Tuesday, September 24, 2013

"Failed VBAC"

I got my medical records yesterday.  I requested them a couple of weeks ago from the clinic where I was seen throughout my first two pregnancies.  I was surprised at the large stack of stuff I got, but there wasn't any information in there that was new or surprising really.  The OB had made various notes during my second pregnancy about 'patient desires vbac' and how he had counselled me on the risks and benefits of a vbac. Mostly the risks and repeatedly on the 'chance of rupture'.  Don't get me wrong, the OB is a great one and he was very supportive and mentioned that the risk is only 1% higher for rupture as compared to a first time pregnancy. But is was interesting to look through all the paperwork and look at all the test results of all the blood tests I underwent.  I was in a groove and had a good pace going in looking through everything beginning with the infertility before we conceived our daughter and the procedures and tests we went through to figure that out.  Then the pregnancy when we finally got pregnant including the sudden bleeding at 17 weeks and how the ER doctor told us we had a 50% chance of losing our baby and diagnosed me with placenta previa.  I had to wait 2 weeks to find out from my OB that is a subchorionic hemorrhage and that everything was fine. All of this I knew and read over with relative ease.  And then I got to my second pregnancy, specifically the birth.

'Failed VBAC', 'Failed attempted vbac' or some variation of those words appear repeatedly on the pages. It describes my 'failure to progress', and that they couldn't use augmentation methods due to my previous cesarean.  I knew this too, of course.  I still have a lot of regret over not staying stronger for longer to wait it out.  I could have done it.  I should have done it.  Then I wouldn't be where I am now.  I would have a chance now, if only I had persevered last time. Its already hard when you internally feel like a failure and weak because I caved in to the pressure and negativity being thrown at me by the medical staff.  But nobody forced me to make that call.  Yes, they mentioned it every single time someone walked into the room, but they didn't make me do it, I could have said no.  I did many times, but that last time I didn't. I failed.  I failed because 'they' failed me.  Because they wanted me to fail.  They expected me to fail and did absolutely nothing to help me not fail.  None of those people working there that day, on Good Friday, were there for me.  None of them wanted to be there and none of them wanted to wait for my baby to be born on his terms.  So I failed. I am a failed VBAC patient.   Now because of the '2' added to VBA2C, I will have to fight twice as hard (if not harder) for what I want for me and my baby.  Because I failed last time.

Thursday, September 19, 2013

Searching, Searching and Searching

Since it appears its the money is going to be an issue and I may not get to go with the midwives, I've been calling and searching and calling, desperately trying to find an OBGyn who is willing to work with me on a VBA2C.  Every single place I call tells me that they 'don't do those here'.  I have had some secretary/nurses tell me that that OB sometimes does VBAC, but not a VBA2C.  They say its because of the risks and I just want to SCREAM!!! I want to throw a temper tantrum the likes of which could compete my nearly 3 year old daughter.  Do you not ever ready anything new that comes out from the ACOG?! You are so misinformed! I asked on a local facebook group for suggestions and advice and I got nothing but negative information about how impossible it is to find a VBAC friendly doctor, much less someone who'd be willing to advocate for me.  Its an impossible dream, apparently, to want a VBA2C in the state of Texas, or at least in my area of Texas.  Its been suggested that I go to a town 2 hours north of me, where there are supposedly some OB's who would 'allow' me a trial of labor.  The issues I have with that are that it is 2 hours away, and if I go into labor in the middle of the night, I have to wake up my two kids and drag them with me because I don't have anyone to watch them here, and I wouldn't be comfortable with that anyway because I don't like being that far from them. Or from home, for that matter.  It would also mean that I'd have to drive 4 hours for every single appointment, with my two kids.  And I'd have to drive that every week during the last month.  That wears me out just thinking about it.  I shouldn't have to do that. It shouldn't be this hard! Its my body and I should be able to choose this for myself.  I am a grown as woman and I have done my research! I can make my own medical decisions! Why should they get to force a surgery on me when the overall risks of surgery versus vaginal birth after cesarean (even multiple) show that vaginal birth is overall safer?  Anyway, that's where I am with that.

I went to a hospital tour of the local hospital that is literally one minute from my house.  How awesome would it be if they were an awesome hospital?  Unfortunately, they are not in the least bit VBAC friendly. There were a few things I did like about the place.  I liked that in a vaginal delivery they immediately place the baby on mom's chest as routine policy.  I like that they encourage breastfeeding and rooming in.  I liked the big clean labor rooms, but why are the regular rooms always so cramped and small?  That is where you have more visitors.  Also, why separate rooms for labor, recovery and then a regular room?  Why can't there just be one room that you stay in? But I digress.  I didn't like that they take the baby after you leave the recovery room just to bathe and observe the baby for 2 hours in the nursery.  I don't understand that. Why are parents in a hospital not allowed to bathe their own baby for the first time? And why can't they 'observe' the baby while he or she is with mom?  I didn't ask, but I imagine the separation is even longer with cesarean babies. I am also annoyed by the no pictures of video policy of hospitals during the deliver of the baby, especially cesareans.  It makes it seem like they have something to hide.  They don't want any record of it if the screw up, giving them deniability.  That's how I see it anyway.  Maybe they have a genuine and reasonable reason for this policy, but it has never been explained to me.  They also had a booklet handout at the tour.  I've read through it and am annoyed at the tone of it.  The baby will have routine this or that, This WILL happen, that WILL happen.  As though there is no other way and no choice whatsoever of the parents/patients.  That was that tour.  I will hopefully not see the inside of that L&D anytime near May!

This is where I am now.  Still not sure what will happen or how or even if I will get my dream.  I have had almost all hope dashed at this point, but I am not above going rogue and just doing my own prenatal care and waiting till the baby is literally coming out before going into the hospital if I can't get the midwives.

The Back Story

On September 6, 2013 I got a positive pregnancy test.  The line was very light but definitely there and confirmed the following day with another test and a darker line. My mined immediately went to the birth and what I wanted for the birth.  A VBA2C.  This is apparently twice as hard to get as a VBAC.  

I didn't think it would be THAT hard.  We moved about 9 months ago from one Texas town to another one 2 hours away, but this one has a birth center and midwives so I had high hopes.  I thought that was all there is to it. I'll go with the midwives and that will dramatically increase my chances of success because they will support me and help me.  They will believe in my and the ability of my body to do what its designed to do.  There is no reason for me to not be successful.  My first cesarean was scheduled because my daughter was breech, my second was an attempt at a VBAC with absolutely no support.  My water broke at 2:30am on Good Friday and we went to the hospital at about 5am.  My progress was slow and the nurses wouldn't let me eat or drink anything.  I was told my birth plan was meaningless and it was completely disregarded and then I was badgered non-stop for the next 13 hours to give up and just go with a c-section.  I finally ran out of energy to fight it anymore and gave it.  I have regretted that every day since.  I promised myself that if I ever had another child I would try harder, be stronger and be successful.  Now, here I am. Pregnant again.


After I got that BFP, I called the midwives a few days later and made an appointment for a consult the next week.  When I met with them a week later, I adored the one I spoke with and at the end of the meeting she went in and consulted with the other midwife in the practice and they decided that if I wanted to use them, they were willing to take me under their care. That was exciting.  Then she asked about insurance and when I told her my carrier, she told me that they don't pay for midwives.  Apparently, the midwives have been trying for years to get them to cover their service, but the refuse.  This would make me a cash paying customer, and that fee is not too outrageous, but still pretty high when paid out of pocket.


When I got home, I began researching my insurance company.  I looked over the policy and couldn't find anything there. I googled but didn't come across anything new or helpful to my situation. So, I called them and confirmed what the midwives told me, but I also got a rough estimate of the cost to us, after insurance, in the event of a repeat cesarean.  The amount is almost exactly the same as the no-insurance amount we would pay the midwives.  If it were a simple choice of picking one or the other its a simple choice, but in the event that I go through the entire pregnancy with the midwives into the start of my labor and then, for some reason, end up as a hospital transfer we would instantly double the cost of having this baby.  And that is a LOT of money to us. When I told my husband about the costs being the same either way, he immediately went to how much it would cost if we had to pay both. And said that its a lot of money to throw at a MAYBE (referring to my VBA2C attempt). Without his full support and backing, I've got nothing. The midwives are my only option for even having a chance at a VBA2C at all. There is no doctor within a 4 hour drive from here that would even allow me to try for a VBA2C. Under the current circumstances I am left with only one option and that is a scheduled RCS.