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11-28-2012 at 10:52 PM
AshleaB12
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How many of you had VBACs after a c-section for failure to descend?

I need some reassurance that it is possible to deliver vaginally after a diagnosis of failure to descend which resulted in a c-section.  I had a doctor's appointment yesterday and met with the one OB in the practice that I really wasn't looking forward to meeting.  I hadn't heard good things about her at all and she didn't disappoint.  My husband went with me and she said that my chance of a successful VBAC was less than 50% because I had actually made it to the pushing stage with my DD.  Right then I knew she had my husband convinced I should have a c-section.  She also went on to say that if she was on call on a weekend and I went into labor and was trying for a VBAC that she wouldn't be very happy if she had to hang around all day while I was in labor.  She also found out that I work at the hospital that I would deliver at and she said if I had any friends in the OR that they wouldn't be very happy with me if I tried to VBAC because the anesthesiologist would have to be there the whole labor, an OR team would have to be immediately available, and they would have to keep and open OR just in case.  I was immediately irritated.  I won't be meeting with her again.  That's for sure.  I just want to know that there are actually people out there who were able to deliver vaginally after having a section for failure to descend and actually pushing for awhile.  I really, really don't want another c-section if I can avoid it.  I think it really contributed to my PPD and I'm going to have a toddler and a newborn to take care of.  Sorry this got a bit long.   

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11-29-2012 at 12:00 AM
nosoup4u
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Oh man, what a horrible person! Sorry you had to listen to that, yikes. I pushed for over four hours with my first son before having a c section, and went on to have a successful, straight forward VBAC with my second, who was also significantly larger. My MW never once gave me grief about having been FTD with my first. If anything, she was more optimistic about my ability to VBAC than I was.

Can you interview other providers? Good luck and hth.

DS1 - Feb 2008

DS2 - Oct 2010 (my VBAC baby!) 

11-29-2012 at 2:53 AM
emaddock
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I will give you the perspective of someone who failed bc of failure to descend both times. First off you need a supportive OB. Mine was wonderful and I cried in her office about attempting a vbac many times. During my attempted vbac she never gave up on me but I had asked her if it got to a point where she didn't think it was going to happen to be honest with me. This time around I made the call to stop pushing and do the csection which of course was disappointing but I felt more in control.

Also my OB said bc I pushed before that my odds for vbac were lower than someone who didn't get a chance to push but still around 60. It has to be at least 50! Either you will vbac or you won't? :

I has PTSD after my csection with dd. I was so worried that a failed vbac with DS would result in the same thing. I am happy to say that even though I failed and ended up having a very difficult surgery I gave felt good in my recovery both mentally and physically.

So my rec is to find a supportive OB abd go for the vbac. Even though i failed i am glad i got to try. But also take some time to be at peace with the fact that you might have a csection again.

Good luck!

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11-29-2012 at 8:45 AM
sbevmc09
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I don't have any info for you because my circumstances are different, but yikes!  I would run far, far away from the practice.  There is no way I would be comfortable with the possibility of that OB attending my L&D.

GL!


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11-29-2012 at 9:10 AM
UberBiz
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WTF I would run fast the other way if a doctor was annoyed to what, do their job??? I had an emergency c-section with my daughter because of similar reasons, I was pushing, she wasn't descending, and also her heart rate wasn't coming back up after contractions (cord was around her neck and in front of her face).

I know this is something that may or may not happen again, but my OB is very pro-VBAC and I'm willing to try a natural delivery again before resorting to a RCS.

Find another OB ASAP!


 
11-29-2012 at 2:29 PM
iris427
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That doctor sounds like a peach.

I had a c/s for failure to descend/cephalopelvic disproportion.  I pushed for about 2 hours and baby did not descend past 0 station, so we did a c/s.  My OB told me I would never deliver vaginally in the future unless I had a preemie.

I did some research, found a new doctor, and had an uncomplicated VBAC.  I pushed for around 3.5 hours but my new OB was patient, and baby was doing well and moving down gradually.  Oh and baby #2 was NOT a preemie and actually weighed slightly more than baby #1 :)

So yeah, it is definitely possible. There are studies showing a 60%+ VBAC success rate after a c/s for FTD/CPD. 



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11-29-2012 at 2:34 PM
iris427
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Also, do you know if your baby was in a weird position, like sunny side up?  That can lead to a higher c/s rate because those babies are harder to push out.  It's not a reflection on your body's ability to deliver a properly positioned baby.


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11-29-2012 at 3:21 PM
MAprincess
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No advice other than get away from that doctor!  You shouldn't VBAC because it is inconvenient to her and other medical professionals?  You should take a higher risk with your life and have surgery so she can get home at 5?  She picked the wrong profession. 

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11-29-2012 at 11:32 PM
AshleaB12
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iris427:
Also, do you know if your baby was in a weird position, like sunny side up? nbsp;That can lead to a higher c/s rate because those babies are harder to push out. nbsp;It's not a reflection on your body's ability to deliver a properly positioned baby.


I'm honestly not sure if DD was in a weird position. My OB never said and I can't find it in my chart either. I just remember him saying, "Oh yeah, there was no way she was coming out" when he did my csection. I was in labor for 22 hours and had terrible back labor the entire time. Like, I don't recall ever feeling a contraction in my abdomen. Everything was in my back. After describing everything to one of the midwives in the practice, she started to think that maybe DD was OP. She however, was very encouraging about a VBAC. She actually told me her first child was a csection and her story sounded similar to mine and she had a VBAC with her 2nd and then delivered 2 more vaginally after that. I would love to continue to see the midwives in the practice rather than the doctors, but I need to find out if they are allowed to manage VBACs in that practice or if it has to be an OB.

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11-30-2012 at 7:39 AM
cchill01
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Wow!!  What an @$$.  Everyone in OB, surgery and anesthesiology understands that they chose an unpredictable area of practice.  If she wants regular, she should try a new field.

DD#1 just wouldn't come out.  I had a 60 hour induction with a good amount of pushing.  Failure to Descend or Failure to Wait was probably my diagnosis.  I was pushed into the c-section by a doctor who sounds an awful lot like the one you saw.

DD#2 was a totally different labor.  I had a 9 hour induction with just 45 minutes of pushing.  She lid out easily with minimal tearing. 

Your chance of success is much closer to 70%, which for me was hope enough.   Good Luck!  And try to stay away from that ridiculous doctor. 



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11-30-2012 at 11:31 AM
AshleaB12
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cchill01:

Wow!!  What an @$$.  Everyone in OB, surgery and anesthesiology understands that they chose an unpredictable area of practice.  If she wants regular, she should try a new field.

DD#1 just wouldn't come out.  I had a 60 hour induction with a good amount of pushing.  Failure to Descend or Failure to Wait was probably my diagnosis.  I was pushed into the c-section by a doctor who sounds an awful lot like the one you saw.

DD#2 was a totally different labor.  I had a 9 hour induction with just 45 minutes of pushing.  She lid out easily with minimal tearing. 

Your chance of success is much closer to 70%, which for me was hope enough.   Good Luck!  And try to stay away from that ridiculous doctor. 

 Yeah she was a total jerk.  I may even mention something about that to the OB in the practice who delivered my DD.  I think that was absolutely ridiculous.  I hadn't heard good things about her and I knew from previous research that she already had sanctions against her.   A girl I go to church with use to be a L & D nurse at the last hospital she worked at and she said at one point in time she wasn't allowed to practice on her own.  She also said she saw plenty of the "products of her handiwork in the NICU."  That was enough for me.  That lady isn't touching me, that's for sure...no matter what I decide to do.  I already know that she wouldn't let my cousin VBAC when she was on call even though that had been my cousin's plan all along and it had been okayed by all of the doctors.  I just don't think I'll be successful if I stick with the doctors in the practice, but I'm not sure if they allow the midwives to manage VBACs.  I love my OB who delivered my daughter but there is no guarantee he would be on call when I went into labor.  I feel that he would definitely give me a fair chance at a VBAC as well as the other male doctor in the practice.  I have yet to meet the other female OB and she is new, so I don't know anything about her.  The crappy doctor the other day did at least tell me to play it by ear and see how things go.  So, I guess that's what I'll be doing.


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11-30-2012 at 6:16 PM
annabelle....
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Lots of us have. I pushed with my first for three hours and had a csection. With my second, I delivered in an uncomplicated vbac just two hours after my first contraction. My friend had a similar story and went on to vbac a 10 pound baby.

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11-30-2012 at 10:36 PM
AshleaB12
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Thanks for all of your replies! It's good to know that it truly is possible to have a successful VBAC after a diagnosis of failure to descend and a csection. Especially when some doctors out there make it sound like you have a better chance of going to the moon than having a VBAC. It's just frustrating. I want the recovery of a vaginal birth but I'm afraid it will just end in a section like my first. I guess I'll see how everything pans out and hope for the best. Thanks again!

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12-01-2012 at 9:40 AM
nosoup4u
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AshleaB12:
cchill01:

I just don't think I'll be successful if I stick with the doctors in the practice, but I'm not sure if they allow the midwives to manage VBACs. 

Are the midwives part of the same practice? As long as they are CNMs and work out of a hospital, you should be fine. I think some hospitals require a visit with an OB if you're planning a VBAC, but not all. I never saw an OB for my entire VBAC pregnancy, but the MW group I went to had a lot of autonomy.


DS1 - Feb 2008

DS2 - Oct 2010 (my VBAC baby!) 

12-02-2012 at 2:53 PM
Ceefome
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What a horrible doctor!  Sounds like she needs to find another specialty, or just stick to gyn and get out of the baby business.

I pushed for 3.5 hours with my first, and she never made it past -2 station.  I switched practices and had a few doctors in the new practice tell me that my odds of VBAC were not good, one go so far as to recommend against my attempt and write as such in my record.  Well, he delivered my VBAC baby after not even 30 minutes of pushing. 


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12-07-2012 at 8:10 PM
hansa11
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What I learned from my experience at an attempted VBAC is that you need not just a supportive OB/MW, but a supportive practice and hospital.  So I would run far, far away from not just that OB, but the whole practice. 

My OB was very supportive of my attempt at a VBAC even though I wasn't considered a good candidate.  I ended up with a long and painful labor, just like with my first, but this time around, I felt like the doctor on call and the nurses had written me off as a repeat c-section.  I got no support at all from anyone on staff.  I had delivered at a different hopsital with my first (we moved, so I had to find a new OB and hospital) where I felt like everything possible was done to help me have a vaginal birth and even though I was disappointed I ended up with a c-section, I was at peace with the decision.  When I told my OB at my post-op about the lack of support I got, she admitted she was afraid that was going to happen.  What?! 

So now I tell my friends considering VBACs to not only find a supportive OB/MW, but to ask whether others in the practice support VBACs AND to ask specifically how the hospital supports VBAC patients. 

 
12-18-2012 at 4:23 PM
acsago
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I did!  I couldn't push baby#1 out after almost 3 hrs and they said she was too big for me to deliver.  I pushed out baby#2, bigger than the first, in about an hour and a half with a tiny little tear.


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12-21-2012 at 11:56 PM
passionclo...
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Soo glad I've found this... My son was born via c-section after he failed to descend... I had started my induction on a thursday evening ( induced 3 days after due date b/c they feared with my gestational diabetes that my son would be too large), pitocin at 8am on friday, contractions soo bad i had 1 pain killer before my epidural... 530 rolled around and they told me i needed to push even though i wasn't fully dialated b/c his heartrate was dropping and i was running a fever.... (they think it was an infection from being checked soo much b/c i kept feeling like i needed to push) anyhow got to the OR, they gave me a spinal block and it truly made me feel like i couldn't breath, i panicked & they ended up putting me to sleep.  Well my son came out weighing 6lbs 13 oz... not big by no stretch but he got lodged in my pelvic opening and thats what caused the lack of descent.  Dr told me then i'll never deliver a baby vaginally if i can't get a 6lb baby out... but i really really want to try a VBAC with baby #2 (once he or she is concieved)  Some of these responses give me hope that maybe it truly is possible if i find the right dr/group to support me in trying it.... the first birth was soo horrible I'm terrified to do it again like that..... :(   

Good luck to you in your journey & I really think you need to find a new group if they aren't going to be supportive and result in scare tactics to get you to change your mind... truly believe there is a difference between knowing all the facts vs being scared to do what works best for the dr's agenda~!!!!

 
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