Questions to ask?

[Betcha]

I'm heading for an appointment at the hospital tomorrow. It's my second, but at my first appointment I didn't realise that I would have so many restrictions on me attempting a VBAC.
I want to be armed with a list of questions... here is what I have so far:

What is their VBAC success rate?
How long over due will I be allowed to go, and if I reach this stage will they want to induce me or do another cesarean?
How long am I "allowed" to be in labour for?
What pain relief will they "allow" me during labour?

I know they can't force me to conform to their policies and procedures, but I want to know what they are so I know what I will be fighting against.

Any suggestions for other questions to ask?

[Emma1979]

maybe ask about their policy on monitoring, and when to come in to hospital....?
if they have ever experienced a uterine rupture? my hospital hasn't in the 15 or so years my ob has been there, so they must be REALLY rare.

[HollyC]

I don't have any more suggestions, just thinking about what has been raised so far.

I have only spoken to my doctor briefly about about a vbac and he seemed fine with it.....

What is still worrying me is what restrictions there will be, or that they will try to impose on me. Things like monitoring and time limits. Is there any point in me attempting a vbac if the restrictions will make it impossible?

So next time I see my doc I'm going to ask about time limits, monitoring and success rates.

[jasp]

I think most of them have been covered....
My questions were -
- how far post-dates will they allow me to go
- what happens then
- can I go to 42 weeks with monitoring
- at what stage of labour do I need to come in to hospital
- I understood I would need more monitoring but I wanted to know could it be intermittent rather than constant - I wanted to use water for pain relief, shower etc
- what time constraints would be placed on my labour

more importantly, I wanted to know WHY for all of the above. For example WHY did I need to come in as soon as I was in labour etc. The Drs were very good, discussed everything with me & said basically - 'we'll have our ideas of your labour, and you'll have your idea of the labour you want, the idea is we compromise'. I was ok with that.

Good luck!

[Betcha]

Thanks all, just thought I'd give a quick update on how I went today...

I am part of a midwives clinic so a lot of this will depend on who attends my labour and birth when the time comes.

The only thing they are quite set on is continual monitoring. However they do have wireless fetal monitors and they can be taken off if I need to go to the toilet etc. This is also something I am happy to negotiate on the day e.g."I've had this thing on for 2 hours with no problem, I want half an hour off!"

There is a time restriction on labour, however no-one could tell exactly what it is... which is kind of a good thing as it says to me that they don't strictly adhere to it. I was also told that as long as things are progressing and bubs and I are going ok, then time limits are not important. I was told that in this aspect I am essentially treated as a "normal" birth.

Same goes for how long I'm allowed to go over due ... as with a "normal" labour/birth at my hospital, they will give me to some time between 41 and 42 weeks to go into labour. I will have a date somewhere in this time for a scheduled cesarean...(the obvious difference here is that for a "normal" labour, it would be an induction not a cesarean).

As for when I "have" to go to the hospital, the same guidelines apply... if my waters break before I go into labour, or there is sign of bleeding/meconium etc, or when my contractions become very close (can't remember the exact timing) or unbearable.

I can use a normal labour and delivery room (some hospitals like to keep VBAC's to an operating theatre UGH!!!)

Any pain relief is fine, but obviously an epidural may have adverse affects on my labour.

I think that's pretty much it.

I feel a lot better!!!! I just hope they weren't saying these things to pacify me!

[Betcha]

Originally Posted by HollyC

I don't have any more suggestions, just thinking about what has been raised so far.

I have only spoken to my doctor briefly about about a vbac and he seemed fine with it.....

What is still worrying me is what restrictions there will be, or that they will try to impose on me. Things like monitoring and time limits. Is there any point in me attempting a vbac if the restrictions will make it impossible?

So next time I see my doc I'm going to ask about time limits, monitoring and success rates.

There is EVERY point to you attempting VBAC (if that's what you want of course). It sounds like you may just be realising the restrictions you may be facing??? I discovered all this stuff nearly 2 weeks ago, and when I first realised what I was up against, I felt sooooo freakin deflated. But it is all about educating your self and empowering yourself. I have hired a Doula (statistically, this alone increased your chance of a successful VBAC). Do your research, find out the restrictions you may face at your hospital, but remember you CAN decline any medical intervention they want to impose. If they request you have constant fetal montoring but can't offer this in a way that will still allow you to move freely, then ask them to provide you with the evidence that this is in fact beneficial. Be prepared to negotiate during labour (a doula can be helpful here... not to provide medical advice but to remind you that you CAN do it), if they accuse your labour of not progressing, ask them why this has to mean another cesarean when the fetal monitoring is showing no concerns with bubs etc etc etc....
All I can say is research, research, research and be ready to use that research when you are asking why your doctor wants to impose certain restrictions on you.

[HollyC]

I'm glad that things are looking good for your vbac.

I knew a lot about how difficult it can be to have a vbac and I expected my dr to confirm this. I was really surprised that he didn't seem to think it was a problem at all.

I think the point of what I was trying to say is that I want to be aware of what restrictions my doctor/hospital usually place on vbac-ers and how this effects the outcome. My first question was can I? and I was surprised to be told sure. I didn't even think to ask how likely it is that a vbac will work out.

I need to ask more questions, but I know I still have the right to refuse treatment and do my own thing. If it comes to it I may chose to find a new doctor and hospital. But going back to your original post, these are important questions to ask.

[blackduckies]

Your hospital sounds very reasonable, i think those restrictaions are very doable. i found last time i really wanted the monitering, I did'nt have a fixed moniter on me so could move where I wanted, i liked that there was a time restrication, but again it was'nt strictly adhered to, what did distress me was that when things were'nt progressing I decided that I wanted to go to the CS (it was too much like my other labours that had ended in CS) Basically I got scared!!! but baby was'nt in distress, so they wanted me to keep labouring...part of that I believe was it was the middle of the night.. it had got too much for me and the fear of uterine rupture was really getting to me I had to pull the plug, they came in and did the CS.
So I guess that is something I would suggest you ( or anyone in this situation) work on..belief that you can do it and a doula or private midwife is a great idea someone to keep you focused and believing in yourself and the fact you can do it. Once fear creeps in and you lose that belief in yourself and your body you might as well call it a day, it's near impossible to get it back yourself.