34 Weeks and Change of Heart
34 weeks and just realized I really want to pursue a VBAC/TOLAC — what should I be asking/doing this late in the game?
I’m 34 weeks pregnant with my second and only recently realized that I actually have more of a choice about attempting a VBAC than I thought. I’d love advice from anyone who has been in a similar situation, especially if you decided on TOLAC relatively late in pregnancy.
My first birth was an induction at 37 weeks because of chronic hypertension. I did not have preeclampsia. I progressed all the way to 9 cm, but baby was OP/sunny-side up and didn’t tolerate Pitocin particularly well. Ultimately I chose to have a C-section. It was unplanned, but not emergent — I was told I could continue labor if I wanted to, but at that point I was exhausted/scared and chose the C-section.
Looking back, I feel like I made that decision sooner than I might have if I’d had a doula or someone there helping me understand my options and advocate for what I wanted.
This pregnancy I still have chronic hypertension, but it is treated and very well controlled. At 34 weeks everything has looked good, no preeclampsia, and baby is doing well. Because of the hypertension, my OB recommends delivery somewhere between 37–39 weeks and has been leaning toward a repeat C-section.
I’ve realized that I really want to pursue a TOLAC if I remain medically eligible. I’m absolutely not opposed to another C-section if something develops that makes it the safest option. I just don’t want another C-section to be the default simply because I had one before.
I’m planning to have a much more direct conversation with my OB at my next appointment about whether she considers me a good TOLAC candidate and, importantly, whether she would be willing to induce me for a TOLAC if I reach the recommended delivery window without going into labor spontaneously.
Since I’m already 34 weeks, I’m also scrambling a little. I’m reaching out to doulas, but I know there’s a decent chance everyone will already be booked.
For those who have had a VBAC/TOLAC:
-What questions would you be asking your OB at this point?
-How can I tell the difference between an OB who is genuinely supportive of TOLAC versus one who technically “allows” it but is likely to push for a C-section?
-If you had to be induced for a TOLAC, what did that look like?
-Are there specific things I should ask about regarding induction methods, monitoring, Pitocin, time limits for labor, etc.?
-What circumstances did you and your OB agree ahead of time would mean it was time to stop TOLAC and move to a C-section?
-If I can’t find a doula this late, how would you prepare your partner/support person to advocate for you during labor?
Anything you wish you had done in the last few weeks to prepare physically or mentally for a VBAC?
And if you ultimately attempted TOLAC but ended up with another C-section, is there anything that made the experience feel more informed/positive than your first one?
I’m not looking to ignore medical advice or pursue a VBAC at all costs. I mostly want to walk into this birth feeling like I understand my choices and that, unless something changes medically, I was given a real opportunity to try.
Would really appreciate experiences, questions I haven’t thought of, or advice on what you’d do at 34 weeks.