Deciding on a VBAC-hoping this is not too insensitive-long

[cilantromapuche]

I didn't realize that my hospital even did them still. My Dr. is encouraging me to try and I have to say that after Beth's experience I am a little hesitant (OK, a lot).
I have read up and still have some questions (I am not due until June).

Studies say that 80% of VBAC's are succesful (which is a good number). If the uterus ruptures how many emergency c-sections are succesful and what makes it dangerous for the mother?

Did anyone have a VBAC experience and wish they would have stuck with a scheduled c-section? DS was breech and didn't turn when they did the external, so it was scheduled. The only thing that I hated about a c-section was the recovery time. I didn't feel that I missed out on the "womanly experience".
Thanks for your input, because this is really bothering me.
Christine

mama to A (7/03)

[dogmom]

Well, I think having a an OB to encourage the VBAC probably says a lot. I think you should make an appointment with your Dr with extra time and write all your questions down that you have about VBAC, including what kind of emergency coverage they have for C-sections, how long would he let you go in labor, what has his experience has been with uterus ruptures if any. (Oh, and ask about the average number of years of experience of the nursing staff in L&D, an often overlooked question that is SOOO important.)

I would also be honest and expresss your hestitation, including the specifics. If it were me, I would spend hours upon hours of doing research and still not find the comfort I needed to make this decision. In the end they statistics can guide you, but you need to be comfortable with the decision as it relates to you and your specific situation. I know there are people with much more information about VBAC than me, but I just wanted to point out the other aspects of making a difficult health care choice.

I did find one study on predicting emergency c-sections in attempted VBAC, but it's not a huge study: http://www.medpagetoday.com/OBGYN/Pregnancy/tb/1734

Jeanne
Mom to Harvey
1/16/03

[lmintzer]

I had a VBAC and was happy I did. My first ds was breech and couldn't be turned due to low fluid. My 2nd was an induced VBAC due to low fluid again (it was either induced VBAC or immediate c-section). My doc felt comfort inducing with Pitocin. I was very very carefully monitored in an excellent teaching hositpal. He would never have tried this in a community hospital. His group had special expertise in these and knew exactly what to watch for.

Risk of uterine rupture for all-comers is roughly 1%. Sometimes it is quoted at .5%. If the doctors are good and the hospital is well-equipped, they can typically get the baby out safely and stop mom from bleeding. The trick is early detection and action. They need to get baby out fast, and this can be done if there are good contingency plans for this.

I agree with the pp that you should sit down and have a heart-to-heart with your OB. It's natural to be concerned, but s/he may be able to help you be more comfortable with the idea if that's your leaning.

My personal experience was that the pain after the c-section and the VBAC were equally bad for about the first 24 hours. But then, after the VBAC, I felt much better much more quickly and was getting around the house fine by the time I got home. The first 24 hours after the c-section was also worse due to nausea from the medications and tail bone pain from not moving in the bed. All and all, the VBAC was easier, and it was an amazing experience to get to push out my little one.

Good luck with your decision. I'm sure many here will share their stories.

[kimbe]

Thank you for posting about this. I am eager to read the responses. DD is not even 6 months and we haven't even thought about #2 (well, I have :) ), but I am alread agonizing about what I should do if I am lucky enough to have more children. My OB is much like yours I think. She told me that she totally supports a VBAC, but that when the time comes, we will make a decision on whether to try or not based on a few factors. The rupture precentage haunts me, but so does the thought of being in labor for 30hrs and not getting past 8cm. However, I would love to have the quicker recovery time and to have the experience of childbirth! Thanks again for posting. Keep me posted on your decision and good luck in your research!

[mamicka]

I can totally relate to your indecision. I had a very difficult time deciding on VBAC vs c/s - there's not really anything info out there, IMO, that makes it cut & dried.

My c/s was due to anterior position (baby facing forward) & I really feel that my doc & the L&D nurses were either uneducated or lazy in how to cope with this kind of situation. (I didn't realize how much they were lacking until waaaay afterwards, after educating myself.) I was induced due to possible large baby (mistake #1) & went on to labor for 36 hours at which time DS's heartrate was dropping drastically with each contraction. After the consent was signed, DS was out in less than 15 minutes & his apgars were great - but he needed to be under oxygen for 7 hours because of the fluid in his lungs that wasn't pushed out since he didn't come out the birth canal. His need for oxygen had nothing to do with laboring for 36 hours, only the c/s. My c/s recovery was really a breeze, I thought. My biggest problem was the gas pains - which is normal for any major surgery. Other than that I had no pain, no pain killers necessary. I also didn't feel like I missed out on the "womanly experience" - because honestly, I didn't know what I had missed. All I knew was that having the c/s, while it was necessary at that point, wasn't how it was "supposed" to have happened, for me. It just didn't feel right.

I guess the bottom line for me was that after researching as much as I could, the risks (to me & my baby) involved with having another c/s were much greaterthan the risks involved in having a VBAC. This is assuming, of course, that your doc is on board & that you are confident in the hospital staff.

It's a tough decision, I know.

Good luck!
Allison

[MegND95]

I've had two VBAC's. My dd was breech, and I had a scheduled c/s around 39w. When I got pg with #2 just six months later, I was lucky enough to have an incredibly supportive team of OB's and MW's. Both my older two kids were born in a very large, Naval teaching hospital, and I think they were much more open minded.

My first VBAC was 30+ hours of labor. My water broke when I was only a fingertip dilated. So basically, I was induced. 2.5 hours of pushing with an episiotomy and a third degree tear...OUCH! But despite such a long, long labor (it took me 15h to dilate to 4cm), not one of the OB's even mentioned "repeat c/s." They knew I wanted a VBAC and were willing to help me achieve that goal.

As for recovery, even though I suffered perineal trauma, I felt worlds better in the hours and days that followed, compared to my c/s. I was able to get up and move around right after birth. I was so much more comfortable all around. Admittedly, a third degree tear carries issues of it's own, but still better than a c/s!

For my third pg I was cared for by a group of three CNMW. They were incredible, and expressed no doubt about my ability to VBAC. They were willing to try a host of things to safely help jump start my labor, if it came to that. No help needed, as I was 4cm when I checked into the hospital. Ds #2 was born 5 easy hours later. Again, recovery was a breeze relative to the c/s.

Given your history, and my knowledge(not hugely extensive) of VBAC, you are an excellent candidate. Plus, in today's anti-VBAC environment, having a supportive provider is crucial. Clearly, for your own sake, examine all sorts of information to help make the right choice.

Good luck!

[SewSarahSew]

>I guess the bottom line for me was that after researching as
>much as I could, the risks (to me & my baby) involved with
>having another c/s were much greaterthan the risks involved in
>having a VBAC. This is assuming, of course, that your doc is
>on board & that you are confident in the hospital staff.

Ditto! After an emergency c-section with Daniel, I did tons of research in my 2nd pregnancy. I know the term "uterine rupture" is very scary, it sounds like a volcano exploding or something like that. Actually, more ruptures are nothing like that and are caught quickly and everything is fine. It is definately a risk, but a smaller risk than infection with abdominal surgery, like a c-section. Or that's what I remember - it's definately something you need to research and ask questions of your health care providers.

My VBAC was hard work, going the whole labor and pushing, and then having a hard time sitting for a week afterward. But recovering from the section was much harder and longer, I wasn't myself for days after. I grimice looking at the photos of me in the hospital, I was so "out of it". After the VBAC, I walked to my hospital room. Huge difference. We are done having babies, but I would always try for a VBAC myself.

Good luck - it's a huge decision.

[JacksMommy]

I had a vbac and was so happy I did. I was also happy with my c/s experience - my recovery wasn't bad at all but it still SO much better with the VBAC. Like you, I wasn't someone who felt robbed of the birthing experience from having a C, but it was amazing to have it with my vbac (even more so from my husband).

I did a lot of research at the time and my understanding was that VBACs are not more dangerous than having a c/s, which has a lot of dangers as well. All the numbers are pretty small, but childbirth still has its risks no matter which way you decide to go.

My hospital was willing to let me decide at the very last minute. If there had been even the smallest complication, I was ready to do another c, but everything went smooth as silk and I would definitely do vbac again.

If you do a search on this board, you will find many stories.

Laurel
WOHM to Jack, 6/4/02
Baby Madeline 12/14/04

[cilantromapuche]

I have printed off tons of info and am feeling more positive about a VBAC. I have plenty of time to think about it even more and appreciate everyone's input.

Christine

mama to A (7/03)

[joliesboutique]

I had an emergency c-section with my first, and a VBAC with my second. The VBAC was a wonderful experience. I enjoyed every moment of being in labor and delivering. I know that sounds crazy but I really did. I also had a doula, which helped immensly. Some of them are expensive, but alot of them are willing to work with you on price if it is an issue. I highly reccomend having a doula, and the VBAC was wayyyy better than the c-section. I hope this helps.

[kimbe]

Christine,

Sorry to be hijacking your post, but I also feel much better about a possible VBAC in the future. Thank you again for posting this.

Thanks to all the mamas that were so kind to share their thoughts and experiences!