Shortly after finding out I was pregnant with my second biological child last year, I was faced with a major decision. Would I have a VBAC (vaginal birth after cesarean) or HBAC (home birth after cesarean)? A repeat cesarean was out of the question.
Midwives are not currently allowed to assist VBAC’s in a birthing center. So, I had to decide, would I have my child at home or in a hospital where the risk of a repeat cesarean was great.
After much thought, I decided, along with my husband’s support, that we would have a VBAC. I quickly found a VBAC-friendly Obstetrician. I thought we were set.
Approximately half-way through my pregnancy, my OB told me he had chosen to stop assisting VBAC’s due to hospital policy changes. Evidently, The American College of Gynecology, ACOG, had just revised some of their statements. Many of the hospitals had begun adopting new policies to accommodate their interpretations of these statements. One of the new policies includes that the
OB has to remain inside the hospital throughout the entire labor and delivery process. My OB felt he could not assume these new requirements.
If I stayed with this doctor, I was essentially agreeing to a repeat cesarean. My first biological child was deemed too big for natural delivery. My body had never proven it could not labor and deliver a child. I felt like it was my human right to at least a trial of labor.
After many calls to physicians, polling of other mothers in the area, talks with my insurance company, prayers and tears, I finally found Dr. Eric J. Edwards. He has his own practice, Crossings OB GYN in
Oviedo. He also acts as the back-up OB for a local midwife.
Dr. Edwards is very frank and to the point. Some people want warm and cuddly, but having worked with physicians in the past, straight facts is what I expected and wanted.
We had a few interventions in getting labor going, which at first made me wonder if the VBAC would still happen. Labor was synthetically induced and my cervix was still found to be high and 1cm after 7 hours of Pitocin contractions. Although it was painful, Dr. Edwards was able to reach to break my water, which he later told me he is one of the only doctors in town that can do that when the cervix is that high.
After 22 hours of labor, our daughter was born via successful VBAC in a hospital setting and with a few interventions. I urge every mother to be, if you have had a cesarean, do not accept that you must have sequential cesareans each time unless it is proven to be medically necessary. Dr. Edwards is not a doctor who makes promises he cannot or does not intend to keep. He did a wonderful job assisting in bringing my daughter into this world and helping us have a successful VBAC.
**Response to Comments:
Wow, what a hot topic! I appreciate all the comments. I would like to respond to a few and provide some additional facts.
As some have pointed out, not everyone is comfortable birthing at home. I remember just a few months back feeling like I had virtually no control over how my beautiful daughter would be born. That feeling I will not soon forget. In my heart of hearts, the sole purpose of writing this particular piece was to give women in our community hope, all the while keeping in mind that this site is marketed to natural-minded as well as mainstream families, both with an array of birthing ideas.
I would like to address the idea of being induced with pitocin causing a greater risk of rupture. Yes, there is a small increase in chances. According to the American Academy of Family Physicians and a study of more than 20,000 women who had a previous cesarean delivery, rate of uterine rupture was 0.52 percent in those who had spontaneous labor. This number goes up .25 percent for those with induction. That small of a percentage gave me hope.
http://www.aafp.org/afp/20070315/practice.html#p4
or http://findarticles.com/p/articles/mi_m3225/is_6_75/ai_n18744527
As for inducing vbac clients going against medical studies, please refer to the American Academy of Family Physicians.
“Labor induction is a reasonable option, and it may be necessary in patients with VBAC.”
http://www.aafp.org/afp/20070315/practice.html#p4
or http://findarticles.com/p/articles/mi_m3225/is_6_75/ai_n18744527
The comment was made that I did not mention if there was a medical reason for my induction. This brought to my mind that Dr. Edwards will only allow vbacs if the baby is under a certain weight. The exact measurement he gives, it is in grams, escapes me. I do know that it is close to 9 pounds though.
Dr. Edwards was very optimistic as to the weight factor in our case. He does not believe going over the due date and having a big baby to be so much hereditary but an environmental factor. I agree, but on the other hand am not convinced that heredity does not play a very big part.
My Mother at 5’2″ and maybe 100 lbs at both times birthed me, a 9 lb. 2oz. baby, and my brother who was closer to 10 lbs.
She went over her due date with both of us and had to be induced both times. My first biological child was 10lbs 15oz at 41 weeks.
I stand grateful for my induction. It was used intially to test that my uterus could withstand contractions. Since it
appeared that it was helping to kick-start my labor, we continued with it to try and avoid a repeat cesarean due to another very large baby. Some people only use black licorice, EPO, castor oil, etc. to help ripen and/or to get labor going. I chose the Pitocin route for the above reasons to get my vbac started.
If my Bishop score had been assessed and considered to be a required parameter before induction, who knows, due to my family history, when I would have gone into labor and how big my baby would have been.
Being able to break my water while still high and 1cm was painful but in the end welcomed by me. The state of my cervix very well could have meant a long labor ahead. Again, please keep in mind my history and particular case. My cervix was the exact same with my first biological child at 41 weeks. I do not personally feel he was not ready for birth. He was 10 lbs, 15 oz. If left in there “to cook,” I only dare imagine how big he could have gotten and the complications that could have arisen from shoulder dystocia.
I have to add some personal information in response to the comment about Dr. Edwards not having faith in women’s bodies. In our first meeting, he told me that shoulder dystocia is very real to him. It is not my place to reveal his personal business, but I have to say that he has been there in a very personal way.
(See the following link for more information and American Family Physician’s article on Shoulder Dystocia):
http://www.aafp.org/afp/20040401/1707.html
Finally, yes, there is an out of pocket fee with Dr. Edwards. This fee was recently introduced when the hospitals where he has priviledges changed their policy requiring that he remain in the hopsital throughout the entire labor and delivery event. Again, he has his own practice. This fee helps cover his costs for having to be out of his office and in the hospital building the whole time. You could always check with your own insurance company to see if they would subsidize since a vbac is essentially more cost effective for them than a cesarean. My insurance company refused simply because there is no CPC code for the fee.
I still stand grateful for Dr. Edwards for going against the norm and giving women who choose to vbac that option. It was amazing to see the looks and hear the comments made by the nurses in the hospital when we first admitted. I was referred to as “the vbac” and heard several comments outside my door and even swallowed one nurse’s rude attitude as she questioned me as to why I was vbac-ing and if I was aware of the risks. I believe Dr. Edwards is one of the reasons vbac is still alive in central Florida.
Jill enjoys spending her days being a helpmate to her husband and raising her three children. She holds two bachelor’s degrees in Psychology and Biology. Some of her favorite hobbies are gardening, playing the piano and cooking. Jill is a Juice Plus+ distributor. Her family are the humans to Lucy, the rescued dog, Smokey, the rescued cat and soon to be humans of a flock of chickens, too!
