First prenatal visit today.....disappointing

jacqued

jacqued

Cathlete
Hi everyone,
I just have to vent here. I had my first Drs. appt. today. I was bummed to find out that if I want to have a VBAC I have to deliver in a hospital in Tucson which is 2 hrs. away :-( I don't understand their reasoning here. You see, I live in a small town which has only one hospital. Five years ago when I had my last baby they let me have a VBAC which was successful (and my baby weighed 9 lbs!!!) But now their policy is not to allow VBACs anymore which doesn't make any sense to me since they never had a problem here in this hospital. There's only a very slight risk that a uterus rupture will happen. I don't know what they're so afraid of! Having had a C-section with my first baby and a vaginal delivery with my second I'd pick the vaginal delivery any day! Even if it means driving 2 hours to a strange hospital. Hopefully the baby will wait til we get there. I'd hate to deliver on the freeway. :eek:

Thanks for listening,
Jacque
 
RE: First prenatel visit today.....dissapointing

Hi Jacque! First, congratulations on the pregnancy.

I am so sorry you will have to deliver in Tucson, and I certainly understand your frustration and confusion. You are correct that the risk is very low. I remember a several years ago VBACs were "it", but OBs and hospitals are a bit more hesitant with VBACs. There is a fear of litigation, because if there is a uterine rupture the outcome is often catastrohpic and there will most likely be a lawsuit. The physician and/or the hospital may end up in court.

There is also the issue of medical malpractice insurance costs that are rapidly increasing and will definitely increase if the physician has been involved in a medical malpractice lawsuit. In fact, there are some malpractice insurers that won't cover VBACS. In addition to the cost of malpractice insurance, the American College of Gynecology has a new new standard of care for VBACs that requires "a full surgery team (including a surgeon and anesthesiologist) to be immediately available during labor and an operating room kept open". This is an expense some small hospitals just can't afford.

I know this won't ease your disappointment, but maybe it will make a more sense why the policy has changed. I am still so sorry that you had a disappointing first prenatal visit. How was everything else?

Autumn
 
Hi Autumn,

Thanks for your post. It made me feel much better. I didn't realize that the policy had changed so much. Maybe I should think twice about the VBAC and consider the C-section. I have a few months to think about it. My visit was good otherwise. I got my script for prenatal vitamins and the lecture on eating right and exercising. Thanks again for clearing some things up for me. Do you work in the medical field? You sound like you know what you're talking about.;-)

Jacque
 
Jacque, I too empathize with what your concerns. It is best to find out now (at first visit) than at your last visit, right? I'm curious, are you concerned about the 2hr drive? Perhaps you could be induced and deliver vaginally?

I fully expected to have an epidural during labor. My platelets were low throughout my entire pregnancy. I had no idea this would be a contraindication for an epidural. I didn't find out until I was 6+cm dilated that I wouldn't get an epidural. Had I known earlier I might have been better prepared. Knowledge is power. :eek:) Right?

Congrats on your pregnancy. I"m sure everything will work out for the best for you.

Melanie
Baby Justin born 1/17/04

" Take care of your body like it will last a lifetime. Take care of your soul like it will last for eternity"
 
Wow, I agree that is frustrating, Jacque. I also agree with everyone else saying, better to know from the beginning than to find out right at the end. You have time to figure out what is right for you. Trust yourself to make the right decision - you know yourself better than anyone! Congratulations on your pregnancy. I hope you are feeling well.
 
Jacque,

You are welcome... and I am glad you feel better. It always helps me to understand the rationale for change, so I thought it may help you too. Melanie and Emy had good advice... don't give up on the VBAC until you have researched your options. It sounds like this is what you really want so take the time you have to make the best decision for you, your hubby (they get nervous at the thought of a long drive with a laboring woman :)), and that precious baby.

Glad to hear your visit went well. I think I need a lecture on eating... I have been so naughty this week... I mean REEAALLY naughty. I just had a piece of chocolate chess pie, so I am not even ending on a healthy note. :) Oh well!

Oh, and yes I work in health care, I am a Women's Health (AKA OB/Gyn) Nurse Practitioner. I absolutely LOVE my profession... it is so much fun. I also am a Maternity Nursing clinical instructor. I love this specialty in nursing!!

Take care!

Autumn
 
Autumn, we're so priviledged to have such an educated lady on the forum. You're so helpful. :) Thank you.

Melanie
Baby Justin born 1/17/04

" Take care of your body like it will last a lifetime. Take care of your soul like it will last for eternity"
 
Thanks Melanie! I also feel priveledged to share these forums with such a fantastic group of ladies (and gents)!

Autumn
 
RE: First prenatel visit today.....dissapointing

> There is a fear of litigation, because
>if there is a uterine rupture the outcome is often
>catastrohpic and there will most likely be a lawsuit. The
>physician and/or the hospital may end up in court.
>
>There is also the issue of medical malpractice insurance costs
>that are rapidly increasing and will definitely increase if
>the physician has been involved in a medical malpractice
>lawsuit. In fact, there are some malpractice insurers that
>won't cover VBACS. In addition to the cost of malpractice
>insurance, the American College of Gynecology has a new new
>standard of care for VBACs that requires "a full surgery team
>(including a surgeon and anesthesiologist) to be immediately
>available during labor and an operating room kept open". This
>is an expense some small hospitals just can't afford.
>
>
I think Autumn raises a very important point about malpractice insurance costs which are driving some OB/GYN in smaller, rural areas out of business so that there may be more cases where there may not even be an OB/GYN in your community! So it just won't be an inconvenience to drive 2 hours for delivery, but you may be driving 2 hours for every doctor's appt.
Even with your one VBAC, given the current climate, it is best to deliver in a hospital which can give you immediate attention with your doctor and an anesthesiology team if something catastrophic were to happen.
Having had a c/s and a vaginal delivery, I agree, I would much rather deliver vaginally - it a much easier recovery and it should get easier with every delivery.
Good Luck and CONGRATS!
 
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