Wednesday, February 11, 2009

to vbac or not?

v9 A29 concrete c????

So I realize this is a completely personal decision, but I wanted to hear your opinions, your voices, your experience. This is an amazing community of women... smart, talented women and what better place to go for advice than right here? 

Lily was a regular birth and Stella was an unplanned C-section. I labored, did the whole bit and when it was time to deliver they realized she had a brow presentation. My water had broken so they couldn't turn her without possibly snapping her neck. 

I was certain I wanted to do a vbac with this third baby, until I went to the doctor today to sign the forms. It was a scary experience to sign on the dotted line, saying that a vbac was what I wanted, that they were not liable should something go wrong etc. etc. not to mention his continual encouragement to schedule the C-section.

I feel that I have researched it out, I've weighed the risk and the vbac is a solid choice, but like I said I'm curious to hear your thoughts and experiences in this matter. For now, I have a scheduled C-section on my due date, but signed the forms and if I go into labor prior to the due date I can try for the vbac. It seems like a good compromise...

33 comments:

  1. This is definitely a deeply personal decision, for sure. I've heard successes on both sides, but the most traumatic childbirth story I've ever heard was a VBAC where the hospital wasn't prepared to give her an emergency c-section when things didn't go as planned. Her son had to be resucitated because they couldn't get him out in time & he has permanent catastrophic brain damage as a result. But that's just one person's experience & no decisions should be made on that alone. You should do what you & your husband feel is right, based on the doctor's recommendations.

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  2. I had a VBAC and it was a great experience. The hospital was ready to do a c-section if needed and I was almost whisked away to the OR a few times but I was allowed to continue as things settle back down quickly after a decel or two. I felt cheated by my c-section, like I was missing out on something. I recovered so quickly from the VBAC. It didn't hurt to laugh or cough and I was home from the hospital after one day. I was able to drive right away if I needed to!

    It is a personal decision though so do what's best for you.

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  3. Definitely up to you and your doctor, but I'll give you my opinion. I'm an L&D nurse and at the hospital that I worked at there were very few doctors that would do VBACs simply for liability reasons. When things go bad with VBACs, they are bad. I'm sure the doctor informed you of all the risks. I guess it just all depends on what your first labor was like. It sounds like it was just the baby's presentation so it sounds like you're a good candidate. A bad candidate would be a person that ended up having a c-section because they wouldn't dialate or the baby was too big for the pelvis. It's more likely that it would probably happen again in the next labor so why take the risk. I think people that have had previous c-sections find it convenient to have another one since it's all scheduled so there aren't too many surprises and they've already been through the process. There are many success stories too though so you just have to weigh the risks and benefits and see where you find your choice. Hope this helps, good luck!

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  4. I would say try for it...(vbac that is) I live in NY and know that they make everything a big deal on paper since they can get sued so easy it is enough to make anyone nervous...but I would say really feel it out in you heart and you will probably have the right decision for you there. Best of luck!
    Oh and don't ever listen to the worse case stories cause they will just freak you out...

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  5. Well, I've done both of my birth vaginally. The first time my son was 3 months premature, so I had to do it natural and wasn't given anything. I swore I would never do natural child birth again if I could help it. It was unpleasant and very stressful. I just had my second baby in October and it was a planned induction. I was given an epidural and it made labor a more pleasant, less stressful experience. I would say if you are going to do a vaginal birth, use the epidural. And I think that others have given good advice about having them on stand by ready to do an emergency c-section if necessary.

    I hope that things go well and I'm wishing you lots of luck. It is normal to be nervous even with your second child. I'm sure things will be great and I can't wait to see pictures of your new little bundle.

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  6. I did the same thing I wanted a VBAC, and they are risky but not as risky as the Drs make you think.
    I had a c section because I was 40 weeks and the risks of going over 40 weeks, having my labor induced ect was too much so I had the C section on my due date.

    Good luck!

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  7. I was in your exact same boat with my daughter last July. My son was breech so he was a scheduled c-section two years earlier. I was so torn and I scheduled a c-section the day after my due date. Then I went into labor.

    I ended up doing a vbac and I'm really happy I did. What helped me to make my decision was that I realized opting for a c-section was an unnecessary surgery this time around (with its own set of risks), I trusted my doctor and knew I was in very good hands, and I got informed. You can read horrible stories and people love to tell you them, but the percentage of something going terribly wrong with a vbac are very slim.

    It's a very personal choice. Do what feels right for you and your family. Best of luck with everything whatever you decide!

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  8. I also had an unplanned C-section with my first daughter and really, really wanted a VBAC with my second. My first C-section wasn't due to any complications except that my water broke and my labor never progressed. After 36 hours of trying to get her out naturally I was too exhausted to labor any longer and moved into the C-section.

    My OB (the one I had with my first daughter) refused to do a VBAC with me for my second pregnancy. The hospital I delivered my first in won't do VBACs either. They are just so paranoid about being sued if something went wrong. The funny thing is that things can go wrong with the healthiest of pregnancies. So I did some research and found an OB and another local hospital that would allow me to do a VBAC. My new OB was very supportive of me doing a VBAC. We did have it planned though that if I didn't go into labor by my due date that we would need to do a C-section because they could not induce me, due to my previous C-section. However, she did everything possible to get my labor to start naturally (stripping my membranes and pushing my due date back).

    After it was all said and done, I did have my VBAC and everything went fine. Doctors are trained by the insurance companies to push C-sections on patients because they feel less can go wrong (which is so untrue) and it costs more, bringing more money into the hospitals and doctors. Oh, and it fits so conveniently into doctors schedules to do C-sections rather than being called to the hospital in the middle of the night for a delivery.

    So, my suggestion is to find an OB who is very supportive of your choice to do a VBAC. Unless you are delivering at a hospital who does not have the ability to do an emergency C-section you should have no worries. Remember, all those forms are meant to scare you. Don't let them. Know that women have been delivering babies naturally for years, even after C-sections. Do what feels right to you! This is your labor and delivery, your body, your baby!

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  9. I only have one child, so I don't have any of my own experiences to share. BUT, my mother had 7 children 'regularly', her eight was an emergency c-section (and an awful one at that) and she had her ninth regularly and everything went well.

    My older sister had her first by c-section. She was set on having a VBAC with her second and was SO scared after she signed all the disclosure forms. Her Dr. told her that the chances of anything happening are pretty slim, but that normally things go smoothly so not to worry. She's had three children regularly since her first c-secion and all went fine.

    From what I've seen around me, it's worked out well every time.

    With that said, I don't envy your decision. Good luck!

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  10. I had to have a c-section with my first child, and I personally have already made the decision not to try a vbac, because the potential risks are not worth "the experience" of have a vaginal birth, for me. That being said, I don't have anything to compare mine to, and because I had dystocia with my son, I know the next would most likely be the same way, ending in a c-section anyway. So I can't justify putting my body through that. I do feel a twinge of jealousy/regret hearing that other moms have sailed through the procedure! Best of luck whichever way it goes.

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  11. I think you have made a good decision...I wish you the best of luck!

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  12. First, obviously do what you feel is best.

    In my opinion. Try it!

    I had a c-section with my first, small pelvis, which equals not a good candidate for a c-section. I tried anyway which resulted in another c-section BUT I am so glad I tried. I feel like even though it didn't result in a vaginal birth it brought me the peace I needed.
    Supposedly is is good for the baby to even go through the labor even if it results in a c-section. (I have a few home birth friends).

    You from all the research I have done are a very good candidate. You have already have one successful vaginal birth. The second was just because of position.

    Again, do what you feel is right. I am glad I made the decision for an attempted V-BAC even though the result was a c-section.

    Good Luck.

    Let us know what you decide. I am a sucker for any birth story.

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  13. My friend just had a vbac and it sounded like it was positive all the way. She is a midwife and that complications from vbac are so minor/percentage is really small and it went extremely well. That being said, it is a personal decision and I think you've made a good one. Good luck!

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  14. I'm due in July and am so hopeful to have a VBAC. My son was born in 2007 by c-section, ten days late and Memorial Day weekend. I was encouraged to be induced, and ended up laboring alone for 24 hours before they said I was "failing to progress". I ended up getting the c-section on Friday at 7 pm of Memorial Day weekend.....which I don't think was a coincidence. I wish I had listened to my inner voice more and had not gone in to be induced. But they scare you - my doctor was so unsympathetic, and told me I had to sign something stating I'd be going against her wishes, and didn't I want what was good for the baby? I want to do everything I can this time to make sure I don't end up in the same situation, including using a mid-wife, being in a different hospital, and getting a doula.

    I hate that people try to scare you into a repeat c-section. Your body is made to have babies! It's normal! It's not something that has to be done to you. I say give your body a chance to do its thing!

    Good luck to you whatever you decide. Thinking of you,
    Chiara

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  15. my first child was a unplanned c-section, i labored for 12 hours, 2 of hard labor and he just wouldn't fit. he was starting to stress so we went with a c-section. after that we simply planned the other 2 as c-sections just in case they didn't fit either. but i had a friend who had a c-section with her 1st and then 3 more children were vbac and all is fine with them. good luck. if they are prepared (and you and your husband are prepared emotionally) to have to move to a c-section then try vbac.

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  16. I had a friend that vbaced after 3 c-sections with a midwife, not in the hospital. We all thought she was crazy, but nothing went wrong. She had a long labor, but let nature take its course and she and baby did fine. She had strength and faith that all would be fine because of many many prayers.

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  17. Oh, I do not envy you! I was in the same predicament last summer, and thought, and prayed, and debated, and prayed, and thought about it forever! My doctor sang the praises of a scheduled C-section because having one without labor first is MUCH easier to recover from than having labor, and then ending up in C-section regardless. My baby ended up being transverse - meaning he was laying lazily across my stomach from right to left, which also meant my decision was made for me: there's no possible way to vaginally deliver a transverse baby. I gotta be honest, as much as I was not looking forward to another C, it was a relief to know I didn't have to make the decision. That being said, it is such a personal decision, that if you are at all a person of faith, I would sincerely pray about what decision is best for you. I did, and figured He knew way more than me.

    Anyway, if you do end up in a C-section that is planned, let me tell you that they're a bit anti-climactic. Kinda weird. "You will go in at 11 for prep and have your baby by noon." At least with being induced it's still a bit of a surprise. And I felt a little bad that my baby didn't even have labor to let him know something was coming. It was basically a rude surprise party for him -- "We're cutting you out whether you like it or not!" (BTW, he's a happy little guy and I'm sure no worse for the wear. I think it was harder on me to think that than it was on him. Birth is traumatic no matter what). Anyway, since I will now always have to have C-sections, I've devised a plan to make the process a little more normal.

    *If we can afford it, we will get a photographer to come in. My poor husband felt like the photographer, not the father.

    *They gave me an option of having a see-through drape so I could see the baby born, but the doctor only told me about it when I was already on the table! I was creeped out by it and certainly didn't want to see MYSELF get cut open. But if I had had more time to think about it, I would have said yes, and just turned my head during the gross part and looked when he was actually delivered/born. It's a moment I've missed for both of my children and I don't want to miss it again. I've thought of asking if they can put up the see-through drape, and the solid one, and have someone remove the solid one right before the big reveal for the birth!

    *Part of what was great about our first child's birth was that despite ending in C-section, labor proved to be quite bonding for my husband and I. I was doing hypno-birthing and he was so supportive. Plus there's all the anticipation of birth that's so fun. With my second (the planned C) it was just a normal morning, sent our daughter off with cousins, drove to the hospital, blah blah. I think in the future we want to have some time alone before the scheduled births, so maybe send the kids away the night before -- as if you really were in labor, and just spend time together ... anticipating. Because anticipation makes things fun and exciting!

    And fyi, recovering after a planned c-section is WAY easier than recovering from one with 32 hours of labor first. But had my baby not been transverse, I honestly can't tell you what I would have decided. Best of luck with everything!

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  18. I have had two c-sections, the first one was a natural delivery at first, after pushing for two hours and having the forceps used, which caused major trauma on my part and causing my son to almost die, NICU, they ripped his left carotid artery, he had to intubated, it also caused Horner syndrome, and Klempke palsy in him. If it didn't go right the first time for some reason, like in my case, I would NEVER chance it again! Its not worth the life of my baby, he is doing a lot better these days, but we could have lost him! Good luck with your decision, it is different in everyones case! If you have an emergency c-section {like my first} it is so scary they whisk the baby away. But when it is planned it is wonderful! I was terrified, but it went with out flaw, a great experience I needed after the first!

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  19. I am so happy that I did VBAC. No complaints here at all. It seems that you have to sign a gazillion forms just to be seen by a doctor anymore. Everyone is so scared of being sued. Horror stories happen, even for routine procedures, all the time. But, most of the time you don't even hear about the positive stories. My story was great, and I am so grateful that I did not have stitches, and pain, and just the whole recovery from major surgery. I felt great. I had 2 vaginal births, and my third was an emergency c-section, this last one was VBAC.

    My doctor is a relative, and would never let me do anything that he did not feel was safe (he has to answer to my grandmother if something happened), and he was very positive about doing VBAC with me. He insisted on my having an epidural, and that he was on the premises of the hospital the whole time I was in labor-- all just in case. Insist on being closely monitored, and make sure the hospital staff knows you are a VBAC.

    I think you need to look at the risk for you personally, it sounds like you are a good candidate. Don't worry about the horror stories. Make the decision on how you feel. And, you can always change your mind. It is inconvenient for the staff if you change your mind, but really you are in charge.

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  20. A complete stranger posting.

    You have already had 1 vaginal birth, so the chance of success is much higher than if your first child was a c/section.

    The risk of uterine rupture in a woman who is not induced is 0.4%

    I would cancel the c-section scheduled for your due date. If you are serious about not having an unnecessary c-section cancel.

    Your risks DO NOT increase past your due date unless you agree to an induction (induction is "almost" NEVER necessary)

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  21. I had an emergency c-section with my first... one that I now think was completely unneccessary. So for my second I wanted to VBAC for sure. It was really hard to find a doctor around here that was willing to do one. I found a great dr and he was completely positive about the whole thing. I tried for a VBAC, was dialated to a 10 when they discovered that the cord prolapsed... so it was off to the OR. I even pushed... but he just wouldn't come out. So I had another emergency section. This time it was absolutely necessary... he was born with an apgar of '1'. But if I had it to do all over again I'd do a VBAC in a heartbeat. The prolapsed cord had nothing to do with it being a VBAC... that could've have happened to anyone. Just make sure that the hospital is prepared if an emergency section has to happen. But, now I'm having my third and am having a planned c-section...
    My whole point is do what you feel comfortable with. If you want to try a VBAC... then cancel that c-section. My dr. was positive I could do a VBAC and wouldn't have let me attempt otherwise. I felt totally comfortable with my attempted VBAC. So if you, your husband, and your doctor feel it's what you should do... then do it!

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  22. Hi mama - What a hard decision! I would say to go with your gut feeling. :) But I just wanted to share my experience - My 1st was a c-section due to breech presentation and my other 2 were VBACs. The first VBAC was not as pleasant b/c my OB was not totally on board and I had to get pitocin without an epidural! That was very painful and I don't think I'll ever do that again! LOL! But with my 2nd VBAC, I had such a great experience! I found an OB that was totally supportive and I got to do almost everything a midwife would let me do (showers, walk around, etc). I also felt good having an OB there in case something were to go wrong....though in my research re: VBACs, the risk of uterine rupture is only slightly higher in VBAC candidates vs those who've only had natural births. Anyhow, I hope you find a good practioner that will give you good advice and support you and your decision! God bless!

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  23. I'm in a similar situation. DD was born via c-section (I got an epidural & she wasn't able to progress past my pelvic bone - she was 6lbs so not a big baby - my body just took too well to the drugs & I couldn't feel a thing below the waist). Now I'm due in May and I'm planning a VBAC.

    My choice is made for several reasons - birth is something my body is born able to do, if this is my last child then I want to be able to at least give it a real effort at doing it vaginally and I think recovery will be much better if I do the VBAC which is important to me w/DD #1 running around.

    I switched from a doctor to a midwife which has been great. She is super supportive but even the doc she practices under made me schedule a c-sec. It made me mad at first but they do have to protect themselves - end of the day it's a business for them. I was able to push the scheduled date just under a week after my due date which made me feel better.

    I'm also doing a Hypnobabies self-study course which is really helpful. I'm educating myself more and surrounding myself with people who are supportive of my decision. It doesn't sound like much but it makes a huge difference.

    You have two great things going for you - a successful vaginal birth w/your first child and a unique situation leading to your c-section. It's unlikely you'll need another c-sec.

    It's scary to think about what might happen but realize that complications happen in vaginal births as well. If you want to chat more about it feel free to reach out I'm no expert but I'm in the same boat =)

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  24. i was planning on doing a vbac- and was totally happy about it! then i had the same complications as with baby #1 and had a c-section. ah well... i guess things happen.

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  25. I know there are several scary stories about c-sections out there and even more about the recovery. I had a planned c-section (wanted to try natural-but it didn't happen). At any rate I must say my PLANNED c-section was wonderful! If I could I would be the Douala of c-sections because I think they can be such beautiful things (for women that this is the best/safest option for). And my recovery was a cinch (I kept telling my husband I felt like I had cheated). I was walking all around within 8 hours and driving by the time my baby was a week old. As for number 2, we will just be going with a planned c-section and I haven't looked back once. There's my 2 cents.

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  26. dont second guess yourself. let me say it again: DONT SECOND GUESS YOURSELF. of course a dr and hospital will try to talk you out of it. it makes their insurace go up, it means more time that the dr has to give to you, it means its not just in their hands and on their schedule, it means less money for the hospital...

    do as much research as you can...look at whats going on when vbacks dont work...i garantee almost all the time there are things such as pitocin involved.

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  27. I've had two VBACS and I would highly recommend them. My first was born by C-Section due to failure to progress (umbilical cord wrapped around his neck 4 times so he couldn't descend). I wanted to try a VBAC with my second (born in Dec. 2002), and it went perfectly. My doctor wouldn't induce me, naturally, and I finally went into labor on my own 8 days past my due date. I was at 4 cm when I arrived at the hospital, and they gave me a little pitocin and an epidural. My daughter was born a few hours later - requiring only a few pushes. My third child was born by VBAC (is it still a VBAC when it doesn't immediately follow a C-section?) and her delivery was just as smooth.

    As you can see, I am definitely in the camp that has had good experiences with VBACs, but I think that should be decided on a case-by-case basis.

    Best of luck to you!

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  28. My first was an emergency c-section after 21 hrs, including 2 hours of pushing. She just didn't fit, I was running a substantial fever, and her heartrate was over 200. I always felt like I had failed somehow.

    My doctor scheduled a c-section for 4 days before my due date. We had an ultrasound at 37 weeks which indicated another big baby, so he thought it was 95% likely I'd need a c-section, but said I could try for a VBAC if I went into labor beforehand. Which I did (9 days beforehand) and even though I had the same outcome - got to 10 cm and she got stuck - it wasn't my pushing, it was physiological. And that put me at peace with both sections. So I'm really glad I tried the VBAC, even with the scary forms I had to sign and even though it didn't succeed!

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  29. Oh goodness, what a tough decision to make, especially when internet moms and dads all have very strong opinions. My baby was a vbac baby, everything went [reasonably] well. For giving birth anyway.

    My sister had a c-section [unplanned], and while her recovery was totally different from mine, I almost wish I had had her set of recovery problems than mine.

    I hope everything goes well with your delivery [whichever method you do], and hope you have a good healthy baby. YAY for babies!

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  30. i say give a try .i did and came out good. give a try never no,bless you and baby.tina

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  31. I tried to have a VBAC with my last child. I had 16 hours of labor again (save the 3 hours I spent pushing with the first one) and ended up with another C-section. However I don't regret my decision to try. I felt much better afterwards and somehow things feel settled in my heart now. I'm ready for my next C now without any hesitations or second thoughts. I say go for it. As long as you're being monitored constantly by your dr. (not the nurse) I'd say you have nothing to worry about! Good luck! Keep us posted!

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  32. i'm so so glad you posted this question. i had a c-section and have wondered what i'll do with the next baby. my doctor is all about doing the v-bac and i know he'd talk me into it. so i want to do my own research first. i've heard from a lot of moms that the v-bac is a good way to go. but i would be terrified as well. best luck to you.

    thinking of you and thanks for the question.

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  33. so I don't usually comment on people's blogs whom I don't know, so excuse me. Having said that, my first and only so far was a c-section. My body performed as it should however there were problems with the umbilical cord around baby's neck. Since my body did everything it was supposed to I am told that I am a perfect candidate for a VBAC. I will definitely be pursuing this route. I did not enjoy the whole C-section experience. However some people wouldn't have it any other way.

    I would say since you have already had a natural birth AND your second was a cesarean due to position only you should do what YOU want to do. Keep in mind doctors like planned cesarean better than those pesky surprise births, so don't let them pressure you. Sounds like you are a perfect candidate for a VBAC too--if that is what you want. I am only a perfect stranger though, so take it for what its worth:)

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