C-sections and subsequent pregnancies--more questions

[fedoragirl]

I had a C-section with DD and am now 36 weeks pregnant with #2. I have sharp, cutting pain in my c-section area and my OB says this is normal. I didn't have any complications in my 1st pregnancy but the labor stalled and OB insisted on a c-section. I healed fast and without any issues. I desperately want a VBAC with this delivery but my OB says that if my c-section site hurts so much, they might have to consider another c-section. I have had no other complications during this pregnancy either.
I am afraid this sets me up for another c-section. Any experiences?

[emily]

My c-section story is much like yours. With VBAC, I think it depends a lot of the doctor. Some are more willing to work with you to make a VBAC work while others practice more conservative medicine. My OB was the latter. All he talked to us about were the risks involved. I wasnt set on having a VBAC so I had a second c with DC2 and will have another with DC3 in March since I am also planning on gettng my tubes tied. I didnt push very hard with the VBAC cuz my scar healed terribly with my first. With the second, he said he would cut the scar tissue and give me some injection so that it would heal better. FTR, you can even see or feel my scar. You really have to look for it to see it. Kinda shallow I know. (Plus I think I was scared of having a natural birth).
The recovery was much easier the second time around, BTW.

If you are set on trying to have a VBAC, I think you need to make it very clear to your OB.

[BabyBearsMom]

Does your practice have a midwife? My midwife can do births in the hospital so you stay with her and she only gets an OB if it is an emergency.

[bisous]

I wish I had some advice. I hope you get your VBAC! I am expecting DS3 in a few weeks and have had two previous sections. I don't have any pain at my incision point. My mom, (who had four sections) mentions that pain in that area is "normal" and to be expected. I don't know how that figures in ability to have a VBAC though, since she didn't take that route.

Best of luck. I hope someone who knows more chimes in!

[BayGirl2]

I think if you want a VBAC you should seek out a doctor or midwife who is supportive of them. It really varies by Dr and by hospital policy. I know my Doula works specifically with VBAC patients. She herself ended up with labor+CS for her first DC and then had 2 VBACs after.

Depending on the area you are in it may be easier or harder to find a VBAC-supportive situation, but I do believe more and more practitioners or HC systems are becoming VBAC supportive as CS rates are so high now.

[fedoragirl]

I do have a midwife, and she is very supportive of a VBAC. In fact, the doctor only comes in if there is a medical emergency. However, because of the current pain in my c-section area, my OB is being cautious and advising a c-section. However, she is open to letting me try a VBAC. They'll let me know a little more next week. I really don't want another c-section but if it has to happen, oh well. I refuse to cry and be depressed about the method of delivery as I was the last time.

[BayGirl2]

Good for you. It sounds like you have the right approach and have found support for your choices. That's a good attitude to have, advocate for yourself but don't be too upset by what ultimately ends up happening. The goal is to have a healthy baby and mother and you can get there either way.

[Edensmum]

Please vist the ICAN site to talk to those ladies. If you have severe pain at the site it could be rupture. A decent percentage of ruptures occur prior to the onset of labor. If it does not go away get in and insist they check you out. If it's sharp but not too bad it's likely just adhesions. They will be an issue after any surgery and aren't a reason to repeat the surgery. I would ask exactly what about this discomfort is indicating surgery.

[fedoragirl]

So, I have been told by the OB who will deliver my baby that they will need to do a C-section because the baby is measuring larger than normal (although he is at the 7 lb. average mark). The head and length of the femur seem to be longer and I have a very narrow pelvis so a c-section would be advisable. He also told me that the chances of uterine rupture are high because of the measurement of the baby, my narrow pelvis, and the fact, that I have had a previous c-section.
They want to do the C-section at 39 weeks because of the danger of the rupture since the baby is putting pressure on it.
I don't know if this is all right. I trust this OB but I didn't want another C-section. In my circumstances, what should I know and do? I am especially concerned with breastfeeding since that was the big issue in my last birth. I will have a midwife with me, and will room in the baby. Any other advice?

[SnuggleBuggles]

What does your midwife say? I know you have concerns over birthing a bigger baby so I don't know. I would really discuss it with your midwife and go over risks and benefits.

Beth

[fedoragirl]

My midwife works in conjunction with the doctor so she won't contradict his opinion. I had a second opinion today and both doctors concur.

[Edensmum]

So, I have been told by the OB who will deliver my baby that they will need to do a C-section because the baby is measuring larger than normal (although he is at the 7 lb. average mark). The head and length of the femur seem to be longer and I have a very narrow pelvis so a c-section would be advisable. He also told me that the chances of uterine rupture are high because of the measurement of the baby, my narrow pelvis, and the fact, that I have had a previous c-section.
They want to do the C-section at 39 weeks because of the danger of the rupture since the baby is putting pressure on it.
I don't know if this is all right. I trust this OB but I didn't want another C-section. In my circumstances, what should I know and do? I am especially concerned with breastfeeding since that was the big issue in my last birth. I will have a midwife with me, and will room in the baby. Any other advice?

Large baby is not a reason for a section. Nor does it increase your risk of rupture. There is a risk of rupture. There is a risk of rupture in any pregnancy. It's slightly higher for VBAC, but it's still very small. Less than one percent. The risks of another major surgery are nothing to gloss over. This doctor is not VBAC supportive and is not giving you good info. Talk to the Midwife. Get another opinion. Get involved with ICAN and get some good information to make good informed decisions.

[Edensmum]

My midwife works in conjunction with the doctor so she won't contradict his opinion. I had a second opinion today and both doctors concur.
Contact ICAN and look for supportive providers in your area. These are not VBAC supportive and if you do not want the surgery, it's your body. Good luck. I know how frustrating this search is.

[essnce629]

I agree with the previous posts-- contact ICAN to find a provider who is both supportive of vbac AND has a high vbac success rate. Anyone can say they are supportive of vbac, but if their vbac success rate is only 10% then there's a problem! A good vbac provider should have a success rate of at least 80%. Like in San Diego where I'm from, everyone who wants to have a successful vbac goes to one specific doctor. He's extremely supportive of vbacs and has the stats to back it up. And I'd hire a doula asap.

ICAN website
http://www.ican-online.org/

[sste]

OP, I am not sure what to make of the scar hurting - - I would personal go see a maternal fetal medicine doctor for an opinion, that may be nothing. My understanding is that they can image scars but it is not terribly predictive.

Having a large baby does increase your risk of rupture. ACOG does not list a large baby standing alone as a contraindication to VBAC. But you must understand it does increase your risk (along with other factors such as age, being overweight, pitocin induction, malpositioning, etc).

Hope this helps and good luck with the upcoming delivery. :)

[kdeunc]

I just wanted to wish you luck with your delivery. As far as breastfeeding goes another section does not automatically doom your chances. DD was my third section, she had issues with her sugar and I was unable to see her/nurse for 4 hours after birth. We went on to have my longest nursing relationship of any of the three kids (13 months). I think rooming in can help and having good family support. I hope that all goes well for you.

[fedoragirl]

Well, I didn't want a c-section but it seems that the uterine rupture is looking more serious since I've had sharp, stabbing pain in the area since the past 2 days. Also, I am with a very pro-VBAC hospital and I checked my statistics. The doctor is someone I trust so I'm willing to go with his opinion even though I don't like it. I just can't risk a rupture---the pain now in my c-section area is unbearable.
I am glad to hear about the breastfeeding success story. Thanks! That reassures me. My midwife will be with me during surgery and they'll place the baby to nurse right away--while I am being sewn up (as I've been told). The baby will room in and my midwife will make weekly visits to help with breastfeeding. I hope it works out. I am a little nervous and plenty scared.

[Multimama]

OP, can you contact LLL in your area before you c-section and try to get the phone number for at least one leader there? I really believe that doing this and her excellent advice saved my breastfeeding relationship after my section.

ETA: Sorry you're going through this! Good luck with whatever you decide!

[kdeunc]

Good luck to you! I know its not what you wanted but it sounds like it is for the best. :hug:

My third section was my easiest recovery and best breastfeeding experience. I hope the same for you!

[bisous]

Breastfeeding post c-section is way possible. Its all I've known and my kids nursed great!

Good luck and I hope your pain subsides soon!

[sste]

Oh my goodness, yes, BFing should absolutely go great after a section. I had a much more serious operation than that, blood transfusions, and didn't see my baby for three days . . . and breastfeeding has been great. Just remember it is a highly dynamic and adaptive system and absent something extremely unusual eventually supply WILL respond to demand. In my case my milk was a little delayed but I pumped alot in addition to nursing on a normal schedule and I ended up with a great supply and DD and I are going strong EBF at 11.5 months. At my hospital the week before I was there a mom AND her baby coded (I believe this is a heart flat line so kind of died) and were resuscitated and both left the hospital a week later BFing. :)

[fedoragirl]

Very encouraging! Thank you so much. I am still praying that I'll go into labor and have a superfast delivery the day before the C-section. :D If not, oh well....it's not the end of the world as long as I have a healthy baby.

[BabyBearsMom]

I am glad to hear about the breastfeeding success story. Thanks! That reassures me. My midwife will be with me during surgery and they'll place the baby to nurse right away--while I am being sewn up (as I've been told). The baby will room in and my midwife will make weekly visits to help with breastfeeding. I hope it works out. I am a little nervous and plenty scared.

I had a C Section and was able to successfully nurse DD even though I was BFAR (breast feeding after reduction). I didn't get to hold DD until they finished sewing me up (which took about 20 minutes) because my arms will still fairly numb, but I nursed her as soon as they wheeled me out and all was fine.