? to ask provider about vbacs

[metta4]

hi all...just need some suggestions...

we aren't pg yet but want to ttc starting in Feb 2003. my ds was born april 2002 "emergency" c-section. basically they said his head was stuck and they were not able to use forceps. i labored without meds, and was very mobile until i became incredibly naseous and lightheaded..then i ended up in the bed and i think thats a big reason why i ended up in a c-section. i had been very mobile up till then and had dialated quickly once contractions started.

i thought i had done everything to prepare, i read lots, hired a doula, went to classes, wrote a birth plan/preferences etc and still had a c-section. i am ok with it most days but as we start to think about baby 2 i get pretty disappointed in myself that i didn't get the heck out of that bed.

anyhow....after my rambling i have a few questions...

i have an appt with my midwife next week. i want to talk to her about vbacs before we are even pg as i want to be sure it is even a possibility with her group. any specific questiosn i should ask? here is what i have so far?

WHAT REASON IS LISTED IN MY CHART AS TO WHY I NEEDED A C-SECTION?


WHAT TYPE OF INCISION (UTERINE) WAS C-SECTION?
-LOW TRANSVERSE
-LOW VERTICAL
-HIGH VERTICAL
(my scar on the skin is a low transverse but i read that that is not always what the uterine incision is)

WHAT % PATIENTS HAVE SUCCESSFUL VBACS ?


WOULD A MIDWIFE OR OB DO MY PRENATAL CARE AND VBAC? (there is both in the practice)

i have been doing lots of reading online about vbacs and plan to also buy some books.

any suggestions would be great....

[born2birth]

Good for you for doing this now! Definitely ask what their vbac success rate is. And ask it of EVERY OB and midwife in the practice. It should be at least 75%. If not, run! You should also ask them what their protocol is for a VBAC. Find out if they require external monitoring and an IV. Find out if they will let you go past your due date or start screaming induction at 38 weeks. Find out when they want you at the hospital after labor starts. They should look over your medical records and discuss with you the reason for your last c/s and the likelihood of it happening again. If they tell you that you can have a VBAC as long as your baby isn't "too big," then you need to keep looking. My VBAC baby was actually larger than my c/s "too big" baby. Size doesn't always matter. And above all else, no matter what practice you choose, hire a doula. :)

[metta4]

lauri..thanks so much for the questions!!!

we had a doula with our ds and will definetly have a doula again! Doula's rock!!!!!!!

[catkrazy99]

I know what you are saying, as I've been there. I thought I was all prepared as well, labored for 48 hours with no pain meds using hypnosis, had a doula and though I thought I was doing everything "right" I still ended up with a c-section b/c of a swollen cervix. I worry about #2 and we are not even ttc yet.

I hope you get some good answers and get pregnant and have the labor and birth you dream of.

Good luck!

[miche]

In the cubby is an excerpt from "The VBAC Companion" by Diane Korte which lists <a href="http://www.storknet.com/cubbies/vbac/10questions.htm">10 Questions for a Doctor or Certified Nurse-Midwife</a>

I would also recommend asking them about protocols during labor. Questions like:

Do you do intermittent or continuous fetal monitoring?
How do you feel about internal monitoring? (some OB's insist on this for VBAC - which requires AROM)
Does the hospital have telemetry monitors? (allows more mobility and use in water)
Can I labor in water (shower or jacuzzi tub)? With telemetry monitoring?
Is there a jacuzzi tub available?
Will you require an IV or a heplock or nothing?
How do you feel about induction and augmentation of labor with a vbac? What would you use and under what circumstances? (ie. are they going to be a pitocin pusher like my OB's back-up was? I managed to convince her to let me try nipple stimulation instead - nursed my 2 yr old! :))
Do you have any time limits? After rupture of membranes? For overall delivery? (I progress at a MUCH slower rate than doctors like - the reason for my first unnecessary c-section)
What happens if you are out of town? Does your back-up/partner share your views on childbirth? Will you be the one delivering me?

Well most of these are more relevant when chosing a provider than for a pre-pregnancy check I suppose. As for what to ask NOW I would definitely find out what kind of incision you had (I'd be surprised if it was anything other than a low transverse) and find out how many of HER patients vbac (percent) as well as how many even try! Sometimes they have a great vbac rate, but they "allow" very few women to try.

That's all I can think of now. Oh, order copies of ALL your records now! Get your hospital and OB's records now and ask questions about anything that doesn't make sense to you. They are your records and you have a right to them.

Good luck! About 75-85% of women who attempt a vbac have one, so your chances are very good! :)

Oh, and please visit the VBAC cubby. The link is in my signature!

[metta4]

I am going back to the same midwives/ob I used last time. If I don't like what I hear I will be looking elsewhere. I want to do this all now b/4 I am pg so that I don't have the stress of dealing with that then.

i plan to buy a couple vbac books to in the next few weeks...through the stork net of course...

i have been to the vbac cubby and done a 1000000 internet searches...the cubby is great......thanks for all your hard work.....

I'll keep you all posted..thanks again

:)