VBAC SUPPORT

Hi again everyone!

I've ordered me the Hypnobirthing book and finished it within a day of getting it! It's installed a sense of calm and confidense and I'm not scared at all, nor am I dwelling on what happened last time. Everything is still going really well, and I'm having a check-up next Friday @ 27 wks. My husband and I are doing a hypnobirthing workshop on Saterday! He's not at all excited about it, but he's going with!

I'll be asking my gynae some questions on VBAC - he's promising them to a few people I've met out of own accord and as far as I know he's the best chance I've got with the docters available in PE! We've talked about it before, but I'll be reminding him of the subject to see where we're at. Won't change easily because he's loved by both his patients and the nursing staff! I'm confident that I'll get a fair chance!

Keeping a watch on everyone's stories, so please keep them coming!

Anthea, thanks for your input!!! I agree, the environment is a key factor!

You mention that you where at Femina, I often doula there. Here is the thing about Femina... The gynies at Femina actually ASKED a midwife to open a birth center at the hospital. And a lot of ladies goes straight to the midwifes instead of the gynies there. They have 4 full time midwifes and are doing around 30 births per month in that section. They have a normal birth rate of 90%!!!

Then the normal Femina hospital where you go to gynies and go the normal hospital route, has the lowest private c-sec rate in SA (standing at 70%) and I can promise you that its only that high because so many low risk ladies go through the midwifes and all the high risk cases from the midwifes are sectioned in the hospital, so that counts against the gynie's c-sec rate as well as the midwife's rate...

You should look into the midwifes-exclusive active birth center! You could have an even better experience, they are finishing up their new quarters and should be moved in by Aug. You would then still see your normal gynie as back up (seeing that he is at Femina) and he will work with the midwifes as part of your caregiver team. Only thing is that you won't have to fork out R6000 or so for his 15 min input if he is not needed!

Hi there ladies

Sorry to but in here but i have been following this thread with interest. This is because, as a first time mom, i had a totally natural birth - no epidural, and my rights were respected. I didnt have a widwife and i birthed at Femina Clinic in PTA! I think the environment definitely makes a huge difference, this is a woman's hospital and the sisters are midwives first! I had a birth plan drawn up with both the OB and sisters respected to the TEE! I was allowed to be mobile during the 20hour labour process - i had access to a birth bath and when i couldnt handle the pain anymore i asked for an epidural. I was about 6cm and they had broken my waters at 4cm - utter agony contractions after they broke my water. But the sister told me straight that i didnt want an epidural and she assured me that as i had come this far i was through the worst! They respected my decisions so much that they denied me the epidural. In hindsight i am ever so grateful to them for that!

True the OB worked all of 15mins - he walked in as i was ready to push, safely delivered my baby and left again till the Sunday morning - my daughter having been born the Friday night! The staff at Femina Clinic were TRULY amazing!

I am pregnant with number 2 and am hoping for the same experience again!

I truly do wish that all of get to experience the miracle of childbirth. Remember, its called labour for a reason - its not easy! But with the right support structure it is possible! The ward was full the night of my daughter's birth and my hubby was the other "sister" in the room! He was a wonderful birthing partner - supportive throughout and waiting on me hand and foot! Massaging my back when my contractions became unbearable, to the extent that he had a huge bruise on his wrist the next morning from pushing so hard. All i had was some rescue remedy in water to keep me calm!

We were made to this ladies! And you all CAN do it!!!

Hi LeeAnn,

Like Spiral said, a low placenta previa is one of those cases where its just not a good idea to try a natural birth. But it should be diagnosed late in pregnancy (like 36 weeks) because the placenta can move up and out of the way.

Its also not very likely for it to happen again as it is actually a rare thing. So you should be able to give VBAC a shot if you wish to have a natural birth.

But I think the most important thing about trying for a VBAC or any natural birth is to be prepared and to have the right team of care givers. I would strongly suggest a midwife as primary care giver and OB as back up only.

One of the most important advantages of having a midwife as care giver is that she will be with you during the whole labor. She knows your medical history, details of your pregnancy and will monitor you the whole time. While if you go with an OB at a hospital, then you will have a strange nurse midwife coming in and checking on you from time to time, when the shift changes, you get a new one... Your OB usually only comes in for the birth and maybe once or twice during the labor if you are lucky. So I personally think that the chances of picking up a problem if there is one, is better when you have the same person who did all your prenatal checks, monitoring you constantly instead of random people coming and going. You will have an OB as back up and if he is needed, your midwife will be able to give him a full breakdown of your labor and potential problems.

Good luck with your decision.

Hi LeeAnnF. A cesarean for placenta previa is a very good reason for a cesarean. Your doctor would suggest this even if you had had a succesful vaginal birth the 1st time round. Yes, there are degrees of previa, like Grade 1 or 2 but that combined with a previous csection does make very good reason for a repeat cs.
I have supported many women attempting vbac's and it's only once you've had that 1st experience of having your birthing power taken away from you do you become like a pitbull with a bone to have a natural birth.
Like elamsmoms'story - birth has become the domain of the medical fratenity & what works best for them - with dissapointed mothers & disserviced babies in the aftermath.

I've come to realise that some women crave a natural birth because it is a part of your sexuality! So you plod along assuming everyone is on the same page as you only to find they're only looking out for themselves. And so if I can liken it to making love - but never achieving an orgasm! Yes, you can live your life without ever having one but you kinda left wondering - am I missing out? what's the fuss about? is there something wrong with me? am I less of a woman?
These are all the emotions woman go through when their birthing rights are violated.

So yes, i feel strongly that woman speak out to other woman and tell them not to assume that your caregiver is in favour of you having a natural birth. planning a vaginal birth is HARD WORK - it is easier in this country to organise an unneccessary csection than a safe natural birth. We have got to be more proactive with our 1st birthing experiences because let's face it, you only have one chance at a 1st birth!

Thank you soooooooo much for the post, I promise to respond to you tomorrow I love that you gave me all the nitty gritty and went into detail it is greatly appreciated. Have a lovely evening.

Hi Lee-Anne

I am no expert on the whole vbac thing but I'm sure ppl like Hasie will respond soon to provide some expert advice

I had an elective c-sec with my 1st baba. It was literally the day before my due date and i sat in the doc's office and he asked me how I was planning to give birth. And I realised I hadn't given it a lot of thought Then my hubby was super keen for a c-sec and my gynae didn't even hesitate to say ok & set everything up in a flash for a c-sec for the next day. I don't blame him. It was my decision. I hadn't given it the adequate amount of thought.I let myself be swayed easily because I was at that vulnerable stage where u are 39.6days pregnant. Tired as hell of being preggy and a "quick way out" seemed like the easy option So anyway, I had ac-sec the next morning. and guess what? I had gone into labour that morning as well! but i felt like i couldn't change my decision at that stage. (I dont blame him, but I do think he could have asked more questions, asked me why I wanted a c-sec, advised otherwise, given me the options, i mean, i was a 1st time mom. NO risk factors! Absolutely NO reason to have a c-sec. one day before my due date...but anyway)

ANYWAY, that was just a bit of background. The minute my c-sec was done, I knew that it was the wrong decision (for me). I felt empty. I felt like a coward for not even trying. i felt like a failure. I felt robbed...i was just a mess emotionally.

So, that is why I have decided to try for a vbac. What I have been told is that the main risk factor is the rupturing of the scar. But the probability of that happening is like less than 1%. BUT they have to be very careful and monitor you quite closely during labour so that they can pick up early on signs of stress on the scar.

I saw a gynae up to 20 weeks then moved to a midwife at Genesis clinic. I felt that my gynae wasn't really keen on the vbac and that he also wasn't being honest with me about it. So he would keep saying "we'll see" and "it depends" and "its too early to think about that now." So, i made the decision to move to a midwife and to an Active birth centre where you will be much less restricted during labour. Also, i obviously chose a midwife who has done quite a lot of vbacs before.

So, final decision for me will be made at 36 weeks. Main things(according to MY caregivers) that will determine whether I can try for vbac will be:

> Position of baby: If my baby is still breech at 36 weeks, that's like a total no-no. (my baby was breech at my appointment on Monday at 30 weeks)

> Size of baby: Gynae (back-up gynae) said that he would be comfortable with a 3.5 kg baby. Above that, he would start to worry. (my baby was weighing 1.56kg's at 30 weeks so that's a bit of a worry for me)

> Reason for previous caesar: if u had a compelling reason for your previous caesar that might occur again then that's something that they take into consideration. (at least with me this is not an issue as i never even tried to labour the 1st time round )

Ya, I think these are the main considerations in assessing whether you're a good vbac candidate or not.

So, its quite a difficult thing because you want to stand your ground and not let anyone scare u into having another c-sec. At the same time, you don't want to put yourself or baby at risk.

I know I will be devastated if they tell me at my 36 weeks that i cant do a vbac, but at least at Genesis, I will be 100% sure that they are coming from an honest place and not just because c-secs are more convenient for them...

I think that's what was key for me. I had to TRUST that my caregiver was giving me the BEST chance to have a vbac & that it was someone who actually truly believed that vbac is better than a 2nd c-sec, and if she then advised me against it, i would be SURE that it was the right advice.

Sorry for looooong post. Hope that helps.