*UPDATE* To VBAC or not to VBAC?

[Ann.without.an.e]

If you know me or are friends with me on FB, the real world does not know that I am expecting...so please, mums the word. Thanks. I had three, non-medicated vaginal deliveries. Then along came #4. I had a placenta infection, there were two true knots in the umbilical cord, and he had the cord wrapped around his head several times. Needless to say, we had to go with a c section because he was stressed. I honestly think he would have died via vaginal delivery. So now fast forward to today.....I just found out that I am pregnant with #5. I need to choose an OB. No one at this hospital will consider a VBAC. No one. I can drive a bit and choose a doctor I am less familiar with and it would be a possibility. The biggest obstacle is that I never went into labor on my own with any of my other babies. I will need to go into labor on my own by 40 weeks for a VBAC to be considered. Do I travel to see a doctor an hour away with the hope that I will magically go into labor this time OR do I go to the doctor here that I know is good and resort to a scheduled c section. If I had gone into labor on my own with first four, it would be a no-brainer. Also, the hospitals around here are all anti-VBAC so the pressure to find a reason for a c section is high. Even this doctor who says he might consider given the situation, will be unlikely to follow through unless everything looks absolutely amazing.
Just curious, what would you do?

 

 

UPDATE

 

I finally found that the largest hospital in our region will support VBAC.  I hadn't checked with them because they have a reputation for being very high tech medical.  I called them and they are supportive for VBAC.  The nurse on the Baby Line was incredibly nice.    I asked what their success rate is and she said 75%+.  She said they have worked so hard the last few years to change their anti-natural reputation and they believe in the mother being in control over the birth.  She gave me the name of a large, reputable OB that is connected to the hospital network that is very supportive of VBAC.  This practice will let me induce with a VBAC.  One reason this hospital is more supportive is because they are so large that they always have 4 OR units prepped and can do a section asap.  So what do you think?  It is a 45 minute drive....is it worth it?  I really hate the idea of major surgery.  At the same time, I hate to jump through hoops and end up with an emergency section.  Agh, decisions, decisions.

 

Also, has anyone been induced with a VBAC?  That is what makes me lean toward the VBAC, but it also makes me nervous as the risk of rupture increases with induction.  

 

[wapiti]

My first was a section and all the rest were vbac.  In your case, I'd probably lean toward the repeat section considering the unlikelihood that you will go into labor on your own and the distance you might have to go for a vbac.  If you were hoping to have more kids after this one, that might be another factor to consider.

[ErinE]

Would you like more children? If so, I'd try for the VBAC, even if it means a bit further of a drive. If this is the last, I'd say do what's most comfortable for your family and you.

 

FYI, the recovery from the 2nd section wasn't near as painful as the first. Don't get me wrong, it hurt, but by the 4th day, I was off pain meds (but not anti-inflammatories) unless I over exerted myself. I had to take it easy the first six weeks, but you should be doing that anyways ;-). For each delivery, family stayed with us for the first week home to help, but honestly, it wasn't necessary. Between DH and the kids, we did fine.

 

If you've never gone into labor naturally, perhaps strive for the VBAC, but mentally prepare for another section.

[bolt.]

After my first unplanned c-section, I was told that the medical risks of a VBAC and a planned c-section for my 2nd pregnancy were approximately equal, and therefore the choice was entirely up to me. I was also told that for a VBAC, I would need to be constantly on the monitor, unable to move much or do any of the more active labour-relief techniques.

 

Given that I was looking at a less-than-ideal (highly medical) labour vs a quick (highly medical) c-section, I opted for the c-section.

 

Honestly, I know that "regular" labour is less risky than a c-section (and therefore much to be prefered) but when the options are medically equal, and you've already had a "c" I've never understood any fear or shame about going with the surgical option. So many women seem either terrified or ashamed that they might "have to" have a c-section. It's honestly a perfectly normal way to have a baby, and no big deal.

[Ann.without.an.e]

After my first unplanned c-section, I was told that the medical risks of a VBAC and a planned c-section for my 2nd pregnancy were approximately equal, and therefore the choice was entirely up to me. I was also told that for a VBAC, I would need to be constantly on the monitor, unable to move much or do any of the more active labour-relief techniques.

 

Given that I was looking at a less-than-ideal (highly medical) labour vs a quick (highly medical) c-section, I opted for the c-section.

 

Honestly, I know that "regular" labour is less risky than a c-section (and therefore much to be prefered) but when the options are medically equal, and you've already had a "c" I've never understood any fear or shame about going with the surgical option. So many women seem either terrified or ashamed that they might "have to" have a c-section. It's honestly a perfectly normal way to have a baby, and no big deal.

 

 

 

Thank you, Bolt.  I can't explain it.  I am very holistic, natural, organic, crunchy, etc so I should feel the need to go as far as necessary to get that VBAC, but my gut says no.  I have no idea why my gut says to go for a section.  I can't explain that.  

[Ravin]

I went in to labor on my own with my son at 42 weeks on the mark. If you've always been induced at 40 weeks, how do you know you can't do it? It's simply not that precise a process.

 

I planned a VBAC with my son, as a homebirth with an ND/CPM. We ended with a hospital transfer, trial of labor on the hospital while monitoring DS's stress, and C-SEC, but the cesarean wasn't the default, it was the last resort.

 

Which is what it should be, from an evidence based medicine approach. "Once a surgical birth, always a surgical birth" is not evidence based, or best practice. Neither is induction at 40 weeks of a fetus not in distress.

 

I had a better experience with DS's birth with the on call OB than I did with DD, with a doc I feel pushed me into induction before letting my body have a chance on it's own, then decided on section after things didn't go fast enough for him without stressing DD. It just happened to be Friday.

 

ETA that for all of that, my recovery after DS was much easier than after DD, even though the section followed 3 days of labor (I fully dilated, DS was hung up on his cord.) DS was also bigger and DD was jaundiced.

[unsinkable]

Congrats, Charleigh!!!

 

I had a emergency section and then VBACs but I wasn't in your position so I'd not know how to advise.

 

((((Hugs))) and best wishes!

[Ann.without.an.e]

I went in to labor on my own with my son at 42 weeks on the mark. If you've always been induced at 40 weeks, how do you know you can't do it? It's simply not that precise a process.

 

 

 

 

I was never induced at 40 weeks.  I always pushed and whined for them to give me my full 42 weeks.....still no labor.

[hsbeth]

Agreeing with others that this partially depends on how many more children you'd like to have (if any). Multiple c-secs damaged my fertility in a couple of ways. My docs advised against having more than 3 c-secs  total. Secondarily, I developed issues with uterine scarring and adenomyosis that later necessitated a hysterectomy when I was only in my mid 30's. I had one natural birth and 3 c-secs. I wish I had advocated harder for v-bacs.

[prairiewindmomma]

Follow your gut.

My birth history is emergency c-section, three VBACs, emergency c-section. I chose to drive an hour to find an ob practice and hospital that were pro-vbac. The pendulum has swung back to vbacs being not popular in our area, but according to the peris and high risk obs who work with me, it's because of maternal choice and not medical indicators.

 

All of that said, follow your gut.

 

And, as an aside, I have had two babies with true knots in their cords--one vbac and one section.

[Caitilin]

I had 3VA2Cs, and I'd not trade any of them. I went to 41 and 5 with last baby, and we had an induction scheduled for the following day when I went into labor. (I was about ready to perform csection on myself by that point! Lol) I had such good experiences with my vbacs, I can't imagine opting for a section, given the choice. Best wishes as you decide, and many congrats on new baby bean!

[Ann.without.an.e]

To answer the question of how many more babies.  I have no idea, lol.  We thought we would have 3, hehe.  We take it one at a time.  I am almost 36 though.  I really think this will be the last.  At most, I could maybe see one more for a total of 3 sections.

[Ann.without.an.e]

I had 3VA2Cs, and I'd not trade any of them. I went to 41 and 5 with last baby, and we had an induction scheduled for the following day when I went into labor. (I was about ready to perform csection on myself by that point! Lol) I had such good experiences with my vbacs, I can't imagine opting for a section, given the choice. Best wishes as you decide, and many congrats on new baby bean!

 

 

You must be in a very VBAC friendly area?  Or else it was a bit ago and the tide has changed.  Everyone here seems scared.to.death of a VBAC.  Even 5 or 10 years ago they didn't have such one-size-fit-all policies against VBACs.  I have no idea what is forcing this change.

[trulycrabby]

Go with your gut. If it is telling you to c-section, then do it. Congratulations, btw!!!!! :hurray:

[coffeegal]

Thank you, Bolt.  I can't explain it.  I am very holistic, natural, organic, crunchy, etc so I should feel the need to go as far as necessary to get that VBAC, but my gut says no.  I have no idea why my gut says to go for a section.  I can't explain that.  

 

 

Follow your gut.

 

 

All of that said, follow your gut.

 

 

Go with your gut. If it is telling you to c-section, then do it. Congratulations, btw!!!!! :hurray:

 

:iagree:  :grouphug:  and Congratulations! :party:

[Forget-Me-Not]

My history is two vag, emergency csection (spontaneous placental abruption), scheduled csection. I really agonized about the VBAC thing with my 4th and even looked into an HBAC because my area is so anti-VBAC. I'd have to drive 2.5 hours to get one, and even there the climate is becoming more hostile.

 

In the end I went with my gut, which told me to schedule. I prayed for spontaneous labor so I could maybe pull a pop and drop, but I was at peace with going ahead with the surgery if I hit my scheduled date--which I did.

 

BTW, the recovery from that second one was SO much easier. My emergency section was done under general anesthesia and they had to get my daughter out fast. I was pretty beat up, but it saved one or both of us. The scheduled repeat was much more peaceful and my pain was much more controlled.

[Ann.without.an.e]

My history is two vag, emergency csection (spontaneous placental abruption), scheduled csection. I really agonized about the VBAC thing with my 4th and even looked into an HBAC because my area is so anti-VBAC. I'd have to drive 2.5 hours to get one, and even there the climate is becoming more hostile.

 

In the end I went with my gut, which told me to schedule. I prayed for spontaneous labor so I could maybe pull a pop and drop, but I was at peace with going ahead with the surgery if I hit my scheduled date--which I did.

 

BTW, the recovery from that second one was SO much easier. My emergency section was done under general anesthesia and they had to get my daughter out fast. I was pretty beat up, but it saved one or both of us. The scheduled repeat was much more peaceful and my pain was much more controlled.

 

 

With your scheduled section, did you have an epidural?

[bolt.]

Thank you, Bolt.  I can't explain it.  I am very holistic, natural, organic, crunchy, etc so I should feel the need to go as far as necessary to get that VBAC, but my gut says no.  I have no idea why my gut says to go for a section.  I can't explain that.  

 

I get what you are saying, and (hopefully without making you uncomfortable) I want to gently ask "who told you" that a VBAC is "holistic, natural, organic, crunchy, etc" ?

 

I know that people tend to buy into whole philosophies that help guide various areas of their lives according to a set of values that seems to be cohesive... but... sometimes... the things that are lumped together into a philosophy of life, well, the grouping might actually be a bit random.

 

I encourage you to think about your own perspective on *each* idea that is contained in that "basket of ideas" of crunchiness. It's not a package deal, like a good food box. ("Good food box" is our local random good produce delivery service for cheap -- do you have that?). Ideas are more like a farmer's market: you can bring your own "basket" and take home just the carefully selected ideas that actually resonate with you.

 

If you want a VBAC, want it for your own reasons, not just because it is an idea that frequently gets grouped together with other ideas you like. It's too big of a decision to make based on mere association.

[Flowing Brook]

Is a midwife a option for you? 

[Forget-Me-Not]

With your scheduled section, did you have an epidural?

Spinal :)

[Ann.without.an.e]

Is a midwife a option for you? 

 

 

Midwives are only legal here if they are working in a clinic with a doctor and delivering at a hospital.

[Ann.without.an.e]

Spinal :)

 

 

With baby #4 (CS #1) I had an epidural.  Thankfully, my doctor caught my infection and saw baby's stress and decided to go ahead and order an epidural as a precaution.  She thought it would be safer than general anesthesia if I needed a section.  It was my first epidural.  I had natural labor with my first three.

[trlt]

I would go with your gut feeling.

[Caitilin]

You must be in a very VBAC friendly area? Or else it was a bit ago and the tide has changed. Everyone here seems scared.to.death of a VBAC. Even 5 or 10 years ago they didn't have such one-size-fit-all policies against VBACs. I have no idea what is forcing this change.

Youngest ds is 5; my area is not especially vbac friendly (South Dakota is not known for its crunchiness!), but I have a great midwife. This last time I had to meet with a doctor who was required to lay out for me what the risks would be, which was a new thing with that birth. She "couldn't advise me to do the vbac" but there was no hospital policy prohibiting it. I think it's largely to do with the docs themselves and their CYA concerns vs the hospital, in my experience.

[Ann.without.an.e]

Are you sure?

 

 

I think you will end up with a section regardless since most OBs are doing things that way and given that probability I think scheduling it makes sense. If you don't want a section I would plan a homebirth with a CNM

 

 

Midwives are only allowed to deliver under the supervision of a physician.  Home births are not technically illegal, but midwives are not legally allowed to supervise.  Therefore, you either must find an undercover midwife or have the baby without help.  Sad, huh?

 

 

While it is not illegal to give birth at home -- some women do it by accident -- it has been illegal to do so with the help of a midwife in North Carolina since 1983. As most women aren’t willing to give birth unassisted, home birth is not an option for them. 

[cjzimmer1]

I've had 4 VBA2C's.  So I'm a big proponent of VBAC's.  My recovery hasn't always been faster than my c-section but my mental clarity was so much better that I didn't want a c-section unless absolutely necessary.  I hate the feeling of my brain foggy even when I stopped taking the pain medicine.

 

That said, I was going to respond to your first post but before I did I say you say your gut was telling you to go for the c-section.  This completely changes my answer and I will say go with your gut.  Those instincts are there for a reason and I've never been wrong following them. 

 

Since you commented to another posting about living in a VBAC friendly area I thought I'd comment on that.  My 2nd c-section was at a time when VBAC's were heavily encouraged and I attempted it but baby was face up and just got stuck.  By 3rd kiddo, VBAC's were considered okay but not encouraged the way they had been with previous kiddo.  My 3rd kiddo was a dream VBAC and so I knew I could never consent to a planned c-section without a medical reason.  By the time 4th kiddo was due the tide had turned and VBAC's were very much discouraged.  My doctor and I had a very long talk about pros and cons and she really wanted me to do a c-section but ultimately it was my decision (no one can force you to have surgery).  I chose a VBAC.  Every doctor/nurse I encountered while in labor questioned me about was I there for c-section, why was I trying for a VBAC etc.  It was unnerving to say the least because the environment was such that I was set up to consent to a c-section if I hadn't been so stubborn.  It was another easy delivery but I sure could tell the "climate" had changed.  With kiddo number 5, the climate had thawed some but I was back with the doctor I had for #3 and with a record of 2 successful, fast, uncomplicated deliveries, she was fine with having another VBAC (best one yet by the way).  Kiddo #6 was born earlier this year.  I have no idea what the current climate is.  I simply told doctor (a new one) that I wanted a VBAC.  He said with my history of uncomplicated deliveries that it pretty much erased the risk of complications from the prior c-sections (not his words but that was the jist of it).  He was far more bothered by my age (I'm 40) than by previous birth methods.  My point is that I think after a certain number of VBAC's you have "proven" your uterus so to speak and I think it becomes less of a concern, at least that was my experience.

[T'smom]

I say go with your gut.

 

I am facing a similar situation and I am going with the scheduled c-section. My first was an emergency c-section. I had hoped for/planned for a VBAC with my second but she was a week late, they didn't want me to go any longer than that and wouldn't induce because of the previous C-section. My doc does do VBACs but not VBA2Cs. I didn't want to switch offices because even if I found a doc to do it, chances are good I would go past my due date again and end up with a C-section anyway. (My first was also a week late.) I'm coming to terms with it. Recovery was horrible for me both times, but I am trying to look on the bright side! My family is out of state so before both births my parents were at my house for more than a week waiting for me to go into labor. This time I'll know in advance and can make plans around it.

 

Anyway, good luck with your decision. It is a difficult one.

[Mrs Mungo]

I had a vaginal birth, then a c-section, then a VBAC (I went into labor on my own and he was born 2 hours after arriving at the hospital even though I was only 2 cm when I got there). I was in Germany, which leans toward the least amount of intervention because it leads to better maternal and baby outcomes. However, if you are having trouble finding someplace to deliver a VBAC (which is a shame, IMO), and you feel fine about scheduling a c-section, then you really need to do what makes you feel most comfortable.

[Rubix]

I think you need to go with your gut as well. 

 

For me, I chose a VBAC.  I was induced, and if I go to my due date, they will likely induce again, this time due to high blood pressure, with my son who was VBAC he had very low fluid and ended up pretty stressed with meconium.  The VBAC was still very successful though, and obviously I would do it again.  My OB doesn't have a problem with inducing for a VBAC, didn't have trouble with them allowing me to try a VBAC or anything.  They do not like to do more than 3-4 C Sections though.  Since my first was a C/S, and I knew I wanted 4 kids or so, it was worth it to me to try. 

 

For me, I felt like it was what I should do.  I'm very careful with the dangers I expose my kids/babies to, and despite the higher risk to baby with a VBAC, I still felt and feel like for me, it was the way to go. 

 

If you feel led to do another section, I don't see anything wrong with that!

 

ETA: I've never went into labor either, although I didn't really fail to go into labor...my first was at 37 weeks due to blood pressure issues & breech presentation.  DS was over 39 weeks but no signs of labor when they induced.  I have no idea what that is like, hopefully this time I will do it on my own :)

[Ann.without.an.e]

Well thats the same everywhere but you can generally find someone who has a dr who has agreed to back them. They dont usually have to be in the room or anything.

 

It may well be you are led to choose c section bc that is the right choice for you. Listen to your instincts is generally good advice.

The physicians in this area will not put their license on the line. If something goes wrong, it falls under their license and malpractice insurance. I know of not a single midwife that delivers at home legally. The only legal midwives deliver in a hospital or similar delivery center.

[eloquacious]

Thank you, Bolt.  I can't explain it.  I am very holistic, natural, organic, crunchy, etc so I should feel the need to go as far as necessary to get that VBAC, but my gut says no.  I have no idea why my gut says to go for a section.  I can't explain that.  

 

 

I know EXACTLY how you feel. My first was supposed to be a home birth, but wound up being a transfer with emergency C/S. The problem was that my water broke, but labor didn't start. Similarly, with my second I had Pitocin again, only this time the baby's heart didn't crash. We did eventually have another C/S, but that was because his hand was out ahead of his noggin.

 

So not only do I not go into labor, but also I've never had a vaginal delivery. My doctor and hospital are the exact opposite of yours, as it sounds. He is super pro-VBAC and the hospital is totally open to it.

 

BUT. But. I don't want to have an induced labor (Pitocin) because that ups the risk of uterine rupture. And the constant monitoring and not being able to assume certain positions, probably not labor in the water, etc... that all makes it that much less likely that the VBAC will succeed. Given the choice between trying for a day or two, esp. on Pitocin, and just scheduling the C/S, I confess I'm tempted. The main thing stopping me is the knowledge that the two very active little men I already have will make recovery that much more challenging. (And for me, the second C/S recovery was far more difficult than the first.)

 

Sigh. Why do you think your gut is leading you towards C/S?

 

And for what it's worth, I'm 39 weeks now... so I'm trying everything I can to go into labor naturally. I just had an awesome pedicure with crazy foot rub earlier today. But after all that, I still can't help but feel that I'll wind up on the operating table anyway. I just hope that it doesn't involve a rupture, because that seriously messes up your recovery. (More blood loss, longer surgery, won't get to see the baby as soon, etc.)

[JudoMom]

Congratulations!

I agree--go with your gut.

 

FTR, my first was an emergency c-section, and the rest were VBACs.  I was induced for all 5.  I did have to have an epidural hooked up, just in case something went wrong.

 

[Ann.without.an.e]

Sigh. Why do you think your gut is leading you towards a c section?)

Even the doctor and hospital that might "possibly" entertain the idea are not pro-VBAC. I honestly

Feel that in the end they will search for a reason to section. Also, they will not let me pass 40 weeks and they will not let me be induced. I know my history and I know how unlikely I am to go into labor on my own. I waited til 42 weeks with two of my kids. The other two were past 41 weeks. I still had no signs of labor! I fear that getting geared up for a VBAC will be a road to disappointment. I feel like i will jump through hoops and do all of that traveling just to be let down. if i went into labor on my own and/or i was in a vbac friendly area, it would be worth the gamble. I am typically an optimist. :)

[eloquacious]

Even the doctor and hospital that might "possibly" entertain the idea are not pro-VBAC. I honestly

Feel that in the end they will search for a reason to section. Also, they will not let me pass 40 weeks and they will not let me be induced. I know my history and I know how unlikely I am to go into labor on my own. I waited til 42 weeks with two of my kids. The other two were past 41 weeks. I still had no signs of labor! I fear that getting geared up for a VBAC will be a road to disappointment. I feel like i will jump through hoops and do all of that traveling just to be let down. if i went into labor on my own and/or i was in a vbac friendly area, it would be worth the gamble. I am typically an optimist. :)

 

Makes sense.

 

Even as pro-VBAC as my doctor is, I still feel like the cards are stacked against me. My husband agrees...he's the one who said we should just schedule. 

[Ann.without.an.e]

Makes sense.

 

Even as pro-VBAC as my doctor is, I still feel like the cards are stacked against me. My husband agrees...he's the one who said we should just schedule.

Who knows....with a pro VBAC dr you may be just fine :). I am glad you can give it a try!

[Loowit]

I went to a birth center further away from my home with my second so that I could be in a VBAC friendly environment.  The local hospital was working on banning it at the time.  My sister who was pregnant at the same time was talked out of even trying for a VBAC by her doctor.  My doctor, OTOH, was very supportive.  But in the end I didn't go into labor even though they "let me" go to almost 42 weeks.  They would not induce, and I wouldn't have done it anyway, because of the higher risk of uterine rupture.  So I had a scheduled c-section.

 

I was very sad at first, but looking back it was the right thing to do and my birth experience, while not what I dreamed of, was okay.  I got a healthy baby boy out of it and that in the end mattered more than how he got there.  It took me a long time to come to terms with it, because I had spent so much time studying up on VBACs and hearing wonderful stories about how great they were, etc.  While a c-section didn't fit with my ideal, I realized that I could still be crunchy, wholesome, etc. in other areas of my parenting.

 

When I got pg with my third I was told that they would do a c-section and VBAC wasn't an option for me.  It really helped knowing it and coming to terms with it early on in the pregnancy so that I could focus on having a healthy baby.  I was actually looking forward to a planned date and everything, then I ran into complications and ended up having him early and he was in the NICU for about a week.  Birth is a great unknown and sometimes you just have to follow your gut.

[Elfknitter.#]

(I haven't read all the responses)

 

Maybe this site could help: http://vbacfacts.com

 

There's also a Facebook page with lots of info.

[NASDAQ]

I had two emergency sections and then two VBA2Cs (in a hospital with an OB).

 

In terms of recovery, my first and fourth labours were the easiest to recover from, then the third, then the second. The worst recovery was from the first VBAC.

 

VBACs carry a non-negligible risk of uterine rupture. I would not have done them except that we weren't near done our family and the risk for placental problems increases with subsequent pregnancies.

 

A section can be a nice experience. It doesn't have to be the lights-and-sirens type of the emergency c-section. I would do that if that's where you're feeling led.

[ktgrok]

For me, the biggest factor was that a VBAC is safer for mom than a repeat c-section. For me, with that many children at home counting on me, that would be a deciding factor. Also, if there is any chance you will have more children the risks of c-section go up with each one. So with one c-section your risks in this pregnancy of placental problems is slightly increased. If you have two sections the risk in your third pregnancy of placental problems would be significantly increased.

 

As for you going into labor "on time", that's a scare tactic. There is zero evidence that 40 weeks is a good cut off. It's just a way to get around doing VBACs. I know MANY women that were given cut offs by doctors and at the end refused the c-section. The doctor really can't drop you at that late a date according to accepted medical ethics, and really, they don't care that much. Generally the women bargain and do non stress tests or biophysical profiles until they go into labor. Personally, I've had two VBACs, both were at 41 weeks 5 days. If I'd had a c-section at 40 weeks I would have had a baby born almost two weeks early!  

 

Also, even if you do agree to the c-section at 40 weeks at least you get a full 40 weeks. With your local "no VBAC ever" doctor I am sure they will want a section at 39 weeks to make sure you don't go into labor, if not earlier. And, given that you normally go late, that's going to be REALLY early for your particular baby. So another reason to go with the farther away doctor. 

 

Finally, are you in contact with ICAN? If you have a local chapter they can hook you up with the doctors with good VBAC rates and policies. There is a national website, national yahoo group (which can get a bit rowdy I hear) and there are local chapters. I'm a leader in my local chapter, and would be happy to discuss this further, either here or via PM. 

 

Hugs..it sucks to have to fight for what you want in pregnancy. But, as a fellow leader says, personal responsibility is a b*tch. 

[ktgrok]

After my first unplanned c-section, I was told that the medical risks of a VBAC and a planned c-section for my 2nd pregnancy were approximately equal, and therefore the choice was entirely up to me. I was also told that for a VBAC, I would need to be constantly on the monitor, unable to move much or do any of the more active labour-relief techniques.

 

Given that I was looking at a less-than-ideal (highly medical) labour vs a quick (highly medical) c-section, I opted for the c-section.

 

Honestly, I know that "regular" labour is less risky than a c-section (and therefore much to be prefered) but when the options are medically equal, and you've already had a "c" I've never understood any fear or shame about going with the surgical option. So many women seem either terrified or ashamed that they might "have to" have a c-section. It's honestly a perfectly normal way to have a baby, and no big deal.

 

I know you didn't mean any harm by this, but I do want to let you know that many women might be offended by what you wrote. 

 

Major abdominal surgery is always a big deal. Risking life threatening complications is a big deal. Being separated from your baby for up to many hours (as is standard in MANY hospitals) is a big deal. Being unable to pick up your other children is a big deal, Being unable to drive is a big deal. The numerous infections that many women get is a big deal. So yeah..it's a big deal. I'm gad yours went well, I'm glad you recovered well. But I sit each month with 20-40 women who have issue surrounding their births, and for them being told "it's no big deal" is part of what keeps them upset. It denies them their own emotions, and minimizes what they have gone through. So please....be careful with your words. 

[ktgrok]

As for inducing, many doctors are willing to do an induction with a foley bulb, if you ask. It doesn't involve any drugs, and doesn't increase the chance of rupture. They just put a plastic bulb like they use for catheters in your cervix, and inflate it with water. The weight of the water pushing down on the cervix helps it to start dilating. Which can trigger labor. Or, if it doesn't, at that point the cervix is open enough to break your water, which is also a safe method in VBAC women. Happens all the time, you just have to ask for it. 

 

I hate to see a woman have surgery just because it is more convenient for the doctor. I would never have, say, unnecessary gall bladder surgery just because the doctor didn't want to bother doing another, equally valid treatment. 

[texasmama]

Thank you, Bolt.  I can't explain it.  I am very holistic, natural, organic, crunchy, etc so I should feel the need to go as far as necessary to get that VBAC, but my gut says no.  I have no idea why my gut says to go for a section.  I can't explain that.  

I had four vaginal births, and two of them were unmedicated.  I lean natural and holistic like you.  However, in your situation (particularly given that you don't go into labor on your own), I would opt for the c section.  You are not crazy.  I think your gut tells you that you may be chasing something that is unlikely to happen with your circumstances.  I would be disappointed if I were faced with your situation, but I would likely choose the c section.

[happypamama]

I am a home birthing mama, so I would do whatever I could to avoid an unnecessary c-section.

 

However.

 

If your gut is telling you to go for a c-section, I would give your gut serious consideration. Our instincts are there for a reason. I absolutely feel that my son's birth was safe and okay because I listened to my gut feeling (which, as a Christian, I attributed to God' Spirit speaking to me, and when He prompts, I listen!). So it may well be that you need another c-section.

[NASDAQ]

I know you didn't mean any harm by this, but I do want to let you know that many women might be offended by what you wrote. 

 

Major abdominal surgery is always a big deal. Risking life threatening complications is a big deal. Being separated from your baby for up to many hours (as is standard in MANY hospitals) is a big deal. Being unable to pick up your other children is a big deal, Being unable to drive is a big deal. The numerous infections that many women get is a big deal. So yeah..it's a big deal. I'm gad yours went well, I'm glad you recovered well. But I sit each month with 20-40 women who have issue surrounding their births, and for them being told "it's no big deal" is part of what keeps them upset. It denies them their own emotions, and minimizes what they have gone through. So please....be careful with your words. 

 

Is uterine rupture a big deal?

[Jenn121]

Yes, uterine rupture is a big deal but I believe that what ktgrok meant is that those of us that end up feeling misled, betrayed and pressured by the very medical system that we trusted, feel that our valid feelings of grief in losing our envisioned birth have been pushed aside too often by the comment of well meaning people that say to us, " Oh well at least you got a healthy baby out of it. No big deal." But considering there are many emotions, desires and hormone involved in birth it is a big deal.

 

I am not talking about a truly medically needed intervention but things done for convenience of Dr's, CYA or without informed and unpressured consent of the mother.  

 

 

To the OP....I had an 3 day induction that ended in a C/S with DD1. With DD2 I was given the option to try to VBAC but due to the fact I have chronic HBP and was on meds they did not me to go past 1 week over. I did go 1 week over and my "gut" told me to schedule. It turned out she had a short cord and it was wrapped around her neck twice. She would have died.  I am a big believer in listening to your instinct. 

 

I am currently 18 weeks with child #3 (find out next week B or G) and I have a complete placenta previa so I have no choice but to schedule. Our insurance( Kaiser Permanente) does not allow VBAC2C. So I would have had to pay out of pocket and find a midwife that is willing. A hard find even out here in crunchy granola Northern California

 

Prayer for your decision making.

 

[8circles]

My first was a c/s and my other 3 were VBAC.  I don't have anything against sections, my recovery was actually better than my VBACs.  But I didn't want unnecessary surgery & in my situation there was no medical reason why an automatic section would be better, so I felt doing it the most natural way made more sense.

 

I had 3 different drs for my VBACs and I didn't have any of those restrictions on my VBACs.  I was post-dates for each one, was given pitocin to keep the contractions regular, was able to walk around during labor.  I did have to make sure that I delivered at a hospital with an OB on site 24/7.  Besides that I was good to go.  My last baby is 3, so not that long ago.

 

Yes, uterine rupture is a risk.  I think I remember it being like one in 500 chance.  There are also many risks to c/s and the risks increase with each surgery.  I think the risk of blood clots is like 5 times greater after a c/s than vag delivery.  

 

Either way is a valid choice.  You have to decide which one is right for you.

[Heather in OK]

If your gut is telling you something, don't ignore it.  

 

 

 I've never understood any fear or shame about going with the surgical option. So many women seem either terrified or ashamed that they might "have to" have a c-section. It's honestly a perfectly normal way to have a baby, and no big deal.

 

 

 

Because some women have had quite traumatic c/s experiences.  So yes, some women are horribly terrified of going through that emotional trauma again and having another c/s.   

And it is a big deal.  It is major surgery.  There are more risks involved with c/s than there are va*inal delivery.  

[NASDAQ]

My first was a c/s and my other 3 were VBAC.  I don't have anything against sections, my recovery was actually better than my VBACs.  But I didn't want unnecessary surgery & in my situation there was no medical reason why an automatic section would be better, so I felt doing it the most natural way made more sense.

 

I had 3 different drs for my VBACs and I didn't have any of those restrictions on my VBACs.  I was post-dates for each one, was given pitocin to keep the contractions regular, was able to walk around during labor.  I did have to make sure that I delivered at a hospital with an OB on site 24/7.  Besides that I was good to go.  My last baby is 3, so not that long ago.

 

Yes, uterine rupture is a risk.  I think I remember it being like one in 500 chance.  There are also many risks to c/s and the risks increase with each surgery.  I think the risk of blood clots is like 5 times greater after a c/s than vag delivery.  

 

Either way is a valid choice.  You have to decide which one is right for you.

 

Uterine rupture is more like 1/100. At one time it was thought to be much lower than it is, which is why the recommendations changed and fewer hospitals do VBAC now.

[Jerico]

I honestly would schedule the c-section. Especially if there is something in your gut- listen to it.

[eloquacious]

Is there a price differential between a VBAC and a C/S? We don't have maternity coverage, so for us it would be around $4K more for the C/S, even with cash pay options... Definitely something on my mind. My husband doesn't care as much, though of course it is a LOT of money. I guess I should rephrase and say that he doesn't want it to be the deciding factor, while I feel the weight of that extra money deeply.