pregnancy update and concerns with peri

[spu]

Hi ladies!

I've been taking a break from everything, (due to being a little scared with this pregnancy), but now here I am at 19 weeks, finally had a cerclage at 16.5 w, so far no cervix funneling and no bedrest, and all the blood and u/s tests have come back normal! Plus, it's a.......... boy! I'm so relieved that things are off to a much better start this time around.

The only thing that's driving me nuts is my peri - he wants to do a scheduled a c, and put it in the books now... He didn't even ask me about my thoughts for a vbac, just threw in a host of scare-tactics to get me to schedule it now... why on earth? all I can think of is he wants to schedule it on his time so he gets the check. Is that absurd? or are there real reasons to schedule another c? I've spent some time on mothering.com vbac section, and it's helped, but I still feel like I'm in need of some strong ammunition for when I go back for my next appt in 2 weeks. How do I talk to him about my fears / feelings without insulting his 'expertise'?

tia for any advice!

susan

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nursed for 3 years!
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charlotte + else
7.20.02

baby #3 due 10.8.06

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[annasmom]

Hi Susan, I am right behind you - 18 weeks. I am also being seen by a group of perinatologists at a maternal fetal medicine group.

I am having a scheduled c-section, but I have a host of factors that make me a bad VBAC candidate. In fact, my doctors won't let me go past 36 weeks (this is the same thing my old OB had told me). Has your doctor discussed exactly WHY he wants to do a c-section?

FWIW, I would absolutely try a VBAC if I could, and I don't think my perinatologists are against VBACs as a general rule. Whenever I bring it up, they pause, look at my chart, and then say no. But I have also had lengthy discussions with each of the peris in my practice as to why exactly I am at such a higher risk. I really don't want to be a downer, but I honestly believe that every case is different. I really truly hope you get the birth experience you want.

[LucyG]

Susan,

I would suggest doing some reading on the ICAN website (International Cesarean Awareness Network). The website is www.ican-online.org. I found invaluable information there. I also joined the Yahoo group for the ICAN chapter in my area. The woman on the group were extremely supportive and well-informed about vbac. I used info. from the ICAN site, from www.vbac.com and from the Mothering VBAC site to formulate my questions for the OB. I used a midwife, but did meet with the OB in the practice at my four-month visit. I requested my surgical records from my c-section, and I read over them before my visit with the OB. I wanted to make sure that I had a low transverse internal incision.

Of course, I don't know the specifics of your situation, but unless there is some medical reason that makes you a poor vbac candidate, I would absolutely stick to your guns and go forward with plans to vbac. While I know that it's not for everyone, and I respect each woman's right to decide for herself, I would encourage you to do all you can to have a vbac. My vbac was an amazing experience.

Have you considered using a doula? We found ours to be a great source of information and support, particularly when the OB was not gung-ho about VBAC.

Feel free to PM or email me if you want to talk!


DD #1 (2/03)
DD #2 (3/06)

[spu]

Thanks, ladies, for your support. It really helps.

My peri said that in doing a vbac, (not just me, but anyone...) there's a 1 in 100 chance of uterine rupture, cerebral palsy, and being born stillborn. I find that hard to belive. He's using these scare tactics on me which I don't find respecful. I'll definitely check out these websites to see what information is out there.

--p.s. my previous c was a low horizontal incision, small... and with only 1 baby this time, there's no medical reason why I would need to have a c, other than what he described as the "1:100" statistics...


susan

http://www.gynosaur.com/assets/ribbons/ribbon_amethyst_36m.gif
nursed for 3 years!
http://sunger2.home.comcast.net/superpower.gif

charlotte + else

http://bd.lilypie.com/u2jym5.png
http://b4.lilypie.com/Bmr5m5.png

[annasmom]

I am not sure about the risk ratio, but I do know that in recent years OBs have learned that the risk for uterine rupture IS greater than once thought. That being said, if that is the only reason he wants to do a c-section, I think you need to start doing your own research both into the risks involved in VBAC, and also more VBAC friendly practices. I have been very *forunate* in that both practices I have been with were supportive of VBACS, *I* am just a bad candidate. My old practice gave me a copy of the report, not just the handout provided for patients, but the actual report published for medical professionals. Remember, there are risks associated with repeat c-sections as well. I had a long talk to my OB recently about this (re how many c-sections is considered "safe").

[LucyG]

Susan,

I believe that for vbac labors that are not induced with prostaglandins (Cytotec or Cervadil) and do not use Pitocin to augment, the risk of uterine rupture is actually about 0.5-0.6 in 100, or about 1 in every 200. Many OBs shy away from VBACs because they fear the legal ramifications if something should go wrong. This is just my opinion, but it sounds to me as if your peri. is going out of his way to scare you with risks. I don't blame you for being upset by this. I felt the same way when the OB I saw played scare games with me. Definitely do some research of your own, because it sounds like a vbac would be a good option (medically-speaking) for you.

ETA - If the peri. continues to be unsupportive, and if you decide that a vbac really is a priority for you, you might consider changing care providers. At this point in your pregnancy, there is still plenty of time to look for a more vbac-supportive doctor.

DD #1 (2/03)
DD #2 (3/06)

[MegND95]

When I was researching VBAC prior to having mine in 2001, this was exactly what I found too. I've had two VBAC's, after a c/s for breech presentation, and was very lucky to have supportive healthcare providers each time. Given my history, I was an excellent candidate.

You might consider a Midwife? Not sure if that is possible given your situation. During my third pregnancy I was cared for by three MW's who worked in a practice with six OB's. No one ever questioned my desires or tried to scare me with "statistics." They were 100% supportive.

Good luck to you!