Posterior baby with previous labour (c-section) gives lowest percentage of sucess in VBAC?

I had my first appt. with my midwife last week (10 weeks). It was our first time meeting as I had my first pregnancy care done at a maternity clinic (whole other story ;). I liked her and the appt was great, about 45 min and we talked a lot about my desire to have a VBAC.
However one of the things she said kinda took away some of my 'can-do' attitude about having a vaginal delivery with baby #2. I told her I had a posterior baby, and after 2 hours of pushing, she didn't budge, although she did come out with a partially molded head. Mind you I had been in labour for 22 hours before pushing, had pitocin to start regular contractions because my water had broke and I was GBS+ so the hospital had a time limit, had continual fetal monitoring on baby's scalp, an I.V, bladder catheter and antibiotics, then at 7cm dilated had an epidural wherein I quickly got to 9 but stalled there for 2 hours until I got to 10!
SO finally time to push and I did for about 1h and 40 min but it was so bloody difficult because I couldn't feel the contractions. Finally the OB was called in and he said I had 1/2 an hour to make progress. I didn't so I had an emerg. c-section. I really do feel my daughter was so close to coming out, if only I could have had more time!
So when my midwife said - with these type of labours (posterior) they have the lowest chance of success for VBAC'S, she said about 60%. My midwife said this is because there is probably some cephalic-disproportion because many women can have successful vaginal deliveries with posterior babies.
I feel bummed but still determined. Does anyone have any stories or alternate wisdom to share? As well I do not have the option of finding another midwife. I live around Vancouver in BC, Canada and here midwives are in such high demand that if you do not sign up with one by about 6-7 weeks they will be all full and I would rather go with a midwife than an OB or GP.
Also I have no idea what position this baby will be in but I have already started doing exercises and trying not to recline when I am sitting- having my knees lower than my pelvis, and also trying to rest smart. I checked out the spinning babies website it is great!
Thanks in advance for sharing!

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Replies to This Discussion

I had VERY similar story w/ #1 as you WITH posterior baby! AND I had a successful VBAC, only 6 hours of labor and 16 minutes of pushing on Oct 30th! I did spinning babies to help turn him and he WASN'T posterior when he came out. Probably turned while labor started b/c I didn't have back labor this time. SO don't give up hope!!!!
Many of the interventions you had can make it harder for a posterior baby to turn as labor starts, esp the pitocin. Were you active during your labor? I am guessing that with the internal fetal monitor and the IV and the catheter you were not able to be very mobile. That also has a huge effect on the baby's ability to rotate into anterior position during labor.

So, while I don't know about the effects of a posterior baby on the success of a VBAC, I would say that by avoiding (as much as possible) the interventions that may have caused/exacerbated the problem in your previous delivery, you can eliminate it as a factor. Continue to do the exercises on spinningbabies.com to encourage a well positioned baby. Chiropractic alignment (if you can afford it) is great as is craniosacral massage by someone trained specifically to work on pregnant women.

Since many of your interventions were due to GBS, ask your midwife about natural things you can do in the last weeks of pregnancy to reduce your chances of having GBS--my Midwife gave me a list of herbs & veggies to use but I didn't (wasn't GBS+w/either of my last pregnancies so I didn't anticipate it being an issue this time so i didn't use any of the things) and don't remember what they were.

Check out this link from ICAN, it talks about CPD due to posterior babies and ways to prevent it http://ican-online.org/vbac/cephalopelvic-disproportion-cpd

Good Luck!
Thank you all for your encouraging words :)

Kaisha, that is very hopeful. Thank you for sharing your story. I am hoping to get an exercise ball for work now so I can continue sitting properly while at work.

Sara, I was active only during the very beginning of labour. I did labour on all fours for about two hours but the baby still did not turn like the nurse hoped she would- I can't remember but she may have already been engaged so I think she was already 'stuck' and simple gravity wasn't going to help- also I think being induced forced her further down before she was able to turn. As well movement was pretty much nil after all the interventions, most notable in the beginning the internal scalp fetal montioring and the IV, then later the epidural (and catheter) which made me completely immobile and unable to feel any contractions until they turned it down and then I felt the contractions but still couldn't move! I have read a little about natural methods to reduce chances of GBS so I will definately ask my midwife about them at my next appointment.

Elizabeth, wow you're so close! I'm actually in Maple Ridge so Vancouver is a little far to see your friend but thank you so much for the offer :) I will be looking into finding a chiropractor locally in the next few weeks. Thank you for your story. I would love to have a doula though it is just out of our budget. Hopefully my husband, midwife and a good friend will be enough support.

I am going to try and research as much as possible too and make sure my wishes are known to my midwife. I also need to ask more questions to my midwife- about continuous fetal montioring (what hospital policy is), about time allowances, how often will I be checked for progress, what positions does she advize during labour if it is a posterior baby, etc. Hoping it'll all work out :D
Kim,
I had my posterior baby via VBAC Dec. '08 after a c-section for a breech position in April '07. I was hell bent on VBAC and actually switch in my 32nd to a fabulous midwife after feeling that my OB practice wasn't going to be as supportive as I needed. He (yes, he - my wonderful male midwife) told me he naturally couldn't promise me anything but he'd give me all the support in the world and that I was a great candidate. I was obsessed with making sure this baby was in a good position and NOT breech - I was on spinning babies and various other site and read a ton of books and even went to a chiroprator who specialized in the Webster Technique. I also hired a doula to give me that extra support.

A few weeks prior to my due date we found out thw baby was posterior but I wasn't too concerned thinking she could rotate in time or in labor. I was in labor all day at home, mild I guess but they weren't really settling into a consistant pattern. My midwife said my body was probably just warming up and that probably the next day we'd go to the hospital. Long story short, my water broke in bed and I was at the hospital by midnight. Horrible back labor and only 2 cm at this point. Hours later I wasn't really progressing and he suggested mild pitocin to really make the contractions work and dialate my cervix. Here, since the baby was posterior the cx's weren't as effective - the pitacin did the trick though. I didn't want an epi since the research I read said that it could possibly slow or even stall my labor and I wasn't having any of that! I pushed for 1 hr and 40 minutes and it was tough but she eventually come out and it was an incredible experience.

I highly highly recommend you researching and reading as much as possible and going for the VBAC. Take it from me, try NOT to obsess about the position but do everything you've found to try to make the position of the baby the most favorable for a VBAC. Just believe in yourself and the power of your body. I was really transformed by the Business of Being Born and all the books I read. Just amazing how strong women really are! Good luck!!

I know you posted this a long time ago, but I wanted to  reply, just in case other women have the same question. Chriopractors often help women who have had a baby that was posterior for quite some time in labor and then end up with c-section for failure to progress. My daughter was posterior for much of my labor....at the time I didn't know much about chiro care. But the center near me has great success with helping women who'd like a vbac do it successfully. The baby's position in your womb is significantly influenced by the health of your spine and nervous system...that's where all the messages that control labor and birth travel.

 

I know most people only think chiro care is for turning breech babies or back pain lol...but it just ain't so. Seeing the success of the chiropractic center near me with vbac moms who've had posterior babies gives me hope :).  So, it is *not* about CPD!  Your pelvis is, in all likelyhood, just fine. But it may be worth your while to check out a well-respected, very experienced chiro for this. Don't be afraid to ask for their success rate - if they're really good, they'll be proud to tell you :). 

 

P.S. Research on chiropractic care shows that it reduced labor time for 1st time moms by around 24%; for second time moms, around 39%.  (Wish I'd known about chiro before my 56 hour labor that ended in c-section!!!)

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