Met with doc about VBAC yesterday..long story!

[BeccaSueCongdon]

Originally Posted by jenner0280 I'm sort of in the same situation as my son was overdue and my doctor told me that I have a decent chance that this one will be late too. I'm wondering if any of you had a doctor tell you when "enough is enough". I saw 42 weeks from a few people. Did anyone's doctor give them a recommended time after 40 weeks that they should schedule a CSection? Is 42 weeks when the baby begins to not thrive from the placenta?

It's not a set date. ACOG makes certain recommendations based on overall statistics. Mostly rates of stillbirth. And individual doctors work from their to develop their own practice protocols. They also have to deal with what insurance companies will and won't reimburse, and what their own malpractice insurance requires of them. They are really limited in what they can "allow," some of them by their own choice/philosophy, and some just by the political climate around vbac.

So when "enough is enough" time really depends on the doctor.

[erin_c_odonnell]

Agree with the aboved- I'd be looking for a new dr. Period.
This was dd2's birth. She was my second vbac and we had just moved to NC where few obs are pro vbac. At 40 weeks the dr told me specifically- you're baby WILL die if you don't do a c/s right now! (Because I'd had a c/s before and because her fluids were 'slightly' low . I left the hospital- just walked out. It was scary and terrifying BUT I think it was the wisest thing I ever did. No she didn't die and yes I had a vbac the 2 days later with a different dr. The dr on-call at the hospital told me something profound- "hospitals are not jails". They can't force you to do ANYTHING.
Like someone else said- how baby comes isn't as important as that they come safely. Just listen to your body and your baby.

[erin_c_odonnell]

Adding- all 4 of my vbac babies got larger. The last was 10lbs 14 oz. he was also 14 days late but we homebirthed and there was no stress from drs rules. Just saying it is possible and still have a healthy vbac.

[nrsenadenos]

So I've done it all:

#1 - spontaneous labor, vaginal birth.
#2 & #3 - induced labor, vaginal birth.
#4 - induced labor, C/S birth
#5 - spontaneous labor, VBAC birth.

It was "my" OB that delivered 2, 3, and 4. (I go to a multi-doctor practice and you get who is there when you go into labor). I would consider him very VBAC friendly and vaginal birth friendly in general. I know he has done breech vaginal birth and twin vaginal births. With #4, the one that did end up in a C/S, we tried everything that he, I, and the midwife down the hall could think of to get the baby out the regular way (his head just would not fit into my pelvis, poor guy was severely bruised and had a ring around his head where he'd gotten stuck). He stayed after to do the C/S himself and made sure that I was extra-stitched for a future vaginal birth. When I got pregnant again, he was the one saying "you can do a VBAC" while I was the one saying "OMG what if this one is bigger and I have another failed delivery?" About the only thing he wouldn't do was induce me - he said the pitocin caused stronger contractions that would increase the risk of rupture. So I had to go into labor on my own and the little booger was 2 days later. He would have allowed me to go to 41 weeks before we started talking about either an induction by rupture of membranes or a repeat C/S.

Your doc does not sound VBAC friendly at all.

[songbird516]

Originally Posted by jenner0280 I'm sort of in the same situation as my son was overdue and my doctor told me that I have a decent chance that this one will be late too. I'm wondering if any of you had a doctor tell you when "enough is enough". I saw 42 weeks from a few people. Did anyone's doctor give them a recommended time after 40 weeks that they should schedule a CSection? Is 42 weeks when the baby begins to not thrive from the placenta?

There is no "date" that the placenta starts to shut down in every woman. Almost always the baby is born before then, maybe even for that reason. My second was born at 42.5 according to LMP, but since I ovulate later CD 14, I was really 41 weeks. Even then he was little and looked like a 38 weeker. My placenta was very healthy, even better looking than the first born at 40 or 41.5 weeks. Babies know when to be born, generally speaking.

[ktgrok]

Whoa...you do NOT have a 50/50 chance of rupture! That's CRAZY! It's less than 1 percent, and only a small fraction of those that do rupture have any long term complications. Secondly, VBAC is much safer for YOU than a c-section. Your risk of death goes up by 400 percent if you have a repeat c-section. Bet the doctor didn't mention that! Finally, there is NO evidence that VBAC risks go up after 40 weeks, so your doctor has no reason to insist you go into labor by then. ZERO evidence. Ask him for studies. Show him that his own governing organization, the American College of Obstetrics and Gynocology does NOT support his "rules'. Finally, YOU are in charge. You are PAYING him to do a service and YOU are the boss. If you don't want a repeat than don't schedule one. Or schedule it and don't show up. I've had 2 VBAC's, one was 9lbs and the other was 10lbs 2oz, both born at home with no complications. My c-section was for a 7lb 13oz baby that got stuck, and I was told he was too big. Obviously not! Do you have a local ICAN group? Talk to them ASAP. Do you have a doula? Get one! And switch doctors if you can find a more VBAC supportive one. There is NO reason for you to schedule a c-section!

[ktgrok]

Oh, and both my VBACs were at 41 weeks 5 days. That means if I'd had your doctor I would have had two unneeded surgeries, greatly increasing my risks. Bullcrap. My friend had her VBAC at almost 43 weeks, they just checked regularly with biophysical profiles.

[mibarra]

VBAC here. Chance of uterine rupture was less than 1% according to my doc. Wanted me in the hospital just in case. Uterine rupture can be extremely dangerous for mama and baby. He also didn't want me going late (past 40 weeks). I had started softening and dilating at 39 so I agreed to stripping my membranes. Went into labor 12 hours later. Vaginally birthed DD2 after another 12 (with an epidural I gladly consented to). DD3 will be vaginal barring complications.

However, my C/S was not due to failure to progress, fetal distress, etc, but a very pregnancy specific issue that did not occur again. It's possible to have a repeat of the issue that caused your first C/S. Good luck!

[Harmony96]

Originally Posted by jenner0280 I'm sort of in the same situation as my son was overdue and my doctor told me that I have a decent chance that this one will be late too. I'm wondering if any of you had a doctor tell you when "enough is enough". I saw 42 weeks from a few people. Did anyone's doctor give them a recommended time after 40 weeks that they should schedule a CSection? Is 42 weeks when the baby begins to not thrive from the placenta?

My OB scheduled me for a NST and U/S (to measure the fluid) at 41 weeks and then was going to talk about induction at 42 weeks. I had my baby (VBAC) at 40+4 so I didn't make it to either appointment.

[Karenact]

Check out ICAN which is a pro vbac group. I had a successful VBAC with my 4th child after delivering my first two vaginally and third was an emergency c section due to a cord prolapse. I was scared and during the whole process they kept offering me to schedule a section, even while I was laboring. I ended up having a posterior baby which is wy I labored for 18 1/2 hours. This time around I have really educated myself surrounded myself with people I trust and also put myself in a situation where I won't be bullied or pressured into meds/section. A uterine rupture is not just a uterus that bursts open but if they do a section in the end and they see a tear in the uterus anywhere that is also charted as a rupture so though the risk is 1 in 100 even some women without having a prior section can tear on the exterior of the uterus and be charted as a rupture if they ended up with a section.
Pray about it, that gave me the peace to know I was doing the right thing. No one has to live with your decision except you but do know that because of liabilities and what not, they will mke you sign away your life and possibly scare you into a c section. I would also look for a doctor who is pro vbac!
Just my opinion.
Best of luck,
Karen