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I need vba2c advice

Last post 06-02-2009 5:16 PM by RobsGirl. 14 replies.
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  • 05-30-2009 6:58 PM

    I need vba2c advice

     I hesitate to tell a dr my concerns since I was told to not pursue a vbac any way.  I had my second c-section in august.  My daughter was posterior and forehead presenting.  The drs here said that once you have presented in a poor position it is most likely it will happen again, also that to vbac after 2 is not recommended.  I was also told that if we conceived and the due date was before 18 months after myk section, I would have an impossible time finding a dr to allow a trial of labor.  My dh and I decided to prevent until the end of this year to heal. (HOwever, we just found out we are expecting.  Estimated gap is only 16 months.)   I still do not feel it has healed well.  I feel a lot of scar tissue, a long lump running the length of my scar and I have continued to have sharp twinges and pulling feelings that are not painful but remind me that I have had surgery.  I did not have any of this from my previous c-section.  However, I was 21 with the first and am now 38.  I had 7 successful vbacs between the two and this was my first posterior baby.  I hate to tell the dr about the discomfort I still feel, it may turn his opinion.  What are your thoughts?  Is this discomfort a concern?  Does this mean I still haven't completely healed?  What will this mean for the pregnancy and labor?  I so desperately do not want another c-section, it would guarantee that I would never be allowed to vaginally birth ever again and we are open to more precious children. 

    Thank you for your opinions!

  • 05-31-2009 9:34 AM In reply to

    Re: I need vba2c advice

    Sorry, to read about your problems with birthing your children.  Highly recommend that you check out MT site as well.  At the same time do recommend that you check Our Bodies, Ourselves, The Boston Women's Health Book Collective and their companion website/blog as well.  By the way they do have a Pregnancy and Childbirth and Menopause as well.  Found its really helpful no matter what.  At same time do recommend that you do additional learning and research besides the books and website I give you to give you.  For more info on this. 

    Hope my recommendations do help you.

    Good luck and etc.

  • 05-31-2009 10:00 AM In reply to

    Re: I need vba2c advice

     What is the MT site?

  • 05-31-2009 10:08 AM In reply to

    Re: I need vba2c advice

    MT Site-Midwifery Today

  • 05-31-2009 10:26 AM In reply to

    Re: I need vba2c advice

    Jessica, I'm beginning to believe that the Boston Women's Health Collective is paying you a fee to advertise them and their book so much on here! Wink

    Midwives, any advice for Littlemother? (I remember you from the old forums!!)

    Brlnbabies, Moderator

    Susan
    Moderator

    I get up every morning determined to both change the world and have one hell of a good time. Sometimes this makes planning my day difficult. --E.B. White
  • 05-31-2009 10:46 AM In reply to

    Re: I need vba2c advice

    Brlnbabies:

    Jessica, I'm beginning to believe that the Boston Women's Health Collective is paying you a fee to advertise them and their book so much on here! Wink

    Susan,

    No, they aren't and they are non for profit organzation anyway.  Wish that they can pay me for that because I do need the money.

     

     

  • 05-31-2009 12:11 PM In reply to

    • midwifea
    • Top 10 Contributor
    • Joined on 02-12-2009
    • Kailua Kona, HI
    • Posts 475

    Re: I need vba2c advice

    Littlemother,

    I respectfully disagree with your OB about once a malpositioned babe, it will happen again.....not so, not so.  May I ask why your first birth was a cs? 

    While optimum time space betweeen births after a cs is 2 yrs. for maximum healing of the uterus and surrounding tissue, it is not written in stone. I have done HBAC's at 15 months space interval.

    Is there a midwife you can make an appointment with to sit down and talk to in your area?  You'll will probably not find anyone in the western medical world who will treat you as anything more than a surgical canidate.  Your strength and belief in yourself are what is most needed now.  Visit the ICAN site, read books by Nancy Weiner Cohen,  Enjoy your pregnancy and ask your baby what is the best possible birth for the 2 of you.  Know that the hospital is always there.  Go deep and find what it is you need and seek that out,  Everything is possible.

    Blessings,
    April
    moderator

    "The Voice

    There is a voice inside of you
    That whispers all day long,
    "I feel this is right for me,
    I know that this is wrong."
    No teacher, preacher, parent, friend
    Or wise man can decide
    What's right for you--just listen to
    The voice that speaks inside."
    — Shel Silverstein
  • 05-31-2009 10:10 PM In reply to

    Re: I need vba2c advice

     My first cs was due to failure to progress after induction due to preeclampsia.  I had seven wonderful vbacs between.

     

    My previous two births were homebirths.  My midwife says that by law I cannot have a homebirth after a cesarean.  She also said there was something or other about it being law or nearly law if the next birth is within 18 months.  She will be providing care for us during this pregnancy as long as the dr we end up settling on for our care is okay with that.  Our options are rather limited, however.  I understand why women decide to show up pushing or do unassisted deliveries.  It seems insane to me that I would be sectioned again just because the obs in this area do it that way.  I was told I could labor for awhile if that is what I would prefer.  If I was a more efficient laborer I could just dawdle answering all the questions and then announce that the baby was coming.  Sigh.  I am notorious for start and stop labor and am fearing that even if I am allowed a trial of labor I am a sitting duck for all sorts of reasons why it isn't working and would be best for baby to section.

    Is the pinching pulling pains and the big, lumpy bunch of scar tissue a concern?  Is there anything I can do to help heal as this pregnancy progresses?  I've begun rrl tea.  Anything else?  Would gentle massage of the scar tissue be helpful or not? 

    Thank you!

  • 06-01-2009 2:18 AM In reply to

    Re: I need vba2c advice

    Littlemother, hi!  I can't comment on the "law" side of things (though it sounds off to me - laws are not usually so specific - either the medical practitioner can do homebirths and risks out their own clients as per their experience and insurance or homebirth is illegal - the law rarely tries to medically diagnose and risk out for the medical practitioner!  However perhaps other midwives will know about this and can advise better) but i thought i'd talk about your scar.

    Be clear - it is the UTERINE scar which you risk rupturing during a VBAC, and you cannot feel the uterine scar from the outside.  The scar tissue you are feeling is that of the skin and muscles of the stomach.  It is possible to heal very poorly outside and very soundly inside.  Of course this doesn't mean that the scar on your uterus is perfect - we cannot know that - some places in the world scan their VBAC'ing women at the end of pregnancy and assign risk on the basis of uterine scar thickness.  But the pains and lumpiness associated with your outer scar do not automatically reflect on your uterus and how well it is healed.  Massage often helps the body flatten and smooth scar tissue so it's not a bad idea.  I have read that Bio-oil can help with lumpiness and general appearance, and may also help aid healing and thus ease pulling pains at the scar site.

    As for the comment your doc made about malposition - seriously - he told a woman who'd had NINE babies, ONE of whom was malpositioned that if it happens once it always happens?!  *shaking head*

    Me 32, DH 41, DD 2006, DD 2010, DS 2013
  • 06-01-2009 4:45 AM In reply to

    Re: I need vba2c advice

    Someone correct me if I'm wrong, but I don't think the law is for the mother, it's for the birth attendant.  In other words, the midwife is afraid of losing her license or arrested for going against the standard of care.  She also probably risks losing her back up MD. Correct--yes? no?  Although I wouldn't be surprised if someone who liked to poke into a birthing mother's business, took the mother's plans into their owns hands either, I don't think that it's against the law for the mother to birth as she feels the need but someone might feel it's their duty to set her on what they feel is the straight and narrow path to follow.  It sounds like the MD just doesn't want the hassle so he pulls something he feels will sound plausible and valid out of his nether region located at the back of his body.  It's a dang shame that pregnant women have to hide and sneak around simply trying to get the best birth possible for their baby.  There's so many layers to this, it's mind boggling.

    Susan
    Moderator

    I get up every morning determined to both change the world and have one hell of a good time. Sometimes this makes planning my day difficult. --E.B. White
  • 06-01-2009 6:34 AM In reply to

    Re: I need vba2c advice

     Brinbabies you are exactly right, there are no laws governing specific birthing practices, like attending VBACs.  The laws are against the midwife, especially if she is a direct entry midwife, for practicing midwifery without a license or practicing medicine without a license.  The law only becomes involved if something goes wrong or if someone alerts the law (usually a doctor in the hospital you transferred the patient to.)  I'm licensed in NY and we are bound by our practice agreement with an OB.  Obviously, no OB will "allow" me to attend HBAC or a multitude of other things.  So...I try to stay under the radar and do VBACs, twins, breeches, etc. at home.  To find someone that does "unconventional" births, you will have to search under the radar.  I agree, it's demeaning for women to hide and sneak to get the birth they want.  Years ago on MT forums there was a story about a grandmother talking to her granddaughter in 2050 and she was saying, "Oh, yes, there were midwives in hiding and midwives put in jail at that time. It wasn't always like today, where everyone can choose their birth." 

  • 06-02-2009 9:20 AM In reply to

    Re: I need vba2c advice

     As to my scar...on the outside it has healed beautifully, it is smooth and hard to even locate.  But you can feel that underneath the skin level there is a lot of scar tissue.  It feels like I have a rolled up washcloth somewhere deep inside me along the inside incision area.  I was seeing a pt for prolapse issues (I prolapsed after this past birth, sigh.) and she told me to gently massage it in a star shape to encourage it to break up, I wasn't sure if I should continue that since it has been so long.  Will it make a difference now at 9 months post-partum?

    As to the law...it is a fairly new law here.  My midwife said it was just made, that makes her unable to care for me as a new vbac at home.  She is on probation for something and said that if she wasn't on probation she would care for me, but since she is she doesn't want to take the chance.  After I have proved my new scar and have successfully delivered vaginally she can once again care for me.  I think the new rulings regarding 18 months between cs and vbac are acog guidelines.  Well, I will just have to ride it all out and see how it all eventually comes out in the end.  I will let you know.  Birth is so fascinating and God is so awesomely wise and good, I know that He has it all taken care of.  I just tend to be a control freak. :) 

    Thanks for the info.

  • 06-02-2009 10:58 AM In reply to

    Re: I need vba2c advice

    OK. Help me out here and I'm not intending to offend or be smart ... which is Southernese for wise-a**: How can you "prove" your scar if you can't get anyone to attend you in a VBAC?  Can you go to the hospital to birth?  Didn't the doc say he wouldn't attend a VBAC either?

    Susan
    Moderator

    I get up every morning determined to both change the world and have one hell of a good time. Sometimes this makes planning my day difficult. --E.B. White
  • 06-02-2009 2:09 PM In reply to

    Re: I need vba2c advice

     Sorry, I must not be making myself clear.  My midwife said she cannot care for me with a first vbac after a cs.  She said if I prove my scar by a successful vbac (which would have to under an ob's care and birthing in the hospital) then I could be cared for by her for any subsequent births.  The dr who did my cs, however, is against my doing a vbac, mostly because it would be a vba2c.  There are only two practises in town who make the decision whether a  vbac is allowed a trail or not.  One practise does not allow vba2c at all and the other does so very rarely. 

    The dr's reasonings against me do not make sense to me.  Not only the comment on the malpositioning repeating itself, but what seems so ridiculous to me is that he told me I could wait until I went into labor and even labor for awhile before the section.  It just makes no sense whatsoever then, that they couldn't verify the baby's positioning during labor via us and if baby isn't posterior we could take in from there as long as things progress well and baby is doing well and mommy is doing well.  If the head is in a malposition decels are going to happen and I am positive that I would be on continuous monitoring, so I just don't get it why I would be allowed to get that close and then we section, just in case.  Of course, first I have to receive approval for a trial of labor.  The group of ob's who make that actual decision will not be the ones I go to for care because they don't take my insurance.  I will have to go back to our family docs.  They have to send me to consult at 32 wks for the approval.  I will not know anything until that time.  I would like to do everything that I can to give my uterus what it needs to continue to heal and strengthen it to prepare for a hopeful vbac.  That was mostly what I was asking about.  I probably cluttered it up with the venting about the whole politics regarding vbacs and how unfairly trapped I feel.  It is so very frustrating to be viewed as a quack who is willing to risk her baby's health and safety for an "experience" of homebirth so that they feel they need to protect me from myself and my unwise decisions.  Hopefully I have cleared it up.

  • 06-02-2009 5:16 PM In reply to

    • RobsGirl
    • Top 10 Contributor
    • Joined on 02-04-2009
    • Mid-Hudson Valley, NY
    • Posts 364

    Re: I need vba2c advice

    Hi, Littlemother.  I remember you from the old forums too. Welcome back!!

    Are there any lay midwives in your area?  You might check with homeschooling groups or other natural mothering type groups to see if the mothers there know of any midwives practicing under the radar.  Since they're not particularly interested in being licensed by the state, they probably don't care too much about the picky little laws in effect either and would be a little less biased in their opinion when looking at your history.

    RobsGirl, 31
    Wife of one fabulous guy (34)
    Mommy of 3 awesome boys, ages 11, 8, and 4, and a precious 2 year old daughter.


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