VBAC questions - several

[Mamatoabunch]

1. I have bigger babies too. I have had 9 VBACs, all at home, 4 of those over 9lbs, one over 10lbs. I don't deal in risks so I never have it a thought, I figured my body knew what to do and grow the baby I could birth.

2. You can absolutely request your records. I never worried about acreta.

3. and 4. I never dealt w/ at home.

[babybean#5]

Wow Mama! You are a birth warrior! I'm going to have my 4th homebirth and 2nd Hbac in December. My babies are big, too. My last baby was 10.4. I had no problems hbacing a 10 pound baby last time, and I don't anticipate any problems this go round either.

Originally Posted by Mamatoabunch 1. I have bigger babies too. I have had 9 VBACs, all at home, 4 of those over 9lbs, one over 10lbs. I don't deal in risks so I never have it a thought, I figured my body knew what to do and grow the baby I could birth. 2. You can absolutely request your records. I never worried about acreta. 3. and 4. I never dealt w/ at home.

[meesh38]

About the size of the baby question, I just had a VBAC of twins a few months ago and my doctor said the odds of a rupture increased a little bit because it was twins (I'm assuming because of the over-stretched uterus?) I think I was increased even more because I was induced with pitocin. I didn't ask about specific percentages. My doctor was very pro-VBAC but said they wouldn't tolerate any signs of distress like they might if it was a non-vbac birth. I felt very comfortable with the process, at my hospital VBACs are given the labor room right next to the OR just in case, and i had continuous monitoring. I had an epidural very early on in the labor process and I knew they could get the babies out so fast if they needed to.

[tinams8]

You need to bring these questions to your doctor and have a good long talk to find out exactly what the "rules" are in your hospital. And you can find out about the scars and ask about your specific level of risk.

The only other thing I can add is I opted for a hep lock instead of an IV so I had a little bit more mobility, but it was required to have one or the other during a VBAC. And yes, you can request your records and it often takes some work so get going on it if you want them. Here the doctor doesn't even have them, the hospital does. Which makes no sense to me.

[oddduck]

1) I personally don't know. My VBAC was almost 3lbs heavier then my c-sction.

2) Yes, you can request a copy of the medical records. Even if it was only a single closure -- the risk of rupture isn't huge, I'd feel comfortable vbac-ing with either. A double closure is the standard closure here.

3) It would depend on how quickly you need a c-section. If it's a matter of life and death within minutes, they'll knock you out. If it's the "things just aren't progressing well, HR's aren't great, you've been pushing for hours, etc" -- they will normally give you a spinal for a c-section.

4) With my hospital vbac, I was GBS+ and had a line. The MW group strongly recommended at least a "I can't remember the name, but basically a line without any thing attached to it" -- just to make things a bit easier. Being GBS+ made it an easy decision for me.

Both my primary, secondary and backup MW were not able to attend my birth (long story) -- I had a group of MWs I hadn't met show up. Monitors went on once things started to pick up. They hospital gives them some trouble if they don't have at least some data being sent in. I didn't wear then during transition (as I was sitting on the toilet) -- MW would came and did external monitoring every 15 minutes or so.

I showered and stuff a few minutes after the birth with the IV in (it just sat it on the vanity). I had no issues moving around, sitting on the ball, leaning over the back of the bed.

[Riverdavidsmama]

Originally Posted by tinams8 You need to bring these questions to your doctor and have a good long talk to find out exactly what the "rules" are in your hospital. And you can find out about the scars and ask about your specific level of risk. The only other thing I can add is I opted for a hep lock instead of an IV so I had a little bit more mobility, but it was required to have one or the other during a VBAC. And yes, you can request your records and it often takes some work so get going on it if you want them. Here the doctor doesn't even have them, the hospital does. Which makes no sense to me.

Thanks! Hep lock is a great idea.

Originally Posted by oddduck 1) I personally don't know. My VBAC was almost 3lbs heavier then my c-sction. 2) Yes, you can request a copy of the medical records. Even if it was only a single closure -- the risk of rupture isn't huge, I'd feel comfortable vbac-ing with either. A double closure is the standard closure here. 3) It would depend on how quickly you need a c-section. If it's a matter of life and death within minutes, they'll knock you out. If it's the "things just aren't progressing well, HR's aren't great, you've been pushing for hours, etc" -- they will normally give you a spinal for a c-section. 4) With my hospital vbac, I was GBS+ and had a line. The MW group strongly recommended at least a "I can't remember the name, but basically a line without any thing attached to it" -- just to make things a bit easier. Being GBS+ made it an easy decision for me. Both my primary, secondary and backup MW were not able to attend my birth (long story) -- I had a group of MWs I hadn't met show up. Monitors went on once things started to pick up. They hospital gives them some trouble if they don't have at least some data being sent in. I didn't wear then during transition (as I was sitting on the toilet) -- MW would came and did external monitoring every 15 minutes or so. I showered and stuff a few minutes after the birth with the IV in (it just sat it on the vanity). I had no issues moving around, sitting on the ball, leaning over the back of the bed.

That is so great. I'm thinking you also had a hemlock then? I'm find with being monitored...can you eat and drink normally?

My doc confirmed that mostly constant monitoring with 15 minute breaks would be fine. I forgot to ask about a line.

[Harmony96]

Originally Posted by Riverdavidsmama I have a very ugly overgrown (and itchy, painful) scar from my c-section. How do I know it's not placenta acreta or whatever? I requested a double-layer closure - but I know they didn't let the cord stop pulsing. How do I know they did what I asked? Could I request the medical records?

Just to echo other posters, you can't tell accretia from the outside, and you can request your records. You'll specifically ask for the operative report.

I am planning a natural labor and delivery and have a doula hired who is a labor/delivery RN at the hospital I'm delivering at (also will be a certified midwife in August). But an anesthesiologist at my church today said they will have to knock me out if I rupture or need a c-section. Is that true? I was thinking that in the case that I needed one, it would be a discussion and there would be time to get the epidural/spinal for the c-section. If that isn't the case, shouldn't I get the epidural just to make sure I can be awake when baby is born?

My c-section was a true emergency. My placenta completely abrupted. From the time they said "c-section" until DS2 was born was just three minutes. I was under general anesthesia. I was given an inhaled anesthetic and then later intubated once I was under, where they apparently continued to provide me gas? Then when the extubated me, I woke up after that.

I doubt that they will let your baby come to the PACU (post-anesthesia care unit). I couldn't sit up w/o the help of the bed's motor for several days. My c-section was just before 8:00 in the morning, and midnight that next night, I lifted the bed slightly, then used my arms to pull myself up to a sitting position, and dangled my legs over the bed. I might have stood up briefly at that time, too. I can't remember. But it was HARD and took a long time. Having had no epidural meant that I didn't have that sort of pain relief available in recovery and instead had to rely just on a PCA morphine pump (which felt like it didn't do anything for me).

Will they make me have a line for fluids, be hooked up to monitors, etc., even if I DON'T get the epidural? That would serisouly suck. And make it way harder to get through labor naturally.

Yes, yes, yes. I am planning a homebirth for my VBAC, though.

[mulherin]

I've had two VBACs, (expecting a third in September) and my last one was 8lb 9oz, my biggest so far. My first VBAC baby was 7lb 7oz. My smallest baby (5lb 10oz) was my c-section. Personally, I wouldn't consider 9lbs an overly large baby. Bigger than average, but not huge.

Also, you can request to just have a hep-loc. That way, you can easily be hooked up to an IV in case of an emergency, but don't have to be tied to anything during a normal labor and delivery.

Good luck with your VBAC!

[Riverdavidsmama]

I will do that. thanks!

[Mom2jandb]

I can comment on 3. For my vbac, which I attempted to do natural, my doc recommended I do an IV in case they needed to emergency knock me out. So no epidural required.