Induction or risk another c-section? Need your opinions.

[LosingMyMindInGA]

Ok, most of you know that I'm in a small town where NO ONE does VBACs.  Fortunately I had already had 3 by the time I started seeing this doc with my last pregnancy and he let me do another one.  Everyone around here is amazed that he let me.  But anyway, NO ONE else in this town will do a VBAC.  Well it's getting closer to time for me to deliver (36 weeks tomorrow).  I'm due Sept 10th but my doc really thinks I'm gonna go before the end of August.  So heres my dilemma..  If I go into labor when MY doc is not on call the doc who is will most likely (like 99% chance) want to do a c-section.  I know I can refuse but then I will run into arguing with them and pissing them off while I'm in labor.  Stress + Labor = Not good.  So, I'm debating on talking to my doc about inducing me. I really didnt' want an induction either...but it's the lesser of the two evils.  

What would you do in my situation? My doc says we'll just wait and see how I progress and take it from there, but this is my 6th fullterm pregnancy I could spontaneously go into labor at anytime.

[Michele, Katy, TX]

I can't be for certain on your question, but I hear the the recovery time for a vaginal birth is shorter.  When you have that many kids, you need to recover as quickly as possible :)

[LauraB78]

This may be a ridiculous question, and I am just straight up curious, but why is a VBAC so important you? Did you have an awful c-section experience? I am not judging or trying to argue, I am just trying to understand where your passion for a VBAC comes from. I feel like I could give better advice if I'm sure I know the "whole" story.. =)

[DoulaSummer]

This is what I am talking about.  Hope this works...it always blocks me   http://www.      thebirthsurvey.    org/

[LosingMyMindInGA]

Thanks again ladies.  

I know the risks increase with induction, but I WAS induced last time.  According to the new ACOG recommendations they are even saying induction is safe with certain candidates, I do still want to keep that option open just in case.

I know, legally, they can not force me into a c-section, my problem is that EVERYONE I have dealt with aside from MY particular doctor and his nurses have given me such crappy attitude everytime I've mentioned having VBAC'd here before and that I'm planning to do it again.    This hospital already has a reputation for having lousy staff and patient care and I'm afraid if I DO refuse they are going to treat us even worse and while I know I can file complaints, which I most DEFINATELY would, it wouldn't go back and change the fact that I had a lousy birth experience becuase of it.  Does that make sense?

DoulaSummer: you are so right that doctors/hospitals are so used to people just following whatever the doctor recommends, they very well may not know WHAT to do when *I* get in there LOL.  For me it's already going to be bad enough going into labor knowing that my Mom is 4 states away dying and won't even be able to respond when I call to tell her I had the baby. IF she makes it that long.  So it's already going to be a VERY emotional time for me.  

Right now, I've decided to play it by ear and see what happens.  I would really, really prefer to have MY ob deliver but we'll see.  I know a little bit about a couple of the other ob's around here, but I'm gonna check out the rest of them too.  

I know one of them was on probation a few years back becuase he was screwing around with staff members and patients (and is a married man).  Most people around here don't know that and think he's just great (probably becuase they think he's good looking) but I've done my homework and checked their licenses and complainst against them.  

So many decisions to make!!!


BlueEyedTabbyCat:  Even though I have had FOUR Vaginal births since my c-section, it's still considered a VBAC

DoulaSummer: What birth survey are you talking about?

[LACh1]

I would prob go the induction, however there is higher risk that you will have to have a c-section anyway once induced as the drugs they give you can often start things off ok but then slow them down and you then run into problems and then a c-section (this is what happened to me).  I would wait a bit longer and monitor how you go over the next few weeks and then make a decision based on the avaliable info - good luck.

[DoulaSummer]

I think you should take a print out of the recommendations!  I totally forgot to include that!!  If you are showing you did your research, maybe they won't fight so hard!  They are SO used to people rolling over and playing dead to their every word.

If they do not care to follow the recommendation, you can file a complaint with ACOG and I advise that you do it!

Just need to put a plug in for The Birth Survey...if you have had a child within the last 3 years PLEASE do fill one out.  The information is VERY helpful to expecting parents!

[blueeyedtabbycat]

Okay so I may be way off cause I didnt read the other responces but I would flat out refuse a csection unless for a medical emergency. They would not want me in there big huge pregnant and in pain, lol! I dont think they can legally forse you to considering you have had 3 VBAC. Those are vaginal delivery so why cant you continue. A VBAC is a vaginal delivery after ceserion (sorry sp) But it wouldnt be a VBAC since the last three were vaginal right?? Confusing, lol!
Anyways I guess to answer your question I would vote induction but with that you have risks and "could" end up with a csection anyways:(
Best of luck!
Tabitha

[LosingMyMindInGA]

Thank you so much for that, the information is wonderful.  Everything it's saying in the new guidelines points to me being a PRIME candidate for a VBAC.  I will have this information in my hospital bag with the pertinent areas highlighted for reference.  I will also have a list of the reasons why I SHOULD be allowed to VBAC:

1) my c/s was for reasons that are likely nonrecurring (and have NOT recurred in 5 subsequent pregnancies) Lack of fluid, breech and IUGR
2) I have had not only one vaginal labor but four so we know my pelvis is plenty big enough
3) my c/s was done by low tranverse incision both external and uterine
4) I have never had stalled labor, my labors have all been under 8 hours with the exception of my stillbirth but that was only becuase they had me on morphine and a sedative.  That one was still under 24 hours.  
5) I dialate quickly and I've never had to push more than 10 minutes to get any of my babies out.
6) I'm NOT advanced maternal age
7) I do not have large babies (biggest so far was 7 lbs 15 oz)

I'm sure there are more, but those are off the top of my head.  At this point I'm thinking I may just ride it out and fight for it, but I'll talk to my doc wednesday as well.  I'm really glad the ACOG revised their guidelines, this once a c/s always c/s BS has gotten outta hand.

[LosingMyMindInGA]

I didn't know about that but I'm defiantely going to check it out, Thank you.  

I seriously doubt that the docs around here will change their minds that fast though, but it's worth having to use :)  

I think it's pretty ridiculous that I have to fight so hard to have a freaking VBAC when I've already had FOUR.  I mean come on, I've proven I can do it for crying out loud.  

[tiredbuthappy]

i wonder if maybe you stand a better chance now since just in the past month the recommendations have changed? The ACOG just released their new stance on VBACs... perhaps you could throw that in their faces? Ask if they flat out go against this recommendation without considering the patient's desires and specific circumstance.

http://www.ourbodiesourblog.org/blog/2010/07/acog-releases-updated-vbac-practice-bulletin-emphasizes-individualized-approach-and-maternal-autonomy

[LosingMyMindInGA]

I'm in Middle Georgia but we really don't have the money to hire a Doula so that's out of the question at this point. DH will be with me and he's just as stubborn and steadfast as I am and we're on board together about the NO c/s thing unless it's absolutely necessary.  

My only problem with laboring as long as possible at home is that I tend to dialte quickly.  So the longer I stay home the more chance I have of not being able to get to the hospital in time.  

Another thing is that we like to do a "family" birth. we have always had our older children there.  I guess we'll just wait and see for now. I'm going to try and talk to my doctor more about it at my appt wednesday.  

Even the stupid anasthesiologist here assumed I was having another c-section....here we have to do this stupid "epidural class" where you watch this 12 minute long 20 year old boring video about crap I already know and could probably teach better myself.  Then you have to sign the consent forms for the anasthesia...if you don't sign ahead of time, you don't have the option of an epidural.  So, just like last time, he sees "previous c/s" and says "so your having another c-section" and I said "NO, this will be my 5th VBAC" and like everyone around here does he looked at me with his eye brow cocked, like "say what?"  

[DoulaSummer]

So far, I have only had to speak up one time when I felt my clients rights were being violated.  She request not episiotomy and the doctor reluctantly agreed, but then I noticed him stretching her and trying to RIP HER! I flat out told my client what was going on (in her ear) and her husband told the doctor to GET OUT and never to come back.  The doctor claimed to not understand, but I spoke up and said I know he was trying to punish her for her request.  He said no pushing until another doctor came, but about 6 pushes later baby was out and the nurse caught him - no even a tear or skidmark.

[LauraB78]

I would labor at home as long as you can stand it, it sounds like that is the most promising shot at getting your VBAC, unless you induce. The only thing I would be nervous of is something not being "right" and not being in the hospital to be monitored. I thought I was dying when I was in labor, I thought I would get to the hopsital and they would tell me I was 7-8 cm... I was 1.5 cm! Thats IT!  You bet I got an epidural... I am not all about no drug, vaginal births.. It was more important to me that I wasn't in severe pain and Jaxson was monitored. But he was my 1st (and only), so you have MUCH more experience than I do.  I ended up with a vaginal birth, but I wasn't opposed to c-section either. I hope you get your successful VBAC, I know it's really important to you. Best of luck.

[Spiket77]

Go Ashelen! HA!

Sorry if I misspoke about doulas. I know mine would fight a tiger if I asked her to.

I would take up DoulaSummer on her offer to help find you one. I get that's a small town but they can't force you to have a c-section.

[Ashelen]

Girl if it comes down to it I'll drive the 3 1/2 hours up there and put up my dukes!

[DoulaSummer]

Who is going to be at your birth?  Would any of them take a firm stance and fight FOR you so you can labor?

[DoulaSummer]

Where in Georgia are you?  I can post something on a doula site I am part of to see if there is someone willing to travel to your area.  I will get back to you as soon as I get a response and then you can go from there.  Up to you, but if you really want a doula I will do my best to find one.

[LosingMyMindInGA]

None that I'm aware of, I tried to find midwives and doula's when I first got pregnant but couldn't find anything closer than 2 hours away.  I mentioned something to my Doc at my last appt about what should i do if I go into labor and he's not on call, he said the other doctor will want to do a c-section and I said "well I don't want one" and he just smiled and said "we'll watch your progress and see what you and take it from there.  

He induced me with my last one because I was throwing up so much and not eating and having horrible hip pain....we induced on my due date.  I didn't have any problems and that was my 4th VBAC.  

[Cassandrajane]

MY CAT JUST RAN OFF WITH MY MUFFIN THAT I WAS EATING :@.

Happy birthday for then <3 LOL.That would be so cool if you turned up for your apt and he brought you cake :) I like cake... I would like it even more if my cat didnt steal it.:(.. I will bash him in the head if he says no don't worry....

I think personally you ARE set on having a VBAC and the only way you can get that is for an induction.. I think you're 90/10 with the choice... :)

xx

[Ashelen]

I absolutely know what you mean...having to argue with your birthing group while you're trying to enjoy and have a healthy labor is completely counter-productive..I'd say go with the induction. Like you and Summer said, it's harder on your belly because the contractions are sharper, but since you're like me and have fast labors it probably won't even matter.

[LosingMyMindInGA]

LMAO, bash him in the head...My docs pretty cool.  I think he'd go for it if I request it.  I just need to think on it some more and get some more opinions. My next appt is this coming wednesday (my bday :)   )

[DoulaSummer]

I would talk to you provider, but pitocin inductions are definitely harder on c-section scars.  I would personally labor at home and not go to the hospital immediately.  If you go and you are only say under 7 cm you can choose to not be admitted right away and walk around the grounds of the hospital.

Just for the record...doulas do NOT fight for you, they give you the tools to empower yourself and your partner to fight for you.  It is out of the scope of practice for a doula to speak for the mother.  Things are a LITTLE different if the doula is the sole support system, but even in those cases I still have never spoken up for a client.

If you go to the hospital late (i.e. labor at home) or refuse vaginal exams, they cannot MAKE you have a c-section.  I know it might be stressful to think about it now, but you must take control of the situation and have your support system support you.  If your husband is going to be there, make sure you and him arrange for him to take the doctor in the hallway and talk there so you are able to labor in quiet.  I suggest not leaving you alone with the doc or nurse if possible because they will take advantage of the vulnerable moment.  If your spouse is not the confronting type, then you need to have someone around who is (i.e. mom, sister, friend, etc) but that will also respect your boundaries and hush when you ask.  They do NOT have to be there for pushing or could wait behind a curtain, so they are still in ear shot and can step in with a voice if need be.

Please feel free to email me if you need some support!!  Where in Georgia are you?  Are there no doulas within an hour of you?  Maybe I can help hook you up with one if you give me your info.

[LosingMyMindInGA]

I know they say that your risks of uterine rupture are increased slightly if you are induced for a VBAC, but I was with my last pregnnacy and didn't have any problems.  

Ashelen: LOL yeah, DH and I both agree that they have NO IDEA who they are messing wtih hehehe.  There's a LT. at Portsmouth Naval Hospital who got the raw end of my mood after we lost Joey.  I chewed is @ss so bad they called DH's command who asked him WTH my problem was.  DH told him...Hey, you told me I couldn't tell her what to do and besides someone needs to tell that jerkoff that he has a LOUSY bedside manner.  LOL  I had finally fallen asleep after laying in bed listening to everyone elses babies cry all night after having lost my son due to stillbirth and he came in to tell me I couldn't go home that day.  I ripped him about 6 new ones.  I let loose and didn't hold anything back....this man, a military officer, sat there with a dumb look on his face and didn't say a word. When I was finished he said "i'll check on you later" he NEVER came back to see me, he sent his tech instead.  

I'd just really prefer to not have to go through all that during labor if you know what I mean .

[Cassandrajane]

I know you cann too :) We was talking about it...
So why don't you ring your doctor explain that you WANT an Induction if its the only way you're going to 99% know you'll get that VBAC with YOUR doctor that YOU want....... the 1% is the induction not working and you have a Csection. (I read your comment after I wrote mine that a Csection CAN be avoided if you are induced)...

I think you should talk to your doc...and say you would preferr to be induced because then you will know and be certain your doc will be there and you get the VBAC you want. If he doesnt mention it at your next apt... then mention it when your apt is near enough finished and say this is what I want! :) if he says no. I'll bash him in the head! I'll use my pregnancy hormones.

x