In need of support for potential VBAC

Specialties Ob/Gyn

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L&D Nurses - I will be giving birth to my second child in mid-September and I'm trying to gather as much information as possible about VBACs. I do have a very reputable and supportive OB, who is in favor of me having a trial of labor if everything looks favorable at the time of delivery, but I would also like some feedback from experienced L&D nurses.

My previous section was for FTP, maternal hypotension and fever. After an uneventful and very healthy pregnancy, I labored for nearly 22 hours and became stuck at 8cm. My c-section was a nightmare for me, for several reasons including an extremely insensitive on-call doc and a terribly tired and overworked anesthesiologist. Fortunately, my 8lb, 12oz. baby boy was born perfectly healthy and beautiful, and for this I'm eternally grateful. However, I would like to have a better overall birth experience this time around, even if it means a repeat c-section.

What are your thoughts on issues such as induction and uterine rupture? Do you think I would be better off without an epidural? Or would that increase the chances of receiving general anesthesia if something were to go wrong?

I've already done a fair amount of research and already have read many of the arguments from those both for and against VBAC. I'm really just looking for your subjective opinions and experiences as nurses because I trust your judgement and think that you all can give me perspective that I'm not going to get from books or articles. Thanks in advance!

SmlingBlueEyes...wonderful teaching! One suggestion I would add is to hire a doula. I believe hiring a professional labor support person helps not just for TOLACs but for just about everyone. I'm not a doula but a L&D nurse. I have been impressed with the doula services. Just a thought.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Yes a DOULA, great advice, esp. if you plan a VBAC! I can't believe I forgot that! A good doula is worth his/her weight in PURE PLATINUM! And often, there are CNM's who will take on TOLAC/VBAC cases at many hospitals. THEY are VERY supportive of the family's desire for a low-intervention course in most cases, if that is what you elect.

And you guys, thank you for the kind words. Really, I don't feel all the knowledgeable, but do want to help out! I appreciate the nice remarks! Elenaster, any more questions, please ask. You have a very smart group of OB nurses here (not me) who can help ya!

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I'm with you on that Deb. The VAST majority of our VBACs were women who also wanted epidurals as soon as they could, so pit was the norm not the exception. I have had very few VBACs that didn't include my "pit kit" at the bedside:)

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

rofl fergus. you have such a way of putting things. Iguess that is why I agree with you more than not. Have a good day!

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You too, my L&D guru/sister!:)

LOL! I didn't notice you changed your sig quotes! I especially like the Britney Spears one! :rotfl: I guess I should be thankful she knows we are another country;)

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Thank you all for your kind sentiments and support! So far, "little baby" (as it's called at our house) is doing great and actively kicking me in the ribs as I type. I'll be sure and keep you updated, and I should be finding out the gender next week.

As for the suggestion about the Doula, that's a wonderful idea and something that I've actually considered. I do have two wonderfully supportive nurse friends who both have OB experience who I plan on having with me, mainly because my poor DH is pretty much useless in the delivery room.

Marla- I appreciate you sharing your story. That's the exact scenario that I would like to have, but my greatest fear is being "put under" for an emergency c-section. I really would like to go the natural route, I was actually talked into the epidural last time to see if it would "speed up" my labor and it only caused problems, but I'm so afraid of the worst case scenario resulting in general anesthesia. My doctor assures me that he won't let things get to that point, but he and I both know there's only so much we can control.

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Specializes in cardiac, diabetes, OB/GYN.

Our hospital does not carry insurance for VBACs any more. We are supposed to have a VBAC waiver but with the literature out there we don't have any docs willing to do it...So, I think some of our successful VBACs, who want to deliver with us but understand why we don't do them now, wait until they can't take it anymore at home and then come in, despite the fact that they are STILL made to have csections until they are actively pushing. Too bad....Thats potential litigation for ya...

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

and how, mother-baby.

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Specializes in cardiac, diabetes, OB/GYN.

Yep, it is really too bad, isn't it?

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Specializes in cardiac, diabetes, OB/GYN.

Did you all hear that there is a new trend toward elective csections ( and of course Hollywood types don't have to do a trial of labor if they don't want to). Much like in Brazil where an elective csection is the thing to do...The reason being according to the documentary I saw, was to alleviate the pain and potential complications of labor..Although I have done it both ways and it hurt less for me to have csections, I am happy that I got to experience the lady partsl delivery and even the labor ( that said LONG afterward), but wouldn't it be sad if people just decided not to take the time or trouble to go through labor and all it entails. Times they are a changin........Sigh...

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

There was an article in some magazine that was entitled

"Too Posh to Push" that discussed this phenomenon. I also read an article in LHJ or some other housewife mag, written by an obstetrician who stated she would elect to have a csection with each child she bore to avoid "likely" prolapse of the uterus and damage and resulting incontinence of her bladder. NO trial of labor for her, nuh-uh. So, it's no surprise in our fastfood world that women of means will demand a csection in order to make the birth more "convenient" or "easier" in their minds.

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Deb covered it all in an earlier post. I do have one more suggestion for you. If you can, find a doula in your area who is EXPERIENCED in working with VBAC clients. They have additional resources for you to consider. If this is what you truly want, I'd invest in a doula who has this experience.

Good luck and I hope that all goes well for you!

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