Doc says I must have my vbac in hospital...

[jouli]

I'm aiming for a vbac in feb,when DS 2 will arrive on the scene.However,my doc has remarked that I can't give birth in the birth centre,but must do it in the hospital,under her care,due to my previous CS scar needing to be monitered.She also said I cannot have a water birth for this reason & that I cannot go beyond my due date. I really don't want to be induced,as I had a sweep with DS1,which began a very slow & unproductive labour,ending up with an emergency CS when I was 9cm,after they discovered DS1 was breech.I'm wondering what my rights are....& who has the last say...

They probably have the last say over the birth centre, but you don't have to go to hospital, you can home birth if you want.

They also have the last say on the birthing pool, unless you have one at home.

You have the last say over if/when you are induced - they can only advise.

I would get an appointment to discuss this again - get the doctor to explain their advice and reasoning further, present you with some evidence of the risks etc, so you can make an informed decision.

Ok it sounds like she phrased this badly.

She is advising you to have your baby in hospital.

She cannot insist you have your baby in hospital.

You can still choose a homebirth with a pool if you wanted, or if you wanted the birth centre, ask them. The VBAC greentop guidelines are worth a google, and generally women who have had a section are supposed to be treated the same as any other woman.

But, the birth centre can refuse you. It may be a good idea to have a think about what you want, and have an appointment with a Supervisor of Midwives to discuss how they will support you.

I would also suggest you consider the risks of having a monitored VBAC in hospital. You can accept of decline any constant monitoring they offer of course.

Who gets the last say? You do.

You can decline anything you are not happy to consent to. But they can decline things too - like access to a birth pool, birth centre etc.

The cannot go beyond the due date is really a load of rubbish - generally it is very unwise and risky to induce after a previous CS - the risk of uterine rupture increases hugely. So it would usually be waited for spontaneous labour, and perhaps book a date for repeat CS at 42 week if baby has not arrived.

Have a look at the Yahoo VBAC HBAC list - lots of fab wise women on there who can help you right accurate information.

I'm also due DC2, having VBAC.

The main thing strongly suggested to me was to be monitored during labour due to risk of scar rupture. Although it's fairly rare, if it happens it can be catastrophic for the baby and they have very little time to get baby out safely if it happens. Transfer from a MLU or home may take too long (no guarantees in hospital either-but you play to the odds!) Your decision on this (and you CAN refuse) may depend on how long ago your CS was and how well it healed.

I particularly don't want to be pinned down on my bed with the CTG monitor, and forced to deliver on my back, but my hospital has mobile monitors so I can walk around, change positions and use the pool. For me, that seems to be a reasonable compromise.

As for going overdue, I was not aware that there were any problems going overdue following CS, but that as I'm an old gimmer over 40 I they would have concerns re placenta failure. However consultant agreed that induction would increase the risk of scar rupture so is perfectly happy to monitor every 2-3 days after 40 weeks with scans to check placenta function and DCs growth.

I definitely think you need to question further the reasons for the advice you've been given, as you can only make the right choices for you, if you have the full and correct information regarding risks, available to you.

Good luck!

I'm also having a vbac and I have been given similar advice re. hospital birth, continuous monitoring, birthing pool etc BUT they were very clear that they would not want to artificially induce me due to a slight increase in risk of scar rupture. They will offer increased monitoring to check baby and placenta and any problems they will recommend repeat c/s.

I've agreed to monitoring at the hospital (as I don't mind hospitals) on the proviso I can still stand/move which they've said is fine. I'm also doing natal hypnotherapy as a way to increase my confidence etc. They do a vbac cd which I think will be helpful for me.

Anything that is being 'done' to you - you control. So you can say yes or no to monitoring, or compromise on monitoring when admitted, handheld monitoring etc.
Anything you have to ask for eg birth centre, pool , they can say no to. If you speak to the supervisor of midwoves of head of midwifery, they might be more sympathetic to those requests
I did the first vbac by staying at home til 8cm, and the second as a hbac.

Anything that is being 'done' to you - you control. So you can say yes or no to monitoring, or compromise on monitoring when admitted, handheld monitoring etc.
Anything you have to ask for eg birth centre, pool , they can say no to. If you speak to the supervisor of midwoves of head of midwifery, they might be more sympathetic to those requests
I did the first vbac by staying at home til 8cm, and the second as a hbac.

Ooo mercibucket I'm really interested in your hbac - what made you decide to do that? Did you find you were supported in your choice by friends/family/birth professionals? [sorry to be slightly hijacking thread]

My midwife was supportive but she got a v hard time from her managers and it was not 'allowed' at the time in my area. Sigh. Anyway, I paid no attention to that! I needed to see a consultant to get signed off on the risks etc. I think tbh I was v phobic about hospitals by that stage and just couldn't face going to one again. It all went v well and was straightforward. I've since met a few more women in my area who've done it so they must have got a bit more used to the concept by now. I think overall it was safer than my first vbac which happened an hour after arriving at hospital as I was so worried about interventions etc. I had a lot more midwifery care for the hbac. I actually wonder if there is an equivalent of tokophobia about c sections,as I supect I have it!

FWIW I chose to try for an HBAC rather than have a hospital VBAC, I felt the risks of hospital VBAC were unacceptable(to me) Frequent intermittent monitoring from a MW one to one is at least as safe IMHO as cfm from a machine with random people popping in and out of the room.

I was able to get a pool, be mobile, eat and drink what I wanted, and felt fully supported by the MW looking after me (NHS). I didn't progress and had a non scary transfer in for a repeat CS in the end but no regrets at all - I would have still needed CS if I had tried in hospital too but it would have been a much worse experience over all. Most transfers are not for dire emergencies but boring things like failure to progress or desire for further pain relief, but it is a case of balancing the risks and benefits and choosing which set of risks you are more comfortable with.