staying home in labor - a good idea?

hey everyone!

I had my GP visit today for 30 weeks, it went quiet well, no dramas. The doctor even seems to think that this baby is going to be smaller than my last which increases my chances of vbac providing theres no other obvious problems.

He did say that they wont let me labour for long after previously having a c section, but a natural labour in alot of cases just is long! So how do I avoid them rushing me off for an emergency c section or nagging me to go to theartre if Ive been in labour "too long"?

I had the idea of maybe staying home during my labour to let it progress naturally, but I am really scared, because if I want to attempt Vbac I have to go to a hospital an hour away from here, and they have said i will need to go straight in when i go into labour to be constantly monitored?

I was thinking a birth doula, or someone who knows what is right and not right in a vbac situation? so i can stay home for a bit. Do they do internals and everything? so I would know if it was progressing or not being home? My hubby just wants me straight in the hospital so I am where its safe, but even my GP isnt overally supportive of the whole vbac idea.

Doulas do not do any medical stuff at all..
I can't help you much about being in a VBAC situation, but as a Doula I encourage my clients to labor in a place where they are comfortable and they feel that there is no pressure.
Maybe one of the other beautiful ladies around the forums can help some more.

A doula isn't medically trained and cannot do any examinations on you at all. A doula is there as a support person for you, to tell you that you CAN do it when you think that you can't. I would still highly recommend one to have with you for the birth though. She can come to your home and travel in the car with you to hospital too if thats the way you want it. I also think that if you are determined to have your VBAC, I think that you would be best off staying at home for as long as you can before heading in, even if it is a long drive ahead of you because you don't have that added worry of them placing time limits on you and wanting excessive monitoring simply because you are having a VBAC. Check out the Doula Locator on the main site and find one for your area, arrange a meeting with the both of you because it seems like your DH has some concerns about it and is erring on the side of the Dr's. If you want to be successful, you need his full 100% support too.

ETA - here are some articles you might find helpful, HTH;
https://www.bellybelly.com.au/birth/...n-doulas-birth
https://www.bellybelly.com.au/birth/...estions-to-ask
https://www.bellybelly.com.au/birth/...ps-suggestions
https://www.bellybelly.com.au/birth/...fter-caesarean
https://www.bellybelly.com.au/birth/vbac-on-whose-terms

Hmmm, a vbac should be much like any other labour.... so I can't see why you shouldn't stay at home for some of the early labour stuff. If you go to hospital, they are going to hook you up to monitors....

A doula would definitely be useful to help support you in your labour, and also help you negotiate with the hospital (so they aren't coming at your with all their requests and questions, so you can concentrate on labouring). I would say that all you need is a doula.

But if you really feel that you need someone professional knowledge, there are some independent midwives around that will accompany you to hospital. You could look that if that is the kind of support you want.

A doula is fabulous for VBACs because you have more hurdles to jump when you shouldn't have... they can make sure you have a voice and options... studies show 50% less c/s with a doula.... staying home I agree until you are in well established labour and coping, and there is nothing worrying you. All the best :)

Hey Danielle

at 30 weeks I find it a little hard to believe that your doctor can be thinking that your baby will be a little small, unless of course you have had an ultrasound to confirm growth

this sounds like the beginning of a tactic to coerce you into an elective c/s...especially as he is not very supportive of the whole vbac idea

there are less risks to mother and baby associated with a vbac than a repeat c/s

a vbac is a contentious issue, without real reason. Many mothers feel bullied and made to feel that they are putting themselves (and their wishes for a vaginal birth) ahead of their baby...which is rubbish

you could write a very comprehensive birth plan...to ensure you are not bullied, and surround yurself with a wonderful, supportive, empowering birth team that will do everything to act as your advocate.

if you go into labor naturally there is no reason you need to go into hospital until you feel ready. There is no reason for continous fetal monitoring, or any intervention that does not allow you to labor and birth naturally

the standard 1cm per hour for cervix to dilate on labor is based on text, not fact, and currnet research actually suggest that this is more likely to be 0.5cm per hour (especially for primips)

maybe you need to consider changing your care giver, or at the very least employing a professional birth attendant

sorry for the rant ;) Im just sick of scaremongering

xx

No, no, dont say sorry for the rant I am tired of it too. All I want is for someone in the medical profession to give me some real information on Vbac's, and not only half answered or dodged questions. No one around here seems to know a great deal about it all.

Oh yeah - I have read a few different things, that vbac is 70-80% successful then I read elsewhere that it was only 40% successful, does anyone know the true figures?

And I would really like to stay home while I labour, but my GP is making me feel like it would be unsafe because I am high risk after a previous c section I just want to be safe as well. I think hospitals should offer more info on vbacs, I cant find any anywhere, only on C sections and a normal natural birth nothing assosciated with vbacs.

Have you got some good VBAC books?

Silent Knife

The Thinking Woman's Guide to a Better Birth

I'm reading New Active Birth at the moment which has got great strategies for coping with labour at home. Maybe grab a copy to read before you go into labour?

I'm intending on staying at home as long as possible this time. When I got to hospital with Alexzander I was around 3-4cm and they made me stay. Had I known better I would have stayed home until much later. I intend on doing so this time, because I'll be having a VBAC as well & don't want to be on a timer from the very start of labour. I would think that it would stall or slow labour if you knew you had a time limit.

hey Danielle

you are not putting your baby at any risk at all hun...going into the hospital is the risk, medical intervention increases the risk factors to you and your baby

there is plenty of info out there. Birthrites offer a informative and supportive advice regarding vbac

you are aiming for a natural birth :) its everyone else (doctors and other health professionals) that want to label you a walking risk factor. Birth has risks. Life has risks. The risk of uterine rupture is not a common thing in vbac if a woman is left alone to labor naturally. Medical induction increases the risk of rupture, as does a prolonged and slow to progress labor, as this puts a great deal of pressure on the uterus, and causes tension in the weakened scar

I could go on ;)

x

I think the whole misoprostol disaster is so fresh in doctors minds with the ruptures that they have just labelled all VBAC women a rupture risk, even though it is so minute.

as Kelly said ;)

misoprostil has its place with PPH, but is not a safe drug for induction, as the research indicates

sigh

x

Hi, I'm 40weeks as of tomorrow and have had a previous C-sec, 22 months ago. The baby was found to be breech 3 weeks ago and was successfully turned. So I'm hoping for a vbac too! So far the dr's seem pretty positive and have told me that the chance of achieving this is 60%. I don't intend to go into the hospital until I absolutely have to, and the dr so far agrees.... Good luck. I will try and let you know how things went if I go into labour soon...

Good luck Emma, can't wait to hear all about it :D

Ok well i had my first vbac nearly 14 yrs ago, I did go to hospital about 4hrs after labour started ( i started labour at 3am and didn't know if i was in labour or not as it was my first natural) anyway they said come on in and i did. I had 11and a half hours of labour all up no dramas what so ever. I then followed that with 3 more vbac's all successful and with no intervention but at the hospital.
My last one was a c-sec due to breech presentation and they talked about trying to turn bub but the place where they send people from here said they wouldn't touch me as i had had a previous c-sec! Hence i had the c-sec and now i am expecting an unexpected bundle at the end of April! My doc that did the last c-sec has already suggested i have a repeat c-sec but i have done some research and i will be going natural as long as this bub is head down.
The statistics are definately on my side for a vba2c so they are def on your side too. This is what i have

chances of uterine rupture go from 0.07% after one c-sec to 0.09% after two c-secs, a non significant difference.
However the rates of hysterectomy we significantly increased in the multiple c-sec group from 0.2% to 0.6% as were transfusion rates whcih went from 1.6% to 3.2%!

So in my opinion our chances are much better going natural than what they are going back under the knife! The docs jsut see it as more convenient for you to go under the knife because if anything goes wrong they are already there! Whereas if you go natural and something goes wrong they have to be rushed in, in other words much less convenient!!!! My doc said this to me and as i daid to him thats great for you but it is hugely inconvenient for me to have another c-sec wheni have to go home with 7 children and won't have the timeto recover properly! I have talked to my midwives and they are fine with me going for a natural birth, and the way i see it they are the ones who will be there so thats all that matters.

Good luck and i hope you get the vbac that you want, it is well worth the fight!!!!

:

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No, no, dont say sorry for the rant I am tired of it too. All I want is for someone in the medical profession to give me some real information on Vbac's, and not only half answered or dodged questions. No one around here seems to know a great deal about it all.

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As for trying to get information - I've had friends that were in exactly the same position as you - they wanted info on VBAC's, asked a lot of questions and didn't get any or really vague answers. They kept asking questions and ended up with the head OB - which was great for them because they started getting the answers they needed, but I think it is pretty silly that that is where they had to go to get their answers and that it isn't readily available.....

Keep asking. Read articles. Inform yourself. VBAC is not as dangerous as people make out to be. It is the big emergency that needs such close monitoring that everyone (doctors) has made it out to be.

I hope you have the birth you dream of and get the answers you need. I'm sorry you're having such a tough time finding the info you need. It sucks that you must struggle in that area - it must put of bit of a taint on your pregnancy when you have to fight like that....

^ I agree with Kaos - when it comes to VBAC we really need to take responsibility for finding out the answers ourselves...because the people who we'd expect to be able to give us these answers cannot.

Lots of reasons - they are trained to view vbac as a risky endeavour regardless of the research that shows otherwise, and because of this it's out of their comfort zone to encourage women who want one. They are not the source that's going to provide you with balanced and factual information. If you want that you need to seek it out for yourself ;) But that's a GOOD thing because when you do your own research you form your own views - which will be stronger than those you just take on from others opinions ;)

As far as success rates go, they are different everywhere because there are alot of variables. The views of the OB/midwives, the policies of the individual hospital will affect their vbac rate. Your individual chances are affected by your choice of caregiver, your choice of hospital, the level of support you have, how long you spend in hospital, and most importantly the level of confidence you have in your body to do the job ;) You can ask about the rate at the actual hospital you are going to...this will give you a good idea if you're in with a shot there or if you need to look at other options (which TBH sounds like a good idea anyway in view of the lack of support thusfar).
All the best hun, you can do it. :)

Hey,

no I dont have any vbac books, are there any good ones I could use, becuase I have no info on vbac's, my hospital here and caregivers have no infoo available on it as they don't support it. I feel like I am fighting a never ending battle with the public health system. Because even my doctor told me that even if I do go to Nambour to try for a Vbac (which they do there), that they wont allow me to labour for a long time or anything anyway, so he seen it as pointless to try I guess. Sounds like Nambour hospital is pretty quick just to get you in thearte quickly if you've had a previous C section, its the only other hospital I can go to anywhere else is too far to travel. I have heard Buderim and Nambour have some really good private hospitals that fully support vbac's, but I don't have health insurance or that sort of money. It's starting to get me down, I feel like I am going against what my GP and Ob want and that I am being a pain and unreasonable. I wish I had medical caregivers that would support my decision, and were able to inform me on everything that goes on with it all.

I have only had the one C section with my 1st, posterior and 10lbs 2oz, labour just failed to happen. I went to my ante natal classes before I had her and felt very deflated when a C section was scheduled. So I really have no idea about birth, what goes on with it, let alone the implications that could arise with a vbac. Is there anyone that could tell me what goes on in hospital if your having a vbac?

I had a big cry to my husband yesterday, because I am 30 weeks pregnant, the obstetrician has already said he doesnt want me going past term because of my previous c section. And the ante natal care I am receiving is pretty bad for someone who may be trialling vbac. I have a growth scan at 34 weeks on the baby then back to the public Ob at the hospital here at 36 weeks and my GP in between, whom none of them support Vbac, so what am I meant to do? I feel like I am runing out of time I need to be informed, I just really want some medical support and I feel like Im on my own.

Also does anyone know what the midwives are qualified to do, I am thinking of hiring one before I go to hospital if I go into labour. I dont even have a clue where to find a midwife, or how much they are either... hmmm the public health system sucks! I rang the womens health centre here to see if they had info on Vbacs, they gave me some web links which had absolutely nothing on them only about normal births and c sections. Guess the government must not be very supportive of Vbacs huh?

Its so dam frustrating!

hugs to you Danielle

I can pm you some midwives in QLD if you like

x

Thanks Natalie,

I think I have already found a midwife finder online, I have only found 1 private one in my town though. Could you tell me at all what midwives are allowed to do. They are allowed to do more than a doula huh? It would really put my mind to ease if I had my own medical support at home while I waited to go to hospital. I am really concerned the hospital will only give me so much time then rush me off to theartre, but I also want to be safe for me and my baby also this is why I thought a midwife would be good, because they would be able to tell me when I needed to get to the hospital if something was not going right? I have no idea, I am just guessing. But if a midwife can provide at home medical support then it seems like a good idea to me.

yep a midwife can do everything regarding birth...educate, nurture, guide, and if the poo hits the fan, then we are trained to provide best outcomes for mother and baby (a nice way of saying we know what to do in an emergency ;))

a doula is a support person for the birthing woman

the problem with an independent midwife with you in the hospital is they may not have practising rights at the hospital...meaning they can act as your advocate in everything, but cannot care for you clinically

x

do you think it would be hard to find a private midwife who is supportive of Vbac? Nobody else in the medical profession seems to want a bar of it, do midwives have knowledge on Vbac's from their training? Or do they have general birthing training which applies to all situations? I am just wondering if midwives would be more excepting of Vbac than the dam doctors?

:)

midwives see birth as a natural event that needs no intervention

doctors see birth as a medical event that most be handled to prevent anything 'bad' happening

midwives watch, doctors touch

midwives are certainly more accepting of all types of birth...except anything that puts mother or baby at risk

a vbac is really not the huge drama that it is made out to be...its just that medical professionals feel the need to put rules and regulations on birth and put you in risk groups. Doctors are trained this way, so they are still nice people ;)

A private midwife would be your best bet for a vbac, and also look up birthrites on the internet, they have lots of info and have groups in most states

x

Hi Danielle,

Your best chance of having a VBAC will be if you stay home, not just for the labour but the birth as well. There is a really high VBAC failure rate in hospitals because of the way the medical establishment views birth. Every women deserves support and you are clearly not getting it from the system. How we give birth is important for ourselves as women so why don't you reclaim your body and your right to give birth unpressured and in your own time. You can birth beautifully and safely and you don't need to be in a hospital to do so.
Contact an independent (private) midwife and see what they have to offer you. You won't regret it.

I am a little worried about staying home to do the whole lot because if something does go wrong the hospital here does not have the facilities to deal with a Vbac situation, therefore I would have to travel an hour away, which is a bit worrying if it were an emergency and I had to get there ASAP. Otherwise I would birth at home, I have never experienced birth yet if I had I wouldnt have a worry doing it at home.

Danielle would you be will to travel as far as Kingaroy??? ITs not that far from gympie and they fully support vbac after one c-sec!!!! This is where i had all my vbac's and they are really good. I went 11and a half hours with my first vbac there and they didnt even talk about a c-sec! IF you can't travel there then at least ring and ask to speak to a midwife there to get as much info and help as you can! I have found them brilliant. Good luck and just yell if i can help with anything.

oh thanks katstribe! My mum used to live at Kingaroy, I know the area very well, I will give them a ring and see what they say, I have heard all awful things about Nambour with Vbacs that they dont really give you much of a chance.

Gee I thought kingaroy hospital wouldnt have the facilities required for a Vbac incase something went wrong - wow! They look like a small sort of hospital, but I will certainly ring and see what they say!

Thanks for the idea!!

No worries! I know they are a relatively small hospital but they do the births for all our surrounding districts. They had i think just on or just over 500 births in there hospital last year which is huge for a little hospital apparantly the biusiest rural hospital in the state!!!. But the midwives there are fantastic and i know heaps of people apart from myself that have had vbac there with no dramas what so ever!
Let us know how you get on.
Cheers
Kat

Oh! - heres a question if anyone knows... I was sitting thinking about the things that could happen, bla bla, so I can have some sort of plan or sort of know what to do....

Apparently alot of women go into labour before their waters break?

Would it be safe to stay at home and labour if my waters hadn't broken, or should I go to the hospital to have my waters broken?

Also if I went a while labouring if my waters hadn't broken, could that stress the baby out?

Just wondering:D

thanks!

Hi Danielle, I have had a natural VB then went on to have a c-section with DS after my waters broke. 12 hours later they induced me and the baby became distressed so I took there advice and had the c-section. When I was pregnant with DD I decided I wanted to go the VBAC way my OB was reluctently supportive, there is only 15 months between babies so he was concerned about the scar. He told me that if I had to be induced, if my labour dragged on for too long he would want to go the C-section. I agreed, I went 2 weeks overdue and went into labour naturally, I stayed at home for a long as DH lol felt comfortable which was a couple of hours, then went to the hospital, I personally was happy to be monitered, mainly because of my concerns about how quickly the previous baby had got into distress, but still made the most of my birth experience. Showered had the large hot birth and the birth attendants that I wanted, after 8 hours of labour my OB was called becayse I had'nt progressed past 8 cm he explained he would break my waters, because we could'nt keep putting pressure on the scar,when the waters were broken there was alot of poo (sorry can't spell the word) in the waters. It was explained that indictated the baby was a bit distressed but we could continue on for the moment. He came back 2 hours later and I was still 8 cms, he tried to reach the baby but was still too far away, so a C-section was advised. Intially I thought about asking if it was really nessecary, but I also believe he gave me the best chance inthe first place. So I went with what I thought was best for the baby as it turned out she was 9pound 10 and had a big groove around her head that went away after a few days, I guess thats where she had been stuck. So I believe that I made the best choice, that I don't think I could deliver her naturally, well at least without major damage to me and maybe her?????

Anyway I am pregnant again, have seen my OB told him I want to try again if baby is in the right position and everything is going well at the time. He is prepared to support me, the only thing he wants is to do a scan late inthe pregnancy to make sure the baby is not another big one, and I am happy with that.

I think a midwife, would be a good choice. Have a look in the phone book or have a look around here post requesting one? I live 30 mins from the hospital and took that into account, I think the key is stay home until you feel like you need to go to hospital, maybe stay away from DH as long as possible, given he is already concerned he may have you there before you want to be there. Listen to your body, I guarentee you will now how you are going. Monitering does'nt have to be constant, at hospital but they will want to check on you. There will be someone out there who can help you and if you have info i think you will find your doc will be more likely to support you. One more thing my OB did say he has seen c-section scars that have been paper thin but he has never seen one actually burst, but you do need to know that it does happen, the reason why induction and a very hard long drawn out labour will not be an option. Oh and I can say that I did'nt feel robbed of the chance to birth VB because I gave myself the best chance I could and in the end I was ready to birth my baby the safest way possible. I hope you have gotten some answers and you get the birth you are looking for.

The best possible thing for your baby Danielle, is to leave the waters intact. They will break of their on accord when ready. They are there for a reason and there is no evidence to support breaking them in a normal labour. Having your waters broken will be more likely to cause the baby (and you) to become distressed so guard them with your life :)

If your waters break before you are at hospital, they want you to go straight away, risk of infection!!! But if you have a private midwife, she will be able to advise you on this. if you go into labour without the waters breaking stay home as long as you feel comfortable. The baby will not get stressed, just because your waters have'nt broken.

I really think a midwife is your best chance, because she will be able to give you the support that you are looking for and enable you to safely stay at home for as long as possible and even whenyou get there if she can't assist she can be you supporte and advise you.

Hehe, never mind my randomness, I posted but a million people said what I said, so um...hi everyone! :p

:

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The best possible thing for your baby Danielle, is to leave the waters intact. They will break of their on accord when ready. They are there for a reason and there is no evidence to support breaking them in a normal labour. Having your waters broken will be more likely to cause the baby (and you) to become distressed so guard them with your life :)

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Yep. There are two reasons waters are broken by careproviders during labour.
The first reason is if there is some reason to believe that the baby may be distressed, waters are broken to check if the baby has passed a bowel movement (meconium). Babies who are in genuine distress will sometimes do this and if the waters are broken they will be "meconium stained".

The second reason (and this is by far the most common) is for nothing more than to "speed" things up. When the waters are broken the theory is that the baby's head comes down further, and applies pressure to the cervix making the contractions more effective at dilating it.
What they never tell you though is that breaking your water makes it more likely also that your baby will not get into position properly to be born (because once the fluid goes it can't move as easily), and a whole mess of other dramas no one ever tells you about either.

So as Samantha said, guard them with your life ;) In an undisturbed labour membranes usually rupture on their own around 6-8cm, but can sometimes stay intact through to the birth which is also fine.

There is actually no study to prove that breaking the water speeds things up! As one Ob said to me, 'That's what we think.' !!!

Also once you break the waters, babies who are in a posterior position seem to have a harder time moving into the right possie for birth and if waters are broken with a high or malpositioned baby (sometimes undiagnosed) then you will be down the path of intervention to get that babe out. Don't think Obs wont break waters with high babies - have heard it a few times now. Cord prolapse is a real problem with that.

^ Happened to me. Waters were broken early in labour with a posterior baby AND a high head. Still can't believe he did it.

Cochrane review summary on this subject which concluded that breaking water artificially has no benefits and increases risk of fetal distress, prolapse and caesarean: Amniotomy for shortening spontaneous labour

Amniotomy for shortening spontaneous labour

This is the Cochrane review of ARM or amniotomy.
The highlights are ;-) :increase in c-section rate and no shortening of first stage labour.

Ok you're freaking me out Tobily :lol

LOL snap! :D

Hi,

I don't know if what I have to say will be of any use to you, but I hope that you will at least find some encouragement. I had an emergency c-section with my first and was told by the OB (while still in theater) that I would never have a natural delivery.
However, when I was 24 weeks along with #2 a midwife told me not to fall for that and gave me some wonderful information about VBAC's. She even runs a VBAC class that informs women of the risks and what to except as truth etc. So through the class and my own research I learned that the risks are small and to stand up and fight for what I believed in. I made sure that my hubby and my support person knew what I wanted and I wrote a birth plan stating my wishes.
When I finally went into labour I stayed home as long as possible. By the time I got to the hosp. I was already 7cm. Never once did I let them tell me that I couldn't do it and when time was mentioned, I reaffirmed that unless there was a medically sound reason for C/S I would continue to labour. My DD was born safely and naturally. It can be done!

Some quick points I would like to add:

I'm not completely convinced that a scan to determine size will be useful. Two reasons, it could make you very apprehensive about something you cannot control and nobody knows what your pelvis or the baby's head will do during labour. I am convinced that positioning of the baby is much more important than size. (Friend of mine had c/s due to breech with her first and second was VBAC of a healthy 10lb10oz baby).

The other thing is that I don't see any reason why you should not be allowed to go post dates (its only an estimate anyway). I am currently 6 days past dates with bub #3 and if all is well my OB will let me go to 14 days. I really hope for another VBAC, and will be sure to let you know what happens.

Last thing, from what I understand if women are given time and support the success rate for VBAC is 80-85% and that sounds great to me!