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Old 01-23-2009, 01:34 PM
 
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Looking for a OB GYN in SW Charlotte area who will do a VBAC. Also Hospitals that will do them. Thanks for your help I am finding that most will not.
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Old 01-23-2009, 01:57 PM
 
Location: State of Being
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Well, the docs I spoke w/ years ago all agreed that they make that decision on a case by case basis. So I have never heard that there is some "blanket" agreement or disagreement about VBACs after C-sections. The rate for VBACs after C-sections was under 30 % back in the 90s when I wrote an article on the subject.

If you read the guidelines from the American College of Gyneologists and Obstetricians, I think you will find that this is an individual call, and if a woman has had a transverse incision (bikini cut) - the incidence of rupture is much lower.

I find it hard to believe that docs are flat out saying - NO WAY - unless they have examined you and feel your situation poses a high enuff risk to insist on a subsequent C-section.
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Old 01-23-2009, 02:51 PM
 
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Quote:
Originally Posted by anifani821 View Post
Well, the docs I spoke w/ years ago all agreed that they make that decision on a case by case basis. So I have never heard that there is some "blanket" agreement or disagreement about VBACs after C-sections. The rate for VBACs after C-sections was under 30 % back in the 90s when I wrote an article on the subject.

If you read the guidelines from the American College of Gyneologists and Obstetricians, I think you will find that this is an individual call, and if a woman has had a transverse incision (bikini cut) - the incidence of rupture is much lower.

I find it hard to believe that docs are flat out saying - NO WAY - unless they have examined you and feel your situation poses a high enuff risk to insist on a subsequent C-section.
Ani, many practices do, in fact, have a no-VBAC policy. It's driven largely by their insurers. I ran into this information quite a bit during my pregnancy last year. (I was not a vbac, but was on a lot of preggo boards and moms who wanted to vbac were having this issue). I know Presby Huntersville considered having a policy that a mother with a history of 2 c-sections would under no circumtances be allowed to VBAC. I don't know the end result but I know it created controvery. The whole vbac thing has been a very hot topic in the last couple of years.

Edited to add: Then there are doctors who say they will do it if that's what the mother wants, but really aren't supportive of it... which can mean that in the end, they jump to a c-section faster than doctors who truly support it.

To the OP, I'm sorry I don't have a recommendation for southwest Charlotte. I believe there is a local VBAC support group / information group that might have some recommendations, I think it's call ICAN.

GT
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Old 01-23-2009, 04:39 PM
 
Location: State of Being
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GirlTravels - you can tell it has been a long time since my c-section, LOL. I wrote about this subject in the 90s, and at that time, docs took a conservative approach but didn't have blanket rules for their practices - against VBACs after a transverse c-section. It appears that in the years since I last checked this issue, things have gotten more conservative. I totally get what you are saying about liability - that makes total sense. I do not work w/ OB/Gyn practices and had no idea this was such a hot button issue.

Having known a friend who experienced a rupture and came close to not making it (and ended up w/ a hysterectomy). . . I am one to advise a really conservative approach w/ the decision . . . but I know other moms who have successful delivered after a c-section.

Your suggestion about a VBAC support group was really helpful. (Maybe it's time for me to write another article on this subject!!!!) :-)
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Old 01-23-2009, 07:53 PM
 
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Originally Posted by anifani821 View Post
I do not work w/ OB/Gyn practices and had no idea this was such a hot button issue.

(Maybe it's time for me to write another article on this subject!!!!) :-)

You should! It's such a big issue now. And the OB/GYn practices are getting so hammered from the patient side and the insurer side... I believe that their med mal insurance premiums are among the highest.
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Old 01-23-2009, 08:01 PM
 
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Most dr's will talk you out of it. Even if you find one, the chances are high that when the time comes, complications will come up and you will be getting a c-sec anyways. Why would you even want a vbac after you've had 1 c-sec? There are significant risks to doing that. I would think the health of the baby is priority #1.
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Old 01-24-2009, 10:54 AM
 
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I find the insurance thing interesting. When I was pregnant for my youngest, back in 1998, I did not want to have a VBAC. My doctor told me that she technically could not put on my file that I was going to have a C-section. She said that the insurance would not approve it without a "reason". By the time I was in my 3rd month we found that I had developed gestational diabetes. At that point my dr. told me that I would definitely be having another C-section. The diabetes was a "reason" for the insurance company. I don't know why the insurance companies wouldn't encourage doctors to try for a VBAC in most cases that don't have complications. The cost has to be much, much less for them.
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Old 01-24-2009, 12:32 PM
 
509 posts, read 1,641,141 times
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Originally Posted by Justpeachee View Post
I find the insurance thing interesting. When I was pregnant for my youngest, back in 1998, I did not want to have a VBAC. My doctor told me that she technically could not put on my file that I was going to have a C-section. She said that the insurance would not approve it without a "reason". By the time I was in my 3rd month we found that I had developed gestational diabetes. At that point my dr. told me that I would definitely be having another C-section. The diabetes was a "reason" for the insurance company. I don't know why the insurance companies wouldn't encourage doctors to try for a VBAC in most cases that don't have complications. The cost has to be much, much less for them.
I should have been more specific - not the health insurance companies paying for the procedure. The med mal insurance carriers that insure the doctors in case something goes wrong. If they allow a woman to VBAC and something goes wrong... well, there's a risk of costly litigation.

For the same reason, my ob told me that they are not allowed by their insurance carrier to deny any woman a c-section who asks for one, even if it is not medically necessary. It aggravates me that doctors are restricted in their practice by the insurers... but that's another post for another day!

I encourage anyone interested in VBACs to contact a support group. It can be a very safe and healthy way to deliver, depending on your circumstances
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Old 01-24-2009, 12:46 PM
 
Location: between here and there
1,030 posts, read 2,763,354 times
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As a 4 c-section veteran who did investigate vbac with number 2 and was told by numerous doctors my intersecting incisions knocked me out of the running, let me share my feelings if for no other reason but to quell some fears young moms out there may have.

There is so much controversy concerning c-sections because women are made to feel as though c-sections are the less motherly route. But my children bonded with me fine, I was able to bf no problem, and suffered no ill-effects because of multiple c-sections such as bladder problems, etc and my kids are in their 20s.

Intially, I felt a bit robbed, I'll admit, as all my birthing classes had me pointing directly at the bullseye of "natural birth" so an emergency c-section after a day and a half of halted labor was a shock.

But the end result was my children were healthy and ultimately, that's every birthing mom's goal

Good luck with your searches moms!
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Old 01-24-2009, 01:48 PM
 
Location: NC's southern coastline
452 posts, read 2,122,763 times
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A good doctor would take it on a case by case basis, but a good doctor who feels competent in his or her skills will allow a mother to have a VBAC if she wants one and everything looks ok, they will at least let her choose to attempt one. I recommend checking with nurse midwives in the area, who usually partner with OBs....

I'm now near Wilmington, NC...I will have to look up her name, but there was an OB in this city who was about the ONLY OB in town who ROUTINELY did VBACS...her patients adored her and she had an EXCELLENT safety record. Her c-section rate was the lowest in town. She would deliver breech babies vaginally. I wish I could remember her name off the top of my head. But anyway, a few other OBs started complaining about her. The average csection rate at this hospital is 20-25% or something, creeping up there even more as time goes by, and this doctor had a c-section rate IIRC of something like no more than 6% every year. And had tons of patients. The other OBs started complaining that she caused patients to demand VBACs or vaginal deliveries when they wanted to do c-sections. And started turning her in to the hospital.....and the doctor rec'd a letter from the hosptial stating a physician should have a much higher c-section rate and that she was not performing enough sections! Despite her success and safety rate, she was never sued, had a clean record. She was pretty much run off....and she was about the best and only chance you had around here of having a VBAC under certain conditions or trying to deliver a breech baby safely without a c-section.

One of the OBs in my group, a man, publicly came out and said the hospital lost a very skilled and rare doctor, and that they should realize it's better for women who want to deliver vaginally to have doctors try instead of just doing c-sections for convenience. (I meanm if it's needed, it's needed--the bad thing is doctors DO do them for convenience, just because a patient wants one so she can schedule the birthday, or other nonmedical reasons....in a lot of cases someone who has had a previous c-section can certainly still have a vaginal birth go well if they want one- it's harder work for the doctor I guess).

Anyway- try calling midwives....I know there are some in Gastonia. And I guess check with Presbyterian hospital? But I think it is going to come down to midwives partnered with doctors being a good bet, and also just a doctor's discretion - just have the doctor tell you early and up front if he/she doesn't want to do VBAC or thinks you are not safe for one.

Good luck.
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