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VBAC's...anyone had one or planning one Rss

Hi there

We had an emergency c/section with our first and hubby and I have agreed that we would like a VBAC for no 2. Not TTC yet, maybe after bub's first birthday.
Just wondering where everyone has gone to do this, back to the same ob or to a midwife? Same hospital? What has the response been by the medical staff?

Thanks
Merry Xmas everyone:)

Mum 2 2 boys

Great to hear you are considering a VBAC!! Have you considered a Hombirth.

I assume the local service is able to provide birth care if needed?

Homebirth with a midwife you know and trust is the safest way to give birth and be cared for. Why? Because unlike standard care where one midwife cares for several women in labour (or in country areas also looks after Acc& Emerg and all other bits) you have one midwife that has got to know you from pregnancy and is caring for only you.

What if something goes wrong? Most people are unaware that in any setting it is a midwife who will always detect a complication and take action, Drs (even when contracted privately) do not spend any real time with women, they come in and out and rely on the midwives assessment of how the labour is progressing. In the event of an emergency (ie bleeding and cord prolapse) midwives and Drs are all trained in the same emergency management. An emergency caesarean cannot be performed in isolation a theatre needs to be set up, with an anaesthetist as well as an obstetrician and theatre nurses etc. So even if you were giving birth in a hospital and needed emergency surgery it would by no means be instant (at least 1hr, sometimes more). In the event of needing this in a HB situation, the midwife calls ahead and the theatre is set up while you are travelling. The benefit of having your own midwife is that the complication will have undoubtedly been detected earlier as midwives working in Hosp are not present at all times (in fact many must just pop in and out due to competing pressures in other areas).

Independent midwives are experienced at mother and baby resuscitation and carry oxygen for this. They also carry Syntocinon (a drug to stem bleeding). Many independent midwives will cannulate and insert a drip if need be and they can suture 1st and 2nd degree tears.

To understand the safety of homebirth I think you need to understand the huge pressures and problems with the current health system (no-one questions the hosp system, but everyone questions homebirth!). We need to apply the same scrutiny to all birthing services.

I am attaching a basic reading list for you, also some attachments from academic journals re the safety of HB, may be a little heavy going but you will get the idea! (see below)

I am very happy to talk again and provide any support you may need.

I wish you all the best for a beautiful birth.

> Active Birth by Janet Balaskas has a homebirth section and is full of the real
> facts on why an active (ie upright birth is physiologically the easiest and
> best) so it will prepare you for what homebirth is all about (staying upright
> and working with your body) rather than what much of hospital birth does
> (forces women on their backs on beds etc.
>
> Nicky Wesson (UK) has a book on Homebirth, called Homebirth as does Sheila
> Kitzinger (she is a guru, also UK). I found homebirth stories very good.
> There is a book on homebirth stories by David Simon (a little dated but
> Australian stories) also Homebirth Access Sydney www.homebirthsydney.org.au
> have compiled a book on birth stories.
>
> It depends what you want, I was convinced from the start that homebirth was
> for me so I read the opposite to prove that HB was as safe if not safer than
> hospital birth and that so much of the intervention and resultant morbidity
> that women endure is not based on evidence but merely the convenience of
> practitioners and large hospitals.
>
> For info on unnecessary intervention and the lack of evidence based medicine
> the bible is called “Effective Care in Pregnancy and Birth” by Enkin M et al
> an edited work of all the research evidence, disproving so many myths.
>
> It is available on line through the Cochrane database (a database of evidence
> on medical procedures) The entire text is available on line at
> www.maternitywise.org
Here’s the link
http://www.maternitywise.org/guide/index.html

> Another good read is Henci Goer, Obstetric Myths vs Research Realities this is
> a US text (but our care is very similar so it is well worth the read) Henci
> Goer also has a text called “The Thinking Woman’s Guide to Better Birth”.
>
> Birth from a babes perspective is another interesting thought and a book
> called Birth Without Violence by Frederick Leboyer was one of my favourites
> (yes scary title I know) but a beautiful story that really makes you think.
>
> Most of these books will be available at alternate type bookshops or you can
> get them on line at birthinternational.com (located at Annandale Sydney) or
> Capers Bookshop in Brisbane (I think www.capersbookstore.com.au) they
> specialise in birth/midwifery texts.
>
> Another thought depending on where you live is to go to a coffee morning of a
> HB support group to talk with women who have birthed at home (quite a few will
> have experienced both hosp and HB so could be a useful resource)
>
This is a précis on the safety of homebirth

The safety of hospital birth for all women is largely taken-for-granted by doctors and the public even though no research evidence exists to support this commonly held belief (Dodswell, 1996; Olsen, 1998; Springer, 1996; Zander, 1999). The safety of free-standing midwife-led care for women in the United States was established beautifully in their National Birth Centre Study of 11,814 women. There were no maternal deaths, for women with low risk pregnancies the neonatal mortality rates were no different from hospital births but the caesarean section rates were lower (Rooks, 1992). The safety of planned home birth versus hospital birth for low risk women has been systematically reviewed (Olsen, 1998) with the conclusion was that “there is no evidence in favour of planned hospital birth for low risk pregnant women”. The Australian study which has generated the most discussion (H. Bastian, 1998) cannot be used to evaluate the safety of planned birth for low risk woman because that study included all planned home births, included premature births, breech and twin births at home. Indeed, when responding to criticism of the original article the authors stated that “our study shows that low risk home births in Australia have good outcomes” (H. Bastian, 1999). The most recent study on the safety of planned home birth, published in the Canadian Medical Association Journal (P. Janssen, 2002) compared woman at low risk who birthed in hospital or home settings. The results were that women who were attended by a midwife at home had fewer inductions, less augmentations, less epidurals, less episiotomies and less caesarean sections when compared with a matched hospital group. Outcomes for the babies were the same in both groups. On the basis of all available evidence and in the absence of disconfirming evidence we can say that for women of low risk, homebirth and free-standing birth centre birth is as safe for babies and even safer for women than hospital birth.

http://midwiferytoday.com/articles/dozen.asp

http://www.ican-online.org/

Joyous Birth
Home Birth Forum - a world first!
http://www.joyousbirth.info/forums/

Accessing Artemis
Birth Trauma Recovery
http://health.groups.yahoo.com/group/accessingartemis

http://www.australiansocietyofindependentmidwives.com/index.html

http://www.homebirthaustralia.org/

http://www.maternitycoalition.org.au/

Contact me again if you would like anymore info. VBA

Qld Mummy, 22 month baby boy, 1 MC 11 weeks

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