VBAC / EBAC Discussion #4

[MummyTummy]

Would love to hear what conditions you have Suzi... for both plan A and plan B.

In fact that goes for everyone... what sorts of things have you put in your plan to make sure that you are getting the empowered birth you deserve? And how are you planning on enforcing it?

The reason I ask is that I had a plan last time... and my stupid half-wit m/w didn't read it so while in labour I found I had to keep repeating myself (she didn't even listen when I said what I wanted either). This time I am planning on hiring a doula, someone who can let me and DH concentrate on the task at hand and still be my advocate.

[MeganH]

Mummytummy, Im assuming you are probably not in Adelaide, but if you are I am training to be a doula and will do it for free.

Thats goes for anyone who might be in SA. Probably for the next 12 months or so, until Emily is a bit older, Im going to be training to be a doula and am looking for people who I can help and in turn it will help me gain more experience.

[Eluned]

That sounds really good Suzi.

MT, I don't have a formal birth plan yet, just some key points jotted down on a piece of paper so I remember to tell the midwife at my pre-admission interview on Tuesday! They are mainly I want minimal monitoring and want the ability to move around as much as I like and to use the bath and shower as much as I like. I want to breastfeed immediately as well. If I end up with a c/s then I would like DH to be there and I do not want any visitors or any person other than DH (or the midwives if necessary) to hold bub before I get a chance to. When I had DS, I wasn't allowed to BF on the table so I'm going to ask for that again and see what happens.

I'm also considering hiring a doula to help me labour at home as long as possible and to be my spokesperson when I get to the hospital.

[MeganH]

Eluned - Just a tip - if you do have another c/s (fingers crossed you dont), get DH to take bubs straight from them, dont let them take him/her away. Then he can put bubs straight on your chest to BF in the nudie just like any vaginal birthed baby would. They can get a blanket to cover bubs so he/she doesnt get cold.

I had an independant midwife who did this for us. DH cut the cord while I was BFing Emily in theatre. I then would not allow them to take her from me and demanded DH, and my midwife remain with me in recovery. I BF Emily the entire time I was in recovery too. I never allowed them to take her from me until until about day 3 I think it was. I told them that if they wanted to check anything or do anything to her they could bring their stuff to us and do it here. LOL! She wasnt even weighed until we were in recovery, I made them bring their stuff to me.

So unless there is a genuine medical reason, there is no reason why you shouldnt be able to do the same.

Just these couple of things made this time round an entirely different experience.

[ryatha]

Originally Posted by MeganH

Eluned - Just a tip - if you do have another c/s (fingers crossed you dont), get DH to take bubs straight from them, dont let them take him/her away. Then he can put bubs straight on your chest to BF in the nudie just like any vaginal birthed baby would. They can get a blanket to cover bubs so he/she doesnt get cold.

I had an independant midwife who did this for us. DH cut the cord while I was BFing Emily in theatre. I then would not allow them to take her from me and demanded DH, and my midwife remain with me in recovery. I BF Emily the entire time I was in recovery too. I never allowed them to take her from me until until about day 3 I think it was. I told them that if they wanted to check anything or do anything to her they could bring their stuff to us and do it here. LOL! She wasnt even weighed until we were in recovery, I made them bring their stuff to me.

So unless there is a genuine medical reason, there is no reason why you shouldnt be able to do the same.

We had this too with my second CS. The paed tried to send Fred to the NICU even though her apgars were 9 & 9 - just to be sure that she was ok! My MW flatly said no, since fred was happily feeding from me on the table, she is staying with her mum to BF and like megan didn't leave my side until about day 3.

[MummyTummy]

I got this part right with my c/s. I insisted that Jett stay with me. Even though my stupid half-wit midwife (do you detect i have issues with my m/w??) still tried to take him up to the room to wait for me. As it was I think I was only in recovery for about 20 mins which I attribute to the fact that Jett and DH were there with me, plus my really lovely student m/w was very tactful and did all the tests for Jett by observation and made sure not to interfere with us establishing b/f. Stupid m/w decided to go home by this point - lucky!! Jett wasn't weighed until I got up to my room and settled in either.

This is one thing I say to anyone who is pregnant - if you end up with a c/s DO NOT LET THEM TAKE THE BABY FROM YOU - unless medically necessary of course!

[Eluned]

Thanks for the tips girls. Will definitely be more demanding this time. Last time they told me it was "hospital policy". I was only in recovery for 20 minutes. Well actually, I stayed in the operating theatre with one midwife who was great. When I got back to my room, I had a really lousy midwife who wanted to take DS to the nursery because she couldn't get him attached. I refused her and we got ourselves sorted with the first breastfeed.

In any case hopefully it won't come to that.

[MeganH]

They will tell you lots of things are hospital policy. Dont accept it. Its your body and your baby! They cant take your baby from you unless you allow them and they wont usually ask either. So you need to tell them before it happens. Once they have taken bubs to be cleaned up and weighed etc it is harder to get them to bring him/her back so you need to get in first.

That first skin on skin is awesome and its not gross at all (like some people might think). You'd be surprised how much less baby cries (if at all) when they get that immediate skin on skin and BF. Its beautiful.

Now I feel all emotional lol.

All the best.

[rufalina]

Good tips girls. I have an OB appt this week, and want to get talking about my VBAC... So I have some good points for this discussion...

And for that someone with her VBAC coming up... a very gentle NO PRESSURE good luck hunni.... Know you are in my thoughts and I am sending you every good vibe I can muster... Go get 'em girl!!! xo

[MummyTummy]

Oh yes.... they like to hide behind hospital policy. If they pull that one on you and you don't agree, ask them to show it to you in writing..... I bet you they can't and won't, because it is just accepted hospital practice, not policy at all and therefore not in writing.

Eluned - I can't believe your m/w wanted to take your baby to the nursery because you couldn't establish b/f. I couldn't establish it until my milk came in when I could use a nipple shield to aid attachment. But my baby was never taken to the nursery and not put on formula. I just got milked every so often for the colustrum which we syringed and then fed by finger. Worked a treat. I think I was just really lucky that my m/w in my room was an LC and was all for the mother/baby bonding stuff. Unlike the agency nurse I got stuck with on the second night.... but that is another story!

It really makes me mad when I hear about individual m/w taking it upon themselves to tell you what they are going to do with your baby without even taking in to consideration the all important mother/baby bond. And then it makes me sad that so many women just accept it, because they don't know any better. It isn't their fault, we rely on these specialists for their knowledge, we don't think they would steer us wrong. And alot of the time they make these decisions because it is what is easiest for them at the time.... grrrr

[Eluned]

Originally Posted by MummyTummy

Eluned - I can't believe your m/w wanted to take your baby to the nursery because you couldn't establish b/f. I couldn't establish it until my milk came in when I could use a nipple shield to aid attachment. But my baby was never taken to the nursery and not put on formula. I just got milked every so often for the colustrum which we syringed and then fed by finger.

Yeah I was so pee'd off at this midwife, but in the end she didn't take him away and her shift finished and the next midwife did the same as you - milked me with a syringe for the colostrum. My milk didn't come in until very late day 3/early day 4.

I think this time, I really know what to ask for and how the "system" works so I'm going to be braver and more demanding!

Anyway, I'm all psyched up for the vbac and when I imagine myself giving birth, it's a vbac and I can't picture myself at all having another c/s. I can only picture myself labouring at home and then giving birth at the hospital naturally and having the baby placed on my chest straight away. A pregnant friend of mine said to me she admired me for not being afraid and then it hit me that I'm not afraid at all.

Another friend who is also pregnant and wanting a vbac, made me feel a bit annoyed at her ob because at their last appointment the ob has booked her in for a c/s "just in case"! She talks about wanting a vbac so badly but is just letting the doctors dictate it all to her.

Ruf, good luck with your appointment this week!!

[Eluned]

Just an update, had my pre-admission interview with the hossie midwife and it's looking very positive! Basically, they will follow the obstetricians rules when it comes to monitoring and all that. So as my ob is happy for me to labour at home as long as possible and have intermittant monitoring when I get to the hospital then I should be good.

The midwife did say they don't have many vbacs at this particular hospital (why didn't I know that before?!) because alot of the obs that deliver there do not do them. So luckily I have a vbac friendly ob. She did seem really pleased when I was having a vbac and explained that she herself and other midwives there have attended a lot of vbac births in their career so that is reassuring.

I also asked about having a doula there as well as DH and she said I can if I want but the role a doula does is done by the midwives. Being a vbac, I will apparently have a midwife with me the whole time. She had a good case so I'm still debating on a doula now.

And in the case I may need another c/s (touch wood, didn't want to ask about that!), baby can stay with me in theatre while they close me up and we all go back to our room together, so we won't be separated at all!

[rufalina]

Lyn, that sounds great and so positive!!! We are really getting close now!!!!!!! EEK

[MummyTummy]

That sounds fantastic and so positive Eluned. Yeah I am feeling a bit braver this time around too to throw my weight around and be more demanding to get what I want.

I have a friend who although isn't pregnant now really wants a VBAC, but she isn't prepared to change OBs and her Ob who is her FS is against VBACs.... so I get annoyed with her because she isn't prepared to help herself. Frustrating isn't it???

[MeganH]

Mummytummy, I know a number of people who say they want a vbac but dont do anything the prepare or dont have a plan and just think its gunna happen. I have to admit, I was like this when I was going for my first vbac and of course you know how that ended. It is very frustrating.

I had no-one to prepare me and I was so naive and didnt know anyone who had c-sections and wanted vbac's after so when the hospital had no problems with me having a vbac I assumed it was going to happen. It wasnt until my third pregnancy and doing all the research I did that I realised from the get go, unless I had the textbook labour dilating at least 1cm an hour, it wasnt going to happen. They had me laying down in bed, with a big strap around me monitoring bubs and they also put me on syntocin only about an hour into the labour so now I can see it was all gunna end in another c-section even before it started.

But anyway, I understand how you feel frustrated. I have had a number of girls who have had the exact same thing happen to as what happened to me, even after I have tried to educate them. It makes you think maybe they didnt want it that bad.

I hope no-one finds anything I have said offensive. Its a touchy subject and I havent spoken to many people about it as I dont want to offend. This is why I am becoming a doula, so I can at least try to help some people to have an empowered birth, so even if it does end in a section, the mother will know she has done everything possible to try to have the baby vaginally and it will be an empowering c-section.

[*suz1*]

Hi Girls,

It's been great reading everyone's posts in preparation for a VBAC. All the different experiences have really helped me to think about it all.

When I first started planning for my VBAC I was emotionally numb about my previous caesar experience. Now I've grieved for the loss of my much wanted vaginal birth and after reading about empowered caesars I got angry about the way my caesar was done. That gave me the motivation to prepare the best I could, rather than to just trust the medical staff. I have also after much meditation, many affirmations and reading, regained confidence in my body's ability to vaginally birth my baby.

I've just had my 36 week appointment with the hospital OB to follow up my 34 week ultrasound. They've given me the 'thumbs up' for a VBAC (baby head down,anterior, 'normal-sized', scar healed well and placenta well out of the way). So it's a hospital VBAC for me. If I'd started preparing sooner I could have planned a HBAC.

I've written a birth plan because it got to the point where I had too many things to remember if I didn't write them down. The last thing to resolve on my plan was induction and augmentation. With DS I had a spontaneous labour at 38+2 weeks with spontaneous rupture of membranes. The OBs are hoping I do it again before 41 weeks but don't want to consider a caesar until after then. There don't appear to be any time limits, the main concern seems to be whether my cervix will open by itself. I was told it all depends on my progress on the day and the OB attending. None of them want to use prostaglandin gels but some will consider syntocinon if labour slows down.

Now that I know this I think Plan A is to go in to labour spontaneously, have no non-natural (pharmacological) induction or augmentation, no pethadine or epidural (will use heat packs, water, massage, hypnosis and maybe gas), be upright and active during labour. I want to hop in the bath as close to the end of stage 1 as possible and if it feels right I'm thinking about staying in there for a water birth. Plan B will have to be for if labour fails to progress (and how we define that) and if I'm offered any assistance that will allow me to have a vaginal birth. Plan C is an emergency caesar with all the things I didn't get to have last time (no separation from bub, skin to skin and breastfeeding in theatre, DH to cut the cord, etc). Plan D is an elective caesar after waiting at least 14 days from my due date and my cervix still hasn't ripened.

There's more reading and thinking to do, with maybe a few things to add to the birth plan, but I otherwise feel ready and confident that I'm prepared. Obviously you can never prepare for everything, but I figure this is a list of my 'preferences' and I'm trying to get the best possible outcome for me and baby.

This has been an interesting journey! There's a lot more involved in preparation for a VBAC than I thought when I fell pregnant.

Good luck to all the VBAC'ers on here.