Confused!!!!!!

[babyella]

i'm having some trouble with some of the things i am reading and hearing about the whole C-section/VBAC debate

what i can't understand is why my OB and the two other opinions i got tell me that a C/S is my only safe option for giving birth but alot of the ppl on this site and other sites seem to think that a VBAC is safer than a repeat C/S??????

i have heard some pretty silly reasons like 'doc's get paid more to perform a C/S'....i'm using a private OB and i really don't think he's scraping for a dollar!!!!
and the other one i've heard is 'it's so the Doc. can keep up with his schedual':eek: ....my guess is when he or she decided to be an OB they knew about the unpredictability of birth and it was no great shock when they had to cancel plans to deliver a baby!!!!

so if all the info i'm reading is correct why is my Doc. only willing to give me a C/S???????????
if VBAC's are so safe why can't i try?? surely my Doc. has read up on all the info out there and experienced evey type of birth and labour, has he got it in for me?? does he want me to have another bad recovery while i look after a 1yr old and a new born?? wouldn't my Doc. only want the best for me and my new baby??

sorry for the vent it just makes me so angry when i read all this stuff about it being so safe to have a VBAC, when a person with so much experince and dedication in this field would tell me the complete opposite.......

WHO DO I BELIEVE???????????????

i'd love to hear any opinions!!!!!

jess

[becstar]

babyella I found that really confusing as well. My OB recommended an elective ceaser after my last experience and he did not sound at all positive when I questioned him about a VBAC. Anyway, I went on to have a very happy elective ceaser 4 weeks ago. Compared to my emergency ceaser I had a really good recovery. I am a happy mum with a happy healthy bub. Does it really matter how he got here? Well, to me it doesn't matter but I can understand how it does matter to some people......I guess it depends on if you feel strongly about having a VBAC. If you do then change doctors, get a second opinion and seek support from other organisations such as birthrites.

Good luck,
Bec

[Tea Lady]

The safety or otherwise of VBAC / Csecs seems to depend alot on why you had the c/sec in the first place and what sort you had. I too don't buy into the whole "Obs just love hacking people open for no reason / want your money" attitude that gets around sometimes. A bit of an unfair overgeneralisation IMO.

Bear in mind too that while many people may have strong opinions about what is safer / better they may not have the expertise / training to be giving you the full story (especially for your situation). Why not talk to your Ob more about it and do some research yourself (finding something unbiased may be tricky though!)? At least you've got awhile to think about it - good luck! :)

[nats]

I think the Ob's are only confident with birth after caesarean if they can have complete control over the situation. Surgery the can schedule and plan and are practised at, labour and birth are things which are unpredictable. Does this mean it is dangerous?

VBAC have only really just gone out of trend. Untill more comprehansive studies are done Ob's will always be skeptical of the safety of a VBAC with it's increased rate of uterine rupture which I realise is devastating should it happened (0.8% chance)
but I wonder do they take into account that as technology progresses so too must the procedures involved in making a disected uterus heal well.

Perhaps they do not have faith then in themselves and their colleagues to be able to properly suture a uterus so it will hold well in subsequent pregnancies and labours?!..... or it the strength of a scar down to "environmental" factors??? ie the mothers body.... Always a disclaimer :no:

It's a shame that there's little support from the professionals who introduced the risk that make VBAC an event so nessesary for a women to have to fight for. Often the primary c/s having been performed for no adequate reason at all :thumbsdown:

Child birth is unpredictable but it's not impossible! Seeking a health care proffesional who understands this and is able to give guidance during labour seems imperative to a sucessfull birth by VBAC or otherwise!. However I don't think an Obstetrician is the professional who will encourage a woman not to need medical intervention.

[SassyMummy]

In general, a VBAC is safer than a c-sec... but that's really not every case. Perhaps, in your case, a c-sec is the safest option...or perhaps you're just getting biased info because you're only getting opinions from surgeons. I don't know which it could be.

IMO, to only get opinions from OBs is a bit like asking religious questions only to Catholics. Of COURSE they're going to say that Catholocism is the "BEST WAY" because to them, it is. An OB is a surgeon - they're trained to perform surgery.

Perhaps if you wanted some different opinions, you should seek those of midwives as well. They could very well have different advice/recommendations for you because they specialise in different aspects of childbirth.

[nats]

In general, a VBAC is safer than a c-sec... but that's really not every case. Perhaps, in your case, a c-sec is the safest option...or perhaps you're just getting biased info because you're only getting opinions from surgeons. I don't know which it could be.

IMO, to only get opinions from OBs is a bit like asking religious questions only to Catholics. Of COURSE they're going to say that Catholocism is the "BEST WAY" because to them, it is. An OB is a surgeon - they're trained to perform surgery.

Perhaps if you wanted some different opinions, you should seek those of midwives as well. They could very well have different advice/recommendations for you because they specialise in different aspects of childbirth.


Well put. :thumbsup:

[Missus S]

what i can't understand is why my OB and the two other opinions i got tell me that a C/S is my only safe option for giving birth but alot of the ppl on this site and other sites seem to think that a VBAC is safer than a repeat C/S??????

I'd be taking advice from medically trained and clinically experienced health professionals..........as opposed to opinions from people on internet forums.

[MrsMiggins]

VBAC have only really just gone out of trend. Untill more comprehansive studies are done Ob's will always be skeptical of the safety of a VBAC with it's increased rate of uterine rupture which I realise is devastating should it happened (0.8% chance)
but I wonder do they take into account that as technology progresses so too must the procedures involved in making a disected uterus heal well.
I have to disagree with you on this one, nats. It is absolutely not the case all the time as you have stated.

My OB is renowned for being a little on the conservative side, however he has nothing but encouragement for me attempting a VBAC this time round. That is, if all the indicators are that it can possibly be a success. He is well aware of my previous PG & c/s having been my OB last year as well, and has been keeping a close eye on everything this time. He has also been very keen to listen to information I have researched and brought to him regarding my options, as indeed he was during my previous PG.

babyella, you need to be confident in the care you are receiving from your OB first & foremost. That way, if he suggests (or insists upon) a c/s, then you know that is the safest option for you. Do your homework - get stats & facts based on your own personal situation. Present these facts to your OB and ask his opinion.

I too think it can be very dangerous to tar all OBs with the one brush saying that they are all knife happy, golf addicts more intent on keeping their tee-time than ensuring a mother & baby's well-being. They have been through extensive & ongoing education & training to be where they are and any OB worth his/her salt will be willing to listen to your questions & concerns and will be able to give you information to back up their opinions & decisions regarding your care.

As SassyMummy said, it would be good to get some info from midwives, birthing groups etc to present to your OB, but listen to what he has to say also.

I agree, with all the info & conflicting opinions & advice going around out there, it can certainly be very stressful when you are faced with the dilemma of not knowing whether a VBAC or repeat c/s is right for you. That is why it helps to do your own research & discuss it with your OB. That is the only way you can be completely confident in the care you are receiving & will go a long way to ensuring a positive birth experience for both you & your bub.

[Perth_Pony]

Hey there!!

Everyone/body is different, there are many reasons why a VBAC could be/isnt safer than a C-Sect. I think that your doctor would be better equipped to make a recommendation on your part than anyone on a forum ect.

However, In saying this, IMO a very high % of OB's recommend a C-Sect for "personal" reasons. As sassymummy said, Obs are trained in surgery and most prefer this route.
They feel they have more control of the situation and the outcome (and can make it to their 3pm golf round :rolleyes: ) They are also paid a great deal more than for a C-Sect than Vaginal birth.

Midwives usually deliver vaginal births and obs are only neccessary if there is a complication ect.

I have said a million times before. AN obstetrician is not neccessary in a "normal" pregnancy or birth. Go and see a midwife (it pains me to say it, but honestly, some middies are so much more experienced in births than Ob's) They havent had their head buried in a book for 10 years, but most have had a great deal more practical experience. And they are not financially influenced!!

***Text removed by moderator*** this has been my experience. If you want a VBAC and you meet the basic criteria for one, then have one and tell the Obs to go jump. :D

Do your own research on this, trust yourself and follow what feels right in your heart.
Good Luck. :thumbsup:

[rynosmum]

However, In saying this, IMO a very high % of OB's recommend a C-Sect for "personal" reasons. As sassymummy said, Obs are trained in surgery and most prefer this route.
They feel they have more control of the situation and the outcome (and can make it to their 3pm golf round :rolleyes: )

That's a very broad generalised statement. Both of my OBs have been pro-birth - nothing else. VB if possible or C/S if required. I admire their experience, their talent and their understanding that safety of myself and more importantly, my child, is paramount.

Personally, I wouldn't care if my OB played golf or collected stamps in his/her spare time. All I care is that they are giving their very best and in my experience, they always have.

An OB will do more C/S's than a Middie purely because they are trained in it - a Middie is not. For a risky birth, I would much rather have a fully trained professional by my side who could offer other options if required.

For the OP, speak to your OB and get their opinion. Tell them your desires for birth but be open to their advice. You may be pleasantly surprised:thumbsup:

[MrsMiggins]

That's a very broad generalised statement. Both of my OBs have been pro-birth - nothing else. VB if possible or C/S if required. I admire their experience, their talent and their understanding that safety of myself and more importantly, my child, is paramount.

Personally, I wouldn't care if my OB played golf or collected stamps in his/her spare time. All I care is that they are giving their very best and in my experience, they always have.

An OB will do more C/S's than a Middie purely because they are trained in it - a Middie is not. For a risky birth, I would much rather have a fully trained professional by my side who could offer other options if required.

For the OP, speak to your OB and get their opinion. Tell them your desires for birth but be open to their advice. You may be pleasantly surprised:thumbsup:
Exactly my opinion RM.

As I said in my post, I think it can be very dangerous to assume that any medical professional is more interested in their casual hobby than in the well-being of their patients.

In my experience, I have never witnessed this to be the case.

[xkwzit]

...
sorry for the vent it just makes me so angry when i read all this stuff about it being so safe to have a VBAC, when a person with so much experince and dedication in this field would tell me the complete opposite.......

WHO DO I BELIEVE???????????????

i'd love to hear any opinions!!!!!

jess

Hi Jess
I think you've got to take the advice of a doctor who knows you over anyone's opinion on a forum. No-one here knows anything about you or your medical history. If you don't like what your doctor is telling you, you could always get a second or third professional opinion and weigh them up against each other.

Everyone/body is different, there are many reasons why a VBAC could be/isnt safer than a C-Sect. I think that your doctor would be better equipped to make a recommendation on your part than anyone on a forum ect.

This is very true. Forums are great in that you will always get every single opinion there is out there. It is a fantastic way to find out about options you may not know you had. But at the end of the day, you've got to make your own mind up, weighing all these opinions and then STOP listening to the ones that don't fit with what you know to be true about your situation.

Hugs

[stellarella]

I think you should seek out information for yourself...NOT just what your doc tells you or what a FORUM tells you. You need to RESEARCH and make up your own mind with the guidance of your care providers...

I would be careful about thinking just because your OB has experience and is a "professional" that they know everything....sure, they are skilled in what they do BUT OBs are trained to do C/secs...so that is what they are good at/comfortable with...whereas a midwife is trained to do VB's so that is what they are good at/comfortable with....either one may be the best choice for you...its a matter of figuring WHICH one...but dont JUST go on what an OB says.

[becca74]

I think you should seek out information for yourself...NOT just what your doc tells you or what a FORUM tells you. You need to RESEARCH and make up your own mind with the guidance of your care providers...

I would be careful about thinking just because your OB has experience and is a "professional" that they know everything....sure, they are skilled in what they do BUT OBs are trained to do C/secs...so that is what they are good at/comfortable with...whereas a midwife is trained to do VB's so that is what they are good at/comfortable with....either one may be the best choice for you...its a matter of figuring WHICH one...but dont JUST go on what an OB says.


Precisely...

I wouldnt let an ob touch me with a barge pole anymore.....click my name in my sig to find out why.

Obs were/are dangerous to me when I was/am in labour. My Midwife was far superior in her experience, given my straightforward outcome last June. Obs just want to attack me with needles and knives for no good reason.

Obs are trained specifically in pathology and abnormal birth. Most (not all, but the majority for sure) of them are looking specifically for negatives. They more often than not facilitate an abnormal outcome, full of intervention. (disclaimer: Thank God for the likes of Michel Odent, or else I would say I have a blanket hatred for Obs - but due to Michel's existence, I do know there are some good ones out there!)

Proper Midwives (I'm not talking about 'med-wives' here, as they are a waste of space) are trained in normal birth, therfore know how to facilitate a normal outcome.

This has been my personal experience......what more can I say?

[nats]

I have to disagree with you on this one, nats. It is absolutely not the case all the time as you have stated.

My OB is renowned for being a little on the conservative side, however he has nothing but encouragement for me attempting a VBAC this time round. That is, if all the indicators are that it can possibly be a success. .

Actually, you're quite right. Not all Ob's are the same. The more I read the more I see that women after vbac's are being received so differently by various care providers.

I guess the dangers are interpereted on a case by case, patient by patient (shouldn't really call a mother apatient really should I? basis.

I guess you will have to research, decide and then find a care provider to bendto you

[suemp]

That's a very broad generalised statement. Both of my OBs have been pro-birth - nothing else. VB if possible or C/S if required. I admire their experience, their talent and their understanding that safety of myself and more importantly, my child, is paramount.

Personally, I wouldn't care if my OB played golf or collected stamps in his/her spare time. All I care is that they are giving their very best and in my experience, they always have.

An OB will do more C/S's than a Middie purely because they are trained in it - a Middie is not. For a risky birth, I would much rather have a fully trained professional by my side who could offer other options if required.

For the OP, speak to your OB and get their opinion. Tell them your desires for birth but be open to their advice. You may be pleasantly surprised:thumbsup:

well said :thumbsup:

[MrsMiggins]

Actually, you're quite right. Not all Ob's are the same. The more I read the more I see that women after vbac's are being received so differently by various care providers.

I guess the dangers are interpereted on a case by case, patient by patient (shouldn't really call a mother apatient really should I? basis.

I guess you will have to research, decide and then find a care provider to bendto you
Just as many women have said, I too went into my first PG suspecting that all OBs were just as so many here describe them, so I was perhaps a little sceptical. I was fully expecting to be fed a bunch of BS and treated in the public hospital system exactly the same as every other mum-to-be without true regard to my own personal circumstances. In fact, I think you'll even find if you looked back at some of my very first posts on bubhub, I posted asking for people's experiences because I was terrified of just this situation.

BUT..... I was pleasantly surprised to discover that my care was taken very seriously and openly & extensively discussed both with myself and various other medical professionals to get different views on the situation (given that my circumstances were, although not rare, certainly not run of the mill). My team of OBs thoroughly investigated every avenue before coming to the conclusion that a c/s was going to be safest for my baby & myself.

I have often said here that I have the utmost respect & confidence in the OBs at my hospital (and in particular the Dr who's care I have been under each time), wholly & soley due to the fact that they have proved time & time again just how up to date they are & just how willing to ensure the best possible care for me & my babies. I think it speaks volumes that as much as I desperately wanted to avoid a c/s, I had come to accept it before my Drs did!

While I desperately want a successful VBAC this time, I also understand that given certain circumstances, it may not be the safest option to get my baby safely into the world.

I guess my point here is that it is a difficult decision you face when you don't know whether to try for the VBAC you truly want, or to put your trust in your carers & get have your baby delivered safely via c/s. That is why I cannot overstate how vital it is that you are confident in your OB.

[Perth_Pony]

Obs are trained specifically in pathology and abnormal birth. Most (not all, but the majority for sure) of them are looking specifically for negatives. They more often than not facilitate an abnormal outcome, full of intervention.

Proper Midwives (I'm not talking about 'med-wives' here, as they are a waste of space) are trained in normal birth, therfore know how to facilitate a normal outcome.


Very nicely said. :thumbsup:
I cant seem to put my point across like you without being complained too or whinged at.??
Maybe its because i havent yet had my baby, but being around Ob's and doctors 24/7 (including members of my own family!!)and knowing what most of them are like seems to mean nothing. :rolleyes:

[Missus S]

Just thought I'd add that I was at a friends house last night who is 17 weeks pregnant with her 2nd baby. Her first baby was delivered by scheduled C-section as he was breech.

Even though she indicated to her obstetrician that she was prefer a repeat C-section this time..........he told her no, she will be having a VBAC as unless there is a medical reason for doing a C-section he won't do it. So you certainly can't classify all OB's as knife-happy.

[Roopee]

I think you should seek out information for yourself...NOT just what your doc tells you or what a FORUM tells you. You need to RESEARCH and make up your own mind with the guidance of your care providers...

I would be careful about thinking just because your OB has experience and is a "professional" that they know everything....sure, they are skilled in what they do BUT OBs are trained to do C/secs...so that is what they are good at/comfortable with...whereas a midwife is trained to do VB's so that is what they are good at/comfortable with....either one may be the best choice for you...its a matter of figuring WHICH one...but dont JUST go on what an OB says.


I have had three vb's and all delivered by an OB.

I think that OB's are actually trained in BOTH aspects of birthing- unlike a midwife who is only trained in one?

To the OP- research your options, ask midwives, your OB and search the internet for info. Then sit down and make your decision because ultimatley it is your decision.
Good Luck!

[melissa.r]

I think the saftey of a VBAC versus c/sec depends on which philosophy of birth you draw from. There appears to be two schools of thought, the OB view which percieves birth as a medical condition or a midwifery view which percieves birth as a natural processs (in their simplistic forms). In Australia I think that the most prominent viewpoint is from the OB and therefore we as a community are provided with information from this stance. I think if you are considering which alternative is best for you, you need to consider information from both schools of thought. If you are wanting solid Australian statistical information on the risks of VBAC versus c/sec and general information then I would recommend visiting the Birthrites website. Also considering the World Health Organisations stats on birth intervention from their website is also useful.
I also believe that many OBs are becoming less 'practiced' in natural birth and there are probably a variety of reasons for this. I think there are less OBs around who have a low c/sec rate (or close to that which is recommended by WHO). I think it is always useful to ask your OB what their individual c/sec and VBAC stats are, and also how many of their patients have actually had uterine rupture (which seems to be the main concern in VBAC). My guess is that c/sec rates would be quite high and uterine rupture would be quite low.
Anyway, these are my views only and I guess you have to consider the information you seek out carefully. Good luck!

[Kaileysmum]

I'm having some trouble with some of the things i am reading and hearing about the whole C-section/VBAC debate

what i can't understand is why my OB and the two other opinions i got tell me that a C/S is my only safe option for giving birth but alot of the ppl on this site and other sites seem to think that a VBAC is safer than a repeat C/S??????

i have heard some pretty silly reasons like 'doc's get paid more to perform a C/S'....i'm using a private OB and i really don't think he's scraping for a dollar!!!!
and the other one i've heard is 'it's so the Doc. can keep up with his schedual':eek: ....my guess is when he or she decided to be an OB they knew about the unpredictability of birth and it was no great shock when they had to cancel plans to deliver a baby!!!!

so if all the info i'm reading is correct why is my Doc. only willing to give me a C/S???????????
if VBAC's are so safe why can't i try?? surely my Doc. has read up on all the info out there and experienced evey type of birth and labour, has he got it in for me?? does he want me to have another bad recovery while i look after a 1yr old and a new born?? wouldn't my Doc. only want the best for me and my new baby??

sorry for the vent it just makes me so angry when i read all this stuff about it being so safe to have a VBAC, when a person with so much experince and dedication in this field would tell me the complete opposite.......

WHO DO I BELIEVE???????????????

i'd love to hear any opinions!!!!!

jess


Hi Jess,

I just wanted to say in some cases a VBAC isn't possible and a elective c/s is the safest option. I had a 36 hour labour (pushed 2hours) and she wouldn't budge, she got just past my cervix (-1/5 engagement), then she was stuck, so I had to have a c/s, which had complications as I had been in labour way to long.
Anyways both the ob that did my c/s and midwifes told me next time that I'll have to have a c/s as I have something wrong in my pelvis that they saw when pulling bub out.

I would love a vbac next time around, but I don't think it will be possible, but I will be getting my Ob to investigate this "pelvis thing"before making the decision.
The point I'm trying to make is maybe something that went wrong last time, is why your ob is saying its safer to have a c/s. Id get him to explain his reasons why? And if you feel that you need a second opinion get one. Everyone is different so you cant get medical advise from the internet that applies to everyone, so please listen to medical professionals before people of forums etc.

[samh1706]

Hi Jess

There does seem to be a lot of conflicting information around, and a lot of anti-OB and anti-C/section sentiment, particularly on the internet. I had my first child naturally with no complications and a very easy birth, my second was an 'emergency' c/section as he was showing signs of decreased heart rate before I went into labour. Now, nearly 9 years later i would dearly like a VBAC.

I have read everything i can get my hands on regarding VBAC's and the risk of uterine rupture appears to be about 0.5% - a risk I can live with. However, if a uterus does rupture, the results are catastrophic, with 50% of babies dying. That thought alone is very sobering.

I can't find a great deal of meaningful data on the risks of elective c/sections which makes a true comparison difficult. Most of what I have seen has been retrospective stories by mothers who have regretted their c/sections (understandably) and are also understandably angry and/or distressed.

My OB won't particate in a VBAC as he has seen 8 ruptures and 4 dead babies and never wishes to see that again. He had tears in his eyes when he told us this - it is a personal choice of his to not be involved as he finds the risk unacceptable to him. He was very supportive of us finding another OB and or getting a second opinion.

At this stage, I am resigned to having an elective c/section for a number of reasons. Firstly, I really like this OB and really respect his honesty, I don't want another one. Secondly, I don't want to scare the pants of my husband, as this is his first child. And thirdly, I don't EVER want to be in the position of asking myself 'what if' after a VBAC gone wrong. I understand that there are risks to a c/section but my recovery from the last one was as fast as most people's vb, so for me the risks are acceptable.

My point is that this is an incredibly emotional topic, and anyone you speak to on here or anyone who has experienced unplanned or unwanted c/section, is emotionally involved. All you will get is opinion based on their experience which is naturally biased. To get FACTS, you need to do medical research AND seek a second opinion from another professional. Mid-wives, while wonderful, do not know how to do c/sections so can't really provide much useful information on that particular topic.

In regards to the point about OB's charging a large amount more for c-sections than vaginal births, my OB for the c-section 9 years ago didn't charge anymore. The c-section was done at 11 at night, instead of letting me go into labour and delivering conveniently the next morning. I can't see anything there that was done for her convenience. The OB I am seeing now charges about $200 more for a 'complicated' labour and delivery, which I don't think elective c-sections fall under. Given what they earn, I don't think any decisions would be made based on $200.

Good luck with your investigations, and which ever choice you go with. Remember to balance opinions with the fact that there are emotions involved, and beware of what you read on the internet. Ask your doctor for medical research, speak to other doctors (there are OB's out there that are pro-VBAC and make the decision that you feel most comfortable with.

[lilpearl]

Okay, MOST obstetricians have an obstetrical view of birth (not all), believeing that birth is a dangerous process that must be managed, and obstetricains are trained in the problems of pregnancy and birth - they are not trined in-depth in normal physiological birth, their training is done with women experienceing problems. Most women do not need to see an obstetricain in pregnancy or labour. In fact, studies have shown that women who do not require an obstetrician (that is, women not experiencing a life-threatening situation) have more positive and SAFER birth outcomes than women who employ a midwife. Some obstetricans are fantastic, and do have a "midwifery view" of birth. However, most of the fantastic ones will happily admit (even with frustration) that most women should not be under their care. Because obstetricians are trained in the problems of birth, they go to great length to find problems, which can be dangerous if done for no reason. This is why obsterticians are more likely to do continual fetal monitoring, which has been shown to have dangerous outcomes when not 100% necessary. All STUDIES have shown that a VBAC (in most cases - in itself) is a far safer option than a repeat caesarean. Many figures, etc will be found at www.birthrites.or, as well as in fantastic books, many VBAC books are available from www.capers.com.au (and wont be available ina book store.

MOST midwives have a midwifery view of birth, believeing that birth is a normal, intrinsically safe, life event,a nd that intervention is required only if a problem arises. Therefore, one employing a midwife is far more likely to avoid a cascade of intervention that will often lead to further complications, as well as very dramatic interventions, such as caesarean (which, int he majority of cases, is not truly required).

An obstetrician has to pay around $80,000 insurance per year (so, they're not necessarily rolling in it), and certainly do not want to have to end up in court, so due to the nature of their job (i.e, they are expected to intervene), they are more likely to use intervention throughout labour as a matter of fact, as it covers them from litigation (they can say "but I did everything I could, I even delivered the baby via caesarean). If they have used intervention, which is what an obstetrician is trained to do, they are less likely to be found negligent. Unfortunately, most women under the care of an obstetrician don't realise that it could cause more problems (if not necessary), they think "my mother/sister/friend had an obstetrican, and I am now pregnant, so that is what I have to do".

It is not always that an obstetrican performs a caesarean for convienience, but it is often the case (some obstetricaians have a caesarean rate of 90%). Caesareans can be schedueled, and so it is then easier for the obstetrician to ensure they are in the office for pre-natal appointments. It's so important to go with evidence and instinct when it comes to birth, and to research and make decisions for yourself, not simply go with whatever a care provider says. Shop around and find a care provider who you like, and who shares your own birth philosophy. Once you know the evidence, and know what you personally believe and want, go to a care provider and tell them what you want. if a care provider says "no", don't go to them, as it's so important that YOU are in charge of YOUR birth. Just because one is a trained professional does not necessarily make them more knowledgable than you, if you have done your research (maybe they are better at using a pair of forcepts than you would be, considering you've never done that before....but there is nothing that makes a care provider smarter than you or their beliefs more valid than yours. It's really dangerous to give yourself over to a professional when you are a healthy person without any major problems. Even someone with problems should be in a position where they have consultations with a specialist, but make desicions for themselves.

Indeed, many midwives hold an obstetrical view of birth (mostly those found in hospitals, and not usually those working in more women-centred care situations, or birth centres).

Famous obstetricain, Michael Odent has stated "The history of obsterics....is largely the history of the gradual exclusion of mothers from their central place in the birth process". Clearly, he has a midwifery view of birth, and has been brilliant at using his position to reach a wider demographic of people to teach of birth as a normal process, introducing water birth to hospitals, etc. Unfortunately, that is a real rarity when it comes to someone with obstetrical training.

[lilpearl]

woops...posted twice

[Gruzzlebub]

I'd be taking advice from medically trained and clinically experienced health professionals..........as opposed to opinions from people on internet forums.

Well said. I totally agree.


Liana said quite a lot in her post and I am troubled by it. I am not trying to be argumentative, but I think it's really important on threads like these to not spread generalisations which are not supported. For example:

Okay, MOST obstetricians have an obstetrical view of birth (not all), believeing that birth is a dangerous process that must be managed,

Where does this come from? I know my own experience of my own ob does not track with this at all. Have you spoken to MOST obstetricians? Is there somewhere where they have been surveyed?

Most women do not need to see an obstetricain in pregnancy or labour.

It depends on what you mean by "need". In any event, I may not need to see my ob - meaning I had a trouble free pregnancy - but I certainly was glad he was there.

Some obstetricans are fantastic, and do have a "midwifery view" of birth. However, most of the fantastic ones will happily admit (even with frustration) that most women should not be under their care.

Again - do you know of somewhere where all the fantastic obs have put forward their views?

Because obstetricians are trained in the problems of birth, they go to great length to find problems, which can be dangerous if done for no reason. This is why obsterticians are more likely to do continual fetal monitoring, which has been shown to have dangerous outcomes when not 100% necessary.

I really disagree with this. Obs are specialists who are trained for a very long time to deal with complications etc - this does not mean though that they "find problems" which don't exist (which is implied by the "no reason" part).

I am not sure how fetal monitoring can have dangerous outcomes. Do you have a source for this?

All STUDIES have shown that a VBAC (in most cases - in itself) is a far safer option than a repeat caesarean. Many figures, etc will be found at www.birthrites.or (http://www.birthrites.or/), as well as in fantastic books, many VBAC books are available from www.capers.com.au (http://www.capers.com.au/) (and wont be available ina book store.

I don't mean to sound rude, so forgive me if I do, but have you read ALL STUDIES? I looked on birthrites - and I could not find anything which said that VBAC was a far safer option.

I found this:

Enkin et. al. considered a wide range of factors including all the risks and benefits of each option outlined above to determine the optimal birth choice after a caesarean. They came to the conclusion that planned labour proved to be the safer choice.

Enkin is from a book published in 1995. I also saw that there is a current trial underway for VBACs regarding their safety (look on the birthrites webpage) - I wonder why this would be necessary if all studies have shown VBACs to be far safer?

I'm not spoiling for a fight with anyone. I just don't want important issues like birthing decisions to be subject to generalisations. I am also heartily sick of hearing obstetricians being insulted.

[tootiredtosleep]

I'd get a 2nd or 3rd opinion or ask more questions.
My DD is receiving treatment and the doctor we saw admitted that he uses a cast because that's what he learnt at uni. Its not the only method, but its what he knows.

Ask, even if you think you might offend him, chances are you won't.

I love this site for ADVICE, but I would be asking my doctor for the FACTS.

[becca74]

Well said. I totally agree.


Liana said quite a lot in her post and I am troubled by it. I am not trying to be argumentative, but I think it's really important on threads like these to not spread generalisations which are not supported. For example:



Where does this come from? I know my own experience of my own ob does not track with this at all. Have you spoken to MOST obstetricians? Is there somewhere where they have been surveyed?



It depends on what you mean by "need". In any event, I may not need to see my ob - meaning I had a trouble free pregnancy - but I certainly was glad he was there.



Again - do you know of somewhere where all the fantastic obs have put forward their views?



I really disagree with this. Obs are specialists who are trained for a very long time to deal with complications etc - this does not mean though that they "find problems" which don't exist (which is implied by the "no reason" part).

I am not sure how fetal monitoring can have dangerous outcomes. Do you have a source for this?



I don't mean to sound rude, so forgive me if I do, but have you read ALL STUDIES? I looked on birthrites - and I could not find anything which said that VBAC was a far safer option.

I found this:



Enkin is from a book published in 1995. I also saw that there is a current trial underway for VBACs regarding their safety (look on the birthrites webpage) - I wonder why this would be necessary if all studies have shown VBACs to be far safer?

I'm not spoiling for a fight with anyone. I just don't want important issues like birthing decisions to be subject to generalisations. I am also heartily sick of hearing obstetricians being insulted.

Maybe you would care to check out my comparisons of models of care (click in my sig). Obs scare the bejebus outa me! You wont ever see the likes of me trusting my pregnant body with one of them.....

I think real life experience is a pretty good judge to me......

[lilpearl]

Gruzzlebub - yes, all I said is knowledge i have from in-depth doula training, and reading some fantastic books from highly respected midwives, obstetricians and experts in birth. As my training has been over some time, my knowledge is not categorised by who said it in my head, but it's legit knowledge non-the-less, I wouldn't be a qualified doula without it. In fact, it's part of my job to have statistics stored!However, I will name a few books that if you read, should clarify some of your misunderstandings surrounding birth.


* ANY book by Dr. Michael Odent
* 'Spirital Midwifery' and anything by Ina may Gaskin
* 'Gentle Birth, gentle Mothering' by Dr. Sarah J Buckley
* 'Silent Knife' - can't think of the author this second....has AMAZING statistics on intervention, especially caesarean.
* 'Once a Caesarean' is a brilliant documentary video, including quotes from a Brilliant obstetrican, who is one who agrees "most women do not need to see an obstetrician".

These books, and many more, will show all the research.

It has been shown that high risk women who have midwifery care have BETTER (that is healthier and happier outcomes in the long term) outcomes than low risk women who employ an obstetrician and use a private hospital.

My views are not biased, but based on years of aquiring an in-depth knowledge and apprieciation of the nature of birth. :)

[becca74]

Gruzzlebub - yes, all I said is knowledge i have from in-depth doula training, and reading some fantastic books from highly respected midwives, obstetricians and experts in birth. As my training has been over some time, my knowledge is not categorised by who said it in my head, but it's legit knowledge non-the-less, I wouldn't be a qualified doula without it. In fact, it's part of my job to have statistics stored!However, I will name a few books that if you read, should clarify some of your misunderstandings surrounding birth.


* ANY book by Dr. Michael Odent
* 'Spirital Midwifery' and anything by Ina may Gaskin
* 'Gentle Birth, gentle Mothering' by Dr. Sarah J Buckley
* 'Silent Knife' - can't think of the author this second....has AMAZING statistics on intervention, especially caesarean.
* 'Once a Caesarean' is a brilliant documentary video, including quotes from a Brilliant obstetrican, who is one who agrees "most women do not need to see an obstetrician".

These books, and many more, will show all the research.

It has been shown that high risk women who have midwifery care have BETTER (that is healthier and happier outcomes in the long term) outcomes than low risk women who employ an obstetrician and use a private hospital.

My views are not biased, but based on years of aquiring an in-depth knowledge and apprieciation of the nature of birth. :)

It was by taking on the knowledge that Liana is describing here, that I managed to finally have a good birth experience. My experiences under Obs were horrid, to say the least. When I finally learnt about the superiority of Midwifery care, I finally had a birth the way it is meant to be....dignified, straightforward, and estatic :yes: :D

[stellarella]

I think that OB's are actually trained in BOTH aspects of birthing- unlike a midwife who is only trained in one?


Theoretically you would hope this is true....however if you actually discovered how many NORMAL vaginal deliveries an OB had manged/witnessed or even seen...you would most probably be appalled at how few it really was.

OBS are trained to manage birth...they are trained to see it as potentially dangerous...im surprised some people still dont understand this!!

[melissa.r]

OBS are trained to manage birth...they are trained to see it as potentially dangerous...im surprised some people still dont understand this!!

I couldn't have said this better myself.

[kadownie]

Hi- I don't really want to give an opinion- I just wanted to ask if you have asked your OB whether or not he ever 'allows' VBAC??

Everyone has their 'way' of doing things- and it may be his belief - right or wrong- that a repeat c-section is safer.

I'm also pregnant and having a VBAC- definatley choosing a midwifery model of care, having a doula and hoping to only see an OB (hopefully my lovely OB from my first birth- lovely man)- at my 16 week antenatal appointment!

Good luck with your choices-

[sarahs]

Just wanted to add my 2 cents. I elected to have a c-section 2nd time around after an emergency c-s first time.

My OB told me that if I wanted VBAC he would support me. The risk of VBAC is a 1 in 200 chance that your scar could rupture. This means that you need to be rushed to surgery (assuming it is available and that an anaethetist etc is available). If your scar does rupture there is a large risk to the baby and yourself. My OB told me that it had happened recently (when I was pregnant with DS2) and they had lost the bub. He said it was entirely up to me whether I considered the risk acceptable - he said in his early days as an OB it was considered by all to be acceptable and it had swung to unacceptable. For me, I wasn't willing to take the risk - I'd had a terrible labour experience first time around and a great c-section experience - so I opted for c-section.

His other reasons were:
in his opinion I was likely to have the same problems second time around
I had saved my pelvic floor once
he's use the same scar to do it

I'd ask your OB to discuss the risks in your case.

Good luck!

Sarah

[lilpearl]

I had saved my pelvic floor once



He doesn't realise that it is pregnancy that puts strain on the pelvic floor, not birth???