When I found out I was pregnant again and faced with making the decision between a repeat C-section or a VBAC (vaginal birth after Caesarean), at first I was torn on what to do. Since we recently moved to a new state I had to choose a new doctor. I searched online and got recommendations from other women. I decided on a highly recommended and award winning OB who was affiliated with one of the best hospitals in our area. My husband and I loved her. Based on her recommendation, since the risks are minimal I decided on a VBAC and wanted to do everything possible to avoid surgery. She seemed to be very supportive of the VBAC option…or so I thought.
Each visit my doctor revealed information that began to show me that her practice, a large office of ten obstetricians and one midwife, were not actually VBAC supportive at all. I started to read a lot…I would even say I became slightly obsessed. I soon realized that her so called “support” created many impediments for how I wanted this birth to go.
First, I was told that the baby’s heart rate had to be continuously monitored so they could see if there were any heart decels, which is an indicator of a uterine rupture (about 1% risk with VBAC patients). While I agree with my baby being monitored the entire time, I was also told that since they don’t have wireless monitors, I would not be able to get out of bed at all. I couldn’t understand how this was not available in one of the best hospitals in the NY metro area. This meant my plan for walking around, using the birthing ball and laboring in the tub was out.
The next red flag was when I was told I could not labor as long. If my labor started to stall in any way they wouldn’t give me much time and do a repeat C-section. Next, I was told that I HAD to get an epidural. This really threw me for a loop because I was determined to go the natural route this time after my negative experience with epidural anesthesia. When I asked why, my doctor told me it was a precaution just in case I needed an emergency c-section.
The last straw was when I decided to look up the C-section rate for my hospital and I almost fell off my chair when I saw it was a staggering 45%! The national average for c-sections in the US is 32.8%. At this hospital almost one of every two women were delivering their babies via c-section!
My once VBAC supportive doctor had now stacked the cards against me and put me at a very high chance of ending up with another C-section because I had to abide by her practice’s policies and procedures. I was so frustrated and faced with another hard decision…should I stay or should I go? My gut told me to go, and so at 20 weeks my search for a new doctor began.
I continued to read everything I could get my hands on. I watched documentaries, read hundreds of birth stories and many reviews of doctors and midwives in my area. I decided that my best bet was to go the midwifery route with a hospital birth. The first midwife group I found seemed great and VBAC supportive. I was so excited until I called and found out they didn’t accept my insurance. However, they were willing to work with us on the financial end so I thought it was worth a shot to meet them. My consultation definitely did not go as planned.
As soon as I told her I was a VBAC candidate (which I already told her several times on the phone) she reviewed my operative report from my previous C-section and said it had to be reviewed by the OB affiliated with the hospital because they only take VBAC patients on a case per case basis and it didn’t look good for me. I was devastated because I was previously told I was a great VBAC candidate, but now I was being denied. She then smiled and said I could continue to come to their practice and receive midwifery care but I would have to schedule a repeat C-section. When I nicely told her that the sole purpose of my visit was to avoid this outcome and I would be going elsewhere she became offended and told me she didn’t want to waste any more of my time because I “clearly didn’t understand the value of midwifery care.”
My search started to feel hopeless as I met with two other OBs that claimed to be VBAC supportive and pro natural birth. I again found they were not the right fit with similar policies that my first doctor had. I was exhausted by my search and considered throwing in the towel and going back to doctor number one.
However I didn’t give up and when I was on the local HypnoBirthing website I FINALLY found the provider I’ve been looking for and I’m thrilled. We’ve decided on the midwives affiliated with Danbury Hospital in CT. They are open to giving women a TOLAC (trial of labor after Caesarean). They have telemetry fetal monitoring, so while I need to be monitored 100% of the time, I am free to walk around as I please and even labor in the tub. Also, receiving an epidural is my choice.
I know there are many women out there like me in a similar situation and since I went through the ringer with my new doctor search I thought I’d share a few tips I wish I’d known in the beginning. This not only goes for VBAC candidates but for first time moms as well.
- Collect all of your medical records from your previous pregnancy, labor progress notes and operative report from the hospital where you delivered (if you had a C-section), and your current pregnancy ultrasounds, lab and office visit notes. When you go to a new doctor they can request your records but it’s a smart idea to get them yourself so you can keep your own copy. I made copies each time I went to meet a new provider.
- Go to your insurance provider’s website and print a list of OBs and midwives that are in their network and in your area.
- Take that list, read reviews online and narrow it down by docs that seem to be a good fit and who deliver at the hospital you want to go to.
- Read as much as you can! Think about what you want your birth experience to be like and do more reading. When you’re informed you know what to look for and can ensure you are putting yourself in the hands of a provider who is on the same page. Write down a list of questions you want to ask your potential new doctors.
- Decide if you want a large or small practice. Both have their pros and cons and keep in mind that a large practice has doctors with differing opinions.
- Narrow it down to about three providers and book consultation appointments with each and when you meet with the doctor reiterate that it’s a consultation. In my experience doctors assume you want to come to them and they have to accept you into their practice. Don’t be intimidated and remember that you are interviewing them just as they are reviewing your records.
- Ask questions about the hospital’s policies in the labor and delivery unit.
Keep searching until you find the supportive provider that you are looking for! Here are some other resources that are great for VBAC candidates:
After all of this is it possible that I could end up with another C-section? Of course it is. If I don’t get my VBAC at least I’ll know that I’ve educated myself and created a support team who will do everything possible to help me reach my goal and that makes me feel confident.