VBAC Or Repeat C-section? - Omaha,NE

You might be interested in the documentary film "The Business of Being Born." It is a personal choice but perhaps a second opinion from anoth OB and/or a midwife if you're wondering.

I had experienced labor with my first, but his heartbeat was all over the place; so I also had an emergency c-section. I had really wanted a VBAC with my second, but it didn't happen. Dr. said that if baby didn't come by x date, then they would do the c-section.

Recovery from the planned c-section was much, much easier -- so easy that I overdid it and broke my incision apart a little (by day 5 or so -- I don't want to make it sound toooo easy!).

Something that really helped me emotionally was that we recorded the delivery.

Good luck with whatever you decide -- you're right -- it doesn't matter how they get here as long as everyone is safe:)

If you are a candidate for VBAC then it means that the reasons for your first c-section did not have to do with your uterus or vaginal canal. Probably your baby was breech, the cord was short, or something else like that. It means that for you the risks of VBAC are low. The one risk they are concerned about is uterine rupture, right? I just did a quick read of an article in a medical journal online. If you go into spontaneous labor after a previous c-section and your incision was a low transverse, the most common kind, your risk is 0.44%. That is less than 1%, so not a big risk AT ALL. If you are induced, the risk increases to between 1 and 4% depending on the study.

The advantages of VBAC are quicker recovery and being able to hold your toddler. I had a repeat c-section because during my first labor my daughter's head would not go through the bony pelvis. During the surgery they told me nothing was getting through there; don't even try. So I scheduled the c-section and then, huzzah, went into labor two weeks early. Because my first was induced with pitocin, the contractions were SO MUCH WEAKER with my natural-onset labor that I wasn't sure I was in labor. I was at 8 cm and still not sure it wasn't false labor. Anyway, when I told the doc that for my first birth I was at 10 cm and pushing for nearly 6 hours, and then had to get the c-section anyway since she didn't advance, he recommended the c-section to avoid that again. So I got one.

I told you all that so that you know that I am not knee-jerk biased against c-sections. However, not being able to hold my toddler was VERY VERY difficult and awful for her. She felt so rejected and sad. It took a long time to get over that and it really was a big deal. And the recovery for the second one was a little bit longer, but honestly not too bad. The part that makes me sad is not being able to hold her.

My advice: go for the VBAC but be aware that you can change your mind really at just about any point. If you were induced with pitocin the first time, spontaneous labor IS A WORLD OF DIFFERENCE. You may still want an epidural, but it's not the same experience at all. If you need induction again, skip it and go for the c-section. And if you have the opportunity to choose your c-section meds, choose the spinal block over the epidural. It is SO MUCH NICER. No shakes and it's safer too because it's more medicine but it's farther away from your spinal cord.

Scheduling a c-section only guarantees the end date; it does not guarantee your baby won't come early. I went ahead and scheduled and like I said, went into labor two weeks early. The universe laughs at your scheduling plans!!

After you have 2 c-sections they will not do VBAC at all, so this is your only chance if it's important to you. If you choose a c-section don't let anyone guilt you about it either. I get so sick of people pitying me or looking down on me or criticizing me for getting a c-section. Hey, I'm genetically inferior and science saved my kid's lives so they can suck it as far as I'm concerned. Sometimes it's just the way a baby needs to be born. Good luck with your decision and I wish you the best.

I have had three c-sections, the most recent three and half weeks ago. I just decided that VBAC was not for me. Good luck in your decision and congratulations!

I made the decision to do VBAC if I deliver within 1 week late. Schedule if after (Yes, my doc wanted to schedule me early if I choose to schedule but I am refusing that as it doesn't even really give a chance for VBAC at all). BUT, I delivered my first vaginally; delivered my 2nd c-section after failed induction 1 week late due to a short cord (6" umbilical cord). I want 2 more kiddos after this one (which is #3). If I didn't want 2 more kiddos so quickly, I would probably schedule the c-section. I must admit, vaginal delivery was MUCH quicker recovery (I was at the gym doing spinning and started running 2 weeks after my first delivery; waited until the 6 week check-up and didn't run comfortably until months after 2nd/c-section) and the benefits of being able to pick up your other child after vaginal versus c-section is great too! My other one was only 17 mos when I had my c-section with #2 so I had to have my mother in law basically move in for 3 weeks to help out with just lifting her.

I am not one who is all into "the experience" -- I am choosing VBAC for my own reasons as I have listed....and it sounds like you have already made your decision to do the repeat c-section for you/your family's reasons. I would stick with your "gut" so to speak. The last thing you need when going through labor and delivery for a VBAC is a negative nilly freaked out about the risks (which it sounds like your husband will be). My husband is wholly supportive of the VBAC or I wouldn't even consider it. Of course I also have all my in-laws within 7 miles of us (3 SILs and my MIL) and have an awesome au pair who lives with us so I don't have the same toddler care issues you have. My parents will come out (dropping everything) when I give them "the call" -- no matter when it is. They are still working age but luckily their employers just "make it work." :)

Best wishes on your soon-to-be here little one!

I am not as far along as you are, but I will also be having a repeat C-section. Here were my reasons:

1. Our families live 7 plus hours away. It will be nice to know when the baby will come so they don't have to reschedule plans last minute.

2. While I completely dilated last time, I pushed for 2 hours and then found out that my son's head was too big. Needless to say, I don't want to go through that again (there were other complications as well). While baby number 2 may not have a big head he/she could, and that's not a chance I'm willing to take.

3. Just like you, I have another at home who is younger (will be 5). I want to be able to coordinate his day, know who he will be with, etc.

Those are my 3 main reasons...I really don't know if we will be missing out on anything, but like you, I think that either way I am getting my baby, and that is the most important thing. Good luck!

P.S. I have heard that with each c-section it gets a little easier. Don't know if it's true or not yet, but hoping that it is!

I had a c-section with my first. With my second, I opted for the repeat. And currently we are planning for number 3, and I want more than anything to have a vbac. Unfortunatly, the odds are against me with having 2 c/s's and not having a previous vaginal delivery. I think if there is any part of you that thinks you might regret this, try for the vbac.

And, don't be so certain that just because you are scheduled for a c/s at 39 weeks that you won't go into labor before then! All of your plans might fall through, and you might wish in all the chaos you just went ahead and did a vbac.

I have 3 close friends who's having VBAC. All of them said that VB is way better than C-sec. Some others prefer C-sec for convenient reasons.
I have all my kids with vaginal birth. Having to deal with episiotomy wounds, I cannot imagine how will I deal with c-sec wound. If there's no medical issue, I'd rather do VB. Less risky and you're doing it the way God intended it to be :) You'll heal faster too.
I don't know why your doctor said the risk has increase for VBAC in the past 5 years. What makes the difference ? Some OB rather perform a c-sec; it's faster, more convenient (don't have to get called at 2 am), and more money. Unless you have a medical issue that will put you or your baby in danger, I'll stick to VBAC.

My first was also a c-section, for a similar reason, although I didn't go into labor or push at all - I was on bedrest for high blood pressure for the last 3 months, and then at one of my appointments at 38 weeks, they were doing an NST, and the baby was no responding with her usual amount of activity, and My blood pressure had started to climb again. They did an Ultrasound and could tell the cord was around her neck....so we got to go home and get our stuff and come right back, she was delivered at 3:53 pm, and they had a hard time even getting her out of the incision, because he cord was wrapped 3 times around!!!

I got pregnant when she was 9 months, and I had a miscarriage at 12 weeks - naturally, and it was HORRIBLY painful and scary.

8 months later I got pregnant again, and we had a much healthier pregnancy, and I was debating too....BUT like you said, with a baby at home, and not having success the first time, knowing this was a bigger baby, as well...well, I went with the scheduled C-section. It was just easier to plan for care for my little girl, time off from work for my husband and mom, and I knew EXACTLY what to expect as well - I had no clue what would happen with a VBAC, if I would be able to do it, if I would tear, if it would end up in a c-section anyway. So I went with what I knew.

Also, though I had already made my decision, a month before my boy was worn, our hospital changed their policies and dissallowed VBACs from then on.

Good Luck! I know it is a hard decision!

Jessie

I've had 4 vag deliveres and 1 c-section. My c-section was with my 3rd child. It was emergency from a placental abruption.

I've had 2 v-back's since then and I had no problems from it. You will have to sign something that says you understand agree to the risk involved with having a vbac. Personally, as a nurse, I know there are more risk of complications after surgery than the risk involved with having a vbac. On the flip side, I do know someone who had her uterus rupture during a vbac delivery after having a c-section. Fortunately, they were able to get baby out on time with another c-section. She's had more children since then and always has a c-section.

I'm still opt for vbac but always prepared for possible surgery.
The recovery from a vag delivery is so much better and faster!

You do what you feel you need to do!! You do what's best for you and baby. I wanted a VBAC with #2 but he was breached...thus, C-section #2. I recovered quicker than from my first C-section because like you I labored for 22 hours and nothing!!!! Because I had two C-sections already I just scheduled the third. Recovered quickly as well. There are pros and cons to both types of delivery...Personally I am glad now because my three children are here and are healthy...No complications for them or for me. Of course Vaginal delivery is ideal so you don't have to be "cut" however, I don't think a vaginal delivery is a picnic in the park either....Tearing or episiotimy, incontinence..pelvic floor dysfunction...etc... I know it is a hard decision. You could go natural and if things don't progress you can have the C. Best wishes and Congrats

Birth is birth, it makes no difference how it happens. You will not "miss out" on a thing. I had both my babies vaginally, but only because that was how it worked out. I did not receive a medal for this method, so it is not considered superior. I think you are leaning toward the c-section because it feels more controlled, and I think that is good logic considering your last experience, doctor's recommendation, and family situation. Trust yourself, and go with your instinct. It will be so beautiful!!

If your main motivation is to have a healthy baby and mom C-section is still safer. The incidence of maternal mortality is thankfully extremely low for either decision. The incidence of fetal mortality is higher w/ VBAC but only for babies weighing less than 1500 g. The primary difference is with the incidence of uterine rupture which studies and meta-analyses continue to show a higher risk (0.53% v. 0.28%) for VBAC v. planned C-section.

I'm sure you'll get a ton of answers here! My first was a C-section after failure to progress. I wanted a VBAC so badly with my second, but it was not to be. He was born 6 weeks early via C. Anyways, obviously you never know what's going to happen, but you have to do what feels best for you. If your heart's not really in the VBAC, chances are you will be easily persuaded by your doctor, who's clearly not for them either, to schedule the C. I'm not really sure about his statistic that risks are going up - I have not heard that one, but I do know that doctors are typically against VBAC and nurse midwives are totally for them. Go figure.

On my pulpit: Your doctor be embellishing things a bit to steer you toward scheduling a C. Doctors have to face huge liabilities, and if something terrible happens to you during your VBAC, they may be held liable. However, you sign on the dotted line for your C-section, essentially exonerating them from any possible liability. So, no wonder they will steer you in the C direction.

That being said, the decision's in your hands! Many many women have had successful VBACs, and the recovery's faster! :) But there are no labor pains with a C section, you get more time off, and a longer hospital stay with lots of helpful nurses!

Best of luck in your delivery!

I had both children vaginally. I don't think you would missing out on anything by having your kids by c-section. You have already experienced everything but the pushing, and you don't have the minuses (vaginal scar tissue, mild incontinence). You may want a vbac so recovery is faster, but it's not, in my opinion, that you have missed out on anything.

I didn't have the option. My first was born emergency c-section at 29 weeks because of placental abruption - but mine was the classical, vertical, up/down whatever you want to call it so I couldn't even consider a VBAC. I didn't feel like I missed out on anything with my 2nd. Her c-section was planned however she decided to come 3 weeks before that! The only difference was for her emergency c, I was awake and the first I was completely out. So that was a whole different experience! I think though if I would have had the option I would have gone ahead with another planned c-section because I would have been too worried doing a VBAC.

no matter what doctors tell you, they get more money when you go under MAJOR SURGURY. a vaginal birth is simply less expensive. so remember they might not have the best intentions.

at the same time VBAC is a big deal ; theres risk of rupture, so you have to have made this decision a long time ago and been properly examined to be sure that a VBAC would be safe for you. a friend of mine just went through this, wanted the VBAC, but because of the way things went the first time, the cut was in a particular area or something, she cant.

ill have you know that the risks of C-SEC increase time and time over for each one. the risk of maternal death is MUCH higher in c-sections, especially multiple ones, so its not all flowers and roses either.

THAT BEING SAID: i want you to know that many many women have multiple c-sec and they do just fine. im very sorry you had to have it done the first time. its so scary when things like that happen. but those are the emergency reasons that we do them anyway. there are things we can do to prevent the cord from doing that, but there are still times that it will. the typical hospitol bed lying down laboring and birthing horozontally isnt the ideal position but thats just what they do.

in your position, i would go with the c-sec. mostly because you probably dont have the time to have the ultrasounds and stuff needed to find out if the VBAC would be safe for you. the risks are actually lower with a vbac under normal circumstances, but since it was an emergency with your first one, its likely they didnt do the "proper" cut and it might be like my friend's. but also like you said, you can schedule it better.

however, i would like to caution you about scheduling.
due dates are ESTIMATED. that means that not only is 40 weeks not the "typical" pregnancy length, due dates can be off due to a woman's personal cycle and etc. unless you are a woman who has an EXACT 28 day cycle, its likely that your due date is not exact. if you can wait until 40 weeks, thats healthier for the baby, though if your last one went into labor earlier, its likely that your pregnancies are shorter, so tis probably ok. im no expert, but its so funny how they make due dates seem like "dates of arrival" when really they are a guesstimate based on the perfect woman with a perfect cycle. its unfair and i think it causese a lot of infant issues. the lungs are the last to finish developing, and they set of a hormone that triggers labor. anything before that is unfinished lungs. so just take caution, talk it through with your doctor, and do what YOU think is best.
a friend of mine even was told to come in (she was going over her ESTIMATED due date) and she refused. her baby was fine, and i think, better off, since he didnt go into labor until 3 weeks later!!! she was so sure that he wasnt ready yet, and she was right. you dont have to do what they tell you to do, yet be sensible to.

anyway, ive overwhelmed you. listen to your body. listen to your instincts. those are much more important than some stuffy doctor's rules or ideas.

I have a lot of friend that had VBACS, even with the midwife, and the births went GREAT! IMHO, you should go for the VBAC but be open to a c-section if there is an emergency. I have given birth twice (going on third time) vaginally with the midwife and it is the most amazing feeling and accomplishment ever! I feel women who never get the chance to deliver vaginally are missing a lot. But of course, that is your choice. Vaginal births are much quicker recovered from too. My SIL had two c-sections because her pelvis was too small and she spent weeks recovering from both. I spent 2 weeks recovering from my first birth (because I decided to do too much too soon by going to the mall 4 days later and it took longer to recover) but it only took me 2-3 DAYS to recover from birth #2!!

I had an emergency C-section with my first. I am considered a high risk pregnancy, but opted for a VBAC for my second. The risks are around 1% of a rupture and it is not true that they have gone up, verbatim from a specialist at Mayo. I would moniter in the hospital and go for the birth. There are a lot of reasons to want a natural birth. Less stress on you, decreased recovery time, less stress on the baby, and natural birthing is very beneficial for the baby, that is how God designed it. There are a ton of risks with major surgery. Good luck with your decision, it really is an individual thing.

Updated

I had an emergency C-section with my first. I am considered a high risk pregnancy, but opted for a VBAC for my second. The risks are around 1% of a rupture and it is not true that they have gone up, verbatim from a specialist at Mayo. I would moniter in the hospital and go for the birth. There are a lot of reasons to want a natural birth. Less stress on you, decreased recovery time, less stress on the baby, and natural birthing is very beneficial for the baby, that is how God designed it. There are a ton of risks with major surgery. Good luck with your decision, it really is an individual thing.

There is no right or wrong choice, as long as you are comfortable with it. Everyone's situation is a little different with one common goal - the delivery of a healthy baby (and mommy).
I decided a VBAC was right for me and couldn't be more happy after the fact. I went into labor on my on with both my pregnancies. However, both came at 38wks. Like you, I am a planner - my family wanted to fly in for the delivery and I needed to make arrangements for my 3yr old. Well, most OB/GYNs will only schedule c-sect one week early (39wks). Had I gone with a planned c-sect, I would not have made it to the scheduled date.

I'm not really into the "all natural birth". I had epidurals with both my kids, so even the pain of the VBAC was minimal. However, the recovery with my VBAC was amazing! I felt great within days of the delivery. That made caring for my active 3yr old much easier.

I was lucky - my OB/GYN was very supportive, and my "in-network" hospital allowed VBACs. My family did make it in time - as soon as my body showed signs of going into labor, my mother-in-law changed her flight. She arrived the day before the baby - just in time to watch our 3yr old. It all worked out for me. Good luck to you!!

Are you sure the doctor said the risks have gone UP? You should ask again. I tihnk that if you can try it, you should go for it. Especially since the doctor and hospital are willing. Best of luck!

What my doctor told me was that VBAC risks have decreased since 20 years ago. This is because they use to cut you up and down instead of across like now. This give is less risk of rupturing your uterus during labor. They will not do VBAC if you have had 2 c-sections. I would double check with your Dr. maybe you misunderstood him when he said the risks have increased, because Drs I have talked to said they decreased.