C-sect vs VBAC (kinda long)

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AimeeLynne's picture
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C-sect vs VBAC (kinda long)

Okay so I basically have the option for either one I want to do. The place I am giving birth is the best hospital around (they are the ones who everyone else sends patients to). Since with DS the only reason I needed a sect was because of fetal distress (pretty sure it was his giant head trying to fit through a tiny tunnel) my doc said I could be an excellent candidate for a VBAC. I'm really torn on what to do. DH wants me to get another sect because he's afraid of uterine rupture and so am I. But I think with the sect, because it was an emergency, scared the crap outta me. I was literally only in surgery for less than an hour and recovery was really a breeze! I was up walking and feeling great the day after. When I went into labor with DS I was really looking forward to doing it with little or no drugs...I had been having contrx for 5 days already and was convinced I could. I know no one can answer whether they know if it will rupture or not (I keep asking the drs though lol). If it does rupture what are the chances of me surviving? I don't know if I want to take a chance with my 2 babies, DH and my life. I have been trying to do research but I either come up with just all pro VBAC or articles totally against it. I want to find something that basically puts it all out there. :help1: Does anyone know where to look?? Sorry this is so jumbled and hard to follow my I got a lot of my mind and it isn't working today! lol

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I was in your same spot when I had DS#4.

My first was an emergency c/s, then I had twins and though it wasn't planned, the c/s was a given as one was breech and they had distress.

Fast forward to pregnancy with DS#4 and my doctor was up for VBA2C and I thought I was pretty sure, too. I did the sane research and only found the same info...either all in or all out.

My DH, like yours, was pro c/s but basically said it's your body and you have to decide what you want. I took 8 months to decide. I honestly went back and forth. No one can make the decision for you and I'm not sure you'll be able to really find any unbiased information out there unless it is just facts and statistics.

In the end, I chose another c/s. I know it was the absolute best decision for us.

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I think you should go with the VBAC it is way easier recovery wise. Most women in Canada have VBAC and the rules here are...

- you must go into labour on your own (induction increases the chance of rupture).
- you can't go past 41 weeks
- baby must be head down
- recommended use of epidural

My first was vaginal but with the twins I had a csection. I've had 2 more vaginal births since... the last one was extremely quick, I had no epidural.

Your risks if you have a VBAC is your uterus could rupture. If you are monitored well, everyone will know and they will section your baby immediately if it ruptures. You risk the chance of losing your uterus but it's unlikely you'll lose the baby or your life if you are monitored and an epidural is in place (to get you in the OR fast). The situations where you hear of a women losing their uterus/baby I find are situations where the medical staff weren't really paying attention or "believed" the mom when she said something felt really wrong. Your baby should definately have fetal heart monitoring during labour. Lots of women do VBAC's with no problems... there are risks with a normal vaginal birth and a csection as well. Just be sure to not have any induction procedures (gel/pitocin) as it greatly increases the rupture rate. I may be having an induction myself but low dose... I'm also unlikely to rupture since I've had 2VBAC's. Goodluck!

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This is totslly something YOU have to decide on your own. I had a HORRIBLE recovery after my c-section with DD in 03. I mean I felt fine right after was up walking and everything and felt fine for about a week then I got an infection in my "wound". Had to have it RIPPED open and packed with gauze for 7 days then had to go in for surgery to have it reclosed. My incision wasn't completely healed until DD was 4 months old.
FAST FORWARD to March of 07....found out I was preggo with #5 and I KNEW as soon as I found out I was preggo that I would read everything I could find (whether good or bad) on VBACS. I absolutely did not want to go through a c-section again, and the reason for my section was just that little miss was a footling breech and I went in to labor on my own 2 weeks before my scheduled version. Anyhow I read read read (I even believe there is VBAC support board on here).

At 36ish weeks I had to have a consult with an OB to go over pros and cons (and he DID lay it all out there for me). Basically I had ALOT of things going FOR me to be successful. I had delivered THREE babies vaginally before (the twins and my 3rd DS) therefore we knew that my body was capable of getting to 10 cm, one of them was over 8 lbs so we knew my pelvis was "adequate, I had the horizontal incision and the reason for my section was NON emergency. He said that my chances of success were also dependant on me going into labor on my own versus induction and needing pit.

I prayed and prayed for labor to begin on its own with no such luck. I was scheduled for induction at 42 weeks preggo. Once I got there and my "trial of labor" began I had to sign papers saying I ackknowledged the chances of rupture and whatnot. Thankfully my body DID show signs of being ready for labor as I was 3cm and 50% effaced. Once they started pit and I was in labor I just didn't let myself even think about the possibility of rupture.....and about 6 hours after being hooked up I delivered DS#4 by VBAC with abour 5 min of pushing. He was my BIGGEST baby at 8lbs 12 oz, 20 in and a 14.5 in head. I fully plan on a vaginal delivery this time as well.....

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All I have is my opinion and logic(no experience). IMO, I dont see why if you have had on c-sect you wouldnt go for another. I am told that the recovery is pretty easy, you dont tear down there and you already have a scar so I dont know why you would put yourself through the worry and pain of a VBAC. I dont want a c-sect because I have already done 2 natural and wouldnt want the scar if I can avoid it. Honestly someone doing all the work of labor for me sounds wonderful(although I know there are of course lots of other considerations involved). Good luck deciding, make he decision for yourself, dont let anyone talk you into either way or you will probably regret it.

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:lurk: from September

I had a c-section with my first but this time I am going to try for a VBAC. I have to go into labor on my own and before 41 weeks but I am excited to have the option to try. For me personally, I would rather avoid the surgery if I can avoid it and the risk is quite small. For us, I know I'm making the right decision, so you just need to figure out what the best decision is for you and your family. Good luck.

There is a VBAC board here and they links to resources you may find helpful.

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This will likely be long, and I apologize. Smile

I really wouldn't worry about rupture. It's really REALLY really REALLY super rare. If that is your deciding factor, I would go with VBAC. I have a friend that is trying to decide between VBAC and repeat (hers was due to distress also) and we were just discussing it the other day. The risk of a rupture is as low (or lower) than any other risk in labor (the example she used was cord prolapse). The stated risk of rupture is between .2 and 1.5%. It is very important you try not to induce or augment labor with pitocin though, because that does up your risk of uterine rupture. Most sites I've read state there are no deaths due to uterine rupture from VBAC to date. I would never (personally) have a vbac with induction/pitocin. If it came to that I would repeat.

Now that I've gotten all of that out of the way...;) Choosing VBAC/repeat C is a VERY personal choice. There are SO many factors to consider, and I honestly hate that I was ever put in the situation to have to choose.

Even after all I've stated and how pro-VBAC I am, I chose to do a repeat with my second daughter. It's taken me until about last month (so 14 months or so after my repeat) to be completely okay with that decision. In my heart I KNOW it was the right decision for me. VBAC in my area is really low (like 16%). One reason my daughter was a c-section was because her head was stuck on my crooked/narrow pelvis/hip bone. I also went to 39+ weeks (with both) without any indication of labor. Not one contraction, no change to my cervix, nothing. Which increases my risk of needing to be induced. So in the end, I know my chance of a c-section is greater.

The most important reason though was that I just couldn't have that same feeling after my DD1's c-section. I started my induction at 3:30pm and didn't sleep I had my water broken at 7:30am and labored HARD (with pitocin) for 7 hours. I was nearly DELIRIOUS from the pain (even with my epidural. I was so out of it from lack of sleep/high blood pressure that I couldn't remember to push the button), lack of sleep, and high blood pressure that I barely remember my daughters birth. The idea that I wasted 24 hours to end up with a c-section made me feel like a failure. We ended up both having to have abx for 24 hours because I had a fever. I will say though that my recovery was awesome.

I just couldn't mentally go through that again. Choosing to have a c-section made it MY choice, MY decision, something I was in control of.

My second c-section was great. I went in at 6:00 in the morning, and had my daughter by 7:30. It did take a while longer to stitch me up. It was great being lucid and knowing what was going on around me. They don't take us to recovery, we go immediately back to our rooms. I breastfed right away (did with DD1 too) and was up exactly 24 hours after my c-section (I actually set an alarm on my phone so I could call the nurse an hour before so I could be sure I was up as early as I was able). I was walking around immediately, had a shower about 3 hours later (they made me wait because they were worried I would pass out :rolleyes:) and left the hospital exactly 48 hours after I was out of surgery. (again with the phone alarm. ;))

So in the end Smile I would just do some soul searching and decide what is important to you. I would talk to your doctor and make sure they are confident with a VBAC and ask about all the things that can go wrong/how you'll be monitored/how long you'll be allowed to go past your due date, etc. Smile

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I also just way to say that having a vaginal birth does not mean you will definately have tears/rips/stitches. I've had 3 babies vaginally and never had any tears/rips/stitches (except the first which was episiotomy which I do not count since that OB did episiotomies on every first time mom).

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Sally is right, tearing is just what it has meant for me:( You might get lucky! Either way, I hope you get to do what you want!

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"CanadianaSally" wrote:

I also just way to say that having a vaginal birth does not mean you will definately have tears/rips/stitches. I've had 3 babies vaginally and never had any tears/rips/stitches (except the first which was episiotomy which I do not count since that OB did episiotomies on every first time mom).

I'm gonna ditto this.......the only one of mine I "tore" with was DS#3. It didn't even require a stitch.....the midwife called it a "skidmark" because he came so fast. I pushed once and he was born. I didn't tear even with my big headed last baby (14.5 in head). They had me do controlled pushing to allow enough time for me to stretch.

But I also want to say that being induced doesn't necessarily mean you will rupture either.....I was 42 weeks and induced, had the pit turned up 4 times before I was in a "normal" labor pattern and he was born with no complications....

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Everyone has a chance for uterine rupture, it is just an increased risk while you VBAC. The thing my Dr told me was that if a woman who has had a CS before does rupture it is, of course, usually along the scar and that area has the least amount of blood flow and is the safest place. Which is why they cut you there. And the placenta is further up so its safer for baby too. I know someone who had 2 VBACs and with her first her scar came apart a tiny bit in a little spot, a lesion I think they called it. They didn't even find out until after she successfully gave birth and it healed on it's own. But they counted it as a rupture. So not all "ruptures" are serious.

I attempted a VBAC last time and while she stopped tolerating labor and it was unsuccessful I'm glad I tried. I'm going to try again this time. Like you I recover quickly and without complications but the worst part for me was not being able to pick up my son for 6 weeks. He was only 17 months old and while he could sit with me it was hard on him to have a new baby around and to suddenly have mommy stop holding him. Haha I'm crying about it now! It broke my heart and I don't want him and my DD to have to go through that this time.

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Very personal choice it's true.
I'm just curious as to what your reasons are to try a VBAC if you decide. To have that ultimate birth experience, to see if you can do it, b/c there is a belief vaginal births are better for babe? I think ultimately your decision will stem from your reasons.

I agree with previous posters. Uterine rupture wouldn't be my main reason to avoid a VBAC. While it's true it does happen I think the percentages are only slightly higher then in regular pregnancies/births & is now used mainly as a scare tactic by the health industry.

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I have no advice to offer, as I really have no experience with this, and haven't done much in the way of research. I do want to say though, that I vaginal delivery can make for a great recovery afterward. I've been up walking around at the mall 2 days after the birth of a couple of my babies. I can't imagine that being possible after a C/S. Also, I only tore slightly with one of my babies. With my others I did not tare at all.

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Thanks for all your advice!! I think one of the reasons I am scared of the VBAC is that some hospitals won't even do them...well if they are so "safe" then why don't all hospitals offer them, KWIM??? Smile I still have about 9 weeks before I have to decide, my doc needs to know by 30w to schedule the section. If I do go they will schedule me a week before my due date. I'm going to look into it a little more, and talk with my doc (the one I like)! I love being able to come here and ask questions, you get such real advice from people who have/are going through the same thing! :bigarmhug:

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I had a C Section with my first - he was stuck at 7 cm for 3 hours and my contractions weren't strong enough (could have fooled me!). And my recovery really wasn't bad at all with it either! So with my second my thought was I'll schedule a C Section for after my due date and if he wants to come on his own we'll give it a try. Sure enough I went into labor early (first time false) but second time I got to the hospital and was 6 cm (had C Section scheduled for the following am) and they asked what I wanted to do so I said well let's just see where this goes - worst case I'm scheduled at 10 at the latest. So they took me to a room and I was 8 cm already and got an epidual and it slowed me down so I could rest. Got up in the morning they broke my water, I pushed for an hour and out he came. The whole time I was CERTAIN they were going to say "OK enough time for a C Section". I was really surprised I could do it. I wasn't insistent one way or another so I thought that was a good strategy to not have my hopes set too high. I was REALLY surprised how much easier the recovery was with the VBAC because I didn't think the C Section was that bad, but especially with having one running around that I came home from the hospital and was just able to do so much more. The dr's think there should be no problem VBACing again this time!

Hope that helps! If you have any more quesitons for me ask away!!

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Oh and about the uterine rupture - if you're in a hospital they'll get you back so fast for the C Section if any complications happen it really shouldn't be a worry. My sister tried to VBAC and had a uterine rupture and they got her right back for a C Section and she's had no problems.

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"scotty620" wrote:

Oh and about the uterine rupture - if you're in a hospital they'll get you back so fast for the C Section if any complications happen it really shouldn't be a worry. My sister tried to VBAC and had a uterine rupture and they got her right back for a C Section and she's had no problems.

Absolutely no experience and no research either really. My thoughts would be this- if I go for vbac and there's a complication, how fast can they get me in for a section? I'm assuming it'd be pretty quick and they'd be on you like a hawk watch g for any signs of trouble. If that's the case then I think I would try for the vbac. I guess I'd be more afraid of major stomach surgery than uterine rupture? But again, no experience and no real research, just my thoughts.

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Part of the reason, certainly not entirely but part is b/c sections are just easier for docs. They know what time & how long. Its much easier to make your golf game if you section a patient as opposed to wait for that baby to show up on his/her own. Plus the hospital makes more money. Now I know that sounds cynical but if those reasons come into play AT ALL for a docs reasons to section a patient it makes me very leery.

Just know that whatever you decide you'll be very happy to see that babe. Smile

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Thought I would throw my 2 cents in... I have no specific advice for you but I thought I would relay my thought process for my decision.

Last time DD ended up being born by an "emergency" csect 24 hours after labor pain started. DD had a large head (it runs in my DH's family) & got stuck in my pelvis and I never progressed to pushing. I spiked a temp and a csect was strongly recommended. I remember being so exhausted from such a long drawn out process. The csect was fine and the staff was wonderful. My recovery was also fine. I had some leaking from my incision but never had an infection and it was easy to care for.

I chose to do a repeat csect this time. For me, I like the idea that I will know when the "birth" day will be (barring an early appearance, of course). I like the fact that I will be able to plan for DD's care as well as not be so worn out from the multiple day process of labor & delivery. I have no desire to have another large head get stuck (if DS has the same trait). :eek:

I, also, did my research prior to choosing my OB practice last time. I was blessed that it worked out to get one of the best csect OBs in my area to do my emergency csect last time. I will be scheduling with the same OB this time. He takes a bit longer than other OBs because he takes his time stitching you up so well. He rarely has any post op complications and the scars tend to heal smooth without bubbling, etc. I think your choice of OB can make a big difference in your recovery, etc regardless of your choice of delivery method.

Good luck with your decision process! You have to be comfortable in whatever you decide. Smile

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Size of Baby

Maybe you could just propose two alternatives for different scenarios. You could arrange with your doc to have a C-section if the baby looks like it will be over 8 1/2 or 9 pounds, if it looks like the head size will be over 14 inches, and/or if you are overdue by a week or more. This way, you can reduce the threat of rupture. If you go into labor before 40 weeks, and/or the baby is smaller, you may feel more confident about having a vbac. I've never had a baby before, so take my insight with a grain of salt! Smile

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"pwbattist" wrote:

Maybe you could just propose two alternatives for different scenarios. You could arrange with your doc to have a C-section if the baby looks like it will be over 8 1/2 or 9 pounds, if it looks like the head size will be over 14 inches, and/or if you are overdue by a week or more. This way, you can reduce the threat of rupture. If you go into labor before 40 weeks, and/or the baby is smaller, you may feel more confident about having a vbac. I've never had a baby before, so take my insight with a grain of salt! Smile

No you're right, its a good idea! lol DS was only 5lbs10oz born 5days early but he had a HUGE head. And I really think that the docs can't predict how big the babies are going to be...they told me DS was going to be 7 1/2lbs lol, he wasn't! (and a friend's kid at 6lbs, she was 8.5!!) I haven't fully made my choice, but I am waiting till July 7th (my next dr apt) to speak more in detail with my doc.