VBAC advice

[MeaganS]

I had an emergency c-section with my daughter a year ago and am going to start trying to get pregnant again in about 4 months. It took me a few months to recover from the c-section and it is something I do not wish to repeat. I've researched vbac and am convinced that I want to try it with my next child.

 

I was wondering, though, if anyone had any recommendations on what to do to prepare myself for the best pregnancy. My first pregnancy was just fine up until the delivery, but I didn't really go out of my way to be healthy. I'm pretty much open to any ideas: herbs, diets, excersizes, etc. Also, any encouragement or words of wisdom?

[Aggie]

It is my understanding that not all doctors and hospitals will do a VBAC now. Check with your ob and midwife.

[Jami]

I had an emergency c-section with my daughter a year ago and am going to start trying to get pregnant again in about 4 months. It took me a few months to recover from the c-section and it is something I do not wish to repeat. I've researched vbac and am convinced that I want to try it with my next child.

 

I was wondering, though, if anyone had any recommendations on what to do to prepare myself for the best pregnancy. My first pregnancy was just fine up until the delivery, but I didn't really go out of my way to be healthy. I'm pretty much open to any ideas: herbs, diets, excersizes, etc. Also, any encouragement or words of wisdom?

 

I had a c-section with my 3rd child. And determined that if I ever have a 4th I would do EVERYTHING in my power to have a VBAC. When I had my third my doctor at that time said a VBAC shouldn't be a big deal, since I'd had two other vaginal births previously. But then 4 years passed, so it's possible policies changed.

 

But we moved. To Texas where there were OPTIONS. So I chose a very VBAC friendly midwife and opted for a birth center birth. I knew that things like induction and epidurals would add the the likelihood of not succeeding at a VBAC. So I wanted someone who would be a support for a natural, non-interventionist birth. I also knew that baby positioning was very important to birth progressing well (I'd had some positioning issues with previous pregnancies), so I also chose to have regular chiropractor visits for my third trimester, those included Webster manipulations to improve baby position.

 

I did go 2.5 weeks past my most accurate due date. But I went on my own. Had a wonderful labor and birth. And felt amazing afterwards. It was so worth it. The c-section had been a little bit traumatic for me and I couldn't honestly think about hospitals and doctors without a little panic attack. Working with a loving, supportive midwife was so very healing. (I can see how giving birth could be addictive!)

[MomLovesClassics]

I do not have a lot of advice for you, but some suggestions. I would take a good quality natural prenatal vitamin, a super green formula and green tea. I would also do pilates to really strengthen those abs, and get some pilates for pregnancy books and videos. It is important that you are healthy by eating a good diet and exercising. Herbs are not really necessary, and are not recommended during pregnancy, there are pregnancy teas, but I would consult with a dr. before using.

[Remudamom]

All I can tell you is that my dad (OB) says vbacs are disasters waiting to happen. My friend proved him right. She had a section, then went with vbacs, and hemorraged on the third one a couple of hours after the birth and nearly died.

[Mrs Mungo]

I had a vaginal birth with my first, a c-section with my second and a VBAC with my third. It went perfectly fine. I was very happy, it's much easier to recover from a vaginal birth in my experience.

[yslek]

I'll have to ask my cousin. She had a wonderful VBAC (in the hospital) w/ her 2nd. She does walk a lot (runs & hikes regularly when not pg), so I know she was in good physical shape.

 

On a recent thread about baby positioning, several people have recommend this site, which looks useful: http://www.spinningbabies.com/.

 

On a side note, I recommend my favorite birth book (if you haven't read it yet): http://www.amazon.com/Ina-Mays-Guide-Childbirth-Gaskin/dp/0553381156/ref=sr_1_1?ie=UTF8&s=books&qid=1251825159&sr=8-1. She specifically discusses VBAC in the book, as well as some of the untold risks of C-Sections (and why VBAC complications have risen in recent years...not because of anything to do directly w/ VBACs, but with the way they're too often managed, for example, by using of Cytotech and other chemical induction agents.)

[Karen in CO]

I had two VBACs after an emergency c-section with my oldest. My advice is to have your ob review the surgery records from the c-section to see if the VBAC is possible. My ob had discussed the c-section narrative with me and found no cause in the description of the c-section for excessive concern. She had done many vbacs before and was comfortable with doing a vbac based on the reason for the original c-section and the description of how the c-section had gone. All of my kids are surprises or I would have had this discussion before I tried to get pregnant again. There is real risk of uterine tears after a c-section, but if you have had long enough to heal and there were no underlying issues or problems with the original c-section then there shouldn't be a problem.

 

However, my sister had emergency c-section with her first also and her ob warned her to NEVER go into labour again because of the way they had to cut her. She had planned for a scheduled c-section with my nephew but went into premature labour, and they both nearly died.

 

VBACs can be very safe, but they do carry more risk. You just need to know as much about your risk as you can.

[Mary in GA]

I had a c-section 19 yrs ago, and I had no idea at the time how much that was going to impact future deliveries. It was not an "emergency" and might never have become one. Had I had more info I might have chosen to labor some, but I was 21, in college, and not really getting into those pregnancy books so I played it completely safe. I had my 2nd natural 6 yrs later and all was fine. I had never heard the acronym VBAC until I had my last 6 yrs ago. They treated me like a total high risk case in the hospital. Very annoying.

 

I don't really have much advice except I completely agree with the poster who said work your abs and make 'em strong. Add in some Kegels too! Best of luck to you.

 

Mary

[RoughCollie]

All I can tell you is that my dad (OB) says vbacs are disasters waiting to happen. My friend proved him right. She had a section, then went with vbacs, and hemorraged on the third one a couple of hours after the birth and nearly died.

 

I desperately wanted a vbac after an emergency c-section with two of the boys, but my doctor wouldn't do it because he said it was too dangerous for both me and DD.

 

I have 4 kids and have never felt a labor pain, not even a twinge.

 

Back to the issue at hand, I think it is different with an emergency c-section (as opposed to a regular one) because the incision is vertical, not horizontal, and hastily done, so there is more danger of the uterus rupturing during labor. It's been 14 years since I begged for vbac, so I may be remembering this wrong.

Edited September 1, 2009 by RoughCollie

[PiCO]

I had an emergency c-section with my daughter a year ago and am going to start trying to get pregnant again in about 4 months. It took me a few months to recover from the c-section and it is something I do not wish to repeat. I've researched vbac and am convinced that I want to try it with my next child.

 

I was wondering, though, if anyone had any recommendations on what to do to prepare myself for the best pregnancy. My first pregnancy was just fine up until the delivery, but I didn't really go out of my way to be healthy. I'm pretty much open to any ideas: herbs, diets, excersizes, etc. Also, any encouragement or words of wisdom?

 

I tried a VBAC, but ended up with a second C-section. My advise is to analyze why you needed the first C-section, and leave your options open.

 

I should not have tried the VBAC. Everything was fine, but I didn't need to go through that pain when I wasn't going to be able to deliver anyway.

[lighthouseacademy]

I would suggest contacting the local ICAN network. http://www.ican-online.org/

They will be a wealth of information for you.

[Radish4ever]

WHEW! I'm glad someone mentioned ICAN! I am an ICAN chapter leader and am 37 weeks waiting on my second HBAC birth (homebirth after a Cesarean)...

Read read read and you decide what YOU want. It is absolutely illegal to be refused a VBAC, but that doesn't change the fact that fear of litigation has made it nearly impossible to get the option of a VBAC in many, MANY places.

ICAN has a directory of hospitals that "allow" VBAC from a phone survey that was done very recently. If you have a local chapter of ICAN or even one in your state, I'd certainly recommend talking with them and finding out which providers in your area are VBAC friendly.

 

Truth be told, the biggest "risk" is to the care provider as far as being sued. Risk of rupture is actually lower than the vast majority of other birth catastrophes and Cesarean birth has a 3x higher risk of death to mother and baby... so that's something to think about as well.

 

PM me if you need more info.

 

As far as your pregnancy and all that - I'd certainly recommend taking a prenatal vitamin prior to conception (most will recommend that so you have good folate stores, etc), but I'd also recommend being in good shape and staying active during pregnancy.

[Samiam]

Please don't let the horror stories scare you away.

 

1. Many older OB's don't believe, and won't do VBAC's...thus the other person who's DAD says VBAC's are not good. Medical info and times have changed A TON in the last 20 years, but many Dr's don't want to change their ways.

 

2. There are horror stories for every situation, vaginal, c-sec, VBAC's...everyone can tell a story, good, bad and ugly.

 

Your first step is to find an OB who will do a VBAC. You might have to make a few calls. It's mainly about insurance and malpractice these days. Malpractice insurance doesn't want to cover VBAC, so that's the way the Dr's go, it's not ALL based on medical reasons.

 

Once you find your VBAC-friendly OB, she/he will want your old medical records to see why you had a c-sec and what kind of "cut" you had. Certain cuts are not VBAC friendly and carry more risk of hemoragging. But guess what, that's the same kind of "cut" that was used in the old-school days. Most modern OB's no longer cut that way in C-sec, unless extremely necessary. I think I also read that if you had a vaginal birth the first time, it's even better for your chances of doing a VBAC.

 

Once your OB determines if you can do a VBAC, the next step is making your mind comfortable with it. Remember all of the positives of a vaginal birth, the way nature intended. It has so many benefits for the baby. Write it down, so when the horror stories start coming your way, you can reassure yourself. Find a VBAC support group, to help with your fears and worries.

 

I don't knock C-sec, as I had one myself for emergency reasons during 2nd pregnancy. But I was determined that I would do a VBAC for 3rd baby, it I could. Found a OB who would do it, in next town, 30 miles away. But he was wonderful, his mid-wife was open-minded, and all went well, and it was a wonderful, all natural birth. So my first birth, was main-stream, drugs, epi, the whole works, 2nd was C-sec for necessity, and the 3rd, VBAC and completely the way nature was intended.

 

As far as prenatal care, I don't believe this will interfere with VBAC or any other way, unless you have pre-existing medical conditions. Of course, you want to do everything you can to take care of you and baby.

 

hth

[MamaT]

I hope you a VBAC works for you. I so wanted to have a vaginal birth after my first delivery, which was a C-Section. My doctor said no, so I had a second C-Section. He told me I would never be able to deliver without a C-Section.

 

I changed doctors for my third pregnancy and he agreed to let me try a VBAC. After 22 hours of labor, I had my third C-Section. Needless to say, my fourth was a scheduled C-Section.

 

I would definitely listen to what your OB has to tell you about whether or not a VBAC is an option for you or not. I wish I had listened to my first doctor and saved myself those 22 hours of labor.

[KS_]

I agree with getting in touch with the ICAN network. I had an HBAC with a midwife after having a c-section because of a very long labor (and it was approaching 5pm and the dr. didn't want to have to be on call overnight). I still had a very long labor the second time (37 hours), but was thrilled to not have another c-section. The difference in how I felt and the recovery was so much easier the second time around.

[Jennay]

All I can tell you is that my dad (OB) says vbacs are disasters waiting to happen. My friend proved him right. She had a section, then went with vbacs, and hemorraged on the third one a couple of hours after the birth and nearly died.

 

I think it's important to realize that pregnancy itself is a risk. And that c-sections are major surgery and can also have some pretty serious complications. I know of 4 women who dies during their c-sections. You have to weigh which risks you want to take. The VBAC forum at Mothering.com is a good place to go to look for links to studies and sugestions for preparing for a VABC.

 

I'm planning to have a VBAC in a few weeks (God willing). I had a c-section with my first due to too many interventions, a VBAC with my second, a very disappointing C-sect with my 3rd due to her being breech, and my OBs are supportive of me planning to VBAC again baring any complications.

[Macrina]

I haven't read all the replies but make sure you check out ICAN and see if there is a group in your area and above all, find a health care provider who is 100% on board with it, not one that says "sure, I'll let you try..." becuase then they just really won't.

[cjzimmer1]

My first was a c-section. I tried to VBAC my second but he was face up and I just couldn't get him out so I ended up with another c-section. With my 3rd I REALLY wanted to try the VBAC again. My friend is a doula and during the latter part of my pregnancy she gave me some stretches and exercises to do to help baby get in optimal position. We also discussed non-medical pain relief (because epidurals are not a good choice when trying to vbac because you can't move around to help things along if needed). My 3rd was not only a successful VBAC she came so fast the doctor delivered her in the bathroom (where I went when they put me in the room) because no one thought someone who had never delivered vaginally could go that fast. My 4th and 5th kids were also vbac's but I did have a few more minutes in the room so that I was actually on the bed with them.

 

I would really recommend talking to doulas and midwives. The OB's kept pushing me to do c-sections just because I had already had them but we knew we would be having more children (we believe in allowing God to do our family planning) and having lots of c-sections carries risks too. While I will probably always deliver in a hospital setting just in case, I won't automatically do a c-section (unless there is a clear medical emergency)

[Stacie]

I had a c with my first and tried a VBAC with my second. My doctor was very, very supportive of it though the hospital we used was not. They required him to be with me from 3cm on. He cancelled all of his afternoon appointments to be with me the entire time. Things went really well until we hit an emergency that was not a result of the attempted VBAC. I had an emergency c and once he was in he told my dh that we almost had an emergency on top of an emergency because I was bulging and near rupture.

 

I'm glad I had a very supportive OB, and I'm glad I tried the VBAC. What I'm most thankful for is the fact that I tried it in a hospital. The first emergency would have been a transport by air or ambulance, but within that time I would have ruptured. My next two deliveries were scheduled c sections.

 

If you are concerned about the recuperation, I recovered soooo much more quickly with the subsequent c sections. The first was by far the hardest. I encourage you to try it, find a very supportive OB, and do it in a hospital or a birthing center attached to a hospital. Best wishes to you!!!

[swellmomma]

I had a section with my 1st and VBAC's with all the rest. My first was difficult, but I think if it had been my first pregnancy it would have been the same. I never had labor with my first so my body say this as a first delivery, AND due to issues with the pregnancy/labor I was tethered to the bed with monitors so I could not move. If you are healthy, the pregnancy is healthy, and the incision is the right way a VBAC is worth a shot. Everything that helps make a VBAC successful are the same things that make a regualr vag delivery successful imo.

 

I did hemmorage a bit after my 4th but that is due to her being my 4th and being born in an ambulance not the VBAC itself. After that many your uterus just doesn't work as well immediately after birth. They gave me an extra shot of oxytocin(or whatever it is they give for that) along with a shot of morphine for the pain as they laid on my stomach and within 3 minutes I was done bleeding.

 

My recovery from my section was a nightmare(I don't respond properly to pain killers, so I went 48 hours post op with ZERO pain relief and my ex and his mother pulled me upright in teh bed hours after surgery to make me sit up causing extreme pain). It terrified my so much I swore I would never have another c-section. Luckily for me when I had my 2nd only 11 months later it was when OBs were pushing VBACs and mine supported me with it. After that one was a success the OBs assume the rest would be and have been.

 

If I every have another I would love to try for a HBAC if I can carry the baby to term, otherwise it will be another VBAC like the rest. Though my 1st VBAC recovery was hard(tearing/scrapes fromteh vacuum) the rest were a breeze and I was back to my oldself within 24 hours.

[Veritaserum]

It comes down to risk analysis. Which risks are more comfortable for you? There are risks to VBAC but there are also significant risks to c-section. It's not like VBACs are risky and c-sections are 100% safe (although that is how some people like to slant it) or vice versa. There are pros and cons to both options and you need to choose the one that makes the most sense for you and your situation. You will, as others mentioned, need details about your surgery (particularly the type of incision and closure) to help you calculate the risks involved.

 

In any case, it is enormously helpful to have a supportive and competent care provider. The doulas and out-of-hospital childbirth educators in your area should be able to give you recommendations for docs/midwives/hospitals/etc. to interview and which to avoid. :)

[Heather in OK]

I was wondering, though, if anyone had any recommendations on what to do to prepare myself for the best pregnancy. My first pregnancy was just fine up until the delivery, but I didn't really go out of my way to be healthy. I'm pretty much open to any ideas: herbs, diets, excersizes, etc. Also, any encouragement or words of wisdom?

To answer your questions...

 

As far as diet goes, just maintain a healthy diet. Good nutrition is important to any pregnancy, not just a VBAC.

 

Red Raspberry Leaf tea is great and safe to take during pregnancy. It is a uterine toner and can help prepare the uterus for labor. When you are about 36wks you can start taking Evening Primrose Oil to help ripen the cervix (it does NOT induce labor).

 

Exercise is great regardless of a woman's VBAC status. Even just something simple like walking for 20 minutes a day can be very beneficial. Swimming is excellent exercise during pregnancy.

 

Then just read all you can about normal pregnancy. I'd be happy to email you a recommended reading list if you need some suggestions.

 

I HIGHLY recommend hiring a doula. You will be facing the unknown and having the support of someone experienced in helping women with VBAC is priceless. Also start asking around NOW about which care providers in your area is 120% supportive of VBAC.

[sweetbasil]

I tried a VBAC, but ended up with a second C-section. My advise is to analyze why you needed the first C-section, and leave your options open.

 

I should not have tried the VBAC. Everything was fine, but I didn't need to go through that pain when I wasn't going to be able to deliver anyway.

 

Since the baby emits a hormone that starts labor when he or she is ready to be born, it's best whenever possible to wait for labor to begin naturally.

 

The contractions are really good for the baby too, as they clear fluid out of the lungs. Babies born via c section have higher asthma rates than those born vaginally.

 

So all in all, even though you ended up with a C-section, the labor was actually a very good thing for the baby!

[squirtymomma]

I also knew that baby positioning was very important to birth progressing well (I'd had some positioning issues with previous pregnancies), so I also chose to have regular chiropractor visits for my third trimester, those included Webster manipulations to improve baby position.

 

I agree with this, as it also seemed to help me. Also, accupuncture has induced labor for me with both of my births (even though the first ended up in a C-section), so that is an option if you go overdue and have an impatient care provider. I had a very supportive OB who actually talked me down when I was mentally heading toward interventions. I also had a doula which I think can help a lot mentally/emotionally when you're having a VBAC. Try to find a care team that is supportive. It makes me nuts when people use the term "trial of labor". Go with someone who believes you can do it.

 

Please don't allow fear of the pain of labor to motivate your decision. I think way too many decisions about childbirth are made out of a fear of pain that have many detrimental consequences. Also, there are always risks. You choose the ones you are more comfortable with. But no method can guarantee a healthy mom and healthy baby every time. That's part of what makes childbirth and parenting so powerful. Neither is for cowards.

 

Oh... one more thing. I read Baby Catcher: Tales of a Modern Midwife when I was pg with my second. It was so helpful to read so many stories of normal healthy births (although those aren't the only kind she tells about). You literally will laugh until you can't breathe and cry at times too. Although you want to do everything you can to have a healthy body, I think the biggest challenge for a VBAC is the mental/emotional strength to believe you can do it.

[EmilyK]

I guess I'd reflect on why you want the VBAC. I had the same situation you did with my first, and a long recovery. The second time I had a scheduled C and an unbelievably fast recovery. I think now my first, long recovery was more related to long labor and pushing than the surgery. So if that's the reason for wanting a VBAC, I wanted to share that.

 

If you just want the experience, that's fine. I just wasn't attached to that, and was willing to go with the recommendation to have a C, and frankly my husband felt more comfortable with the C (from the perspective about being worried about me), which factored in for me too.

 

Good luck!

[tadbhoward]

I have had an unplanned section and 3 very successful (and natural) vbacs. I have had supportive medical teams though. My OB is awesome and hands off unless he needs to be otherwise. I didn't take any extra precautions with my last 3 pregnacies outside of research and excersice.

[AmeliaJade]

I had an emergency c-section with my daughter a year ago and am going to start trying to get pregnant again in about 4 months. It took me a few months to recover from the c-section and it is something I do not wish to repeat. I've researched vbac and am convinced that I want to try it with my next child.

 

I was wondering, though, if anyone had any recommendations on what to do to prepare myself for the best pregnancy. My first pregnancy was just fine up until the delivery, but I didn't really go out of my way to be healthy. I'm pretty much open to any ideas: herbs, diets, excersizes, etc. Also, any encouragement or words of wisdom?

 

If at all possible I would hire a doula or midwife. At the very least work out a birth plan ahead of time and be 100% sure your doctor is on board. This won't be easy because there is a trend for doctors to pretend to be on board with a patient only to have every intention of performing a c-section anyway. They figure they can just manipulate you later on into doing what they want you to do. Obviously, not every doctor is like this. I'm just saying to be sure your doctor understands what you want and that you understand your doctor as well.

 

My second c-section was called an emergency c-section. Only I found out later that it wasn't an emergency at all and wasn't even necessary. Actually, none of my c-sections were necessary but I didn't know that at the time because I trusted the doctors were doing what was necessary. I no longer rely on that.

 

I really think a doula could be beneficial in your case. Just my opinion. As far as being healthy, if you've exercised before pregnancy then it should be no problem to continue. Avoid prepackaged foods or anything with preservatives. Keep hydrated. Lots of water!

[Mom-ninja.]

All I can tell you is that my dad (OB) says vbacs are disasters waiting to happen. My friend proved him right. She had a section, then went with vbacs, and hemorraged on the third one a couple of hours after the birth and nearly died.

 

 

To the OP, please ignore all horror stories. Every pregnancy is different. Every woman is different.

 

Contact ICAN.

[caitlinsmom]

Find a practitioner who will do a VBAC. Not someone who pats your knee and says "Oh sure you can try." The "try" part of the sentance is the issue. Many Dr.s will say but you have to perform at a certain rate, like dialate at at least 1 cm an hour. Find a care provider that is completely aware of the benefits of VBAC, knows the issues, and is very supportive of them. Find out what that specific care providers stats are when it comes to successful VBAC's.

 

Something you may want to consider. "They" say that your body needs a full 18mo- 2 year to recouver from a c-section. That time frame allows for scar tissue to form and become strong, uterus to become firm and happy again, etc. Talk with your provider about this before you get pregnant to find out what they advise.

 

Lots of people will use scare tactics when talking to you about VBAC but most stats they quote are false or have long since have been debunked. Vaginal birth is just as safe for a VBAC mom as it is for any other woman, assuming they are healthy and there are no other issues at play.

 

I am a midwife in training now and if you want any information on the midwife perspective just PM me. As someone posted there are a lot of providers who cant do a VBAC, not because they dont belive in them or know the benefits but because hospitals can not cover them through insurance companies. Its a very sticky situation that takes some researching.

 

Good Luck! VBAC's are so incredibly worth it for both the mother and child!

[caitlinsmom]

If at all possible I would hire a doula or midwife. At the very least work out a birth plan ahead of time and be 100% sure your doctor is on board. This won't be easy because there is a trend for doctors to pretend to be on board with a patient only to have every intention of performing a c-section anyway. They figure they can just manipulate you later on into doing what they want you to do. Obviously, not every doctor is like this. I'm just saying to be sure your doctor understands what you want and that you understand your doctor as well.

 

 

:iagree: It is proven that if you have a doula at your birth not only will it go faster but there will be much less intervention and stress. Check out www.dona.org for more info on doulas.

[DragonflyAcademy]

I just wanted to extend support and love to you. I had an HBA2C nearly 3 years ago.

 

There are some wonderful resources at ICAN http://www.ican-online.org/ and on http://www.plus-size-pregnancy.org/