How Many sucessful VBAC's..

Cherry2 · Sep 14, 2005

Well my reason for asking is that I would like to have a VBAC- My inital c-section was done after my induction failed. I got to 2cm but not enough that the doctor felt okay to break my water, and my baby stopped moving as much as they would like- so I guess they didn't feel it wasa good situation to give pitocin in.

Anyway, I want to go for a VBAC next time (no induction though, b/c I heard this is could be the reason why so many VBACs don't work out?) and I will hopefully have a natural birth- preferably a water birth if it is allowed.

All I have heard are bad stories about VBACs and how no one will do them so I just wanted to hear any stories or anything really tha might happen at your hospitals. Thanks

NurseKratchet · Sep 14, 2005

My first C-section was in '89 and my second was in '94. I then had a VBAC in '98.

Give me a VBAC anyday. The recovery was so much nicer and was able to nurse for 6 months overall I just faired much better after the VBAC and yes it was high risk and I was monitored very closely.

Nurse Kratchet, RN

OB_or_NICU_hopeful · Sep 14, 2005

I didn't realize you were asking personally....I'll go in to a bit more detail!

My first child was born at 35 weeks exactly. My water broke at 3:30am; I was given my epidural and at about 2:00pm I was 7 cm it was discovered that he was breech (frank). About 10 minutes later I was nearly complete (midwife to OB switch - how nice, I meet the guy and he does an internal WITH my dad at the foot of the bed). C-section at 2:58pm.

I switched to a different OB with my second son. Pro VBAC, and with my history he says I'm a great candidate. My body did what it was supposed to, and in good time. My water broke at 12:30pm with my second son. I was complete at 6:30pm and he was born at 6:46pm. I was given pitocin after I received my epidural. I trust that he factored everything in and deemed it appropriate. They used a very small amount - nowhere near what they use to truly induce labor.

I LOVED my VBAC! It was nice to be up and about so quickly :) Good luck!

NurseNora, BSN, RN · Sep 14, 2005

My current hospital doesn't do VBAC's because we can't meet the time requirement; no in-house anesthesia or OR. We've had a couple of accidental ones where the woman delivered before the OR crew got there.

Used to work in a large tertiary center. Did lots of VBAC's there. As I remember, the statistics indicate that 3 out of 4 moms can deliver lady partslly a baby that is larger than the one they were origianlly sectioned for. Position of the baby has so much to do with everything.

I've seen only two women with uterine rupture attempting VBAC, and I've worked with a lot of them. Both women were getting Pit (I've worked with a lot of these too). One had no pain from the rupture. One had severe pain that the epidural could not control. The one with severe pain had a live baby with good Apgars. The one with no pain had a stillborn, but it had anomalies incompatable with life and had died during the labor before the rupture occured.

If you want a VBAC, be sure you have a doctor who is supportive of this (ask about his personal statistics) and plan to deliver in a hospital that can deal with the infrequent, but very dangerous risk of uterine rupture. Also, your first incision must have been a low transverse and healed without problems.

AggieNurse2B · Sep 14, 2005

Same thing for me. My kids are 18 months apart, so my OB didn't want to even consider VBAC for me, which is fine with me. Even though the odds are in my favor, I don't want to take even the slightest chance with my baby's life or my own, for that matter. It's just not worth it to me...What do I get for that added risk? The priviledge of saying I pushed the baby out? A shorter recovery? Who cares? In the grand scheme of things, I'm all too happy to go under the knife if I can avoid some of the risk of uterine rupture.

Not sure about the first question, but I have 2 kids and have never experienced labor. First was a breech 10 pounder. I didn't ask my OB to VBAC but he advised against a VBAC because I had less than a year between pregnancies. I would choose an operative delivery again if given the choice. Mine was a good experience all around.

RN-oneday · Sep 14, 2005

I had a VBAC and it was great. My first baby was born in 88, 6 hours of hard labor with 1 hour of hard pushing. Baby's HR dropped and I started hemorraging. Emergency C-Section due to partial placenta abruption, tearing a considerable size hole in my uterus. I was told I probably should not have more children because of the possiblilty of opening up the scar tissue. Well got pregnant in 94, DR said lets try a VBAC. She was fully aware of the last delivery. Well my second baby was born 2 hours after I was admitted to the hospital, I am not sure how long I pushed because I was given Stadol (best drug ever). He was almost 8 pounds, with a large head. I had no problems whatsoever. I was in the hospital for only 34 hours. My next baby was born by c-section because she was breech. I was in the hospital for 4 days after that. In my situation, my lady partsl delivery was so much better.

PegRNBSN · Sep 14, 2005

First delivery lady partsl, second c-section for distress, 3 and 4 VBAC.

I would only do it in a hospital where you can do a c-section immediately. In-house anesthesia and an in-house MD. Our hospital does them frequently I think I last heard our success rate was 75-80%.

We have had several uterine ruptures over the 20+ years that I have been there. No fetal or maternal deaths associated with them, one c-hyst that I know of. I think the key is to be able to immediately do a c-section and having staff with the ability to recognize a possible uterine rupture.

SheaOBRN · Sep 15, 2005

that would mean getting anesthesia to stay in house 24/7, and they're just not on board... yet.But

I am confused, if you don't have anesthesia on all the time, what so you so in emergency situations? or for epidurals? so the patients wait?

~Shea

debi538 · Sep 15, 2005

Wow! So many opinions. Being an "old" OB nurse who was around when VBACs first became a viable option in the US, I worked with 98 women in the late 1980s who had at least 1 previous C/S . Only 2 were unable to give birth lady partslly. One of those 2 delivered a 12 lb 1 oz baby by C/S. I learned to respect natural labor, avoid inductions, use ausculation not fetal monitors, and avoid epidurals. The majority of these moms were told that the indication for their C/S was CPD......many delivered larger VBAC babies.

I work in a hospital as a lactation consultant now. I can see, on a daily basis, how unnecessary cesareans affect breastfeeding. In the last month I have seen 2 post operative pulmonary embolis (after primary elective cesareans) and 2 pulmonary edema cases (after a repeat cesarean and a primary cesarean). These were with healthy women! We also see lots of transient tachypnea in c/s babies which delays mom beginning breastfeeding.

I guess what I am trying to say is that a repeat cesarean has its risks as well, which seem to be whitewashed by doctors trying to convince mothers to just have a c/s for their convenience. It is not that VBAC is unsafe...... it is all of the non-evidensed based procedures (inductions, fetal monitoring, enforced bedrest....) that make it unsafe. Give mothers the truth and then let them decide.

I have had 4 natural lady partsl births (2 with midwives) and if I had ever needed to, I would have had a VBAC in a heartbeat.

Cherry2 · Sep 15, 2005

I learned to respect natural labor, avoid inductions, use ausculation not fetal monitors, and avoid epidurals.

I know not to get an induction- and I won't be going that route no matter what anyway. I want to have a natural birth, but even if I feel I need something, I will NOT get an epi. Why though did you say no monitors? Is it b/c you can't move around with them on? What do doctors usually say to a patient that says they don't want them? Is that a problem? TIA =)

debi538 · Sep 15, 2005

I know not to get an induction- and I won't be going that route no matter what anyway. I want to have a natural birth, but even if I feel I need something, I will NOT get an epi. Why though did you say no monitors? Is it b/c you can't move around with them on? What do doctors usually say to a patient that says they don't want them? Is that a problem? TIA =)

As far as EFM, yes, it is primarily because of the inability to move around. We have become very dependent on a piece of equipment that has never been proven to be better or safer than auscultation by a trained professional. Look at the research, all you keep seeing is more C/S with EFM but no better outcomes for mom or baby than with intermittant ausculatation.

Most hospitals are going to require a baseline strip of about 20 minutes with EFM. But after that you should be allowed to get up and move around. That is..... if you are not medicated and aren't being induced.

I would recommend a good childbirth class (Like Bradley) that teaches you how to repect nature and use medical intervention ONLY when there is a problem and using a nurse midwife to maximize your ability to birth naturally.

PegRNBSN · Sep 15, 2005

At our hospital we have telemetry monitors without cords that can even go in the shower. My second son would have died if I had not used a fetal monitor. He wasn't moving and I did a strip in the morning. It was flat and because of that I repeated it in the afternoon (I was working) even though he was moving more. I was having huge spontaneous variables to the 40s. They tried to induce, I had huge variables, lates and no variability. He was on his way out. I ended up with a c-section. His cord was around his neck three times and then around his body. As they delivered him his cord tore because it was so taut. If I would have just auscultated it would have sounded fine in the morning.

Using the telemetry monitors allows you to move around and be monitored. Sometimes the first thing you see with a uterine rupture are small variables, which cause you to be extra vigilant.