v-bac in NJ

I hope that someone will be able to help me, though this isn't related to Hackettstown.

My husband and I are thinking of having a third baby. Our first two children were born via c-section (the first because of a resistant induction and the second because of position) at St. Clare's hospital in Denville. My ob has since moved out of state and I'm in the business of finding a new practice.

Should we be lucky enough to have a third baby, I'd like to try again for a V-BAC. Hackettstown hospital doesn't do them for liability reasons. Does anyone know if Hunterdon Hospital will allow them, and of a ob/midwife practice that is V-BAC friendly in Northern NJ. I am willing to travel a bit.

anna July 19, 2008 10:08 pm | Link

I know someone that had two C's and then V, so it's possible. It was in NJ, but down South Jersey. I don't think you want to travel that far. I had an old friend that was a ob/gyn. I'll see if I can see if he can suggest anyone. Good luck to you!!

INeedMoreCowBell July 19, 2008 11:29 pm | Link

I can give you the name of an OB/GYN practice and you can see if it's a fit for you.

Women First OB/GYN in Cedar Grove. It is an all women physicians' practice owned by Morristown Memorial Hospital, and they are strong advocates for women. 973-239-3865.

Worth a phone call..... ?

Just Me,

I will call tomorrow. Where is Cedar Grove? Is it off of Rt. 10?

anna July 20, 2008 9:29 am | Link

No, that's Cedar Knolls... common mistake LOL :)

Cedar Grove is in Essex County. It's down the road (Rte. 23/Pompton Ave) from the Willowbrook Mall

my OB's out of morristown would not do a do a vbac after my 2 previous c sections. Typically not recommended for risk of rupture. I agreed as I did not want to put myself and my baby at risk if I didn't have to.

But whatever works out for you I wish you the very best.

It is a hard thing to find a doctor who will "allow" a woman to birth vaginally after having had one c-section let alone two for the same liability reasons that Hackettstown states.

There is a great ICAN group here in NJ - you can use this link to find one close http://ican-online.org/chapter/search and here's a link to the general site regarding VBACs http://www.ican-online.org/vbac/home

Also, there are a few moms in the local Holistic Moms Network who have had VBACs and CBACs depending on various situations and they could speak to your concerns and offer names of doctors with whom they worked.

If you'd like specific contact info for HMN, click on the envelope next to my name :)

CrunchyMom July 20, 2008 2:28 pm | Link

I had a c-section and have spoken to my doctor about a v-bac if I were to have a second. He said he would go with what I wanted unless something were to go wrong...he delivers out of St. Clare's in Denville. Dr. DePasquale - he has offices in Landing and Rockaway, but I only have the Landing phone number (973)398-0661.

Htown Resident July 20, 2008 3:51 pm | Link

Thanks for all of this information. A friend of mine emailed the ICAN information earlier today. I am unfamiliar with the group, but just looked at the website and it all sounds so supportive and positive.

Until recently, I honestly believed that if I'd ever want to have another baby I'd HAVE to have another c-section. This was a heartbreaking thought. It defies everything else I do in pregnancy- not to mention the general way I live.

I really should join the Holistic Moms Network.

anna July 20, 2008 5:13 pm | Link

Anna - I had two c-sections. The first was a very difficult recuperation time. I had my daughter before insurance laws were changed and I was out of the hospital with my newborn within a day and a half of surgery. I was contemplating a v-bac with my second but my doctor (and this was ten years ago) told me there was a 2 in 100 chance of a uterine rupture in which case there is a eight minute window to get the baby out - hardly time to even prep someone for surgery. I opted out because of the risk factor. As things turned out the cord was around the baby's neck when they did a schedule c-section so everything worked out for the best. I never felt cheated or heartbroken because I was so thankful that my children were healthy, and I think the real work is all the carrying around for nine months (especially through the summer).

Kate S. July 20, 2008 5:34 pm | Link

womens health care in andover does them at newton hospital. 973 383-8555.

I read the subject line and I new it was you.

Holler at me :) (lol)

Hahahaha!!!!

Victorious! I just saw this now!

anna July 26, 2008 12:15 pm | Link

The Midwives at Dr. Smith's office will perform VBAC at Htown hospital.

anna,

I'm sorry... I did discuss with my staff whether they would perform a V-Bac, specifically following TWO C-sections, and I'm afraid they would not. They feel is is entirely too risky for the mom as the uterus has already been weakened twice.

They do not recommend it. Please research this thoroughly and much good fortune and happiness to you.

Hey BT Resident,

I've done a lot of research on the subject, but if your co-workers could recommend any further studies supporting their opinions for me to read... I'd really appreciate that. As is, I can not find any research/statistics that support an increased incidence of uterine rupture after two previous c-sections. In fact, what I do find overwhelmingly shows that repeat c-sections have higher mortality rates from complications that VBA2C do. I've been reading at the ICAN network and have talked with lots of reputable people on the subject. That being said, I am completely open to new opposing information and am even trying to find that research because v-ba2c is so controversial.

At this point, my family has been relacted to Philadelphia and will be leaving NJ in the next month. At the U-Penn Hospital there is a great practice and the dr's and at least one dr. will do the vba2c. I do draw the line at homebirth, as I feel my labor is too questionable for one and I prefer to be in the hospital in case of emergency. I will keep reading and talking and researching before now, when I get pregnant and through my pregnancy to assure as informed a decision as possible.

So, if anyone has seen research or studies... or even heard first hand stories differing from mine... please don't hesitate to post it. I am eager to learn.

anna August 17, 2008 8:15 pm | Link

Anna - you might try looking for research done by John Hopkins - they are the best hospital in the country for women's health. They saved my sister-in-laws life following a very complicated pregnancy.

Kate S. August 18, 2008 8:31 am | Link

there's a reason why hospitals are not allowing v-bac deliveries anymore. IT'S DANGEROUS!!! why would you put yours & your baby's life in danger by insisting on a v-bac? i dont get it .... btw, newton or H'Town will NOT allow them at all.

My sister just had her 2nd c-section, and the doctor told her afterwards that she was so thin that she almost certainly would have ruptured if she had tried a v-bac. It wasn't something she was even considering, but my point is, it's hard to tell from the outside how likely you are to rupture, so I would never want to risk it. It's just not worth it in my opinion.

I have to agree with marissa - nothing is worth the risk to either the child or the mother.

Kate S. August 18, 2008 10:18 am | Link

I suggest that before making assumptions based on who will and who will not allow vba2c, you read the research. Mindlessly believing what people say without seeing any proof is ignorant.

I am trying to make an educated choice about the birth of my next child. C-sections are considered major abdominal surgery. It is CRAZY to me, that when the mortality rates and complications with c-sections are higher... factually and statistically than the rates of c-sections, people feel comfortable lecturing about what is safest for my child and children.

I HAVE two very healthy and happy and safe children. I dedicate my entire life to them... and that is done MINDFULLY. I don't just open my ears to whatever one or two or one hundred people say... but I turn to the source of their opinions. I seek the truth.

Please do not feel so comfortable making rude and rash judgments about the health and safety of my children. If I can find reason that supports the claims that v-bac is more dangerous than c-section, my mind will change. There are LOTS of reasons dr's want to do c-sections and few of them relate to the health and well being of the mother or child.

anna August 18, 2008 11:10 am | Link

EDIT****

"when the mortality rates and complications with c-sections are higher... factually and statistically than the rates of v-bac..."

anna August 18, 2008 11:11 am | Link

Hey, I just did a search for Johns Hopkins research. Their site directed me to several studies, centers and lots of research on the subject.

Here are a few things I found on the subject within minutes of researching there:

"Insufficient scientific evidence is available to support routine elective cesarean delivery, and she will seek the normal physiologic process (labor) to protect . herself. Less educated, more fearful, or less aware women will comply, however, consenting to scheduled cesarean delivery rather than Proceeding to labor, and herein lies the societal unfairness of this wayward recommendation. Physicians have a duty to "First, do no harm."


"The morbidity associated with successful vaginal birth is about one-fifth that of elective cesarean. Failed trials of labor, with subsequent cesarean section, involve almost twice the morbidity of elective section, but the lower morbidity in the 80% of women who successfully give birth vaginally means that overall women who opt for a planned vaginal birth after cesarean suffer only half the morbidity of women who undergo an elective cesarean section."

"Maternal mortality and serious morbidity are fortunately very rare, and for this reason estimates of their frequency are imprecise. A large meta-analysis showed maternal mortality of 2.8 per 10 000 for women undergoing trials of labor, and 2.4 per 10 000 for women having an elective cesarean. Uterine dehiscence (asymptomatic separations of the uterine scar) or ruptures occur in less than 2% of trials of labor, the same proportion as is seen among women who have routine repeat cesareans. Most of these are asymptomatic and of no clinical importance."

anna August 18, 2008 11:49 am | Link

There's ample evidence that vbacs are a safe option in many, many cases. I think that the judgment that has popped up on this thread is absolutely unwarranted, and, quite frankly, cruel. When a woman opts for a c-section today, no one questions her decision despite the fact that it has been shown beyond a doubt that c-sections increase risk for both mother and child. No, Newton and Hackettstown won't do vbacs, but my guess is that it's largely an issue of perceived liability rather than reality. Morristown Memoria will do vbacs, so that's got to tell you something.

Good for you, anna, for seeking out ALL of your options, and remaining open to all of the information. Best of luck.

NewHere August 18, 2008 11:52 am | Link

Anna - I wasn't making a judgement about you. I think you have to make a personal decision for yourself as to the safest route for you and your child. Personally, I made the choice to have a second c-section and like I said was glad for the decision because the birth would have resulted in a c-section anyway. For my first child I was in labor for 16 hours when it was discovered she was a face breech and there wasn't really any choice because the baby's neck could have been broken on delivery. I would question the rate of complications from c-sections over v-bacs based on the fact that many c-sections are done not as a result of a botched vbac but from other serious complications of pregnancy or fetal distress. Also, I made my decision 10 years ago and the research then supported that 2 percent of all vbacs resulted in a uterine rupture - that would be 2 out of 100 births (the risks were two high). Good luck with whatever you decide to do.

Kate S. August 18, 2008 12:11 pm | Link

Anna, with all due respect, I think you're being a little overly sensitive. I don't see anyone being rude or judgmental here. You say that you are eager to learn and asked for firsthand experiences, and you got them. You just don't like what you're hearing, but that doesn't make it rude. Like Kate S. said, good luck with whatever you do. The simple fact that you are doing all this research is wonderful and I'm sure you'll make a very educated decision.

Input, I have to disagree ... a prior poster stated that she was putting herself and her unborn child at risk by considering vbac ... those are fighting words to pretty much any mother I know (including myself!).

NewHere August 18, 2008 2:07 pm | Link

"... a prior poster stated that she was putting herself and her unborn child at risk by considering vbac ... "

Can you argue that Anna would not be incurring risk? I'd like to see you try!

And why are they fighting words? Heck, I'd like to know the truth even if I didn't agree with it! I'd call them "intelligent discussion" words.

We take risks every day when we step out the door and onto the sidewalk or in our cars. Anna is educating herself on the risks and only she can decide whether or not she feels the risk is acceptable. Frankly, I wish more people would understand the decisions they are making instead of simply relying on someone else's judgments. Good luck Anna, whatever you choose you'll know that the decision was right for you.

Anna, well done stating your research and the reasons you are actively considering VBAC again.

After two hospital births, we opted for a homebirth this time. I was amazed at how many people accused me of putting my baby's life in danger or that I was risking my life as well. A lot of times when people don't recognize that new research and education can reveal mistaken truths about birth, they think that the conventional medical model is the only way to go. Kudos to you for doing the work involved with finding the right answer for you and your family!

HappyHtownMommy August 18, 2008 3:00 pm | Link

"there's a reason why hospitals are not allowing v-bac deliveries anymore. IT'S DANGEROUS!!! why would you put yours & your baby's life in danger by insisting on a v-bac? i dont get it .... btw, newton or H'Town will NOT allow them at all."

I apologize for pointing fingers, but the above statement is what made me feel defensive. The implication of it is that I am willingly putting my (non-existent) unborn child's life in danger by making an "insistent" and "dangerous" choice. This statement upset me because I went out of my way to mention that I am trying to become more informed and also mentioned that c-section is just as dangerous... if not more dangerous than v-bac. Perhaps this statement was misinterpretted by myself and others who read it... but I doubt it. The use of caps and punctuation do a nice job conveying the message.

anna August 18, 2008 3:47 pm | Link

justintime, of course she would be incurring risk! For that matter, carrying a child is a risk. And a c-section is beyond a doubt a risk, as it increases both infant and maternal mortality and disability (I can provide sources if anyone is interested). My problem with the above post is that it doesn't enhance the discussion with any studies, facts, or personal experiences, but rather just suggests that anna is putting herself and her child in DANGER by considering a vbac, which may or may not be true depending on a number of variables (type of incision she's had previously, maternal health).

For that reason, I think that if anna is offended, and I can't say whether or not she was, she has every right to the feeling. I find it very upsetting when someone questions my parenting choices in such an aggressive way.

NewHere August 18, 2008 3:48 pm | Link

I believe if you do research, it is suggested that only hospitals that have the means to support immediate emergency surgery in case of a uterine rupture do vbacs. That means a full staff such as anesthesiologist has to be in the hospital not on call at home. Also, I would assume that only hospitals with neo-natal units should do vbacs in case of complications. I don't think if I was opting for a vbac that I would go to a hospital that couldn't deal appropriately with a high level emergency. Also, Anna if you look online there are several websites that do list what candidates are considered high risk for a vbac.

Kate S. August 18, 2008 3:55 pm | Link

The implication of it is that I am willingly putting my (non-existent) unborn child's life in danger by making an "insistent" and "dangerous" choice.

non-existent? Wow, why are we having this conversation then! ;)

Anna, you've read the studies (studies are ALL biased, in case you didn't know) and so you must know that vbac's most certainly can be dangerous, unless you call an increased risk of a ruptured uterus safe? There is potential danger, but why are you getting upset about it? You've learned what you needed to know and are willing to accept the risks, and that's great. That's what you are supposed to do so I applaud you for that. Good luck with your delivery.

Hmmmm... I'm actually not upset at all. I felt a little defensive for the reasons I stated, but I'm not crying into my soup or anything.

When I began this thread I said that we are still in the thinking stages about having another baby. I want to be prepared if I am lucky enough to have a third baby. I want to have a doctor who supports my choices reserved as well.

When I am looking at studies, I am mostly looking at percentages and numbers that reflect the dangers of v-bac in comparison to cesarean. I hardly know what I need to know... which is why I started the thread. I am trying to figure out what the risks are and where they are greater. Because I have had two previous c-sections I am hesitant to have a third because everything I read says that my risk is greater by doing this.

I have also heard from numerous women who have told me that their third c-sections were much, much, much harder to recover from.

Thanks for so many well wishes.

I know that some people do want c-sections. They choose them and are comfortable with them. I'm not entirely oppossed to having a third c-section. I'm just not so sure it's the wisest choice in respect to mine and my child's health. That's all.

anna August 18, 2008 4:19 pm | Link

Re: non-existent

Oops, my bad! Guess my reading comprehension is deteriorating with age!

Since the question has been asked, you will certainly be getting various opinions both pro and con. Certainly, using caps does convey strongly the poster's opinion but thats all it is...an opinion. Some will cite specifics some will not but again, its just their opinion more likely based on their personal experience or learnings (whether it actually happened to them, or something they read). To them, v-bac is very dangerous while to some others it may not. Strong words contrary to your belief will certainly make you defensive (which is human nature) while strong words in favor of your position will make you feel more justified. While it seems like you really want hear strong support of v-bac, no one here should get offended if someone says otherwise. In the end, its your decision to make and good luck with it. As a parent, we always try to do our best for our kids. For anyone else to accuse otherwise, is uncalled for as well.

by the way, percentages and general studies are a good starting point but its a close call. There are risks and successes on both sides. Your decision should really be based on what you and your doctor are comfortable with. Situations may be different and complications may arise either way you chose. Just be ready to make the call as you go through your pregnancy. If you want v-bac, go for it but if the doctor says otherwise when the time comes, trust in him/her. Find a doctor who is open to it but not someone who would do it just for the sake of statistics.

Good luck!

XM SAM, I am going to assume that you're kidding... or that you're one of my buddies pulling my leg or playing a little trick on me. No one could possibly ever write something so ridiculous as a retort to a factual, civilized and intelligent conversation and expect to be heard.

I'm just going to laugh you off and believe that's what you want me to do.

"Good one, I guess..."

anna August 19, 2008 4:38 pm | Link

Hey, where'd XM SAM's comment go? Are there moderators that pull comments?

anna August 19, 2008 4:41 pm | Link

anna, I wish nothing but a healthy delivery for you and anyone else that chooses to go vbac. you know the risks. thats all i'm saying. from a husbands point of view, the 2 things that are most precious to me (wife and baby)would absolutely not be put at risk.