VBAC again :)

  1. sorry if I'm beating a dead horse here but I just got back from my ob appt. and was told by my doc that in order to try for a VBAC, I would be REQUIRED to be induced and REQUIRED to have an epidural. I asked why and she said the induction so that the labor would be in a controlled environment and the epidural for an emergency section. I asked how I was to feel my uterus rupture with an epidural and she said that you can feel it, trust me, I've been doing this for 19 yrs. (did they have epidurals 19 yrs ago??)

    Anyways, I am so angry...does she think I am a complete idiot?
    she said all of this is according to ACOGs guidelines....isn't that a load of crap? (I have searched acogs website and can't find anything that I don't have to pay for)

    Thanks for letting me vent (AGAIN!!!)
    feel free to comment...or I'll give you her name and we can all harass her
    •  
  2. 18 Comments

  3. by   imenid37
    the drs. where i work don't like to use pit on vbac's. they prefer to have the pt. go into spontaneous labour. if the pt doesn't, then they usually suggest repeat c/s. pg-gel and cytotec have really fallen into disfavour for use in vbac's. they had epidurals back in 1986 when i had ob inschool, but believe me length of experience is not everything when it comes to ob practice. sometimes that just means their heels are deeply dug in to their "standard routine."

    Here's an exerpt from an article on acnm.org http://www.midwife.org/focus/health/...aroundvbac.cfm

    The majority of cesarean scars-about 99 percent-hold up just fine. In about 1 percent of women, the scar tears or ruptures during labor. Meier explains, "In most cases, if the scar separates during labor, the first sign is persistent changes in the baby's heart rate pattern. In those cases, it may be necessary to deliver the baby quickly by repeat cesarean. In the vast majority of these cases, the baby and mother do well." (The risk of rupture seems to be greater when drugs are used to start labor, and in women who have had more than one prior cesarean.)


    Please notice the last sentence. This is a pretty good article. Maybe you can e-mail it to your dr. She sounds a bit stubborn. Whatever you decide, it's your body. I hope you have a great delivery and a safe birth.
    Last edit by imenid37 on May 27, '03
  4. by   SmilingBluEyes
    I wish you well in your delivery!
  5. by   Sable's mom
    ???Induction for a VBAC??
    I've been doing this for 23 years and that has been a big NONO for a long time.
    I think I'd reassess my choice of OBs if I were you.
  6. by   mark_LD_RN
    induction with vbacs is not a good idea in most docs opinions. I know 2 that will do it. one does it at 37 weeks theory is baby is smaller and more likely to deliver. that doc will even do cytotec inductions with vbacs, i will not touch that one
    as far as the epidural I have seen one vbac rupture with an epidural she did not feel a thing, i personally think it is a bad idea also,JMHO

    good luck
  7. by   babynursewannab
    Isn't it "well known" that induced labor contractions are more intense in the first two stages???

    I agree with the others, see if you can find another OB to take care of you. If not, remember, it's your body...your say.
  8. by   Anagray
    Mae, I can't remember from the previous thread, but isn't there any other way for you to have this baby, like moving to another area, where VBAC is encouraged?

    I'm also having VBAC and based on what I learned from people here and from my own personal research I am not going to allow induction, unless it is in the smallest dosage possible.
    I have too much to risk. I also decided that I will not get an epidural, unless I am freaking out from pain.

    I'm so sorry for all the trouble you are going through I sypathize with you deeply. It's hard to say what I would do if this happened in my case.
  9. by   JULZ
    I had a VBAC with my second child. I was given a choice of having an epidural or not. My water broke first then while at the hospital they kind of wanted to hurry me along to I was given pit. Now that I've been on this site I would have demanded to let it occur naturally. It seems to me that pit and all the other drugs are used too damn often. I can't have anymore but if I was to have more I would definately do things differently! jmho
  10. by   SmilingBluEyes
    Rarely do we do "inductions" on VBAC's; the doctors let nature take its course as much as possible. Rather, we "augment"...that is to say, if labor progresses slowly or not at all, we give VERY small doses of pitocin, carefully titered to enhance the contractions, usually with the use of an IUPC to be sure we are dosing correctly. We NEVER use cytotec or other prostaglandins on patients to induce labor.
  11. by   l_e_mae
    sorry I haven't replied in a couple days....Yes, Anagray, I will be delivering at a different hospital about an hour away. I only went back to this doctor one last time to see if the other hospital closer to us (there are 2) was an option. (This was the first time I even had a chance to talk to her and I'm 20 wks.)

    I was just floored that she was REQUIRING induction and epidural and that she said that these were according to ACOG's guidelines....that goes against everything I have ever heard--here or otherwise.

    thanks again for letting me vent. my next appt. (for the hour-away hospital) is Thursday so, if I can't have a VBAC there, I'm moving out of state...or maybe I'll just try a home-birth (only kidding....no flaming please!!!!!)
  12. by   Anagray
    lol well, if u move out of state, u might as well come here to Albany, NY.
    i feel like I am getting the greatest care..even with a VBAC, they already gave me options for waterbirth, use of showers and jacuzzi during labor ( portable monitors can be used there), discussed all kinds of methods of birth and pain management.
    I actually ended up in L&D today with contractions 10-5 min apart..FFN came back negative, everything is closed, thank god. I really enjoyed talking to my nurses there.
    10 more weeks for me.

    let me know how everything works out.
  13. by   l_e_mae
    I called the other hospital (the one that's an hour away) and they said they have the portable monitors too! I'm excited about going there...they seemed really nice (over the phone anyways) They don't require an IV, only a hep-lock and they have jacuzzi tubs and showers in every room! I can also hire a doula thru the hospital to help during labor!

    I go to the doctor on Thursday...I'm 21 wks so maybe I'll have a sonogram and find out the sex of the baby!

    I'll keep you updated! Good luck with your baby too! I didn't know you were prego!
  14. by   Gator,SN
    l e mae,
    Good luck to you with the birth of your baby! No matter what the outcome you are blessed and I wish you and your family the very best~!

    Gator

close