VBAC vs. C-section

[hedixo01]

I know there have been other threads about this topic, but I wanted to get some opinions on my situation and hear some stories of successful or unsuccessful vbacs. My story:

My son is 15 months old. I am currently five months pregnant. For my first delivery I had a c-section because DS was breech. I had planned to go all natural until he flipped at 36 weeks. We tried to turn him but were unsuccessful. My water broke a few days before I was scheduled and I had an emergency section. However, everything was fine, and I had a normal recovery. Unfortunately I didn't get the natural vaginal birth I so desperately wanted. I'd like to try for a vbac but I am worried about the risks. On the other hand a repeat section is not exactly the best option because I do want a big family; at least 4 kids if not more. My current OB doesn't do vbacs but I am scheduled to see a new one in a couple weeks to discuss my options with her.

Are my pregnancies too close together? Does anyone have any recommendations to make a vbac easier? I'm just having such hard time deciding what is right for me. Am I being selfish because I'm putting my own want for a vaginal birth ahead of the safety of myself and baby girl? This is all very overwhelming!

[3girls2luv]

Hello congrats on the new baby. You mentioned that your first C was an emergency right? Do you know if you had a vertical or horizontal incision? I think it's a good idea to sit and talk to a doctor because they can tell you all of the risks and answer any questions you might have. I don't think you are being selfish because in the long run you will do what is right for you and your baby.

[hedixo01]

It was a low transverse incision. And I have done quite a bit of research on the risks of a vbac which is why I was leaning toward a section until I found out about the risks of having multiple c-sections.

[3girls2luv]

Well there are risks as with any surgery but it depends on what you doctor feels and also on your medical history.

My doc attempted a Vbac with my second child but opted out of it at the last minute because of her size (9lb 4oz). Being that she was so huge my risks for rupture were greater and having the C was a much safer option.

Keep an open mind when you talk to your doc and FWIW I have had 3 C-sections and each one ended safely and without complications. There are some women on here that have had successful Vbacs and hopefully they will chime in and share their experiences as well.

[MrsKitty]

My first thought would be to contact a midwife and see what she says. A midwife is more likely to tell you if she thinks it is really nessescary or not.

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

[tifttu]

My VBAC was the absolute best experience of my entire life. I don't want more children, but I would go through labor and birth tomorrow if I could. To me, there was no question. I didn't want another c/s. All the research I did pointed toward more risk with a c/s than a VBAC. When I was making my choice someone here recommended I read, "The Silent Knife." I was skeptical because it sounded pretty out there, but it was really a great book and now I recommend it to everyone.

My hospital was VBAC friendly in that they would let you "attempt" one as long as you followed all of their rules. I sorta did things my own way because I refused to get railroaded into another c/s like with my first child and, like I said, it was wonderful.

[Indigo]

It was a low transverse incision. And I have done quite a bit of research on the risks of a vbac which is why I was leaning toward a section until I found out about the risks of having multiple c-sections.

The risks of a repeat c-section are more than that of a VBAC. Check out ICAN for some good info.

[Indigo]

Hello congrats on the new baby. You mentioned that your first C was an emergency right? Do you know if you had a vertical or horizontal incision? I think it's a good idea to sit and talk to a doctor because they can tell you all of the risks and answer any questions you might have. I don't think you are being selfish because in the long run you will do what is right for you and your baby.


Many doctors stress the risks of VBACS and brush over the risks of the section which is major surgery. You should inform yourself independently and make decisions with all the info you can get. Unfortunately many doctors do not practice based on current evidence. It's important to find one that truly supports what you are looking for, and that can be hard to do. The risk of rupture is very small, not a whole lot more than for a uterus that has not had surgery at all. The risks of a section are pretty great. If you have no medical reason to have another section other than the previous one, it is not the safer option. Sections are a life saving surgery, but they are used way too often. Women are often given bad info to get them to consent to them, without proper informed consent. Many doctors say they support VBACs then at the last minute give some reason to not do it. Sometimes the surgery is actually needed. Unfortunately it's used way more than it is needed.

Things to look out for include a doctor who seems to think the success rate is fairly small, generally seems negative or says they do VBACS but can't give you a number of how many they do in a year, says you can't go beyond 40 weeks, talks about the risks of VBAC and does not mention the risks of section or says we'll have to see, how things go, how big the baby is, or suggests a lot of sizing ultra sounds, a big baby is not a reason to schedule a surgery. Just some stuff to keep in mind.

Here are a bunch of links and things to help you decide what's best for you. I have done a lot of research, I am planning a VBAC because the risks of the surgery are too much to put us through without a true need. Nothing is completely safe, but a section is major surgery with real risks to consider as well.

Question CPD" http://www.youtube.com/watch?v=roFVkDV45MM
"Someone Like Me" http://www.youtube.com/watch?v=Hyf_9e4LLag
" Empty" http://www.youtube.com/watch?v=PIFNemQfe3s
"1 in 3" http://www.youtube.com/watch?v=2dRF4RtdJdo
"HBA3C- Our Journey to Homebirth" http://www.onetruemedia.com/otm_site/view_shared?p=2a4e81fbf0f66accb8afce
"VBAmultipleC" http://youtube.com/watch?v=yK0K0HAgLDM

Websites on the Safety of VBAC:

http://www.parentsplace.com/expert/b...0547-1,00.html - A closer look at the 2002 JAMA study
http://www.ahcpr.gov/clinic/epcsums/vbacsum.htm
http://www.childbirth.org/section/resVBAC.html
http://www.storknet.com/cubbies/vbac/4studies.htm - Summary of the 4 largest VBAC/Cesarean Studies
http://www.vbac.com/uterine.html - Info on uterine rupture
http://www.homebirth.org.uk/vbacur.htm - more on uterine rupture
http://www.worldserver.com/turk/birthing/rrvbac2005-9.html - HUGE list of studies including abstracts and titles

National ICAN Website:
http://www.ican-online.org

Best Evidence: VBAC or Repeat CS?
http://www.childbirthconnection.org/article.asp?ck=10210&ClickedLink=293&area=27

Vaginal Birth After Multiple Cesarean site
http://www.plus-size-pregnancy.org/CSANDVBAC/vbac_after_2_cs.htm

Optimal Fetal Positioning
http://www.spinningbabies.com

Breech Birth
http://www.breechbabies.com

PubMed Home (Resource for looking up scientific studies):
http://www.ncbi.nlm.nih.gov/sites/entrez

[pawprint]

I'm glad indigo did all the typing for me! Thanks woman. :p

I had a c/s for breech with ds1. Ds2 was orn 21 months later- natural VBAC. It was worth every attle, every birth ook, every class, every red cent for doulas and midwives. If you are committed to a VBAC and have no medical reasons not to, find a sympathetic care provider. You can do it. :)

[StillSingingMom]

What Paw said. I had a section with DS because he was a double footling breech, and I had GD, making us a high-risk proposition. Oh, also "advanced maternal age".

If I were to do that over, I'd try to wait a few more days for labor. But it was good, whatever.

But DD was a VBAC, and it was really a nice experience, and a MUCH easier recovery.

[hedixo01]

Thanks so much for all the awesome links indigo. The ob I'm going to see in a couple weeks does vbacs am I'm hoping that visit goes well. I really want to do vbac; I just got scared for a minute, but it's nice hear from other women in similar situations who had such great experiences with a vbac.

[Justicedog]

You asked for experiences, so here's mine.

DS (1st kid) was bord via c-section after being 10 days past due. I had high blood pressure and was told they'd not even let me get past my due date. Due date came and went and then sometime after it, they had me come in for an induction - they were concerned about my bp. The hospital was full when I came in, they sent one woman home and told me that I really had to go that day, so come back in 2 hours after they'd discharged some moms. So I did, got pitocin, nothing really happened in terms of contractions or dialation. My water did break about an hour after the pitocin started. But, 6 hours into it and there was no progress. Baby was fine, I was fine, but baby wasn't coming down at all. Doctor said that the baby's not going to come out vaginally, but as we were fine, I could keep waiting. I choose a c-section as it seemed the best choice to have one before I got exhaused and before it became an emergency as nothing was happening. When they got in there, the cord was wrapped around his neck a few times and they had a hard time getting him out even with the c-section. One doc was jumping up to push him out. So, I know there are those who say the doctor/I opted for the c-section too early, but, I tend to think that the reason there was no progress was b/c the cord was wrapped around his neck, holding him up and that labor and vaginal delivery could have harmed him. Now, that may just be a fiction I made up to justify the decision I made. I'm comfortable with the decision I made though.

Second baby, 2 of the doctors in the practice were pretty anti vbac, 2 of them were "go for it". I stayed with seeing the ones with the positive attitude. Until the end. One of the pro vbac drs and the one who did the c-section prior, which was an awesome recovery, started being discouraging. This baby is as big, if not bigger than your last one, likely won't be able to deliver vaginally, etc. I elected a repeat c-section for a number of reasons. First, from my research, it seemed the pros/risk balance of a vbac seemed to be riskier for the baby, less risky for the mother, whereas, the pros/risks balance of a repeat c-section seem to be less risky for the baby, more risky for the mother. I choose the one that was riskier for me. I also choose the date to be on the due date, rather than waiting for labor and trying vbac, because the doctor I wanted worked that day and would be off for a week. My first c-section was so much easier than I had ever imagined and I thought if I was going to end up with another one, I'd rather have her do it. I choose the day because it was 4 days before my ds's 2nd birthday and I'd get to be home on his birthday, rather than having them on the same day or not being with him on his birthday.

My 2nd c-section was a bad experience. I didn't like the anesthesiologist, it felt like he numbed me way too high and I was concerned about my breathing. I don't know if he did or if I was just having a panic attack. I'd asked that I have my dh and my mom in the room with me, was told no, there's not enough room, but then they asked if a student nurse could come in and watch, so, if there was enough room for her, should have been enough room for my mom. Said nurse ran out of the room in the middle of the surgery to throw up. My mom wouldn't have thrown up. DD was born with some fluid on her lungs. They suctioned that out and she didn't need ICU care. Another part of the decision was that my mom was just visiting for a couple months in the summer and her time here was running out. Some of the reasons don't seem as important as they did then.

She was hospitalized when she was 9 months when she had RSV. Could it have been b/c of the fluid in her lungs that would have been squeezed out during a vaginal birth? I don't know. Maybe. She has some sort of seizure disorder, could that have been caused by not having a vaginal delivery? Doubtful, but I can still wonder if I did the right thing. When dd was younger, prior to school age, she would get every cold anybody within the state has. She gets ear infections. Is that related to the fluid in lungs b/c it was a c-section? Don't know.

The second c-section I do have regrets about. I wish I would have hung in there and tried the VBAC. However, who knows if I'd have bigger regrets had something gone wrong with the VBAC.

This is an incredibly difficult choice to make. I didn't like having to make it. I wish you wisdom, peace and strength in your decision. Sorry for the book.

[hedixo01]

Thanks for the story Justicedog. It is a super hard decision, and that's why I'm freaking out. I'm slightly hopeful for an ok delivery because the first time my water broke on its own, when I got to the hospital I was already 4 centimeters, and DS was only 7lbs 2oz. I feel like had he not been breech I could have delivered just fine. Now who knows if my labor would have stalled later, but I can dream. I'm prepared to do a CS if that's what it takes to have a healthy baby, but I'd just like the chance to try a vaginal birth.