Vaginal Birth after two consecutive C-Sections

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Specializes in OB (with a history of cardiac).

I was wondering, do any of your facilities do this? Ours apparently does (which gives me hope with two sections under my belt). Is there any offical stance by ACOG or the like on the matter?

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Specializes in Nurse Leader specializing in Labor & Delivery.

Our facility pretty much allows any woman to TOLAC, unless she's had a previous classical incision.

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Specializes in Pediatrics, High-Risk L&D, Antepartum, L.

Where I worked did it...some docs wouldn't but it wasn't against policy.

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Yes, VBA2C is supported by ACOG. They revised their VBAC guidelines in 2010. You'll have to check the August, 2010 issue of Obstetrics and Gynecology but you can see a copy of the guidelines here: http://www.ourbodiesourblog.org/wp-content/uploads/2010/07/ACOG_guidelines_vbac_2010.pdf

Previously, ACOG's guidelines supported VBA2C in women with a prior lady partsl birth but now it's suggested for most women.

I had a VBA2C 6 months ago. My OB actually suggested it (much to my relief) and we have a few area OBs that are supportive of VBA2C. It was a great experience. My cesareans were due to failure to progress and breech presentation.

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Specializes in Community, OB, Nursery.

Yep, we do it too. :)

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Specializes in L and D.

I don't think any of the docs at my hospital would allow that. It is a rare (VERY rare) occassion that they will even allow a TOLAC on a previous c/s. It's pretty much once a c/s always a c/s. I find it sad cause in the Army we did them a lot and had very good outcomes the majority of the time. I guess that's cause we always had an OB in house and here they do not.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Yes, in order to safely TOLAC, you need to have OB and anesthesia in house 24/7.

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Specializes in L and D.

Yeah God forbid a doc hafta give up a few nights a month to cover the hospital so i woman may have the birthing experience she wants and deserves.... Ugh. I think im getting bitter in my ripe old age of 30.

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Specializes in Labor and Delivery.

Yes, we do :)

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ACOG actually lightened up the recommendations for immediate availability of anesthesia because too many hospitals were denying any woman the opportunity to VBAC. While I do agree that it's best to have an OB and anesthesia readily available for VBAC, plenty of other emergencies happen with non-VBAC births and the OBs and anesthesiologists manage to handle them.

My hospital is very VBAC friendly but not VBA2C. I went to our partner hospital with the perinatal center.

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