VBAC vs. Cesarean

[becka]

I thought I had my mind made up about just another cesarean for #2 but as the date gets closer I keep questioning if I have made the right decision. Everything I read just seems to confuse me more. I know it is a decision that I am going to have to make soon so I thought I might see if anyone here had any additional advice since I am sure some of you have been through this before.

I ended up with a c-section with DS because of 1) failure to progress (2 cm after 18 hours and 12 hours pitocin ) and then 2) my blood pressure and DS's heartrate plummeted quickly so it ended up being an emergency kind of thing. At the time I also had preeclampsia so I was being given anti-seizure medications during labor and being monitored continously. It was really not a very fun experience.

I pretty early on in this pregnancy decided that there was no way in you-know-where that I wanted to repeat that experience and just assumed that I would want another c-section for a number of reasons but as it gets closer I find myself wondering if I really have "valid" reasons for going the c-section route again. So far my health has been good. My OB has told me that if I end up with complications again then she will not allow the VBAC and I am fine with that so in the end it really may not be my decision anyway.

If everything continues to go well with this pregnancy then these are the reasons I had for requesting another c-section:

1) Do NOT want to go through another labor experience like last time - constantly monitored and unable to move around at all
2) We don't have family close by (DH's family is a little over 2 hours away) and it would be nice if we knew someone was here to take care of DS when the time comes
3) I am due in January and weather is always iffy that time of year. I am afraid if I go into labor during bad weather DH's family couldn't get here to take DS and then what do we do?
4) I don't want my son to see me in pain during early labor and odds are that he would be here when it starts
5) Honestly there is also a little bit of a fear factor - giving birth is still an "unknown" for me
6) I may be able to get 8 weeks maternity leave rather than just 6 weeks so I could stay home with the baby longer once we get home and keep her out of daycare for a few more winter weeks


The reasons I am thinking about a VBAC:

1) I wouldn't have to stay in the hospital as long. It would be nice to come home earlier to DS and also not have to worry about DS jumping on my surgical incision.
2) For a while after DS's birth I felt a little down about the fact that I didn't deliver naturally and I guess a small part of me still wonders if I have somehow "missed out" on something special.
3) After the baby is born I could actually hold her rather than having the baby whisked away to be observed for hours
4) DH will not be able to stay with me 24 hrs/day at the hospital like he did last time so rooming-in with the baby would be possible and much easier if I didn't have a c-section

I really feel I have valid reasons for both and I just don't know how to make that decision. For others who have been in this situation - how did you decide? Did you just go with your gut instinct?

Thanks in advance for any advice or opinions you may have to offer.

 

[Pin Wizard]

Bless you and the little one, Becka!! If you want to try VBAC, I say go for it. A section will be done if it's necessary.

I have one child and it was a C-section. Being my mom had sections with all three kids, I never felt like I was missing anything. But I can understand your feeling that way. Way in the beginning of my pregnancy my doc planned on a regular delivery. That thought terrified me! I'd have a section again in a second. Was a good experience for me. Delivered on a Monday, went home on Weds. afternoon.

No matter what you decide, I'm sure it will be what's right for you.

 

[airforcewife]

First let me say I've had 3 C-sections. I've never been in labor. My blood pressure just sky rockets the last few months berfore I have the baby and they "take" the baby when it gets too high. I spent so many years ( youngest is 7) feeling like I wasn't a "real" woman because I hadn't been through labor and delivery. What a waste! My kids are real and they are alive! Had I tried the other way like I wanted to they may not be here.

Now, for you there may be other factors. What are your chances of a no problem pregnancy? Preeclamsia usually only happens once. (they thought I had this until it happened with every baby) You sound pretty scared and almost like you have your mind made up. You are just as much a real mother and woman if you had C-sections. So don't fall into that mind set. I did and it bothered me for some time.
Also there are some advantages to no noggins passing through your nether regions....although I 'm sure you can figure that one out if you think about it!!

Robyn

 

[phamton]

Well, I did a v-bac because I had already delivered naturally before with my first child and knew the recovery time was quicker than a c-section. (I wrote another word and the filter blocked it out, so decided to change it to "naturally")

First child- Lamaze all the way, no problems. Recovered quickly.

2nd-3rd children (twins)- they were both breech and so we decided to do c-section. recovery took longer and it hurt to hold the babies when I was nursing.

4th child- V-bac ---Lamaze again but lots of back labor, pretty painful. Recovery was quick and I only stayed in the hospital af ew hours after delivery. ( even went to relatives houses the next day for christmas.)

5th child- V-bac---epidural for pain because of how painful my previous labor had been. I shouldn't have gotten an epidural as the labor only took 2 hours and the epidural had barely had time to work anyway. Recovery was quick and I was out of the hospital 18 hours after delivery.

Personally, I would just see how labor progressed and if none of the same problems are cropping up that you had with your first, then I'd do the vbac. You can always have a c-section if things aren't going smoothly.

 

[bsnyder]

Becka, it's such a personal decision. I don't know that anyone can help you make it.

But I do have a question. After I had my first C-Section, I wasn't really a candidate for a VBAC with the second (I had a complete placenta previa with my second pregnancy) but I remember a friend who was contemplating a VBAC, and her doctor told her no epidural - that she would have to do natural childbirth because having an epidural or pain medication could mask the symptoms of uterine rupture.

This was almost 20 years ago, so things may have changed dramatically, but I was wondering if that rule still applies.

 

[MosMom]

Here is my opinion...I'm just going to comment on your points.

If everything continues to go well with this pregnancy then these are the reasons I had for requesting another c-section:

1) Do NOT want to go through another labor experience like last time - constantly monitored and unable to move around at all. -- If you give birth in a hospital, that is what it might be like anyway and I doubt you want a birthing center instead. I know some hospitals are allowing women to move and even walk around but not many.

2) We don't have family close by (DH's family is a little over 2 hours away) and it would be nice if we knew someone was here to take care of DS when the time comes. -- Good point but do you want to go through the pain and risk to just plan better. There is risk to a VBAC but there is risk to a CS too.

3) I am due in January and weather is always iffy that time of year. I am afraid if I go into labor during bad weather DH's family couldn't get here to take DS and then what do we do? -- Make a back up plan with friends/neighbors.

4) I don't want my son to see me in pain during early labor and odds are that he would be here when it starts. -- Early labor doesn't usually create intense pain. My daughter saw me in early labor and never caught on to pain. It isn't like you will be going through transition in front of him.

5) Honestly there is also a little bit of a fear factor - giving birth is still an "unknown" for me. -- I can totally understad that. This in some ways will be like giving birth for the first time. Most of us have been through that fear as well. It isn't so bad.

6) I may be able to get 8 weeks maternity leave rather than just 6 weeks so I could stay home with the baby longer once we get home and keep her out of daycare for a few more winter weeks. -- I have no argument for that one. 2 weeks home is quite an incentive.


The reasons I am thinking about a VBAC:

1) I wouldn't have to stay in the hospital as long. It would be nice to come home earlier to DS and also not have to worry about DS jumping on my surgical incision. -- Those are all good reasons to try a VBAC.

2) For a while after DS's birth I felt a little down about the fact that I didn't deliver naturally and I guess a small part of me still wonders if I have somehow "missed out" on something special. -- I understand these feelings. I think that this is a great reason to give it a try. Just don't feel bad if you do end up having another CS. If baby is in danger, most important thing is delivering her safely.

3) After the baby is born I could actually hold her rather than having the baby whisked away to be observed for hours. -- Another good point. Are you going to breastfeed? That time together in the beginning could be beneficial for that.

4) DH will not be able to stay with me 24 hrs/day at the hospital like he did last time so rooming-in with the baby would be possible and much easier if I didn't have a c-section. -- You could also be home quite quickly. I was home within a day with both of my kids and it was great. I was MUCH happier home than at the hospital.

In the end, I would say try for the VBAC depending on your health. I think your only real concern for having the VBAC is that you don't want another bad birth experience but all of us who are having normal births risk that as well. I think you need to weigh that risk along with your health. Follow your gut. You'll know what to do.

 

[becka]

Originally posted by airforcewife

Also there are some advantages to no noggins passing through your nether regions....although I 'm sure you can figure that one out if you think about it!!

Robyn

Actually I probably should have added that to my pro c-section list. I have had that lovely "stress incontinence" issue during both pregnancies. Thankfully it went away after DS but I do worry that it could just become a permanent thing if I delivery naturally. I live in constant fear of sneezing!

 

[Beth76]

I haven't been in your situation, but I'm more afraid of the C-section than the V-birth (I don't think I can say the v-word here, can I?) That was my biggest fear-having to have a C/S. I would want to avoid any surgery that wasn't necessary.

Now, the whole birthing process wasn't up on my all time greatest moments. Really, I could have done without it, but that's just me. Some people "love" giving birth. Me? Eh, not really all that great. But, I didn't have a bad experience like you did. But, remember that not all labors/births are the same.

As far as recovery goes, this will be like your "first". My first recovery was awful. My second was so much better. So that's another thing to consider. The recovery could be the same for both.

I think if you're having doubts you should try for the VBAC. If you start having the same problems, then you can have the C/S. Will your doctor make you wait as long as you did the first time? Talk it over more with your doctor and see what all your options are.

My sister had to have a c/s with her first (breech). She ended up having her other two c/s either, but for no reason. She liked the "convenience" of it, which I didn't agree with. But, that's not for me to say.

Good luck with your decision. I know it's a tough one.

 

[MosMom]

Originally posted by becka


Actually I probably should have added that to my pro c-section list. I have had that lovely "stress incontinence" issue during both pregnancies. Thankfully it went away after DS but I do worry that it could just become a permanent thing if I delivery naturally. I live in constant fear of sneezing!

Do your kegels!

 

[padams]

Similar circumstances here...failure to progress with DS#1 so I had a c-section after 24 hours of labor. I was also monitored constantly and couldn't move around- I hated that part. I planned to have a VBAC but I went 2 weeks past my due date and the ob scheduled a 2nd c-section.

For the 2nd one, I was able to make arrangements for the care of 22 month old DS#1. I was able to get a goodnight sleep the night before DS#2 was born (well, as good as it gets when you're 9.5 months pregnant). I woke up the morning of the scheduled c-section, took a shower, and did my hair and makeup. I walked into the hospital looking and feeling like a supermodel compared to those unfortunate women pacing the halls in labor, who had clearly been up all night as I had been the first time. I actually looked good in the photos with DS#2!

Because my epidural had been in place for less than an hour for DS#2, I had a much quicker recovery, and DS#2 was alert a lot sooner than DS#1 (who must have been feeling the effects of mom's epidural marathon). Consequently, nursing was easier. DH couldn't stay with me the whole time in the hospital but DS#2 still was allowed to stay with me. I think the nurses just checked on me more at night. Also, because c-section #2 was expected, and DS#2 was just fine, I was able to hold him immediately, and the nurses only took him long enough to clean him up. By the time I was in the recovery room, DS#2 was back in my arms.

I couldn't pick up DS#1 for a couple of weeks but realistically, DS#2 nursed so much that my lap was seldom empty during those 1st weeks. DS#1 snuggled up next to me a lot.

Good luck with your pregnancy and birth. I hope you are in a position to make your own decision as to how you want to give birth. After my 1st c-section, an ob on call told me that I should be thankful for modern medicine and the ability to have a c-section. He reminded me that a healthy mom and a healthy baby are the best possible outcome and it doesn't matter hw the baby got out.

BTW, DSs are now 7 and 8.5. When they started asking questions a few years ago about how babies are born, it was so easy to say "the doctor cut a hole in mom's tummy, took you out, and then stitched up mom." I didn't have to go into any details about female anatomy.

Also, when I look at DSs' large heads (comes form DH's side), I am happy those heads haven't passed through you know where. DH agrees.

 

[disneygals]

I had 3 c-sections and only the 1st was taken to be checked in neo-natal (luckily, they kicked her out-she was fine ).

My second 2 were breastfed right away. I was lucky to have a special breastfeeding nurse around (sorry can't think of her title) the second time and she just plopped her on my chest and she knew what to do. I was flat on my back and the spinal hadn't worn off yet. The third time I made sure my dh did the same thing that the nurse did.

Good Luck...

 

[MaryAnnDVC]

With my first baby, I had a C-section due to fetal distress after about 15 hours of rough labor. I spent 6 days in the hospital afterwards, and DD was in for two days longer, in Special Care. (I had a Strep infection during labor, so we were both treated with antibiotics.) It was actually a very good experience...I had a wonderful doctor, and the midwife that I had PLANNED to deliver the baby was also in the delivery room and visited me and offered support daily.

I NEVER felt like I missed anything. When I was pregnant the VERY first time, I had this romanticized picture of the whole natural delivery process...and then I had a miscarriage at 3 months. All I wanted after that was a baby...how it got there didn't really matter to me. I never felt like I missed a thing having a C-Section. Actually, I felt kind of relieved because DD weighed 10 lbs 1 oz and I thought "who the heck wants to deliver a baby THAT big??"

My next pregnancy was actually another miscarriage.

After that, when I was pregnant with DD#2, I KNEW it was another big baby. The midwife (not the one I really liked) said..."so what? Who says you can't deliver a big baby?" So I did have a VBAC. Honestly, it was NOT a great experience, largely due to this particular midwife doing the delivery. (Long story.) DD#2 weighed 10 lbs 5 ozs, and I had a very difficult recovery.

When I was pregnant with my DS, I didn't know WHAT to do. I switched back to the doctors (altho I'm a big believer in midwives still, the one I loved had left the practice and the one who delivered DD#2 refused to acknowledge my whole bad recovery), and with every appt, I'd discuss with the doctors my desire to have a C-section. They were definitely NOT of the belief that "once a C-section, always a C-section", esp since I had already had a VBAC. I finally "negotiated" my delivery with two doctors in the group (ie, an epidural ASAP!, etc), and I got one of those doctors because I was induced and knew one of them would be at the hospital. I had a pretty good VBAC, despite the fact that DS weighed 11 lbs 5 oz. He spent 24 hours in the Special Care Nursery due to low blood sugar and "thick" blood (high red blood cell count). You should have seen him next to the preemies!

I decide not to try to see how big a child #4 would be!

Maybe you should consider a doula?

I think you just need to discuss your concerns with your doctor(s). You are NOT missing out on ANYTHING by not having a VBAC. It really bothers me that women have to feel that they have to "perform" and "compete" with other women for the ultimate delivery. Some people who've never had a C-Section (like all the people in our Childbirth Refresher course, where we were the only ones who had a C-Section first time) don't understand the fears of going through ANOTHER labor just to end up with surgery. Whatever you decide, just cherish the fact that your baby is here, and hopefully of course, healthy.

Good luck!

 

[amid chaos]

My first was a regular delivery, second a C-section and third was a v-bac. I didn't have any problems at all.

in addition..the hospitals around here are NOT letting their patients attempt a V-bac due to insurance costs...a shame, the decision was taken away from these women.

 

[lapinluv]

My experience with DD was exactly like your. Never progressed, a day's worth of pitocin, then high blood pressure. I ended up with a c-section.

I haven't even really considered a V-BAC, mainly for the first set of reasons you listed. I do NOT want to go through anything like I did with DD. Recovery will be more difficult, but I have DH's support to help with that. Honestly a ******l birth scares me more than a c-section. Don't know why, but it does.

As to your points for a V-BAC -

-- I'm looking forward to the extra recovery time in the hospital, just so I feel better when I get home to DD. She will have strict instructions not to jump on me when I do get home. Also, since I'm a nervous nelly, I liked having the doctors check out DD for a couple of extra days. Made me feel more comfortable when I was on my own.

-- I never felt down about not doing it naturally. I know I gave it my all during DD and it just wasn't meant to be.

-- I didn't have this experience either. DD was back to me in about an hour and that was the time I needed to recover from the epidural and the day's worth of labor. I was shaking so bad, I wouldn't have been able to hold her.

-- I plan on having the baby room in and if I need help when DH or visitor's aren't there, I know the nurses will be there to help me.

Good luck with whatever your choice is!

 

[6_Time_Momma]

My first was a section due to him being breech. The remaining 6 were v-bac. I loved having the vbacs. Able to go home within 24 hours. I never had an episiotomy, so other than cramping, I had no pain after. Best of luck whatever you decide!!

 

[crz4mm2]

Becka,
I have many patients who wrestle with this decision. Some know right away which way they want to go. I must say that those that have had a long long labor that ended in a c-section are generally the ones the jump for a scheduled repeat. They don't want to repeat the experience.
I can also tell you that I have only had one person in all the years I have worked with women who later said she wouldn't choose a VBAC again. Only ONE. All the rest were very glad they had a VBAC. Having had two sections myself, I would have given my eye teeth to have the chance for a VBAC, but my doctor didn't do them 17 years ago.
Most places are recommending continuous fetal monitoring during labor (of a VBAC) and anesthesia and physician "immediately available". Many hospitals no longer offer VBAC because of liability concerns of not having in house anesthesia and OB physician.
Complications from VBAC are rare (uterine rupture being the major one but it is still less than 1%) and of course recovery is much less and VBACs are LESS $$$$$.
It is a very personal decision and I tell my patients to be successful, they have to really really be committed to a VBAC delivery.
You can still have an epidural if you want one.
Best of luck to you. What ever your decision, it will be the right one for you!!
6 time Momma, You GO GIRL!!! how wonderful for you. I have a nurse I work with that had her first child via section for breech, the remaining EIGHT (8) were VBACs! She (and now you) are my hero!!

Cathy

 

[mtemm]

good luck with your decision!

one question for you...are you sure the baby would be whisked away for a few hours after your section this time if you do have one? I've had 2 sections now at 2 different hospitals and that never happened with either one. I could see them immediately, and they went to recovery with me. I'm wondering if that happened with your first because he was in distress for a bit? something you may want to ask about.

I had an unexpected section with my first because he had been non-responsive most of the day. His heartbeat was strong, but he wasn't showing movement. Even after my dr. tried to get him to move...ouch!...it just wasn't happening. thankfully all turned out to be fine, he had double knotted his cord but was fine. But I walked into the OR that day planning my VBAC with the next one.

My next pregnancy I planned to get a doula, researched the different hospitals in my area (we had moved) to find out who was really VBAC friendly, chose a midwife, etc. Then at 16 weeks we found out we were having twins. Still all was okay because baby A was vertex. I was more hesitant about a VBAC but not ruling it out, until around 24 weeks when both babies were breech and never changed. In the end I didn't have a choice, and I will say that my second section was far better than my first. I had a very easy recovery with my first but emotionally I was scarred....I dreamed of an unmedicated natural birth. My second section this past March healed a lot of those wounds. I had horrible pre-eclampsia with the twins (had mild PIH with my first). That had us in the hospital for an extra day but even after the twins coming 5 weeks early, we all went home together 4 days later.

Its such a hard decision. I would consider a doula...they can be helpful if you choose to repeat section or if you choose to VBAC. If your dh can't be there that first day maybe your mom or someone could plan to stay over in case you do have a section and you do want to room in.

Good luck! Hope you have a healthy rest of your pregnancy!

 

[disneymom3]

I had a c-section the first time after a horrible labor over about 36 hours and failure to progress after my water was broken--manually.

Next pregnancy I switched docs. He was great. Really wanted to try the VBAC but would support whatever I chose to do. Also told me at the beginning that if I or the baby was in danger, he would whisk me off to the operating room. His plan was to induce early as DD had been so big and he felt that would help. Ended up that baby #2 had health issues and thankfully was induced just over two weeks early--good thing, or he may not have survived. I did do the VBAC, but after about two hours of pushing my doc said if I didn't make significant progress in the next half hour he was going to take me to surgery as he was getting concerned. I said a very meek, "Okay." But in my head, I thought, "You are nuts! I have not come this far to give up now!!!" Baby was born in 45 min. Seriously though, I would have trusted him whatever decision he would have made. That is my point of posting. If you have a doc who will see you through your pregnancy and through delivery, I would try the VBAC with the understanding that he or she would decide if you needed to have the c-section done.

Yes, it is hard to think about what have you missed. I know it was for me too. But a "real mom" takes the needs of their babies and puts them first which is what you did!!

Oh and by the way, an epidural is a beautiful thing! Don't let anyone tell you otherwise!

 

[Jeafl]

My first was a planned c-section because she was breech, the second two were both VBACS.

I had a horrific experience with my c-section because my incision got infected. I will spare you the gory details, but lets just say I wanted the next one to be a VBAC if at all possible. The first VBAC was technically my first labor, even though it was my second child. It did take awhile, but it turned out fine. My second VBAC was less than 5 hours from the first pain to delivery. It was a breeze.

In my experience, I found the VBACS so much easier to recover from that I would never choose a c-section again unless absolutely necessary. Don't forget it is major surgery with it's own risks. You have very valid reasons for both procedures, so just do your research and make the best decision for you. Good luck!

By the way, have you picked out names yet?

 

[Luigi's Girl]

my 1st child was delivered VBAC with no pain killers, no anethesia, no problems. couldn't wait to have baby #2 never even considering i might have to have a c section. unfortunately for me after many hours of labor my doctor wouldn't let me go anymore and the surgery was performed. it affected my body so much i couldn't even hold my baby for days it hurt so much. that rough experience compared to the ease of my 1st child"s birth was one of the reasons i didn't have any mor children. i'm sorry now 13 years later i didn't have more. you've already had a section and know how that is. i say go for a VBAC. with no unforseen problems it's a wonderful experience. Good Luck!