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  1. #1
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    Question VBAC the facts/truth/lies and more

    Please help me
    I have been reading a butt load on this but still thought I could reach out and get more info! I need what the title suggests The facts the truths and the lies!

    Just read this taken from a UK homebirth site am I allowed to do this?

    So once a mother has had a past caesarean, her risk of needing emergency caesarean in future rises from around 2.7% to around 3.2%. Even taking higher figures for uterine rupture, she is still more than five times more likely to need a true emergency caesarean for other reasons, than for uterine rupture.

    That 5 times more likely terrifies me

    Bloody hell I was feeling very positive and then I read that

  2. #2
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    It's not saying you're 5 times more likely to need a caesarean than someone who hasn't had one before... it's saying that uterine rupture is not that common, and that you're 5 times more likely to need an emergency caesarean for some other reason.

    So if you have a 1% change of uterine rupture, you have a 5% chance of needing a caesarean for something other than uterine rupture... basically saying that uterine rupture isn't an overly common for a VBAC woman to need a caesarean.

    I hope you can understand what I'm saying, it's hard to explain.

    It did say there was a rise in risk for a necessary repeat caesarean... but only 1.5% more chance of needing a caesarean than someone who hasn't had one before... which is really quite small.

    It's positive info Pixie... it's not scary info. I mean, yeah, it would be scary if you were 5 times more likely to need a caesarean this time round, but it's not saying that. I think you may have just read it wrong and got freaked out for no reason...

    Keep in mind that about 1 in 200 VBAC attempts experience uterine rupture... 5 times that means 5 in 200, which is still only 2.5% of women that need a TRUE emergency caesarean for any reason other than uterine rupture. It's really in your favour... because it's a 97% chance that you WON'T need a caesarean for uterine rupture OR any other true emergency... which is fabulous, don't you think?
    Last edited by SassyMummy; 28-09-2007 at 21:07.

  3. #3
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    So once a mother has had a past caesarean, her risk of needing emergency caesarean in future rises from around 2.7% to around 3.2%.
    This is purely because having had a previous c/s you are much more likely to have an intervention, such as ARM, continuous fetal monitering, not being allowed to move around at your descretion, not being allowed to labour at your own rate before being deemed FTP (failure to progress) etc., etc.,
    In most cases it is the interventions that increase the likelyhood of an emergency c/s, not the labour itself.

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    Quote Originally Posted by mamaoffour View Post
    This is purely because having had a previous c/s you are much more likely to have an intervention, such as ARM, continuous fetal monitering, not being allowed to move around at your descretion, not being allowed to labour at your own rate before being deemed FTP (failure to progress) etc., etc.,
    In most cases it is the interventions that increase the likelyhood of an emergency c/s, not the labour itself.


    Someone who has already had a caesarean will be more closely monitored, have more restrictions placed on her labour, and will be more likely to have interventions than someone who hasn't had a caesar before.

    The risks are relative.

    If you can get a hold of a copy of The Thinking Woman's Guide to a Better Birth by Henci Goer, she covers the pros and cons of VBAC with a balanced analysis of the risks, it's an awesome book.

    If you're researching a vbac be careful about where you source your info - there is a lot of scaremongering out there, you need to only take on board balanced and objective information, Goer's book is a good start

  5. #5
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    Emmy this is the thing, where to look and not to be sent into the thought of oh no!! Thanks for that I shall write it down and find it!

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    I just had my last VBAC at home - a waterbirth. My first VBAC was a waterbirth, in the birth centre at the RPAH in Sydney. VBAC is SAFE. The RPAH pretty much runs with an evidence-based approach, and I was told there that they DO NOT do continual CTG monitoring, as there is NO EVIDENCE to suggest it leads to better outcomes. Any hospital/care provider who had a continual monitoring policy or the like is not giving evidence-bassed care. There is the Cochranes library on-line, which will give you up-to-date analysis of studies, and is where care providers should be going to ansure they are providing evidence-bassed care, but they rarely bother. It's a sad fact that a lot of the 'care providers' who have been in the industry for a while, simply do what they are used to, what they feel comfortable, never mind the actual risk involved.

    Since having my first VBAC, I went on to become a doula, and have researched extensively on this subject (I'm writing a book on VBAC in Australia, in fact). Basically, as long as there is no underlying need for a caesarean, the simple fact that you have had one in the past, statistically does not justify having another one (elective caesareans for fear of birth aside....I'm not talking about womens personal preferences here, just medical facts. I respect elective caesaran for no medical reason in extreme circumstances, who are we to judge?).

    During my homebirth, my midwife listened to my babies heart, using a doppler monitor, at least every fifteen minutes (and this actually gives just as good readings as continual CTG monitoring, while avoiding all the side-effects of continual CTG monitoring, such as inability to use different positions; extra pain, due to often being on ones back; longer labour, due to often being on ones back; 'FTP' or 'failure to progress", due to often being on ones back (worst posible position to birth in, as it does not aid gravity and keeps the pelvis closed - best cure, getting into an optimal position, such as squating; and the fact that the CTG monitor often gives mis-readings - all up continual CTG monitoring DOES NOT lead to better outcomes for mother or child, only it DOES lead to a higher chance of caesarean (due to all the side-effects I've mentioned). Normal labour (normal= you feel fine, baby is happy) should not be 'managed'. Unessesary intervention leads to unessesary risk, and often to caesarean section.

    Aside from the doppler monitoring, my midwife did not touch me at all. She used evidence-based care, sat quietly, watched me, used her skill as a midwife to listen and look, using her own ears and eyes, for any signs of veering from a safe birth. This is the most skilled care, and obstetricians are only necessary in emergency situations, or where there is high expectation of complications (VBAC does not classify as high risk in itself, in the slightest). A midwife knows when obstetrical care is required, or likely to be required.

    In some states, such as Vic, birth centres do not welcome mothers who have had a past caesarean. There is no reason for this, it's just 'hospital policy'. Sometimes homebirth is the only way to have a truly normal birth experience. I believe all women should have all options open to them, and hospitals should be a safe option for women, sadly it often is not. As long as a mother lives close to a hospital, homebirth seems to be the safest, most rewarding way to go. That is the conclusion I came to for me, and it prooved to be true in my case. Keep eading up, including midwifery manuals and research data if you can get your hands on them, as well as 'normal' birth books, such as anything on homebirth, anything by Ina May Gaskin, and 'Gentle Birth, Gentle Mothering' by Dr. Sarah J Buckley. Gabbie Target has a good book, too....the name escapes me,a nd I have so many books lying around, i can't find it!...there is another readily-available quality book, called 'Better Birth' by Laeen Newman and Heather Hancock. All the best!

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    From reading all these stories I don't know if I'm mores stressed out about planning my VBAC or not. I feel so lost at the moment, as it looks like my only choice is to have this baby in a hospital ward.

    Something I really don't want to do. My c-section was the worst experience of my life, I didn't sleep for 3 days, and was on morphine after for the pain. I'm really scared that I will be forced into having another one.

    I liked the idea of seeing if I can have the baby at the Monash Birthing Center, I've got a feeling they won't take me as I have had a c-section, can anyone confirm if Monash will let you have a VBAC?

    I would like to have a doula, or even a midwife for a home birth, but I just can't afford the upfront fees. Is there any way to pay for these services by using the baby grant?

    I just found out today that I'm expecting (haven't even gone to the doctor yet), I'm guessing I'm due in May. I've found that if I get all these worries sorted out in the early stages, I can approach my labour time with less stress and more positivity. At the moment I'm feeling negative about the whole experience, wondering if I'm even capable of having a 'normal' birth.

    Sorry for all the questions.....

  8. #8
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    Quote Originally Posted by mamaoffour View Post
    This is purely because having had a previous c/s you are much more likely to have an intervention, such as ARM, continuous fetal monitering, not being allowed to move around at your descretion, not being allowed to labour at your own rate before being deemed FTP (failure to progress) etc., etc.,
    In most cases it is the interventions that increase the likelyhood of an emergency c/s, not the labour itself.
    Couldn't agree more!

    I had a successful vbac this April! I put my guard up and I laboured pretty much alone in the room with just DH. They did have to hook me up to an iv for antibiotics for a while but that was soon out as I had a reaction to it.

    I refused as much intervention as I felt safe with and i truely believe it helps!!

  9. #9
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    Oh, I also got into whatever position I wanted, I walked, showered and didn't get strapped for a fetal monitor. The only time I had to do what they said was when her shoulders became stuck and it was a medical emergency to get her out fast!

    I also refused anything but the gas which I think helps aswell (well for bubs sake anyways!)

  10. #10
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    Quote Originally Posted by catalytic View Post
    I would like to have a doula, or even a midwife for a home birth, but I just can't afford the upfront fees. Is there any way to pay for these services by using the baby grant?
    There are many homebirth midwives who will defer the bulk of their payment until the baby bonus comes through - it's very common. Having a known midwife who is comfortable with VBAC support you at home will be your absolute best chance of a natural birth. While their fees seem steep at first, remember you are paying for total care for the duration of your pregnancy, birth and post-natal - and you and your baby are definitely worth it.

    Have you been to www.birthrites.org - tonnes of VBAC info there. Also try www.joyousbirth.info for homebirth info.

    And don't apologise for asking questions - those who ask questions about their maternity care have better experiences than those who just do what they are told!

    Cara


 

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