VBAC

This section is for discussions with other women who have probably been through the same signs/symptoms that you may be experiencing. Please note, we cannot offer medical advice and encourage members to discuss their concerns with their doctors. New members, come on in and introduce yourself!
grantk
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Re: VBAC

Postby grantk » Sun Jul 10, 2011 07:47 pm

Thanks for sharing your story Shannon! hearing something positive like this really helps.

I can see how having all that info can help the doctors. I like how your doctor let you rest when you got to 10 cm. I have heard that is a good thing to let your body do the work, they talked about it in my birth class. Hopefully my BP will stay low so I can move around a bit too.

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panguitch02
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Re: VBAC

Postby panguitch02 » Sun Jul 10, 2011 04:42 pm

I had a successful VBAC in January...despite 5 weeks of bed rest for gestational hypertension. I first had to go into labor on my own (no induction allowed) before either developing PE or going past 1 week overdue. 4 Days before my schedules section I finally started contracting. Arrived at the hospital only 1/2cm dilated but they kept me because my BP was spiking due to the labor. They broke my water to get things going, inserted the internal pressure monitor & scalp monitor, and let me labor lying down until I reached 4cm. At 4cm we started the epidural which was recommended to keep my pressure down and to be ready in case they needed to get me sectioned quickly. After the epidural they started to augment the labor with Pitocin. When I finally reached 10cm my doctor wanted me to rest for a few hours and let the contractions work the baby down. He did this because of my blood pressure...he didn't want me to work too hard. During the pushing portion I pushed every other contraction so ensure I was resting and the baby was getting enough oxygen.

I think the extra monitoring and intervention made my VBAC possible. I would never had made it without the Epidural or Pitocin, and the medical staff needed to know how powerful the contractions were since they were augmenting with Pitocin. I say the more info they had on me and my little one the better. In my mind...I trusted my doctor and was prepared for a repeat section when he felt it necessary. I do not have a medical degree and I feel that labor, though Natural, can be DEADLY.

Had I not had gestational hypertension, I would have preferred laboring longer at home and moving around more. In my state, spiking pressure and decreased fetal movement during labor, I only wanted to get to the hospital and have a safe baby.

IMHO, I think we are going to see a trend towards more VBACs driven by pressure from the public and competition between hospitals. I also think many healthcare professionals preferred VBACs and were excellent at them, but had too much pressure to avoid them from insurance companies and hospitals because a handful of OBs made very poor decisions. The staff at our hospital, which has a high section rate, is very excited about VBACs again, but they are not going to skimp on safety and are only offering VBACs again because they hired 3 full-time OB Hospitalists and have setup guidelines to cover their rear-ends.
Shannon (34) & Jason (35)
Jameson 6/1/07 33 weeks to Severe PE... 5 weeks NICU
Lilah Noel 1/2/11 PIH from 19 weeks... VBAC at 40 weeks

thaiba2000
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Re: VBAC

Postby thaiba2000 » Sun Jul 10, 2011 07:13 am

Quick version of my labour story....

Was having pain from the day before (due date) so decided to get checked out the next day. I had an appointment already made to see my OB. Had A hospital apointent in the morning at 10am for the c-section tests etc etc (40+1 weeks, so the day after my due date) they told me i was 1cm dilated but totally effaced. They told me to come home to progress, they werent even sure if i was in albour or not but it was a good sign because i was 1cm dilated. Came home and just breathed and realxed through the pain. I was told that being relaxed made labour progress faster. The at 4pm i had the sudden urge to push but seeing as ive never laboured before i didnt realise why i needed to push...i stayed in this condition until 9.30pm when my waters finally broke and i knew i had to go in straight away...i was still pushing as hard as i could uncontrollably. They took me onto a hosital bed to examine me and saw they could see babys head...too late for any pain relief and didnt even use the gas and air...after 4/5 strong pushes she was out....

So basically i did most of my labour at home without realising i was in proper labour! But im glad i did because if i was to go into hospital they would have interfered and i probably wouldve ended with a csection. Although i realy do count myself lucky and grateful that my labour and delivery was all safe. Labouring at home is fine but if u feel ill or not right then please go into hospital. I didnt know why i needed to push so i decided to get ready to go hospital anyway but then my waters broke so i had to definatly go into hospital....

Im sorry if i havent made sense. Like i said this is the short version but what an amazing experience it was. I hope to have another VBA2C for/if i decide to have a 4th baby....and ofcourse will have to be PE free again.
England, Luton Thaiba (28) and Adil (37)
My son (first child) born via Emergency caesarean at 36+6 weeks (04/11/03) due to PE. Weighed 4lbs 1oz.
My daughter (second child) born at 33+4 weeks via Shceduled caesarean (19/07/07) due to SEVERE PE. Was in special care for 1 month. Weighed 3lbs 5oz.
My 2nd daughter (third child) born by successful Vaginal Birth after 2 c-sections (VBA2C) (26/05/11) full term at 40+1 weeks. Weighed 6lbs 10oz. PE FREE!

thaiba2000
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Re: VBAC

Postby thaiba2000 » Sun Jul 10, 2011 07:02 am

I had a successful VBA2C... I copied an pasted this from another site i posted to. It may not be relevant but hope it helps.

The reson for my 2 previous c-sections was due to severe pre-eclampsia, it was all very traumatic. My son was born at 36weeks 6days and my daughter born at 33weeks 3days. So basically in my 2nd pregnancy the pre-eclampsia was at its worst and my life and my babys life was in danger. So the decision to have a 3rd pregnancy was very hard. My OB told me i could try for a VBA2C as long as i have no pre-eclampsia, he was very suportive in the early weeks pf pregnancy. Once i hit 36 weeks i relaised PE wasnt showing itself So it suddenly hit me "oh my gosh, maybe its possible to have my much longed for Vbac". So i waitied unitl 36 weeks to try any sort of natural inducing techniques. I didnt walk before 36 weeks just incase it raised my Blood pressure (pre-eclampsia). I went to my 36 week appointment with my OB and he gave me until the 31st to go into labour...could you believe he booked in a c-section for me just 6 days after my due date! So the supportive doctor wasnt so supportive in the end but to be fair he was just concerned about me and the baby. He told me that if i went over 41 weeks my placenta will start to fail etc etc. I was so worried that i wouldnt labour before then...So at 36 weeks i started doing light walking. Took my children to school by walking instaed of taking the car. Once i reached 38 weeks i increased the level of intensity of the walking because i knew i was in a good place. So basically i walked faster and for longer. I would take the long way instead of shortcuts. I also started drinking Rasberry Leaf tea from 37 weeks ( cant remember) but it was so disgusting. It doesnt really induce labour but helps labour progress at the 2nd stage (the pushing bit). At 39 weeks i had a membrane sweep which didnt work and i was so dissappointed. Once i reached the end of 39 weeks, i think just FEW DAYS before the 40 weeks mark i and hubby decided to give love-making a go. Its not the love making that matters its what your husband provides during it that helps ripen the cervix. We only did it the once because it was so uncomfortable but guess what...i went into labour on my DUE DATE and had my FULL TERM baby the next day by successful VBA2C. If you are healthy and have no complications then start walking as much as you can from 36 weeks BUT DO NOT exhaust yourself. You are carrying a baby which is knackering as it is. I couldnt even walk because of my hip pains but i wanted to achieve my VBAC. I walked round and round in my garden too...i looked mad but walking is the best and it worked for me! Also from 36 weeks do hula hoop movements- put your hands on your hips and move your hips round SLOWLY as though you are doing the hula hoop. Have u got a birthing ball??? I didnt have a ball BUT i used the edge of my bed to bounce on...sit on the edge of you bed, makesure your knees are lower than your hips, they shouldnt be aligned and just gently bounce for 5/10 mins. i didnt start doing this until 38 weeks pregnancy.
England, Luton Thaiba (28) and Adil (37)
My son (first child) born via Emergency caesarean at 36+6 weeks (04/11/03) due to PE. Weighed 4lbs 1oz.
My daughter (second child) born at 33+4 weeks via Shceduled caesarean (19/07/07) due to SEVERE PE. Was in special care for 1 month. Weighed 3lbs 5oz.
My 2nd daughter (third child) born by successful Vaginal Birth after 2 c-sections (VBA2C) (26/05/11) full term at 40+1 weeks. Weighed 6lbs 10oz. PE FREE!

alexis
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Re: VBAC

Postby alexis » Sat Jul 09, 2011 07:00 pm

Some docs will use pit to augment but not to induce (lower dose and therefore safer). I do know someone who got a Foley-and-pit VBAC induction, and it worked. But, not preeclamptic. I'm not sure I'd want to take that time under those circumstances. Same reason they skipped the induction with my first: an unripe 37 weeker is going to take time they did not have. (I'm still somewhat annoyed about that, but only because they let it progress to that point.)

The only thing about "setting you up for failure" is that if you know they are setting impossible conditions that are going to send you to the OR anyway, you might as well skip the labor, because failed TOLAC has the worst outcomes. Which, of course, is sometimes why docs do that... but depending on circumstances it might be the best decision. If you're an otherwise healthy person who just lucked into an OB who doesn't like VBAC, it's different from someone with serious conditions who's just wound up in a tight spot.

The scalp electrode is more accurate than the belts (usually), which is good--and as someone who had to stay still during NSTs because they could never get the belts to stay in place, I can't say I'd view it as all bad! The problem is really that they need to do AROM to put it in, which starts the clock.
Chronic hypertension
Aliza - 01/05/2007 - Severe preeclampsia, emergency CS 37 weeks
Isaac - 09/26/2011 - controlled on 150mg Toprol, NO PE, 39 weeks!

grantk
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Re: VBAC

Postby grantk » Sat Jul 09, 2011 09:06 am

Yep there will be no induction, they won't use pit on a vbac. I have heard of docs who will though, but I wouldn't want that.

Caryn- good point that our bodies do what they will do!

I have been told that I can move or stand with these things in, but not far from the bed. I think what I was trying to say also is that I'm nervous about the risks of a screw in my baby's scalp and the infection risk of the iupc. But, there is also risk associated with abdominal surgery... I think I just need to seek out and ask for more information. I am an engineer so maybe it is my scientific head thinking about all that. My pressures have been quite good 100/60 the last two weeks. So I hope my kidneys look good and maybe I can have a 'normal' pregnancy. Ha, normal doesn't exist right?!

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caryn
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Re: VBAC

Postby caryn » Sat Jul 09, 2011 08:01 am

Yeah, if it gets to the point where a preeclamptic with a prior Caesarean needs an induction, she's going back to the operating theatre.

Honestly, I wouldn't worry too much about being "set up for failure", simply because there's not a whole lot of your achievement wrapped up in this. As you know from your last pregnancy, we don't exactly contribute to whether or not pregnancy and delivery go well - our bodies just *do* this. But I would definitely ask for a justification for whatever your docs want to recommend and ask about the evidence base. Then again, my docs wanted to know if I was a rocket scientist, or what, so I think this tends to annoy them and surprise them and they're not ready for it (even if you are genuinely asking because you are dying of curiosity and not because you want to Prove! They're! Wrong! or something.) So maybe ask them if they could pull together the cites before your next visit, or tell you where to find them? (That's what I did - it led me here.)
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

nov_mum
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Re: VBAC

Postby nov_mum » Sat Jul 09, 2011 05:23 am

From what I have read, in most cases VBAC carries less risk than repeats section. Pitocin is contraindicated in VBACs but hopefully you wouldn't need an induction??

Keeping as active as possible and as mobile as possible is best for a progressing labour but all of the monitoring that the Drs are talking about will leave you anxious, laying on your back on a bed and every movement your baby makes a pathological problem. I guess, you could talk to the team closer to the time about how monitoring can be minimised to ensure you and bubs are safe but that they don't get overzealous with interventions??

alexis
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Re: VBAC

Postby alexis » Sat Jul 09, 2011 05:06 am

That reason isn't really medical, though. It's got a lot to do with legalities, and ACOG and the NIH aren't really happy with the situation. The risks just don't trade off that simply. There are risks to a VBAC and risks to RCS, and you need to balance them based on your particular situation.

Continuous monitoring is standard of care for a VBAC. Scalp monitor and IUPC are not.
Chronic hypertension
Aliza - 01/05/2007 - Severe preeclampsia, emergency CS 37 weeks
Isaac - 09/26/2011 - controlled on 150mg Toprol, NO PE, 39 weeks!

laughinggirl127
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Re: VBAC

Postby laughinggirl127 » Sat Jul 09, 2011 03:07 am

I guess I am more of the stand point of the dr. There is a reason that it has become the norm to have repeat C sections. If you dr. is obvisously uncomfortable with the procedure are you sure you want them doing it? Also, I have heard that they are willing to let you try sometimes to go into labor on your own but that most dr.'s are unwilling to induce for a vbac as it causes more stress on the scar tissue from the pitocin. I say take which ever road will lead you to a healthy baby at delivery. There is only a chance that your uterus will rupture with vbac but are you willing to take the chance of not coming home with a baby? just some food for thought.
DS born 2003- 39 weeks preeclampsia, 6LBS 7oz
DD born 2009-32 weeks preeclampsia, 3LBS 1oz
DD born 2012-38 weeks, PIH, IUGR 5lbs 4oz- no pree


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