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Friday, July 9, 2010

VBAC vs. repeat c-section

I see a new dr. on August 3, for a consultation to get their opinion.

My dr's reccommendation is to get a repeat c-section. His reasons are, 1. They don't do them because there are several hospitals women deliver at in the county. By law the dr. must remain on the L&D floor at all time while a woman is laboring during a VBAC. He can't promise the on call dr. can do that because somebody else may go into labor somewhere else, and it's just an inconvenience for them to have to be glued to the hospital. 2. He can send me to the university doctor's, they have residents and doctor's overseeing them at all times. I could switch and see them, however that would mean my dr. would lose a patient and money so he's not advocating that. 3. The reason he's giving for not being a fan of that option is because at 38w3d when I was induced for several days I hadn't made much progress. I wasn't even quite to 3cm yet, even after they broke my water that morning. He says my pelvic opening must be too small causing me not to progress.

My opinion, is 1. Rememeber the amniotic fluid was dwindling for about a month and it got too low, so they had to induce. I was 38w3d when we had the c-section. I was still somewhat early, especially considering a pregnancy can be up to around 42wks. I was also tracking my ovulation via fertility friend and I know based on ovulation signs CM and temps that I ovulated a week late. I just so happened to always measure right based on my LMP. I don't know, but I think my EDD was really a week later so it made me more like 37w3d and I just don't think my body and the baby was ready to come out. Maybe I'm wrong. Maybe regardless of how far along you are your body should respond to the oxytocin...

That's why I'm getting a 2nd opinion. I'm living in the county beside the county we used to live in the one that has 3 different hospitals. So where we are now we have 1 hospital and I found a doctor (a female dr. yay) that takes my insurance and does VBACs and has been recommended. I will just have a consultation with her and I have tons of questions to ask her, both specific to my situation and also questions I've found online. I was going to go with a midwife but they said that a doctor has to be there at all times anyway so I might as well just go straight to the dr and especially since it hasn't been a real long time since I had my c-section. I think it's probably best anyway. I'm thinking about looking for a doula, especially if Simon is still over the road trucking because there is a chance he misses the birth if we let the baby come on his/her time schedule.

Before the appointment I need to tour the hospital I will be delivering at and make sure I like it. I also want to tour the hospital I will have a repeat c-section if I stay w/ my current doctor. It's closer to where we live and a lot nicer and newer than where we delivered Ellie at. I know I'm still in my 1st tri and its a little early to be touring hospitals. But I currently have a wonderful dr. and the office is super nice as are the staff. This new doctor's office and doctor has a lot of impressing to do. Plus the place I deliver at is really important to me. When I had Ellie since she was ok, they didn't wheel her away from me. She stayed in the operating room while they sewed me up then in the recovery room I was able to hold her and nursed her. I've heard from a lot of people that they generally take the baby to the nursery to do all the testing and bath. People complain because other family and friends get to see the baby better first before the mom sees and bonds. It's really important that whichever hospital I deliver at can grant me the same experience as long as there are no complications. So you see there is a lot for me to think about right now.

Slight change of subject...I have a friend selling their van, about the year we are probably looking for and it's a Honda so we like that. I asked how much so we'll see if we're going to follow through. I will feel so much better if we had a van or suv w/ 2 rows of back seats. Right now we have an older car that isn't perfectly reliable anymore. We'll see if this will be our van or if we will have to begin a search.

3 comments:

Jacksprat said...

Your blog post came up on my Google alerts. I'm a doula, and I think it would be a good idea for you to hire one, especially given your husband's work schedule. And it doesn't really sound like your doctor is very supportive of VBAC or supportive of you making your own choices. All of his reasons for repeat cesarean are for his own convenience and benefit, not your own! If you plan on having more children, VBAC is definitely the safer way to go, as repeat cesareans become exponentially more dangerous each time. And you're absolutely right -- your first baby was very likely not ready to be born yet, and your first cesarean probably had nothing to do with your pelvis at all. Good luck, and remember, you always have the right to make the best choice for you and your baby, even if it means finding a new doctor or midwife. And by the way, there is NO law in any state regarding doctor's attendance at a VBAC. There may be hospital policies requiring the doctor to stay in the hospital during a VBAC labor, but they are in no way the law. And if you do choose VBAC, you can labor at home for as long as possible to both increase your chance of success and decrease the number of unpleasant interventions ...

Elana said...

I 100% agree with Jacksprat. If your body wasn't ready for the induction, then the oxytocin won't do a darned thing. In order for an induction to be successful your cervix needs to be ready, and if it's not then you'll end up with a C-Section (as you did). 37w 3d is MUCH too early for an induction, as is 38w 3d. Obviously you had another issue, but under normal circumstances a doc wouldn't induce that early because the chances of your body (and baby) being ready are quite low. It has nothing to do with your pelvis...he's just trying to get you to do a C-Section because it's easier for him. It's the same song and dance I got from the MFM doctor--a load of baloney. VBAC is always the way to go, and if his hospital won't do it then you find one who will. You may love the doctor, but if he's not willing to give you the birth experience that's best for you then you need to find someone who will. Midwives are awesome, and as long as you're delivering in a hospital there should be an OB on call (or right on the floor) in case of emergencies. So if you're having a normal pregnancy, there's no reason not to see a midwife. My main care is through the midwives, but I still get to see the OB once in a while and the MFM doctor when I have an ultrasound. I'm getting thorough care and hopefully will get to have a midwife do my VBAC. As for doulas, they are awesome and I highly recommend getting one! She'll be there to remind you of your birth plan and to help you through labor and delivery. Good luck!

ssbean said...

Thanks to both of you I will have to read what you 2 have written as a pep talk right before my appointment. You've given me hope that a VBAC is within the realm of possibilities as my OBGYN has led me to believe otherwise.