Vbac Vs. C-section

Updated on April 17, 2009
V.W. asks from Safford, AZ
33 answers

Heya Mommas-

I am faced with a dilemma. My first baby was delivered via c-section after dilating to 4cm. She was trying to come out hand first and despite the doctor's best (and painful!!) efforts (bless his heart...he really tried to avoid it...) we had to have a c-section. Now I'm pregnant again (on purpose, about 20 weeks, with a boy YAY!!) and was just planning on having another c-section because everything was just fine the first time (what can I say, I'm one tough cookie!!!), but I just learned that you are limited to the number of c-sections your uterus will hold up for. I know we want to have 4 kids for sure, possibly more, and I don't want to be told after 2 or 3 that my baby bag just can't hack it (or be hacked...hehe). And I don't want to end up having a hysterectomy at a young age (I'm only 23)because of too many csections.

So, I've been reading up on vbac and it seems to be a pretty good deal...once you have one successfully, you're golden for as many kids as you want, but my concern is I live about 2.5 hours away from a major hospital/drs that CAN do vbacs. So I'd likely have to be induced if I was to go for the vbac.

Has anyone had a good vbac experience or more specifically an induced vbac that went well? I'm not really concerned for ME (of course I want to live through the experience, but I'm not afraid of long labor or big scars :) but I don't want to do ANYTHING that could jeopardize my baby and future babies. A little scary...

Any advice would be greatly appreciated. Also, if anyone knows of a good vbac dr in Tucson (where I'll have to go to have it...but my mom lives there, so not TOO bad), let me in on it! Thanks!

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So What Happened?

After doing more research on VBAC, I decided I wanted to try it if I could. I went to Dr. Reinhart in Tucson (thanks for that tip...She was great!) and did my best to have a VBAC but I ended up not going into labor on my own before the Dr's deadline for doing a VBAC, so we had a c-section that went very well. Baby and I are both doing great and I have no regrets. Though I would have loved to have a VBAC, we tried our hardest to go into labor (all of the fun little "tricks" and wivestales) and it just wasn't meant to be. Thank you all for your input and advice!

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K.B.

answers from Tucson on

I would also highly recommend James Macuilla at UMC. He is the chief of obstetrics, and truly the best doctor in Tucson. I have had 2 high risk pregnancies, and both were amazingly successful with his help. I adore him and his staff.
Good luck,
K.

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J.M.

answers from Tucson on

Hi V., Congrats on baby!!!! The very BEST Ob/gyn in Tucson or anywhere is Dr. James Maciulla he works in UMC. He is the very best, call the office ASAP! Good luck and let me know if I can do anything eles! xoxo J.

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K.F.

answers from Albuquerque on

I recommend looking into Hypnobirthing! It is great! and has a high success rate especially for VBAC. www.hypnobirthing.com
It is amazing!
K.

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L.W.

answers from Santa Fe on

Hi, V.--

My first was a C-section because he was breech...for the second one, I knew I wanted to have a natural birth. It was really hard to find a doctor who would support this, and still, at every appointment, she would ask, "Don't you just want to schedule a C-section?" It was very frustrating. They called it a "trial of labor," (TOL) and my doula advised me to stay home for as long as I was comfortable to avoid the pressure of possible interventions. I labored largely at home, had the baby in the hospital, naturally, and it was the moment of my life! It was beautiful, empowering, and I felt great. I was on a high for the next six weeks. I healed quickly, and my milk came in easily. My son and I were able to bond right away, and he was healthy and strong and didn't have to process anything extra in his system. It was definitely a wonderful experience. Challenging, hard, and amazing, too!

We found out we were pregnant with our third a couple of years ago, and I got to have the third type of experience...I had another natural VBAC, this time at home with a midwife using hypnosis. It was peaceful and beautiful and easy. I am so glad I had the opportunity to have this experience as well.

As some of the people stated above, you won't be a candidate for induction due to the intense contractions produced by Pitocin and Cytotec. Cytotec is largely responsible for the current state of our VBAC crisis...they were applying a drug designed for a different purpose altogether to laboring women and causing uterine rupture in even non-VBAC situations. The generally accepted figure for natural uterine rupture with VBAC is somewhere between .3 and 1%, and has adversely affected the language in the doctors' doctrine, causing a large number of unnecessary surgeries, with huge risks to mother and baby. I would definitely bone up on your research if you decide to go this route...you will almost certainly be pushed to just go for the operation. www.mothering.com has some amazing articles about the importance of advocating for yourself and your baby, and pushing for the natural route. I highly recommend it myself...it was wonderful and important, and the perfect setup for becoming a mommy.

Expect to find a hospital with an anesthesiologist on staff all day and night...part of the hospital language that makes it challenging. Fight for what you want. You are the client, and deserve to have your wishes honored. If more women stood up for their right to birth naturally, we might not be so far behind other developed nations in our infant and mother mortality rates. Unnecessary major surgeries are a major part of our current birth crisis. I hope you get what you're looking for! Birthing your baby is empowering and amazing, and you heal much more quickly. Your body was designed to give birth!

You might look into finding a doula to help advocate for you as well, and to increase your chance of success. Good luck! I hope it's amazing for you!

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E.M.

answers from Phoenix on

Vbac is very unpopular in this country due to risk pronouncements put out by ACOG. (whether this was the intended result or not is a moot point...many hospitals just won't do vbac, or highly restrict it.) If you have found some places that can...I guess the next question I would have to ask is ...will they? And if yes...under what circumstances...(like you can only labor so many hours before they thrown in the towel?)
There are more short and long term health risks for babies born via "C", so it's not just a risk to your equipment we are talking about either. With all the stuff about MRSA and superbugs, I do not regard hospitals as a place I would want to be hanging out in for longer than needed. C sections keep you in longer.
Have you thought about home birth...or birthing in a midwifery based care birth center? Midwives tend to be more dedicated to letting a woman's body get a baby out on is own.
If you are not afraid of longer labors, and want someone more dedicated to avoiding a section, midwifery care...in or out of a hospital.. may be for you. Even if you do not choose a midwife, talking to a few could get you an idea, of which doctors and hospitals really are more supportive of vbac. They may also be able to recommend doulas etc.

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C.K.

answers from Tucson on

Hi V.!

Congratulations on your upcoming birth! I admire your willingness to research your options, and to consider a VBAC delivery. I am a DONA certified doula, and I have had many clients successfully give birth vaginally after a cesarean birth. There are also some very good books on the subject...

A wonderful doctor in Tucson is Dr. Jennifer Reinhart. She is absoultely awesome. I've worked with her many times with my doula clients. They just moved to a new office at Swan/Grant: ###-###-#### http://www.awhcllc.com/providers.shtml

If you are interested in doula services, please feel free to contact me. To learn more about what doulas do, click here: http://www.dona.org/mothers/index.php

Best,
C.

[email protected]____.com
###-###-####

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D.R.

answers from Tucson on

V.,

I had my daughter via c-section - my doctor induced my at 41 weeks. I was fully dialated and 100% efaced, but she was stuck and no amount of manipulating was going to move her down. She was presenting with the back of her head instead of the top and she came out one ounce shy of 10 pounds (I'm not a big person). I had my son 19 months later and it was a successful v-bac. Up until the moment I went into the hospital I hadn't decided on a v-bac or another c-section. My water broke at home and I was 7 centimeters when I got to the hospital. I delivered at TMC and the wonderful L&D nurse there told me she could see no reason why I couldn't be successful with a v-bac. I also had an ultrasound the day before and knew that my son was about 2 pounds smaller than my daughter was.

My OB/GYN is Dr. Goldberg at Ironwood OB/GYN, right across from TCM. She did not deliver my son though b/c it was after hours. Dr. Laird was on-call and she performed the v-bac. The whole staff there is wonderful. I did have a c-section date planned, but as it turned out I went into labor before than. One thing my doctor told me was that she would not do an induction after having a c-section with my first child. So I don't know if you'll be able to find a doctor willing to induce you.

Hope this was helpful and good luck to you.

D.

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J.S.

answers from Phoenix on

Hi there, I had a c-sec. first (I tried to do a home birth and only dilated to 6 after 40 hours, talk about pain) and then a VBAC with my 2nd child and I would never have it any other way. The only place I could find that would "let" me have a vbac was Phoenix Baptist Hospital. I used Donna Tash, a mid-wife, and have met others that used her too. There is a great book called, Silent Knife about how c-sec. are better for the Dr. due to scheduling and how they like them cuz they get paid more. Not saying everyone is like that but another good one is that Ricki Lake documentary called, 'the business of being born." Whatever you decide, cheers to healthy babies cuz that is most important! Good luck!

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K.L.

answers from Phoenix on

Hi V.,

Just as an FYI, inductions are not recommended for a VBAC due to increased risk of uterine rupture. So, when attempting a VBAC, you will have to go into labor naturally. I tried a VBAC, but I was unsuccessful. :( I have very large babies!

K.

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S.S.

answers from Phoenix on

Homebirth for VBAC is illegal in the State of Arizona so this will probably not be an option for you. I'm a big supporter of VBAC and I probably shouldn't have sounded so harsh in my message to you. If you do find a practitioner willing to induce, please make sure you discuss all of the risks of a VBAC induction as this does greatly increase your risk of uterine rupture. I agree wholeheartedly with those who suggested ICAN as a resource.

Best of luck!

T.O.

answers from Phoenix on

Hey there V.!

I have 3 boys. My oldest was an emergency c-section..my 2nd a vbac (in San Diego) and was told here in Phoenix that I had to have a c-section due to the alarming amount of ruptured uterus'. According to my Dr. it would be difficult to find a physician to do a vbac after a c-section. I wish you well!

Oh and Congrats!

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M.G.

answers from Phoenix on

Hi V.!

I have had 3 c-sections and am about to have my 4th c-section. When I was going to have my 2nd baby I did ask about a possible v-bac but it was not recomended and I didn't like the risks involved. Of course there are risks with a c-section as well but the risk was much lower. If you can have a v-bac good for you but if not it is not unusual to have multiple c-sections. Your Dr. will tell you. Good luck to you and your family!

M.

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J.F.

answers from Phoenix on

I've had 2 V-bacs. My first son was a c-section due to being breach.

My first V-bac I had to be induced (well at least given Pitocin) as my water broke but I was not progressing far enough fast enough in labor. Stubborn little guy decided to try and come 2 weeks early then took all darn day to come LOL

My second vbac was with my now 3 year old. I had Dr's Goodman and Partridge as my OB/GYN's. Dr. Goodman had told me that not a lot of doctors will induce for a vbac as the chance for uterine rupture increases. This would be the first thing I would suggest you find out about.
I was also told that after a certain point, if I had not gone into labor naturally (by my due date) I would have no choice but to have a c-section. Again going past the due date the chance for uterine rupture increases.

If you are able to have a VBAC and have a doctor willing I absolutely suggest doing it. Having experience both I'll take a vaginal delivery anyday. I was up and on my feet immediately and felt great. With the c-section even at my 6 week checkup I was sore and hurting.

Definately talk to your doctor about all the risks involved with inducement, going past the due date etc. Leave no stone unturned in your search for information.
Best of luck and I hope you are able to have a successful VBAC.

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J.R.

answers from Phoenix on

Dear One Tough Cookie,
From the sounds of it you'll do great!! You have youth and vigor on your side. If you did not have any complications healing after your C-section, there should be no problem.

I've had 2 Vbacs after having an emergency C-Section the first time. The first Vbac was natural. The 2nd Vbac we induced 1 day early to be with a specific doctor. I did NOT have to find any special Vbac doctor willing to do this delivery. They should all be trained equally. In both pregnancies I informed my OB of my decision to want to attempt a vaginal delivery. The first time they were more cautious. The 2nd time they were more relaxed. And I was older than you, 41+ with my last baby.

I've not heard of finding a Vbac doctor until now. Perhaps that is an insurance dilemna as OB docs pay such outrageous insurance premiums now and have to cover their behinds.

Best of luck to you and your growing family!

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C.V.

answers from Tucson on

V., I just asked my daughter about your vbac concern. (She's a doula though not very active now because she's studying nursing.) She suggests you call the Birth Center ###-###-####) and/or the Congress Clinic ###-###-####). The midwives can guide you in learning your options.

C. Villa

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S.C.

answers from Phoenix on

"baby bag"

Hee-hee-hee......

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J.R.

answers from Phoenix on

Hey! I've had a c-section with my first (and only). I am totally against having another one, so I've done quite a bit of research on vbacs, but have not experienced one obviously. Anyway, from what I understand, you can not be induced for a vbac.

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T.R.

answers from Phoenix on

V. please try the v back. I did and it went great. I had a c-section baby, vaginal, then another c-section. The scar tissue you can get from surgery can effect you later. It becomes very painful and sometimes has to be removed. Anytime you can avoid surgery you should. Of course talk to your doctor and make sure it's safe but if it is unavoidable go for the vaginal delivery. Good luck and congratulations.

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J.J.

answers from Phoenix on

Ok I'm a little late to respond and I see you have quite a few responses already. But, I thought I'd give you my two cents. My first child was a C-section due do being breech. My Dr. recommended that I try a V-bac with my second. Since the C-section was not due to the birth canal being too small or complications like that that I should try a V-bac. She did induce me so the baby would not be too big and risk rupturing the uterus. She said if things didn't progress, we could always do a C-section if necessary. I had a V-BAc with no problems and I was glad I did. The recovery time was far better than the C-section. There was a recent article in the Phoenix newspaper regarding having too many C-sections (and internal scarring problems)that you may want to look up.

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L.M.

answers from Albuquerque on

Hello V.. I had the same concerns you did. I wanted more than 2 kids and I did not like the idea of having multiple cesareans. I had an emergency cesarean (at age 33) with my first daughter 36 hours after my water broke. The determining factor was fetal distress. My daughter was 8.5 pounds and a beautiful healthy girl. The reason for your 1st cesarean comes into play in deciding if you are a good candidate for VBAC. The orientation of your uterine incision is also a factor to consider. I specifically stated on my initial birth plan to be double stitched for future VBAC in the event of a cesarean. After careful review of the literature I decided to pursue VBAC with my second pregnancy 2 ½ years later. I stayed as active as possible, did water aerobics throughout the whole pregnancy, and gained only 30 lbs. I was just shy of 42 weeks when I was induced with pitocin and 12 hours later my 9.7 pound robust son was born vaginally. It was a beautiful and joyous experience. I would do it again in a heartbeat. I felt connected with everything going on and not just a participant in my own surgery. My recovery was quicker and I resumed exercise sooner. Do your research and decide what works best for you and your family. A repeat cesarean isn’t without its risks but I have friends who say their second surgery was easier than their first.

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A.P.

answers from Phoenix on

My daughter's first child was a c-section because of failure to progress after the water broke. She did MUCH research and decided to have a home birth with her second and did great. The first two are boys and last August she delivered her third baby (a girl) at home.

If you want I can give her your email to discuss it with her. Mine is [email protected]____.com

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L.R.

answers from Albuquerque on

I think each situation is different for each person. I personally went with the VBAC and am glad I did. my daughter was induced, and I ended up having a C-Section because her heartrate kept dropping with each contraction. Now, since there wasn't anything medically wrong with the first childbirth, I told my midwife that I wanted to have a VBAC with the second. With my son, everything just seemed to happen so quickly and before I knew it, my body was ready to push. with my 2nd child, I went through everything naturally, and that really wasn't by choice. :) not that I regret any of it. you'd be amazed with how quickly recovery time is not to mention (if you're going to nurse this next baby) how quickly you produce your milk.
Good luck with whatever choice you make! :)

A.H.

answers from Phoenix on

I have not personally had a v-bac or even a c-section for that matter. The reason I wanted to write though is to tell you that I have a friend who has 9 children...yes, nine children. She did have twins, but that said, all her babies were delived via c-section. Although it is not recommended, I can say that I personally know someone who has defied the odds and she is just fine. Of all my friends who had c-sections, some have had all other babies that way, some have done v-bacs. If I were you, I would do everything in my power to have a v-bac. Anytime you can avoid a surgery, I would. Good luck though! And congrats on #2!! I hope whatever you end up doing goes well!!

Blessings,
A. (SAHM of 4 boys)

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M.B.

answers from Phoenix on

I don't have a good suggestion for a Vbac doctor (sorry), but I do know that if you are going to have a Vbac, you do not want to be induced. Pitocin, the drug they use to induce you, could possibly cause the scar from your C-section to rip apart. That would not be very good for you or for the baby. If you are going to try a Vbac, you'll want to go into labor on your own (as much as possible), and with second babies (at least in my experience) that is a lot easier. Another option is you could possibly live with your mother for the last few weeks of your pregnancy, so that you don't have to drive 2 1/2 hours to get to the hospital once you go into labor. Good luck with all of your decisions! And congratulations on your second! It is such an exciting time!

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R.C.

answers from Albuquerque on

I had nearly the same dilemma. :) Baby #1 was an unexpected c-section due to failure to progress. We stalled at 4 cm as well. Since we want a large family, and the risks during pregnancy and delivery increase with each c-section, I decided that I was going to go with a VBAC. I have no regrets! There are risks and the docs will be particularly worried about uterine rupture. (I think the kind of c-section you had before -- vertical or horizontal -- and the way that you were stitched up afterward also impact the likelihood or risk of rupture. I was lucky, my risk was low. Also, I think --maybe-- that the length of time between the deliveries may be significant as well. For me, it was 3 years.) They're going to monitor the baby's heart-rate carefully for that reason, the risk of rupture. A dipping heart rate could indicate rupture.

Now, I was told that the epidural could cause a dip in the heart rate and that if the docs saw such a dip, they might be concerned about rupture and rush me to c-section. So, I decided NO epidural. I didn't make it, hard as I tried. :( At about 6 cm, I got the epidural but the anesthesiologist knew my concerns about mixing up the causes for the dipped heart rate. To keep my blood pressure at a level that would not affect the baby's heartrate, she kept giving me epinephrine (I think, I was a little dazed at that point... my labor lasted nearly 60 hours start to finish, so I hadn't slept much). I would recommend some more research so that you know the risks, of course, but it can definitely be done.

Also, on the two hour hospital thing... now that's a little more risky than us. :) We lived about 40 minutes from the hospital this time (instead of the 5 minutes distance during my first pregnancy). So my doctor just advised me to leave when my contractions were a little further apart (7-10 minutes) than we'd normally have left. With my first baby, I hadn't even really had good contractions so I didn't know when to start counting and I kept panicking that I was in labor long before I was. Once I actually was having contractions that were regular, and we went to the hospital, it turned out to STILL be early labor. (About 24 hours later I finally found out what REAL contractions feel like. haha) All in all, the doc said that my first labor didn't really "count" and this was still like having my first baby "naturally" so the process would likely be fairly long. She was not at all concerned about me delivering at home if I left when the contractions were regular. Though, delivery at home was not something she recommended because of the previous c-section.

In any case, it can be done! :) God bless and congratulations on your growing family!

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K.P.

answers from Phoenix on

My sister in law is actually pregnant with her 4th and she is having another c-section. She was told, along with my other Sister in law - that they will do 4 c-sections before saying no more...sorry I've had all natural so I have no experience with that. But they too were concerned as they wanted a large family too.

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C.H.

answers from Phoenix on

I am a successful Vbac'r. My first was 7 weeks early (my water broke) - Emergency cesarean. I was in pain for 6 months and could not imagine trying to recover from a C-section again. I found a doctor for my second, who though she did not promote the Vbac, she was willing to allow it (so long as there were absolutely no red flags) because my previous reason for a c-section was a total fluke and not because of complications.

At one week overdue, dialated to a 3 and 90% effaced we induced and 3.5 hours later I had my son. 8lbs, 3oz. I had a mid-size episiotomy - but come on - he was a porker! The labor went perfectly - no issues. Only in pain for 2 weeks, and that was because of the episiotomy.

My experience taught me that the importance with Vbac's is to let your body do it's thing first. Your readiness for delivery needs to be progressing on it's own in order for the possible complications to be minimal. And no doctor in their right mind would induce on a Vbac if you are not progressing naturally.

Best of luck!

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K.T.

answers from Albuquerque on

I think it is fantastic that you are considering a VBAC for your next birth! From what you have said, my first birth sounds very similar to yours. I felt very strongly that I wanted to deliver vaginally the next time around, so I chose to take a Hypnobirthing class in hopes that it may allow me to block out some of "baggage" from my previous birthing experience. I highly recommend looking into this method if you haven't already.

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L.M.

answers from Tucson on

Check out the VBAC boards at Mothering.com, as well as ICAN.org. This is something where you have to do a lot of research, and those two boards are a good place to start. I believe Grace Maternity does VBACs, and there's some docs out of the U of A that do as well.

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A.H.

answers from Phoenix on

You might want to get in touch with "ICAN of Central Arizona" to discuss your options. The group leader is Sally Stevens. She can be reached at [email protected]____.com and she can give you the meeting times and locations as well as give information to help you make your decision.

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A.

answers from Albuquerque on

If I were in your shoes, I'd seriously consider a VBAC. I know TONS of women who have had one successfully and many of those had homebirths, to boot. While there are concerns with a VBAC, the risks of an elective c-section still far outweigh VBAC risks. Look at the statistics and choose what's best for you. This place is not local to you, but here's an article on elective c-sections:
http://www.bodymindandspiritabq.com/articles-and-past-new...
Good luck!

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J.S.

answers from Phoenix on

I am faced with this same decision, but it is my understanding that you can't be induced when having a vbac. You have to go into labor naturally. hope that helps with your decision.

J.

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M.F.

answers from Phoenix on

I know that my cousin had 4 kids via c-section so that may be a possible number for you. VBAC can be successful but the other comment was right, there are not many doctors that are willing to do it. I think you would definitely want to be in a hospital because if your uterus were to rupture suddenly during labor, that is where you would want to be- not en route to the hospital. Look around, call around and find a doctor that will do it... and ask if he thinks it can be done successfully- and if he/she will support it, not just be willing to let you "try" for a few hours and then make you have the c-section anyway. Good luck.

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