Tuesday, March 4, 2008

Why VBAC?

If you're out there and still reading, Liza (who commented on my last post - yay comments!), I'm sorry for being such a loser and not updating my blog. I'm about to write a post about just that. In the mean time, I'll answer your questions.

Re: *knowing* you found the right midwife - I thought I had the right one the first time, too. Turns out she was way too afraid of the OBs at the hospital. She would've shaved me and prepped me for surgery herself if she thought it would make them happy.

Before getting pregnant, I studied VBACs. Seriously. I lived on the ICAN yahoo group and read the research. I learned how to use PubMed so I could find studies/evidence on my own.

Then, I went looking for a midwife. I interviewed 4 and all gave me the feeling that I would end up in the hospital (and probably not progressing due to the stressful environment). They were afraid of failure more than I was. When I met my current midwife, she listened to my story and said, "Oh! So you'll be just like a first time mom giving birth!" That was all I needed to hear. No trying to convince me that I'd end up with high blood pressure again. No telling me that she doesn't attend HBACs because "HBAC moms don't go to the hospital when the midwife tells them to" (all real life things I got from one midwife I interviewed). I grilled her and made sure she knew I'd done my homework. We spent a good 30 minutes after my appointment discussing why the c/s rate is so high in our city.

So, that's how I knew. I also kept/am keeping an open mind. I can change providers at will if I get uncomfortable with her for any reason. I suspect this won't happen because we've already had several frank and honest discussions. I showed her my cards and she showed me hers. Time will tell if we're the right pair.

Now, as for scheduling at 39 weeks. *Most* women will not go into labour on their own by 39 weeks. Often, I've heard of providers telling women they can VBAC as long as they go into labour by their due date (40 weeks). Gee, uh, thanks. I don't have the study to hand, but I do recall reading that most Caucasian women gestate beyond 40 weeks. It's known on the ICAN list as "the old bait and switch". Doc says, "Sure you can have a VBAC! I love VBACs! Then, at 36 weeks, Doc says, "Baby's getting awfully big. You better have an ultrasound before we let you grow this monster any bigger. You better go into labour soon, or baby just won't fit." Then, at 37 weeks, we should use pelvimetry (see ICAN website on CPD for references to why pelvimetry is complete bullshit) to see if your pelvis is big enough."

Bait and switch. Mom ends up with a c/s unless she has some major guts and can outrun this knife-wielding, fear-mongering physician.

But, this doesn't answer your question. Why schedule? Why not wait for labour if you're bound and determined to have a c/s? Baby will be more likely to be fully developed (i.e. lungs will function properly) and there's evidence, I believe, that shows that the oxytocin mom and baby share during labour provide some benefits after birth (you'd have to address that question specifically to the ICAN list).

Why 39 weeks? Are they afraid you'll explode if you gestate to, say, 40 weeks and 5 days?

Ok, I'm one person trying to represent the thousands of women on the ICAN list. I recommend you post your two questions (or at least the one about why 39 weeks?) to the list and watch the replies flood in. Go to Yahoo Groups and search for ICAN. Subscribe. It's like entering a whole other world where the birth process is celebrated - not feared.

My wish for you, dear Liza, dear Liza? That you change midwives - fast. FTP is no reason not to VBAC. There's a TON of preparation you can do to make sure your baby is in the right position, that your uterus is toned, and that you're limber and can move into different positions easily. Beyond that, I wish for you that you will go on to experience a glorious birth in spite of all the naysaying you've heard expressed by your care providers. You CAN do it!

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