Thursday, June 18, 2009

Increase your VBAC chance--Decrease Cesareans

Even though about 80% of women have successful VBACs I think it is important to be proactive to help increase your chance for VBAC and decrease your chance for a repeat c-section. We shouldn't just sit back and hope for the best, but seek out ways to improve our chances and be prepared.

I think the most important way to increase your chance for a successful VBAC is to find a doctor or midwife that 100% supports and encourages your decision. They should be offering advice on how to be successful and not focus on what would cause you to not be successful. Some doctors might be tolerant of your decision or say "well, you can try" while others help you realize that you can do it! Those that are "tolerant" are usually either looking for reasons/excuses to end up with a c-section or if anything seems at all "abnormal" might just end up saying you need to have the c-section. I have even heard of some that seem supportive, only in the last couple weeks of pregnancy totally change their tune and recommend a c-section. When that happens many women feel it is too late to change doctors so end up with the c-section they were trying to avoid and often times was not necessary. It is important to take the time to interview a few different people and to ask the right questions so you can really see what their philosophy is. Don't just end up with someone because you used them before or your sister/friend uses them and says they are good, or they are the closest, etc. To increase your chances it is necessary to find just the right person. I highly recommend midwives but also know there are some great very pro-VBAC doctors as well. You might even consider hiring a doula to help and support you through your delivery.

In my research I found these other tips to also better your chances of having a successful VBAC.

  • Wait at least 9 months before trying to conceive again, even longer is better: I think I was actually told wait a year before trying to get pregnant again while others say even 18 months. I know the longer you wait allows your scar to heal better and become stronger, which is what you want to help decrease any chances for problems with the scar that could lead to complications and a c-section.
  • Avoid induction of labor, whenever possible: My research said that induction agents can increase the risk of uterine rupture. Along with that though is that inductions significantly increase the likelihood that you will end up with a c-section---this is true in any vaginal birth, not just VBAC. Because you don't want to be induced you need to find someone who will not pressure you to be induced due to being "overdue" or for having a "big baby". If for some necessary medical reason you need to have labor induced you should avoid the cervical ripening agents such as prostaglandin found in Prepidil, Cervidil, Cytotec.
  • Avoid use of synthetic oxytocin (Pitocin or "Pit") early in labor:
  • Avoid interventions: Some of these were listed above but the more interventions that happen during any birth have greater likelihood for ending up with a c-section.
  • Wait until your cervix is beginning to open to be admitted: You are less likely to have a VBAC if you are admitted before your contractions are well-established. If you go to the hospital before labor is under way the more interventions are usually pushed on you as well. Also some hospitals have time limits for how long they allow VBACers to labor.
  • Avoid epidurals and spinals: A common side effect of these pain relievers is that they slow down the baby's heart rate. This is also a symptom of uterine rupture so even though it most likely would be the side effect of the drug most doctors would push for a c-section whenever the heart rate drops even when they are unsure of the cause. I had my baby naturally and there are many techniques, positions, etc. that can ease the pain. I will talk more about these in another post.
  • Work on a healthy diet and exercise: The stronger our body is will help during the hard work of delivery. I already talked about the diet changes my midwives suggested but I will list them again: going off sugar, limiting wheat and carbs, no milk, lots of protein, taking magnesium.
  • Healthy mental well-being: Take the time to process and work through whatever emotions you went through after your c-section. Don't ignore or suppress them. Visualize the whole labor, pushing, and delivery with the beautiful outcome of a precious baby and a successful VBAC. Positive outlook can do wonders for the mind and body.

21 comments:

  1. Thanks for putting all this information together. I had an emergency c-section with my first baby because she was breech and I had hired a doula and was prepared to have a natural birth. My doula did suggest researching birthing a breech baby but when the choice came I decided it would be safer to have a c-section than deliver a breech baby considering it was my first and my baby wasn't putting enough pressure on my cervix to dilate.

    I have been looking into a VBAC because I did feel pretty emotional/depressed about not having a vaginal birth. The information you have posted is great.

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  2. Welcome Sandy! How did you find my blog? I'm so glad you did. Thank you for writing a comment and for your encouraging words about my blog. I'm so glad you are interested in a VBAC. If there is anything I can help with let me know. I wish you the best!

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  3. Thank you so much for sharing your blog site with me!! I am due on Monday and haven't even started to dialate and my doctor told me if she hasn't arrived on her own by the 16th he wanted to do a c-section. Now that I have read your blog I will refuse to allow that to happen. I feel there is a reason that she has not came yet and I can't believe they want to take her when I will only be 3 days over due!!! The only thing he stresses to me are the dangers of the VBAC he never mentioned the dangers of a repeat c-section nor that the chances of death are higher with a repeat c-section. I am so thankful for the information that you and others shared on your blog site and I am half tempted to print it and the resources sites and take them with me to the doctor on the 16th. Again thank you so much for your information!!!!!! My doctor was somewhat supportive of my atempt at a VBAC until about 4 weeks ago then he became all about a c-section and I hate that it is to late for me to find another doctor.

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  4. I am here so long after you first posted this but THANK YOU for putting this together like this! I've had a bit of a tough road with pregnancies, (6 total, 1 live birth) but the one child we have was born due to a completely unnecessary c-section. I was admitted and induced out of fear...they scared me into believing it was the only way. After almost 30 hours of drug-free labor in which I wasn't allowed to leave my bed (!), the doctor told me I had a fever and the baby had a fever and both of us could die (true, but a little dramatic if you ask me!). He told us it was time for a c-section, so we believed it and did it. I believe that the induction was the cause...my cervix wasn't favorable and my body wasn't ready for labor. Anyway, thankfully we have a beautiful son as a result of that painful story.

    However, now here I am almost 5 years later...5 children who have been lost to miscarriage and pre-term labor, and at least 3 years during which we weren't able to conceive (the most recent stretch is from January 2010 until now...can't seem to get pregnant again!) and I can't help but wonder if that c-section might be part of all of it. When we get pregnant again (I'm hopeful!), I WILL have a VBAC, and I have told my husband numerous times that I believe the key is finding the doctor who will support our decision. I have done extensive research on VBACs but having your blog to see it all in one place...GREAT JOB! Thanks so much!

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  5. Wow Sandy thank you for sharing your story...you have been through so much! I'm glad you have found my blog a little helpful. I totally agree that finding the right, supportive doctor is the first main step. I wish you the best with having another child and I would love to hear from you again.

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  6. Thank you so much for providing such valuable vbac info.....I had a c section with my first because she was breech. With my second pregnancy I had twins and although my doc says shes pro vbac, she told me that because I was having twins, my uterus would be stretched and more apt to rupture. I ended up going into perterm labor at 351/2 weeks and although I was already dilating and both babies were head down, they took me straight to surgery. I'm planning to have one more but have been really depressed about missing the whole experience of a vaginal birth so I began researching vba2c. I found a practice that will support it but will not actually see the doctor until I'm pregnant. Good luck to the rest of you ladies in getting your vbac experience!!

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  7. Great information! I just found out I'm pregnant with my third and plan on going for a VBAC2. Emergency C-Sections with my first two girls. I googled "How to better your chances at a successful VBAC" and that's how I found your blog. I especially like the advice about waiting until your cervix is starting to open before going to the hospital. No reason to be hasty.

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    1. Congrats Julie! I'm glad you found my blog. I would love to hear your story too and wish you the best through your VBAC journey.

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  8. Great information. I also had an "emergency" c-section after being induced. I hadn't done enough research beforehand and I wish I had! I went to 6cm without anything and then got the epi along with having the pit after 26hrs and 3hrs of pushing the dr whom I had never met told me I had to have a c-section. I delivered a healthy 10lb 8oz 22 1/2in baby boy! :0)
    We are planning on having another baby in about a year. That will have given me 2 years to fully heal.
    If you have any more information for us cs momma's please post!

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  9. Monica congrats on your big baby boy! When did you have him? I'm sorry your birth didn't end up as planned. That is great that you are giving your body time to heal. You can also use that time to research and read up so you will be more informed of your choices and get prepared for a VBAC if that is what you want. I hope to continue posting, I have been so bad lately but really want to get back into writing. If you ever have any questions or any specific subjects you want me to address feel free to let me know.

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  10. I would first like to thank you; we've been trying for over a year and a half to get pregnant again. We are! Our first labor (09) wasn't anything like I expected or wanted. I had to be induced after three days of my water breaking... Labor stopped after my son and I couldn't tolerate the spinal. So I now know what I want and don’t want, it’s nice to see there is an outlet where you can find people who relate to your situation and have come out of it successful. I feel vindicated that I can do this and I have found a wonderful doctor who is going on this journey with me. I hope to see more writing from you! I really do appreciate what you do and you have really helped me greatly. Thank you, Courtney

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    1. Hi Courtney and welcome! I'm glad you found my blog. Congrats on your pregnancy, how exciting! That is fantastic that you have found a wonderful doctor. I really think that is key to have a doctor who is so supportive, and unfortunately sometimes that is hard to find. Thank you for your nice comments and I really hope to get back to blogging. When are you due? If you ever feel like sharing your c-section story or your current pregnancy story further I would love it. Best wishes to you!

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  11. Just googled and found this! Great info...but why no milk? Just wondering :)

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  12. Thank you so much for this blog! My daughter was in the frank breech position and refused to turn so I was required to have a c-section ( I would not let them try to turn her and risk hurting her) . However, I feel like I missed so much because I didn't even get to hold her until she was an hour old. She is now 18 months old and my husband and I are discussing trying for another. We have discussed waiting until I'm healthy and in great shape before we start trying and now I know its essential to do that. We're hoping when we do have another that I can have a water birth. I would really like to be fully aware of what's going on. Thank you for all the advice.

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    1. I would love to hear back from you when you are pregnant. Let me know if you have any questions. I would also suggest even now to find a local ICAN group. It is great to get support from other ladies who have been there.

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  13. I live in the country and the nearest hospital is an hour away that will do VBACs, but because it is so important to me I've committed to driving an hr for each of my appointments. Luckily my boss if supportive of my decision and willing to work around this. I just hope that I am successfull, I'll take any tips I can get! I'm due May 2, 2013 so I still have a long way to go but I figured the sooner I start preparing the better. There are also a lot of books out regarding VBACs and I'm ording my copies today. Good luck everyone!

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    1. So glad you found this blog and congrats! I know many people who traveled an hour or even further to get to a supportive hospital for their VBAC. I definitely think the commitment is worth it. Not sure where you live but I would also suggest finding a local ICAN group. They are a wonderful support group. I would love to hear how your birth goes and wish you the best!

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  14. I am so glad I found your blog. I was searching google for Vbac information and found this. I am due March. 2013 and tomorrow is when I have my midpoint u/s and I want to discuss a vbac with my doctor. He brought it up last appt but then backpedaled and said maybe I am not an ideal candidate. I have had 2 previous csections and a Tubal reversal. My first the placenta was torn and my blood pressure skyrocketed. The second one she stopped growing at the end and right before surgery my blood pressure jumped too.
    I am only 28, no medical issues, eat healthy, active, low bmi, low weight and I usually have low blood pressure. I so want to try. This doctor did approve me for my Tubal reversal which is a plus since my last obgyn suggested I have the Tubal with my track record, so I am keeping my fingers crossed.

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  15. This is Arshiya from India, My doctor has cheated me. this was my first pregnancy and I used to go for regular check ups and everything was normal. When I was about to complete 38 weeks my doctor told me that my baby is overweight and can't be delivered vaginally if we wait for few more weeks so she told me to get admitted into the hospital the next day and she said they have to induce labor artificially. I got myself admitted into the hospital, They kept 1/2 pill in my vagina for 10 minutes and then they gave me some injections and after sometime they performed some test and told my family that my baby's heart beat is falling and they have to perform immediate c section else the baby and my life will be in danger. Finally my baby weighed only 3.2kgs, he was not at all overweight. So, my first baby was born through c section, I want to go for VBAC for my next delivery. I feel so upset whenever I think about this incidence and I blame myself for blindly trusting the doctor. I pray to Holy Christ to teach such doctors a lesson so they are afraid to cheat their patients. I want to advise all the readers not to fall in such trap. I am preparing my body for VBAC, its been 7 months since the birth of my first child and m not pregnant yet, i want to wait for atleast 3 years.

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  16. With my first I had an emergency c-section. I was scared at the time, and at 41.5 weeks, I blindly trusted my doctor. At the moment it was awesome, I mean, after waiting for so long, I had her in an instant after they told me. But with time, it got rough. When I was pregnant I would dream almost every night that I was in labor. Maybe I watched a lot of movies, who knows, but I felt like I missed out on something I have been looking forward to my whole life.
    When my daughter turns three, my son will be born (7/2013). A Dr kind of scared me from having a VBAC, but reading has made me feel better. Thank you for all the information you put here! It is giving me confidence, and I will talk to my midwife, who I know is pro VBACS. I had to talk to this dr mainly for liability purposes, I am glad she is not my doctor! Changing now would give me little time.

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  17. My first daughter was born via emergency c-section. I was six days from my due date, not dilated at all and my cervix was so high and tight it felt like the doctor was sticking his whole arm up me feeling for it. I'd had pre-eclampsia for weeks and they had to let it progress to an alarming state. My blood pressure was dangerously high. To make matters worse regular ultrasounds had been mapping my unborn daughter's growth and were showing that she was losing weight in my womb! The amniotic fluid was dropping with every visit. I was admitted to the hospital under the guise of being induced but shortly after settling in the doctor came in and basically told me if he induced me my daughter would die and so would I. My c-section was unexpected and frightening. I dealt with the awful pain of c-section recovery along with the emotional let-down. I felt inadequate and like I was to blame. I didn't even feel like a real woman.

    Unexpectedly, we're pregnant again...six months after my daughter's birth. I returned to my previous doctor but I've not seen him yet, only a PA under him who told me my chances of VBAC are slim. In two weeks I go in for an exam and to talk about birth options. How can I plead my case to him and increase my chance of him agreeing to allowing me to at least attempt to deliver this baby naturally?

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