VBAC (vaginal birth after c-sec)

 

That is, "vaginal birth after caesarian." Has anyone here done it? I am not pregnant or even yet planning baby #2, but I'm wondering if I am still living in Malaysia whether I will be able to find a supportive doctor so I can try for a VBAC. Or do most of them still push for repeat caesarians? I know in many places in Europe it is expected that a mother who has had a caesarian will, in most instances, try for a natural birth the next time around. In North America it depends more on your doctor, or the hospital you deliver in. I also wonder if public hospitals in Malaysia would actually be better for someone wanting to have the least intervention as possible in their birth - they probably don't give you as much attention as they do in a private hospital! Actually, my top choice would be to have a home birth, but I haven't heard of any midwives who are licensed to attend home births here. Thoughts? Thanks! Jen _________________ Canadian expat in Malaysia,

I have been through that. It is actually a non-issue. It depends on why you need a caesarian earlier. Mine was because the baby was too big (4.1kg) and my cervix couldn't dilate. But there are some who need repeated c-secs because of other problems. I would say that this has nothing to do with countries, hospitals or doctors. But rather, depends on how confident the mother is, the kind of trust she has on her ob-gyn and whether she is ready to endure long, long labour that last two days.... Back then, 12 yrs ago, I am knowledgeable enough to listen in to the midwives/ob-gyn conversations about the progress of the labour etc. In fact, I went to labour equipped, 14yrs ago, with many terms they used, probably to impress them, to warn them not to mess with me and to be in control. I went on to have two VBACs. Then again, my ob-gyn is one of kind ... _________________ Lilian (mom of 5)

I mean, as a whole I think Malaysian doctors tend to try to "medically manage" birth rather than letting nature take its course... whereas in Europe there is much less intervention (Holland, for example has about a 7% caesarian rate, whereas the last stats I saw for Singapore were 27% - haven't seen any for Malaysia but I think it's probably about like Singapore). It's about 22% in North America. When I was pregnant I actually got laughed at by my first OB here for wanting to walk about during labour, and to be able to choose my position for delivery, or use a birth stool or tub. . These things are the norm in many other countries or in non-MD attended births. So I think it does depend where you are. My dd was in distress and that's why I had a caesarian. Labour was going fine naturally, there just wasn't time to wait. Her heart rate was plummeting and she very nearly aspirated meconium - it was all over her head when they took her out . I was VERY informed about birth and caesarians and legitimate reasons for them and that didn't change the fact that she wasn't getting enough oxygen.... Now, for LOTS of other moms I have met here in Melaka, they had caesarians and didn't know until after the fact that the hospital they delivered in was being investigated for doing unnecessary caesarians, and to this day wonder if they really needed them (ie: some of them were told after only three hours of labour that it was taking too long!!!). Staff at the same hospital told a mum who wanted to breastfeed that her nipples were too small, but that's another issue. Anyway, all that to say that I think MDs attitudes are very pervasive within a region, so I wondered if the very medicalized approach here meant they went by the old-fashioned "once a caesarian, always a caesarian" especially in light of the two US studies a couple of years ago that had everybody THERE, even, rushing back to the operating theatres, despite the fact that they were completely biased studies. Having a supportive doctor and attending staff for a natural birth and especially a VBAC is as important as having staff who are helpful with breastfeeding. A woman can be as confident about it as she can be, but if her doc has only given lip service to natural birth and is sharpening his scalpel the second she walks into the hospital she's not going to make it. So to call it a non-issue... well, I can't disagree more! Sorry! Regardless, I'm glad you were able to do it - that IS promising! Thanks! If the situation arises I may have to get a referral from you! Anyone else "been there, done that"? Jen

Back in time, 14 yrs ago in 1990, I had recognised the word meconium and kaput (bump in the baby head due to him pushing, not kaput as the Malaysians reference to death). The moment I heard these two words from the midwife reporting to the ob-gyn, I told my ob-gyn to cut me ASAP. He held my hands, look into my eyes and say 'Oh Lilian, you are so brave!' I think this is the very reason ob-gyns prefer to stick to the safer side of cutting rather than waiting, to save their butt from lawsuits. And 2 years later in 1992, while I was trying for VBAC, he did the same hand-holding thingy and probably that's how the VBAC is successful. Oops, you can't find my ob-gyn anywhere in Malaysia 'cos he is an American missionary doctor who travels the world, serving God. BTW I named my eldest son, Jeffrey after him! _________________ Lilian

I've just been reading through and my gosh - how ignorant am i! I had an emergency c-section, but i think it was valid anyway - dds heartbeat was going down fast . I mean, my doc waited for me to dilate and didn't even suggest the c-section, but i was induced and between 5 am to 3 pm - i had zero intake of food or water. I just read another mom saying you can bring sandwiches as a light snack or drink lucozade while waiting for active labour. Really?? They allow that here? I ended up having really low blood sugar and could not even hold my girl when she was born - i was shaking uncontrollably for at least 4-5 hours after the birth. I do want to try for VBAC for my next one (i have to conceive the second one first - but that's another story) and i guess i should get updated about what's possible and what's not possible here to avoid the same disappointment as the first time(due to my big fat ignorance). -Celya

Jen, Haven't had a chance for VBAC, but just to tell u that there are many gynaes that truly support vaginal birth. I had mine in Penang. Despite what many locals think of that hospital, believe it or not, he talked me out of thinking of c section at all! From the moment when we discussed about modes of delivery till i was induced to dilate, second induction & when i was crazily shouting for pain during crowning! In fact, after being in pain for hours, when the whole thing was finally over, i told him how i understood y so many moms opted for c section, & i thought i might think so for the second one (back then), yet he still insisted that vaginal birth is the WAY to go unless u really encounter real danger. All in all, all I’m saying is that he's not a lips service gynae. And on top of that, all the nurses in their maternity ward & nursery were all truly supportive of total breastfeeding. I think to really be able to try VBAC, u just have to get more info from talking to moms around to find a good gynae. (And maybe I’ll need info from u the next time if i happen to need it in Melaka ) angie