VBAC Or Repeat C-section? - Mokena,IL

Hi K.
Speaking from experience, I would take a VBAC any day. My first was a c-section due to breech presentation. I had a VBAC 12 months ago and the difference in both me and my baby was night-and-day. For me: recovery was amazing. I left the hospital 36 hours after the birth, feeling great. I went for a nice walk with my 2-day old daughter for a quick weigh-in at the clinic. Nursing was easy. I was thrilled that I could play with my 2-year old son.
For the baby: my son (c-section) had a lot of crud in his lungs and spent the first few days coughing it all up. My daughter (VBAC) had none of this, having had it all squeezed out during the birth. My daughter weighed 1 lb more and "cooked" for 2 weeks longer than my son. She was much more robust and seemed much stronger.

Given that the risks to MOM are roughly similar (though a vaginal birth will be a MUCH easier recovery, in my experience) and the risks to babies are significantly lower for a vaginal birth, I would advocate for a VBAC. Especially if you are considering the possibility of having a third child.

As for your husband, sometimes re-phrasing how the risks are stated is helpful. There's approximately a 0.5% chance of uterine rupture for a VBAC. that means there is a 1/200 chance, or conversely, a 99.5% chance that it will NOT happen. The risk of uterine rupture is not zero even if you have not had a c-section before. In one study ("Maternal and neonatal outcomes after uterine rupture in labor." OW Yap, ES Kim, RK Laros Jr - American Journal of Obstetrics & Gynecology, Volume 184(7)June 2001 pp 1576-1581) out of 38,027 births there were 21 ruptures, 17 of which were in VBAC patients. There were only 2 deaths and those babies were 23 and 25 weeks gestation. All babies who lived had no signs of any damage. So you see that even in the worst-case scenario, the risks are quite small, and those risks even exist if you are not a VBAC.

I would strongly encourage you to stop by the next ICAN meeting (International Cesarean Awareness Network). This is a great group of women who have either had or are planning VBACs or just want to learn more. You will be able to speak with many people who have been there/done that who can help you strategize and work through any concerns you might be having to make the best decision for yourself. There may even be someone who has VBACed at the hospital you're planning to give birth at. Here's the meeting info:

ICAN of Chicago monthly meeting
Date: Sunday July 12, 2009
Time: 7:00 pm - 9:00 pm
Location: Mother Me Inc.
Street: 3717 N. Ravenswood Suite 213
City State Zip: Chicago, IL 60613

I am an L & D nurse and nurse-midwifery student. We do VBACs in our facility, even after two c-sections. The risk of uterine rupture after one c-section (horizontal incision) is .4%. That means that the risk of NOT having a rupture is 99.6%. To put it in the perspective, that is lower than the risk of losing a pregnancy due to amniocentesis, yet those are highly recommended to many women.

The risk of complications from a c-section are much, much higher than the risk of a rupture. Babies born by scheduled c-section with no health concerns have a 3X higher mortality rate and mothers who have scheduled c-sections for with no medical indication have a 2X higher mortality rate. About 50% of uterine ruptures are considered "catastrophic" meaning they have serious health effects for mom or baby- so the risk of a rupture with a serious health effect is .2% Babies frequently suffer from respiratory distress after c-sections, the risk of infection is higher for mom, risk of blood clots, risk of hemorrhage and hysterectomy is higher, more infant blood sugar issues, more breastfeeding problems, and c-sections affect future pregancy and fertility. Healing time is considerably longer with risks to the bladder and bowel from the surgery.

Obviously I am pro-VBAC! but every woman needs to decide for herself. It is tough because it is hard to get good info. Check out ICAN (international cesarean awareness network) www.ican-online.org Read the information and decide for yourself. Also, get some opinions from the local ICAN chapter on your doctor- often doctors say they are supportive of VBAC when they really aren't. It sounds like your doctor has exagerrated the risks of VBAC to you while telling you she is supportive so I would be concerned about that. This could mean that you will be subtly (or not so subtly) talked into a c-section as your due date nears.

Good luck.

I'm probably going to mention things that other women have but here goes...

I had an emergancy c-section with my first after 72+ hours of labor and only getting to maybe 4cm! With my second I wanted so bad to try to have a VBAC but then a whole bunch of complications (placenta previa, pre term labor....) I opted for another csection we scheduled if for the 17th of Sept. and she decided she wanted to come on the 29th of August it wasn't emergancy but I wouldn't stop contracting so they just took me for a csection. For me my recovery time for my first was long I was in the hospital for a week recoverying from preeclampsia and ended up having fluid on my lungs. My second I was out of the hospital in less than 24 hours (strange I know) but my daughter was transfered to another hospital because she was in the NICU. But I still recovered great even with having a 13 month old at home. (plus I didn't have pain meds because I was a llergic to them didn't know until I started taking them and ended up with hives for two weeks!)

There is a lot I would probably do different wth my second if I could. Almost a year later I wish I would have tried for a VBAC. So I only say that to say that if you wanted a natural birth the first time try the second time. It doesn't hurt and if something happens they can always do a csection. I would have had to go to a different hospital because the doctors and nurse would have all been there if I was going to do a VBAC.

Just do what you want not because someone else is pushing you. You can always try VBAC and if not go to a csection but you can never try csection and go for a VBAC!

Another voice for a VBAC try. I had one emergency c-section and two VBACs. Of course there is always the possibility of a problem with either type of delivery, but the advantages of a vaginal delivery, in my mind, outweigh the risks, for baby, and for you. You really can't compare having to recover from major surgery, even if you have a quick recovery, with recovering from giving birth vaginally, and the experience itself is amazing. I don't regret my c-section, after all, the most important thing was that our baby was healthy, but given the choice, I'd never choose a c-section.

Hi K.. I had the same issues with my girls. My first delivery was a c-section because my daughter was breech. I also wanted to have natural chld birth so I went with the vbac. I had no problems with my delivery at all. I did tear a little so I had to have stiches which seemed to take forever to heal but I think that had more to do with my three year old wanting to climb all over me than anything else. Not to mention I was more active than I should have been right after leaving the hospital. My second was born july first and I wasn't going to miss out on the festivities of the fourth just because I had had a baby three days ago. BIG MISTAKE! But I am glad that I had the vbac and would do it all over again. I was able to hold my baby and nurse her right away and that was worth it all.
Good luck with which ever you decide.

If your insurance covers a c-section I would do it. Mine did not so we tried for a v-back and ended up with an emergency c-section. I arrived at the hospital 80% dialated and 100% efaced--so no time for drugs. They broke my water and told me to push. I started pushing and the cord ended up being too short (I had several level 2 ultrasounds and this was not picked up)My baby went into destress. I was told to stop pushing--which you can't. Kept feeling gushing--found out the day after that that was blood--I thought it was more amniotic fluid. Ended up strapped to a gurney with my legs shut so there was no exit. Screaming like a mad woman--remember no drugs due to no time. They knocked me out and did an emergency c-section that my husband was not able to be in. Oh did I mention my husband almost passed out seeing his wife in so much pain. My healthly daughter was born at 1 in the morning (I had arrived at 11:30 PM) I first saw her around 5:30 AM when the nurse asked if we wanted to--I was so worn out that didn't even care that I hadn't seen her- My husband had but and showed me a picture.

I tell you all this not to scare you but to let you know that things can go very bad very quickly. I found out the next day that I almost spilt open and died that night.

The good news is I have a very healthy 3 year old and 2 wonderful boys 8 and 10. My doctor told me that next time a v-back would not even be an option--I informed her that there would be not next time! That night was the scariest most painful night of my life and I have no intention of ever repeating it.

I had a vbac a year ago. From what I know your chances of success sound great so you could do it. I would ask your OB when she'd induce you, recommend a csection, how she monitors during labor and how long you could labor before you'd have a repeat c.

I interviewed 3 providers and got 3 diferent answers to these questions.

Midwives have statistically the best vbac rates. I went to kathy puls in evanston (offices in buffalo grove too). I gave birth in evanston hospital.

Mothering.com discussion board has a message board for women wanting to vbac.

I'm so glad that I had a vbac and I believe it wouldn't have happened without my midwife.I can share a blog post with my story if you message me

Hi K.,

If your doctor considers vbac an option, go for it! I had two vaginal births and my third one was a c-section (breech baby). I can tell you from having both types of deliveries that a vaginal birth is easier on your body after delivery, and you are going to hold and nurse your baby as soon as you deliver her not an hour or more later after you're sewn up. I have a friend who had a c-section with her first and delivered her second and third vaginally with no drugs and the use of a midwife. She's now pregnant with her fourth and is planning for another natural delivery.

If I were in your shoes, I would choose the VBAC. I think it's an easy decision to pick the C, because you, your husband and doctor know what to expect - day of delivery, expected recovery, etc. A vaginal birth will be much more exciting with all of it's unknowns. If you choose vbac, get yourself a doula; I had one, and she was an amazing resource, childbirth educator, and support person.

If you want the name of my doula or the number of my friend who did the Vbac, you can contact me at ____@____.com luck!

A.

Hi! Def go VDAC, the recovery is much faster and easier on your body. Delivering by c-section does not signal your body that you have given birth right away and recovery is much slower not to mention the recovery from surgery, which may be more dificult this time around since you have another child to care for besides the baby.

Your baby may have flipped the last moment. I have 3 children, 2 vd and the 3rd c-section. I experienced what you described....something that felt like contractions but irrregular..2 mins, then 10 mins, then 3 back to 7 min for about 4 hours. Turns out that's when the baby was flipping. Thought I was in labor but when the 'contractions' stopped I decided not to go in. Next day went to the Dr., baby was breach and 2 cen dialated, 2 days later water broke....c-section and healthy baby.

good luck!!

Hi K.,

I applaud your desire to research and decide what is optimal for you. There is a lot of good information out there. Just 10-15 years ago most all woman with a previous history of cesarean were encoruaged to labor and birth vaginally. There was a problem with labor management using the drug Cytotec which did make VBAC unsafe for many moms and then the litigation crisis really began to hit obstetrics and it was "safer" to reccomend a repeat c-section.

Go to http://www.ican-online.org/ It has current and fabulous information.

You should ask you current doc and the hospital (If you are choosing a hospital birth) what their c-section rate is. You should also find out from your provider how supportive they are to understand where challenges will lie.

Some reccomended books: (There are many more)
The Thinking Woman's Guide to a Better Birth - Henci Goer
The VBAC Companion by Diana Korte
Open Season by Nancy Wainer Cohen.
Ina May's Guide to Childbirth
Silent Knife

As a Doula and lactation consultant I am very much pro-VBAC for most women. I fell deeply that women should be given options and choices. However, in the current state of birth VBAC is not an easy choice as you are seen as an increased liability. Some situations such as having a vertical incision, have a single layer horizantal incision ect raise the rates of uterine rupture. However the typical woman with a double layer suture who has an unmedicated labor has an increased risk of uterine rupture of less than 1%. A woman with no previous history of c-section has about a .3% risk. The risk is much less than the risk to your infant has from respiratory distress as a result of a scheduled cesarean and a host of other complications. C-section is a life saving option for some cicumstances, however I feel it is overused in the United States at this point in time. I worked with and personally know many moms who have VBAC'd, even VBAC after 2 c/sections, and VBAC of twins, home and hospital. They are tremendous stories.

But this is about your birth. Not my birth, not Nancy or Jen who might respond here to. Women need to feel safe and supported in their labor and birth and only you can create and choose what that means for you.

Blessings,

E.

PS if you want to talk more PM me. As a doula I do offer free consults - but even if you just need to talk more or need further refrences I'd be happy to help.

I had an emergency c-section with my first and was teaching aerobics, again, by six weeks post partum. With my second, I had a scheduled c-section, back in my clothes at two weeks post partum, running errands with both kids at three weeks and teaching aerobics at six weeks, again. The recovery, in my opinion, has more to do with your state of health/fitness pre-pregnancy than with the c-section itself. I only had a few days of being out of commission.

Hi! I had a vbac and it was a great experience! I was planning on having a repeat c-section up until I was in active labor and my Dr strongly encouraged me to attempt the VBAC. The only thing they did tell me there is a greater chance of uterine rupture but they definitley monitor closely for that and it is very rare. I had had both csect and vaginal deliver before and will tell you the recovery from the VBAC was very easy and if the Dr is willing to let you try u should go for it!

I had my first son with a c-section in 1996 because of pre eclampsia. i had a vbac with my second son in 2000. i layed in a bed with no drugs for 36 hours refusing the c- section. I hope to never do a c-section again. i am on my third pregnancy and plan for another Vbac. so much more worth it. i felt like i was cheated and robbed of my bonding with my first son that i got with my vbac baby! VBAC all the way!! no c-sections for me!

For my background I have worked on a labor and delivery dept. and have seen successful VBAC's and unsuccessful attempts that resulted in C-section. Perhap's the accurate question is do you want to have more children? That can play a role in your decision making process. While your body can recover from repeat surgery; an attempt at a VBAC would be prudent if you want to have more children and be healthy to care for their needs. If perhap's you are content with the healthy two that you have considering a tubal at the same time is also prudent. IF that is something you desire? I do understand your apprehension and it is valid. Your body is made to deliver babies, but it is scary none the less. I had two C-sections and the first was URGENT, and I had a hard time recovering from it, I also needed a blood transfusion and lots of extra care! It was scary! My second decided to avoid the complications and did the C-section. I recovered in a very short time! I was floored at the differences! But again the first was under mitigating circumstances. So for me the controlled environment was best and safest for my babies. I do believe in minimal intervention from the hospital staff, but they are there to care for you in the best manner possible to achieve a healthy outcome for both Mom and baby. I will say this, I do have a momma belly that is not going to go anywhere, no matter how much I work out!! It is the price I paid for my babies! And the C-sections. The muscles are never the same. I did not have the options you do, Hope that helps?

I just had my second c-section 9 weeks ago. I wish I could have had a VBAC, but my chances were slim for success and my baby was huge, so we went ahead with the second C. (My first baby was an emergency C, she did not descend after pushing for many hours - you are a much better candidate for the VBAC)Let me tell you that the recovery was NOTHING like my first one - it was way way easier. Except for the no driving and no lifting, I was up on my feet doing mostly normal activities the next day.

The other thing is, You can wait. You can wait all the way up to 38 weeks, check the position and size of the baby, and then make your choice. I would wait to make the decision, I know it might be easier to plan ahead for you and your husband, but its a huge decision, give yourself a little more time.

Much love to you.

Hi K.,

From my own experience, I definitely thought the VBAC was the way to go. With my first, I had an emergency c-section (my daughter did not survive) and the physical recovery was horrible. I could not get out of bed on my own and the incision area was horribly painful for weeks. A year later I had my son and my new doctor was 100% supportive of the VBAC decision and thought I was a good candidate. The recovery was amazing. I was up walking around within hours of delivering. I delivered at 8pm on a Monday night and went home around noon on Wed. I'm pregnant again and plan on another VBAC unless there is some sort of emergency reason to go with a c-section.

Either way you decide, a healthy baby is most important :-)
A.

Hi K.- I know that every woman's childbirth experience is different. I had a c-section with my daughter who is now 18 but with the help and guidance of my wonderful OB-GYN I had a successful VBAC with my son who is now 12. Let me just say that it was the absolute BEST decision we made. My recuperation time with the c-section was 6 weeks and then some, due to an infection I contracted. I received a T cut and developed a hematoma(?)
at one of the staples, so I came home with a new baby, lots of pain and the top portion of my incision still open. So I was not looking forward to another c-section if it wasn't necessary.

To ensure that I was given the opportunity for a VBAC, my doctor arranged for me to check into the hospital during his 24 hr. round. I received his personal, individual attention throughout the labor process and the VBAC was a success! I hope this is helpful.

..A little about myself, I have been married for 24 years with a daughter who is going to be a freshman in college and a 12 yr. old son.

K., we have very similar 1st baby birth experiences. I progressed to 10, when the doc broke my waters. That was when he discovered the baby was butt first, not head first. No one caught it before I was ready to push. I was very disappointed in how it all turned out. Anyways, with my 2nd baby, I switched a midwife delivered birth and had a wonderful VBAC. I would do it again in a heartbeat. I was paranoid during the 2nd time around that I would have another breach baby, so I made sure to not recline back and did some pelvic tilts from about 34 weeks on. I had 2 weeks of bedrest before my 1st was born and I think he flipped then. Though, I never felt it.

I am 29 weeks and planning a VBAC for my second baby. I think it is great that your doc supports you either way. I have had a really hard time finding that in my area. So right now I am currently doctor-less. That is how much it means to me to have a VBAC!
Def. do your research (some already listed some excellent book and the ican website so I will not repeat) and make the best decision for you, your baby, your family. I think you will find that by far and away VBAC is the best for everyone involved!
Good luck with your decision and your birth :)

Go for the VBAC. It doesn't hurt to try. They will monitor you and you will be able to get the c-section if it is needed. I had an emergency c-section with my first, and vaginal with numbers 2 and 3. The vaginal delivery recovery is much easier, and with child number 1 waiting for you at home, anything that makes things easier is needed! Let us know what happens! Will be praying for you. :)

You have probably made your decision by now, but if you're still looking for ideas, I recommend that you check out this website and this book (probably available through your public library or through inter-library loan), if you haven't already...

http://www.ican-online.org/

http://www.amazon.com/Silent-Knife-Cesarean-Prevention-Va...

Best wishes,
J.

I had my daughter via V-BAC last year. My other kids were already 9 yrs old so it had been a while since my c-section. I had my c-section due to infant distress-one of my girls could not keep the heartbeat up where it should be and they could not tell why. Turned out her cord was around her neck, though loosely. She was flipping around while I was in labor.
When I went to the same OB I had seen the first time around I was asked if I wanted a c-section. I said not unless it is needed. The risk of rupture is fairly small if you did not have it done the first time due to problems. I think they told me something like 1%. Also higher if you have a vertical opening due to the way it heals. I am very glad I had my daughter the way I did. The experience is so incredibly different. I saw her come out versus them showing to me later. I felt I had missed out the first time. If it had become necessary, I would have gone with the c-section but so happy it did not become an issue. My daughter was born very healthy and I did not have the extra recovery time that c's require.
I was surprised though about the cramping when nursing her. I was told I would feel cramping for a short time when nursing due to my uterus completing its return to normal. I didn't have that the first time around.

Would I change the way I had my little girl? Not for the world. If your doctor does not see any reason you cannot have a VBAC, I say go for it. If there are problems, you will be in the right environment to take care of any emergencies.

Hi I've never had a C-section but check with your local hospital to see if they offer a class on this.