Monday
Jun252012
VBAC: "Should I stay home to labor until it's too late?"
Monday, June 25, 2012 at 3:41PM
This search arrived on the blog:
“hospital doesn’t allow vbac, so should I stay home to labor until its too late?”
I would like your thoughts on this. If you have experience with this from either the patient or provider side, please share. Comments left here or on one of the Facebook pages will be de-identified and compiled for a future post.
Reader Comments (21)
The craziest thing is to go to the hospital in the first place! My craziest story with a doula client was staying home until she felt the urge to push, showing up at the hospital, and after about an hour and "4" different Ob's coming in and trying to force her into a repeat cesarean, she simply pushes the baby out, much to their surprise! They had no idea that all the time they are arguing with her and her husband, that she was slowly pushing her baby out! It was incredible! She has since had another baby and birthed her at a birth center!
I'm planning a HBAC. I had seriously contemplated just laboring at my parent's house (2 mins from the hospital) until transition, but in the end decided that it was pointless; why bother going to the hospital at all if you're waiting until the last minute? I feel safer having a midwife at my home monitoring the baby and me. If I get to the point that I feel unsafe or uncomfortable by not being near all the wonderful life-saving equipment that a hospital has to offer, I transfer and I've lost nothing. I still will have safely labored at home no longer than I had "planned" anyway. Hospitals aren't realizing how deeply personal and difficult this decision is for women. As mothers we just want what's best for our babies and ourselves. I just wish we weren't forced between a rock and a hard place; a csection is major abdominal surgery and should not be the "default" for what could be a normal vaginal birth.
I would!
As someone who had a rupture while attempting to VBAC (I really AM the <1%!!!) I would advise caution. Had I stayed home until nearly pushing, we would b oth be dead. I had the "luxury" of a VBAC supportive DR and hospital. ( most awesome nurse ) my rupture was very hidden, my experienced dr knew something was off and called for the emergency Csec. Blown uterus and bladder, 2 for the price of 1!
To each their own but 1 in 100 does happen. We do exist!
And believe me, I did everything right. There are no "if onlys" in my story.
I am fascinated that no one mentioned staying home and calling 911. As an Emergency Medical Responder I am trained to catch babies and attend to obstetrical emergencies. I am also a doula. You could totally labor at home, call 911, and get to the hospital when you're good and ready. You would make some EMR, EMT, or Paramedic's day. You could also deliver in the ER if you wanted, their docs are good at catching babies, too. :-) My emergency medicine textbook has been the best pregnancy guide I've ever read - it's simple, to the point, and deals with the basic normal physiological birth process, as well as the typical emergencies. I recommend it to all moms. ;-)
I was told by both of my midwives to stay home until either my water broke or I started having a lot of pressure that I hadn't had previously. I was going to labor less than 15min from the hospital and they expected everything would go well. Both work in OB offices with VBAC supportive OBs (I switched practices the day I ended up delivering), so they weren't worried about an OB telling me we couldn't VBAC there. They instead were trying to encourage me to labor in the most comfortable place to keep things moving along in my and baby's time and allow me to eat and drink as desired as well as move around as I please without any pushy staff trying to follow out-dated protocols.
No one *wanted* me to stay home until it was too late. They just wanted me well into active labor before arriving at the hospital. We followed their instructions implicitly and were in constant contact with my midwife planning to attend the delivery. However, my body spent literally 20 minutes in transition and took all of 2 half-hearted pushes in our van on the side of the interstate to birth our 3rd baby, my first VBAC (vag birth followed by double-footling breech c/s) and my first unmedicated delivery. Everyone was so proud of us and we were ELATED to have our amazing doula with us making our "unassisted" birth feel very far from unassisted.
What will we do if there is a next time? We will likely labor at home again, but won't be waiting until labor is intense to hit the road. :) Despite his birth being the most amazing, peaceful, beautiful moment in my life... it could have gone very wrong. We need to either PLAN to be home under the watchful care of a trained midwife or get our butts to the hospital. Either is a great option in the right conditions.
Obviously VBAC bans are a hot-button, hot-blooded issue amongst VBAC-tivists, and a blase business-as-usual policy enforcement among pointy headed hospital bureaucrats. My advice? Don't listen to any of them. Do your own research, figure out what YOU feel comfortable with. Ask yourself the tough questions: Are you going to be prepared to fight, really fight, with hospital staff to get a VBAC even if you roll in the door pushing? Is your birthing partner? Are you prepared for the possibility that "too late" may really mean "too late" and you have an unassisted birth at home or elsewhere? Conversely, are you emotionally, physically, psychologically prepared to consent to a c-section you KNOW is absolutely unnecessary? Are you willing or able to find a new hospital or doctor? These are not things that anyone else can answer.
Whatever you do, don't allow yourself to be bullied by either side of the aisle. Explore all of your options. Make decisions and choices that are right for YOU and YOUR FAMILY, whether that's an HBAC, a conscious unassisted birth, finding a new doctor/hospital, or a repeat cesarean. Really make the decision, and stand your ground. Everyone else can go f%*& themsevles.
Wondering how the women who said they would have died if they hadn't been in hospital know that for sure. A lot of people don't know that home birth midwives know to look for the signs of a rupture, CNM ones (and DEMs in certain states) have pitocin, IV fluids, and oxygen, and as long as you're within commute of a hospital, it's as safe (or safer, depending on the hospital stats) as being in one.
I am so glad you asked this question, it has been on my mind since my failed VBAC (failure to descend). My midwife suggested that I schedule a c section for my third, thinking I must have a narrow pelvic opening. I believe that is not a reason for a c section and since the hospitals in my area are not VBA2C friendly and my husband is against a homebirth, my thinking is I will labor at home until I am thoroughly in transition. But more information is always helpful. Thank you!
For any woman who has ever received comments along the lines that her pelvis is not adequate, funny shape, too narrow etc, a resource that may be helpful is The Pink Kit. The author, Wintergreen, onced helped a woman have a vaginal birth after 11 caesareans. It is a DVD and book kit plus PDF files. Google! Also check out Fiona Hallinan and Jenny Blyth's work on "making space in the pelvis". Jenny's Down to Earth Birth Book may be helpful. Blessings!