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Thread: VBAC Care - Ob or Midwife?

  1. #1

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    Default VBAC Care - Ob or Midwife?

    Just wondering if it would be better to be under the care of an OB or to just use the hospital midwives for care when planning a VBAC?

    What are the advantages of using an OB?

    What are the advantages of using midwives only?



    What about shared care with a GP?

    Do you have a choice either way?

    Is it true that you're considered high risk right from the start? If yes then I would assume you'd have to be under OB's care?

  2. #2

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    If it were me, and if you didnt want a homebirth, I would go public and get a private midwife. If you go public, an Ob will be available to you if there is the need. But the benefit of the midwife is that she looks at birth to be normal until proven otherwise... it's very well known that intervention is much higher in private establishments, particularly caesars, so much so that the NSW govt has demanded an enquiry!

    Caesarean section rates are spiking and the figures are so noteworthy that NSW health minister, John Hatzistergos ordered an enquiry into what he described as the “alarming” caesarean section rate in NSW hospitals. In January this year he said, “The decision ultimately as to how a birth should be delivered is one which is to be made by the mother in consultation with her medical advisor. However I am concerned, particularly at the private level, that it appears to some extent the increased number of caesareans is accentuated by reasons that are not clinically based.

    Reading between the lines, this points to a stronger likelihood of having a caesarean in a private hospital (note the “particularly at the private level”) and this fact is verified by the report that sparked Mr Hatzistergos’s publicly aired concern: New South Wales Mothers and Babies 2004 report which published the following eye-opening statistics:

    • 13% of women in public hospitals had an elective caesarean section, compared to 23 per cent of women in private hospitals
    • 18% of mothers in public hospitals who had a previous caesarean section went on to have a normal vaginal delivery with their next child, compared to only 8 per cent of mothers in private hospitals
    • 25% less women in public hospitals had an epidural compared to women giving birth in private hospitals.

    By focussing on the private versus public birth, the Minister has effectively thrown open up a highly charged debate, tabling the idea that your choice of health care provider can effect the outcome of your birth and the level of intervention brought to bear on the proceedings. Looking at the figures, it seems not only is a caesarean more likely of you choose private health care, but intervention of some description is almost the norm."
    Women have VBACs at home but you wont get one in most, if not all, birth centres. You'd have to be in a normal labour ward.
    Last edited by BellyBelly; October 18th, 2006 at 10:13 PM.
    Kelly xx

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    Author of Want To Be A Doula? Everything You Need To Know
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  3. #3

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    Sarah - I am just wondering if I missed a BFP announcement????? Sounds awfully like you are preggas to me!!!

    (excuse me if I have! LOL)

  4. #4

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    Yep from all of my research so far everything has said OBs aren't the way to go, but I keep finding people telling me to make sure I get a VBAC friendly OB, so I'm a little confused.

    So is a private midwife different to a birth attendant? I guess they are, but what's the deal with hiring a private midwife? What's the difference to having a public one.

    Sorry for all the questions, but I really have no idea about what sort of care I should be getting!


    ETA: Nup Relle, not just yet. Just researching & working out my options. I'm not even in the TWW yet

  5. #5

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    Yeah Sarah where's that link to your chart?!
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
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  6. #6

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    A private midwife is a midwife there to work for you, and be there for you to help you with the birth you want. She can see you in your own home for pre-natal and post-natal check-ups and is of course medically trained and can give you medical advice...
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    Follow me in 2015 as I go Around The World + Kids!
    Forever grateful to my incredible Mod Team and many wonderful members who have been so supportive since 2003.

  7. #7

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    Hehe I took it away from all the stalkers

    http://www.fertilityfriend.com/home/sarah_h

  8. #8

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    Okay so if I had a private midwife she'd do the antenatal appointments rather than going to the hopital or OB office? But then if I have one would I still need a birth attendant? Or are do they do really different jobs?

    Sorry Kelly, if I'm driving you nuts with all my questions!

  9. #9

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    If you were going to be in hospital you can have just the midwife but you'd need to check with your midwife when she covers you - some come closer to the birth and some will be there longer. So if they only come closer to the birth, an attendant is a great addition, those having homebirths tend to have both or more - they suround themselves with lots of empowering women. As long as you have trust and confidence in your circle, there's no such thing as too much support
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
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    Forever grateful to my incredible Mod Team and many wonderful members who have been so supportive since 2003.

  10. #10

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    Sarah - I am learning so much from your chart!! Would it possibly be right to say you have just O'd on day 17 or just about too????

    Anyways, sorry to hijack - couldn't help myself from asking! heheheheeheh Look forward to keeping an eye on your chart!

  11. #11

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    Thanks Kelly I think that's all for tonight

    ETA: Relle I think either yesterday or today. So it's bedtime for me now

  12. #12

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    Anytime LOL Make the most of it while I am here - expo's about to start and then I am off to QLD!!!!!! YAH!
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    Follow me in 2015 as I go Around The World + Kids!
    Forever grateful to my incredible Mod Team and many wonderful members who have been so supportive since 2003.

  13. #13

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    Hehe I'm sure there will be even more once I'm finally pregnant! I'll have to put your number on speed dial LOL!

  14. #14

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    PML and I will be loving every minute!!! Keep reading those books before preggo brain sets in too :P
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    Follow me in 2015 as I go Around The World + Kids!
    Forever grateful to my incredible Mod Team and many wonderful members who have been so supportive since 2003.

  15. #15

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    Sarah, when I was pg with Tehya, you'd probably remember anyway. But, I was booked into hospital as a public patient. I was classed as a high risk patient as I'd previously had a c section. Because of this I could not be seen or birth in their birthing centre.

    The visit's that I did go to were in the hospital and I was seen by OB on shift. I only went to the major appts. I think my first appt, then 28 weeks and 36 weeks from memory. I saw my GP in between as I put myself down for share care. I didn't want to go along ot the hospital for clinic appts with Noah in toe and besides I didn't plan to birth there.

    I also saw my private midwife at 14 weeks, 28 weeks and weekly from 36 weeks. I could call her whenever I wanted to and as you know she was there with me from very early in my labour until a couple of hours after Tehya was born. She then came back to see us that afternoon and every day for the next 4 days.

    So my on going care with my midwife was a fantastic thing to have. Definately not something I would have gotten going to hospital.

    If you do hire a private midwife I am pretty sure they do not allow her to assist in your birth at the hospital, well not in any hand's on way. Perhaps if you choose to have one she could be with you at home when you are ready for her to join you and then accompany you to hospital and stay with you throughout your labour and birth. She could be your advocate and because you will have a rapport with her, you will more than likely feel alot more comfortable in your surroundings.

    Sorry if I have gone off track there. But I hope some of it helps you out hun

  16. #16

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    Sarah I'm so glad you are coming up with these fab questions - as i'm learning heaps. From reading that info from Kelly i'm feeling quite relieved that i'm going public as it does look like my chances of a VBAC are slightly higher than if i went private. I posted an inquiry about the High-risk OB i'm seeing at Nepean Public and had some good news that he is supposedly encouraging of VBAC's ...so fingers crossed! It still might be worth looking into a private midwife as Kelly suggested though! Oh - and have fun with the BD

  17. #17

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    Yep thats right a Private Midwife cannot catch your baby but I have heard some awesome stories. An example: a couple had a private midwife for a birth centre birth. They go to hospital, birth centre about to close in 40 mins, have to go up to main ward. Relief when the birth centre midwife comes with them. Not so relieving when the birth centre midwife says 'you've been pushing for a while, the Ob is coming soon how about I just do a quick episiotomy'! The midwife whispered in mums ear telling her not to listen to that midwife and listen to her instead... getting her back on track and labouring well... she doesn't need it. Baby came out after a few more contractions perfectly fine.
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    Follow me in 2015 as I go Around The World + Kids!
    Forever grateful to my incredible Mod Team and many wonderful members who have been so supportive since 2003.

  18. #18

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    Wow! That private midwife was certainly worth while!!!

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