bec. Believe in yourself and surround yourself with other people who believe in you.

xx Bella

bella : Oh i see now! Anaesthetics wouldn't be an easy job but isn't that what they get paid the big bucks for? you are right he just doesn't want it to be hard for HIM!

My suggestion is to search around on the forums for the most VBAC friendly Obs in your area and then go to him/her. Forget what anyone else tells you.
I hope ot all works out perfectly for you.
If it helps I had a high BMI for my VBAC and even though it did not happen, it did not get in my way. But if your BMI is high your fitness may not be as good as it could be so I suggest walking, swimming and watching what you eat.
Wishing you all the best
xoxo

I had VBAC in march this year, I started the pregnancy weighing around 112kg, but lost 16kg throughout the pregnancy due to severe all day sickness (hyperremesis gravidarum). I also had GD and I told my OB that under no circumstances was I to have a c-section or an epidural, we actually had a couple of arguments over it lol

With my DS I got fully dilated and then he got stuck, afterwards I was told that I would never be able to give birth vaginally and that I had cephalo-pelvic disproportion, where the lower opening to the pelvis is smaller than the upper opening and the baby can't fit out once it gets past the upper opening. My DSs head circumference was 34cm, they said any baby I had would have to have a head circumference of 30cm or smaller in order for e to have a vaginal delivery.

I proved them wrong and gave birth to a 3.65kg baby girl with a head circumference of 34cm at 40+2, with gestational diabetes, I had been 2cm dilated for 3 weeks, a huge difference to how it was with DS where I never dilated on my own and had to be induced at 41+3 with him arriving 2 days later.

With my DS I weighed 96.8kg when he was born too.

This time I weighed 80kg about 5 weeks ago, so I'm only classed as overweight now, but it will also depend on if I gain weigh this pregnancy or not, which with all the chocolate I'm eating (it's one of the few things I can eat lol fruit smoothies, veggies and chicken are the other things) is highly likely to happen.

And re: heartrate dropping - my DS got down to 81bpm which was when my old OB decided a c-sec was needed, with DD she regularly got down to 110bpm in the last 43 minutes of labour, especially when I was pushing. I was told it dropped that low because the cord was wrapped around her neck and compressing during contractions, makes me so glad it only took 23 minutes to push her out from the moment I first said I had to push.

In the end though they can't make you have a c-sec, they need yours or your OH's signature on the paperwork to make it legal, if there is no signature then they are in deep trouble.
So all you have to do is continue to refuse, you can compromise with them for intermittent monitoring during labour (I am demanding that they only use the doppler this time as I can't stand the belts/straps when I'm in the middle of a contraction, it makes the pain even worse and harder to cope with for me) or if you don't want intermittent monitoring then you can compromise that they use the doppler or physically hold one of the CTG things on your belly while you are pushing.

I was told I could have a trial of labour - eg, if I didn't dilate within a certain time or didn't dilate fully within 12 hours then they would send me for a c-sec, I cried and told them it wasn't happening and started to panic a bit when they said that, I think that helped my body get it's butt into gear though knowing I had a deadline to beat. You can extend the deadline out though as they still can't force you to have a c-sec unless the baby is in real distress (not just the heartrate dropping solely dutring the contractions and then going back up) or something is going wrong with you.

I hope you can get your VBAC hun, wishing all the best! xxx

I think you also need to remember that the anesthetist pretty much only sees the VBACs that turn into repeat CSs. So his view will be colored to think it always happens. The Mums who push their babies out with help from the midwives and obs don't really register with the anesthetists at all!