VBAC info/support

[hakunamatata]

good luck morgan!!

 

[x__amour]

12 days shy of my due date and 19 days until my ELCS and I find myself doubting my ability to do this.

 

[hakunamatata]

try to relax hon!

 

[futuremama88]

Under tremendous pressure to have a c-section at 41 weeks if I don't go into labour by then and feeling really uncomfortable with this. I am with a midwife but had to see an OB consult as a requirement for VBAC. With the OB I refused to book the c-section. But my midwife convinced me to agree for them to book it so that they don't see me as a rebellious sort of patient or think I'm 'unconventional' trying to go against the rules, and if I get to that point that I can just cancel it.

The OB told me that the success rate for VBAC after 41 weeks is only 10% and that the risk of uterine rupture increases for every day that I go overdue. I was also really bothered by her saying that every woman needs Pitocin at some point during her labour because I don't believe that and I want to avoid Pitocin! She also said that going overdue puts my baby at high risk of inhaling meconium, and that my amniotic fluid will go down and placenta start to deteriorate.

Looking for support, encouraging facts/statistics, or success stories. Wondering what to do in all of this and finding it hard to stand up for myself.

 

[lauraclili]

So much of what she has told you is total baloney! If you have Facebook please join one of the vbac support groups - vbac community is very good or vaginal birth after caesarean. If you posted this there you will have people provide you with facts and evidence based suggests. You ob is simply not providing you with evidence based care. (I had my vbac with no pain relief and no pit at 40+5 xxx )

 

[futuremama88]

So much of what she has told you is total baloney! If you have Facebook please join one of the vbac support groups - vbac community is very good or vaginal birth after caesarean. If you posted this there you will have people provide you with facts and evidence based suggests. You ob is simply not providing you with evidence based care. (I had my vbac with no pain relief and no pit at 40+5 xxx )

Thank you The OB office called me and asked about booking the section at 41 weeks and I declined, but even my doula doesn't agree with me and thinks I shouldn't be going against hospital policy... I am feeling like nobody is on my side! Do you have any tips on how you managed to get your natural vbac?

 

[lauraclili]

I did prenatal yoga, Pilates and relaxation which helped physically and I had yo spend a fair amount of my labour refusing various interventions as they tried to insist on them. I wrote down everything I wanted and said I simply wouldn't consent to anything that wasn't on the plan without a sound medical reason that theyr had to explain to me. (Difficult patient right here!)

Can I post your original post on the Facebook group to get some advice for you? (I'll use your words) it's just, I'm English not American so can't give you us specific advice.

Xxx

 

[futuremama88]

I did prenatal yoga, Pilates and relaxation which helped physically and I had yo spend a fair amount of my labour refusing various interventions as they tried to insist on them. I wrote down everything I wanted and said I simply wouldn't consent to anything that wasn't on the plan without a sound medical reason that theyr had to explain to me. (Difficult patient right here!)

Can I post your original post on the Facebook group to get some advice for you? (I'll use your words) it's just, I'm English not American so can't give you us specific advice.

Xxx

Sure thanks I would appreciate it so much as I don't have facebook! I am looking into trying acupuncture next week too and I've never done it before but have heard great things

 

[BintUmmi]

Has anyone know anything about complications hypertension can cause with regards to having a VBAC?

 

[futuremama88]

So I found statistics and it turns out the risk for uterine rupture is about 1.5% after 41 weeks. I am comfortable with that level of risk. For going overdue in general, the risk of stillbirth was said to be between 4 and 7 deaths per 1000 babies. I am also comfortable with that level of risk but my midwife used the 'you could have a dead baby' line on me. They are giving me 5 days after my due date to go into spontaneous labour and I am supposed to go have a c-section if I don't go into labour by then. Today is my due date so I have 6 days and I am really stressed My midwife still said that it's my choice, and I don't have to show up to the appointment if I truly decide that, but that the hospital will be quite angry with me. I don't know what to do? My pregnancy has been 100% healthy and normal, no complications, and baby is doing great according to all the various tests and ultrasounds I've had to do. I don't understand why they think it's so extreme that I don't want to end up with c-section just for going 5 days over my due date when everything is totally fine?

 

[lauraclili]

Hi there, below is a cut and paste of the information I was able to find for you, I've taken the names out because obviously it's not fair to post them. I hope this is helpful. xx

1: That OB is full of you-know-what. Every woman needs pitocin?! However do/did women ever give birth naturally, then? You aren't actually overdue until after 42 weeks, and there is no evidence for her likely completely made-up claim that the success rate for VBAC after 41 weeks is anything, because I don't believe it's been studied.


2: Every woman needs pit? Holy crap! How did I ever have an all natural VBAC then?? What a crock of $#%+!!
Just tell her to keep doing what she's doing! If she goes past the 41 week mark she can just cancel the scheduled RCS! That OB is full of scare tactics!

2: She can also have NST's and BPP's done to help keep her mind at ease if she goes past 41 weeks.

3: It may be true that ur rates increase every day you go past 41 weeks, but that number is so tiny it's almost negligible. The doc is using naivety as a scare tactic


4: https://vbacfacts.com/.../uterine-rupture-rates-after-40.../

Uterine rupture rates after 40 weeks
vbacfacts.com

4: I'm guessing the doc also forgot to mention that inducing/augmenting with pitocin does raise the risk of rupture.


4: "Spontaneous labor is always preferable to induced or augmented labor but there are medical conditions that can necessitate the immediate birth of a baby. It’s nice for those women for whom vaginal birth is still an option to have a choice: gentle induction/ augmentation or repeat cesarean."

"ACOG’s latest VBAC Pratice Bulletin No. 115 states that going over 40 weeks or suspecting a “big baby” should not prevent a woman from planning a VBAC. I suggest asking your care provider at your first appointment about what they would recommend doing if you go past 40 weeks, past 42 weeks, or if they believe your baby is large."

https://vbacfacts.com/.../myth-vbacs-should-never-be-induced/
Myth: VBACs should never be induced
vbacfacts.com

5: I had my VBAC at 41 + 1......

4: There's really no reason you can't go to at least 42 weeks, and then decide if you want to do NSTs and/or think about induction or RCS depending on your bishop's score. This doctor is not sounding good.

6: Messenger my midwifery group started preaching that 41 weeks was the "end of my journey" and that they would induce then. I refused and they gave me until 42 weeks after a physical exam. I relaxed, meditated, and prayed that I wouldn't have another section... My midwife suggested a prenatal massage, so I went and got one...went into labor 16 hours later. Go get one with someone who understands pressure points and it should help you progress. Good luck and please don't give up!


7: Massage and chiropractic care!

8: 2 nat births here without use of pitocin after a medicated birth of my first son... not every woman NEEDS pitocin but maybe she needs her patients to have it cause she isn't a very good doc

4: I'm thinking maybe her patients need it either because she pushes induction and/or because they are stuck on their backs the whole time with epidural placed early on.


Me: Thanks for the replies

The 10% success rate after 41 weeks really bothered me. Is there any chance that's true or any studies to suggest it might be? I've never heard it before which makes me think it's being made up but...


4: Read the VBAC Facts articles and check out the studies they cite and link. It's made up. We don't have that much information about that to make a claim like that.

9: This ob needs her medical license taken away. She's an idiot.


10: I'm not sure I have a link on the 10% success rate after 41 weeks, specifically. The post on VBACFacts about UR rates has a little bit, and I think there are also issues with induction/RCS scheduling, meaning not many moms actually get to 41 weeks. "For instance, a standard deviation of 13 days means that 90% of babies will be born within three weeks of their EDD, and 21% will be born within three days of it." and " The median found by Naegele's rule is merely a guideline for the day at which half of all births occur earlier, and half of all births occur later" from https://en.wikipedia.org/wiki/Naegele's_rule - so statistically, you're already coming up on 3/4 of babies born by 41 weeks even w/o scheduling births. https://www.scienceandsensibility.org/?p=4714 looks related to your question, and there ought to be more in Optimal Care in Childbirth if you can find a copy to check.

 

[lauraclili]

1: I agree that it might be good to simply let the OB schedule the section and then either be a no-show (oops, I forgot!) or call the surgery center the night before and re-schedule it for a week later (maybe due to family emergency? ).

If an OB started giving me outlandish statistics, I would become quite interested and ask them to pass a long the study, so I could share it with my husband. Let them know that he's really interested in statistics and would appreciate reading up on the complexities of birth. Either they'll give it to you, or they won't. (My bet is that no such study exists--and if it does, it's on such a small number of women that it really doesn't count).

Woman in my family gestate longer than normal. So when I had a c-section for pre-e at 39 weeks, my son was clearly not fully baked yet. My VBAC occurred at 42.1, and there was clearly a difference in their physical and mental development...

My advice? Get a doula. It sounds like your friend will need the support. (Point her toward doulamatch.net to see about locating one in her area).

2: Risks are thought to increase after you have completed your 41st week...so once you are into your 42nd week...though, I'm not sure about all those stats......don't know that UR rates increase other than more time passing...but VBAC statistical success is thought to go down some post term....but I don't by how much. Of course, there are women who still do have VBAC's post term, too.


3: It's not true I went to 42 weeks and had a vbac just fine over due is now not till after 42 weeks compromise with them and say yes ill book one at 42+6 days! Over due is not reason to book a csection as long as your healthy


4: Any risks are mama's, not the doctor's. It is our body, our baby, our final call. The OB can make a medical suggestion, but we are under no obligation to "comply" unless it is the right move for our family. Who cares if our behavior ruffles some feathers amongst the medical staff? We are there to have a baby, not to make friends. This is one of the most important times of our life--and our child's. Advocate for your child if you find it hard to advocate for yourself...


a: Have her look at www.vbacfacts.com

13 Myths About VBAC
vbacfacts.com
Many women believe that the only safe choice after a cesarean is another cesarean. Social pressure plays a huge role in a woman’s decision making process and the prevailing American conventional wisdom is greatly influenced by persistent and pervasive myths about vaginal birth after cesarean (VBAC).…


Me: The 10% success rate after 41 weeks really bothered me. Is there any chance that's true or any studies to suggest it might be? I've never heard it before which makes me think it's being made up but...


6: Tell her your chances do for a UR do not increase if you go over your EDD. Makes me mad. It's a scare tactic! Also not every women needs pitocin another bunch of bs. (Sorry!) she has every right to refuse it. I don't have any articles off hand at the moment, but pitocin can actually be harmful to mom and baby. Have her look up some up and give them to the ob. But in her birth plan that she doesn't want it. Just get the stress tests, and as long as everything is fine there is no reason for a cs. If they are bullying for scheduled cs, then fine make the appointment, but she does not need to show up. She can either skip it or cancel. In the mean time, get a doula and trying things like walking, sex or massage to get labor going. Stay strong!


7: I've had 3 babies and have never once had pitocin! Not once, ever!


8: i would finda new midwife, my midwife was supportive and said NO ONE can make u have a c section


9: Had my VBAC at 42+4!! He's definitely making up that statistic. Tell her to trust her body!! She's got this!


10: The 10% is bullshit. Please ask him for a citation. He ain't got one - it doesn't exist.


11: You aren't "overdue" or post dates until after 42 weeks according to ACOG. Apparently this OB needs a refresher course.


12: I was 42 weeks with my vbac and no pitocin needed! Tell your friend to listen to her body and ignore the doctor 's scare tactics!


2: 42w0d or 42w1d you are considered post term, I think that is why they push for something in your 41w, but it is still up to you and maybe if you make a plan with them for 42w0d or 42w1d, they will stop fighting and have something considered evidence based for their books.


13: I have never heard of your chances going down to 10%. I would highly suggest she get a doula! Then maybe ask for that statistics or maybe find a new OB that is more willing to work with her.


14: And who the heck cares if you have only a 10% chance of a vaginal birth? Is a 10% chance better than lying down for a 100% chance at an unnecessary c-section?!


2: Sometimes those stats matter because an emergency c-section is considered worse than a scheduled one....but I think 10 percent is just plain made up or his own personal figure and even so if a VBAC does not work out, it doesn't necessarily mean it will be an emergency either. So......should be up to mom....I don't even think there is a figure for what the stat is when it possibly goes down at 42 weeks.


15: I just had my VBAC at 41+1 all natural. The only pitocin I got was after delivery to help my uterus contract to avoid hemorrhage( they give it to every mother after a vaginal delivery VBAC or not). My doctor was completely fine with me waiting until 42 weeks before worrying about an induction... Not RCS. My water broke on its own and there was mec in my water. Yes there is always a risk of that, some babies even die from it but it's rare and mec can happen at 37 weeks just like 42, after 42 the risk of it goes up. My little girl was completely healthy they sucked her out as soon as she was born. She had swallowed some so she threw up a little her APGAR scores were 8 and 9. That 10% is crap. Do your research and don't let them bully you. I went online and printed stuff off just to bring to appointments so I wouldn't forget the facts and had them there incase I needed to defend myself and my right to VBAC.


16: I don't believe the overdue stat either. I had a successful vbac at 41+5.. no pitocin either!

17: babies do not arrive late or early, they arrive when they're supposed to

 

[x__amour]

Well, I didn't get my VBAC...
But baby is here safe and sound. My birth story is here.

 

[Starry Night]

Those of you who are going, or who went, for their VBACs, did you notice any pains along the scar with contractions? My BH are getting stronger as the due date approaches and the stronger ones are causing this hot, almost ripping-like pain along my scar. I know the odds of rupture are low and my OB is very supportive of VBAC (she's the one who talked me into it) but the pain makes me nervous about how the scar will hold up during the real contractions. It's been nearly 3 years since my EMCS so it should have had plenty of time to heal.

Thanks

 

[ShelbyLC]

Those of you who are going, or who went, for their VBACs, did you notice any pains along the scar with contractions? My BH are getting stronger as the due date approaches and the stronger ones are causing this hot, almost ripping-like pain along my scar. I know the odds of rupture are low and my OB is very supportive of VBAC (she's the one who talked me into it) but the pain makes me nervous about how the scar will hold up during the real contractions. It's been nearly 3 years since my EMCS so it should have had plenty of time to heal.

Thanks

I've had pain along my scar area, but not during contractions. I personally would request an ultrasound. Apparently they can determine the approximate thickness of the uterus at the point of the scar with an ultrasound.

 

[BintUmmi]

Well, I didn't get my VBAC...
But baby is here safe and sound. My birth story is here.

Congratulations! Sorry you didn't get your VBAC but it seems you had a much better birth experience, and you make beautiful babies.

futuremama88 I'm so sorry that you are being put under so much stress and pressure

 

[Pinky00]

Hi everyone, just got my Bfp. Currently 4+5 and really hoping for a VBAC! I had a csection last time after failure to progress past 4cm. Turns out I had a 'bandl ring' which is very rare, my surgeon told me that it wouldn't mean I would need another csection with future pregnancies, but there is very little info about it, and what I have found is very conflicting!

I won't have my booking app with midwife for a while, so in the meantime does anyone have any experience of this type of condition???

 

[futuremama88]

Thank you so much for posting that for me lauraclili I am so reassured that so many people agree with me that it is madness! My midwife said that if I don't go for the c-section I could end up with a dead baby that is a really scary thing to hear but I truly don't believe it's very likely. I am 40 + 5 today and my planned section is supposed to be bright and early tomorrow morning... no signs of labour yet and I have tried EVERY natural induction method under the sun... even spent a couple hundred dollars on acupuncture to no avail! Yes the risks of going overdue seem scary to me... risk of stillbirth is very small (6/1000) and should actually be lower to me as stillbirth has been associated with obesity and smoking neither of which affect me. There is risk of meconium aspiration. But nobody talks about the risks of c-section which makes me so angry increased risk of hysterectomy and future ectopic pregnancies and problems with the placenta in future pregnancies if I have this c-section tomorrow. My instinct tells me to call and cancel either that or not show up. My husband agrees too. I am going to meet with my midwife this evening and I don't know how the discussion will turn out as I'm going to tell her that I'm not going in for the c-section tomorrow morning...

Also my doula says she won't be able to make the birth because her son is sick and that she's trying to confirm a backup so that's stressful as well especially since my husband is staying home to watch our other daughter during the birth so I'm either going to be alone or with a complete stranger backup doula... I wish my original doula could be there...

 

[sept10]

I find it a very hard decision... I'm a VBAC candidate but also have c section booked for 40 weeks. I can see things from both sides...a pregnant mom wanting minimal intervention but also as a health professional who works in a childrens hospital and regularly see the devastating consequences of birth injury. I don't think doctors or midwifes make up statistics or try to scare you for the hell of it...small as the risks are, and they are small when you have been present or even heard of colleagues who have had these things happen it becomes very very real! Saying that as a health professional you do need to respect the mother and her needs. I know deep down my chances of a safe vbac are good but even a small risk to baby is a very real risk to me so I chose not to go over dates and not to be induced. Good luck to all you ladies in getting your VBAC!

 

[Cangaroo]

I was told after my last section I'd probably be better off having another section next time around. Last time, despite a very long but calm and natural labour, I stalled at almost fully dilated for hours and hours. Breaking my waters and an hour of Syntocinon didn't help, and my daughter never descended past -1 station. At c-section, I had a very thin lower segment which tore at delivery and was slightly difficult to repair. I recovered very well, and, having felt in control the whole way through labour, didn't feel traumatised or even disappointed with my experience. I had therefore come to terms with having a planned section. I felt that last time everything was in my favour (OA baby, spontaneous labour, use of the pool, gas and air only during active labour, feeling calm and confident, reasonably supportive midwives) and I still stalled, so trying again with a VBAC label and all the restrictions that came with it would be unlikely to go any better.

This week, I had my consultant appointment and was surprised how optimistic they were! They very much encouraged VBAC. They acknowledged that my chance of success is lower than most (estimated 40-50%) but it's unlikely to be harmful to try. I can have telemetry so won't be strapped to a bed, and can even go in the pool if it's free. I actually really enjoyed my labour experience last time, so am pleased to have another chance to try. Even if the outcome is the same, at least I'll know I tried.