Very interesting! So nice to hear from someone who can relate.

I’d never heard that Lovenox is safe for laboring women. My impression was that it could make some emergency procedures (e.g. C-sections) more risky and/or complicated, but I haven’t researched it thoroughly.

Also, the midwives I was going to wouldn’t see me anymore after the clotting disorder diagnosis. They are hardcore natural birth types, but three of them (the owner of the practice, who is a midwife herself, and two of the midwives who had been seeing me) agreed with my doctors that induced hospital labors would be best from here on out. I’ll have to ask my doctors in more detail how they reached that decision. My impression was that it stemmed from two things:

1) I’m homozygous for Factor II, meaning I have both copies of the gene. They know that that makes my condition worse, but they don’t know how much worse because it’s so rare it can’t be studied. I think they wanted to be extra cautious with my labors because of this unknown factor.

2) There was still quite a lot of the DVT left in my vein after I finished with Coumadin, that will always be there. It occurred at a sort of “fork in the road” in the vein, and a lot of it got stuck on the corner. I saw the ultrasound, and that part of the vein is significantly smaller now. Given that, plus the homozygous issue, they think there’s a pretty high risk for recurrence, and I’m on a high dose of Lovenox. Maybe that’s why the doctors and midwives didn’t think Lovenox was safe for labor?

I’m out of time for typing, so hopefully that answers your question.

I had my first VBAC 17 months after my C section.

And then I had seven more babies vaginally! And I had my doctor feel my scar from the inside after each birth and it never stretched out or separated or weakened in any way.

God is not the one who made the 18 month rule! You are in control of whether you stop after hearing one doctor tell you that, or if you first, do some reasearch and find out what that rule is based on. Is it based on studies or is it just a gestimate? If on studies, how were they conducted? On what population? For instance, the studies justifying my first C section, related to infection rates after 24 hours of ruptured membranes, were done on women on public assistance in a big inner city hospital, who were having many vaginal exams by residents. It turns out that the infection rate soars 24 hours after the first vaginal exam, not after the actual rupture of the membranes. And on the whole these women would have been less well nourished and had more unhealthy habits. There are all kinds of confounding factors in studies.

Have you heard of ICAN, the International Cesarian Awareness Network? Have you read the book The Silent Knife, about the C section epidemic?

Please don't give up. If you are healthy and eat well and take vitamins your uterus is most likely in great shape. Unless there is some specific medical reason related to you in particular. Research the subject, and then try a few different doctors at least.
Because of insurance companies you have to have a VBAC in a hospital that has an anaesthetist and neonatologist on staff at all time, which means a big one. If all of that is in place, you may well find a doctor who won't insist on the 18 month rule as an absolute.

I think I went to 5 doctors in Annapolis before I found one in DC who would do a VBAC, back in 1974 when almost no doctor would do them. For a while they became very common, and then insurance companies made it very difficult for doctors to do them and they became less common again.

Very little about birth is an absolute.

I am not arguing against relying on God or against accepting his will. But God's will is not necessarily identical with current medical practice, whatever that happens to be in any particular ten year period. Once your birth happens, well, you made the best decisions you could with the best advice and knowledge you had at the time, and if you and your baby are healthy, that's a lot to be thankful for. (Even in that case, you are entitled to grieve a little for the loss of the birth you envisioned. If you are feeling that way, you can tell God about that too; no point in trying to lie to God and tell Him everything is fine with you if it isnt'!)

But ahead of time, it certainly isn't against God's will for you to question whether this or that rule or policy about birth is really 'research based' and valid, or not.

Susan Peterson

I also know someone who had a footling breech, first baby, delivered vaginally in the hospital by an experienced older OB.(maybe around 1978-79.) Certainly many breech babies could be delivered vaginally in the hospital but they are not, because there is a higher rate of possible complications than with head first birth, and legally no one dares to take that risk.
This is far from saying a breech baby would kill its mother just because of the fact that it was breech! With very rare exceptions, one never knows "what would have happened if" birth had occurred in another setting or if no interventions or if different interventions had occurred.

Someone said that finding out as much as you can isn't as much as you think it is. True. But by the time I had my first home birth with my fourth baby, I had read every popular book about birth which was available at that time,taken two Lamaze classes and a Bradley class, had attended two childbirth conferences and read their proceedings, and had studied a midwifery textbook and several OB textbooks. In fact I had an OB textbook from the 1700's, two from the 1800's, and three or four from the 1900's about 20 years apart. I studied the history of attitudes towards the epidural, and the development of the safe C section. I had memorized and gone over in my mind the maneuvers for unsticking stuck shoulders, since my big babies had big shoulders. I later used one of these when my daughter had her fourth at home. I will say that the first time I helped a friend have her baby at home; her eighth, I was acutely aware that my book knowledge was not the same as experience. It didn't turn out to be as easy as some of her earlier births. I was scared, and I prayed a lot. That child is in college now, by the way.

Nevertheless, the more people know the better, so long as having some knowledge doesn't make them think they know everything. At least knowing something enables one to ask questions, and if one is not happy with the way those questions are answered or not answered, one ought to switch doctors or midwives.
Questions:
Why do you recommend [this procedure/medication]? What will happen if we don't do this, or what could happen? How likely is that to happen? How much time is there for us to decide? If time…What has happened in this situation in your experience…are there any studies…?

Just some thoughts about possible questions. If you have done some reading you will understand the answers and perhaps know some follow up questions to ask.

Susan Peterson

Loved your post. THanks!