I Want to Do a VBAC but Hospital Says No

In my experience if the hospitals policy states 'No VBACs' they will not change that for one person. But, what is your OBGYN's opinion? Is it the hospitals policy or your OBGYN's opinion against it? Does he/she have privelages at another hospital that will allow it? You might want to ask these questions of your OBGYN and then make the decision.

I had my son via emergency C-Section and like you, mine wasn't that bad...but, hospitals/doctors more and more are erring on the side of caution and stirring away from it. Just do some research and call you Insurance Provider and see if they can help you find a hospital that will approve the procedure.

But, make sure you talk to your OBGYN and get the whole story and her professional opinion.

You are going to need to either find another hospital, a birth center, do a home birth, or show up at the hospital pushing. The AMA (American Medical Association) put out guidelines that hospitals must follow in order to allow VBAC's. If they can not meet them, they can not allow them. With that being said, do your research. The risk of uterine rupture is 0.4% with the majority of those being induced with cytotc, a very dangerous drug, not FDA approved for use in pregnant women. You should see the site www.VBACfacts.com for information. Click on California and look down the page and you will find the list of c-section rates for every hospital in California as well as their VBAC rates for 2006. Unfortunately, even when hospitals could allow it, insurance companies are scared of lawsuits.
You mentioned you "can't really have too many c-sections". I have to disagree. If you look at the data available, the risks of complications from a c-section are much higher than a VBAC and subsequent sections have rates that increase from there. The more surgeries you have the more scar tissue, and the risk of problems with the placenta growing into the scar tissue goes up. After one c-section, you uterus is very strong, and can withstand the pressures of a normal vaginal birth, as long as other drugs to induce abnormal contractions are not used.
I would suggest you look up the information you need to have a truly informed decision, and then make yours. I have heard of VBAC's happening at hospitals where they do not allow them, but.... you will need to not agree to have a scheduled c-section prior to 42 weeks. Tell your dr. you want to go into laboo naturally prior to you r c-section, since that is what your dr. needs to think you will be doing. Then labor at home until you feel like pushing and show up at the door that way. Other than that, they wont allow it. I have had clients (I am a doula) who have had that plan.

Good luck,
T.

congrats on your new little girl!
its fun having both, have two boys and one girl and im having my second girl in july!

i havent had a c-section but i have several friends who have had VBACs. If you feel like you can handle a VBAC i think you should get a second opinion or go find a new hospital! i know it sucks and is very hard to do that, but it is your body and only you know what is best as long as you are listening to your instinct!
talk to your OB about how important it is for you to have a vaginal birth and if there is any way that you could do it. if he or she says no then go get a second or third opinion to make sure that it really is for your own safety and not just for protocol. in my vast experience i have learned that doctors and hospitals like to do what is convenient for them, not usually what is more comfortable for the mom-to-be

VBAC's and hospitals are interesting....

- Some hospitals actually have a No VBAC policy.
- Some hospitals are enamored of their equipment (read still paying it off) and encourage Csections whenever there is the slightest justification for it. (There's one up in Seattle that has stats at over a whopping 60% Csection...but their Highrisk Patients % is the same as anywhere else. Yes A LOT are #2 & #3...but that's still RIDICULOUS).
- Some hospitals don't actually have the facilities (aka, needing a L&D room AND a surgical suite to both be available)
- Some hospitals encourage VBAC's

Providers are as equally different as the hospitals. Some encourage, some discourage, some are ambivalent.

And...unfortunately...not all Csections are created equal. There MAY be something about your previous one that makes a VBAC a very risky choice for you. Many providers will actually keep that from a patient. Those reasons are equally diverse. From personal aversion to conflict all the way to not wanting to scare someone who is already anxiety ridden or on the slim chance that their patient might not make it o the hospital for whatever reason.

Now, you may be the IDEAL candidate for a VBAC, but if your OB has cold feet....it's not going to happen. Ditto, if the hospital you want to go to has a policy against them. You may ALSO be very high risk due to factors I have no idea of.

Most birthing centers do NOT take high risk patients, for durn good reason. I had a midwife (MSRN), that was with a clinic IN the hospital, and I delivered also in that hospital. I was high risk. Having a midwife in hospital with surgeons and anesthesiologists standing by (not needed in the end), was my compromise. If nothing happened great, if something did...I was literally down the hall from lifesaving help. We were actually CLOSER to a hospital that preferred Csections, but drove an extra 20 minutes to get to the hospital I preferred. Sure the drive sucked...but I figured I was going to be in labor for FAR longer then 20 minutes.

Checklist:

- Your providers temp. regarding VBAC's
- Other hospitals in the area.

I went VBAC with my second child and it took me to my 7th month to find a dr and hospital willing to let me go natural. One of the things I remember most was that the Dr. said the hospital had to have a 24/7 team of OB's, Anathesiologists, etc. in case there was an emergency when delivering. Have you looked into birthing centers in your area...certified nurse midwives that work with local hospitals might be somthing to consider. Good luck in your search.

I know someone who has had 5 c-sections and she was fine. Also, since you are 29, I am assuming you will not have more than 5 kids, seeing as birth defects start to increase after you hit 35 and you will have to have them pretty close together to get 3 more in after this one and still be under 40. Not to sound rude, but just trying to be realistic.

Kaiser allows VBAC. Many hospitals do not. You may need to change dr.s and hospitals if your heart is set on it.
FYI, I talked with a good friend of mine who is an OBGYN. He was private practice and now he works for Kaiser. The reason some hospitals don't allow VBAC is simply the way they are staffed. I forget if its the anestesiologist, but I think its that they need an on site anestesiologist for emergency c-section to be staffed specifically on the L & D unit. For many hospitals their anestesiologists roam as needed in the hospital. Something like that.

I just had the same conversation with my doctor. His answer was that I would need to go to a teaching hospital because the American Obstetrics (?) guidelines say that with a VBAC you need to have a doctor available to do a c-section immediately if your uterus should rupture. The only hospitals with surgeons on staff at all times are teaching hospitals with senior residents. The difference is that for a normal delivery the guideline is that you have to be able to do a c-section within 30 minutes, allowing your doctor to get to the hospital, etc.

So, I'm in your boat. But I really don't want to change doctors and have to schlep to UCLA or elsewhere every month/week for appts, etc. Hope that helps.

I would check with the hospital directly. And consider switching doctors if it is really important to you. I had 2 c-sections. I tried for a vbac, but when my son's heart rate kept going down, my doctor felt strongly that I should have the c-section. The recovery was not as bad as I thought, even though I had a 2 year old at the time, it was actually easier the second time. I wasn't in labor as long the second time, so that may have helped. As far as the number of c-sections you can have, I have a friend who had 3 c-sections. We unfortunately live in a very litigation scared country, and medical decisions are often made based on the doctor's/hospitals/malpractice insurers fear of being sued.

I midwife or doula might be able to tell you which doctors and hospitals are more willing to support your birth plan wishes.
When I was pregnant I took natural child birth classes (Bradley Method)with a doula, and she had tons of information about doctors and hospitals. Also, having a doula with you could be really helpful, as she can be your advocate during labor to make sure that you're not having unnecessary intervention imposed on you by the hospital.
All the best to you!
M.

I believe it is your decision, it's your body. Does your doc deliver at any other hospitals? I don't know how the hospital can have the say. I would question that. I have had many friends who had done VBAC and it has been just fine.

I had to change hospitals too. I was in the same boat as you, first pregnancy dilated to 10 no anatomical reason why I had to have a c the first time. So I found a doctor that would do a VBAC and he obviously was affiliated with a hospital that allowed them. But for me that was an hour drive--to my doc. appts. and hospital! But it was worth it to me, as c-section recovery is horrible and i had 3 year old twins at home so I really knew i couldnt be down after the birth of my 3rd baby. Also I think 2 c sections in a row disqualify you for VBAC in the future. So I would say go for it for sure this time around especially if you want more kids later.

I don't know where you live but I know when I delivered at Saddleback in Laguba Hills there was a woman attempting a VBAC delivery in the room next to me so I know at least that hospital allows it.

Just in case you are unable to do a VBAC, just know that when your body does not go through labor and you go straight in for a scheduled C-section, the healing process is much easier and faster. I had a scheduled for my second and was amazed at how much faster I was up and about than with my first, where I labored and had an emergency c-section, for similar reasons as you.
Good luck in your search.
J.

I would definitely check with the hospital directly, and if they say no, then see if your doctor (if he is on board with it) can deliver at a different hospital. If not, find another doctor/hospital that will allow you to try. It's YOUR body and YOUR choice...and you should be able to do it if you want to!!!

That being said, someone responded about knowing someone who has had 5 c-sections and is fine. I too know someone who is due to have her 5th c-section this month, and the doctor advised her not to even get pregnant with this one due to her 4 previous c-sections because her uterus wouldn't hold...sure enough she has had a lot of issues but has gone on to have a fairly good pregnancy (lots of bed rest, hard with 4 little ones).

This same person also made a comment about not having kids past 35 due to birth defects, etc. I am 39, and PROUD to say that I am pregnant with our 4th child, 22 weeks along and everything is PERFECTLY normal!!! I had #3 at age 36 and he is PERFECTLY normal!! So don't let the negative comments scare you from doing what you want. Now I must say our 4 kids will be born within 7 years of each other so it's crazy and fun too! We didn't start until we were in our thirties so it's not like we had a choice, and we knew in our hearts we wanted 4 kids. You are young and have plenty of time :)

Bottom line is you have to do what's right for you, and don't let a doctor or hospital tell you what you can and can't do, unless it's a medical necessity of course and means your and/or your baby's safety.

Best of luck to you - we're due in August too! It's going to be a surprise :)

Who is having the baby - you or the hospital? This is YOUR birth experience, and I think it's wrong for a hospital to have a blanket policy like that. I dont know the circumstances, but unless there is an actual MEDICAL reason, not a fear of malpractice reason, you should be allowed to call the shots. Stick to your guns!

Hi C.,

Go talk to Tonya Brooks at the Sherman Oaks Natural Birth and Women's Center. She's amazing.

Good luck.
G.

I would change hospitals. I had a VBAC with my 2nd. after a very traumatic csection and it was the best decision I could make, then I had two more VBAC's after that, 3 total. I would not trade those experiences for anything, it would be 100% worth changing hospitals and OB's if necessary!!

Call Dr. Bruce Hagadorn in Irvine and see if he is delivering at a VBAC approved hospital and go meet him, he is amazing and will point you in the right direction.

Good luck with the information & God Bless you & your family!

You will probably have to find another hospital. I had the same situation, and since I live on Maui, my only choice was to fly to Oahu and wait to go into labor. I went ahead and had the C-section. The reason why the hospital says no is because they don't have the facilities in that hospital to save your life (and the baby's) if you have a uterine rupture. I actually know someone who suffered from a uterine rupture, and it was really touch and go. If you are able to find a suitable hospital nearby, you should investigate the options and the risks.

Congratulations on your family!

Is your doctor on your side? If not, I would find a new doctor and a new hospital. In the end, it is YOU having this baby.....I know when I was pregnant I would get so dependent on the idea of having a certain doctor "deliver" me, but the more children I had, the more I came to realize that it really didn't matter who was doing the "catching" (as long as he/she was competent), but it mattered a whole lot how happy I was with the situation! Remember, YOU are the consumer, and you should be happy with all services provided to you. If not, take your business, your body and your baby elsewhere! I had a vaginal birth, follwed by a C-section (emergency), followed by 2 VBAC's with no problems whatsoever. Good luck, and go with what is going to make YOU happy.

I attempted a VBAC at a hospital that allowed VBACs. Prior to this I thought I understood through some research I was doing that if a hospital doesn't allow it, they don't allow it. They can tell you to go elsewhere if you refuse the c-section. So plan ahead. Talk to your Dr. if you are bent set on a VBAC then find a hospital that will allow it rather than wait till "the day". That all being said, I mentioned that I attempted one, we were close but my son just didn't want to come down, so I ended up with a repeat c-section, I too had a 2 yo at home. Everyone is different but for me, it was no big deal and I didn't have any help. I healed really well, despite the fact that from the moment I came home I was going up and down the stairs, picking up my toddler, etc.. all things you aren't supposed to do. Plus, I didn't have to take pain meds this time (I took them around the clock with my first, not for c-section pain but my back was killing me). So, if you can find a place to have a vbac, I wish you the best and hope it all works out, however if you end up having to have a c-section, I'm sure everything will be fine there too.

Enjoy your pregnancy!
M.

If the hospital says no, there's a 99% chance you won't be able to have a VBAC. Probably the only way it would happen is if you walked in the door 10cm dilated and your baby's head is already crowning :o)

That said, there are some hospitals down here that do allow VBACs (although you also need a dr who will allow you to try). Go here to find out if the ones near you do http://www.ican-online.org/vbac-ban-info

If you have a healthy pregnancy, there's no reason that you can't try a VBAC - and there are countless reasons to go for a VBAC. Personally, I would find a doctor who would deliver me at a hospital which allows them :o)

Good luck!

I know of someone who refused to sign the papers to have the c-section at the hospital and so that had to do the VBAC...

C.,

Ask your doctor which hospitals he delivers at do allow VBACs. I had a VBAC 2.5 years ago at Mountain Vista Hosital in Las Vegas. At least at that point it was more up to the doctor than the hospital because the hospital required than my OB and an anestisiologist (sp?) be in the hospital with me the ENTIRE time in case there was an issue. Lots of doctors don't want to do that but mine was cool about it. My VBAC was great. I had my son at 4 a.m. and I was up walking around and felt great by 7 a.m. The recovery was SO much easier than that of a c-section.

Good luck,
T.

Your options are to either 1) find a new hospital/doctor or 2) stay at home and labor without any pain meds until you're fully dilated and about to have the baby, risking complications in the meantime, then walk into your hospital when the baby's already crowning. Short of that, I can't imagine how you're going to get around it.

I personally would switch to a new hospital where pregnancy and birthing is not seen as a medical condition, but rather a natural occurence that should be monitored in case of a suddently arising medical condition.

I had a successful VBAC at Cedars-Sinai.

I really like what Tracy wrote... you can also look at this site -

http://www.vbac.com/

Good (BEST OF) luck to you!!!!

I have but I had a few things go in my direction. One I had already had a vbac, but at the last minute we scheduled to do a csection on number three but she came two weeks before the scheduled csection. My water broke and by the time I got to the hospital no drugs no csection it was to late. Not really a plan I recommend.

I had a VBA2C a year ago this past March. I was going against a hosptial that did not allow VBACs, so I decided to go with a homebirth instead, where I had a VERY supportive and knowledgeable midwife. It was an awesome experience. Each woman has to weigh out the pros and the cons and the risks of both VBAC *and* the c/s (they are by no means risk free). I did a lot of research, reading, and soul search and in the end I took full responsibility for the birth of my child and knew that homebirth was the safest option for me. Check out ICAN-online.org for LOTS of info on preventing a c/s and much much more.
Congrats on your little one and I hope that you are able to find and have what you desire. You do not have to be cut again. You can email me offlist if you would like to talk more about VBACing. :)

Do your VBAC!!! Find a place that will support you, or just remember that you are in charge of your health decisions and go with the hospital you want.
I had a very similar situation to you for my first birth, as well. I just had my 2nd child and he was a home birth VBAC - out in 1 hr from when my water broke! Stay healthy, do your research and make the decision that feels best to you, but don't let any tell you that you can't do it. You CAN.
Check out ICAN international for more info and support.

Not to be all doom and gloom as I am sure you know the risks, but my dear friend attempted a VBAC and had a uterine rupture. Both she and her baby nearly died. Happily both are just fine now. However, she cannot carry any more pregnancies. That heavily influenced my decision to have a second c-section. My doctor said I'd be fine carrying another pregnancy. I don't know what the max number of c-sections is but you can do at least three...