VBAC after C-Section

[isyne4u]

Okay, I want to know what other doctors are saying about this. My obgyn said that he reccommends another c-section instead of VBAC since the risk of rupture is so much greater if you do it naturally.

I questioned him about it and said that I kept hearing that more and more doctors were allowing VBACs since the risk was really very minimal if you had a bikini cut. He said that was the thinking in the past and that the tide was shifting back to repeat c-sections.

My personal opinion is that the shift is happening because people that tried VBAC and suffered a rupture are suing the doctors for the damage done.

What have your doctors said and what have you done? I want to at least try VBAC before I automatically go for another c-section. I'm not opposed to the c-section since I recovered pretty quickly the last time.

Thanks for any thoughts you all have to offer.
tara

 

[dcgrumpy]

I have read that a lot more doctors are recommending c-sections instead of VBACs. When I had my daughter 7 mos ago, my doctors said it was my decision I could choose whichever I wanted, but they thought a section would be a better choice for me. I didn't want to try a VBAC so the decision was easy for me.

 

[MaryAnnDVC]

I had a C-section with my first, due to fetal distress. I though "thank God!" because she weighed 10 lbs 1 oz.

I did go ahead and have VBACS for my 2nd and 3rd children, because I was STRONGLY encouraged to by my medical group, and everything was fine. I had, in a way, WANTED another C-section, because I knew I was having another big one (2nd weighed 10 lbs 5 ozs, and my third was 11 lbs 5 ozs), but I don't think there was a single doctor in the group that even felt that I should consider it...they were VERY pro-VBAC, but said that decision was up to me. (My kids are now 15, 13, and 10.)

My niece has two kids...4 and 1, and she had a VBAC with her 2nd, no problem. I don't know if she was in any way encouraged or discouraged by her doctor.

Good luck, whatever you decide to do.

 

[peg2001]

If you really want to try VBAC, you need to find another doctor who will fully support your decision. Otherwise, your current doctor will continue to pressure you for the section. You don't want to be in labor and have him come in and say "Have you had enough yet? How about we end it now and do the c-section?"

Peggy

 

[geffric]

My first was an emergency C section and then the second was VBAC.. no problems at all.. My SIL was the same thing too.

 

[Toby'sFriend]

I know that there has been alot of literature over the past year stating that VBAC is riskier than what was thought 5 to 10 years ago, but I don't know anything about the statistics behind the trend.

I suspect you may be right in thinking that your Dr. is concerned about his or her own liability should something go wrong. Malpractice Insurance for Obstetrics is astronomical.

 

[married2grumpy]

My first child was delivered by c-section because she was breech. I felt sort of cheated because I never even got to feel a contraction. When I got pregnant 6 months after our first was born, I knew I wanted to try a VBAC. No one from my OB/GYN group discouraged it but they did warn of the possible complications. They offered VBAC classes at my hospital which I took. The class was great because it informed you of the risks but you also heard of the successes. Most of the doctors in the group did say that if I did not go into labor on my own, they would not induce me because of the pitocin induced contractions being stronger. I was due on Christmas day and wanted to be induced before Christmas. One of the younger doctors in the group said she would induce me because I was already 4 cm dilated, without having any noticable contractions. I delivered a healthy 8 14 oz boy by VBAC with no epidural in 1 1/2 hours and was home by Christmas Eve. I was lucky. I had a VBAC with my 3rd child under the same circumstances, induced at 4 cm with no contractions. My 7 11 oz daughter was born in a little under an hour with no epidural and no episiotomy this time (I guess my big boy paved the way)! I was very lucky and thankful. I had great VBAC experiences as did my sister.

I think a lot depends on why you had the c-section the first time. If you have large babies, I would opt for the c-section. If your labor just didn't progress, I would try the VBAC.

Most importantly, you should be 100% sure about what you want and have doctors who support whatever decision you make.

Just be careful what you wish for. I remember that first big contraction and thinking to myself...Why didn't I just get that c-section. Good luck with what ever you decide!

 

[MosMom]

If you've only had one c-section and you have a bikini cut, you have a very low risk for rupture. Even women with more than one have done fine but the risk increases with every c-section you have had. If this is something YOU want, find an OB that backs you up on that decision. As with several other issues, different doctors have different opinions. If you feel you have made an informed decision, find someone who agrees with you. Have you considered a midwife?

 

[Jenn Lynn]

I have never had a VBAC so I do not have any personal experience regarding it. I did want to say that there were 2 women in my childbirth class who were going to attempt a VBAC. We all saw the same Midwife who was excellent. Midwives are (usually) very supportive of VBAC's. They tend to look at it from the Woman's point of view vs. the Doctor who doesn't want a law suit. Both Women ended up having their babies at home with a sucessful VBAC.

Good Luck!

 

[Lars624]

I had my twins by c sectin & then I really wanted to try a vbac with my youngest DS. I did not have a bikini cut, I'm cut from my belly button down on the outside but my uterus is cut horizontally. My doctor was very supportive of my decision & my vbac was successful.
Good Luck

 

[Melora]

I had a Csec with my first. Then went on to have 3 natural (no medication) births.

You should do lots of research (there are great websites). They have found that woman who rupture after having had a csec rarely rupture on the scar tissue itself because scar tissue is very strong and does not tear easily. When you do rupture along the csec line and its a clean, easier to stich close repair. When a rupture occurs in another place its a jagged hard to fix tear.

There are SO many risks invloved with a csec.

I heartily encourage you to read a book called Silent Knife which has lots of information and can help you make an informed decision. Unless you have a physical reason to have a repeat Csec there should no reason that you cannot at least give a VBAC a real try.

It frightens me to think that the tide is shifting back to repeats. I agree that it might be because of law suits. You really do need to have a doc who will support you.

I had a csec with my first baby because of misdiagnosed fetal distress. The doc was trying to save his own butt because he did not get to the hospital until quite awhile after I arrived and couldnt find the babies heartbeat right away and instead of being calm about it, he panicked and ordered an immediate csec instead of trying a different approach or another method. My son was fine, never any distress but I was miserable about having to have that operation. (At that time I was young and wasnt thinking I was glad to have a healthy baby, just angry at the doc). Then I had 3 great births. My last baby was a csec. We had a clue he might have to be because he never settled in right and when I started pushing he wasnt budging. When they got him out he had 3 raised bruises along the top of his head where he was trying to get down the chute kind of ear first and the top of his head was jamming up against my hip bone. One of those reasons that I am glad I wasnt back in the old days because Im not sure what could have been done.

PM me if you need any more support!

Actually even if you have had more than one csec, if the doctor who does them is good, and if they cut on the same scar inside and close in the same place taking away the old scar and leaving a new scar, the risk does not increase with more babies. When I had my last one the doc said my old scar looked stretched out but was still holding strong. (3 babies in there after the first csec). She reminded me that scar tissue is very strong and can take a certain amount of abuse. She cut out the old scar tissue and said "Now you have just one brand new scar and if you wanted to have another baby it would be as strong as if you had never had a baby after the first csec. Never stretched out and nice and strong." (No more babies for me!!)

 

[6_Time_Momma]

My first was a C-section. The following 6 were VBACs. My doctor was always extremely supportive of VBACs. I would look into another opinion if I were you, if you really want a VBAC.

 

[snoopy]

My doctor was willing to let me try VBAC, but it didn't work. Its my understanding that the more C-sections you have had, the harder it is to have a VBAC.

 

[mtemm]

I have been planning a VBAC with this current pregnancy since I walked into the operating room with my son nearly 2 years ago. I've done a lot of research, and one thing I am finding is that the recent study that dr.s are citing regarding increased uterine rupture was severely flawed. I was talking to one of my dr.s about this a couple of weeks ago, in fact. He's the dr. I am considering switching to (nothing wrong with my previous practice, and they are very pro VBAC, just carrying twins now and want to change hospitals).

What they are finding is the safest way to VBAC is to avoid induction at all. The UR rate drops dramatically if you take inductions out of the picture. It also helps if you are an ideal candidate...and remember, the cut you see on the outside isn't necessarily the same on the uterus. If you have the low transverse (bikini) cut, your chances of a successful VBAC are greater. If the reason for your section had nothing to do with you or your labor, like your baby was breech or placenta previa or fetal distress, again, those are all better than if you pushed for 3 hours and nothing was happening.

I would say do your research now, there are some great books out there and some useful message boards, too. Here's one to get you started. http://messageboards.ivillage.com/iv-ppvbac

Don't forget there are risks to a repeat section, too. Dr.s tend to gloss over them. Its such a personal choice, and weighing the risks on both sides is so important.

As for me, I don't know what I'm going to do now that they are twins. With a singleton my choice was obvious to me. Now, not so much. But I hopefully have till April to decide!

 

[amid chaos]

I had one almost 9 years ago, but our hospital isnt doing them anymore because of insurance..very sad.

 

[MaryAnnDVC]

Originally posted by married2grumpy
If you have large babies, I would opt for the c-section. If your labor just didn't progress, I would try the VBAC.

If the reason you had a C-section the first time was due to the size of the baby, and they suspect the next baby is as big, then it would make sense to have another C-section. My babies were VERY large, but size was not the problem for my C-section, so there was no reason to believe later that I couldn't deliver a large baby by VBAC.

FYI, I was also induced for my 3rd delivery, no problems.

 

[jel0511]

I had a section with my first and a VBAC with my second, but after discussions with my Dr, was told that if I wanted a 3rd I'd need to get a section again. It is all due to medical malpractice premiums and here in NJ, that's a pretty big issue. It is true that more and more Dr's are moving back to the once a section, always a section mantra, and it is all because of insurance. As stated by a previous poster, it is true that some hospitals aren't allowing a Dr to allow a VBAC at their hospital, again due to insurance. Sometimes the Dr's hands are tied because of the hospital they are associated with.

 

[isyne4u]

Wow! Thanks for all the responses.
My doctor did say I could try it if I wanted to, but he felt it might be better if I didn't. I told him I wanted to try it. Not that I'm a glutton for punishment, but it would be nice to see what it feels like just so I can say I did.

I thought about a mid wife, but I've seen and heard that they are very anti pain medications and I'm a big wuss when it comes to pain and I don't want to suffer.

My son was born because of an abrupted placenta. I didn't like the fact that I was unable to see my son for 8 hours because I had had a full spinal. I'm also planning to nurse again and I don't want to have to wait so long before the baby is brought to me.

I'm going to check out the websites and the books mentioned here so that I can get more information. I have until July to decide (hopefully)!

thank you for all the wonderful responses!!
tara

 

[mtemm]

what is the difference between a full spinal and a spinal? I had a spinal with my section with my son and had him with me the whole time...he was examined by peds in the OR while I was being stitched up and went right to recovery with me. I nursed him first unsuccesfully when he was an hour old (he was sleepy) and successfully at 2 hours old. We roomed in and were only parted for a few minutes each morning while he was weighed in the nursery (I could have gone with then, but I think I would get up and shower/etc then).

 

[MosMom]

Midwives aren't anti-meds. Midwives are anti-meds if you are. Midwives are all about YOU and what you want. Of course, you would want to interview different midwives and see how they feel about certain issues, but I think most of them are open to anything that will give you the birth you want. Just talk openly about what you want with the midwife ahead of time so there won't be any surprises. With what you've said in your posts, I think a midwife might be the perfect fit for you.