VBAC Vs. Repeat Cesarean

I am a senior midwife student and a former NICU Respiratory Therapist. I have worked in high risk labor and delivery. I now attend homebirths and will open my own practice in 2009. I have been to many VBAC's and the majority have been successful. We went to a VBAC homebirth a couple of weeks ago. The mom is a labor and delivery nurse. In the 10 years I have been attending births in and out of the hospital I have never seen a uterine rupture. It is extremely rare and usually open happens when a mom has been induced or when there is a single layer closure or when the classical c-section was done. The reason you had a failed induction was due to your body not being ready to go into labor. It has nothing to do with you being able to have a successful vaginal birth. Also, an epidural can have a lot to do with slowing down progression. You need to be able to move around and try lots of position changes. I had my second at home and was in labor for over 16 hours and spent most of that time standing up in the shower. The warm water is natures epidural.
You should visit this website: http://www.ican-online.org/. This website has a lot of great information and studies on VBAC's. You should also read these books, Silent Knife and The Thinking Woman's Guide to Better Birth. Have you considered hiring a midwife to be your care provider? Studies have shown time and time again that birth with a midwife is safer and healthier than birth in the hospital. If you have any questions please feel free to ask and good luck with your decision.

L.

2 moms found this helpful

It really sounds like your doctor is trying to scare you into a repeat c-section. Do what you want but you're not a good candidate and I've seen babies and women die from uterine rupture...Give me a break! I'd drop kick that doctor so fast his/her head would spin. At a time like this you need good, solid, unbiased, research supported medical information, not fear based scare tactics.

My c-section happened after 10 hours of labor for failure to progress. Never mind that first time mom's can take 24 hours or more to give birth with no problems. I never got past 1.5 cm and yet they broke my water and inserted a internal fetal monitor on the baby's head. Even though the strip never showed her heart rate leaving the "normal" zone they told me they didn't know how much more the baby could take. The way they worded it, I all but begged them to cut me open and get her out. Afterwards they told me her cord was wrapped around her neck and leg...thank goodness they "saved" her.

After all of the incompetence I endured with my c-section, I was traumatized and vowed to never let that happen to me again. I went on to thoroughly research vbac and evaluate myself if I was a good candidate or not. Low transverse incision, no infection after surgery that may have affected the incision healing properly etc. Then I looked into ways to increase my odds of having a normal vaginal birth. I was determined to avoid unnecessary interventions like induction and augmentation of labor, continuous fetal monitoring, early rupture of membranes, movement restriction, nutrition restrictions during labor. After speaking with my ob/gyn I realized there was little to no chance of me being sucessful in a hospital setting. I found a homebirth midwife to help me and made a back up plan. I went on to deliver a daughter at home after 21 hours of labor. It was amazing to me and yet completely boring because there was no emergency anything. Just a completely normal, boring birth process. Eighteen months later I hbac'd again and gave birth to a son after only 6 hours of labor. No hospitalization required.

I recommend that you do not blindly accept what your doctor is telling you and look into it further. His/her motivations may be very different than just what is in your best interest. Don't have major surgery just to cover the doctor's you know what. Homebirth was my solution but it may not be yours. Look at the ICAN website for more sources of information.

What's sad to me is that doctor's think they should be able to force us to do what they think is best. I think they should give us all of the information without bias and fear mongering and let us decide what risks we are willing to assume.

Blessings.

2 moms found this helpful

Just a couple suggestions.
Find a copy of Pushed: The Painful Truth About Childbirth and Modern Maternity Care, it's a very interesting read.
Also, if you haven't yet seen Riki Lake's doc. The Business of Being Born, it's worth a viewing
I think today's doctors have their own agendas which aren't always in our best interests. Seems to me mother nature knows what she's doing. Let's not forget c-sections ARE major abdominal surgeries
Best of luck to your family!

2 moms found this helpful

My first was a vaginal birth.. my second a C Section because the baby was large and breech....my third 22 month later was a C Section....... I did not want to take any chance of anything happening to my baby or myself.... I was totally awake during both my c sections.... I WOULD NOT TAKE A CHANCE WITH THE BABIES LIFE OR MY OWN. I was almost 32 when I had my normal deliver and 36 when I had my last C Section.

J.

1 mom found this helpful

Why would you even consider risking it? Have the c-section!!!!!

1 mom found this helpful

1st cesarian for failure to progress (I'm a doula and studying to be a midwife. Now I see that the signs all pointed to occiput posterior position.) She was induced after 24 hours since my water had broken but I got stuck at 7 cm for 7 hours. They went in after her.

Second baby born at home!!! Best decision I ever made!!! Don't let people scare you. I can reccomend midwives and tons of resources. There is a birthing center in town with the most incredible midwife in the universe, close to a hospital.

There is a book called THE THINKING WOMAN'S GUIDE TO A BETER BIRTH which spells out the stats on VBAC. I'd read it from cover to cover if I were you. It outlines all the procedures in birth and their statistical impact.

Birthing in a hospital is almost always more dangerous than at home. The World Health Org. does not reccomend repeat C-sections just for the sake of repitition.

There is an incredible amount of misinformation out there, perpetrated by doctors who are afraid of liability suits. My own OB/GYN told me that. He encouraged me to try a VBAC, even though he lost me as a patient because he was honest and told me why he wouldn't attend it. He had done tons previously but in 1995 there was a lawsuit no now no dr. in San Antonio will do them! I love that he was so forthcoming with me.

I labored for 44 hours with my second. He was born by candlelight in my bed in the presence of peaceful, loving people. We're perfectly healthy.

Please e-mail me if you want more information at ____@____.com VBAC in the subject line so I don't delete your e-mail before I read it.

I wish you peace in this journey and Congratulations!!!!

1 mom found this helpful

I saw your post and just wanted to encourage you to find a doctor who is supportive of YOU. Here's the thing, they are very quick to say that women have "too small" a pelvis...but it is actually EXTREMELY rare. I am a doula - and I spend nearly all my time in the study of birth related topics. What I have found is very disterbing...doctors get a whole lot more money for a whole lot less work when they do a cesarean. There is a huge amount of pressure on doctors from their peirs and from INSURANCE to NOT allow VBAC. But a repeat cesarean is major surgery and actually holds more potential for harm to mother/child. MANY women are told they have too small of a pelvis with their first and go on to deliver vaginally...a much larger 2nd baby. It is a statistic of about 3% of those who are diagnosed with CPD that actually do have it. Generally you have to have been in a serious car wreck or been very ill as a child to be unable to deliver your own baby.

As to the epidural...I HIGHLY recommend that you get a good doula. I know that it may seem like tooting my own horn, but the difference is amazing!!! REALLY.

You might want to contact ICAN also, just for information and support!!! http://ican-online.org/

How much do you want a VBAC? ONLY you can decide that, but once you decide...then you can find the right doctor and the right hospital and you can get the support you need. But it sounds like your doctor is trying to scare you out of your dream, and it is wrong of him (in my oppinion).

I hope you are able to get all the info you need to make the right choice for yourself...no one else can define that for you, so please don't let them.

-R.

1 mom found this helpful

I would recommend a repeat cesarean. I am a mother of 4 boys and although my first delivery was vaginal I have had to have cesareans with the other 3 due to me stopping at 4cm each time. Although I have tried for a vaginal delivery each time even though the doctor has strongly suggested a c-section. I think by you having a c-section just 21 months ago is a bit soon to try vaginal as well. It is a great risk for you and the baby if you take that chance against VBAC so I would say just have the c-section

With my first delivery I was 28 years old. I had an epidural and still dilated to a 10 without any problems; it couldn't have gone better until it came time to push. I pushed for four solid hours and she wouldn't descend; they put me in every position you could think of to help her come out, with the exception of hanging me off the ceiling...but she still couldn't descend...that's why I had my first section.

Then 3 months ago I just had my second c-section and it was the best decision for ME. It still hurt...but not as bad as the first one and I am recovering quicker too, because I didn't have all the added trauma on top of it. I just felt better about the decision...I didn't want to worry about all the things that could go wrong no matter how small the % was. My baby was as healthy as they get in case you're worried about that.

However, it is your decision to make...but I couldn't be happier with the choice I made to have a rpt c-section. I will have c-sections from now on...I know someone who has had 8 c-sections and she is fine and all her children were very healthy and just fine. The other bonus is knowing your due date...no surprises...but I personally hate surprises. Good Luck!

I had to have a emergency c- section with @# 2 due failure to progress- after 2 days of induced labor. He was 3 wks early, 9.4 lb and his head was a few mm shy of 15 inches.
I tried a vbac with #3. After 8 hours and little progression I had to have a c-section. # 4 was a scheduled c- section.
#1 child I had vaginally after 36 hours of labor.

My opinion - Do you trust your doctor ? Do you have a good relationship with your doctor ? I think a question that you should consider is why is it important for you try to have a vbac considering your medical history. What does your husband think. In my opinion go for the scheduled c-section - you and your family can prepare for it .

hi M.
I am in the same boat as you are. I am pregnat also with my second baby due in december 2008. I ask the same question to my doctor if i could do the VBAC and she told me no. That a repeat C-section was the best for me. With my daugther i was in labor for 12 hours and only 4cm. It turn out the she was stuck in my pelvis as she was coming. I ask the doctor of all the risk invole. She said it is better for you to do a repeat cesarean agan. The risk are to high for you and the baby. i suggest you should go for the C-section again. I know it not what you want but it is the best for you child. I hope this help.

Hi M.,

I am in the same situation and am leaning towards a VBAC. My doctor too, has seen first hand the complications of uterine rupture (everyone was ok, thankfully). However, after talking to him, I realized he had seen this ONCE in 15-20 years!! Based on what I've read, your risk of maternal death from a c-section is actually higher than your risk of uterine rupture from a vbac. However, like you, I still struggle with this decision and haven't made up my mind yet. I just keep thinking that a c-section is MAJOR surgery that has a lot of risks of it's own. Good luck and let us know what you decide.

I personally would do what ever was safest for you and the baby. Good luck and Congrats on your new baby. God bless.

My first baby was 9 days over due and I was induced and in labor for 27 hours. They found meconium as well. I only dialated to 1cm before the baby went into distress and my blood pressure went sky high so emergency c-section brough relief. I failed to progress to but my baby weighed 9lb 12oz and was 22 inches long. I am only 5ft. The second baby, five years later, I was never given a choice of c-section. I was forced to try VBAC and again I was induced a day early and never dialated after 18 hours they decided to do c-section. This time the baby was only 9lbs and 21 1/2 inches long. But no problems with distress this time.

I see you have gotten lots of responses and I did not read them all so I hope my respone is not something you already heard.
With my first child I was much like you. My cervic did not dilate all the way, I pushed for over 3 hours and finally had to have a c-section. I too have a narrow pelvis which added to the problem. When I got pregnant with #2, I was not given the opition of a VBAC due to the previous issues with my first delivery. My docotor told me that the same issues would likely happen again and the risk was not worth it. I am glad I chose a repeat c-section...my son was 8lbs 13.5 oz and 21 1/2 in. When they went in to do the c-section I had a lot of scare tissue that my doctor said would have caused serious problems if I had tried for a VBAC. I have now had 3 c-sections and each one has been an easier recovery than the previous.

dear M.,
my experience was simular. i was in labor not very long when they decided to give me pitocin. then i was in labor for another 12 hours, when they told me the scariest things so i went in for surgery. ive heard every woman whos taken that drug is followed by a cesarian. i didnt know that at the time. after that i stopped dialating. that was what led to my first cesarian. i was actually too afriad to try another vaginal birth and opted for a reapeat cesarian. but ive heard of mothers who have done it, alot.
my best wishes go with you.
M.

Hi M., I work in Labor and Delivery and at my hospital we do not do VBAC's anymore. They are too high risk. Lots of different things can happen. My personal opinion I would have a rpt c-section. By the way congratulations on your new bundle of joy that will be arriving before you know it.

Wow! You have gotten some great responses.
I had my VBAC 16 yrs ago. My first labor was 20 hours to only dialate to 5cm. Turns out he was 9lbs 4oz and as mentioned before, I am only 5 foot with small interior hip span. Emergency C-Section had him out in less than 7 minutes. Same doctor for boy number #2 and he insisted I do a VBAC. I was terrified! I went into labor got to hospital at 9pm, I finally delivered my son the next day at 5pm. I had 4 epidurals, pushed for 2 1/2 hours and the doctor finally brought out a vacuum to get the baby out. He had a broken collar bone, dislocated hip and the worst cone head I had ever seen. I ended up with an infection and hemorraged for 4 days. Oh and this baby was only 7lbs 11oz. I was just not made for a vaginal birth. When I had my first visit for #3, the doctor said, NO VBAC! Scheduled C-Section. Wonderful!! No labor pains, no screaming, no walking the halls for hours. And again for #4 a scheduled c-section.

The VBAC was 16 yrs ago!! Lots of things have changed since then. As long as you have a supportive doctor and nursing staff you will be fine! My story is just one out of thousands that were successful. I laugh about it now! Oh my second son healed fine, he has no problems. All my kiddos are healthy. 18, 16, 12, 11.
Whatever you decide will be the best for you and your babies. Good luck and God Bless!!

I had a cesarean my first time because I wasn't dilating and my daughter's heart rate was dropping. The second time I delivered, I thought a VBAC would be better since I'd avoid extra recovery time since my baby would only be 20 months. It backfired on me because my placenta partially stuck to my scar tissue from the C-section and I had to have a D&C 8 weeks later because I couldn't stop bleeding. As a result of my aggressive D&C I was unable to have more children. While these results may not be typical, I always caution those thinking of the VBAC. Good luck in your decision.
By the way...I now have a beautiful baby girl we adopted from China a year and a half now!

I too went over due with my first to be induce 10 days later. I progressed but not quickly and was in labor for 22 1/2 hours. Yes I did end up with a c section and everything and everyone was fine. When I surprizingly got pregnant with number two I did not hesitate to have a c-section with the second one. I had already talked with the doctor who delivered my son and then I moved and in talking with my new doctor both of whom had been practicing for several years, both did not disagree with my wanting to do it that way. Having said that, I don't regret for one minute having the second c-section. Keep in mind that you will have two that need you and the speedier the recovery the better. Surprizingly enough, I recovered quicker with my second one than I did my first, and I think that is for a mulitple of reasons.... I knew what to expcet, I didn't have to also recover from the labor as well as the section (if I was unsuccessful) and mentally I was more prepared. You are NOT any less of a woman for not giving birth the "natural" way. I basically think that the important thing is getting a healthy baby into the world with a healthy mommy to boot. I just want to encourage you to do what you want to do and also listen to the doctors... they have been around. If they think that the risks are too high then you should probably believe them. I also believe in prayer. God will be able to guide you through this. He does give women an instinct that helps them to know what is best for you and baby. My sister had four c-sections and she felt even better after each one of hers as well. So if another concern is the number of total kids you can have since you are having sections, she had four and my last doctor (moved again) told me I didn't have to be done any time soon... it jsut depends on how your body heals. I will be praying for you and that you can have peace about any decision that is made.

have a scheduled c-section. I tried natural first time...19 hours later I had a section. Tried v-bac and after 5 hours baby went into distress. Third time was scheduled and recovery was MUCH faster. The whole process was better when it was planned. Also with c-sections you don't get the vaginal stretching that can cause weak bladder muscles and urinary problems and leakage later. Plus it is like going through two births when you try first and then have a section, why put your body through that. Also because I had tried vaginally for so long during the 1st birth, the epidural wore off during the c-section. I am not kidding or exaggerating. I was screaming my head off and as soon as the doctor held up the baby so I could see she was alright, my first words were "put me out" they had to put me under general anesthesia to see me back up. Again, schedule the section. At least you can pick the baby's birthday!

Ultimately, I think you need to keep in mind that your #1 objective is to have a healthy baby. That, plus decreasing any risk of maternal death and complications, should weigh more than a desire for a vaginal delivery.

Everyone's labor experiences are different due to individual and physical parameters. I would trust my doctor's advice.

I was 27 with my first child (delivered by Cesarean) and 35 with my second (delivered VBAC). With my first, I did not dilate past 4cm and he never gravitated toward the birth canal. I was in labor after my water broke for over 12 hours. My Husband was a little bit upset at the thought of the c-sect, but for me the c-sect was a blessing --- I was exhausted! With the second, I was in what my doctor called inactive labor for over 24 hours and active labor for approx 3 hours. With both I had epidurals. Both my boys are very healthy and none of us suffered any harm during the births. I talked to my doctor before my VBAC and he said that it was totally up to me what I did. I told him I wanted to try, but if (God forbid) things went wrong to have a surgical team available. He said that was totally workable and we went with that. Best of luck with your new bundle of joy.

I understand your concern. My first delivery ended in Cesearian. The cord was wrapped around my baby's neck. My second child was delivered VBAC and he was bigger than his sister. So it is a possible situation, but everyone is different. Good luck.

Well it sounds to me like you have already found the right decision...I ended up with an emergency cesarean due to a placental abruption in one of my twin boys who are now 3. I would have had one anyhow due to one of my twins footling breech presentation. I am now expecting our first daughter and have discussed the risks with my Dr. of a vbac and a repeat and the risks of a VBAC seem way higher then the repeat. The chance of rupture along with your other previous complications you have to ask yourself do you really want to risk it? Honestly due to the fact that I have been through it once already I know the healing process and the pain involved, this time I wont have the added complication of preeclampsia and the extra swelling.

I had a successful VBAC with my second baby. It was SOOOO much easier than a c-section.

I had a c-section the first time after being in labor for 55 hours and trying everything we could think of to move things along. I was very slow to progress but mostly the baby was slow to drop. We felt pressured a bit into the c-section but didnt want to push things any further.

For my second baby I went to a mid-wife who was supportive of VBAC and had another long labor (24 hours) but pushed my baby out in only 38 minutes. It was such a proud moment!

VBACs are MUCH safer for moms and there is a very low risk of uterine rupture. I was told horror stories by my OB as well and felt totally unsupported by her. That is why I went to someone who told me the truth about VBAC being so much safer as long as they dont induce you or use any drug to enhance your labor.

I highly recommend that you educate yourself and find someone to deliver your baby who is supportive of VBAC.

Also read "Ina May's Guide to Childbirth" to encourage you that you are capable of delivering your baby yourself.

I used an epidural with my VBAC at about 6 cm and it really took the edge off but I could still feel to push.

You are young and strong and I you should feel confident going into this and not scared.

Good luck.

Hi M.,

I have 3 children and the first one was a c-section and the second one was VBAC. I didn't want another c-section because the first one hurt so bad. It went pretty well, labor lasted around 10 hours before she was born. But also, my babies are 4 years apart. My C-section had a while to heal. You having had a c-section recently may encounter a problem because the c-section has not had enough time to totally heal and scar yet. That is my opinion. I hope this helps. P.S. My third baby was c-section as well. Who knows, I was in labor for 28 hours and only dilated 8cm. Everyone is different. I hope for the best for you and your new bundle of Joy.

Love,

C.

First, CONGRATS on your pregnancy.

My first was a c-section, due to my lazy daughter never turning or flipping head down and was Transverse Breech - sideways.

4 years later, when I was pregnant again, I tried my first VBAC. Everything progressed as normal. The cord was wrapped around his neck, and when he "dropped" into the canal, his heartrate dropped and went into distress. The doc used a vacuum to assist in his delivery, but everything turned out well. He has never shown any signs of an assisted delivery.

ETA: my 2nd pregnancy I ended up with PIH, and was induced with Pitocin and an Epidural at 38 weeks.

4 years later, I got pregnant again with my daughter. I tried for a VBAC yet again. This time the hospital of choice didnt let me know they did not like epidurals for a VBAC, and I labored for 13 hours with no drugs. When I reached 10cm, the nurses asked if I wanted to use the labor mirror, and I am glad I did. I watched as my daughter was born. It was the most miraculous experience for me.

After 1 c-section and 2 VBACs, it is my greatest and deepest fear to have another c-section KNOWing I CAN have a successful VBAC, and 2 of them. I am expecting yet again, and my OB kept suggesting a repeat c-sec this time again. I wanted to avoid a c-sec so I changed OBs at 5 months. My current OB KNOWs I want another VBAC, and she fully supports my need to try a VBAC again. She is great at her vaginal deliveries and will use a c-sec as a last resort unless it becomes an emergency.

It is possible to try a VBAC and succeed. If this is something you want to try, then I say GO FOR IT! If you think you are having another larger baby, and want to avoid all the labor, then a repeat csec is probably where I would go. But I highly suggest at least trying a VBAC. It is an experience so WORTH IT!!!

Good Luck!

Not everyone will agree, but I have said before in another reply regarding this - My opinion is to NOT have a VBAC - there are TOO MANY RISKS!! Especially since you do not seem to be a good candidate for it. I recommend reading the VBAC information on babycenter.com to help you determine if you are a good candidate. It is more factual than persuasive so might be helpful. God Bless and good luck.

Hi M.,
I had planned a natural childbirth (with drugs!) for my first one, but had a similar experience to yours. I progressed slowly, and my son went into distress, because we later realized his umbilical cord was wrapped around his neck. I delivered my daughter 23 months later, and decided for a c-section again. My Dr said that I was fine to do a VBAC if I wanted, but in my mind, I couldn't find a reason why I should. The experience? Maybe, but to me childbirth is childbirth no matter how that sweet baby is delivered. So, since I already knew what to expect with a section, I opted to do it again. In your situation, if your Dr is already suggesting a section vs a VBAC, then I would strongly consider his/her advice. That is just my opinion, but I can honestly say, I don't regret one bit having had two sections.

My 28 yr old daughter is prety much in the same boat. She had her son after 8 hrs of labor that was induced due to her water having broke. She only dialated to 1-1/2 cm so the doctor did a c section. She wants to have this baby (due in Oct) by a vaginal birth. Her former gyn said that is entirely possible but her current gyn said she runs the risk of uterine rupture. He finally agreed to let her try to have it normally but said he does not see it happening. Let me know what all you find out..I am very interested (so is my daughter) in what you hear.

M., my daughter had the same thing happen, with an induced labor first, then a c-section after many hours. They decided that the safest thing for her and the baby was definitely the c-section option. It is so dangerous when you have to do an emergency, and it is just a safer option than to try and deliver naturally. I'm not a nurse, dr. or anything related to health practice, but am only sharing the experience from a mother and grandmother perspective. I was relieved she did not take any chances...

As a trained doula, I can only try to respond, but wanted to give you another website: www.ican.com
I do know that the most successful VBACs are done when mother is NOT induced, and without epidural would be good (because epidurals can slow your progress).
You don't know the reason you didn't progress with the first (inductions very often fail), so I don't know that the doctor can rightfully say you are a "woman that doesn't progress".

Honestly, your doctor does NOT sound supportive of VBAC, and that will seriously diminish your chances of having one. I think your best bet is to find another doctor if you want VBAC or schedule the C with this one. She may say "it's up to you to try," but....She doesn't sound supportive at all.

And if you need to get induced and then have an epidural, your chances for a repeat C shoot up more.

As far as pain, well, no one can tell you what you can "handle," but I have had two babies with absolutely no pain medication whatsoever, and though the pain was tough, I've heard that the recovery from a C is MUCH harder. Before there were epidurals, nobody died from pain! The key is relaxation and a true understanding of what your body is going through and what it is capable of. I know you didn't ask about natural childbirth, but I thought I'd throw that in there. Also, you had Pitocin with your first, and Pitocin contractions are much more intense (on both you and baby, thus baby's heart rate went down) and that makes it tougher to go without meds.

GL. It's not an easy decision. If you are serious about the VBAC you need to be with a doctor/midwife and hospital/birth center that truly believes you can do it and research your options. Doctors are afraid of being sued, pure and simple. That's why VBACs are hardly done right now. I would not blindly believe what my doctor said. If you are not up for changing, I think I would just schedule the C with your OB. But if you look into VBAC you will see all the possibilites for you!

***ETA: I just read all the other responses, and most of these ladies who posted before me are RIGHT ON! They gave you some great responses about their VBACs and statistics. Please look into what they said. Yes, your number one priority is a healthy baby, but that doesn't mean a C-section is the only way to go.

***ETA again! I read responses again, and one woman, a nurse, asks what your shoe size is because it can help determine your frame. I just wanted to tell you that I am a small/med. frame woman, 5'2", and a size 5 1/2 shoe. I gave birth NATURALLY to an 8 lb. 7 oz baby for my first. Secondly, remember, most doctors and U/S technicians can't really estimate the size of your baby. "Baby too big" is over diagnosed, and is not even a reason to do a c-section, according to ACOG. Squatting will open your pelvis up to 30% more, allowing a larger baby to be born. Lying on your back with your feet in stirrups (how many doctors prefer you to be) will NOT allow a larger baby to be born, and thus they say your baby was too big/ your pelvis is too small. Women didn't give birth lying on their backs before the 20th century (with the introduction of doctors and hospitals)!

I am a Labor and dDelivery nurse with 8 years exp.
1. what is the estimated fetal weight in grams?
2. what is your height, and shoe size? (sounds crazy, but we have and use valid research that the size of your foot can generalize the bone structure. IE: size 6 shoe probably does not have the structure to pass 8+ lbs baby)

The statement I say to my moms @ VBAC is this...when it is good, it is great! When it goes bad...it is devistating. If there is a uterine rupture, the cances are very slim (in my experience, none) that the baby will survive. You will be in bad shape as well. Whatever the statistics, it is 100% if it is you...
As for the epidural...I would recommend that you at least place the catheter. We don't have to infuse the maeds for labor pain mgt, but if your labor goes bad, don't add general anesthesia to the mix, for it can distress the baby further.

I hope this helps. I am por-vag delivery myself...but our ultimate goal above all is for both mom and baby to be healthy, pink, and crying!
Best wishes for a speedy delivery...if by land or by "C"

I am a first time mom, but many of my friends have had VBAC's and actually took HypnoBirthing classes to reduce the pain during birth so that they could have natural births with the second and third babies. I am going to take the classes too! You might want to look into this.

1st and foremost...do you trust your dr with your life and that of your unborn baby? If so, I would trust the Dr's judgement. I drove 2 1/2 hours to deliver my 3rd child, not because there weren't competant (sp?) OB's where I'm now living, but becasue I trusted my OB that delivered my 1st 2 children with their lives as well as my own. I knew that whatever judgement call she made was in all of our best interests. VBAC or not, you have to trust your OB!