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  1. #1
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    Sep. 20, 2009
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    Default VBAC?

    I'm 28 weeks and hoping for a VBAC. I meet with an OB tomorrow to discuss the risks and how long they'll let me go.

    Does anyone have any tips about questions to ask?



  2. #2
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    Dec. 2, 2009
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    20 years ago I did a VBAC - but I used a nurse midwife and just told them that was what I wanted. I do not know how it works today



  3. #3
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    Jun. 20, 2010
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    Default

    C-section rate? Although some OBs might get defensive about it.



  4. #4
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    Quote Originally Posted by handfish View Post
    C-section rate? Although some OBs might get defensive about it.
    It is a good question, though I think (hope?) it won't be bad since he works with midwives.



  5. #5
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    Default

    I delivered VBAC 20 years ago. I'm out of the loop, but I didn't think that OB's would deliver VBAC anymore.



  6. #6
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    Quote Originally Posted by Woodsperson View Post
    I delivered VBAC 20 years ago. I'm out of the loop, but I didn't think that OB's would deliver VBAC anymore.
    They will! Some hospitals won't allow them (they need a certain surgical set up), but many OBs do allow them. Risks of a VBAC are lower than of a repeat csection.


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  7. #7
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    If you have no risks and baby is average for gestational age they might be willing but will have a csection team on hand. I would not consider having an out of hospital birth! Way too many risks.



  8. #8
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    Quote Originally Posted by SarEQ View Post
    Risks of a VBAC are lower than of a repeat csection.
    My mother is an OB-GYN, and she absolutely disagrees with this statement. She very rarely agrees to do a VBAC.
    Riding a horse is not a gentle hobby, to be picked up and laid down like a game of solitaire. It is a grand passion.... ~ Emerson



  9. #9
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    Quote Originally Posted by TarheelJD View Post
    My mother is an OB-GYN, and she absolutely disagrees with this statement. She very rarely agrees to do a VBAC.
    The evidence I've found in medical journals says differently.

    The major risk of a VBAC is uterine rupture . The risk is low, and if it happens, the risk of it having serious consequences for myself or baby is also very low. Uterine rupture can occur at any point, not just in labor, so a csection will NOT eliminate that risk.

    The chance of complications from a csection is higher.

    It is a case by case basis, however. OBs face crazy liability and need to do what they feel comfortable with. Having had a medically unnecessary c-section that I didn't want and that resulted in complications once, I'm hoping for a different outcome.


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  10. #10
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    Jul. 29, 2006
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    I think it depends on where you live. My ob was already talking about how I would be a good candidate for one if I had another when I was still in the hospital from my c-section. (Granted we're done with one). But I would ask what her success rate is and if there are any characteristics of moms who do it successfully.

    It's pretty common here (Boulder).

    I would ask if there are checkpoints as you finish you pregnancy that she will specifically evaluate if it's the right choice and what does she look for. If it's the same OB from your C-Section I would ask what she thinks led to the c-section and what is different this time that she thinks will allow for a different outcome.



  11. #11
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    Aug. 12, 2010
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    My first child was very premature (26 weeks) and born via section. Second pregnancy was 12 years later...my high risk OB told me that I HAD to have a section and that she didn't want me to labor as the section scar for a very pre-term birth would be a very big scar on what was, at the time, a pretty small uterus. She was also concerned that I had a low lying placenta, so on the previous section scar. She didn't like the risk of rupture or bleeding , so scheduled a section.

    She was out of town when my water broke, 3 weeks before the section date, and the residents who delivered son #2 were pressuring me into trying a VBAC...I was pretty angry as 1) that's not what my OB felt was best and 2) I was TOTALLY unprepared to labor and attempt a vaginal delivery. They did, eventually, do as OB had wanted and just go right to the section, but I didn't really appreciate the last minute drama.



  12. #12
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    Jun. 16, 2011
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    Twenty-one years ago I had a VBAC. The doctors were actually surprised I was so adamant about not having a C-section again.

    The reason for the first section was the main concern and since in my case it was fetal distress there really was not an issue and things went well with the birth. I will say that having one vaginally is the way to go.

    Good luck!



  13. #13
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    Oct. 15, 2007
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    I did a VBAC in 1987. My OB at the time said a scheduled cesearean heals very well and would not be a risk factor. That made sense. I opted to have my son at home with 2 midwives attending, one routinely monitoring me and one for my child. In order to deliver at home, I had to have an ultrasound close to the birth time in order to rule out placenta previa.

    Now why would I do all this? The better for the baby part is no drugs. The better for me was twofold. It took forever to get back in shape from the c-section and every hospital at the time, Stanford and El Camino, deemed me high risk due to the prior c-section. The moment I walked in a door, I would be hooked to a machine. Hauling an IV or strapped in bed with a monitor was not how I wanted to deliver. I asked to not have those and was told, sorry that is policy, so just wait until you are ready to deliver to check in.

    I do better walking, eating and complaining. I labored at home for most of a day, pain level was tolerable (enough to complain about it, but able to be distracted by a nice, hot bath or massage). I bounced right back to shape and my almost 11 lb newborn did not put my back out like his brother had.

    It was the best decision I have ever made. Was it safe? I think so. I had registered at the local hospital and could have been relocated there in 10 minutes. Some countries use midwives as the preferred method because the outcomes for mother and babies are better.

    My c-section baby had junk in his lungs and chemicals in his body for a long time. The baby born at home was bright and responsive pretty much from the start.

    Hospitals have a lot of germs these days. If you are thinking of a VBAC, read up and line up your team. Being at home felt luxurious.

    I can understand others choosing the hospital. It is your choice.


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  14. #14
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    I think the prevalence of VBAC's depends where you live. Around here there are not many that will do it. While I was in nursing school we had a guest speaker come in that did a VBAC, but she did it out of hospital. I don't know if that's a risk I'd be willing to take.
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  15. #15
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    What was the reason for your first C section? If it was due to the size of the baby a second baby might be even bigger though they should be able to determine this.

    FWIW it is much easier to recover from a planned C section than one following a difficult labor
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  16. #16
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    Quote Originally Posted by carolprudm View Post
    What was the reason for your first C section? If it was due to the size of the baby a second baby might be even bigger though they should be able to determine this.

    FWIW it is much easier to recover from a planned C section than one following a difficult labor

    It was due to size... But he was 8.5 pounds. Many top OBs and teaching OBs say size is NOT a reason to schedule a C-section without at least a trial of labor. The OB did not let me even try. DS had several surgery related complications and spent four days in the NICU and I couldn't get out of bed without help for three weeks. Plus the six weeks of no driving and additional two weeks of no exercise or lifting... I'd like to avoid that.

    Any birth can have complications and I could have a hellish vaginal birth as well, but chances are I'd at least be able to drive and so provide care to my new baby and older child.

    My main priority is a healthy child and healthy me. The college of OBs recently stated that VBACs after one csection are less risky than a repeat csection, depending on if mom has additional risk factors. Since I don't, I'm going for a VBAC.

    I'd just like to have the chance to try, and since my local hospital has the facilities to allow it, I'm going for it.


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  17. #17
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    Dec. 2, 2004
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    Default

    I had a C-section and then inquired about VBAC. It was the hospital not the doctor at the time. The local hospital would not agree b/c they weren't set up for 24 hr emergency surgery at that time. They would have had to call someone in and with baby delivery that's not a lifesaver. Sounds like I'm old from the stone age huh.

    I had to drive 50 miles to a better hospital to attempt a VBAC. And then that didn't end up well. Can't tell a broodmare by the size of her hips!
    About the only time losing is more fun than winning is when you're fighting temptation.
    -- Tom Wilson, actor & comedian



  18. #18
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    Quote Originally Posted by pony grandma View Post
    I had a C-section and then inquired about VBAC. It was the hospital not the doctor at the time. The local hospital would not agree b/c they weren't set up for 24 hr emergency surgery at that time. They would have had to call someone in and with baby delivery that's not a lifesaver. Sounds like I'm old from the stone age huh.

    I had to drive 50 miles to a better hospital to attempt a VBAC. And then that didn't end up well. Can't tell a broodmare by the size of her hips!
    Ha!

    The surgery requirement is pretty standard. My sister inquired about a VBAC and was told she'd need to drive almost two hours to get to a hospital that allowed them... And she was due in December in upstate NY. She opted for a scheduled csection. Since mine is five minutes away we'll try, and see if my hips cooperate! ;-)



  19. #19
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    I strongly believe that this "hospital needs to be able to do an emergency C section" bit that many of you have been told is garbage. It is more likely the hospital's (and the practitioners') liability insurance that makes them feed you this line. There is no difference in a woman walking in off the street who needs an emergency C section, and a woman who has previously had a C section needing one.



  20. #20
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    Quote Originally Posted by Anne View Post
    I strongly believe that this "hospital needs to be able to do an emergency C section" bit that many of you have been told is garbage. It is more likely the hospital's (and the practitioners') liability insurance that makes them feed you this line. There is no difference in a woman walking in off the street who needs an emergency C section, and a woman who has previously had a C section needing one.
    You're correct.

    It has to do with what the American College of OB-GYNs recommends as "standard of care", since not following standard of care gets them sued. At times a standard surgical suite/team is fine. Other years the recommendation is for the hospital to have a surgical team standing by 24/7 with an open operating room.

    Not all hospitals have the facilities or staff to do that. So those don't allow VBACs, even though a woman deliver in there who needs an urgent csection and needs to wait for a team to run down the hall and scrub in would face the same risks as a vbacer who suddenly needs an urgent csection.

    It's all about not being sued.



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