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If you've had a successful VBAC


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Could you tell me some of the choices you made that you think played into your success? Short of a homebirth, cause that's just not happening here. :) I had an emergency c-section with my third because of her cord getting in the way (she evidently grabbed it in all her tumbling around and pulled it down in front of the birth canal). Anyway, I'm looking into care providers and facilities for having my fourth child and really the only think I intensely care about is not having a repeat c-section. The recovery was awful for me and I'd do just about anything to not go through it again. Though evidently not avoid having another child! :D I'm looking into a freestanding birth center with midwives who do work with VBACs and a hospital with midwives who have privileges there. There is a large cost difference, the freestanding center being more because insurance considers it out-of-network, but if the odds of having the successful VBAC are considerably higher if I avoid even a supportive hospital with a midwife attending, then that will certainly make a difference in our decision.

 

Thanks. :)

 

Jami

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My first was an emergency c-section, the other 4 were successful VBACs. I delivered all 5 with the same OBGYN practice and at the same hospital. My doctor did ask that I get an epidural with each VBAC, just in case there was a rupture or other emergency they could get me into surgery quickly.

 

I think that your chances of having a successful VBAC are high since the reason you had the c-section was because of naughty-newborn behavior ;), and not because of other issues (baby to big, for example). If I were you, and I liked the hospital/midwives, I would probably choose to go that route because I don't think the birth center increases your odds. If I didn't like the hospital or midwives, I would go the other route. Would the freestanding birth center be set up adequately to handle a uterine rupture? If not, I would not consider it because even though there is only a tiny chance of that occurring, it is still a possibility.

 

Oh, and CONGRATULATIONS!!

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I had 2. My first child was born by C due to an infection I got in the hosp. My second was a home-birth VBAC with a very supportive midwife who had a VBAC herself. I will tell you that the risk of uterine rupture is very small, although dr.'s will tell you opposite...it's a CYA issue/insurance issue for them. I had successful vaginal births with 2 subsequent dc after that only to have another C w/ baby #5. He got "stuck" and just would not come out. Had I gone to a different hosp. (we had home births with all the others btw) for transport, I'd have had a vaginal birth, but the hosp. we went to was too quick to cut. :glare: Anyway, I went on to have another VBAC with baby #6. I plan to birth at home with this one. Most importantly is find a midwife or OB who supports VBACS and I mean REALLY supports them. Not, "let's give her a trial of labor and see", but one who is really committed to it. A friend of mine had a VBAC in the hospital and I got so angry w/ her midwives and OB's b/c every half hour they would come in and shake their head and say stuff like, "I don't know if this is going to happen. She might need another C. We'll just have to play it by ear!". How demorazlizing is THAT to a laboring mother? Well, she ended up having her VBAC. You know? The nurses didn't even have the birth station set up when she got to 10 cm b/c they really thought she'd end up w/ the C! Anyway, go with the birth center...midwives are often more supportive of VBACs than OB's. Good luck!

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I've never had a VBAC, but my good friend did, and the third time she ruptured and almost died. She's a lurker here, maybe she'll chime in and tell you what she thinks.

I don't mean to scare you at all, please don't think that.

My dad is an OB, and he says Vbacs are just ruptures waiting to happen. I know plenty of women have done it sucessfully over and over though.

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Ask each provider their VBAC success rate. It may vary widely. It does depend on the midwife, but in a hospital you are more likely to be "on the clock" for your delivery, whereas I often hear of women pushing for 4 or more hours in a birth center (without baby being distressed of course). I really don't think Dr.s would allow extended pushing like that to happen in a hospital. They let me push all of 2 hours with a posterior baby, and on my back, ugh. If I had to deliver in a hospital next time, I would DEFINITELY get a doula.

 

Disclaimer- I haven't had a VBAC YET.... I was a NICU nurse and have attended some VBAC's though ;)

 

ETA- also ask about VBAC policies- at many hospitals VBAC's must have continuous fetal monitoring/ epidurals/ iv's etc. They will probably just use the doppler at the birth center.

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Ask each provider their VBAC success rate. It may vary widely. It does depend on the midwife, but in a hospital you are more likely to be "on the clock" for your delivery, whereas I often hear of women pushing for 4 or more hours in a birth center (without baby being distressed of course). I really don't think Dr.s would allow extended pushing like that to happen in a hospital. They let me push all of 2 hours with a posterior baby, and on my back, ugh. If I had to deliver in a hospital next time, I would DEFINITELY get a doula.

 

Disclaimer- I haven't had a VBAC YET.... I was a NICU nurse and have attended some VBAC's though ;)

 

Very, very typical. My VBAC was a 4 hr. delivery (meaning I pushed for 4 hours). I would have had a second C for sure if I had been in the hosp. I can't imagine being on your back w/ a posterior baby...talk about setting you up for failure! Ugh. OB's. That's why I avoid them. Oh, yes, and getting a doula is another key to success!

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I have had one successful VBAC so far and your chance will be higher with the less interventions you have. I had a birth plan ready incase we transfered to the hospital so I highly recommend you have one and go over it with your care providers well before your due date. Make sure any questions or concerns are out of the way well in advance. Once you get to the birth center or hospital, make sure whoever is on staff that day gets a copy and that they READ it.

 

There is no need for any excess interventions including epidurals just in case ( Sorry to the poster who did this), continuous monitoring etc. Your chance will be higher if you can move around, change positions and do what feesl right to you.

 

Some good books are Silent Knife and The VBAC Companion. Lastly, I highly recommend the web site www.ican-online.org and joining the email loop.

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My first was an emergency c-section, the other 4 were successful VBACs. I delivered all 5 with the same OBGYN practice and at the same hospital. My doctor did ask that I get an epidural with each VBAC, just in case there was a rupture or other emergency they could get me into surgery quickly.

 

I think that your chances of having a successful VBAC are high since the reason you had the c-section was because of naughty-newborn behavior ;), and not because of other issues (baby to big, for example). If I were you, and I liked the hospital/midwives, I would probably choose to go that route because I don't think the birth center increases your odds. If I didn't like the hospital or midwives, I would go the other route. Would the freestanding birth center be set up adequately to handle a uterine rupture? If not, I would not consider it because even though there is only a tiny chance of that occurring, it is still a possibility.

 

Oh, and CONGRATULATIONS!!

 

Well I liked the hospital and my OB in St. Louis well enough. And if we were still there I would certainly work with him again. But there were also no birth center or midwifery options in St. Louis. If there are CNMs (and there aren't many) they basically can work like nurse practitioners with prenatal care, but absolutely can't deliver in any of the hospitals and there are no freestanding birth centers (that I ever heard of). There may be some lay midwives that attend homebirths....

 

All that to say, I can work with a traditional hospital birth and OB if need be. I liked my first two births well enough, though they were pretty typical with interventions (fetal monitoring, induction).

 

I'm curious about your OB thinking you needed an epidural "just in case", I've read some research that thinks an epidural can be a hindrance to a VBAC, because often labor slows with an epidural (if given too soon) and then pitocin would be needed (not good for the uterine scar). Which was why I felt I really needed to find support for a natural birth this time around.

 

The birth center has a hospital and OB back up for transfers.

 

I've not met the midwives that work with the hospital I'd choose (if I don't choose the birth center), I have an appointment next week and a long list of questions about how much support they offer (if they're just going to catch like an OB and the nurses will be my primary support, then the birth center offers something different), how much freedom of movement and positions I'll have, things like that.

 

Thanks for your congrats and sharing your experience!

 

Jami

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I had 2. My first child was born by C due to an infection I got in the hosp. My second was a home-birth VBAC with a very supportive midwife who had a VBAC herself. I will tell you that the risk of uterine rupture is very small, although dr.'s will tell you opposite...it's a CYA issue/insurance issue for them. I had successful vaginal births with 2 subsequent dc after that only to have another C w/ baby #5. He got "stuck" and just would not come out. Had I gone to a different hosp. (we had home births with all the others btw) for transport, I'd have had a vaginal birth, but the hosp. we went to was too quick to cut. :glare: Anyway, I went on to have another VBAC with baby #6. I plan to birth at home with this one. Most importantly is find a midwife or OB who supports VBACS and I mean REALLY supports them. Not, "let's give her a trial of labor and see", but one who is really committed to it. A friend of mine had a VBAC in the hospital and I got so angry w/ her midwives and OB's b/c every half hour they would come in and shake their head and say stuff like, "I don't know if this is going to happen. She might need another C. We'll just have to play it by ear!". How demorazlizing is THAT to a laboring mother? Well, she ended up having her VBAC. You know? The nurses didn't even have the birth station set up when she got to 10 cm b/c they really thought she'd end up w/ the C! Anyway, go with the birth center...midwives are often more supportive of VBACs than OB's. Good luck!

 

Thanks, Sue. Yes, I don't want to be told I can "try" it, I want someone to come alongside me and build my confidence (shattered a bit after the last birth), who will help me do everything I can to be successful. I would be working with midwives either place, most likely, I"m okay with laboring in the hospital if the midwife who works with me is going to offer the kind of support that one in a birth center would.

 

Jami

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I've never had a VBAC, but my good friend did, and the third time she ruptured and almost died. She's a lurker here, maybe she'll chime in and tell you what she thinks.

I don't mean to scare you at all, please don't think that.

My dad is an OB, and he says Vbacs are just ruptures waiting to happen. I know plenty of women have done it sucessfully over and over though.

 

Well I'll have to respectfully disagree with your dad I'm afraid. :) The rates I've seen for rupture are about .05%, and that includes some ruptures where there wasn't even scar tissue, just a weak uterine wall naturally. But I certainly want to make the wisest choice I can, the doc who did my c-sect (and delivered my other babies) was confident right after the delivery and at later check ups that a VBAC shouldn't be a problem for me.

 

Jami

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In our area they're fairly common and expected by most people. I had C-Sec with my twins, my first VBAC with a Doula and it was a really long, hard labor. The second VBAC was so fast the doctor barely got into the room fast enough to catch her.

 

You do need to discuss things with your doctor and the hospital. Our local, smaller hospital will not allow any VBAC so I had to travel further. They have to have people on hand for emergencies 24 hours in order to offer them because on the rare chance (and it is very rare, something confirmed by both my OBs who had no issue with them at all) that it does rupture, unlike most complications where you can usually manage with basic intervention, a rupture can kill you in only minutes. Very rare, but something to be aware of.

 

Also, the last OB I had was great. She said that the less intervention the better. Your chances of a rupture increase if you are induced because it is harsh on the uterus. Natural is better.

 

I know some mid-wives who will do home births with a VBAC, which is funny because so many hospitals won't.

 

If you go with an OB, do your research first. Many are of the old way of thinking that "once a C-sec, always a C-sec" and honestly, many don't give much mind to recent techniques, research or opinions on the matter.

 

When a home birth is not an option, your best bet for peace of mind is to find a birthing center attached to a hospital with a good mid-wife. If I had this option, I would have gone with it.

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Ask each provider their VBAC success rate. It may vary widely. It does depend on the midwife, but in a hospital you are more likely to be "on the clock" for your delivery, whereas I often hear of women pushing for 4 or more hours in a birth center (without baby being distressed of course). I really don't think Dr.s would allow extended pushing like that to happen in a hospital. They let me push all of 2 hours with a posterior baby, and on my back, ugh. If I had to deliver in a hospital next time, I would DEFINITELY get a doula.

 

Disclaimer- I haven't had a VBAC YET.... I was a NICU nurse and have attended some VBAC's though ;)

 

ETA- also ask about VBAC policies- at many hospitals VBAC's must have continuous fetal monitoring/ epidurals/ iv's etc. They will probably just use the doppler at the birth center.

 

Thanks for the great suggestions, Sarah. I'll add these comments to my questions for the midwives. I've already discussed some of these things with the birth center. I guess I assumed that a midwife in a hospital setting would be like having a doctor and doula all-in-one. Is that not accurate do you think?

 

Jami

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I had a very successful VBAC in our local hospital. I followed the Bradley method throughout my pregnancy and had a very healthy happy baby. I'm wishing you the same.

 

Thank you Tammy, actually the birth center recommendation came from a local Bradley instructor.

 

Jami

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I have had one successful VBAC so far and your chance will be higher with the less interventions you have. I had a birth plan ready incase we transfered to the hospital so I highly recommend you have one and go over it with your care providers well before your due date. Make sure any questions or concerns are out of the way well in advance. Once you get to the birth center or hospital, make sure whoever is on staff that day gets a copy and that they READ it.

 

There is no need for any excess interventions including epidurals just in case ( Sorry to the poster who did this), continuous monitoring etc. Your chance will be higher if you can move around, change positions and do what feesl right to you.

 

Some good books are Silent Knife and The VBAC Companion. Lastly, I highly recommend the web site www.ican-online.org and joining the email loop.

 

Thank you for the book suggestions and advice about the birth plan, Jean. I've been to the ican website, but I'll look for the books at the library. My mom (OB nurse--Midwife wannabe) recommended http://www.childbirthconnection.com as a good website with pretty balanced pros and cons for various things--birth providers, locations, VBACs, etc. And I've done some reading there.

 

Jami

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My dad is an OB, and he says Vbacs are just ruptures waiting to happen. I know plenty of women have done it sucessfully over and over though.

 

Woman who have never had C-sections have had ruptures too. The actual rupture rate is very low and is lower the less interventions you have.

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In our area they're fairly common and expected by most people. I had C-Sec with my twins, my first VBAC with a Doula and it was a really long, hard labor. The second VBAC was so fast the doctor barely got into the room fast enough to catch her.

 

You do need to discuss things with your doctor and the hospital. Our local, smaller hospital will not allow any VBAC so I had to travel further. They have to have people on hand for emergencies 24 hours in order to offer them because on the rare chance (and it is very rare, something confirmed by both my OBs who had no issue with them at all) that it does rupture, unlike most complications where you can usually manage with basic intervention, a rupture can kill you in only minutes. Very rare, but something to be aware of.

 

Also, the last OB I had was great. She said that the less intervention the better. Your chances of a rupture increase if you are induced because it is harsh on the uterus. Natural is better.

 

I know some mid-wives who will do home births with a VBAC, which is funny because so many hospitals won't.

 

If you go with an OB, do your research first. Many are of the old way of thinking that "once a C-sec, always a C-sec" and honestly, many don't give much mind to recent techniques, research or opinions on the matter.

 

When a home birth is not an option, your best bet for peace of mind is to find a birthing center attached to a hospital with a good mid-wife. If I had this option, I would have gone with it.

 

My sister lives in western NE and when policies changed at her small hospital to disallow VBACs, she was pretty annoyed. Her first was a c-section (breech), then she went on to have 3 other very fast, natural VBACs before the policy changed. But with her 5th (4th VBAC) technically she wasn't suppose to VBAC, but they managed to get her "grandfathered" in or something.

 

The birth center nearest to me and highly recommended to me is not attached to a hospital, but has a back up hospital and OB. The midwives I have an appointment with next week deliver at the most family-natural birth friendly hospital I could find, based on testimonies and policies, but it's not a birth center. There is another group of midwives that run a birth center within another area hospital...I guess I could talk to them too. But they were the ones that were curt with Aubrey and that didn't encourage me.

 

Jami

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I guess I assumed that a midwife in a hospital setting would be like having a doctor and doula all-in-one. Is that not accurate do you think?

I haven't had a VBAC, but I have delivered in a hospital with a midwife, and that wasn't my experience *at all*. I had zero labor support from anyone except dh till it was time to push. That actually worked out fine, but it wasn't what I expected. I'm looking for a homebirth this time, but if I end up going with an OB, I will definitely hire a doula, both as labor support and to fight with the staff as needed. If you are looking for continuous support, I wouldn't count on a midwife in a hospital to provide it.

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I've had two sections and am planning my first vaginal delivery (VBA2C) in August.

 

My plan of attack is hiring a doula, doing a Hypnobabies homestudy, and going without any sort of pain meds/interventions. I'm delivering with the same OB who did my sections (first was posterior lie not budging after 1.5 hours of pushing, but I'd had epi and was on my back; second was repeat for breech twins). The risk of uterine rupture is higher among women without previous scars who are induced with Cytotec so it's not really a cause of concern on my radar. Concern enough that I'll be delivering at a hospital since I've never had a vaginal delivery, but the risk is so very low -- less than a percent like you said (tho it's really .5% not .05%, IIRC).

 

Here are some stats from vbacfacts.com that help to put the "big" UR in perspective:

 

  • Your risk of dying in a car accident, over the course of your lifetime, is between 1 in 42 and 1 in 75. This is roughly 4 to 5 times greater than the risk of uterine rupture.
  • You're about twice as likely to have your car stolen (that's an annual risk) than to experience a uterine rupture.
  • Your odds of being murdered are 1 in 140 over the course of your lifetime. That's 2 times more likely than the risk of rupture.
  • You're more likely to have twins than a uterine rupture. Odds of twins: 1 in 90. That's about 3 1/2 times the likelihood of rupture.
  • If you flip a coin, you'll be more likely to get heads (or tails) 8 times in a row than to rupture.

Nonetheless, congrats on the pregnancy! I'll keep you updated on my VBAC progress :)

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I've had two sections and am planning my first vaginal delivery (VBA2C) in August.

 

My plan of attack is hiring a doula, doing a Hypnobabies homestudy, and going without any sort of pain meds/interventions. I'm delivering with the same OB who did my sections (first was posterior lie not budging after 1.5 hours of pushing, but I'd had epi and was on my back; second was repeat for breech twins). The risk of uterine rupture is higher among women without previous scars who are induced with Cytotec so it's not really a cause of concern on my radar. Concern enough that I'll be delivering at a hospital since I've never had a vaginal delivery, but the risk is so very low -- less than a percent like you said (tho it's really .5% not .05%, IIRC).

 

Here are some stats from vbacfacts.com that help to put the "big" UR in perspective:

 

  • Your risk of dying in a car accident, over the course of your lifetime, is between 1 in 42 and 1 in 75. This is roughly 4 to 5 times greater than the risk of uterine rupture.

  • You're about twice as likely to have your car stolen (that's an annual risk) than to experience a uterine rupture.

  • Your odds of being murdered are 1 in 140 over the course of your lifetime. That's 2 times more likely than the risk of rupture.

  • You're more likely to have twins than a uterine rupture. Odds of twins: 1 in 90. That's about 3 1/2 times the likelihood of rupture.

  • If you flip a coin, you'll be more likely to get heads (or tails) 8 times in a row than to rupture.

Nonetheless, congrats on the pregnancy! I'll keep you updated on my VBAC progress :)

 

Good luck to you, Megsy! Those are interesting stats (and thanks for correcting my earlier stat.), I had my car stolen a couple years ago, so I'm good there. ;)

 

I think I should be a good candidate, I'm 32, delivered my first two vaginally, the c-section was to prevent a cord prolapse, not because of size or failure to progress or anything like that...but I do lack confidence. I haven't had a natural birth, though I like to think with the right environment and support I could.

 

Jami

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Early induction was the cause of my first csect and the cause of many peoples first csect. The body often is just not ready to give birth when induced. I researched vbacs extensively before my first vbac so thank goodness I knew this as many doctors tried to tell me that the key to a vbac was early induction. In reality...early induction is a huge key csects and repeat csects.

 

I then had 2 vbacs. With my 4th child, no one was willing to do a vbac! Then I found a doctor who seemed like he was willing..only he lied to me. When I actually went in to labor, he said he needed to do a sonogram because he was concerned about something. He did the sonogram and claimed I had placenta previa. I believed him. But after I had the baby, the doctor I had who did the sonograms told me I never had previa and was lied to because the OB wanted to just do a csect. With the 5th baby..something similar happened. I went to a doctor who agreed to a vbac but when it got close to time, her partners told her that they did not want me to have a vbac. So, she scheduled a csect and I was upset about it. I never ever should have gone alone with it. Even if it meant her dropping me, using an oncall doctor at the last second, going to a birth center, whatever..I should have just said no. DH wanted me to say no..but I folded under the pressure.

 

With the 6th child, I went in to labor way too early. Because of it being early, the doctor spent all her time trying to stop the labor and not prepping for a csect. As a result..the baby was born vaginally. Now I have resolved that the next will be born vaginally too..even if I have to do it at home.

 

Anyway..the main key is to stay far far away from invasive medical procedures like inductions and such. I can tell you that MOST doctors will claim to a woman that her baby is getting too big and she must induce early. It is a lie. Some doctors might even believe that. But, in reality, the lack of hormones to soften the bones and spread the hips is going to do far more damage to the birth process than the extra 2 or 3 ounces a baby is going to grow. In fact, babies pretty much do not even grown really in that last week. Some people think babies grow half a pound a week. Just imagine if they did that....your baby would gain 3 pounds in the last 6 weeks....6 pounds in the last 12 weeks...are you getting the idea? If this were true..everyone would be giving birth to 20+ pound babies.

 

Fact is, your uterus will not hold a baby in that is too big to give birth to. Therefore, you will go in to labor naturally in plenty of time before the baby gets "too big."

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I haven't had a VBAC, but I have delivered in a hospital with a midwife, and that wasn't my experience *at all*. I had zero labor support from anyone except dh till it was time to push. That actually worked out fine, but it wasn't what I expected. I'm looking for a homebirth this time, but if I end up going with an OB, I will definitely hire a doula, both as labor support and to fight with the staff as needed. If you are looking for continuous support, I wouldn't count on a midwife in a hospital to provide it.

 

See now that's not what I want. Though dh is excellent support, and I've *had* decent nurses, though I've also had a few that obviously hadn't had much real coaching experience. I will look into a doula if it looks like the midwives don't provide that level of support.

 

Jami

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Jami, you are a perfect candidate for VBAC. Seriously.

 

Have you done any reading at all? May I suggest some?

 

Ina May's Guide to Childbirth

The Thinking Woman's Guide to a Better Birth

Pushed

The VBAC Companion

Birthing from Within

 

(those are just a few off the top of my head)

 

Also, if you haven't seen it yet, The Business of Being Born is an exceptional documentary. You can watch it for free online at: http://quicksilverscreen.com/watch?video=45525

 

And of course if you have any questions (not that I'm an expert, just a good researcher!), I'd be more than happy to answer anything for you.

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Wow, Summer. What a journey you've had. I can hardly believe you've had doctors that were deceptive like that with you. :( I had a wonderful relationship with my OB in St. Louis and he knew what I wanted and so when he told me with #3 that I needed the c-section and quickly, I believed him. I can't imagine how I would feel if I found out now that it hadn't been necessary at all. I'm honestly amazed at your resiliance and courage, Sue's too. It's taken me 4 years to feel ready to have another after my emergency c-section, it just really left me shaken.

 

Jami

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I have had 1 csect and 2 vbacs. I did a lot of intense research when I decided to go for vbac #1, just like you seem to be doing. I ended up going with a midwife delivery at a hospital. I would have been willing to do the birth center, but I think it was against the law. The biggest thing that all of my research taught me is that induction is the enemy. I am totally certain that without the midwives, I would have ended up with another c sect. I went overdue and I have big babies. It was their confidence and guidance that helped me handle my fear in that last week. No doctor would have ever done that for me.

 

With my second vbac, we had moved and there weren't any midwives that took our insurance(we were not in a position to pay out of pocket). So I went to a doc that "supports" vbac. I had my confidence back, and felt like I could advocate for myself. So fast forward to 36 weeks pregnant and she wants to induce at least a week early! I refused and she was not too happy with my decision (she did remain professional though). So we agreed that if I went a week over, I would be induced. Secretly, I knew that I wouldn't allow induction unless I hit 42 weeks, but I just wanted to end the conversation. Anyhow, I ended up only going a few days over. I delivered smack in the middle of huricane Charlie so I'm pretty sure she must have been cursing me for not inducing sooner, LOL.

 

I had an epidural with my first vbac, but not with my second. I don't think it it hindered my first delivery at all. The only reason I didn't have one again was the back pain I had from it. I think that any EPi could be a hinderence, depending on the person, but I wouldn't automatically rule it out.

 

My first vbac was an incredibly healing experience. I think the most important element is the midwife you choose. I think with an experienced midwife, who is fully commited to vbacs, it doesn't matter if you're in a hospital or birth center.

 

Congrats!

Hth,

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my VBAC went against all the recommendations for natural/no interventions. my first birth was a C-section, I was induced with a large baby face-up after three hours of pushing. my second birth I really wanted a VBAC as I had little local support for help with my first child and was very nervous about the long recovery period with a three year old to care for. I looked a little into natural childbirth, hypnobirthing, doulas, but by the time I started calling around for doulas they were all booked up. I was with the same large OB practice I was with for my first, but the doctor who delivered was no longer there and they had a lot of turnover.

 

I went to all the doctors in the practice and one was very pessimistic about VBACs and the others thought I could try it. I finally went to the one male doc who I had not seen the first time because I didn't like the idea of a male doctor. But after I saw him I immediately liked him better than the other women I had seen - he discussed the option with me, telling me about current research, and really treated me as if I was intelligent which I liked better than the more touchy-feely approach of the women I guess.

 

So, two weeks before my due date I again had very high blood pressure, like I had with my first, and he wanted to induce me. I asked if I could wait a couple of days until he was the doctor working the hospital and he said that was fine. I was already starting to dilate and that was the reason he agreed to inducing me.

 

I was induced two weeks early, had the epidural when it got painful (around 4-5cm), and delivered at 1 in the afternoon after a pretty short duration of pushing (the nurse actually advised me to take it slow so the doctor could get back from his lunch break!)

 

In your case, with two previous successful deliveries, I would think you have a very good chance with a VBAC. And you don't have to go completely natural to have one. Good luck!

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I haven't been around much and obviously I've missed something! :)

 

Huge congratulations from me! (And if you're not yet pregnant but just in the planning stages, then a huge good luck from me. :) )

 

I made a pretty subtle announcement in last week's Works in Progress thread. And then changed my signature. I couldn't figure out a clever way to announce. We've been in the planning and trying phase for a couple of months and I *had* thought I would wait longer to tell. But I'm not not good with secrets. ;)

 

We're excited, a little scared, but now that the older three are, well, older, I think we can make it work. They're all very excited!

 

Jami

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Yeah, me too! Congratters, Jami!

 

Thanks, Patty! Did you have a lovely first Orthodox Easter? I remember some of Anna's posts from the past and it sounded like there were some really neat services at Pascha. (That's the right name?)

 

Jami

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You have already had lots of great advice. I will just chime in with another "You can do it!" My first was a c-section. My oldest was long and two weeks late and did head spins the night before he was born so his cord was around his neck - 4 times. My first vbac was 10 years later. None of the birth centers here would accept vbacs. I found a great OB that had no problem with trying for a vbac, but she did require continuous monitoring. I had the next vbac almost 4 years later with the same OB. Finding a place that will accept vbacs and a doctor or midwife that is comfortable with them is the key.

 

Enjoy. Babies are great and vbacs are much less risky than a repeat c-section.

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Jami, you are a perfect candidate for VBAC. Seriously.

 

Have you done any reading at all? May I suggest some?

 

Ina May's Guide to Childbirth

The Thinking Woman's Guide to a Better Birth

Pushed

The VBAC Companion

Birthing from Within

 

(those are just a few off the top of my head)

 

Also, if you haven't seen it yet, The Business of Being Born is an exceptional documentary. You can watch it for free online at: http://quicksilverscreen.com/watch?video=45525

 

And of course if you have any questions (not that I'm an expert, just a good researcher!), I'd be more than happy to answer anything for you.

 

 

Thank you for these suggestions, Megsy. I've only done some online reading so far and I've read Husband Coached Childbirth and Natural Childbirth the Bradley Way before my other births. But I will certainly look into these titles to better educate myself and prepare for this birth. :)

 

Jami

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My first vbac was an incredibly healing experience. I think the most important element is the midwife you choose. I think with an experienced midwife, who is fully commited to vbacs, it doesn't matter if you're in a hospital or birth center.

 

Congrats!

Hth,

 

This is exactly what I'm hoping for, Shannon. It was one of the main reasons I encouraged dh to consider a fourth child, actually. Our family had some tough things happening during my third pregnancy and then having her birth be semi-traumatic for me left me feeling sort of detached from that whole year. Though I certainly can't guarantee a perfect birth and wouldn't risk my health or a child's health for a certain experience, but I know I would feel more empowered and joyful at having a successful natural birth.

 

Thank you for sharing your experiences.

 

Jami

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In your case, with two previous successful deliveries, I would think you have a very good chance with a VBAC. And you don't have to go completely natural to have one. Good luck!

 

Thanks for your encouragement, Allearia and for letting me know how your VBAC went.

 

:)

 

Jami

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My first daughter was born vaginally, the second was a c-section (her umbilical cord was too short and she couldn't descend), my son was a VBAC. My second two were born in a hospital in Germany. They have different ideas than we do here in the US. Probably the socialized medicine aspect encourages midwives and low intervention. They didn't even think twice about me having a VBAC, there was no consideration of doing a routine c-section just because I'd had one already. It went just fine, no complications.

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I've had two VBACs. Both times I was attended by the same OB, a fairly bossy, decisive, somewhat intrusive OB. (But I love him anyway) I was very high risk, which is why I opted for this bossy, decisive, somewhat intrusive OB. HE was more commited to the VBACs than I was. In fact I think about a week before delivery both times I just plopped down in a chair in the exam room and said "Please. Can we just do a section and be done with it?" He just laughed at me.

 

I was induced, I had an epidural. (The epidural was not really for the pain, I'd had natural births before. One of the side effects of an epidural is that lowers blood pressure. In my case this was a good thing. And an epidural is not as nasty as mag-sulfate!) I was hooked up to all the machines. It was a very medical experience.

 

At yet, at the heart of that I had a doctor who cared about me, was committed to me. He would sit on the edge of my birthing bed and prop my leg up while I pushed. I gave birth actually looking in his eyes, we just locked eyes and communicated that way. He did not have to tell me to push, I did not tell him I had to push, we just worked it out together.

 

I hope you never need all the stuff I had. I wish you could have a birth like my amazing homebirth with the wonderful, nurturing midwives. But in the event that all the hospital interventions are needed, the doctors and the nurses commitment to your success makes all the difference in the world.

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I can't read all of the other posts right now, but I wanted to tell you that my first baby was born via c-section and the other three were vaginal.

The doctor who delivered my first baby was a substitute for my regular OB (who was away for the weekend.) It was Memorial Day weekend, and I am convinced that he was in a hurry and had a bbq to attend. I had been in labor only about 6 hours (first baby, mind you) and he said that the baby was experiencing distress whenever I laid on my side, so I should have a section. We believed him and neither dh nor I questioned this man's judgment at the time.

 

When I got pregnant with my second child, I had my regular OB again. He said "There was no compelling reason for you to have that section. Do you want to try a vbac?" I was so happy. Now, I'll tell you that my doctor was almost 70 years old and very set in his ways, so nobody could tell him that I shouldn't try for a vbac if I wanted to.

 

I did it, and I was totally fine. In fact, my labor was so quick that I almost had her in the car.

I've heard that lately there are more and more hospitals/doctors that won't participate in vbacs. I think that is such a shame because they can be done successfully and for me the difference was like night and day. I was incredibly miserable following my section. I felt invigorated and excited and ready for action after my vaginal deliveries (no drugs.)

 

I'd say do whatever you can to have a vbac, because it's worth the trouble.

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And I didn't read all the posts, but I had a VBAC with my second delivery after I had a Csection with my twins. I delivered with a midwife (who worked in the hospital) and I had a doula. I wanted to be in a hospital since I'd had a very serious complication with my first delivery. I was allowed to push for 4.5 hours and the doctors were only called in to give me some pitocin as my contractions were getting weaker as I was very tired (total labor was 40+ hours). The state and university hospital I was in and the fact I had a midwife and a doula I think were all factors in my actually having a vbac. Unfortuanately it's very regional as to the support you find in hospitals and doctors regarding vbacs. With my last child, I had since moved to a different state, and the obgyn I was seeing was supportive of my having a vbac and doing it naturally. The hospital, however, wanted me to be hooked up to a contraction and fetal monitor the whole time which meant I would not be allowed to walk around. Plus they didn't allow birthing balls. So I decided to birth at a birthing center. Unfortunately, baby was too big and not descending so I ended up with a c-section anyways. I don't think my midwife was really committed to me having a vbac since she seemed to rush me and only let me push for 2 hours. So you have to make sure your midwife is really good. And definitely get a doula! Especially if you're in a hospital. Blessings!

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Could you tell me some of the choices you made that you think played into your success? Short of a homebirth, cause that's just not happening here. :) I had an emergency c-section with my third because of her cord getting in the way (she evidently grabbed it in all her tumbling around and pulled it down in front of the birth canal). Anyway, I'm looking into care providers and facilities for having my fourth child and really the only think I intensely care about is not having a repeat c-section. The recovery was awful for me and I'd do just about anything to not go through it again. Though evidently not avoid having another child! :D I'm looking into a freestanding birth center with midwives who do work with VBACs and a hospital with midwives who have privileges there. There is a large cost difference, the freestanding center being more because insurance considers it out-of-network, but if the odds of having the successful VBAC are considerably higher if I avoid even a supportive hospital with a midwife attending, then that will certainly make a difference in our decision.

 

Thanks. :)

 

Jami

Jami,

 

I haven't had a VBAC, but I wanted to mention two books that may be helpful.

 

"Obstetric Myths Vs Research Realities" and "Thinking Woman's Guide to a Better Birth," both by Henci Goer, are very helpful. "Obstetric Myths," specifically, is a good one b/c she outlines the commonly held beliefs of OBs/MWs, then shows what the research says. This can be VERY helpful in making decisions about interventions, etc., and can help you discuss your options with providers.

 

My copies are 8-10 yrs old, so the research is dated. Look to see if there's a newer edition.

 

HIH,

 

Lisa

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My first was a footling breech, and I had to have an emergency c-section because I went into labor before my scheduled c-section. As the doctor was walking in, my water broke and I felt the urge to push. Thankfully, everything turned out O.K.

 

Since then I've had 5 successful VBAC's. I would go with a doctor (or midwives) who won't be quick to go the c-section route. The one thing my doctor did want me to have was an IV (just in case). I had to have an IV anyway because of Strep B cultures.

 

The one thing that has really helped everything go smoothly is that by the time I get to the hospital, I'm usually ready to deliver within an hour (my average labor is 4 hours from start to finish).

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I'm curious about your OB thinking you needed an epidural "just in case", I've read some research that thinks an epidural can be a hindrance to a VBAC, because often labor slows with an epidural (if given too soon) and then pitocin would be needed (not good for the uterine scar). Which was why I felt I really needed to find support for a natural birth this time around.

 

The main reason was that my doctor just wanted the epidural needle in place (no numbing meds required) so they could numb me quickly if there was an emergency/rupture. It helped my dh be more comfortable with the whole idea (the first birth was pretty scary for him). My first 2 were supposed to be 14.5 months apart (ended up being 13.5) and my body hadn't had that much time to heal before the 2nd pregnancy. My first was stuck in the birth canal (they had a hard time getting him back out through the c-section) and because of that we weren't sure that I'd be able to have a VBAC.

 

So there is way more of my personal history than you probably wanted to know! I hope you're able to find a practice/place you are comfortable with :001_smile:.

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