Fab VBAC article

[Celesse]

Dunno if this has been linked before but just doing some VBAC reading and came across this. Thought I would share. https://midwifethinking.com/2011/02/23/vbac-making-a-mountain-out-of-a-molehill/

It starts off outling what a rupture is, then discusses how likely it is to happen and how likely it is to have a poor outcome. It also cites one study that found the same risk in VBAC women as in first time mothers.

She goes on to give her view of the risks of VBAC:

I am a bit confused about why such a huge deal is made about the risk of uterine rupture during VBAC. Why are these women subjected to serious (and often biased) discussions with fearful obstetricians about the dangers of attempting birth? Why are they categorised as ‘high risk’, limiting their care options and imposing additional monitoring and intervention during their labour? If we agree that this is the right approach, then we also need to do the same to first time mothers who carry the same risk of uterine rupture. In fact, we should treat all women like this because the risk of placental abruption or a cord prolapse is greater than the risk of a uterine rupture during a VBAC.

To be honest, as a midwife uterine rupture is the least of my worries when caring for a woman having a VBAC. I actually think the mountain that has been built out of the risk-molehill requires more energy and attention. These women do need special treatment, but not in the form of disempowering fear-based counselling or practice. They have often had a previous traumatic birth experience and are dealing with fear from family, friends, and the medical system, in addition to their own worries. They have been labelled ‘high risk’ and are constantly reminded of the potential disaster waiting to occur. They also risk ‘failing’ if they encounter any complications or end up having a repeat c-section. This impacts on their ability to trust their body, follow their intuition and allow the physiology of birth to unfold. Often these women need more nurturing, reassurance and support from their care givers.

I found it a very useful read and am keeping the page open ready for my booking appointment tomorrow.

 

[tristansmum]

thank you.

 

[chuck]

I love Midwife thinking, I have it on my bookmark toolbar.

I saw this and it really rang true with how I feel about VBAC's...why are we put under so much stress and scaremongering about our births?

 

[indigo_fairy]

Thanks for sharing! I haven't been online for a while due to pc retirement, and only had my mobile to access online stuff, which has been pretty impossible! So thought i'd pop in to see what's new here and what you quoted was perfect for what I need right now - got consultant appointment in just over an hour and I know UR is going to be his main concern.

How did your appointment go?

 

[Celesse]

My appointment was pretty awful really. My midwife couldn't make it so got another who didn't want to talk anything about the birth and just said it was up to the consultant to decide if they would let me deliver at home. I corrected her and told her it was up to me. She also put in the wrong due date which also annoyed me.

Hope your consultant appointment goes well.

 

[indigo_fairy]

Sorry you had a negative appointment, I've had a couple too. You did the exact right thing by saying it's your decision putting them correct! I was told I wouldn't be allowed to have a homebirth, and my consultant today advised against it, but again it was all about UR and when I mentioned theres more chance of a cord prolapse he just spoke over me dismissing it. He also said in his opinion all homebirths were dangerous and 10mins from hospital is too far and 1min can make all the difference, basically laying it on as much as possible. I said as much as I could remember, but doubt any went in as he was talking over me so much.

I also said I didn't want my blood pressure or urine done this appointment (it's always high there, and I've got MW tuesday anyway) and the nurse was absolutely stunned, she said I had to have it done - to which I said it wasn't compulsory and it was my choice politely, she got very argumentative and could not understand at all why I was refusing them. I said I didn't need a wee and couldn't 'just squeeze a bit out' lol she wrote on my notes a snotty comment and walked off. I think she'd never had someone decline them before? I didn't think it was a big deal! I actually think she was personally offended!

So I may have a slightly negative appointment tues, but will stand my ground

Just so you know, my MW has never discussed the birth part much with me either even after me asking, and I'm 35wks tomoro! I will definitely be more demanding on the subject this coming appointment.

 

[chuck]

<facepalm> OB's!!!!

I'm at least a 25 minute blues and 2's ride from the closest hospital and yes my OB said all the things you would expect - dangerous/every minute counts/I saw a UR just last week blah blah blah.

So I didn't bother going back to see him, his ignorance of birth annoyed me!

All the MW's (my antenatal and birth attenders) were fabulously supportive and 1 even stated 'you've made the right choice, you'll get better care at home!'

...HBAC is a better choice than hospital VBAC for many of us...as long as we maintain a healthy dose of 'if I NEED to transfer I will but only when all avenues have been explored within the realms of safety for me and baby'

I transferred once I was 10cm because of blood loss (estimated to be around a pint in the end) but the MW's discussed it and I agreed.

 

[chuck]

another fab VBAC item
https://www.scienceandsensibility.org/?cat=833