For those who have had VBAC

I was given a consent form to sign at my last Drs appointment, basically its homework to go over and then at my appointment next week I am supposed to ask any questions that I might have. So, my question to you ladies is, what questions should I ask?

 

Hmm... I'm right there with you except I don't have that form yet!!! I'll be paying close attention to this thread! Anyone?

 

I had a Vbac. My main question was finding a doc who would allow me one. I know my dh was concerned how many they had performed, how long they would let me labor before deciding on a c/s, will they allow you to go into labor on your own or will you be induced, at what point will they induce and why. I am sure you will come up with other questions as you go to. I do have to say that Mollys birth was AMAZING, I would do it again in a heart beat! If you have any questions at all please don't hesitate to PM me, I love to talk!!!!

 

I had a VBAC with my daughter and hope to have another one this time...and it was AMAZING!! As for questions my big concerns were induction (when, why and what used), how long can I labor, and at what point will they say uncle. I did have a lot of bleeding after my daughter so this time I am making sure I am at a hosp that can handle crisis (ie. have a 24 hour OR staff, NICU and ICU for me God forbib) last time baby and I would have been transferred to different hospitals..that being said, don't let them scare you off...if you read that "permission slip" closely you will see there is less risk to a VBAC than a repeat C-sec...the big difference that I saw is that in the RARE chance of uterine rupture...it's a higher chance of poor outcome with VBAC...beacause you are not in the OR already where they have the equipment to fix that quicker...most OBs who will do them, believe strongly in them and as long as you go into it with an open mind knowing the most important thing is that baby and Mom end up healthy...then I think you will have a WONDERFUL experience! Good luck!

 

I just had a VBAC 2 months ago and all went well. Another question you might want to ask is will they let you go past your due date. Not all Dr's will allow you to go past your due date.

 

#1 question...will you let me go past my due date if everything looks fine with the baby. If they say "no" It's a HUGE red flag that they aren't really pro-vbac. There is no evidence whatsoever that going past your due date or having a larger baby increases your risk for uterine rupture. However there IS evidence that induction methods DO increase your chance for uterine rupture.
#2 if your due date rolls around and you are now 41 weeks pg and they want to get things going what are their conditions??... do you have to be dialated already (this is a good thing...b/c cervical ripening agents are a HUGE no-no for vbac patients...they increase the chance of rupture more than any other intervention.) So if a doc says, we'll induce or get things going if you are 3cm dilated or better, then that is a good answer. There are a few natural techniques they could try, like stripping your membranes which are okay if you are not already dilated...but most docs don't start pitocin until you are a little dilated on your own. Keep in mind that any induction actually has a 47% chance of winding up as a c/s...this is for vbac patients and non-vbac patients. So that should weigh into your decision as to whether or not it's worth it to induce after 41 weeks... If it's a coin flip that you'll wind up with a c/s anyway, is it worth it to go through an induction that might put you at a higher risk for uterine rupture than a spontaneous onset of labor vbac.

#3 if you decide to get an epidural will they augment your labor.... do they treat you as any other patient or do they try to use the least amount of pitocin as possible. this is somewhat important b/c you want to make sure your doctor isn't going to rev you up on pitocin. Most pro-vbac docs are pro-vbac b/c they've seen many, many safe vbacs done....and the reason they've seen so many safe vbacs is b/c they are very conservative about taking a more natural/no-intervention policy. Docs who are really big into induction for non-vbac patients also tend to be very anti-vbac....mainly b/c their "standard" method of care is really, really bad news for vbac patients. The reason why we have such a vbac scare these days is b/c of all the inductions done on vbacs in the 90s that led to bad things happening...particularly inductions done with cytotec. (that drug is almost never used anymore for vbac patients...I would classify it as criminal to use on a vbac patient b/c it can increase your rupture rate up to 10%!)

#4. Will you be required to have constant external monitoring...will there be times when you can come off the machine. Continuous external monitoring is actually a pretty good idea. But you want to make sure that they will be flexible in early labor. My hospitals policy on that was pretty much to just keep sending me home. As long as I could labor at home they didn't need to deal with the fact that I was in the hospital and not on a monitor...if that makes any sense. Once I was in the hospital I was on the monitor all the time except for potty breaks... but I could still stand by my bed... find out if you are allowed to labor in different positions (assuming you have no epidural of course) so long as the monitor is still working properly. Some hospitals have portable units that allow you to walk around wireless....

I would also just discuss how you feel about other things regarding labor as well... how do you feel about episiotomy...make sure it's not standard treatment...some docs like to do it more than others. I was really against it...unfortunately I got a doctor who was for it...and when you are in the delivery room it's not a place to be negotiating.

 

Thanks ladies, you have been a great help I am actually looking forward to my next appointment.