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VBAC Success Tips and Specialists on Mornington Peninsula
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Posted 03 November 2017 - 09:26 AM
Im new to this so I apologise if i've posted anything incorrectly.
My son was born in December last year via CS. I was induced one day past his due date due to a reduction in amniotic fluid (which I am a little sceptical about) and from being uncomfortable due to a ligament issue. I went private and the hospital had a long list being that time of year, so we decided to take that time.
My OB decided not to let me go any further over due to the amniotic fluid reduction and we started induction the afternoon of the 9th December 2016. After 3 rounds of Prostin Gel and 36 hours in the birthing suite, I did not go into labour. Dilation was only 2cm and my OB said he "could" have broken my waters, however it would have been a very risky and uncomfortable labour.
To cut a long story short, my beautiful boy was born at 11am on the 11th December. Note:(This was also a Sunday).
The whole experience I thought went down as well as it could and although it was classed as an emergency C section, we had well enough time to prepare for it considering I did not progress into labour. At that time I was just glad, as you always are to have our remarkable little man with us safely and did not think that perhaps things had been rushed and maybe I wasn't given the chances I needed to have him naturally. As first timers, you are so naive to these things and you really don't know any better until after and you start reading and researching and talking to other people.
I wanted a natural birth and had been counting on it, I feel like you know your body and I firmly believe had we have left it a little longer and given him a few days more, perhaps things would have turned out differently. I have been dwelling over this for a while now and have been given alternative information from a Doula who did my placenta encapsulation. She has informed me that the way things were handled, could have been done differently and believes that my body was not ready to give him up.
I have had no prior issues and had a normal pregnancy the whole way through so there was no reason as to why I shouldn't have been able to give birth naturally.
Now that I have been researching and investigating and listening to other people who are experts in the field I have been informed about certain things which could have been done differently and especially the fact that when my son was delivered, I did not get skin to skin contact with him, even though I had stated on my birth plan that I wanted it. (that's another issue in itself). I just assumed this wasn't able to happen because it was a C Section.
So, although the process was as smooth sailing as it could have been, and we were very well looked after by our midwife and the medical team, I am now looking very heavily into researching VBAC specialists and information for my next one. I want the chance to have a natural birth and believe I have that right. I have been told by my OB that there is a very very low chance that I can give birth naturally now, which I don't agree with.
We will be relocating to the Mornington Peninsula early next year and although I am happy to travel if it means allowing me to have a natural birth, I would prefer to know if there are specialists down that way who deliver VBAC's and fully support this with a good success rate?
Does anyone know of any really good VBAC specialists and their success rates down that way? And could you give me any tips if you have had a successful VBAC and how you went about preparing leading up to the birth?
Thanks so much. x
Posted 03 November 2017 - 10:04 AM
The whole post-birth second-guessing is a horrible process, isn't it? I think that generally women aren't given enough information about why certain decisions are made during the later stages of pregnancy and different options during the birth process. It leaves so many of us feeling negative about the way our births were managed and that we weren't really part of the decision-making even if, given all the information, we might have made those same decisions ourselves.
Did you OB give any reason as to why you would be an unsuitable VBAC candidate? Unless the low amniotic fluid issue reoccurs, would there be any reason you couldn't go a week or two over if you go post dates again to see if labour started naturally (therefore giving a better chance of a successful VBAC)?
Would you also be able to see your records and have someone explain the decisions that were made? It might help with getting closure on your first birth.
If you did need another induction I believe there are other options besides the gel (balloon catheter?)
Posted 03 November 2017 - 10:13 AM
Yes it is a hard process. It's one of those things that you don't really settle until you get the answers you're looking for.
I knew in myself that things were handled well under the conditions, however I do also know that I probably could have talked my OB around and perhaps been able to continue going over a week or so if I were monitored each day etc.
He didn't really give much info around VBAC and why he doesn't think. I think he is very pro caesarian now that I have more information and perhaps he doesn't see a good success rate with women who try for VBAC's - again perhaps they're not given the chance.
He did say its just the statistics that say it won't usually happen, however he did say second time when I expressed my need for a try at a natural birth, that he would be supportive of this, given everything goes according to plan. I want to look for a different specialist though whom I know has experience with these and a good success rate.
Regarding the Balloon method, the Doula I spoke to asked about this too and this particular OB doesn't use it. For reasons he probably explained along the time we saw him but I can't remember.
In my particular case, I don't know why either.
It was almost like he had in his head that I was having a C-Section and that was it.
Im sure I could go over the records if I needed to and he'd be happy to sit and talk over with me, but I just really want the chance second time around, which I why I know I need to arm myself with a good team, potentially a midwife or Doula and maybe Acupuncture etc leading up.
Posted 03 November 2017 - 10:20 AM
I was induced at 38w due to reasons associated with me not the baby - the baby was happy to stay in much much longer. Couldn't get the balloon in (believe me they tried), had all the hormones and zero progression. This was public at royal womens. Had an '"unplanned" CS all went well and had a great recovery. I was happy with all the decisions that were made on the day
Now pregnant with number 2 I would prefer a natural birth but after the first CS they will not induce again - from my reading finding an OB that will induce following a CS is not a good find. So at that level you have to be prepared that if for what ever reason you don't go naturally another CS is on the cards. I am back at royal womens because I am very high risk. It seems that even in the public system VBAC is supported it's just that the odds of having a CS second time around are much higher.
Personally I'm at peace with the high probability of another CS as this baby will need to come out between 36-38wks and the odds me going into labor naturally are not high.
Posted 06 November 2017 - 01:36 PM
If anyone knows of any obs on the Mornington Peninsula who support and have a high VBAC success rate. Please PM me as I’m not sure we should list names here.
Posted 06 November 2017 - 02:06 PM
I can't help you finding doctors unless you were interested in Peninsula Private ?
It is very hard for anyone here to comment on whether your treatment was appropriate but if you are unsure yourself it will probably help to actually talk to your doctor or access the notes but making up a diagnosis of low amniotic fluid does seem odd. The very fact that you are unsure is enough reason to get some closure on what happened if possible.
Induction would be the choice for most obstetricians if there does seem to be low AFI and sadly this often will happen before you are ready to labour naturally which you unfortunately found out first hand.
The other thing I'd like to say is that your Doula is not trained to make calls on obstetric care and it is unprofessional of her to insinuate it was the incorrect treatment.
As for obstetricians and C/S versus VBAC. Many have reputations of being VBAC friendly yet do not have stats to say that they are any more VBAC friendly than anyone else so it is difficult to tell. I think the best bet is to chat with a recommended obstetrician and see if you feel they have your best interests at heart...I do think you can 'feel' it if the fit is right.
There is one very famous Melbourne obstetrician who has a reputation for being all about vaginal deliveries but the truth of the matter is that he does the same number of C/S as others.
I have to admit that I've never met an obstetrician who would not prefer a nice normal vaginal delivery over a C/S though.
Posted 06 November 2017 - 02:37 PM
PM me for the name of someone that can deliver at 3 hospitals (including Frankston). I had my boys at the bays. He is very very pro vbac. According to the LC at the hospital if conditions were right within me he would have done some form of induction if I wanted. My issue was/is a likelihood of a small pelvis (a true one not just an excuse consider bubs was average size and the forceps got literally stuck inside me!) and when he said I should probably look at booking a date (but he would support me either way) I did know he wasn't trying to take the easy way. I have meet a number of women who have had successful vb births due to him. And he has advocated for a number to have vbac s.
Edited by Sandra, 06 November 2017 - 06:57 PM.
Posted 06 November 2017 - 02:41 PM
Thanks for your post soontobegran.
Seeing as private hospitals are limited on the peninsula, Peninsula Private will be on my list. It’s more a matter of the ob though and their success and then comes down to where they work out of I suppose.
If you wouldn’t mind letting me know that’d be great.
I think I know the ob your talking about when you say the one who claims they are all ab vaginal deliveries but I don’t think I’m willing to travel that far or potentially pay that rate of fees either. Unless it was a guarantee.
Edited by Angieange, 06 November 2017 - 02:41 PM.
Posted 06 November 2017 - 02:43 PM
Thanks so much for the info MrsLexiK.
He was on my list of obs to investigate but it’s not easy finding vbac info and success rates.
Posted 06 November 2017 - 03:16 PM
Great. Thank you unicycle.
I do know the one you’re referring to with those initials. Thanks for the info, I will steer clear.
Is there a particular reason you mention that? Just doesn’t support or have good vbac success?
Posted 06 November 2017 - 03:28 PM
I can pm if you like. suffice to say that she is the only doctor/ specialist i have ill-regard for. and i am old
eta: i have no idea about her vbac experience
Edited by unicycle, 06 November 2017 - 03:29 PM.
Posted 06 November 2017 - 04:04 PM
I've had two successful vbacs. I don't think there is anything special to do yo be successful except have a care provider who is not rigid in their "rules". My first vbac I negotiated to be able to go 14 days post edd with monitoring after 7 days (it wasn't needed as she was born at 38w6d) My OB was also willing to use balloon induction if needed. I ended up having an epidural and forceps delivery as she turned posterior in labour but it was still an awesome, positive experience.
My second vbac was with a different ob as we had moved state. After my successful first vbac he really didn't have any issues and treated me as he would any second time labouring women. She was born on her edd after a 1hr active labour (5.5 hours from first twinge) drug and intervention free. I did nothing different and if anything was in worse shape physically going in than my first vbac.
Good luck. Even though my c/s was a positive experirnce I would chose a vag birth over it any day.
Edited by liveworkplay, 06 November 2017 - 04:06 PM.
Posted 06 November 2017 - 05:32 PM
Thank you so much for sharing your positive experiences with me liveworkplay. It’s brillaint to hear from someone who has gone through it not once but twice. Really gives me hope.
Posted 06 November 2017 - 06:00 PM
I work in the peninsula. The obs are all great and sensible and emergency caesars are an absolute rarity at the private hospitals - as someone who works in operating theatres, I get a fair sense of it!
I do feel I have to make a comment about the notion that some obs just like caesars. Most obs care about getting babies out alive, and care about supporting mothers to deliver vaginally. Despite the mythology, obs don’t schedule caesars to get to the golf course, nor do they schedule inductions for fun.
There’s lots of old ‘stats’ out there which were pretty inaccurate and biased. Here are the new stats. The rate of late pregnancy loss goes up after 39 weeks. In my first pregnancy 9 years ago my ob said that she wouldn’t consider induction before 40 weeks unless there was something significantly wrong; in my latest pregnancy and delivery 14 months ago, I was offered an induction anytime from 39 weeks if I wanted. Many many private obs now offer that. It is especially prudent when there are potential warning signs like low fluid levels. Just as all of medicine changes, obstetric care is trying to get safer and safer. Your doula is being either ignorant or disingenuous to suggest that there was anything wrong with your previous antenatal care, as it sounds like it is very much in line with good obstetric practice.
Secondly, there is absolutely no difference in intervention rates for induced labour vs spontaneous labour. None at all. The ‘cascade of interventions’ has comprehensively been shown in numerous studies to be an absolute myth. In actual fact, several studies have shown that there is less likelihood of emergency caesars and instrumental delivery in induced or augmented labour.
Finally, I don’t know an ob who won’t offer a VBAC to a patient who is suitable for one. The only people who are denied a VBAC are those who are high risk.
I actually don’t think there is huge variation in obstetric practice in those country. By and large indicidual obs all sit the same exams and follow fairly standard protocols. Obviously there is some judgement and personal preference in there, but there is actually little variation in the management of fairly standard pregnancies and labours. The biggest difference is perhaps for women who have complicated or high risk pregnancies - for those high risk maternal-feral specialists provide care that a standard ob may not, but for an average person with a desire for a VBAC, I don’t think you necessarily need to search for someone who will support that, because they pretty much all will.
Most importantly, you need to like and trust your ob. This is very personal. In your case, since you have lingering doubts about your prior birth, you need to choose someone who you feel communicates well with you. This may not be someone that a friend or colleague or EB member liked or disliked. It will be someone who gels with your needs and personalities.
If you are not yet pregnant, you can schedule an antenatal appointment with a couple obs to have a chat and see what you think. And that way, once you are pregnant you know who will go with.
But the long and short of it is that everyone is likely to support a VBAC and work pretty hard to achieve that - as long as they don’t think there is undue risk to your baby.
Posted 06 November 2017 - 06:46 PM
Ouch, that is expensive to have so many first consultations, but would be nice if you can afford it. It is a pity that the OP hasn't got a network yet on the insular peninsula, because although the training may be the same, the implementation can really vary. Otherwise Rosebud's low-risk maternity would never have needed to close. What a huge loss.
Posted 06 November 2017 - 07:53 PM
There is a big Facebook group called Mornington peninsula mums. This question gets asked a lot. One name gets mentioned the most. One of the main private hospitals for mat is low risk so while an OB may wish to still deliever a vbac the rules may not allow. If the OB can go to both private hospitals that's a bonus. Of course they all have rights at Frankston as well -for me that wasn't an option. The head at Frankston OB is a pro vb /vbac dr who from personal experience has the welfare of mother in mind - not just baby and takes into account psychological stuff. Due to circumstances my OB wasn't able to be there for my firsts births (thanks HELLP!) so I had his side kick. We had some pretty sh*tty traumatic stuff going on -which he was privy to as he was present at the event- he got me into the positive mindset. He listened. He explained options really well.
A pro vbac /vb OB is good if your wish/want/preference is that and things come up. There was 2 times I was offered/asked about csection with my first at the birth. The first was before my ARM (gels got me from not favourable to 3cms over night), the second was before forceps. I wasn't told "I can do it but it will be painful and long" I was told "I believe doing this will allow a vb, if I thought it would end up in a csection I wouldn't offer these options" we were talked through everything with encouragement and positivity. I think mindset is a big thing. My labour should have ended with a vb but in the last bit it didn't and there was a big massive emergency with codes called etc. the pro vbac OB acknowledged the same thing could happen next time. But came up with suggestions which we could do and try to achieve it if I wanted. As it turned out my second son was even bigger, had an unstable lie and DS1 was booked in for surgery a week after my due date. When discussing the main focus wasn't around if the same thing would happen it was around the timeframe of how long would we (I) feel comfortable going over (original plan before DS1's surgery was suddenly a thing which was needed asap was to get to 40 weeks before we even spoke of booking in a csection), OB was fine with that plan still it was more me who was worried I wouldn't be there for DS1. And the main issue for me wasn't whether baby would fit but whether baby would be engaged the right way (generally would flip from transverse to breech to transverse, very rarely was he ever head down).
I agree with the closing of rosebud - it sucks. The peninsula is big, Frankston services the whole peninsula for mat plus the city of Frankston and some of Kingston. I would hate to drive in labour from flinders or Portsea to Frankston.
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