VBAC advice

[[email protected]]

Well, I'm getting down to the last few weeks (haha if that's not
optimistic speaking, I don't know what is -- I've actually got 8 weeks
left, but I'm so DONE being pregnant that I'm hoping for an early
bird).

Anyways, we're planning on trying for a VBAC this time round. For
those who don't know, my first was a planned homebirth, but he never
dropped, and after about 10 hours of totally unproductive labor at
home, during which time I got fully dilated and fully effaced, we
transported. After another 6 hours of totally unproductive labor at
the hospital, I decided on the section, with the support of my
midwife. She said this was one of the only times she'd seen this
happen, and she's been doing births for decades and is very well-
respected in the field -- I trust her judgement, as well as the OB on
call who happened to be very natural-birth friendly and is actually
recommended as a homebirth backup in the Bay Area.

All this to say, I didn't have a section because of poor labor
management or because of a cascade of interventions or because Micah
was breech (in fact, they said he was perfectly positioned, just
waaaaaay up there and not wanting to budge) or anything like that.
According to my current OB (whom I like very much; she's totally on
board with my VBAC attempt), this makes a VBAC very unlikely this time
around, although she said I can do a trial of labor for as long as I
like.

What I'm trying to figure out is how long I should labor for before
saying forget it. I haven't been able to find any information online
about the failure-to-descend issue, except for a few anecdotal stories
on blogs. I don't want to do another full-blown many-hour labor,
since I think the combination of total exhaustion followed by surgery
is what made my heart go wonky (I had to get a cardio version a few
hours after Micah was born, and that was awful). But at the same
time, I don't want to kill my chances of a VBAC because I didn't give
it long enough. Any thoughts or similar experiences??

Em
mama to Micah, 11/14/04
#2 due 4/27/07

[Ericka Kammerer]

wrote:

> What I'm trying to figure out is how long I should labor for before
> saying forget it. I haven't been able to find any information online
> about the failure-to-descend issue, except for a few anecdotal stories
> on blogs. I don't want to do another full-blown many-hour labor,
> since I think the combination of total exhaustion followed by surgery
> is what made my heart go wonky (I had to get a cardio version a few
> hours after Micah was born, and that was awful). But at the same
> time, I don't want to kill my chances of a VBAC because I didn't give
> it long enough. Any thoughts or similar experiences??

I think the real answer is that you'll go as long
as you feel like it. Labors are so different. There's no
predicting at what hour you'll start to cross over into
getting too exhausted. You know the score. You've been
through this before. I think you can be a good judge of
your body and what makes sense to do at the time.

Best wishes,
Ericka

[Larry Mcmahan]

In article >,
says...
> wrote:
>
> > What I'm trying to figure out is how long I should labor for before
> > saying forget it. I haven't been able to find any information online
> > about the failure-to-descend issue, except for a few anecdotal stories
> > on blogs. I don't want to do another full-blown many-hour labor,
> > since I think the combination of total exhaustion followed by surgery
> > is what made my heart go wonky (I had to get a cardio version a few
> > hours after Micah was born, and that was awful). But at the same
> > time, I don't want to kill my chances of a VBAC because I didn't give
> > it long enough. Any thoughts or similar experiences??
>
> I think the real answer is that you'll go as long
> as you feel like it. Labors are so different. There's no
> predicting at what hour you'll start to cross over into
> getting too exhausted. You know the score. You've been
> through this before. I think you can be a good judge of
> your body and what makes sense to do at the time.
>
> Best wishes,
> Ericka
>
I think this is good advice by Ericka. I just wanted to add
a bit from my own perspective. I agree that you are not going
to get anywhere by laboring while you are exhausted, but there
are multiple ways to possibly deal with that. In some cases
where the baby won't descend, the labor will simply slow down
and stop. If your waters haven't broken it is ok to simply
rest and try again the next time they start up.

In our case, Monika labored with her first some 60 hours over
a 72 hour period. Thursday night, when we went to bed, she
started having contractions, and they continued until we got
up Friday morning. We had a mw appointment, so we didn't
worry about it too much. By the time we went to the appointment,
her labor was completely stopped. At the appointment she was
still completely closed. Friday evening just after dinner,
they started up again. This night they were steadier, and
went once every 5 minutes all night. We called the mw, and
when she got to our house, she said Monika was only 1 cm
dialated. She suggested having some wine to stop the contractions,
and taking a nap. We did. My son's team had a soccer game
that afternoon, and Monika labored off and on during the game.
She just sat on the ground next to the field and rocked back
and forth. After the game they stopped, and she was famished.
We went to eat. When we got home, Monika about 8 PM, Monika
immediately deposited her teryaki burger in the bathroom sink,
and went into labor again. She labored throughout the night,
and gave birth at noon the next day.

Don't think that just because you go into labor you have to
stay in labor, and that you can't stop and rest up in-between.
That may be a way of countering exhaustion and the fact the
baby doesn't descend directly.

Good luck,
Larry

[[email protected]]

> I think the real answer is that you'll go as long
> as you feel like it. Labors are so different. There's no
> predicting at what hour you'll start to cross over into
> getting too exhausted. You know the score. You've been
> through this before. I think you can be a good judge of
> your body and what makes sense to do at the time.
>
> Best wishes,
> Ericka

Thanks, Ericka -- I think a big part of this is that I don't really
trust my body anymore after Micah's birth, and even though I do think
we made the right decision to go for a section, I still second-guess
it sometimes (if I'd given it another few hours... look at all these
women who had much longer labors... etc.).

Em
mama to Micah, 11/14/04
#2 due 4/27/07

[Mary W.]

On Mar 5, 1:07 am, wrote:

>
> What I'm trying to figure out is how long I should labor for before
> saying forget it. I haven't been able to find any information online
> about the failure-to-descend issue, except for a few anecdotal stories
> on blogs. I don't want to do another full-blown many-hour labor,
> since I think the combination of total exhaustion followed by surgery
> is what made my heart go wonky (I had to get a cardio version a few
> hours after Micah was born, and that was awful). But at the same
> time, I don't want to kill my chances of a VBAC because I didn't give
> it long enough. Any thoughts or similar experiences??
>

I don't know if you remember, but my first failed to descend and
ended in a section - but I did have a mismanaged labor and was
pressured into a section so that's where we differ. Also, I suspect
she was a bit malpositioned, although I don't know that for sure.

You don't know why Micah didn't descend, but the circumstances
that led to that may very well not happen again. When I was
going for my VBAC (successful) I worked very hard on fetal
positioning (I sat on a birth ball alot) in the last couple of months.
I also
tried to be very positive about the birth, worked through alot of
my fears (my doula was very helpful with this) and anxiety and
I also let go of any preconcieved notions of birth. Exhaustion
played a big part in my section for DD1, so for DD2 I gave myself
permission to do what I needed to do, and if that was going to
include an epidural or other drugs, then that's what I'd do- I still
wonder that if I had done the epidural with DD1 and gotten some
sleep, if that would have helped. Basically, in planning for my
VBAC, I tried to keep all my options open.

That said, with my second daughter, as my due date got
closer she nestled herself way down - she was farther down
at the beginning of labor than DD1 ever got. During early labor
at home, she moved down farther (it was very noticable).
It was a long labor, and of course it was through the night
so I did get pretty tired, but I felt like we were always making
progress (unlike with DD1).

So, like Ericka said, I think you'll just need to see how
it goes. You'll probably have a pretty good feel for if
things are going to be OK or not. And if you need a
little encouragement, my sister just had a VBAC
less than a month ago! I wish you the best
of luck!

Mary W.

[Ericka Kammerer]

wrote:
>> I think the real answer is that you'll go as long
>> as you feel like it. Labors are so different. There's no
>> predicting at what hour you'll start to cross over into
>> getting too exhausted. You know the score. You've been
>> through this before. I think you can be a good judge of
>> your body and what makes sense to do at the time.
>
> Thanks, Ericka -- I think a big part of this is that I don't really
> trust my body anymore after Micah's birth, and even though I do think
> we made the right decision to go for a section, I still second-guess
> it sometimes (if I'd given it another few hours... look at all these
> women who had much longer labors... etc.).

Don't second guess yourself like that. I was one
of those who had a much longer labor; however, the baby
was descending just fine and there was never any question
that a vaginal birth was possible. You don't have to make
a perfect decision. You just have to do what makes sense
at the time. If you make an informed choice to stop a
trial of labor next time, it will be a decision based on
the best information you have at that time (which may not
be perfect). That's ok. That's all anyone can do.

Best wishes,
Ericka