Monday, June 21, 2010

Once a VBAC, always a VBAC?

Recently, I finally had my long overdue annual exam at my Ob-gyn. Always a "fun" experience as I am sure many will agree.
I took this opportunity to ask my doctor if I am still considered a VBAC and therefor more high-risk, even after already having 2 successful VBACs. I find it frustrating to be limited in my choices. For example, most Birthing Centers will not accept VBACs. Some doctors (not mine, thank goodness, although one of his partners does) insist on continuous monitoring for VBACs. This even though the evidence shows that there is no difference in outcomes between intermittent and continuous monitoring.
In case you are wondering, I am not pregnant, but as a doula, I can't help thinking about these things a lot, especially because I discuss them frequently with my clients.
My doctor's answer was pretty much "yes and no." On the one hand, my two successful VBACS clearly prove that I can give birth vaginally and that I should have no problem doing so in the future. On the other hand, a uterine scar is still a uterine scar and is something that needs to be taken into account. That may mean no birth center birth but that does not mean that I cannot have a low intervention, normal childbirth experience elsewhere. I just need to advocate for myself, choose the right care provider and make it happen.
I was thinking that very few people have a picture perfect pregnancy. Someone may have high blood pressure, gestational diabetes or some other minor kink. Even if they do not, something may come up unexpectedly in labor. Like my previous cesarean, these issues should obviously be taken into account but they do not need to totally dictate a woman's experience. Basically, you make the accomodations you need to make, and you move on. Changing one thing does not mean having to change everything.
It was an interesting thought. Don't think about the things you can not have, rather work with what you do have. And that is usually plenty.

1 comment:

  1. "Don't think about the things you can not have, rather work with what you do have". - that's such a powerful thought!!! we should keep this in mind more often in every aspect of life...