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Vba4c?


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#26 audree

Posted 25 April 2012 - 06:16 PM

Hi OP, I'm pg with my third baby and plan to try a vbac.
Im happy to have been accepted into the nbac/vbac program at Dandenong hospital.
You would need a referral from your GP, and it will depend on where in Melb you live as to whether they will take you or not.
Also, with your medical records, I too wanted mine from my emergency c/s. I called the hospital and although the freedom of information act says you have access, they charge a fee, make you fill out paperwork, and the whole process takes time. Much quicker to just get your GP to fax a request for your records. That should work much faster.
Best of luck with whatever decision you make.



#27 SaraW

Posted 25 April 2012 - 06:23 PM

I would think that if you go into labour on your own, you have a much higher risk of uterine rupture than if you had a planned c/s.

During my 4th c/s 21 months ago, the OB told DH that my uterus was so thin, if I had have gone into labour on my own, it would have almost certainly ruptured.  And this was a planned c/s at 38+2 weeks, I was not already in labour.

You need to remember there are many layers in there, it's not just one cut through the same scar, after 4 c/s.  I remember lying there for #4 thinking it was taking soooo long, compared to #1 emergency c/s where they cut quick and whip baby out original.gif - there were so many layers to cut through, and they were going very carefully, obviously because of the known risks.  If you think about it, every pregnancy is different, your uterus grows differently each time, so there is no way they can cut in the same place every time.

By all means search for OBs that share a similar philosophy to you, and do your own research (uni library is a MUCH better idea than the internet!!) but if it was me, I would be taking the risks very seriously and listening to what the trained professionals have to say.

Good luck with your decision.

#28 soontobegran

Posted 25 April 2012 - 06:24 PM

QUOTE (audree @ 25/04/2012, 06:16 PM) <{POST_SNAPBACK}>
Also, with your medical records, I too wanted mine from my emergency c/s. I called the hospital and although the freedom of information act says you have access, they charge a fee, make you fill out paperwork, and the whole process takes time. Much quicker to just get your GP to fax a request for your records. That should work much faster.
Best of luck with whatever decision you make.


If the GP is the OP's regular he/she should already have a summary of birth in the records.
Aside from that FOI release of hospital notes takes 10 -14 days and costs about $35.


#29 rosiebird

Posted 25 April 2012 - 06:39 PM

I don't agree with searching for an obstetrician who will agree to a vba4c. For example, if you had a heart condition and 5 cardiologists agreed on the best course of action and 1 cardiologist disagreed, wouldn't you be concerned that the odd one out was wrong? Second opinions are one thing but searching for a doctor who is out of step with their colleagues is a different kettle of fish.

#30 mrsboof

Posted 25 April 2012 - 06:45 PM

QUOTE (audree @ 25/04/2012, 06:16 PM) <{POST_SNAPBACK}>
Also, with your medical records, I too wanted mine from my emergency c/s. I called the hospital and although the freedom of information act says you have access, they charge a fee, make you fill out paperwork, and the whole process takes time. Much quicker to just get your GP to fax a request for your records. That should work much faster.


Keep in mind with above, that your GP won't legally be able to just give you a copy of the hospital notes if they are sent them, as the notes remain property of the hospital and the GP could get into a whole world of legal pain for giving just them out to you. They would most likely be more than happy to give you a rundown of them though and (if they can read the Drs writing on the operation notes) tell you if anything was noted regarding the state of your uterus.

#31 soontobegran

Posted 25 April 2012 - 06:59 PM

QUOTE (mrsboof @ 25/04/2012, 06:45 PM) <{POST_SNAPBACK}>
Keep in mind with above, that your GP won't legally be able to just give you a copy of the hospital notes if they are sent them, as the notes remain property of the hospital and the GP could get into a whole world of legal pain for giving just them out to you. They would most likely be more than happy to give you a rundown of them though and (if they can read the Drs writing on the operation notes) tell you if anything was noted regarding the state of your uterus.



The OP doesn't need a copy of the notes so much as confirmation of the state of her uterus. Her GP is perfectly able to tell her that if they have a delivery summary.
If she does want the notes themselves then she can apply for them but she may still need someone to decipher them for her.
Other medical staff usually have no trouble reading their colleagues handwriting. I can't imagine there would ever be a case when an Obstetrician has remarked about a 'paper thin' uterus and not actually recorded it...usually in capital letters and in red!

#32 Mumoffour99

Posted 25 April 2012 - 07:20 PM

Edited

Edited by Mumoffour99, 30 April 2012 - 01:07 PM.


#33 deejie

Posted 25 April 2012 - 08:47 PM

Like PPs, I can't think that a private OB or public hospital will be supportive of a VBA4C. Obviously, all they can do is advise you of the risks involved in either an elective repeat CS or VBAC attempt but cannot force you to have a CS. You can be sure though, that you will be under enormous pressure at your appointments if you continually refuse the repeat CS against medical advice.

Have you thought about talking to/hiring a private midwife OP? I am not suggesting birthing at home, but private midwives can attend hospital as a support person. They would be able to go through your hospital records with you and interpret anything you have difficulty with. They could also attend
antenatal appointments with the hospital and provide support during labour if you do eventually decide to go down the VBA4C route. It might help to have a person "in your corner" so to speak. What does your DH think of a VBA4C, would he be supportive?

If you are in Melbourne and interested, I can send you some names. Please PM me if interested.
Of course I can't say for certain if any of them would take a VBA4C even in hospital, but it is an avenue of support certainly worth trying.

Edit- spelling

Edited by deejie, 25 April 2012 - 08:51 PM.


#34 Mumoffour99

Posted 25 April 2012 - 08:56 PM

Thank you deejie I would really appreciate those names if you could pm me pretty please as my pm is not working to send. It keeps sending blank ones. I'm just taking baby steps at the moment and trying to get educated original.gif

#35 soontobegran

Posted 25 April 2012 - 09:12 PM

QUOTE (deejie @ 25/04/2012, 08:47 PM) <{POST_SNAPBACK}>
Like PPs, I can't think that a private OB or public hospital will be supportive of a VBA4C. Obviously, all they can do is advise you of the risks involved in either an elective repeat CS or VBAC attempt but cannot force you to have a CS. You can be sure though, that you will be under enormous pressure at your appointments if you continually refuse the repeat CS against medical advice.

Have you thought about talking to/hiring a private midwife OP? I am not suggesting birthing at home, but private midwives can attend hospital as a support person. They would be able to go through your hospital records with you and interpret anything you have difficulty with. They could also attend
antenatal appointments with the hospital and provide support during labour if you do eventually decide to go down the VBA4C route. It might help to have a person "in your corner" so to speak. What does your DH think of a VBA4C, would he be supportive?

If you are in Melbourne and interested, I can send you some names. Please PM me if interested.
Of course I can't say for certain if any of them would take a VBA4C even in hospital, but it is an avenue of support certainly worth trying.

Edit- spelling


Deejie, hiring a private midwife will in most cases not mean she will have access to the patient's records, no more than any other support person who will attend any  AN appointments or the birth. I am a great supporter of VBAC under most conditions however I have to say that I would think quite poorly of any midwife, private or otherwise who ignored the warning of an obstetrician who had actually seen the OP's uterus and still advised a VBAC4.

The first thing the OP needs to establish is what her Obstetrician saw and made note of. It is premature to be discussing seeking other opinions until she has either spoken to the Obstetrician or has been able to access what is written in her notes.




#36 Mumoffour99

Posted 25 April 2012 - 09:19 PM

Ok, thank. Soontobegran I've definitely got that happening in the pipeline.  I'll call the hospital as well tomorrow morning to see what I have to do. I'll definitely let you know what I find out but in the meantime it can't hurt to be prepared with names and multiple appointments with diff people to see their views after they see my records. So I'm really appreciating names especially as they get booked really quickly

Edited by Mumoffour99, 30 April 2012 - 11:54 AM.


#37 Mumoffour99

Posted 25 April 2012 - 09:22 PM

Sorry for typos again I'm using my phone

#38 Mumoffour99

Posted 25 April 2012 - 09:28 PM

Edited

Edited by Mumoffour99, 30 April 2012 - 11:55 AM.


#39 soontobegran

Posted 25 April 2012 - 09:43 PM

QUOTE (Mumoffour99 @ 25/04/2012, 09:19 PM) <{POST_SNAPBACK}>
Ok, thank. Soontobegran I've definitely got that happening in the pipeline. I've got an appt at my local go on Monday so I'll see if she's got my notes but I don't think she does. I've also got an appt with a private obs at the mercy where i had my other kids on next Wednesday. I'll call the hospital as well tomorrow morning to see what I have to do. I'll definitely let you know what I find out but in the meantime it can't hurt to be prepared with names and multiple appointments with diff people to see their views after they see my records. So I'm really appreciating names especially as they get booked really quickly


If your GP doesn't have your discharge summary she/he can just call and have a copy sent to the practice.
If you are going back to the hospital you delivered at then I am certain that if your Obstetrician made a special mention to you then it will be recorded in your notes too.

QUOTE (Mumoffour99 @ 25/04/2012, 09:28 PM) <{POST_SNAPBACK}>
Like paediatricians not all obs have the same level of expertise or experience so I'm looking for one that has experience in this area and can really talk with me.


I agree that there are different levels of expertise and experience but there are some things in obstetrics which it wouldn't matter if you've had 5 years experience or 50  it will be the same recommendation from all. This is probably one of them but good luck getting the information you need and are able to make a decision you are comfortable with.

#40 Mumoffour99

Posted 26 April 2012 - 03:16 PM

Ok got some further news. I've called the hospital and their freedom of information dept is sending over a copy of my theatre notes from my last ceaser to my doc by 11am tomorrow morning. I've also got an appointment with a pro vbac doc on Monday afternoon so we can have a chat. I've been told he is really good and if he says no then basically it will be a no.

Edited by Mumoffour99, 30 April 2012 - 11:50 AM.


#41 amabanana

Posted 26 April 2012 - 04:33 PM

QUOTE (Mumoffour99 @ 26/04/2012, 03:16 PM) <{POST_SNAPBACK}>
Ok got some further news. I've called the hospital and their freedom of information dept is sending over a copy of my theatre notes from my last ceaser to my doc by 11am tomorrow morning. I've also got an appointment with a pro vbac doc on Monday afternoon so we can have a chat. His name is Lionel Steinberg. I've been told he is really good and if he says no then basically it will be a no. But I've also got two other appointments with other obs so I can have multiple opinions. Lionel is Monday and my original hospital but now private obs is on Wednesday next week. I'll let you know how I go but it's all I can think about at the moment!!


I have heard him called Lionel Vaginal as he is pro VBAC.  If he won't do it no one will.

Good luck OP.

#42 soontobegran

Posted 26 April 2012 - 06:01 PM

QUOTE (Mumoffour99 @ 26/04/2012, 03:16 PM) <{POST_SNAPBACK}>
Ok got some further news. I've called the hospital and their freedom of information dept is sending over a copy of my theatre notes from my last ceaser to my doc by 11am tomorrow morning. I've also got an appointment with a pro vbac doc on Monday afternoon so we can have a chat. His name is Lionel Steinberg. I've been told he is really good and if he says no then basically it will be a no. But I've also got two other appointments with other obs so I can have multiple opinions. Lionel is Monday and my original hospital but now private obs is on Wednesday next week. I'll let you know how I go but it's all I can think about at the moment!!


Can't ask for a better result OP. I hope you will be OK with the outcome of all these appointments.
Remember these people are professionals with a lot of experience. They are not in the business to ruin women's dreams of a normal delivery but to deliver a healthy baby with a healthy mother.

I have to say I am surprised how you managed to get so many appointments with so many Obstetricians so quickly, particularly LS?  You are very lucky to have scored an appointment for 3 days in advance. Be prepared to pay through the nose however sad.gif

Good luck





#43 7girly-girls

Posted 26 April 2012 - 07:07 PM

I've had 4 c/s with a thin lower segment noted during the 2nd. My ob was supportive of trialling a vba2c if I really wanted although I chose to go with the c/s. During the 3rd c/s ob confirmed again lower segment was thin but 'not too bad' and did some extra repair. For the next baby he said a vb was a no go zone, that it might go ok but if it didn't the results could be catastrophic. During c/s 4 lower segment was 'very thin'. My ob said the c/s was definitely the right decision. Just my experience with thin uterus & multiple c/s. I think you're mad woman!
Good luck.

#44 deejie

Posted 26 April 2012 - 07:46 PM

QUOTE (soontobegran @ 25/04/2012, 09:12 PM) <{POST_SNAPBACK}>
Deejie, hiring a private midwife will in most cases not mean she will have access to the patient's records, no more than any other support person who will attend any  AN appointments or the birth. I am a great supporter of VBAC under most conditions however I have to say that I would think quite poorly of any midwife, private or otherwise who ignored the warning of an obstetrician who had actually seen the OP's uterus and still advised a VBAC4.


STBG- I was referring to after the OP receives a copy of her medical records via FOI, a private midwife would be able to go through them with her in detail. I much doubt any private midwife would "advise" a VBA4C and I never said this. I was simply pointing out that if the OP made the decision to try for VBA4C, they are available to attend hospital with her as a support person. We all know if she does try for VBA4C she will be facing an incredibly tough path antenatally. There will be a lot of pressure placed on her in the public system and enormous restrictions on her labour. I was simply pointing out that you can hire a midwife who you have come to know and trust as a support person and it is worth considering in the event she makes the decision.

OP- Good luck with LSl. Private OBs of course have the right to refuse taking you on as a patient. If LS doesn't take you on in Melbourne, I can't think of an OB who will. Good luck and let us know how you go. Otherwise if you do decide to VBA4C you will have to travel through the public system and this is where having a support person might be worth their weight in gold. I have PMd you a couple of names.

#45 Mumoffour99

Posted 26 April 2012 - 07:58 PM

Edited to remove personal info

Edited by Mumoffour99, 29 April 2012 - 06:06 PM.


#46 soontobegran

Posted 29 April 2012 - 06:32 PM

Let us know how you go tomorrow with LS OP original.gif

#47 Mumoffour99

Posted 30 April 2012 - 11:46 AM

Just a request if people could please delete my comments they have as quotes in their comments pretty please. I'm just trying to remove all personal information. Thank you so much

#48 Mumoffour99

Posted 30 April 2012 - 09:50 PM

I know I'm in good hands when the obs says these are the stats I will support whatever you choose to do. original.gif

#49 anotherid

Posted 30 April 2012 - 10:01 PM

Can I ask what stats they gave you? I am finding if difficult to find any information about VBAC after x 3 caesareans, let alone after 4. I would love any help you can provide.

#50 Fossy

Posted 30 April 2012 - 10:06 PM

Did you go to the ob I suggested OP? He's great, he's my obs stand in(the other ob I suggested).  Glad things are looking positive for you!




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