Posted by My OB said WHAT?!?.
May
22
Posted by My OB said WHAT?!?.
“What’s Worse? Having Scars In One Place or Having Scars In Two Places?”
“What’s worse? Having scars in one place or having scars in two places?” -OB to a mother during a consultation for a VBAC, speaking about the fact that the mother would likely tear while having her VBAC.
There are 68 comments to this post.
The Deranged Housewife had this to say,
May 22, 2010 @ 4:53 am (Quote)
“Yes, I’ll take the scars and/or *possible* tears any day over the pelvic pain and secondary infertility you never bothered to mention!” That’s about what I told my doctor and he looked at me like I had just slit his throat. LOL
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Bronwyn Reply:
May 22nd, 2010 at 3:23 pm (Quote)
I am saving that one for my doula work! Brilliant!
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Sarah Dorrance-Minch Reply:
May 23rd, 2010 at 6:22 am (Quote)
You can use the IBS I now have as a result from post-surgical adhesions in your example, too. I have two modes of elimination: diarrhoea, and terrible constipation, and because I can’t exactly predict which I’ll have at any given time, laxatives and solidifying agents are equally impractical and cause as many problems as they might solve. The constant gas isn’t much fun either.
All because of a c-section that my body “tolerated very well” and “recovered from without any problems.”
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Sarah Dorrance-Minch Reply:
May 23rd, 2010 at 6:28 am (Quote)
PS. Diarrhoea behind a blockage of constipation is especially fun, because it feels exactly like being in labour. At least, it feels like MY labour. I’d put the pain at about a six or a seven. I’ve even considered learning Lamaze just to deal with the pain of intestinal blockage. On the up side, this could be one reason why I tend to shrug my shoulders when people ask me, “But aren’t you afraid of the pain you’ll feel from natural childbirth? I couldn’t handle mine! You’re soooooo brave!” I have migraines, and severe IBS. Giving birth is much easier. Really.
With a c-section, sure, if it’s scheduled you might avoid ALL the pain of labour, and if it’s something resorted to after a “trial of labour” or something along those lines, you might not have to deal with the “ring of fire” that comes with the actual birth. But you won’t avoid pain. You’ll get plenty of pain. It’s just that you’ll get it on the installment plan, after birth, and there’s a good chance you’ll be charged interest.
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The Deranged Housewife Reply:
May 23rd, 2010 at 7:04 am (Quote)
I can relate somewhat! I have Crohn’s Disease and ulcerative colitis, but mine started when I was pregnant with my first. I’m sure the c/s didn’t help. Now I have strange pain when I ovulate that almost feels like round ligament pain that I never had before, so chalk that up to two surgeries. What really ticks me off is that they only look at the short-term side effects, etc. and never the long-term issues. Either women are rendered infertile and don’t know it because they’re done having kids, or they just can’t explain the weird feelings and pain they have afterwards but go on like nothing happened. I think if you went over the long-term risks of having multiple (heck, even one!) c/s *no one* would want to have them.
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jade Reply:
May 23rd, 2010 at 7:18 am (Quote)
Gallstones was the illness for me that made me sure that I could tolerate natural labour, cause belive me, if you can have gallstones, you CAN have a baby, it isn’t nearly as bad!
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Lauren Reply:
May 23rd, 2010 at 7:28 am (Quote)
Those are the WORST!!!!!! I had a gallstone attack two weeks after my VBAC baby. Thought I was dying. Labor is nothing compared to that LOL. Bring on the next natural VBAC. 
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Jade Reply:
May 23rd, 2010 at 7:34 am (Quote)
I ended up having to get my gall bladder taken out when i was 23 weeks pregnant. 15 staples, 5 stitches, a drain hole and OMG was it better than the stones!!! I said to teh nurse when i was in, i am really worried about labour and she said to me “honey, you have just put up with gallstones for 5 months, you can do anything!” I thought she was kidding, but no, apparently i have felt pretty much as bad as it gets, and it wasn’t childbirth!
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Sheva Reply:
May 23rd, 2010 at 7:28 am (Quote)
I’m pretty sure I posted this blog, but it bears repeating, IMO.
http://bringbirthhome.com/birth-experience/birth-safety-as-a-binary-condition/comment-page-1/#comment-390
I hate the idea of docs considering a live mom and baby to be the only deciding factor in a good outcome. Sure, we’re thrilled that everyone is alive and safe, but why don’t (can’t) they respect that pain when voiding, pain on ovulation, secondary infertility, and so many more things , IS part of the outcome of surgery for some women and that it’s NOT OK to just say, ‘well, at least you’re alive’.
So many bad words in my head, so little time…
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Appeal to her vanity because she’s a woman, eh? Nice. (And I’m not normally one to jump to such conclusions.) It’s not about the scars, jerk…
FTR, I did tear a lot during my VBAC, even with a super midwife and doing everything “right”. Guess what? It was still better than a C-section. Surprise!
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Sarah Dorrance-Minch had this to say,
May 22, 2010 @ 6:44 am (Quote)
What about the scars on my PSYCHE from having been bullied into being cut open when I knew I could do it myself if I were just given half a chance? Huh?
Don’t those count?
Attention, medical professionals: VBAC is safe, especially if the mother is allowed to stay at home until her labour is active, rather than being scared into heading to the hospital at the first signs of dilation and pre-labour to be monitored for what you mistakenly believe to be the inevitable signs of disaster. It’s safe if you avoid augmenting her labour with Pitocin and hyperstimulating her uterus – if she isn’t kept immobile in a bed for continuous monitoring, starved on NPO orders Just In Case she has that c-section you believe in so strongly and needs anaesthesia (which is one big reason, along with FEAR, that causes her labour to slow down or stall in the first place), or, heaven forbid, given Cytotec to hurry her along (Cytotec has been known to rupture uteri both scarred and unscarred, especially when used in conjunction with Pitocin, and there’s a great big black box warning on the box saying NOT FOR USE IN PREGNANCY OR LABOUR that you still like to ignore).
VBAC does NOT stand for Very Bad Alternative Choice, so don’t treat it as such. And quit telling us that it does.
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Becky Reply:
May 22nd, 2010 at 7:51 am (Quote)
Wow Sarah, I couldn’t say it better myself. Thanks for being so articulate 
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Luann Reply:
May 22nd, 2010 at 10:18 pm (Quote)
so, the whole NPO thing ‘in case of Cesarean’ what happens then if i’ve been birthing at home, eating when i wanted and then have a TRUE emergency and need a c-section? does my eating prevent a c-section? cuz i’ve never heard of a doctor postponing a c-section because the woman ate before hand..
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Sarah Dorrance-Minch Reply:
May 23rd, 2010 at 7:18 am (Quote)
Eating if you happen to feel hungry, and drinking when you start to feel thirsty (and you’ll definitely get thirsty, even if you may not feel hungry; labour is hard work) is one way to help avoid a c-section.
The reason is that if you have been fasting for a long time, your body reacts accordingly. Most people, if they skip breakfast and have gone for a long while without food because the last time they ate was at six in the evening for dinner, have sugar crashes. They’re tired, grumpy, headachey, jittery… and weak. We’re really not supposed to go without food for twelve hours or more at a time.
And these are people who spent most of that fast in bed, asleep. Can you imagine trying to weight-lift or run or do any other heavy exercise after not having had any food for twelve or more hours?
This is one reason labour can stall in the hospital. I think one reason I got a migraine in the middle of my first birth was starvation (the other being that headaches are common when Nubain wears off; and I think I had a pre-existing sinus infection on top of that, but then again, my sinuses are almost always clogged, so I’m used to that). If you do give birth in a hospital, be sure to sneak in some food in your birth bag. No, seriously. I had a very sympathetic CNM, but she got overruled by her senior partner and the chief OB during my labour, and hospital policy was NPO, so NPO it was. Nothing she could do about it. I suppose I could have sent my husband out for fast food or something, but it didn’t occur to me – I had other things on my mind at the time.
Another reason hunger can contribute to a preventable c-section is that being hungry makes it harder for your body to process endorphins, which means pain will hurt more. So that epidural will seem a lot more attractive, and epidurals mean you’ll need to be on continuous foetal monitoring and stay in bed (it’s REALLY hard to wander around and shift position with an epidural, even if it’s a so-called “walking epidural;” you have all these tubes and wires and lines and things getting in the way) and that can get in the way of effective pushing, because the walking around, wiggling, etc of the earlier parts of labour help get the baby in an easier-to-birth position rather than, say, asynclitic (“stargazing”) or face-up, and the pushing phase is generally harder if you have an epidural because your positions are very limited (and often unergonomic in the extreme, as in the case of the supine and semi-reclining positions usually favoured by hospital staff because they give the doctor most control and visibility, and because they are easier to put the woman in when she is tethered to a bunch of tubes and wires). Also because often you can’t feel a strong urge to push (reaction to the anaesthetic varies from person to person, some women feel very pushy, others don’t feel anything below the waist at all) and that means coached pushing rather than going with your body’s natural cues.
All of which can contribute to a c-section.
So if you feel like eating, eat.
If eating makes you barf, that’s okay. It feels better to have a good wet barf than it does to have endless dry heaves, anyway, IMO (I’m so glad my morning sickness eventually went away) and besides, barfing actually helps push the baby down. Lots of abdominal muscles getting worked, and all that.
Doctors and nurses follow NPO because traditionally, in the past, all women (not just the c-sections) were given general anaesthesia, and back in those days, they also didn’t intubate anaesthetized patients, so if a patient barfed while knocked out, the resulting aspiration of vomit could cause pneumonia and potentially be fatal. Not pretty.
Today it serves no purpose whatsoever, as most labouring mothers are not given general anaesthesia, and even most surgical births take place under epidural or spinal blocks, which do not pose the same risk of aspiration. When a mother is given general anaesthesia due to emergency circumstances, epidural not working properly, etc, she gets intubated so that if she barfs, it doesn’t reach her lungs, at least, if the tube was put in competently. Even then, there would be less danger of corrosive stomach acid eating away at the lungs if her stomach were full. Food is less corrosive than the bile of an empty, sour stomach.
NPO, in short, is utterly worthless in the maternity ward. Mostly it’s just a hazing ritual mothers are subjected to as part of the birth experience. Robbie Davis-Floyd writes about this at length in _Birth As An American Rite Of Passage_.
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Sarah Dorrance-Minch Reply:
May 23rd, 2010 at 7:34 am (Quote)
Anyway, short answer (sorry I’m such a windbag): Eating does not DIRECTLY prevent a c-section. Especially not a c-section due to the sort of emergency that would have you transfer from the comfort of your own home to the operating room. You can’t prevent placental abruption or cord prolapse by eating.
However, eating will not be detrimental to you in any way if you do wind up needing a c-section – contrary to popular opinion.
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Luann Reply:
May 23rd, 2010 at 1:58 pm (Quote)
tone is hard to convey via a typed message
i was following out this OB’s line of logic… that if you ‘need’ to be NPO in preparation for a possible c-section then if i eat while at home are they going to make me wait to have a c-section? the answer being no, to me proves the falseness of this OB’s statement.
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Well unless someone puts their face down there, they’ll never see those scars. I’ll take the possible tears and scars in two places. I tore pretty badly and that I know of, my husband has never noticed any scarring. Plus.. ya know doc.. if you don’t try to make me push when I’m not ready to push, tears probably won’t happen!
Go Go VBAC! Hope you got it!
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Mama Mirage Reply:
May 24th, 2010 at 7:45 pm (Quote)
I agree! I tore both directions pretty bad with my first because the midwife couldn’t get a heartbeat on the baby and told me to push with all I had so out she came in like 4 or 5 pushes and ripped me wide open. She was only 7 pounds 12 ounces. Now my son who was 8 1/2 pounds didn’t tear me because I wasn’t being screamed at to push push push. The midwife for that birth told me to take it slow and I couldn’t really not take it slow as big as he was he didn’t exactly slide out easily… Lol!
So yeah, even the awful tearing from my first I’d take it over a c-section and that probably wouldn’t have happened at all if I hadn’t been being told to push when I wasn’t ready.
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Heather (qtberryhead) had this to say,
May 22, 2010 @ 9:53 am (Quote)
How about we look at the benefits instead?
With a VBAC you can actually “lift” your own baby, you heal in a normal amount of time, and walking doesn’t take an act of God.
How about you ignore the surgical aspect of your job and help me deliver my baby? Or better yet, why don’t you just stand in the corner with your hands in your pockets? Then we can both be sure that I don’t have any problems that are caused by YOU.
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Cmat Reply:
May 22nd, 2010 at 1:35 pm (Quote)
Well for the first few days.. sitting on anything other than a couch is somewhat of a challenge. Buttttttttttt that’s a few days. From what I hear, healing from a c-section is no walk in the park and I’d take tearing over a c-section any day.
I like the hands in the pockets idea.. and the comment about ignoring the surgical aspect of their job. Just because the skill is there does not mean it needs to be used “just because.”
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Jane Reply:
May 22nd, 2010 at 6:51 pm (Quote)
I only had an episiotomy for my first birth. Four hours later the nurse came in to check on me and found me sitting cross-legged on the bed. Apparently I was not supposed to do that — apparently this was leaving me in agony. I had no idea! She made me take an advil, though, to make her feel better that I wasn’t in any pain. :-b
So honestly, even if there’s an episiotomy, it doesn’t HAVE to hurt that badly afterward, even the next day.
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The Deranged Housewife Reply:
May 23rd, 2010 at 7:07 am (Quote)
LOL I had a standing order (I guess their usual, I dunno) for Tylenol #3 or something after my VBAC. I only took a few of the ibuprofen they ordered, and then had a miserable cold in the hospital and was coughing my guts out – I took the Tylenol #3 just so I (and the rest of the floor LOL) could get some sleep that night! LOL
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Cmat Reply:
May 23rd, 2010 at 7:22 am (Quote)
I didn’t have an episiotomy, I just tore in a few places and things were pretty swollen. By the time I left the hospital it was pretty much fine. I think it was just the awful chairs they had in my room.
They tried giving me ibuprofen for a while then I started just saying I didn’t want it, it wasn’t doing much anyway.
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Sarah Dorrance-Minch Reply:
May 23rd, 2010 at 7:40 am (Quote)
Oh, I’d definitely take whatever prescription for T3 or other narcotic was written on it. I don’t mind being in pain from my labour, but the afterpains I can do without, and codeine is preferable to taking handfuls of Tylenol and making my liver hate me. (NSAIDS haven’t done anything for me for years, alas.) That, and I usually wind up with leftovers, which come in very handy when I have one of my five-alarm migraines. For some bizarre reason it’s easier to get narcotic pain relief for after-birth pain than it is for headaches, even when the headaches are so bad that the have triggered seizures in the past. Go figure.
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Mama Mirage Reply:
May 24th, 2010 at 7:50 pm (Quote)
The Boppy wound up being totally useless to me because I have such a long torso I still had to hunch over- was easier to just stack 2 pillows on my lap.
BUT as a result I found a great alternate use for that useless boppy… Makes a great seat cushion for those sore parts postpartum! 
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Mama Wears Combat Boots had this to say,
May 22, 2010 @ 10:30 am (Quote)
Agree with what everyone said! Plus, doc, C-sections don’t have just one scar….you’ll be cutting through 7 layers of tissue. One of those being the uterus. Adhesions are yucky. So is the risk of placenta accreta (part of the placenta growing in the scar) and so is the risk of endometriosis a couple years after the section (cells from the uterine lining get pulled out when baby is pulled out and then the lining grows outside the uterus). All those risks get increasingly worse the more sections a woman has!
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Mama Mirage Reply:
May 24th, 2010 at 7:53 pm (Quote)
Those possibilities give me the heebie-jeebies!
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I tore…I don’t have any scars. Midwives are as awesome at stitches as they are at knitting cute baby hats for their clients. I had to deliver squatting due to a pretty significant cord wrap, so my tear was pretty bad. My OB couldn’t even tell where the stitches had been! I think you only have scars if your stitcher sucks at stitching. Or if they cut a giant episiotomy.
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Heather Reply:
May 22nd, 2010 at 12:11 pm (Quote)
Oh, I just assume I’m scarred–I haven’t looked and DH hasn’t mentioned it. I didn’t have a very neat tear and I have keloid scarring normally, so I just figure I’ve got them. I had very neat stitches, but with my scarring condition and the mess of my tear, I don’t see how I can NOT have them.
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I have two large scars- one from baby one’s necessary and helpful episiotomy (a rare thing, I know), the other from a separate huge tear with baby two’s rushed exit. My husband “puts his face down there” all the time, LOL, and I gotta tell you that neither of us cares one bit that I have some thin white lines in my skin. Enormously preferable to any alternative. I suppose my career as a vagina model is ruined, however.
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Maria Reply:
May 22nd, 2010 at 7:38 pm (Quote)
LMAO! Yes, I don’t think my DH is thinking about scars but darn, I didn’t think about my career choices!!
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Sarah Dorrance-Minch Reply:
May 23rd, 2010 at 7:46 am (Quote)
Thank goodness I’m done with my morning coffee. I hate it when laughing makes me spray coffee out of my nose.
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Speaking as someone who has scars in THREE places (cesarean first baby, my VBAC tore my cervix AND gave me a 3rd, almost 4th degree perineum tear), one scar is worse after you’ve already had the cesarean.
(No, I did not purple push–I didn’t push at all when I tore, actually, she just shot out like a rocket with the first contraction I had after her nuchal cord was removed and she tore my cervix coming out right occiput transverse and turning to posterior and then correcting again before turning posterior again–she was wiggly… and I’m not stretchy–not everyone can handle a 14 1/2″ head coming out without tearing)
I’d rather tear that way every time than recover from a cesarean. It was way easier to heal.
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Karen had this to say,
May 22, 2010 @ 5:38 pm (Quote)
I am the original poster… Having a repeat c section Tuesday at 40 weeks b/c of suspected 10 lb baby. I am trying not to think about it so I don’t get upset 
I did choose a practice that is very vbac friendly though. Just not for big babies I guess.
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Jane Reply:
May 22nd, 2010 at 6:52 pm (Quote)
**hugs**
If you do get upset about it, remember that they can’t induce you unless you show up. But if you trust them that this is the best birth for you, you know there’s no shame and no guilt. I’m sorry though because you sound disappointed.
**more hugs**
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Sheva Reply:
May 22nd, 2010 at 8:52 pm (Quote)
It’s your choice and your birth. You can choose to wait or choose to go in. Do what your heart feels is right. Like Jane said, you show up if you’re ready to birth. They can’t do anything if you don’t come in!!
Whatever you choose, I hope it’s a beautiful day for you and I wish you the very best of luck.
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stephanie Reply:
May 22nd, 2010 at 11:25 pm (Quote)
if you don’t want a section for a suspected big baby then call them and tell them you’re not coming in. Then don’t answer the phone that day. Have your husband answer the phone for you. There is absolutely NOTHING wrong with deciding to wait a little longer to see what happens and then choosing a section on your terms rather than on their terms. The point is that it be on YOUR terms, not theirs.
Big babies are just a guess and ACOG’s own policy statement says that suspected fetal macrosomia is NOT a reason to induce or c/s. Two questions to ask: is my baby o.k.? Am I o.k.? If all is good, then say you’ll wait if that’s what you want.
Remember, your pelvis is different this time than last time. There’s a great video on you tube from ICAN showing lots of women whose VBAC babies were quite a bit bigger than their c/s babies.
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Luann Reply:
May 23rd, 2010 at 2:07 pm (Quote)
ACOG and postdates
One of the most vital pieces of information to know when you are expecting is that ACOG itself (American College of Obstetricians and Gynecologists) does not recommend interfering with a normal pregnancy before 42 completed weeks. This is why knowing your true conception date and EDD is very important; if you come under pressure from a care provider to deliver at a certain point, you can be armed with ACOG’s official recommendations as well as your own exact due date. This can help you and your baby avoid much unnecessary trauma throughout the labor and delivery. Remember, babies can’t read calendars; they come on their own time and almost always without complication when left alone to be born when they are truly ready.
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Jennifer Reply:
May 23rd, 2010 at 7:27 pm (Quote)
I measured quite large during my entire pregnancy, so much so that my OB had me go in for an u/s at 33 weeks to measure the size of the baby. At 37 weeks, (and after feeling that pit in my stomach that an OB was not going to give me the birth I wanted), I switched to a home birth midwife.
Because of that switch, I was able to get (and read) a copy of my medical file from the OB. In that u/s report, the technician writes the “estimated” size of the baby–but it was qualified by the statement “with a margin of error or +/- 1 pound.” ONE POUND!! The estimated size of the baby was appx 5 pounds, and with that margin of error, the tech is conceding that the measurement could be off by TWENTY PERCENT!
It seemed crazy to me, that’s for sure.
I gave birth (at home) to a 9-lb baby and thought at the time “Wow, that’s higher than I would have predicted based upon how it FELT!”
If you want the “trial of labor” then you should have it. According to estimates, my baby should have been well over 10 pounds. But he wasn’t.
If a vaginal birth is something you want, I KNOW you can at least give yourself the chance!! Your body was designed to do this! Isn’t it a miracle?
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stephanie Reply:
May 24th, 2010 at 10:13 am (Quote)
I just want to wish you luck with whatever decision YOU make. I hope nothing here has come across as judgmental, I posted earlier b/c I want you to have as much information and encouragement as possible. I pushed my first 9.5#er for 3 hrs; chose r/cs for the second baby; baby no 3 was 10.5# and slid right out. Until she was sliding out I was sure I was gonna need another section. It’s so hard especially at the end when you just want to be done and to meet your baby. Just remember, it’s your decision. Love, strength, peace and gentle birth. –stephanie
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I had a successful VBAC and the estimated size for my son was a full 2lb off (and these were supposedly detailed U/S and highly accurate) … if that comment was from your current OB I wouldn’t really believe they’re all that supportive of VBACs, that’s a pretty negative comment to make at all. A suspected big baby is not a reason to deny a woman her trial of labor. Any labor is better than none, even if it results in a c-section. I am not criticizing your decision, I just hope you know that there is more than one route to take and that you do not have to be afraid. I switched doctors at 9 months so I’m a little crazy, I guess, but I did get to have my VBAC
And I did tear, that was nothing compared to the pain and complications from my c-section … they’re not even remotely similar!
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Hey Karen..
You do know you do NOT have to have the repeat c-section if you do not want to.. right??
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Luann Reply:
May 22nd, 2010 at 10:26 pm (Quote)
echoing this. i just cringe that your doing this because of a ‘suspected 10lb baby’ when it seems like u don’t want to. you can birth a 10 lb baby if that’s the case. most likely i’m guessing baby will not be 10 lb. you can still change your mind
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Rachel Reply:
May 22nd, 2010 at 10:34 pm (Quote)
Yes! It sounds daunting.. especially if you pushed for your first birth. I’m a small woman. 5’2″. 115 not pregnant. small frame. I birthed a 10lb baby. When I tell people their eyes bug out and they say, “YOU?!” No tearing at all. My first child was 8lbs 14oz with a *smaller* head. I dilated to complete and pushed with her. For several hours. At home with a midwife, and mobile. With that history (small frame, failed to push out smaller baby with ideal support/environment) I was a prime candidate for “probably can’t birth a 10lber”.. but you know what? I DID IT! And you can too. I used to “talk the talk” that “oh, of COURSE women can birth big babies, even small women” but in my head I would think “but not me..” But I did it. And so can you.
And what if you show up for the c-section and out comes an 8lb baby?
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Lauren Reply:
May 22nd, 2010 at 11:34 pm (Quote)
Agreed. Karen, if you don’t want the section, DO NOT GO IN. No one can force you to do this! Hugs!
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Sarah Dorrance-Minch Reply:
May 23rd, 2010 at 8:10 am (Quote)
Some possible evasive tactics you can use:
1) Fire your OB and get a midwife (you can do it even if you only have a few days before your due date; I did. I wound up sectioned anyway, but that was mostly due to hospital politics, and how was I supposed to know that my CNM was a junior partner in a joint practice, and was just starting her career? Also, I’m pretty sure that if I’d refused the Pit drip and if I’d been smart enough to sneak in a submarine sandwich and my Tylenol Sinus, my birth would have been a lot different.) Most CNMs are more flexible than doctors about accepting clients – VBAC or otherwise – at the last minute. Your health plan is bound to have a few, although it may not.
2) If that isn’t an option, fire your doctor anyway, and take whoever is the doctor du jour when you go into labour. I have had much better luck being taken seriously by young residents and interns, too, obstetrically as well as in ER visits for migraines, so that’s another thing you might want to keep in mind. (The OB who gave me my C-section actually tried to talk me out of it. Cool, eh? I explained that my migraine had left me so weak that I could barely lift a finger, let alone push, and I’d been trying to push for three hours. He gave me a blow-by-blow after I came out of the general anaesthesia, including the fact that my newborn daughter had the shoulders of a linebacker and had been face-up, so if I was in a weakened condition, that was probably why I wasn’t having any luck; and he encouraged me to go for a VBAC next time… even if the baby was ten pounds. Awesome guy.) Wait until you are so far advanced that you are unable to talk normallly, so you don’t have to face the Friedman curve. That means try to time your departure for transition or the pushing phase.
3) Try the “I don’t consent to a c-section” line if you choose to go to the hospital anyway, but keep your current OB. (You can also use this line for other routines such as pit drips, continuous monitoring, etc.) Repeat as necessary. You may get the “dead baby” line thrown at you, or if you have a real jerk, a court-ordered c-section, but the latter is rare, and the former is emotional manipulation rather than medical opinion.
4) You can try going to the hospital, and labouring in your car until the baby’s head is almost emerging. This is becoming more and more common for mothers who want VBACs and are manipulated into repeat C’s or denied VBAC outright, from what I’ve heard. It sounds uncomfortable, but it does keep you close to the hospital should anything go wrong.
5) You could try going unassisted at home, and head to the hospital if it looks like there are any signs of an unlikely serious emergency (massive amount of blood indicating placental abruption, a feeling that something has torn abdominally, etc). It would mean doing everything yourself, and not having much support during labour, but then again, some women do better that way anyway (I’m one of them; I am not a people person, and when I’m in pain I want to just crawl into my cave and be left the hell alone. I was secretly glad that my last labour went so fast that the baby arrived before my midwife.) YMMV.
6) If there are any direct entry midwives in your area, and any are willing to work with you, you could pay for a CM or CPM to assist at your homebirth. They’re generally MUCH cheaper than doctors, and also more willing to work out flexible payment arrangements if you can’t pay up front or get your insurance to cover it.
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I have to agree with all the ladies. Waiting until labor starts is best for the baby, and since you are already in labor why not just see what happens, right? You can still get your VBAC, if that is what you believe is right for you and baby.
{{hugs}}}.
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I had a c-sec with my first after pushing for 5 hours… she was 7 lbs 12oz. I just gave birth to my little boy in february, I had a VBAC, I was 1 week overdue and I was not going to be bullied into another section! He was 9 lbs 1oz, I had very minor stitching, and was out ice-skating with my daughter a week later!
Baby’s weight is just an estimate and is quiet often wrong! and even if you do have a 10 lb baby doesn’t mean you can’t do it, and doesn’t mean you will tear!
Ina May’s Guide to Childbirth is a great book on the subject! I read it before my VBAC and it gave me lots of confidence!
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Wren's Mama had this to say,
Jul 13, 2010 @ 8:03 am (Quote)
I’ll take no scars, thank you. I’ll just stick with homebirth, thank you. I think if I had a hospital birth, I would have bit the dr’s head off, and wouldn’t THAT make a heck of a SCAR!
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It’s me- karen- I forgot about this. Thanks for all the suggestions and comments. I went into labor Tuesday before my c section, went to the hospital and my vbac friendly doc said – if you choose a trial of labor you can’t change your mind and have a c section. And my husband wasn’t supportive. So I c sectioned and had an 11.5 lb boy who needed oxygen and had merconium in his lungs. Was taken to the Nicu immediately and was there for five days. He is a happy two year old now. I would have done so many things differently………..
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details Reply:
January 27th, 2013 at 4:13 pm (Quote)
I’m so sorry. There is nothing I can say to fix your birth. With 11.5 lb baby with merconium you probably choose wisely, but I imagine there were lots of other things going on that didn’t need to be going on that made everything so much worse…
I did want to comment on the “you can’t change your mind” comment: That part sounds to me like a doctor who is worried about his VBAC success stats. When I was trying to get a VBAC I was very careful about the local doctors who claimed to have VBAC success rates higher than their first time mom vaginal success rates. I suspect that they were aggressively screening woman out of VBAC’s to protect their stats. If you go past 40 weeks you are forced to schedule a C-section and that doesn’t count against his VBAC failure rate. If you look like you are having a big baby the you don’t get to VBAC so that doesn’t count as a failure. I’m more interested in how many women came in wanting a VBAC and got a VBAC vs. how many women were permitted to go into labor got their VBAC. the doctors have far too much power to wreck a potentially successful VBAC just by chickening out at the last minute. The idea that you “can’t change your mind means to me that if you think you are going to beg for a C-section at 6 cm when you are doing just fine but you are tired then I’m not going to let you mess up my numbers. Just my take on the only reason that a doctor would say you can’t change your mind. There are plenty of women who try for VBAC and end up with medical reasons to go to the OR after labor begins. I’ve done it twice myself. My point the fact that the term for carefully selected VBAC candidates has nothing to do with medical status anymore and much more with the woman’s willingness to say well that is total BS and I’m not going to fall for it. Thus the attitude that you have to fight for a VBAC. You should have to fight for a VBAC. You will always have to pick your doctor very carefully, but once you have found that good doctor you shouldn’t be subjected to any crap. Your VBAC friendly doctor wasn’t. If he had been he never would have said such a thing. My VBAC friendly doctor didn’t pull any of this crap on me. When my second child presented transverse, he laid out the options, said the best we could hope for was to get him to turn to breech, this after my water had broken 2 weeks early and the man waited for my decision. No kidding. C-section was the obvious only answer, but he waited for me to reach that conclusion and take the lead in the decision. That is a VBAC friendly doctor. Yours was an ass with a good rep because his stats for women allowed to go into labor look very good so long as you don’t look too deep. Or at least that is how I read it based on what you have written so far.
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Jane Reply:
January 28th, 2013 at 4:55 am (Quote)
I’m sorry you sound so sad about the way it worked out.
The doctor was definitely making that up about not doing a c-section once you start a TOL. Is this doctor actually asserting that he’d ignore actual medical indications for c-section during a VBAC labor just because the mom was laboring? Because that’s admitting to medical malpractice, and most doctors are shy about doing that.
A c-section may have been the best decision in your case, but you should have been empowered to make that decision in the best interests of your baby rather than coerced into it by your doctor and husband. I’m glad he’s okay now, and I hope you find peace with your birth.
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well i got an episiotomy forced on me and an “emergency” c/s too on the same day thanks to my knOB. and adhesions, thank you very much….not.
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