Successful VBAC at Reading Hospital
Did you know the most influential factor in a successful VBAC is the care provider you choose?
There are three types of providers: those that support VBAC, those that do not, and those that are supportive until the last minute.
It can be a huge red flag if your care provider says, “We can wait until later /until your third trimester /until 36 weeks to talk about that.” Your care provider should be comfortable discussing their VBAC philosophy with you now. You deserve to know whether or not they are genuinely supportive so if necessary you can hire another care provider who is more in line with your goals. Keep in mind you can always switch providers, even late in pregnancy. However,it can prove difficult.
Here are some suggestions for finding the right provider for you:
Ask if they offer consultations. Try to meet in an office, not in an exam room, and hire a babysitter for your kids so you are not distracted. Bring a copy of your medical records and operative reports from your prior cesarean(s), and a copy of the ACOG VBAC guidelines.
How do they feel about you going past 40 weeks? It is important to know how much “wiggle room” you have when it comes to your due date. Your due date can be calculated by your last menstrual period or by ultrasound but neither method is 100% accurate.
Find out their stance on induction after a cesarean. There are studies showing the relative safety of inductions for patients with a prior cesarean, but not all care providers are comfortable with induction.
Do they have any standard VBAC protocols that differ from a non-VBAC mom? If so, ask what they are. Some care providers require an epidural “just in case.”
Do they attend vaginal breech births? 3% of babies are breech at term, so it’s good to know what would happen if you were in that 3%.
Do they put a time limit on how long your labor can go before they C-section you? Generally, as long as mom and baby are fine, labor should be permitted to continue.
Are you permitted to move and deliver in your position of choice? Laying on your back or the “on the edge of the bed with your knees by your ears” are great for their viewing, but may not be the most effective positions for you. It’s always nice to have options other than the standard birthing position.
Should you require a repeat Cesarean do they offer family-centered Cesareans? Will they lower the drape so you can watch your baby be born? Do they support immediate skin to skin? Can you nurse in the OR? These are some of the new practces popping up in operating rooms all over the country.
Can my doula be in the operating room if I need a repeat Cesarean? If they need to get the baby out in a hurry, it may be tough to find a staff person qualified to help initiate breastfeeding, so knowing your doula can join you in the OR can be a huge help.
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