Being refused a VBAC for suspected large baby

Hi all,

This is my first time on these forums. So hi everyone.

I am 28 weeks into my 2nd pregnancy and I so desperately want a vbac but my OB is refusing me a vbac for a suspected large baby.

My daughter was 9lb 11oz born and I had a C-section after 12 hours of labour and dilation of not even 1cm. She had the cord wrapped around her chest and the c-section was done on suspected fetal distress. So in the end I guess this was warranted.

The reason for the refusal of a vbac this time is the greater risk involved on rupture of the uterus with a big baby. I have done quite a bit of research and from what I have read, this isn't the case. I feel my OB is using this as a scare tactic just to book me in for a c-section.

Just wondering is anyone else out there having the same issue and does anybody know of any pro-VBAC OB's in Brisbane that I could possibly gain a second opinion from?

It upsets me greatly to think that I am being pushed down the path of a c-section again and I am getting so frustrated that my needs are not being heard.

Would greatly appreciate anyone's feedback.

Thanks, Vikki.

Hi Vikki and welcome to BB! I am so sorry that you are being treated this way - it makes me so angry when flimsy excuses are thrown about to make you do what they want you to. You are right, the risk isn't any greater and it must be all the more frustrating to know you aren't being told the truth. I don't know of any other obs, but I do hope that someone else can help you.

Welcome to BB.

Utter crap what they told you. My OB NEVER ONCE mentioned anything like that as a risk factor for uterine rupture.

If you were on the sunshine coast I could definitely recommend my OB - she is fantastic and very pro-vbac.

Hopefully someone will pop in with a great one for you!!

All the best on your VBAC journey.

It might actually be worth asking your current obstetrician if they could you refer you to an obstetrician whom they regard as less interventionist/more risk taking than themselves for a second opinion. That way your current obstetrician knows that you disagree, and also that you are handling your difference of opinion in a responsible way.

It certainly sounds like a load of rubbish.

Dr Douglas Keeping is a private Ob at Mater Private, I've heard he's rather pro birth or you could use the public system which has a higher rate of success for birth after caesar than Ob's.

I've recently removed Obstetric's from my health insurance when I realised I dont need a surgeon to birth my baby for me.

Cheers,

Beck

Thank you to all have responded so far. And thanks Beck for the OB referral. I have heard of Dr Keeping and know some people who have used him before. I might just give him a call to get a second opinion.
Thanks again, Vikki.

Hi, reading your post was like reading about the birth of my son. It was very similar and has left me wanting to avoid hospitals all together. All i can say is please, please, please seek a second opinion for your own piece of mind. It could even be worth talking to an independent midwife for her advice. Good luck to you, I really hope you get your VBAC. Please keep us informed of how it all goes.

Sorry I can't help with an Ob referral but I am due with my second on the 25th Feb, I am going to be aiming for a home VBAC. My son was 10lb6oz and born by c-section 50hrs after my waters broke and I only got to 4-5cms dilated. Good on you for seeking a second opinion, basically it sounds like a load of bull**** to be honest.

Come join us in the Belly Buddies forum, there are a few of us aiming for vbacs in the "Due Feb 16-28th", we would love to have you join us.

Good Luck!

Hi there, I second the second opinion option. Good luck.

Another thing to keep in mind is that the size of a baby cannot be accurately predicted, even the most sophisticated ultrasound will be only accurate up to 20% either way, so if the scan says 4kg, it could really be 4.8 (so, lot sof women give birth to big babies) or 3.2 (now that could be average wouldn't it...), I pulled the first ob I saw re my desired vbac after 2 CS (how disgustingly irresonsible of me!!) on this when he told me that they would do an ultrasound at 38 weeks and CS if the baby was big, and he very reluctantly conceded that it is no more accurate than that, so if your ob has a new secret way to be exact maybe he should let in on the secret!! I am not having twins, so this doesn't apply to me, but in the course of my extremely vast research any many posts on BB that were answered by very helpful midwifes, even after 2 CS a twin vaginal birth is no riskier in terms of rupture than any normal VB (Of all the things that can go wrong UR would be quite low down on the list, and the majority of "ruptures" quoted in literature are non medical events anyway) So ask your doctor if that is medical fact or just his opinion, if it is fact could he refer you to his sources so that you can look into it too to become better informed, and if you were really feeling like stirring him ask him if he finds normal births that require no intervention a waste of his time after so many years of uni/internships etc. This last question of course implies that he creates a need for himself even when there isn't one.....
Anyway, I wish I had been more prepared and well researched when I attempted my VBAC, which went to emergency CS on very dubious grounds, but this time will be different, and no surgeon can do a CS on you without your signature on the consent form!!
Good luck!
Kate

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So ask your doctor if that is medical fact or just his opinion, if it is fact could he refer you to his sources so that you can look into it too to become better informed

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Exactly - I did this with one Ob I saw at the hospital I went to and she didn't know what to say, although she was trying to tell me that the risk of rupture is higher if you go past 40 weeks which isn't true either. There was never any mention of size when I was going for my VBAC, and justifiably so because there is nothing to say that if bub is large that you can't birth them vaginally. There is no increase in rate of rupture from any studies so I would be questioning it all you can. Good luck finding another ob, I would search high and low for one that supports VBAC - well worth it and I wish you well! :)

Yay to Silent Knife!!

I had a vbac with a bub that weighed 10 pd 4 oz - #4 bub for me ( my csec was with #3 )
but cant recommend a ob, as mine was in warragul

Hi coops7374,

Sorry to be the one to differ to everyone else but what if in your particular case, the research you did, what if you're wrong ?? :hide: I don't mean to be unsupportive but perhaps getting a second opinion would be the best thing as there may be other factors to consider http://www.birth.com.au/Info.asp?class=604&page=1 and then decide from there ?? Wishing you all the best and hope you have the dream birth you're wanting xx

PB - The coops has been told that the c/s will be for a large baby not shoulder dystocia, and there are studies that have shown that you can VBAC successfully with a large baby. In fact a VBAC is basically a vaginal birth, with risks of rupture that are very minimal and the risk does not increase with larger babies. The studies show that. As far as shoulder dystocia goes, the risk of that occuring is pretty slim as well - many many women birth babies that are larger than 4kgs with no complications. Our bodies are pretty good at making babies that fit our bodies.

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I had a vbac with a bub that weighed 10 pd 4 oz - #4 bub for me ( my csec was with #3 )
but cant recommend a ob, as mine was in warragul

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dr's simon and mclennan at warragul are very pro-VB and very supportive of VBAC from what i've read. i'm actually travelling twice as far to birth at warragul to be under the care of one of these Ob's (or the other if i go in at night and he is on call! i am high risk of GD (which tends toward larger babies) - at my appointment, the Ob said if GD develops, he WILL scan every appointment - but will not look at size at all, as size shouldn't be a factor in any birth - he will look only at placental function. to me, that was a great sign. in another thread recently, there was mention of the c/s rates at different hospitals for "normal" births - warragul was one of the lowest at only 9%

i'm not sure exactly where the OP is from (can't see now!), but if you're in melb south east, warragul may be an option for you....

I contemplated going to Warrigal too but it's an hour away! :rofl: They are apparantly the most pro-VBAC hospital in the state! Lucky you BG it sounds great!

hun, it's 45 mins on a good day from here - and worth it - the Ob i'm under is fantastic (scope out my blog where i rave about him!) - from the outset, i was a person, not another belly. he treated me with respect, discussed everything in detail, didn't care how long it took to get through the appointment so long as we had dealt with everything we had to ask. he was just great. apparently he's like that with everyone (so his only real flaw is that he is often running late). after a single appointment, i would say to anyone to go and see him.

he said something that rang true - no baby is more precious than another - they are all miracles - the difference is the parents, and some need to be handled more delicately because of their circumstances. it made sense. if he's like that with us based on AC, i'm guessing he would be very similar with a stressed out VBAC mumma

Hi there and welcome...I had a similar situation with my ob she did an u/s to check sze towards end of pregnancy and said that I would have a large baby and because of this my chances of having a vbac were not good...

I ended up going into labour natrually the next day...yes it ended in another c/s but I am glad I at least gave a vbac a go

I ended up negotiating with my ob so said that I would agree to be monitored the whole time and would even have an epi in in case there was a rupture she was happy with that...when I look back though I think having those interventions for me contibuted hugly to my c/s

Wishing you the best of luck...and if a vbac is really what you want then stand your ground...it is your body and your baby

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PB - The coops has been told that the c/s will be for a large baby not shoulder dystocia, and there are studies that have shown that you can VBAC successfully with a large baby. In fact a VBAC is basically a vaginal birth, with risks of rupture that are very minimal and the risk does not increase with larger babies. The studies show that. As far as shoulder dystocia goes, the risk of that occuring is pretty slim as well - many many women birth babies that are larger than 4kgs with no complications. Our bodies are pretty good at making babies that fit our bodies.

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I know what you're saying but that's why It's a good idea to get a second opinion because my question was "what if you're wrong?" KWIM?

I had Dr David Simon in Warragul for my vbac, Oh and we did have shoulder distocia with my "little" bub - but was all handled professionally - and not really eventful, just helped to manouver him so he came out

i have heard a lot of good about dr simon - i am under dr mclennan (he has done a lot of extra GD research) - but i have no issue if dr simon had to step in - so i'm happy with either Ob at the hospital

The best evidence we have does not show an increased risk of rupture with a "big baby" for a vbac. Yet we do still see this trotted out quite a bit from OB's - and the ones that use it are generally those who are not keen on VBAC's anyway. I would see this as a major red flag.

If this were me and my decision to make, and you absolutely must go private (VBAC rates are low generally but they are really abysmal in the private system) the only Brisbane OB I would even consider going near for a VBAC would be Doug Keeping.

In Australia at the moment only 15% of women with a prior caesarean ever give birth vaginally after their caesar...so if you really want that vbac, its so, so important that every decision you make is going to improve on those odds. And that really does start with where and with whom you birth. All else being equal, it really is the single most influencing factor on whether you will have a vbac or not.

Good luck :)

Hi Vikki, did you manage to get an appt with Dr Keeping?

To the PP's the OP is in Brisbane.

I can also say having a Doula will increase your chances of having the birth you want :) So another thing to look into.

Cheers,

Beck

Hi Vikki,

My first time on the forums too, so 'Hi' everyone.

I just wanted to give you some hope. My first daughter (2005) was 10lb 2oz and delivered via Elective CS by an OB who had very little faith in the female body :rolleyes: and performed a CS because DD's head had supposedly not engaged. I then went on to have a drug free VBAC in October this year and gave birth to my second daughter who weighed in at 12lb 11oz (5.76kg - the biggest baby to be born at that hospital this year :o)

She did have quite bad Shoulder Dystocia and it was more than a bit scary there for a while but my OB (different one to last time) midwife and Doula handled the situation brilliantly. My OB says that next time he will try some induction methods a couple of weeks early if the baby is looking to be another big one.

I didn't have a sizing scan as my OB and I both agree that they aren't all that useful and the only way to see if baby will fit through your pelvis is to give it a go.

I wish you luck in making your decisions and finding the right care provider.

C.