Tuesday, January 4, 2011

Strategically Planning My VBAC

Fail to plan, plan to fail.

Let's say I made a resolution to lose weight (obviously not gonna happen since I'm PG), but I don't give any thought to making that goal a reality.  At the end of the year, do you think I'd be successful in my weight loss endeavours?  Probably not.  Why would I fail?  Because a goal without clearly defined action steps to make it happen is just a dream.  And dreams don't often become reality.

Though I had a cesarean with my son, I want a vaginal birth if at all possible this time around.  I realize that I can just tell my OB that I want another C-section, but I don't want to be put in the position to care for my busy toddler and a newborn while recovering from major abdominal surgery.  Yeah, I know that some might think I'm crazy to voluntarily decide to "suffer" for no reason or whatever excuse one might use to opt for an elective c-section, but I've already explained in a previous post why a vaginal birth is better than a surgical birth (except for true emergency situations - not 33% of births).

Here's my VBAC plan so far:

- My health insurance company, Kaiser Permanente, encourages VBAC.  This is very important because the policies of some insurance companies stick with the line of thought that says, "once a cesarean, always a cesarean."  Of course, these archaic policies (which make no sense as they are not supported by the latest research or studies) thwart VBAC plans.

- I have already informed my OB that I do not want another cesarean and I have him on-board with my VBAC plan.  He looked surprised that I had already been thinking about this birth, but he's about as supportive as it gets and seemed happy with my decision.  He did inform me that I have an increased risk of experiencing uterine rupture, which (if not caught) can be fatal.  But my OB is honest and he let me know that it only happens around 1% of the time.  Since cesarean deliveries come with all the risks of any major surgery, I'm comfortable with the odds that I will not suffer uterine rupture.

- I looked up the VBAC rate at the hospital and my hospital has the highest VBAC rate (an impressive 22% of births!) in the entire county.  Again, this is important because hospital policies absolutely interfere with childbirth plans.  My hospital's personnel staffing also seems like it would encourage VBAC because the OB's are staffed with a shift schedule.  That is, the doctor is there and getting paid the same whether you deliver or not and they leave at the end of their shift, not when you finally deliver.  So I won't likely have to hear the biggest nonsense excuse for c-section:  "failure to progress."

- I'm educating myself on the childbirth process.  I've been mining the internet for information whenever I have a chance and I will be picking up some particular books to get as much knowledge of the labor and birth process as I can possibly get.  I took Lamaze classes during my first pregnancy and I plan to take Bradley classes this time around.  The Bradley Method is taught in a 12-week class and an overwhelming amount of Bradley students have the impressive birth outcomes that I also want - non-medicated vaginal birth.

- I'm already incorporating Bradley exercises and dietary guidelines whenever possible.  I've had a few weeks of absolutely terrible morning, noon, and/or night morning sickness so I haven't done much yet, but I'm aware of what I need to do (thanks to that research I mentioned above!) and I'll be on it once I'm back up to speed.

- I'm educating myself about VBAC and it's risks.  As far as I can tell at this point, I'm a good candidate for VBAC.  I intend to refuse any "routine" interventions (unless they truly are medically necessary - no, the hospital staff's schedule is not a medical necessity) so I should be able to side-step the snowball effect that often results in cesarean.  I also am prepared to refuse labor induction since it frequently ends up in a C-section and, of course, a failed VBAC.  By being healthy and active throughout this pregnancy, I expect that I will remain a good candidate for VBAC.  Of course, I'm assuming I won't end up with another baby who flips into breech position at the very end of my pregnancy.

I'm not leaving this birth up to my hopes or chance, but is there anything else you can think of that I should be doing to help see my VBAC dreams become a reality?

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