Another C-section?

This is becoming policy all across the nation at many, if not most, hospitals. I highly recommend the book, A Thinking Woman's Guide to a Better Birth, by Henci Goer. Excellent. I personally would not stand for this practice. C-Sections should be the rare exception, not the norm in childbirth. The rates are extremely high in America. Interestingly, America has one of the worst infant/mother mortality rates in childbirth. We are way behind most developed countries in this regard.

certain hospitals have this policy. The one my daughter was delivered in made people go miles away to another town where they would do it.
You would think they wouldn't make it so complicated for us, huh?

Vbacs are RECOMMENDED. The problem is, though, Doctors don't want to do them, nor do hospitals. They want to do what is easiest for themselves. Episetomies were found to do more damage then good back in 2000, yet many doctors still swear by them, when research shows natural tears are better.

Find yourself a midwife practice. If you are capable of having a vaginal birth, a good midwife will tell you immediately. I got check to see if I was "big enough" the first time I went to my midwife practice. How many doctors do that?

As a doula and childbirth educator, I'd like to clear up some misconceptions and statements in responses that are not factual. First of all, most babies WILLL fit. It is not the size of your baby's head that was the problem, but the position. Secondly, it is not significantly more dangerous to have a VBAC than a C-section.
Your instinct is correct, you can opt for a VBAC! I'm sorry that you are attached to your doctor, but he is trained as a surgeon.He has chosen this policy. I don't know where you live. I would run and not walk to a midwife practice. They are more attuned to women, spend more time with you. and will give you the care that you deserve. They are not bound by the malpractice that OB's are. Please feel free to contact me, and I can let you know which midwife practices are best. Some midwives that are paired with OB's are no better than the OB as far as looking at birth as more medical.
I'd suggest the ICAN website as well as the book: "Hey, Who's having this baby Anyway!". Good luck

Hi Wendy,

I had an Emergency C-Section with 1st child after 35 hours of labor. Once I was pregnant with my second, my doctor told me I would have another C-Section. I do believe it is each hospital's/Doctor's own policies. I was told by my doctor that Vbacks were not as safe as previously thought. Ultimately, I did have 3 c-sections. I did not argue the case however. I felt like if the first one was an emergency after almost 2 days, sometimes science needs to step in and help out nature. I can say that the planned c-sections were much less scary than the emergency and not that big of a deal at all.

Good luck on your decision!

My neighbor had this happen to her. I live in south FL and she searched the area and could not find an ob/gyn within a 2+ hour drive radius that would do a VBAC (vaginal birth after cesarian). She oped for a midwife and had a very successful natural homebirth. Just some food for thought.

I had a c-section with my first - unplanned as I couldn't get passed 9 cm. I switched doctor's because I didn't like how much the attending doctor (partners with my former doctor) kept pressuring me to have a c-section when nothing was wrong other than me not dilating to 10 cm after 12 hours of labor. My new doctor asked me if I wanted a c-section or v-bac. I told her I would like to go for v-bac but understood that there were risks. We are playing it by ear. BTW - she told me that hospitals these days push for c-sections regardless but she would stand by whatever decision I make. I researched c-sections for my first and doctors/hospitals due push for c-sections due to less liabilities and convenience. I hate to say this but if you truly want to try a v-bac you might have to switch doctors.

OB/GYN is one of the riskiest medical specialties, and there has been a lot of controversy among physicians as to whether or not VBACs (vaginal birth after cesarean) should be done.

You'll likely find as many people saying yes as no and as many physicians in those statistics.

OB's carry HUGE medical malpractice in case something happens. So, chances are, your OB is more concerned from a legal stand point at the risks of delivering via VBAC.

I ran a search on Google.com/scholar and found some interesting results.
The most recent (you want recent data) shows that there's no evidence to support NOT doing a VBAC in most cases despite the OB's preference not to: http://cat.inist.fr/?aModele=afficheN&cpsidt=22354715

This one is a consensus from the National Institutes of Health that was published only a few months ago and concludes that medical-legal issues appear to be the largest barrier: http://consensus.nih.gov/2010/vbacstatement.htm

I'd have a frank discussion with your OB regarding YOUR preferences and get their opinion based upon the medical evidence vs. fear of litigation. If they're unwilling, I'd consider switching to a different OB who's a little less concerned about malpractice (if that's the issue).

I agree! I'm 31 weeks pregnant and have switched doctors 3 times because I am not about to have another c section. If I knew then what I know now I wouldn't have had a c section in the first place. Depending on the incision that was made in your uterus the risk of uterine rupture is 1%. Definitely look at the ICAN website. I also suggest www.birthdaymidwifery.com. The midwife, Nancy Wainer, is the woman who coined the term VBAC, her website is full of information on VBAC and she is very open to communicating with people who may not be her patients but want a VBAC. Best of luck. It, for me anyway, has been a long battle and has been pretty frustrating, but in the end I know what's best for my body and my baby and it's worth the fight.

I was told that I would need to have another C-Section if I had another child (the 1st C was not planned (long story)). I found that my Dr. does not do vaginal after a C-Section and apparently there are a lot that feel the same way. I did some reading and found that there is increased risk going that route and high % wind up having a C anyway, except that it would be emergency rather than planned. I also believe that there may be insurance considerations for the doctor but that is just conjecture.

In any event, talk to your doctor about. That may be the "policy" but I am sure it is also somewhat dependant on the mommy...

Whatever happens - God Bless!

My doctor's insurance company instated this policy. I had c-section number 2 in April and all went well. I toyed with the idea of VBAC but decided that traveling out of town to a hospital that allowed it was just not worth it. I think it is fairly common for smaller/local hospitals to insist on c-sections if you have had a previous one. Teaching/university hospitals seem to support VBAC.

It depends on your incision and how long it has been since your c-section. If it has been a while (years) since your c-section talk directly with your doctor. Ask him/her WHY they want a repeat c-section? Then weigh their answers. You can always find a doctor/midwife that will do what you want BUT it might not always be the safest and best choice for you or your baby.,

My 1st was a scheduled c-section. I had hoped for a v-bac but my dr said it's their policy to not allow it. I changed dr's because that didn't sit well with me. I didn't think that I should be told no from the start, even without assessing the situation around my due date, and the new one said we will wait and see when the time comes if I looked favorable for the v-bac. So I was happy I switched. I ended up with another scheduled c-section but I was glad that they didn't rule it out right off the bat. (Both of my children were measuring large and when I had internals done, it didn't look like they were anywhere near done baking. They were afraid they'd keep on getting bigger. They were both scheduled a week early, at 9lbs 4 oz and 9lbs 8 oz.) Just ask around at different dr's offices as to what their policy is and switch to them. You shouldn't stay with your dr when this is important to you. Chances are you will like the new dr just fine.

well let me just say that my sister had her first baby by c-section but it was due to other factors so for her next she told her doc she wanted to try a v-bac he said ok but gave her all this paper work or a waver she had to sign saying she understood all the risk involved with a vbac. So she took the paper work home to look it over and after she read all the pros and cons of a vbac she decided the best and safest thing for her next baby would be to have a c-section. So I don't know but also if your fist baby wouldn't fit your next probably won't either babies seem to get a tad bigger with each one you have. I like you was too small to fit my first through so I had a c-section and I did with my second too. On the up side the second c-section was so much easier than the first. The recoveries were like night and day.

It really depends on your doctors way of thinking/practicing. My aunt had vaginal/c-section/vaginal with no problem. Some dr's are dead set against c-section unless medically needed and some are so apt to schedule it no problem if thats what you want. I have a gf who schedules all 3 of her children c-section with no medical neccesity! Talk to your dr at your first appt and go from there. He may try to scare you out of it!

I was in the same circumstance. I had an emergency c-section the first time (her cord was wrapped around her head, so when I pushed her heart rate plummeted). The second time - only 16 mos later, my doctor talked to me at length about the option of a VBAC. The deciding factors to them were to see why the c-section was necessary the first time... in my case it was the baby (cord and sunny side up)... so they gave me the option. The only risk that caused me to go w/ the c-section was that IF (and this very very very rarely happens) I was to go into labor and my uterous were to rupture (from the c-section scar) while the baby was in the birth canal, they would have a very limited time to get him out w/o causing damage to him (oxygen deprivation and brain damage) or me, bleeing out... SO, although it was a very remote risk... I chose the c-section because it was one we couldn't control. I would ask the Dr. why he/she isn't recommending a VBAC and see what the rationale is. If it's just that the "hospital policy says so", I'd get a second opionion. Good luck and CONGRATULATIONS!

It may be a hospital policy. I know that my sister who lives out in Arizona had to plan a c-section for her second because her first was c-section. I had to have a c-section for my first (he is currenlty my only but I plan to have others) because he was breech. I asked my doctor if I would then be forced to have another c-section or if I could try for a VBAC whenever the second one comes around. She said it depends on the circumstances. Because I only had to have a c-section because he was breech that she didn't see a problem with me trying for a VBAC the second time around as long as the baby is in the correct position and everything is going smoothly. However, for other women who had a c-section for various other reasons ... they might recommend a c-section but I don't think it's my hospital's policy to tell you that you HAVE to. However, like I said ... my sister's hospital in Arizona wouldn't even let her try with her second because she had an emergency c-section after hours of labor with her first.

It depends on the Doctor, and the policies of the hospital where you will be having your baby.
Some hospitals, will not allow it.
ALSO, it depends on your medical insurance... some will NOT cover a VBAC.
So, ultimately, you have to check with your medical insurance. And this will determine the outcome.

I had an emergency c-section with my first child.
I then had a 2nd c-section with my 2nd child.
It was my choice. My Doc did give me a choice... and the stats etc. on it.
C-sections are typically done 2 weeks prior to the due date.
C-sections are performed for various emergency situations... not just determined by the size of the baby.

all the best,
Susan

Weird. I had an emergency c-section in April 2005 and got pregnant again at the end of June 2006. My 3rd baby was born in March 2007. My doctor was encouraging me to go for a v-back, and my first c-section was a ROUGH recovery to say the least. But I did a bit too much online research and freaked myself out, so I opted for another c-section...much smoother when it was planned and no labor was involved at all. But she was all for a v-back. Very weird that your doctor is not. Definitely talk to the doctor about it if you are wanting to do it!! Good luck and congratulations!

i had an emergency cesarian with my first born who is now 8yo, then with the second baby who was born 18months later i was going for the vbac. unfortunately when my water broke they said there was meconium in the amniotic fluid and i had yet another c-section. so for the 3rd baby it was not an option anymore. i think the hospitals policy was once you have 2 thats what your gonna be having for every one after. good luck

My first was an emergency c-section because he had flipped 2 weeks before his due date. It landed him breach and broke my water. I had taken holistic childbirth I so wanted to have him naturally but in the end, was thankful for the c-section because he was 9 lbs 3 oz. That was 2 weeks early.

My doctors at the time said I could do VBAC with my next but when the time came, they said that while it was still my choice, they were very much against it. They were worried the next baby would be bigger and sonograms are only so accurate (as I found with my first and 3rd, both of which were over 9 lbs but "should have been" only about 7 or 8). They also said that studies had shown there was a 10 time greater chance of uterine rupture than they had previously thought. That was not a chance I wanted to take regardless of the baby's size! I know people who have been through it and when they said they were glad they were into extreme sports or "it would have seemed worse than it was", I had no interest in taking that chance.

My second was my smallest at 7 lbs 12 oz but my third, who appeared "normal" in size, was 9 lbs 1.5 oz! The doctor was very surprised as there had been no indication he'd be that big; not with my weight gain, the sonos, my stomach measurements, nothing. So, all three of my children have been born via c-section and my 4th and last will be born the same way in August. In fact, I am going to take the opportunity to get my tubes tied while I'm in there. It will be nice not to have to worry about birth control. It is nice not worrying about how big the baby will be because this one is measuring in the 75th percentile but I am huge and measuring 3 to 4 weeks bigger externally than I should.

In some areas, the doctors will NOT do a VBAC because of the risks; sometimes medical, sometimes legal. I've had c-sections in 2 different states and in both, the earliest they would do them were 1 week before the due date.

Personally, I like having the c-sections. I know what to expect and my recoveries haven't been awful.

I wish you the best no matter what you decide.

L.

It depends on what kind of incision they did. some kinds are not compatible with having a VBAC. And because of the risk of complications and lawsuits, some OB/GYNs just prefer C sections in general, which is sad. If you have your heart set on a VBAC then you may have to find a new doc.

All I can say is that based on my research VBAC is actually quite safe. I recommend looking in your area to see if there are any ICAN meetings. Their website is http://www.ican-online.org/. I switched Dr's with my second pregnancy because my doctor originally told me I could try for a VBAC but when I actually got pregnant again he wouldn't do it. I ended up loving my new doctor even more even though I ended up having another C-section:(