[Tilly007]

I am curently pregnant with my second after giving birth via emergency c/s to my DS 20 months ago.

I intend to try for a VBAC for this baby.

I have discussed monitoring with my OB. He has indicated that it is NSW health policy that all VBAC labouring mothers are continuously monitored through labour.

I am yet to really discuss (negotiate!) this with him, as I want to be armed with all the information before I do.

Firstly, I did not realise it was policy that VBAC mothers are monitored continously. I thought it was hospital policy or OB preference, but not department of health policy. I am sure I have heard of women attempting VBACs at RPA not being monitored continously?

What will happen if I get to the hospital and decline continous monitoring? (BTW, I am not opposed to monitoring as I realise there are risks for VBACs. I just don't want to be monitored the whole time, particuarly as the hospital I am going to only has one wireless monitoring machine, so I'll likely be stuck to a bed the whole time).

Has anyone had any success in convincing the hospital/OB that intermittent monitoring is OK?

My OB suggested that I stay at home for as long as I can to avoid monitoring, which I will do anyway, but I really don't want to be monitored continuously the whole time when I get there. I had an induction with my DS and all my plans for an active labour quickly disappeared after being hooked up to that damn monitor the whole time!

This post has been edited by Tilly007: 19/12/2012, 09:30 AM

[bambiigrrl]

You have the right to say no once you get there, and just have intermittent monitering every 10 minutes or so with a doppler. When i had my unsuccesful vbac (i will be trying again next time!) they said they wanted to hook me up for 15 minutes or so when i first arrived and then they would take me off if i wished. I even had the option to go in the shower for a while.

Trust me you have rights and they cant do anything you dont consent to once your there, and they certainly wont kick a labouring woman out of the hospital! They have a duty of care and you have every right to refuse certain things, you just need to be staunch about it cause they will try to pressure you. They will also try to insist you dont drink water or eat, and only give you ice chips, which is the worst thing you could do! What with the sweating, vomiting and diareahh you need to drink lots of water, if they try this one on you tell them where to go!

Also I would avoid a epidural if I were you, as mine caused not only my cervix to swell and go from 9 cm to 7cm, but i also developed a maternal fever which caused fetal distress. So that, coupled with being compleatly without energy due to no water or food, and of course labour for 14 hours, and then the swelling is why my vbac was unsuccesfull. I definatly believe that if i hadnt of gotten the epidural and drank more water, eaten food and kept active I would have had my natural birth. You live and learn hey! Hopefully next time i will have better luck!
Good luck with your vbac, I hope it is a wonderful experience for you!

[AllegraM]

It is Queensland Health's policy too.

You can always refuse or negotiate intermittant monitoring but it would be best to discuss this with your Ob in advance, rather than in labour.

For my planned VBAC, my personal choice is to have the continuous monitoring, due to my small birth to birth gap (17 months). I believe this may increase my chances of having a repeat section as my hospital does not have wifi monitoring which means I will be attached to the bed with limited ability to move around and change positions. However, some studies show that thr uterine rupture rate is higher for 18 month or less gaps so I am covering my bases.

Only you know what you are comfortable with but I do think it would be best to have any arrangment in place in advance.

[charlottesmum04]

Oh and even if they do try to force you. Lots and Lots of Bathroom breaks. Spent my induction supposed to be continuously monitored but in reality spent almost as much time off as on by the time i took a contraction or 2 to get to the bathroom and a few more in there and then got back to bed, then waited for the midwife to come back ( i certainly didnt buzz them)...

[findingada]

I didn't know there was a Queensland Health policy (or any other State policy for that matter). I had hand held doppler monitoring in between contractions with my VBAC 2 years ago in Queensland. My ob was against too much forward planning (which was fine with me) but agreed in principle that if everything was going fine that regular hand held doppler would be fine. I should mention my first birth was a c-section and I was in advanced labour when I had the c-section but there was no medical reason for my c-section. My VBAC birth was fast and no problems at all. I spent most of my time in the shower sitting on a fit ball. I also walked around, experimented with what seemed like thousands of positions (thanks to a very supportive midwife and doula), and my bub was out in no time (actually it was 5 hours from "Hmmm ... was that a twinge I just felt? I will just get breakfast cooked, pack up the kids to go to kindy, tidy the house, then ring hubby" to holding my little one.

[soontobegran]

OP you could ask if the hospital has telemetry monitoring which will allow you to move around quite freely. There are some Obstetricians whom are happy with intermittent monitoring so hopefully you'll be able to convince him and come up with a plan that suits you.

They will also try to insist you dont drink water or eat, and only give you ice chips, which is the worst thing you could do! What with the sweating, vomiting and diareahh you need to drink lots of water, if they try this one on you tell them where to go!

Just want to point out that this is not to try and be difficult but because if your VBAC doesn't work and you need a C/S it is better for your well being to not have a belly full of food so telling the staff where to go is a little silly. Ice chips are the most sensible thing to be consumed in active labour.
Women should not eat much when in labour anyway as digestion slows down terribly. It increases the chances of vomiting and as I just explained it can cause issues in the unfortunate event of an emergency c/s.

[Propaganda]

You have the right to say "no," to any sort of hospital policy.

[Madnesscraves]

Just want to point out that this is not to try and be difficult but because if your VBAC doesn't work and you need a C/S it is better for your well being to not have a belly full of food so telling the staff where to go is a little silly. Ice chips are the most sensible thing to be consumed in active labour.
Women should not eat much when in labour anyway as digestion slows down terribly. It increases the chances of vomiting and as I just explained it can cause issues in the unfortunate event of an emergency c/s.

I agree and was coming in to say this. I totally get where they are coming from. Ive been through a CS and only had water. I still almost threw up in theatre as they were taking my DD out.

[MoonPie]

If you are comfortable with continuous monitoring, make sure you take regular, slow bathroom breaks. Not in an effort to be sneaky or anything like that, but being upright is a great and its so much easier to do it without monitoring belts on.

Good luck!

[Akeyo]

I had a VBAC at RPA in the birth centre in Sept 2010. I was told by the MWs that hospital policy in the labour ward for VBACs was for continuous monitoring but in the BC they were left alone to do their own thing and only did intermittent Doppler monitoring. They only had one protocol they said they had to follow which was a cannula but with the help of my amazing doula I was able to decline it when the time came. I would strongly recommend hiring a doula to advocate for you during labour, to negotiate these hospital protocols. You can refuse them if you wish but it can be hard to voice that when you're in the throes of it all.

Best of luck!

PS - I could never even think about eating during labour. Waay too much going on inside! I even struggled to drink water.