VBAC Question at Sibley?

[Anonymous]

I am hoping to have a VBAC for my second pregnancy delivery at Sibley. My Ob/gyn mentioned that I'll be hooked to a monitor the whole time and that I won't be able to change positions and they won't do any other interventions so my cervix will have to make it to 10 cm or else I'll most likely have another c-section.

For those who have had a VBAC, is this what you experienced?

[Anonymous]

Just a clarification...you don't HAVE to be hooked up to monitors the whole time. They wanted to do internal monitoring on me the whole time and I refused and had the external monitoring every 20 minutes. I sat on a birthing ball a lot, was massaged and shuffled around teh room quite a bit between monitoring sessions and delivered a very healthy son vaginally. You have a right to demand what you want from these people, your OB included.

[Anonymous]

I am hoping to have a VBAC for my second pregnancy delivery at Sibley. My Ob/gyn mentioned that I'll be hooked to a monitor the whole time and that I won't be able to change positions and they won't do any other interventions so my cervix will have to make it to 10 cm or else I'll most likely have another c-section.

Welcome to modern obstetrical care in Washington DC. This is exactly why so many VBAC's fail. If you truly, really, want to have a shot at having a successful VBAC, you need to seek out a care provider who knows how to get your baby out safely *without* keeping you strapped in bed. As you probably know, being strapped in bed drastically reduces your chances of having a vaginally delivery, for a variety of reason.

To get a safe, successful, VBAC, you would be smart to seek out the care of a midwife. There are three great in-hospital midwifery practices (two group practices and one solo practice) in the DC area that will truly help you get your VBAC. Of course there are a few random OB's who are also really supportive of VBAC, but you have to carefully interview them to find the right one.

[Anonymous]

I was the original poster. What are the names of the three great in-hospital midwifery practices? I'm nervous that I'm going to end up with another c-section. I'm already 36 weeks.

[Anonymous]

The practices are:

- Midwifery Care Associates (www.midwiferycareassociates.com) and they deliver at Shady Grove.

- DC Birth Center (www.developingfamilies.org) and they deliver at Washington Hospital Center.

- Whitney Pinger (solo practice) and she also delivers at Washington Hospital Center, but she is full for the next few months.

Who is your current doctor? Have you asked them what their VBAC success rate is? Sibley is not known for having great VBAC success. I would HIGHLY recommend you look into one of the other practices, today!

[Anonymous]

What do you mean "Sibley is not known for having great VBAC success"? Are there hospitals in the area that are generally known as being better than others for VBAC success? If so, what are they? Or, how can I find this information? I would to have a VBAC and think I've found an OB who is very supportive of me, but I don't want to be thrown a curveball by having chosen the "wrong" hospital.

[Anonymous]

Try taking a look at this website: http://vbacfacts.com/2008/05/12/cesarean-vbac-rates-of-new-jersey-hospitals/

[Anonymous]

PP here: I know that website I posted doesn't have info for DC/MD/VA, but it's a good start. Google VBAC rates for more information.

[Anonymous]

Here's a link to information on VA hospitals and C-sections/VBAC rates:

http://icanofnova.org/articles/Cesarean_Rates

[Anonymous]

Also, OP - here is my two cents (I'm the PP) - I'm trying for a hospital VBAC and what I've learned is that I have to prepare myself for that its not going to be easy to get. My current OB just told me she'd require continuous fetal monitoring....looks like I'll be making the switch to Dr. Tchabo pretty soon as he'll let you do it for 20 minutes of every hour. From what I've heard he seems to be the most VBAC friendly doctor in the area. I can't imagine having a successful VBAC if I'm tied to a bed or rocking chair the whole duration of my labor (my son it was 39 hours...2 hours of pushing - and he never descended).

Your cervix will make it to a 10 without any interventions if you just give it time. Every woman labors differently - don't feel like you have to dilate 1 cm an hour...have faith in your body.

Also, pitocin/induction isn't recommended with VBACs due to the risk of uterine rupture. So that's why there really shouldn't be interventions during labor.

Anyway, I'd recommend attending some ICAN meetings if you can. It is interesting to hear the stories of different women there and it is always great to hear of successful VBAC's!

[Anonymous]

I'm 16:20 and 16:23...thanks PP for posting that link to the C-section/VBAC rates for hospitals in Virginia! I couldn't find it although I know I've seen it before!

[Anonymous]

I am the original poster who started this question.

Which group is Dr. Tchabo affiliated with and where does he deliver? Since I'm already 36 weeks, I feel like time is of the essence.

My first pregnancy I made it to 9 cm after around 8 hours at the hospital with steady progression but I never made it to 10 cm; I never pushed. I was told the cord was wrapped around the baby's neck and that her heart rate kept going down everytime I had a contraction and after around 5 hours, it was time to get the baby out b/c it was in distress. I was flat on my back the whole time and never moved around at all to get to 9 cm. I didn't go to the hospital for the first 8 hours of my labor.

[Anonymous]

[phone]

Tchabo is a solo practioner at Virginia Hospital Center. Likely, one of his residents will be attending your labor and child's birth with his supervision.

[Anonymous]

I would go with one of the midwifery practices above Dr. Tchabo. Yes, Tchabo is great because he "let's you" try a VBAC. He is very laid back and supportive, especially compared to some other OB's in the area. However, if you go with him you will still have to deal with all the hospital protocol, which includes being monitored for 20 minutes every hour, which often turns into longer monitoring sessions and being confined to one position. You basically won't see him at all - like a PP said, you will most likely be seen occassionally by a resident, and maybe Tchabo will show up for the actual delivery.

With the midwifery practices, the midwife will stay with you the entire time and monitor you intermittantly with a hand-held doppler. You will never have to lie down in the bed at all. You will might never have to be connected to the machines at all. The midwife will also be able to encourage you emotionally and give you physical help with coping with labor. Overall, it is a far better option for acheiving a VBAC.

Oh, the other thing that can help a lot is a doula. Did you already mention this? If you don't have one, it might be really helpful to find one - it's not too late!

[Anonymous]

Anonymous wrote:I would go with one of the midwifery practices above Dr. Tchabo. Yes, Tchabo is great because he "let's you" try a VBAC. He is very laid back and supportive, especially compared to some other OB's in the area. However, if you go with him you will still have to deal with all the hospital protocol, which includes being monitored for 20 minutes every hour, which often turns into longer monitoring sessions and being confined to one position. You basically won't see him at all - like a PP said, you will most likely be seen occassionally by a resident, and maybe Tchabo will show up for the actual delivery. . .

Do you know of actual instances where Dr. Tchabo did not show up for delivery?