PREGNANCY-BIRTH Messages for March, 2002: Re: Changing ob/gyn @ 34 weeks? Need VBAC friendly doctor!

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Re: Changing ob/gyn @ 34 weeks? Need VBAC friendly doctor!

From: M. Kelly Shanahan, MD, FACOG (anonymous@obgyn.net)
Sat, 30 Mar 2002 18:22:28 -0600 (CST)

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In reply to: abrook: "Changing ob/gyn @ 34 weeks? Need VBAC friendly doctor!"

At Fri, 29 Mar 2002, abrook wrote: >
>My wife's first baby was a c-section (c/p disproportion). She is now in
>her 34th week in her second pregnancy. Her ob/gyn is not very
>supportive of a vbac; he immediately suggested a repeat cs. Only after
>she insisted on a vbac, he sort of accepted, and got her very scared
>with all the potential risks of a vbac. So much for an "informed
>consent". We understand there are risks to a vbac, but shouldn't the
>doctor also weigh those risks against the risks of a repeat c/s?
>
>We are concerned that since he is hesitant to the whole idea of a vbac,
>he may only be paying lip service to her wishes, and my wife will end up
>having another cesarean! Anyway, here is my question: I did a lot of
>research (on vbac in general and on practitioners) and located a vbac
>friendly doctor in a very respected university hospital, but my wife was
>not able to get an appointment with him! The nurse told her that she was
>too late in her pregnancy to change doctors. I have never heard that
>before. They also told her that her current doctor should respect her
>decision to have a vbac... (we know that, but "formally" respecting her
>decision is not the same as actively working with her to make it
>happen). Should we insist in getting a consult with the doctor?

you can't insist if he is book -- and he has no moral or legal obligation to see you

Is it >really difficult to change doctors at this point?

it can be -- most docs don't like taking on care so late, without much time to establish a relationship with teh patient

Any advice on this is >greatly appreciated.
>
>Just for the record - I have nothing against c-sections. It's a great
>procedure that saves lifes. But I strongly believe that trial of labor
>should be allowed and encouraged when possible.

some hospitals are not able to provide an "immediately available" obstetricain, anesthesiologist and oerating room crew, which are prerequisites for allowing a VBAC attempt. I used to really encourage women to try to VBAC, but now, since I practice in a small community, I tell all my patients that they have to have a repeat c-section -- or go elsewhere. >
>Thank you in advance.

--
M. Kelly Shanahan, MD, FACOG
S. Lake Tahoe, CA

author of "Your Over-35 Week-by-Week Pregnancy Guide"

**this is for general educational purposes only and does not supplant the need for you to consult with your own physician**
***private e-mails WILL NOT be answered***

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