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vivrelavie @ : Birth Center vs Hospital VBAC?
Hi everyone. I'm new.. I'm around 7 weeks pregnant and hoping for a VBAC. My first birth was traumatic. It was a battle from the moment I checked in to the hospital due to the size of my child, my nausea (due to eating in a panic since I was afraid the hospital wouldn't have gluten free food, silly Know), and my back labor. I ended up getting an epidural out of panic since my doula wasn't there yet which is a decision I greatly regret. Due to the size of my son and the epidural, I stalled out at 5cm and developed an epidural fever so eventually, I was told it was time for a c-section. I was tested for GD, but was cleared. Despite that, I had an 11 pound 2 ounce son. :D He's still a big boy now (very tall and musclely) at almost 3 years old!
ANYWAYS... I'm debating right now over a birth center or hospital birth. I must admit, the first OB I saw so far has me freaked out a bit about the risks, which only scared me more when I went to the AWESOME birth center near my house. I was about ready to sign on the dotted line, but when I saw those emergency risks again... I thought, maybe I would be better at a VBAC friendly hospital? The birth center is AWESOME. The women are wonderful and while they were a little hesitant due to my son's size, they are totally on board with me trying for a VBAC, especially since I eat a modified paleo diet now (so no more carby treats for me!) The only thing that freaks me out is that if there is an emergency...it's not like they can immediately move me to the OR. The hospitals are near by and they are equipped for an emergency (like a level 1 hospital), but still. I don't know. Despite my major distrust of doctors, they have engrained a fear of not having them into me.
I'd love to hear your thoughts. All I know is that I do NOT want another c-section. I want to give my body a chance to do what it was meant to do.
I am so paranoid that I have to give birth in a hospital! I just couldn't live with myself if something happened to the baby!! However most risks are so low so you will probably be fine at a birthing center. If you really are leaning towards the birthing center why don't you talk to them about how/when they will transfer you to the hospital in the rare case that something does go wrong.
I am also trying for a VBAC this time. My baby last time was 9 lbs 11 and that is why I had a Csection. Sometimes I get pissed at myself because I know I probably could have had a perfect vaginal birth but oh well in the end I just wanted a healthy baby.
I hope we both suceed in VBACS this time!!!
I had a VBAC by pretty much just not getting to the hospital until I was very late in the labor. Unless you had any other mitigating factors (GB Strep positive or Gestational Diabetes), there is nothing to keep you from having a VBAC at the hospital that is close if that is what you feel safest at a hospital that allows for emergency situation care ... I know because essentially that happened to me by accident - long story short, I'd paid for a Doula and was going to a Midwife group in a more progressive hospital. I was happily laboring at home until I left it go a touch too long and we found ourselves having to drive to the progressive hospital an hour away (without traffic) IN TRAFFIC so that I labored in the car for the drive that took us 2.5 hours. We didn't make it to the progressive hospital, but because I was so far into labor, I labored 25 minutes more and gave birth to my second daughter by VBAC in a hospital that has a pretty high Csection rate. Essentially, I realized then that if you don't really give them the opportunity to mess with you... they don't LOL.
Some other considerations since you had a "larger baby". My first daughter was 9lbs 10oz and 22 inches long. Even the midwives were balking at the thought of me going for a VBAC at first but I met with a nutritionist and was advised on going on a reduced carb eating plan. It made a significant enough difference in that my second daughter was a pound lighter... those carbs and sugars go straight to baby even if you aren't dealing with GBS, so staying away from high carb meals might be an idea. I'd also suggest doing exercises to make sure baby is in Optimal position http://www.homebirth.org.uk/ofp.htm
(Midwives have noted that one of the highest contributors to Csection that isn't medically indicated is "mal positioning" of the baby, which makes for longer and harder labors, longer pushing and more likelyhood of both baby and mama fatiguing.) I swear by Pelvic Rocks, Tailor sitting, sitting on a yoga ball. During labor, even if you don't have a coach or a doula, just reminding yourself to relax the muscles so that the contractions can do their work helps. During the labor for my 3rd daughter, when we arrived at the hospital, I was dialated to 4cm and "high"... the labor got pretty intense for me for the first 10 minutes I was there and when I heard that I remember thinking "how am I going to do another 4 hours of this?" Despite that I just kept focusing on one thing... keeping my jaw loose, that was the only thing I kept reminding myself of as I walked around the room and lay down, I would keep working my jaw back and forth (correlation found between tension in jaw and in pelvic region during labor, it's been found if you keep your jaw loose your pelvic region tends to relax too LOL)... it worked, I dialated from 4 to 10 in less than 1/2 an hour. We arrived at the hospital at 2:10pm and my daughter was born at 2:50pm LOL.
Good Luck to you!
Thnks for all this information! This has made me a lot more confident in having a successful vbac!
The thing about pushing it to the last minute that scares me is that you're opening yourself up to a rupture. If I go to the birthing center or the hospital, my baby will be monitored and from my research, it seems like baby's heartbeat is often the first indication of rupture. There isn't always pain, bleeding, etc.
I'm nervous about traffic too! The birth center is only a few blocks away. We could ride our bike there if need be! However, the hospitals with maternity wards (so non-emergency situations) are about 8 miles in either direction. I know that doesn't sound bad, but it's the 5 freeway. You never know!! :)
We've already made the carb reduction in our lives (switched to a modified paleo diet rather than just simply being gluten free). So I think that should help, but I'm going to get more strict about it to prevent growing a gigantic baby. I'm glad to hear that helped you. :D
But your risk of rupture after 1 c-section with a low transverse incision is 0.7%. The risk of you dying from a rupture is 0.0095% and the risk of baby dying from a rupture is 0.095%. Those are all very slim chances. The chances of dying during a repeat c-section is twice as likely, but no one ever talks about those risks.
The concern though with laboring at home is when a rupture happens, they are usually in the earlier stages of labor. So if the plan is to labor at home as long as possible unmonitored and a rupture happens, that's when it is more likely to be catastrophic.
Good luck making your choice. There are a ton of groups on Facebook that are awesome support for these dilemmas. I know there is one called VBAC Facts and another VBAC that is geared toward VBAC and VBAC after multiple c-sections. I have read about many women who have had successful HBA3Cs and birthed twins after a c-section.
Thanks for the stats. I've been trying to find more specific ones than the general 60-80% success rate and 1% rupture rate.
Yeah, right now I'm debating between going to a VBAC friendly hospital/doc that I've found online. I still worry about having to fight there though and my last birth was such a battle that I just ended up giving in to an epidural which ended up causing me to have a fever...and wind up with a c-section. The birth center is great. The midwives are awesome. They have the set up of a level 1 L&D & ER, plus neonatal ambulance.. they are less than 15 minutes away from 2 hospitals with ERs and about 20 minutes away from one with a maternity ward. I just worry about something going wrong at the birthing center and going wrong fast. I posted over on mothering.com and some woman replied saying basically if I wanted to be sure I wouldn't die...I should go to a hospital. *sigh* Every time I feel confident about my decision, I get freaked out.
Sorry, I'm rambling. It's just nice to talk to someone about it. I think what I'm going to do is meet with this doctor (since my doctor already did the ol' bait & switch from my pre-preggo planning appt to my OB intake appt). This way, I've looked into all options before I decide if I should go to the awesome birth center or not.
Definitely meet with the doctor and see how he/she seems. Do you have an active ICAN group near you? They usually know whether a hospital and doctor are really VBAC friendly. They could also be more support and likely have experience with the doctor/hospital and midwives/birthing center. Also, I think the most necessary thing when having a hospital birth is hiring a doula.
The thing with the midwife though is as long as she is good and experienced, they are trained to catch problems early. They deal with normally progressing labors and when something is off from that, they know it and know when to transfer. What people forget is you can die in a hospital, too! Believe me, I've had 2 nontypical, complicated deliveries that scared me. BUT, I know that it was the hospital interventions that caused those complications, not labor itself. When labor isn't messed with, it usually progresses without issue.
BTW, I wish I could do a birth center next time. I'm hoping things change in my area in the next couple of years because as it stands birth centers won't do VBACs here.
There is an ICAN group and I just signed up. Honestly, I think you're right. This birthing center is super well equipped, convenient to hospitals, and will be actively monitoring me the whole time. Being relaxed will help the labor go well rather than me feeling like I'm preparing for battle when I enter the hospital. I am still going to meet with this supposedly VBAC friendly OB (his hospital actually teaches a VBAC class for parents! How cool is that?) if he's accepting new patients. Just because..I haven't seen anyone other than the awesome birth center and my scary OB. All I know right now is that I'm done with scary OB. To pull the bait & switch this early? You can tell she just does not want to deal w/ my VBAC. Her hospital also has a very high c-section rate. :-/
It's so true, you're right. You can die in the hospital. Women do die from c-sections and surgery is just risky. I need to relax. Just seeing the waiver saying "Realize that you could die by making this choice" freaked me out a little bit. :)
And thank you so much for talking with me about this. I really appreciate your intelligent and insightful conversation. You've been so supportive and informative. I really appreciate it. After the bad reception this question got from someone over on the mothering.com VBAC forum.. I was seriously considering deleting my posts to avoid further fear mongering.
Aww, no problem! I have found that for me, researching and discussing VBAC has helped me process my c-section. I don't know if I'll ever have another baby and get to attempt a VBAC, but it's comforting for me to know all that I do. I hang out on my local ICAN group and a couple of supportive FB groups. I'm sorry mothering wasn't supportive. You'd think they would be all for the natural birth as opposed to a c-section!
That's exactly how I feel about the VBAC friendly hospital to me. They are VBAC friendly and it's a great hospital, but they still have a long way to go. I don't know that I want to be up for a fight, you know? And that's the sad part. Doctors and other people talk up the risk of VBAC but NEVER mention the true risk of a c-section!
I hope you have a successful VBAC! You'll have to post what happens when it's time!
Yeah, it's crazy. I've been hearing all these scary stories about how you could DIE from rupture, but nothing about how dangerous a c-section can be.
The other thing people don't talk about is you can have a rupture with any pregnancy, even if you've never had a c-section!
WOW! They aren't sharing based true information though. They are sharing based on fear. It's sad that THEY are playing the dead baby card. Usually the OB's save that one for 41+ weeks! I would like to know of those that ruptured, what kinds of interventions they had (CEFM, inductions, pit, AROM, membrane sweeping, etc). The fact is uterine rupture in a truly intervention free birth is rare. Yes, it happens, but it is rare. I'm really surprised at those responses though. I don't hang out on mothering, but from what I have read in the past, it was way more natural friendly than that. Have you thought about reposting that in your local tribe section on mothering and see what you get? Then maybe you'd get more feedback about the hospital and birth center you are looking at. The other thing to think about it you got several "I would never have a VBAC in a birth center because it's not safe" responses, but how many people just didn't respond that did have a birth center VBAC or HBAC and didn't want to jump in? That's the hard thing. You got some scary stories, but no one really jumped in with their success stories either.
If you are on FB, search for the VBAMC/VBAC/HBAC group. They are supportive with no scare tactics. They'll give you facts and let you decide, but lots of them have had HBAC and had great births. Seriously, many after 2 or 3 c-sections. Another good site that I read a lot is VBACfacts.com. Jenn is in that FB group and she is all about numbers and statistics. She reads so many studies about VBAC risks.
It does all come down to your comfort though. Check that doctor, attend some ICAN meetings and go from there. You have tons of time to make your decision!
And going back and looking at that thread, 3 of those with negative stories joined today and only have 1 or 2 posts on mothering. I bet someone got some friends together and had them post in your thread to scare you. That one person did say she is part of a UR support group. It really wouldn't surprise me.
Did you go through older threads on mothering? If so, I would take posts in those threads into account more than those in your thread.
Yeah, seriously! I ended up walking away from the discussion. Couldn't believe that behavior.
Yes, I did go through them. I'm going to meet with this highly recommended OB (from ICAN) next week. I'm afraid I won't be able to get this paranoia out of my mind now. Also, a hospital birth would be soooo much cheaper and I need to look into it just to see.
I am so disappointed in the mothering.com ladies. I was hoping for more actual birth stories, ya know?
I'm sorry they scared you. That's exactly what they were trying to do. Don't let it get to you. Just go forward, do your researching, and make the decision that is best for you.
Have you looked back in the thread lately? There have been a few that have tried to come in and balance the conversation a bit. Someone did say it's suspicious that all these new people signed up just to share their horror stories.
Yeah, I pointed it out too. :) I just can't believe these ladies. Really? You do not drive solely to avoid car accidents?
Anyone trying to scare you out of what you want, is not "for" you whatsoever. You do what *YOU* feel is best, and if your OB does not support you, find someone that does.
What risks was the OB talking about? Risks for a VBAC or risks for a birthing center? What risks are you worried about?
I know this is only my opinion and I came by it from doing a LOT of research, but if I have another baby, I will plan a HBAC. It is not any less safe than birthing in a hospital. Hospitals here are not very VBAC friendly. They will do them, but you have to fight for no/low intervention. It is easier to have interventions in a hospital and those are what usually lead to uterine ruptures or c-sections.
As for the risks, there are just as many risks to birthing in a hospital as at a birth center. You have to choose the option that is best for you. As long as you have either a midwife at a birth center that is good and experienced, there is nothing wrong with a birth center birth. If you choose the midwife, you need to discuss risks and have her make you feel better about them. If you have a supportive OB who won't do a bait and switch when you get close to the due date and a VBAC friendly hospital, then there is nothing wrong with an OB. Either way, you will not let go during birth if you are worried about where you are birthing and who your care provider is.
|Date:||August 15th, 2012 03:14 am (UTC)|| |
Hey, I hope it all goes well!
I have 6 children, my first C-sec was with #5, due to complications, he needed surgery. But Dr. Tate in Metro Atlanta area was great and very helpful and I was able to deliver a 10. 13 oz healthy boy via VBAC.
Don't stress yourself out. Our bodies can and will help us out if we are able to relax. Happy Babying <3