Seeking Advice on Second Delivery. to VBAC or Not to VBAC

Updated on September 10, 2006
S.T. asks from Jacksonville, FL
31 answers

My first delivery was a c-section due to the fact that my daughter was in a breech position due to a retro flex uterus. I am 8 months pregnant and doc has said this time it is my choice to either do vaginal or another c-section. I am at a loss of what to do. In a way I want the experience of vaginal but I am scared because for one this would be new to me and two I worry about a uterine rupture which I know is rare but could happen. Anyone that has been in my shoes, I can sure use some advice. thanks, S.

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So What Happened?

ok, so its now the second day of December. I wound up not having a choice when it came to VBAC or not. It turns out that I had to have a section. I had severe endo and a very very thin uterine wall. I could have been in grave danger if I would have gone natural. I had a beautiful baby girl 7 lbs 4 ounces, 19 inches long. Although I cant have any more children, God has blessed us with two beautiful, precious girls and for that we are thankful. Thanks to everyone for all the advice and well wishes. S.

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J.

answers from Jacksonville on

My friend just went through this and decided to deliver vaginally and was thrilled with her decision. I was fortunate enough to have all three vaginally I say go for it! You may never get a chance to experience this type of event ever again and it is truely an amazing experience.

Good luck with whatever you decide and congratulations!

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N.E.

answers from Tampa on

If there giving you a choice I would choose Vaginal. Having had a Vaginal birth and 2 C-sections I would have choosen Vaginal, healing time is less and already having a child at home that is important.

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C.V.

answers from Miami on

I had a c-section with my daughter. My sister in law went allllllll the way through labor and then had to have a c with her first. She just had her 2nd last week and had a planned csection and it all went beautifully. I say go with the Csection.

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R.S.

answers from Sarasota on

Hi S...I was in your shoes not too long ago. I thankfully had a very good vaginal delivery for my second baby and loved it so very much! The recovery is so much easier especially since you have to be chasing around another child. My delivery went just perfect. I know people worry about the uterine rupture but I did a lot of research on vbac's before I decided to do it and the risks that you have with a 2nd c-section are in my opinion greater. I think a lot of doctors don't like vbacs because if somethine were to happen they could get sued and all that legall mumble-jumble. But my experience was just really fantastick and I would have another baby vaginally any day over a c-section. And my baby's were only 14months apart..which they recomend atleast 18 months and I was just fine. And I think you said yours was 5 years old. Whatever you decide to do just stick with it and I'm sure that you will be happy!! I know others who have chosen to do repeat c-section and they thought it was just fine too! I just think the recovery is a lot better! Hope this helps some!

R. S.
Sarasota fl

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S.G.

answers from Tampa on

My thoughts are with you as you make this tough decision. I had an emergency c-section with my first child and it was done vertically so I did not have a choice. I can tell you it was much easier doing the scheduled c-section than the emergency one. You choose the day and can prepare you other child better. You will stay in the hospital 48 hours, but that was kind of nice. Older daughter got use to having dad help her do things and I got some time for just me and new baby Sara before coming home to big sister and lots of help. Like I said good luck with your decision. What ever you decide just needs to be right for you.

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M.O.

answers from Sarasota on

I will be in your shoes the next time I deliver. I was forced to have a caesarean because my son was breech and I fretted over it forever because I really wanted to deliver vaginally. They offered us the opportunity to try to turn him in order to allow me to deliver vaginally. We opted not to and it's a good thing....once they performed the caesarean, they realized why he was breech....I have a rudimentary left horn, which basically means that I only have half of a uterus. I will tell you that my obstetrician, who is one of the best in the area (especially for unusual and difficult cases) refuses to do a vbac regardless of the situation. A lot of obstetricians are starting to take that stance as well. I had to think long and hard about it when they gave us the option of trying to turn him and I asked myself the same question that I'm going to ask you. Is the possibility of rupture (danger to you and the baby) worth your being able to say that you gave birth to your baby vaginally? The baby is not going to know any difference, in fact, the baby will likely appreciate the caesarean birth better. You already have the scar and didn't have to experience the tearing and/or episiotomy. Why put yourself through both? Not giving birth vaginally does not make you any less of a woman than those who do. In fact, my girlfriends who had to go through labor and then have a caesarean at the last minute are all thrilled about being able to go straight to the caesarean this time. If nothing else, you could decide to give birth vaginally and then have to have an emergency caesarean, which would mean that you'd miss the birth entirely. Personally, I don't think it's worth potentially missing seeing my newborn come into the world. Sorry for the rambling, but this is something that I've thought about for the past six months as my son is now five months old and the best thing that has ever happened to me.

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M.I.

answers from Orlando on

S.,

Please, please educate yourself on VBACs. So many women are paralized by the fear of uterine rupture. The facts are that the chances are very slim and doctors and nurses can also watch how your uterus is reacting to contractions and they can tell throughout your labor if it's being over stressed. The other thing I will say is that you should not be given Pitocin with a VBAC. Pitocin can produce extremely hard contractions that can over stress the uterus. Please tell us who this awesome doctor is?

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D.

answers from Sarasota on

I had my son in 2000 via c-section--he was breech. I wanted a VBAC with my daughter (born 2003). I had a hard time finding a dr. willing to do a VBAC. I hired a doula and labored at home as long as I could. I arrived at the hospital- already 8 centimeters. No pain medication--nothing. I was so glad I labored. It was amazing. I was smiling between contractions. The nurses couldn't believe it.

Unfortunately, I did not progress from 8 centimeters and after 12 hours of labor-with no progression- (my baby was starting to show signs of distress).---we ended up going for another c-section----After all that. We were all healthy and happy. It all worked out. Follow your heart.

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J.W.

answers from Melbourne on

Hi S.!

I didn't have a choice of VBAC when I had my second baby (my doctor doesn't allow his patients to do them). I was a bit nervous because I remember the recovery from the first one...but let me tell you I was up and about MUCH faster with the second one! I was off the pain killers and sitting up within no time. So whatever choice you make, just know that if you choose another c-section it isn't much to worry about! plus you have the benefit of actually knowing when to go to the hospital and being able to arrange child care for you older child!

GOOD LUCK!!!
Jen

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S.M.

answers from Tampa on

Hi S.,

First I'll address the issue of uterine rupture. ACOG (American College of Obstetrics and Gynecology) state that the risk of a uterine rupture with a VBAC is no higher than for someone who has never had a c-section (if she has had one c-section). A woman doing this shouldn't be induced with cervidil as this increases the risk by 25%. A great website to reserch this is ICAN.org also looking at cochrane.org (evidence based information) and ACOG.org may help with that decision.

Secondly, I've done both (and the vaginal was natural without meds). Recovery from a c-section was far more intense (even if there is an episiotomy or tear).

I think it's wonderful that you have a Dr. giving you a choice. Whatever decision you make at least you'll know it was your educated choice and something you are forced to do.

S. Mills
Touched By An Angel
Childbirth Services, Inc.

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A.

answers from Ocala on

I am mother of 3 happy children. I gave birth natural on my pregnacies. I think is great becuase you feel at that time but when you finish your labor the pain is gone. The recuperation from natural is quite fast compare to C-section. Best of luck,
A.

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T.O.

answers from Sarasota on

Wow, that choice is new to me... 2 years ago I had my second son via repeat c-section. It wasn't even a choice for me. At the time Florida had a law that once you'd had one c-section all subsequent deliveries were via c-section, no questions asked. It's nice that there's a choice now. But at the same time, it's confusing too.
My advice is to go on your instinct and doctor's recommendation. I will say that as difficult as the recovery from a first c-section was, the recovery from a second was MORE difficult. I had a 2 year old to deal with in addition to the new baby, and recovering from major surgery and having 2 kids was tough. At the same time, there are tons of risks of the VBAC, like you said, especially the uterine rupture. I guess all you can do is know all the facts, know how much help you're going to have from friends and family especially with your oldest child, and then be willing to handle a last minute c-section (if you choose to try VBAC) if an emergency arises and the option becomes necessary. Best of luck to you and your family.

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R.

answers from Tampa on

I never had to expeirence a csection but have had several friends that have. It's a hard recovery. I know most doctors don't do vbacs. However, I did a lot of research in preparing for my birth and VBAC was always a big subject. YOU CAN DO THIS!!! It's natural to worry and fear something you have not experienced before. Not to mention our society makes up think it is the most painful thing there is. Women have been doing it for millions of years. I went with a natural child birth program (I had an epidural with my first and nothing with my second)and all I can say is WOW it's a great expeirience. I would imagine when a child comes in to the world it really doesn't matter at that moment as long as your baby is healhty. I just had my 6 week check up with my Midwife at Labor of Love in Dunedin and our converstation was focused on VBACs. I would really recommend that you call them and see if you can set up an appointment to speek with them. They will do it. They care about YOU the mother and would not judge you if you decided to go with a csection. These women have been delivering babies for over 25 years and are educated in the medical field. I highly recommend educating your self as much a possible and it will make your decision eaiser. You can find them at laborluv.com they have three locations Dunedin, Lutz, and Lakeland. I pray that you have a wonderful expierence wether you have a vaginal or csection delivery. CONGRATLUATIONS on your new bundle of love!!
R.

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M.

answers from Orlando on

I was in exactly your situation with my second daughter, who was born when my first was 4 years old. My first was also breech and the second was in position for vaginal. I opted to try the vaginal delivery because I absolutely HATED the recovery with the C-section and envied women who were up and around just minutes after delivering. I am very very glad I tried the vaginal, as it went well and I was up and around in no time. I also had the added incentive to do it this way because my first daughter is mildly autistic and was still a lot of work when she was 4 years old. She responds best to me and the thought of recovering from a C-section was dreadful to me. I am also a terrible delegator, so the whole recovery thing was h*** o* me. I know others have not been as bothered by it as I was. I've done both, though, and can tell you it was a HUGE difference. I'd do it again in a heartbeat.

Now some caveats: I don't have large babies. My first was 6 lbs 10 oz and my second was 6 lbs 7 oz. SOmeone who has a 9 pound baby might have bad tearing or episiotomy and might feel differently. But I'm very small - only 5' tall, so a 6 1/2 pound baby is not as small for me as for others. I had a tiny tear which didn't limit me in any significant way. Still much much much less invasive than having your muscles and uterus cut through. Yes, there are rare cases of uterine tearing. But if your initial incision was very low - as they typically are - and you've waited a number of years between the first and second - which you have - the risk is really really low. ALso, people forget that with a C-section there's a risk of infection and death because it's an invasive surgery. I'm an attorney and represent physicians in medical malpractice actions - and I can tell you there are bad outcomes with C-sections as well. I would definitely go to a large Level I type hospital because they are usually best equipped with the latest monitors and more operating rooms available in the event you needed urgent C-section. They also tend to have the most highly trained nurses. With careful monitoring, the risks are incredibly small. Of course, without this type of monitoring and if there IS a uterine rupture, the results can be catastrophic. As I recall, one of the things that is contraindicated is use of Pitocin because it can make your contractions too strong and if you're using epidural, you can't really feel how strong they are. Make sure they don't plan to give you any Pitocin to induce your labor. My doctor basically told me that if I went into labor myself and progressed without assistance, then I could deliver; otherwise, they'd wheel me into the OR and do a C-section. So just go into it realistically but don't feel disappointed if you end up with the C-section. My doctor told me he would not let me labor for 20 hours or anything like that because that starts putting too much strain on the uterus. My total labor was approximately 12-13 hours and I know I made the right decision. I hope this helps you and I wish you all the best. Please let us know what you decide and how things go for you and your baby. Good luck!! M..

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B.

answers from Tampa on

hi there. I have been in the exact same position. my now three year old girl was breech and I had a c-section with her. When I got pregnant with my son I decided to go v-back. I was nervous at first but the percentage of rupture is very rare, I think one percent. All went well and with out a single problem. I delivered my son completely natural with no drugs at all. I can say that I found it much more fulfiling to do it vaginal. Remember, you will be in the hospital if anything happens and they will be ready for it since they know your history. If you have any worries feel free to e-mail me.

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N.

answers from Orlando on

As an l&d nurse i am surprised your doctor gave you the option to vbac, must doctors don't do this anymore. you can always vbac, but you need to remember, you could labor for a while, never dilate or be unable to push baby out, since you did neither with first baby, if you are willing to try it out and be ok if you end up with another c-section after all that, or you can plan your day, time everything with a c-section. and yes uterine ruptures are rare, but do happen. that is way most docs don't do vbac's.

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L.H.

answers from Miami on

Hey S.,

I have had 3 c-sections. My first was an emergency (overdue) 14 yrs ago... It was really painful and took a while to recover.

However, my 2nd baby was a planned c-section and it was awesome. I knew exactly when he would be born and there was no labor pains as you plan the date a week before your due date. My OB said I could do a V-BAC but he advised a section would be better more predictable. Because there was a possibility of a rupture and then he would have to do an emergency c-section. There was no way I wanted to take that risk and go through that again. I was up and feeling back to normal in a week.Of course I think my Doc is the absolute BEST Doc in the world!!!

I also had my 3rd baby this past Dec. and it went awesome too. Had her Dec. 13 and was out Christmas shopping that Sunday!!! (Wasn't easy but just to tell you I wouldn't have been doing that if I had an emergency c-section!)

Hope I helped!!! PLANNED C-SECTION IS THE WAY TO GO!!!

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S.J.

answers from Fort Walton Beach on

S.,

My first child was a c-section due to fetal distress and the fact that I did not dilate. I was so relieved just to have her born healthy, that it really did not bother me not to have a vaginal birth. My second child was born last summer, via c-section as well. This time it was my choice, mainly because my husband was overseas and I wanted to be sure he was home for the birth of our son, although I think it would have been inevitable. My water broke about 2 hours before my scheduled surgery, and I was not close to being ready for a vaginal birth. In fact, they moved up the surgery by an hour. Looking back, I have a slight twinge of wishing I had a vaginal birth, but both of my babies were healthy, as was I, and that is all that matters. It also helped to know what to expect the second time around, and my recovery was just as fast as friends who had vaginal births. I hope this helps and either way, I am sure you will make the best decision for you and your baby! Good luck and congratulations!

S.

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R.K.

answers from Boca Raton on

read up on vbacs. go to my website www.palmbeachdoula.com. click on the be informed page. scroll to the bottom and read about c-section vs vbac.

I would LOVE to find out who your doc is. if you can email me personally that would be fabulous. ____@____.com

i can also reccoment a couple good books about vbacs and I have a couple clients that I would love to have you speak to so they can share their stories as well.
I wish you much luck with your new little one :)

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M.M.

answers from Tampa on

My OB advised me that any OB/GYN with malpractice insurance wouldn't do a VBAC cause of the dangers so I didn't even get a choice, but the recovery was much easier than the 1st time and I was awake to watch my baby be born (which I missed with the 1st one). I thought I would regret doing the 2nd c-section, but I don't. I was out of bed 6 hours after the surgery, and released from the hospital almost exactly 48 hours after my son was born. Do some research and make an informed decision. It's different for everybody, but I am really happy with the way his delivery went! Good luck.

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D.W.

answers from Tampa on

My first delivery was C-section. They induced and I never progressed (I think she wasn't ready to come yet). My recovery was a nightmare. I was determined to have a VBAC and did not have any objections from my doctor. What I did to increase my chances for a successful one was to do lots of squats (when you know baby is head down and in position) and pelvic tilts (to get baby in right position - face down). I had NO problem!!! The flaky doctor that was on call when I went into labor was afraid of a uterine tear and even though I was at 8 cm, strongly recommended an epidural, so I got one. BIG mistake. They over did it and labor stopped for an hour. Finally, when the contractions started again, I had my daughter in an hour and only pushed for like 30 mins. I felt SO good afterwards I was ready to do it again!!!

With my third, I didn't get the pelvic tilts and squats in as much and it had an effect. She was sunny side up, which resulted in my pushing for 3 hours!!! But I was able to deliver her VBAC as well. Thankfully the doctor had no idea how big she was or he would have probably pushed for c-section which I did NOT want (she was just shy of 10 lbs).

Bottom line: It can be done. Educate yourself and prepare.

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A.M.

answers from Tampa on

My name is A. I also had to have a c-section with my first son along with 4 surgerys during pregnany (one at 8 months)I was lucky enough to become prgnant agin 21months later and was offered the option of natural or c-section I went with the c- I wonder if i missed out not going with vaginal but I new exactly what to expect with a c-section and since my son was 21months old I new I had to recover quickly.I was on my feet and happy within 12hrs of the birth of my second child and I found that since I knew exactly what was going to happen I had no fear and barily any pain. I hope this helps

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P.

answers from Tampa on

S.,

My 1st child I delivered naturally and my 2nd I had to have an emergency C-section. Having done both of them I desperately wanted to not have another c-section. So, my OB told me the same that I could decide and of course I opted not to have one. I had the same concerns about complications if I did go VBAC but my dr. reassured me that if any complications did arise I would be in the operating room within a matter of minutes to do a c-section and everything would be fine.

In May I had my 3rd by VBAC and I'm so glad I did. I was up walking around within an hour of having my son. The recovery is so much better - less pain, quicker recovery. For me every aspect of a regular delivery was better.

I hope I helped....

Regards,

P.

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J.C.

answers from Raleigh on

Just to reiterate what several people have already said. My dr didn't give the option of VBAC with my second and I was very worried about the long recovery, etc. I had experienced with my first. Good news...it was MUCH easier. I had my daughter on Friday morning and was sent home Sunday morning, they wanted to keep me until Monday, but I begged to go home. I felt so much better the second time around and the recovery was much easier, I think it was the lack of stress and the knowledge of what to expect. Because I had a 21 month old at home it was easier to do the second c-section because I had a delivery date and could be sure someone was here to help with him for the first few weeks.

Good luck!

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A.A.

answers from Orlando on

S.- I would LOVE to know who the Doctor is who is willing to do a VBAC. I have so many friends who want one and feel "stuck" because almost no Dr. does them anymore. If I am remembering correctly, the chance of uterine rupture is only about 5%, which means you have a 95% of everything going fine. Very few of the things we do in life offer those kinds of odds. The fact that no Dr. will do them does not speak so much to the danger of VBACs, but of the huge increase of people suing their Dr.s for anything less than a perfect outcome. All the legal actions are the reasons many OB/GYNs are pulling out of the state of Florida entirely-they just can't afford their malpractice insurance. For that reason, they view VBACs as an avoidable risk. The head of ACOG (the medical group for OBs) has even privately proclaimed he thinks ALL women should have their babies by c-section, URRGH!

If it were me, I'd go for the VBAC. I tell my clients it's like climbing a mountain vs. taking a helicopter up. Once you get there the view is the same (ultimately either way you have a wonderful new baby), but you learn something about yourself and your own strength on the climb (natural labor) that you don't learn in the helicopter (surgery-unless you count learning whether anesthesia makes you ill :-).

Best of luck whatever your decision, and please e-mail me at ____@____.com with the name of your Doctor so I can send people his way!

A. A
CD(DONA)

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P.

answers from Jacksonville on

Hi S.,

I am in the same predictment as you. We are expecting our second child and we plan to do a VBAC. My recovery with my first child with the c-section was long and hard. So I can't imagine going through that again and have two kids to worry about. I want to be able to just bounce right back on my feet. Just from everyone I know who had the VBAC done, had no problems. Everything went well. So that's what I'm hoping for.
Good Luck!

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S.R.

answers from Atlanta on

Hello--I was in your exact situation. I had a girl in 2002 via emergency c-section due to preeclampsia. My second daughter was born in 2005 and I had her via vaginal birth with no problems at all. Due to moving I had a different OB/GYN for my births, however they both felt that is was safe to have a VBAC. It was my choice and I was a bit scared but am very glad that I was able to experience a vaginal birth. I did have an epidural so I do have to say that I had no pain during birth. The pain & discomfort came afterwards once the epidural was gone, which you're going to have with a c-section too. My second OB/GYN did say that a vaginal birth is more recommended if you are going to have more than 2-3 children. The cutting of the uterus in a c-section can cause weakness if it is done multiple times. On a personal note, it was an unbelievable experience to watch my child being born via vaginal birth. It was something that I was not able to experience with my first child via c-section.

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L.

answers from Orlando on

Hi. I too had my first child via emergency c-setion (tried home-birth, but got scared when heartbeat could not be found-turns out she was head down, but "angel-faced" presentation, face up;o) Anyhow, had a VBAC 22 months later and all was GREAT! I would say to educate yourself and go with your gut!!! Birthing a baby is an amazing experience either way you go, but I LOVED having my second baby vaginally! (1st baby 7.5 lbs, 2nd 9.8) You have to live with your decisions. Trust yourself, Listen to yourself and you will make the best choice for you and your family.

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M.E.

answers from Miami on

I have had four deliveries. My first pregnancy I had a girl that I gave up due to personal reasons, but I had pre-enclapsia (sp?) so I had to be induced, I did have an epidural and had no trouble with delivering vaginally she was 7lbs. My second pregnancy I was having contractions and they discovered my daughter was breech so I had a c-section she was 7lbs 2oz, my third pregnancy was just short of three years from my second and I had a successful natural vaginal birth of course my doctor told me that once I was in labor and my water broke it'd be quick. It was my water broke and maybe 15 minutes later I had my daughter she was 9 lbs. And I just had my fourth daughter a year ago and again she was breech so I had to have another c-section. Me personally I would go with vaginal birth no questions, I hated the recovery period from the c-sections. Especially with after the second one and then having two older children that want to give me hugs and sit with me it killed me not to be able to really spend time with them like they wanted because of recovering. But good luck with whatever you choose.

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E.

answers from Boca Raton on

I have a 3 soon to be 4 year old by c-section and one ont he way.. NO QUESTIONS and NO DOUBTS C-section for me the 2nd time.. I tried the whole induce, push for 3.5 hours and she was not coming out.. to know how quick it took them to do the c-section.... after additional prep time before and while on the table to know that the whole procedure took 15 min or less that is my way to go... to each is own and good luck!

E.

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