Scheduled C Section Vs. VBAC

Updated on March 04, 2009
G.Z. asks from Monterey Park, CA
17 answers

Hello wonderful mamas! I've got a long post/question this time around. I am entering my 35th week of pregnancy and lost an aunt 4 weeks ago. It was all very sudden and very unexpected. She went in for a hysterectomy on Monday and died Friday after going into cardiac arrest. The hospital's report has the cause of death as a pulmonary embolism. We are awaiting a coroner's report to find out what exactly happened. Prior to losing my aunt, I was all for scheduling a c-section with this pregnancy. Needless to say, I am totally freaked out now. I'm always looking up the risks and I am having a really hard time coming to terms with either delivery method. Now I know she needs to come out one way or another, I'm just spooked about the whole thing. I talked to my Dr. about it and I'll be seeing her again on the 9th. It took a long time for my Dr. to get the previous c-section report from the hospital where I had my son so I will not be finding out if I can even attempt a VBAC until next Monday. I know the risks of blood clots increase with pregnancy, surgery, obesity, and such and I feel as if I am doomed to suffer from an embolism. I'm really trying to get a grip and just feel overwhelmed. Any experiences/thoughts/advice you have on this?

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S.A.

answers from Honolulu on

First of all, I am so sorry for your loss...
I would say just trust your doctor on this one. If she thinks a C-section is better, than that is probably what is safest for the baby and you. It is totally normal for you to be a bit freaked out right now, but think of it this way - how many "routine surgeries" are done in the U.S each day? And how often do people die as a result from those? The stats are definitely on your side ;)
It's kind of like when a plane crashes and someone says "I will never get on a plane again in my life" - well, that is kind of an irrational fear, because thousands of planes fly around the world every day - and how often do you really hear about a plane crash?
Trust your doctor (and your own gut feeling too) and just do what is safest in the end for you and baby, (becuase VBAC can also have complications- just something else for you to research).
Good Luck and congrats :)

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J.H.

answers from Los Angeles on

I am so sorry for you loss. As far as your question: Each mode of delivery comes with its own set of risks. Birth is one of those unknowns were we have to let go of our own control. For me, after having 2 sections I decided that the risks of VBAC were less then having another c/s. You have to accept responsibility for your own choices and not allow others to bully or dictate your choices for you. If you were to go for the VBAC I would make sure you avoid induction, as the medicines used seem to be the main contributor to rupture. One year ago today (happy birthday little guy), I had a wonderful home water birth after 2 c/s (HWBA2C). I would suggest going to ican-online.org and doing as much research as you can. YOU CAN give birth vaginally if that is what you desire. For me, the risks associated with c/s were too great a cost.

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D.G.

answers from Las Vegas on

Take a deep breath and quit freaking out about your aunt's embolism (my sympathies about her passing) -- but you are not destined to have one just because she did!!!!! Obviously, there are risks associated with VBAC and with C-sections. Generally there are more risks with c-sections because of anastesia, etc., but it does depend on the reasons for the original c-section. My first delivery was an emergency c-section and because of a small birth canal, I was not a candidate for VBAC with my second and third. I'm sure you will receive success and horror stories from both methods, sooooooo-- have a long discussion with your OB, discuss the advantages/disadvantages and risks of both methods, and based on YOUR OWN medical history make an INFORMED decision. This should reduce your worries and anxieties and allow you to relax more and enjoy(???) the rest of your pregnancy. Good luck.

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M.I.

answers from San Diego on

Hi, I'm mommy to 4 kiddos. My first was breech and we did not find out till I was in to be induced so we had a c-section. All went well and c-sections I have to say have their good sides ( less pain to sit afterward... ) The last 3 were all successful v-bacs. All induced even since I seem to have large kiddos and don't seem to want to go on time. I am terrified of anesthesia ( no real reason just am ) so the v-bac was a welcome option for me and it worked well 3 times even though some doctors were hesitant. Doing a v-bac successfully may be impacted on why you had the 1st c-section, but it can work. If your doctor sees no reason not to it may help ease your fears. Just read up on it because it does carry risks and if size was an issue 1st time it may not be right for you this time. There are risks either way, but for me I just had to go with what felt was right. Both options had positive outcomes for us, but I have to say I am very glad I had the option and was able to do the V-bacs for so many reasons. Try to make the most informed decision if both do become an option. Having a new baby is overwhelming in the best of circumstances and when something else adds to the worry I know it can be so scary. Good luck and my thoughts are with you .

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T.O.

answers from Los Angeles on

Hi G., and Blessings on your pregnancy!

The evidence supports a VBAC for safety. Dr's will always tell you that you have the risk of uterine rupture with a VBAC, but what they don't tell you is the statistics show that happening only 0.4% of the time, and most of those occured during a cytotec induction. The complications resulting from repeat surgery are greater including risk of infection as in any surgery. Of course you need to make sure you are a good candidate, but get a copy of your records for yourself and look into it, don't rely on your Dr. to tell you if you are a candidate. Also, see www.VBACfacts.com for more information on VBAC's.
Either way, I pray you will have a positive birth experience, and you come away not only with a healthy baby, but good memories and the feeling of empowerment over your choice to birth your way, no matter which it may be. :-)

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T.

answers from Las Vegas on

G.,

I had a successful VBAC on October 14, 2006. My c-section was 9-11-03. I knew I didn't want another c-section unless I had no other choice at all. My recovery was long and painful and I didn't want to go through that again with a 3 year old at home, too. The recovery was SO MUCH easier with the VBAC. I had my son at 4 a.m. and was up walking around by 7. I felt good, I could get in and out of bed without help, it was fantastic. The risks that go with VBAC are actually pretty low - not really all that different than those that are associated with a normal childbirth. The risk of death is certainly lower with a VBAC than a c-section. Folks forget it is still a major surgery.

I think the main thing is to educate yourself, feel comfortable with your decision, and have the support of your doctor. It is good to discuss your concerns with your doctor and seek their input. Just in general, the risk of waking up every day is that you might not still be alive at the end of that day. There are no guarantees. But in the grand scheme of things, with either a VBAC or a c-section, the odds are strongly in your favor that everything will be fine. I can definitely understand your concerns but you just have to have faith in your body to do what needs to be done and have faith in your doctor to take care of any problems that arise no matter which birth you choose. I have a friend who was in her late 30s that died 5 days after having a very minor knee surgery. She had a blood clot that traveled to her lungs. It happens. But fortunately it isn't the "normal" outcome. Not that I'd sign up for knee surgery unless I really, really needed it. LOL {{{Hugs}}} and good luck and peace in whatever you decide.

T.

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K.M.

answers from Las Vegas on

You know this is a very touchy subject for many women. I wanted a vaginal delivery and had to have a c-section. I was ok with it because I knew that was the only way my son was coming out. I trusted my doctor with my life and knew that everything would be ok. Of course, I was terrified!! I had to mentally prepare myself to have this surgery. I blocked out everything surrounding me and went to a happy place...a beach on a stranded island :). I go back and forth all the time whether I want my next child to be c-section or vaginally. But when it comes down to it I think the only way it will happen vaginally is if the baby comes way to quick. Other wise...for me...c-section is what I'm going to do. (The bonus with c-section is you don't have to go through labor...I'm all about that!!!)
I had a sis in law who had an emergency c-section with her first child. Her second child she wanted to try vaginally. Well she did and almost lost her life and the baby's. I had another sis in law who had a vaginal birth first time around, emergency c-section the second time around, and her third time around had a VBAC. She had a horrible experience with her c-section and she vowed to find a doc who would do a VBAC. I would love to have a vaginal delivery but don't know if I want to risk it. Women who do had vaginal deliveries first, then c-sections, usually do better with VBAC's verses someone who has only had c-sections. If you think about it anything and everything we do could cause death. Some women's bodies respond differently than others. I truly believe that there is a time for all of us to leave this earth. If you trust your doc then everything will be fine! I think it's just easier to do the scheduled c-section, especially if you have already had one.
Good luck in your decision! I wish you the best!!

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D.E.

answers from San Diego on

Hi G.,

I'm so sorry for your loss. You have been through a tragedy. You are smart to talk to your doctor about this issue.

I think that if your doctor says that you can do a VBAC and you want to do one, why not? However, be aware that you might just end up with a C-section anyway, and you will have gone through the labor and fatigue unnecessarily in that case.

I had my son via emergency C-section after a long labor. I will not be making that mistake again--we'll schedule next time. I was too exhausted and in pain. I'm sure it will not be a cake walk no matter what, however I felt so cheated after doing all the physical work only to have it end in surgery after all. Remember, a C-section takes only about 30 minutes!

Buck up, G.--I'm sure you are NOT going to die no matter what. :-) You have had a bad scare and been through a sad event. You and your new baby are going to be fine.

Think positive thoughts! I will pray for you!
:-) D.

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T.D.

answers from Los Angeles on

I'm so sorry to hear about your aunt. It's clear that she was very loved.

As for another c-section, you are right to be concerned because even though they are very common, it's still major abdominal surgery (as you well know, having been through it). I have found that many doctors push for repeat c-sections and exaggerate the risks of VBACs because it is so much more convenient (and profitable) for them to do c-sections. They don't want to have to monitor you all night and deliver a baby at 4:00am. They'd rather be in bed than give you and your baby a natural, pleasant, memorable birthing experience.

In reality, the risk of uterine rupture during a VBAC is less than 1%. I was fortunate to have a doctor who was honest with me and willing to work with me to make my 2nd daughter's birth a more natural experience than my first which was a surprise c-section due to the baby being breech. Simply being pregnant and giving birth, no matter the method, carries risks. There's no way to avoid it. But having gone through both a c-section and a VBAC, I would highly recommend you give VBAC a try, providing of course that your doctor clears you for it.

Best of luck to you for a quick and painless delivery!!

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A.L.

answers from Los Angeles on

Lots of doctors seem to say that a section is safer in your situation, but from what I've read, the risks are much higher with a repeat section than with a VBAC.

According to Ina May's Guide to Childbirth, many maternal deaths are not properly reported (or reported at all) in hospitals as being a result of childbirth, and her educated guess is that most of the deaths are related to surgical births. She also writes that repeat sections are much riskier than VBACs, even after a few sections. The method of closing the incision is where the risk lies in a VBAC, as is the direction of the incision.

When it comes to childbirth (particularly with an uncomplicated pregnancy) natural is best. Proper preparation is important, in order to reduce your risk of having an emergency section.

If possible, check out ican-online.com, and watch the movie called The Business of Being Born, and read Ina May Gaskin's book, Ina May's Guide to Childbirth. If you go with a VBAC, look into birthing methods besides lamaze... hypnobirthing is the one I used with my last birth, and it was beautiful and relaxing and we had a wonderful experience with water birth.

Good luck in whatever you choose, I'm very sorry for your loss. Just remember that no matter what you decide, the possibility of giving birth to a healthy child without complications is much higher than the other way.

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A.G.

answers from Reno on

Hi!

I can only give you advice on what happened with a friend of mine as I only have 1 child. My friend in KY had her first baby by c-section. Then she decided to have her next one VBAC. Not only did she have her next 3 babies vaginally after the first one as c-section, but for her 4th baby she and her husband were in Belgium when she gave birth. The midwife there evaluated her at her home to see if she would be able to make it to the hospital and decided she couldn't. So her 4th baby was not only natural but a home birth at that. I guess home births are very natural in Belgium and she had no problems at all.

I would say if the dr says it's safe for a VBAC then do it. Babies born vaginally have less respiratory problems as the travel thru the birth canal helps expel the liquids. And your recovery time is so much less and you can do more much quicker than after surgery.

Good luck!

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F.H.

answers from Los Angeles on

I had a VBAC water birth at a freestanding birth center and was attended by a midwife. It was the best decision I've ever made. There were absolutely no complications and it was very personal and safe. I know it can be tough to find a care provider who is willing to support a VBAC and I think this is mostly for legal reasons. The evidence supports VBAC as a safer method of delivery than repeat c-section. Check out ICAN.org. You'll find lots of great information and support there. Best Wishes!

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C.H.

answers from Honolulu on

First of all, I am sorry for your loss. My father died from cardiac arrest from angiogram and my mom died 8 months after my baby from undiagnosed ovarian cancer. Its hard! Health is fragile. Keep drinking water, taking minerals, being positive. go for the vbac if you have the horizontal incision on the uterus. There is a csectionrecoverykit.com that is great, if you should need a binder post surgery or post pregnancy to help with the abdominal support. The best way to avoid blood clots is through hydration, exercise, and movement. Point /flex feet to move blood through legs, and stay positive. Your loss is real, you deserve support!Be well-

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B.N.

answers from Los Angeles on

First, please accept my most sincere sympathy about the loss of your aunt. I think I know what you are thinking... her operation was routine and so is my c-section. Everyone is so very different. What happened to your aunt is so very sad however I am sure that she would not want you to be frightened about having your baby because of what unfortunatly happened to her. Every surgery is so very different. As long as you trust your doctor, try to relax. I had an unelective planned C-section at 40 weeks and I was so scared. The day of my surgery I found peace in knowing that I would meet my son and my life would change forever. All went fine and I would do it all again in a heartbeat. Try to remember that this all about having a healthy happy baby. Relax and know that whatever is going to happen will happen and that stressing your body out will not help anything. Take a deep breath and know what your daughter has a very special guardian angel watching out over her AND you. Everything will be fine. Try to relax. :)

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J.W.

answers from Los Angeles on

Take a deep breath and relax. What happened is not the norm. When something like that hits that close to home it is normal to fear it will happen to you as well. I am so sorry for your loss. You will be just fine mama. Just talk things out with your doc and do what is best for you. They will do a spinal block with a c right? I don't think they put you under for that. I know it is easier said than done, but try to relax and be at peace. You have already been through alot and the stess of worrying is not good for you and baby. Take care.

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S.H.

answers from Honolulu on

I've had an emergency c-section with my first born and a scheduled c-section with my 2nd born.

My doctor, although he gave me the option for a VBAC with my 2nd baby... does not recommend it. He said it's very risky for both Mom and baby, and that internal hemorrhaging can occur (and death)... or if carried full term (c-sections are done 2 weeks prior to the due date for safety), that it can rupture a previous c-section incision thereby bringing on complications.

Anyway, my Doctor said it is wiser to go with a c-section. I chose a C-section. Am happy I did. I felt better that way.

Mind you, not all Doctors will perform a VBAC after a previous c-section, and some hospitals will not allow it... because of the dangers to both baby and Mother.

All the best... I know you are spooked, but the probability of this happening to you is more an imagined scenario, versus a 'real' one.

And as Sophie said... a VBAC after a c-section has its real risks too... to both Mom and baby.

take care,
Susan

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S.M.

answers from Honolulu on

Everybody has a different experience. My first birth was an emergency c-section. My second a vbac. I was very worried about my second delivery, but it went fine. My mother went the other way and had a planned c-section. Neither of us regret our decision. We can all tell you how we feel about our decisions, but in truth, the answer has to come from you and your doctor. Trust your body and your instincts. Listen to the advice your doctor gives you. I wish you the best of luck.

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