Tuesday, May 18, 2010


I know that I spend a lot of time complaining about my job, but one of the best things about my hospital is that we encourage vbacs for those women who have only had one c-section. Two c/s's though? Well, you are SOL.

Yesterday we had two great vbacs! One was a woman who came in in an active labor pattern. She was already 6cm on admit, within an hour and twenty minutes she was pushing! No time for an epidural (yes she wanted one), her labs weren't even back. She had a vaginal delivery, but it was completely bungled by the resident. He allowed her vagina to explode (descriptive right?) And practically exsanguinated the baby with how he cut the cord. Baby ended up needing an IV bolus, but perked up after that. She had her vaginal birth, but her vagina is going to be very sore for a long time. Her c/s was for breech presentation btw.

The second vbac'er came in contracting, but barely. I do not know why she had her first section as she was not my patient. She did have borderline high blood pressure which was part of the reasoning in putting her on low dose pitocin (yes we pit vbacs) and her contractions were adequate (as determined via IUPC) at a mere 4mu of pitocin. She delivered vaginally too! I don't know the specifics of her birth, but I am happy that she was able to deliver vaginally.

I have to wonder though why the only hospitals in the area that allow vbacs are teaching hospitals? These doctors are taught how to manage a vbac, yet when they create a private practice they refuse to do it for fear if litigation?! Really? (Ginormous eye roll inserted here). The research supports vbac, docs are trained in it, and it is still so difficult for a woman to get one in the private world.

One of my favorite kind of births (hospital anywhoo) are when I get to be the nurse to a vbac'er. Honestly though, most of my patients don't seem as thrilled about it as I do. I wonder how many of them realize how rare it is to get an opportunity to vbac at a hospital- let alone having the hospital encourage them to vbac. As I am grinning ear to ear and telling them how amazing they are they look at me like I am a crazy lady. Well, maybe I am the crazy birth lady :).


  1. PS - I love the VBAC ladies too! I volunteer to take them!

  2. VBACs DO rock, especially when the section was for "failure to progress" on a smaller baby. I'm sure your patient is glad to be recovering from a lac rather than from another c/s, especially with a newborn and (probably?) a toddler at home.

  3. Erin, I really hope so! Her poor vagina though. The OB resident had to leave in the middle of the repair to go to a c/s and called in one of the (very experienced!) CNM's to complete the repair which did make me happy.