Vbacs No Longer Okay at Hospitals????

My 1st pregnancy was also twins and I also had them c-section. Then I got pregnant when my sons were 14 months old. I recently had another baby boy and had to have him by c-section. Before the baby was born I asked my doctor why I had to have another c-section if the baby was facing the way hes supposed to and it's not multiples and he told me that when a women has had a c-section 24 months prior to getting pregnant again they HAVE no choice but to do it again because even though the outside of the old scar is healed doesn't mean that the inside is compleatly healed and if you were to deliver normaly .. the pushing may cause for the inside womb to open which becomes into internal bleeding. Hope I could help! =)

I have not had a VBAC. But many women do. I would look into the Bradley Method birthing classes. Even if you decide not to do the classes, maybe you can talk to someone who can give you advice. I took the classes with my daughter and they were very helpful. They had a whole section on VBAC.

A friend of mine had a vbac in May at Bayfront in St Pete. She was planning on having a c-section, but she was so dilated when she arrived that they went ahead with the vbac. I haven't heard that it's not allowed.

It is ALWAYS your choice how you give birth. The truth of it is csection rates are skyrocketing. It is just more convenient and pays better for an OB to perform a cesarean. Elective cesareans are not the healthiest option for babies or mothers unless complications arise. ICAN is an excellent resource. (International Cesarean Awareness Network) http://ican-online.net/
Please go to this website. Read. Ask questions and know you have rights.

I had a very long converstation with a midwife that is very involved in getting VBACs to become more accepted in the hospitals. I am sure she would love to talk to you about it. She loves educating women on what their options are. She is at the Labor of Love in Dunedin, FL they also have offices in Lutz, and Tampa here is their website. http://laborluv.com/ Good Luck!! Good for you for questioning your doctor!

A previous poster said insurance in FL won't pay for VBACS... this is UNTRUE! Insurance DOES pay for VAGINAL BIRTHS!!!! However, some insurance companies will NOT pay for repeat cesareans!

I've attended & been paid for VBACS!!!

Birth Center law does not specifically prohibit VBACs, only that the birth center must be participating in the national study, which no longer exists... a new study is in the works, so in the coming years, birth centers may be able to offer VBAC's again... for now, it's home or hospital!

Hi B.,
I would highly recommend speaking to a midwife and researching this well so you fully understand your options and your rights. The World Health Organization states that when the c-section rate exceeds 15%, the risks outweigh the benefits. Our local hospital's rate is 42%. Cesaereans are definitely on the rise, but NOT because they are safer. On the contrary, the top studies of 2006 conclude the following:
- Risk of death for babies born by cesarean was nearly three times greater than babies who were born vaginally.
- Having a history of cesarean increases a woman’s chance of having a placenta previa and placental abruption, and each additional cesarean further increases the risk. Women with only vaginal deliveries or only one cesarean do not experience nearly the same risk.
- A history of multiple cesarean does not increase risk of uterine rupture and authors note that VBAC should remain an option for these women.
- A policy of elective repeat caesarean section led to higher cumulative hysterectomy rate, nearly twice the rate.
- Morbidly obese women and their babies experienced a higher rate of injury when the baby was delivered by repeat cesarean.
- A trial of labor in women with a previous low transverse caesarean is associated with a high rate of vaginal delivery (78%) and a low rate of uterine rupture (0.22%).
- The rising cesarean rate is not being driven by an increase in the risk profile of mothers.
- Authors found that cesarean rates varied greatly and that high cesarean rates were only partially due to medical need, and are greatly influenced by non-medical factors like fear of lawsuits. Higher cesarean correlate to decreasing medical value for patients and do not mean improvements in the health of mothers and babies.

And finally: Researchers examined whether restrictive VBAC guidelines issued by ACOG and implemented by care providers and hospitals have improved health outcomes for mothers and babies. The bottom line: Researchers found that, in spite of restrictive guidelines imposed on women with a history of cesarean and those seeking VBAC, mothers and babies fared no better.

For more info, check out http://tinyurl.com/28stnj or feel free to contact me.

One final thought - assuming you are pregnant with a singleton now, I would think your uterus may be even less likely to rupture since it has stretched to accommodate twins before....

ICAN is also a wonderful resource.

Good luck!

C.

Was your first c-section a problem? Is there a reason you don't want to do it again? I had my first C because my daughter was breech and my doctor (who I trust very much) advised me that this was the best way to go since I am overweight and already considered high risk, for that one factor alone (good BP, no other complications....apparently fat women aren't supposed to get PG, but that is another post). So enter my second child, I thought about VBAC, but was advised against it because my second child was large (and so was I HA) and the risk of uterine rupture is higher after C especially with a chunky baby. I had minimal scarring, pain, and recovery. I was able to lift my baby and basically had a great experience both times. The added days in the hospital were a blessing since the hospital I delivered in is very willing to take the babies in the nursery to let mom get rest. Whatever you decide, Congratulations on this newest blessing :)

I personally would question his advice based on the fact that with your previous pregnancy he didn't even give you the option of induction. I only had one baby, but I was induced at 38 weeks and it only took 13 hours, and I wasn't dilated at all. In my opinion, he kind of sounds like he wants it all to be convenient for him.

Hi B.
Congratulations on the pregnancy! I had a successful natural VBAC at the end of August. Here in Tallahassee there were only a couple practices that would allow it. It was a great experience for us. I recommend looking for a local ICAN (international cesarean awareness network) chapter and the book "Birthing from Within" by Pam England. I would also look into hiring a doula.
Best wishes and always remember to trust your instincts!
L.

Congratulations on your 2nd pregnancy! I recently had a VBAC as early as May 2007 at Gynecology and Obstetric Associates office of Dr. Jana Burse-Forsthoefel. Although my midwife performed the delivery per my request, the doctor's monitered this procedure very precisely. If there had been any threatened complications the doctor's would have immediately performed a C-section. They want to ensure the safety of both mom and child. This procedure is very costly to doctor's so most of them do not perform VBAC. Supposedly only two in Tallahassee, FL. This facility,Gynecology and Obstetric Associates, truly supports any women interested in vaginal delivery after birth. Good luck!!

Hi B. - There was a short time where VBACs were on the rise, but I think mostly b/c of skyrocketing insurance premiums for OB/GYNs they are discouraging it more and more. My daughter is almost 5 and I'm thinking about having #2 and was already told (at the practice that delivered my daughter and I'm still with) I will have to have another c-section. You can "shop" OB/GYNs to see if there are any out there willing to do a VBAC or go with a midwife type delivery as previously suggested. You don't have to stay with the OB you're with, but you will have to be very firm about what you want. Best wishes to you in your decision.

Hi, I had a vbac about 1.5ears ago. All those doctors out there saying that it is too much of a risk are really only meaning for themselves. I did a lot of research to find what was best for me and in the end wanted a vbac. I had to search long and hard to find a doctor even willing to let me try. I live here in Sarasota and if you live near by I would highly recommend Dr. Cohen. He is an awesome doctor not only for letting me do a vbac but I felt very comftorable with him. He is very nice. My first c-section and vbac were only 14 months apart. I have heard that it is recomended to go at least 2 years apart. And my labor was only about 7 hours long with 20 min of pushing. It was a wonderful labor and I would not have done it any other way. Recovery is a 180 from a c-section. Wonderful!! I did hear that being induced ups your risks of uterine rupture so I would not recomend that if you are trying to vbac. I labored and delivered at Sarasota memorial where I know that they will let you. I think there and manatee hospital are the only ones of the east coast that will let you. Well, I hope this helped...but do what you feel comftorable with. If you want to vbac let that be heard and stick to it. Your doctor is not allowed to force you to have a c-section but I'm sure it is a lot easier if they are working with you and not against you. If you have any other questions let me know..I can give you my dr's info if you want it. It is sarasota ob/gyn associates they are located on bee ridge rd.

My first was a c-section since he was in a breech postion.
I thought I waould have a VBAC but when getting pregnant 3 yrs later I was told it would also be C-section. I told them I wanted it natural. They offered to help me find an OB that would do this since they would not. We asked what the risks were, when they told us all the risks both my husband and I did not want to take the chance. Everything may go fine but we did not want to take that chance. Why risk yours or your babys life? I would advise having the c-section.

I had a c-section in 1998, then a VBAC in 1999. In 2006 with baby #3, I was told the hospital won't go for VBACs, even though I'd had one already with baby #2. Something about insurance and the risk of tearing scar tissue or something... to be honest, all I heard was "blah, blah, blah, you can schedule the date your baby will be born and not have to go through labor"... Since my first pregnancy ended in HOURS of hideous labor an an emergency c-section, I ran to sign up for a planned birth! They used the same scar for the incision area and I was able to completely skip labor and the whole un-known. I was able to pick my baby's birthday and schedule it on a Friday so out-of-town family could come see me in the hospital over the weekend... then I had that 2 week recovery period after a c-section where I got to milk it for as long as I could that I couldn't lift a finger around the house- hahaha!

Like yourself, I had a c-section with my first child in 2002 due to preeclampsia (in Indianapolis, IN). My OB-GYN that delivered her told me that a VBAC in my situation would be safe (of course there are always risks) for my next child but it would be my decision. I ended up moving and had my second child in Cleveland, OH. My OB-GYN there also told me that she supported VBACs, informed me of the risks of a VBAC but ultimately it was my decision. In 2005 I had my second child via VBAC without any complications whatsoever. I am so glad that I did it. However, now that I am living in Florida I am hearing that no OB-GYN here will allow a VBAC. I do know that there are fewer Florida OB-GYN's due to malpractice insurance rates. The rates are sky high for them so they most likely choose not to allow their clients VBACs for that reason. I know it is frustrating not to be able to choose the birthing method you would like. Just for your own curiosity, you may want to check the VBAC statistics in other states just to see the difference here in Florida.

Hi B., I had a C-section with my first son because he was to big to come out. My second pregnancy my doctor advised me to get another C-section due to the unnecessary complications that can arise from doing a VBAC. He had said because of the possibility of the inner original scar opening up under the pressure and the baby would then be in my stomach which would be life threatening. Also that it could split the original scar on the outside also due to the pressure. These maybe some of the reasons many hospitals advise not to. The risks to the mother and infant are not necessary for the procedure. Hope this helps!

I don't know anything about c-sections, or VBAC's personally. However, they cannot force you to have another c-section.

You could always show up at the hospital last minute. ;) The chances of uterine rupture after a c-section arent as big as they'd like for you to believe. You've got the world at your finger tips. Research, and arm yourself.

Good luck in what ever decision you make. :)

Contemporary Women's Care in Pinellas does VBACs. They also do water births. It's an all-female practice with MDs and midwives. It's who I *wish* I had gone with! I have heard so many good things about them.

Here's their website:

http://www.contemporarywomenscare.com/

Hi B.!
I had to have an emergency C-section with my daughter, 2yrs. ago. We are expecting our second child in June and I am planning on having another C-section. My doctor recommended it and I have a friend who is a Labor and Delivery nurse and she recommended it also. My friend said that she has seen too many ruptured uteruses to take a chance on a vaginal delivery. Maybe things have since advanced, but I thought I would pass along what I know. Hope this helps! Best of luck!

Hi B.-
I have heard some rather similar info. Although I am not yet pregnant with my 2nd, we plan on trying in early spring & I have already spoken to the docs about it. I live in NPR & was told that I could not attempt a VBAC in this area, that I would have to go to BayFront or somewhere else where they have a resident on call, which means I need to have an OB in that area who works in that hospital. Not very convenient. However, my midwife said that I could attemopt it at home, but not at the birth center, due to liability issues. She said it has to be at least 18 mos from my last delivery to get the doctors approval for her to work with me. Long story short, the hospitals & docs are worried about uterine rupture, which happens mostly b/c they induce the patients & that puts undue stress on the uterus. I would not let them induce me, point blank. I had to have a c-section before b/c he turned breech, so not b/c of a medical complication. If all is going well this time with you, I would insist on trying to go naturally to decrease your chances of complications...forcing you to get another section. Talk to a midwife to get some different views on the subject & even to another OB. A friend of mine was also told by her OB that she wouldn't allow her to even attempt a VBAC, so she found another doc who would in the Palm Harbor/Tarpon Spgs area & she delivered at Helen Ellis in Tarpon (she ended up needing a section after all, but at least she tried & knew it wasn't just b/c she had a previous section).

You should at least be allowed to try! Keep looking until you get what you want out of the delivery!

An interesting documentary to see packed with info on all this is "Pregnant in America"...you can find a trailer for it on You Tube.

Good Luck!

B.,
Congrats on your new pregnancy and best of luck with twins and a newborn! You are one strong woman!

I am a mom who has had 2 c-sections. I had one child born in 2002 and another in 2004. I was also told that it was not really a choice in the case of VBACs. In the state of Florida anyway, most doctors cannot afford the insurance liability of letting a woman attempt labor and delivery after a previous c-section. (My first child was born in Georgia and I was told it would be a mutual decision by me and my doctors when/if I had another child to attempt a VBAC... when I moved to Florida while preggo with child #2 I was told it was not an issue. VBAC was not an option.)
I have 3 friends I can think of in Georgia who attempted VBAC and 2 had to have c-sections in the end. Another in Virginia has had 1 c-section followed by 2 VBACs. I can think of at least 5 women I know in Florida who had 1 c-section and were then not given the option for VBAC after that. All of their subsequent children were scheduled c-sections.
That being said, if you are ADAMENT about attempting a VBAC, I would call the state Insurance Commissioner and see what the law actually says about it or if it is really a matter of the doctors making the decision due to risk to the mother/baby, insurance/financial risk, or otherwise. I think sometimes we're TOLD things are one way to make it easier on their part when, in fact, it may be a different story altogether.

Best of luck to you, and I hope you find the answers you are looking for!

I love in Tampa and am going to try for a vbac (first baby was breech). My doctor told me she usually doesn't do VBACs but she will if that is what I want, as long as I go into labor on my own by 39 weeks (I am 11 weeks right now) and follow a perfect labor curve. I am delivering at St. Josephs Women's Hospital. When I was in the hospital with my son, one of the mother/baby nurses was telling me that she has 4 kids, first was breech so she had a c-section and then she had 3 successful vbacs at St. Joe's. I have not heard anything about insurance not covering it though!!! Please someone let me know if they find out more about that!!! Good luck on whatever you decide, either way you will have a beautiful new baby!

I have heard and was told the same thing. Insurance in the state of Florida won't pay for VBACs.
Good Luck.

i was told the same thing after I had a c section with my twins. I really did not want another c section b/c I knew the recovery time is longer and having twins running around Iwanted to be up and going as soon as possoble. However I was told by two different ob that they wont do VBACS and if I wanted one there are a few OB who will do it but that it would cost me alot to have them being at the bed side 24/7 in case of rupture.

Best of luck

I had a c-section (horizontal) with my first son in 94. then 2 1/2 years later, when I gave birth to my second son, it was vbac. While I was in labor, I told the attending dr.s and nurses that I was experiencing pain that was not diminishing like the labor pains, it was constant. They totally disregarded my opinion and told me it was just normal labor. They were wrong. It turns out that the scar on my uterus had ripped open during labor, and I was bleeding internally for several days while they were trying to figure out why my blood count was so low. I was in the hospital for a week, had blood transfusions, and was in a lot of pain. This is my horror story, I hope that it helps.

I have had 3 VBACs, the last one in Sept of '07. All were perfectly fine. It depends on your doctor. My doctor is very "Pro VBAC", so I had no issue. Sorry you are having such a hard time. If you are uncomfortable AT ALL, seek a second opinion. That was how I found my doctor, who has been my dr for 14 yrs now. When I was pregnant with my 2nd one, the initial dr I chose was very "C-Section" happy. I found my doctor after seeking a second opinion, and have been very happy with him.

Hello B....

I recently had another C-Section due to the same issues. The hospital had such specific requirements for me to have a VBAC that it was almost impossible and my doctor advised that if any issues were to arise that I would have to have an emergency C-Section...My first was an emergency and they had to completely put me under...it was horrible!!! Although my doctor did offer a VBAC he does not carry malpractice insurance and he advised me that Florida has such a high rate of malpractice suits and a lot of them are atributed to VBACS....However if you research these accounts it usually has to do with the compantcy or lack there of, of the doctor or hospital staff not due to the procedure....If you find any information on Vbacs after 2 CSECTIONS let me know....
Hope you are able to have the birth you always wanted
J.

I had a c-section with my first too--due to his umbilical corn being wrapped around his neck. Other than that, he was a good size (not too big) and I was ready to go and probably would have delivered him vaginally without a hitch. But I have also been told that any subsequent births with also be c-sections.
The problem is the chance of a placenta tear goes way up with VBACs so many hospitals actually refuse to do it. I've talked to delivery nurses and other moms that have had c-sections and all have told me the same thing too.
I guess you could call your insurance company to see if they would allow a VBAC attempt and then ask your Dr. his/her opinion on the safety of the matter.
I for one will go by the advice of my Dr. if and when I get pg again since I do trust him and he is the specialist in the matter.
But yeah, from my understanding, none of the hospitals around here (ORMC or FL Hospital) do VBACs.

I personally think it's bull...it's the doctor, not the hospital. My sister wanted to do a VBAC and she literally went to 4 doctors before the 5th would agree to do it. She had an excellent experience and no complications. Me personally, I chose to do a second c-section because it is safer, and the risks of VBAC freaked me out. Good luck with your decision and carrying it out.

Congratulations on your new pregnancy. My husband and I found out our first child was breech after we had just finished our Lamaze classes. We were told that a C-section was the only option. Many, many Dr.s will not risk litigation. That was 11 years ago. My children are 11,7, 5 and all were C-sections. I was told a few reasons. One, you do not know how your inside scarring will hold up in labor. Uterine rupture could be fatal for both mother and child. Second, if you become overdue, inducing drugs could rupture the uterus. These days I think it is pretty hard to find a Dr. to do a VBAC. I am sure they are out there, but be cautious.

Please join the ICAN of FL yahoo group. There is a local chapter that meets in Cape Coral.

Hi! Most docs in Florida won't do VBACs anymore. HOWEVER, you can have a homebirth VBAC with a licensed midwife. There is one in Sarasota who does VBACs at home, provided you do'nt "risk out" with other things (like high blood pressure). You also always have the right to refuse a procedure. If you show up at the hospital while in transition and refuse the c-section, they have no choice but to deliver your baby vaginally. I have a friend who was attempting a homebirth for her VBAC, ended up transferring to Peace River, and refused the C-section, so even though the doctor was NOT happy, she got her VBAC in the hospital.

It's all about malpractice and not about the safety of the mother or baby. Cesareans are more risky to both mother and child than a vaginal delivery, even a VBAC.

I hope you can find a doctor or midwife who can work with you, and I hope you get your VBAC!

Your doctor is full of it.

Check out ICAN (http://www.ican-online.org), and join Florida's yahoo group (http://health.groups.yahoo.com/group/ICANofFlorida/).

ACOGs practice statement was changed to say that an OB (not necessarily your ob), surgical team, and anesthesiologist be immediately available for vbac. However the risk of uterine rupture (what this recommendation is based on) happens in 0.04% of vbacs. The likelihood of *something else* going wrong in a normal unscarred labor is actually somewhat higher. So, if a hospital is unprepared to assist a vbac, they are unprepared to assist *any* laboring mom.

I had a home vbac last year, and I'm planning on another one next year. Home birth is certainly a reasonable option if you're being stonewalled by your ob.

Ok, this is just a Fort Myers/Cape Coral thing. The hospitals in town WILL NOT allow a VBAC even though it is safe because there were too many lawsuits and lawyers made the decision (gotta love lawyers... not). There is only one doctor in town that might take you as a VBAC. He is right next door to the Baby Love Birth Center and is actually the doctor used by the birth center for emergency C-sections. You should be able to call them and ask for his number.

website: http://www.waterbirthbaby.com/

B.,
This is true. The governing body for Docs-ACCOG came out with a statement based on years of evidence based practice that the incidence of uterine rupture during labor was significant enough to no longer recommend this practice. Although there are many successful VBACs-even some birthing centers will do them, the catastrophic result of potential loss of mom and baby is too great to risk. As a L&D nurse, I have seen small ruptures occur frequently, and very large ones as well that neither mom or baby would have survived outside a hospital. Remember-your goal is to have a healthy baby and be there to raise him/her :)