Are VBAC-willing OBs hard to find?

[LarsMal]

Assuming everything goes well with this pregnancy, I'm really hoping to avoid another c/s. My current OB told me since I had a vaginal delivery first and a c/s second, she would be willing to consider a VBAC. Problem is we'll be moving mid-pregnancy so I'm going to have to switch doctors.

Is it hard to find a doctor who will entertain the idea of a VBAC? I know the OB I had with DS flat out refuses to do them. I just want to get an idea of what I'm up against in my search for a new OB.

TIA!

[mamicka]

It was a bit hard. This is a generalization, but my experience was that the OB offices that were "high-end" refused to do VBACs. I found several OBs that did VBACs by asking for recs from doulas that I interviewed. They were all excellent but were definitely on the "crunchier" side. Even if you aren't interested in a doula, I would recommend contacting some in your new area to get recommendations. Or maybe even midwives.

Moving while preggo & finding a new OB... been there, its kind-of a pain. Good luck in your search!

[LarsMal]

Moving while preggo & finding a new OB... been there, its kind-of a pain. Good luck in your search!

Yeah, I've BTDT, too! I was almost 15 weeks with DD when we moved here. I was not planning on getting pg before this upcoming move, but oh well! I might be as far along as 7 months by the time we finally get out of here. That will be F-U-N!!! Never a dull moment!

I'm afraid being that far along will make it even harder to find an OB who will entertain VBAC with me.

[ellies mom]

I think it is a regional thing. It seems to be pretty easy where I am. My doctor told me I could have a VBAC before I brought the topic up and told me that if I wanted to do a repeat section that I needed to be prepared for the possibility of a vaginal birth.

[kijip]

If I were you I would look for a provider now in the new town and see if they can establish a relationship with your current doctor, get all your records etc well in advance. Rather than shopping for a doctor with just a few weeks to go. Your OB might know people, Doulas and midwifes in your new area could point you in the general direction you want. No fun calling around long distance now, but less fun doing it newly moved and very pregnant.

The climate for VBAC depends not just on the OB you pick but the hospital you select as well, so I would start trying to research your hospital options. It really varies from city to city but also hospital to hospital.

[sarahsthreads]

My OB group said they would consider letting me have a VBAC, but with every appointment and every question I asked I got a stronger vibe that even though they *said* I could have a VBAC, they were going to do everything in their power to convince me to go with a repeat c-section. I didn't feel like my first birth warranted that - I completely dilated, it's just that DD1 was positioned really poorly and literally got stuck, so there was no reason to believe that the same thing would happen with DD2.

I switched to a midwife group around 22 weeks and I am *so* glad I did. I can't even imagine how the second half of my pregnancy and the delivery would have gone with the feeling that I was going to be somehow coerced into having a c-section.

So if you can't find any OBs in the area you're moving to, consider a midwife. Mine had - and I imagine they all would have - a consulting OB who would have done a c-section if it had become necessary.

Sarah :)

[s7714]

The climate for VBAC depends not just on the OB you pick but the hospital you select as well, so I would start trying to research your hospital options. It really varies from city to city but also hospital to hospital.

Yep. My OB group is willing to do VBACs, but the hospital they deliver doesn't "allow" them. Or I should say the hospital will only support a VBAC delivery if the patient arrives fully dilated and ready to push more or less. (Insert grumbling rant here.)

[kellij]

I was really interested in a VBAC for #2 and I think it would have gone well. The only option I had was one hospital in the whole city. My dr. didn't have privileges there, but said she could refer me. I told her I felt more comfortable staying with her and asked her what she thought of the other hospital (she had done some rounds there or something that they have to do) and she basically said she would never go there. So I hated to be a questionable hospital to do something that might or might not work. So I would definitely research the hospitals that allow the vbac too (in addition to the drs.)

It sucks that the insurance companies have taken away our choice in the matter!

[KHF]

I live in northern KY, just across the river from Cincinnati. From what I understand, there are no doctors or hospitals in NKY that do VBACs. There are some in Cincinnati though. I had a c-section with my first, and I wasn't willing to switch practices (and cross the river) for the chance to have a VBAC. I didn't have problems with my first c, so I'm hoping that this one goes as smoothly.

I think the bigger the metropolitan area, the better your shot at finding a doc and a hospital who will do it.

Kirsten

[JTsMom]

It definitely depends on the area. I can not recommed strongly enough that you join ICAN in the area you are moving to! It is the absolute best way to find the right Dr. or midwife imo. A lot of doctors will say they support VBAC until you get to 30 weeks or so. Then they start with the scare tactics, the "your baby is too big" nonsense, etc. Really rotten bait and switch stuff.

Here in ATL, there is 1 doctor, and 1 midwife that are the VBAC providers that the majority of people flock to. Others do them, but these are the 2 that have the hight success rates, and really and truly support VBAC. A lot of people here do HBAC's too, and we have several really good homebirth midwives.

One other thing to be aware of- hospitals tend to have stricter rules for VBAC moms- things like continual EFM, no laboring in the water, etc. Just keep in mind that you can refuse stuff, even if it's against their policy. They can hassle you about it, but ultimately it's your deciscion.

[JenaW]

All of the suggestions so far have been great. As an OB provider (OBGYN physician assistant), I can tell you it is so variable. Often, it is a hospital issue, where the OB WOULD consider a VBAC, but the hospital policy prevents them. Sometimes you will have one doc in group who will, but none of his/her partners will. Find out what would happen in this case. I had a similar situation with my preemie who was breech. Only one doc in the entire group (of more than 8 high risk OBs) would consider a vaginal delivery, even though she was under 2 pounds and I had already delivered two full term babies vaginally. Luckily, he agreed to give us his pager and home phone and said he would come in anytime to deliver her if he was not on call when I went into labor. Unfortunately, this is probably not typical!

I would definitely ask your OB if she or any of her partners know anyone in the area you are moving to. Next, I would look for hospitals in the area (an internet search should provide you with names/phone numbers) and check which ones will be compatible with your insurance (if you already have this info). Then call Labor and Delivery and ask to speak with one of the nurses. It has been my experience that other than a first-hand recommendation from a girlfriend/family member, L&D nurses often know who is good/bad/scary, what styles they practice with, etc, and USUALLY will willingly share this info. Feel free to call a few different times of the day and get a few recs to see if they are all suggesting the same doc/group. The suggestion of a midwife is also good. Assuming you have no high risk complications, a midwife group (especially if they deliver at a free standing birth center) may be your best option. As long as they are Certified Nurse Midwives, they WILL have a back-up OB/group for emergency transfers. IME, midwives are almost always more willing to work with you to get your desired labor/delivery. SOME OBs are as well, but the docs tend to be more medically focused (and focused on covering their you-know-whats) whereas the midwives see childbirth as a natural process that does not require interventions unless absolutely necessary. Of course this is an over-generalization, but one that I think is usually true.

Good Luck!

J

[octmom]

My OB gave me the option, but I chose not to do VBAC. I live about an hour west of you, if I remember correctly where I think you live now.

[SnuggleBuggles]

I second the ICAN idea or even somewhere like MDC might have a guide of VBAC friendly providers.

GL!!

Beth

[infocrazy]

Maybe I just lucked out with my practice but they suggested from the start that I try a VBAC. They did say though that there are certain things that they won't do such as the ripening gels etc and that if there is even a minimal issue during labor that we would have to move straight to a C-section but I was fine with that plan.

I was able to do a successful VBAC. I did get a fever, which I seem to have problems with in general but they waited an hour and although I still had the fever, I was at 10 and ready to push so we did. Had I not been at 10, I probably would have had to go C/S.

Of the seven drs in my practice though, there was 1 who I could tell was pulling for a CS but never said I had to and the rest were very supportive.