Expert: Catherine Beier MS CBE - 7/24/2008

Question
QUESTION: My husband and I are expecting our fourth child in October.  My three older children have all been delivered via section.  I have had no medical condition during my pregnancies. My first delivery via section was due to fetal distress-I had back labor, offered epidural and complied, later given pitocin, dilated to 10, water was broken, baby's heart dropped after water broken and then again 20 minutes later, hence section.  Second doctor got lazy and assumed CPD, after VBAC request, hence future section and I naively consented. Now may have found doctor willing to allow me to VBAC and at a fork in the road trying to determine the best route.  Can you supply in input to help me make a wise and beneficial decision?

ANSWER: Brook,

From what you've described, it definitely sounds like your c-sections were unnecessary with the first being the result of the typical "cascade of interventions".

If you have found a supportive provider that thinks a VBAC is an option, then I'd stick dearly to that person.  Most providers won't offer a VBAC after more than 2 sections, not necessarily because of risk, but due to liability.

If you choose to VBAC you can always opt for another section if circumstances change.  However, if you plan a c-section, then there's typically no going back.


To learn more about VBAC, visit www.vbacfacts.com - it's a great resource on the safety of VBAC that will help to relieve some of the fears you may have.


I wish you all the best and hope you have a successful VBAC!
Catherine



---------- FOLLOW-UP ----------

QUESTION: Thank you for your input and I have already visited the website you suggested and find it very informative.

Have you heard of women traveling at least 2 hours for a VBAC? The doctor I am pursuing is at least an hour and 50 minutes away with good traffic flow.  I don't have any friends or relatives in his area to stay with towards the end of my pregnancy. Any doctor I try for a VBAC will be about that distance. Distance is obviously a factor should something go wrong. Any suggestions there?

Answer
Brook,

I actually know of a family who temporarily relocated to another state to have a home VBAC - with twins.

You can view the family's story at http://www.givingbirthnaturally.com/natural-childbirth-video.html - it's the last selection on the page.

I also know of a few women who've had a VBAC at home after 2 sections with no complications.  Being in a hospital does not guarantee better outcomes.

Since you don't have any friends/relatives in the area, it might be a bit trickier to manage.  Something you might consider is heading toward that city as soon as you think labor is beginning, but instead of going right to the hospital, check into a hotel instead.  This gives you the advantage of being in the right location but avoiding unnecessary interventions that can cause complications.  You're also close to the hospital in case any complications do arise or you feel that's where you belong.

Alternately, you could also go to the doctor's office or hospital, check your status, and then go to a hotel if things are just getting started.


I hope this helps and good luck!
Catherine