VBAC or REPEAT C- SECTION

[TraciG]

I had a C section last pregnancy and figured I'd have another one this time, now that I'm 33 week's I'm thinking about having a VBAC, the doctor said it's up to me, I need to ask more question's & I want to talk to as many doctor's in the practice to hear what they think about it. Next week I'm seeing the same doc as last time, so that mean's I will have to wait another 2 week's for another doc's opinion.

I wanted to hear experiences from you woman who had VBAC & which one you preferred or recovered from easier . I'm more afraid to have a VBAC, for me the C-section was so easy ! I know if I do decide to have another child & I have a C section this time I would never be able to have a VBAC so this is my last chance.

I know the risk of rupture is rare but when the doc say's it could be catastrophic it's scary !

Just need help & information

THANKS Traci

[psophia17]

You could always give VBAC a shot and see how you do.

I had a terrible scheduled c/s first experience, and did my level best to get a VBAC for DS2. The labour part wasn't all that bad, and I'm glad I got to experience it even if I did end up with a 2nd c/s when DS2 failed to engage.

I should clarify, though, my water broke before active labour started, so I only had 24 hours to deliver to begin with. Since nothing appeared to be happening, I was given pitocin (or oxytocin, in my case) to strengthen the ctx, and I reacted badly to it with ctx that started before the previous one had finished. The part when my ctx were coupling was bloody awful, but the rest of the labour, for which I was not on any meds of any kind, pain or otherwise, wasn't anything I couldn't handle. Even at their worst, if I'd had some time between the ctx to catch my breath, I think it would've been okay.

But do whatever you're comfortable with - it's your body to listen to, right?

[SnuggleBuggles]

This is the best, most neutral site I have found that lays out the risks/ benefits between a repeat c-section and a VBAC. The site has this info and more:
How can this website help you learn about, decide on and plan for a VBAC or a repeat c-section?
This section of the website provides reliable information and support to help you understand the issues surrounding planned VBAC vs. planned repeat cesarean. In it, you will find:

* an in-depth look at your options and the current medical climate for women in your situation
* results of the best available research comparing risks of VBAC with repeat cesarean, including shorter- and longer-term outcomes in mothers and babies and risks for any future pregnancies
* tips for reaching your childbirth goals, whether your birth plan is for VBAC or a repeat cesarean
* VBAC and cesarean resources: websites, books, and organizations for information and support.
http://www.childbirthconnection.org/article.asp?ClickedLink=293&ck=10212&area=27

So, no anectdotes there but it can help you consider the pros and cons of both because they both have them.

Beth

[kochh2]

I know if I do decide to have another child & I have a C section this time I would never be able to have a VBAC so this is my last chance.

I know the risk of rupture is rare but when the doc say's it could be catastrophic it's scary !

Just need help & information

THANKS Traci

not true... you could always do a VBA2C if you so decided!! But, I'd say, it's ultimately your body, and you need to do what you are most comfortable with. For me, I researched it and found that the risk of rupture was so low that it was more likely we'd be in a car accident on the way to the hospital!! I did have a C/s my first time around out of sheer necessity- i fought till the end. The second time around, I tried again for a VBAC and again was faced w/ the same challenges and though i fought again tillt he very end, i had to go with another c/s. Recovery sucks - it's major abdominal surgery. With another child, IMO, it's even worse... but again, you know your body and your family, and how much help you may have once you get home, so it all depends on the situation!!
good luck!!!

[Raidra]

I've never had a c-section so I can't give you personal experience.

I would like to say that you should find out what method of suturing they used last time. I've read that single-layer suturing is becoming increasingly popular and has a much higher rate of uterine rupture (among other complications down the road) in future labors.

I also know plenty of woman who've had VBA2Cs, and if you're planning on other children, you might want to insist on double-layer suturing if you end up with another c-section. :)

ETA: If you did have double-layer suturing the first time, personally I'd much rather try for a VBAC. C-sections bring on a huge slew of risks that definitely outweight the minor risk of uterine rupture. I'd do everything in my power to try to accomplish a VBAC. Even shopping around for another doctor (it's not too late) if necessary.

[belovedgandp]

I chose a repeat c for my now 7 month old. It is a difficult decision. You will get lots of opinions, but in the end it is your body and comfort level.

My water broke, but labor did not progress with the first. Then he was very poorly positioned - leading with his forehead not the back of his head. Ended up with a c after 16 hours of pit.

Personal experience only here. Recovery from the scheduled c was lightyears easier than then first. Physically my body recovered faster. I cared for my baby better, faster, without any issues. The hardest part was not being able to lift my then 3 year old.

The two personal reasons that swayed me to a repeat c over a vbac were that (1) my incision from my first was about 75% larger than a normal incision because my son was stuck in the birth canal and large (2) my first was 9 lbs with an off the growth chart head.

[KrisM]

not true... you could always do a VBA2C if you so decided!!

While there are some doctors who do VBA2Cs, they're really hard to find. I'm not sure "always" is the best word here. I had to really look for someone for a VBAC and that OB is awesome (he regularly is the backup OB for midwife homebirths and when he's needed, he just hangs out at the hospital for the "just in case" moment and if that never comes, so be it.) But, he's not keen on VBA2C either, except in very particular circumstances.

I opted for a VBAC and ended up with another c-birth. It's a hard decision to make, I think. My decision for VBAC was largely based on really wanting to experience a vaginal birth. Also, I had a bad c-section experience with the spinal not working fully and wanted to avoid finding out if that would repeat itself.

Your decision can also be influenced by the reason for your first c-birth. If it was breech or bad positioning or something similar, it's not likely to repeat itself and you'll have a great chance for a VBAC.

Good luck with your decision.

[daniele_ut]

Just wanted to nod my head in agreement with Kris. It has become increasingly difficult to find VBAC friendly docs, never mind ones willing to consider VBA2Cs. I was in the same boat as Kris with my second baby and chose to VBAC. In the end, I went into preterm labor at 36 weeks with a frank breech baby and my fluid level was too low to safely attempt a version. We decided to opt for the repeat c-section rather than attempt a l breech delivery. This was probably a good choice on our part, since DS's head was really big - 95th percentile.

Now, at 36 weeks pregnant with my 3rd, I have reluctantly scheduled a repeat c-section. My doc and I briefly discussed a VBA2C and he said that more recent research supports that it can be as safe as a VBAC. In my case, though, we feel that the repeat c is the way to go. The peri consulting on my case also agrees and I am not sure the hospital would even be on board with a VBA2C. There is a small part of me that will wonder if I could have safely delivered by VBA2C, but I'm ok with the c.

[Raidra]

Most of the people I've heard of doing VBA2C did so at a birth center or at home. I agree that finding an OB/hospital willing to do a VBA2C would proably be quite difficult.

I also think that an experienced midwife would probably have more options/suggestions re: positioning than an OB/hospital. At least, that's what I've heard anecdotally, and that's been my experience as well.

I just read recently that Kegels actually help manuever a baby into a chin-to-chest position in addition to all the other benefits.

[TraciG]

Thank you everyone.

Beth thanks for the website, tomorrow I'm going to read it, just looked now for a few minutes.

[infocrazy]

I had a VBAC with DS2.

DS1 my water broke, I never went into contractions, got pitocin, never got past 7 cm (bad position they think). After 21 hours, I developed a fever which concerned my doctor and after waiting an hour, it went up and I agreed to a C-section (which I wasn't against since the epidural didn't work for me). Really, I had no problems with it, I just wanted a healthy baby--which I got. The only sucky part was that it was so long and then he got rushed off to NICU for a few hours immediately and I only got to see him for a few seconds.

DS2 I wanted a VBAC, but had no problems with a C if necessary. Epidural didn't work again, got a fever again but was at 10 so I was able to push. Unfortunately, because of the fever he again had to go to NICU right away!

The recovery for me was WAY better for the VBAC than the C-section but that is just me. I can't imagine having my then 21 month old and a C-section.

Really though, I would say try for the VBAC but be prepared for the C-section. I will try a VBAC for #3 but I'm really going for no fever!

Hope that helps and that you have a happy delivery!

[deborah_r]

I had a VBAC last June, with DS2. The recovery was so much easier, I was amazed! I am so happy to have had the experience of actually pushing a baby out - I know I am lucky to have had all of the conditions fall into place for it to happen.

If you are lucky enough to have a provider who is open to it, my advice would be to give it a try. Ask the doctor very specifically though how long you can go with the pregnancy before they will insist on scheduling a c-section. (I was scheduled for a c-section on my due date, but Quinn was born the day before. But my doctor had said if I seemed to be progressing on my due date, she would have let me go another day or two to see how it went. If I was showing no progress on my due date - which was the case with DS1, she was not comfortable going past the due date.) I think some doctors want to sound VBAC-friendly, but they do things to steer you toward the c-section.

I was very afraid of the rupturing possibility, but really, childbirth can go wrong in many ways, and it's not as though a c-section is without risk. The release I had to sign before the VBAC (while I was in labor) listed the pros and cons of a VBAC, and although the possibility of rupturing was a definite con, there were many pros which was very comforting to me at the time, because I was getting a little scared and starting to wonder if I was being silly to insist on a VBAC. The staff was respectful of my choice, but the way they all kept telling eachother "she's a VBAC" kept making me aware that I was choosing something kiknd of different from most moms they see.

Good luck with your decision.