Saturday, August 25, 2012

Birth Center? Hospital? Decisions, Decisions...

Yesterday I learned exactly what sort of a coward I am when it comes to childbirth.

Or at least, that's how it felt.

You see, I've longed to be able to go to a birth center.  And when I heard about birth centers attached to hospitals I would sigh dreamily and think that I would totally do that.  But the birth centers near me have always been out of reach... far off impossibilities and while I could dream of the loveliness it was always obvious, after three minutes on a website, that I wasn't the kind of patient that they took on.  No high risk patients, No VBACS has been common wherever we've been.

Until yesterday.

Yesterday I had one major goal (and a whole bunch of little tiny goals):  Find a new doctor and set up an appointment as soon as possible.  After all, we're rapidly approaching 30 weeks.

I had already done some research online before we moved, but upon finding out that the hospital that's really close to our house does have an OB section, I began checking out the statistics and doctor's website at that hospital.

ICAN says that the hospital near our house told them that ever single OB at the hospital does VBACs.  Okay.  Did some have better results than others?

I began to look at parenting boards to see if there were doctor suggestions.

And that's when I saw it.  A woman suggesting a birth center, not far from our home, who explained that she had had a VBA2C at the center, and that they specialized in VBACs.


Because, you know, I've always thought I would enthusiastically jump at a chance like that... and yet I found myself pausing and thinking of the 2% chance of uterine rupture that I now face.  And while one part of me couldn't help but think that 98% are mighty good odds, the other part said, if you're part of that 2% you better hope you're in the hospital.

Maybe it's the fact that I've been on that 2% losing side before, first with Sadie's birth (because CPD is so rare) and then with miscarrying after 12 weeks when I'd just been breathing that long awaited second trimester sigh of relief.  It's made me more cautious.  I've had the odds be dramatically in my favor and had that sliver of a chance turn into reality.

At the same time I don't like the statistically increasing risk of c-section after c-section either.  In fact I like that much, much less.  

In the end I closed the birth center page and called a doctor's office.  And then another.  And then another.  And then finally, the University, where I now have an OB who'll see me.

I breathed a sigh of relief.  And felt like a wimp.  I think I need to go read some more Ina May...

I'm holding out hope, yet again, that at a hospital that claims that all of it's OBs do VBACs, I might actually be allowed to try...  I guess we'll have a better idea after my appointment on the 4th!


  1. My first thought is that since your first cesarean was due to CPD, you are not likely a candidate for VBAC, especially since you tend to have large babies. However, it might be worth a call to the midwives at the birthing center for a consult, to see what they would have to say about it. If they specialize in VBACs, then they are probably able to identify when a woman in labor is at risk for uterine rupture, and should be able to identify the problem in time to get you to the hospital. The birth center would give you the best chance at a vaginal birth, but if you try there and then need a Csection anyway, that will significantly increase your out of pocket expenses. There are many factors to weigh here, and I probably would have made the same decision as you. But I do think a consult with the midwives could be worth a shot, so you can have a stronger understanding of your chances for a VBAC. Also, they may have a VBAC-friendly OB they turn to for backup, and be able to refer you to him/her if you prefer the OB care.

  2. I don't think you're a wimp at all! You might try at least going for a consult with the midwife, just to know ALL your options... but, really, knowing your body/health history/comfort level and going with what feels right is the most important. Nobody gets a grade for childbirth! And certainly, every mama is brave as can be anyhow.

  3. You're not a wimp - you're smart. You're thinking of the baby that is currently living inside of you FIRST. That's what a mother does! You don't compromise the safe delivery of the baby you have for imaginary babies that may or may not ever come to be.

    Ina May, I'm sorry, but she's got a lot of kooky ideas. This isn't about you being brave or "trusting" your body. This is about you doing what is safest right now for your health and that of your unborn child's.

    Don't let anyone tell you that a Cesarean birth is less than a vaginal one, or that just because you could not safely deliver your girls vaginally that there is less value in their safe, healthy deliveries. Because there really, really is not.

    Our obligation as Catholics is NOT to take risks with ourselves and our babies so as to ensure that we can deliver the maximum number of children throughout our fertile years. We are to care for the bodies and souls with which God has already entrusted us in the best way possible. One at a time, my dear. Focus on THIS baby. Taking a risk with his little life may pan out well, but if you're in the 2% (and that's just for uterine rupture, not other life-threatening complications that cannot be handled outside the hospital)... Not only could he be harmed, but it may affect your future fertility, too.

  4. I very much understand feeling like a wimp for a vbac. I myself tried to have a vbac and I found myself in the last weeks secretly hoping it would go to a csection. I did pitocin with my first because I had pre-eclampsia and had to be induced. I did not want to repeat the horrible pain that came from that drug without pain meds. It made me skittish. My silent prayers were answered and I found myself at the scheduled c-section date because they couldn't wait any longer for me to go into labor. I hope which ever route you take is one that will be a good experience for you.

  5. I wanted a home birth with my first, although I was seeing OBs. It is hard to find a midwife in the Upper Peninsula of Michigan. Then I lost the baby at 17 weeks. When I found out I was pregnant again, I looked at a few midwives, but I just couldn't commit. I'm thankful for that now, as my son decided to come early, and had a difficult pushing stage that combined with the prematurity, landed him in the NICU for two weeks. Where we live now has tons of midwives and birth centers, but I just don't feel that they are an option for me. Don't feel bad, they are wonderful options for some women but maybe they just aren't meant for you or me.

  6. Have you seen the Business of Being Born? There is a second DVD set that came out called More Business of Being born and an entire segment is devoted to VBAC. I felt like it was really well put together. Just thought I would recommend it to you.

  7. Cammie, my first was a cesarean for CPD and I went on to VBAC the next three, two of them at home. Here's one of my favorite ICAN videos:

  8. I recently posted a video of my 3rd C-section on my blog. I opted not to go the VBAC route. Best of luck to you :-)


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