How do I decide between an elective section and a vbac?

[mattison]

Just chiming in: I had a c-section with DS1 and was given the option to have elective c-section with DS2 or attempt VBAC. I opted for VBAC and to go all natural. However, I went two weeks overdue and then was not allowed anymore time and was induced. Contractions were much stronger and more painful, BUT! I had a successful VBAC

I am really happy that I gave VBAC a shot, it was a lovely experience and I healed very quickly (like 3 days, back to normal!). I minor tear, bubs was healthy and weighed 7.14.

So, I guess I am encouraging you to consider VBAC if it is truly something you'd like. I don't think you'd regret it. But of course it all depends on the personal circumstance of the pregnancy

 

[fuschia]

Thanks so much everyone and mattison its wonderful to hear a success story!

I am pretty sure I have decided on trying for a vbac!

Its so scary but I am now going to use this time to prepare mentally and physically for this.

I'm looking into pregnancy yoga and hypnobirthing classes. I think that these will help me get in the right frame of mind and convince myself I can do it !
Consultant and I have agreed no to induction though-,so fingers crossed I will labour naturally. Last time my water broke but I did not labour- I just wonder if this time I can try and prepare my body more so that I might just start the natural labour as it is agreed that I will have an elective section instead of induction in this circumstance!

Fingers crosses ladies! Thank you so much! I hope I can update this thread with a beautiful natural intervention free birth in July/Aug!

 

[Sass827]

Hey ladies! Great thread. I've had the same argument with myself.
First cs came after I labored for two days then they broke my waters for me. They came out black. I never dialated past a three so we did 17 hours of pitocin and I still didn't get past an 8. I got a fever and they thought dd had a fever too so we went for an emcs. When they opened me up, my uterine wall was all infected. Not sure exactly what make of all that. Dd was 8 lbs and 21 inches so bigger than expected and they had a tough time pulling her out. I couldn't walk more than a couple minutes for a good six weeks.
I know I should at least attempt a vbac so I can avoid that kind of recovery. I'm trying to put myself in a better position thus time. I gained 55 lbs with dd by eating junk so I'm trying to make better choices this time and work out so I can be in good fighting shape for labor. I also hope to walk more and lay less at the hospital.
What I was hoping to add to the conversation is that through my research I've been finding that the rules are so different from hospital to hospital and dr to dr. For example, my doctors will not induce a vbac period. You have to go into labor on your own. They also make you have an rcs scheduled ahead of time, even if you're going for a vbac. They said they would let me schedule it as late as 41 weeks, but no later. If labor were to stall after starting then you can gave pitocin if you want it.
They also recommend a vbac trial for anyone who wants more than two kids because all the bad risk numbers jump up at #3, but ironically, my bf just had her second cs and her dr never said this to her an encouraged her to, "go have 5 kids if you want."
My husbands co workers wife had her second cs last month and she opted for a rcs. So it was planned ahead. I want to share this not to scare but just to share. I guess I should go back and say my bf said her rcs was so much better than her first and her recovery was really fast.
Ok so vback to my DH coworkers wife. Her water broke the day of her rcs so she ran in and had it done right away. She's now regretting not even giving it a try. And her recovery has been an extreme nightmare. I know it's a rare case but it's really scaring me. She got a wicked infection in her incision and has literally broken back open twice. She has a home nurse caring for her so I'm not sure how this keeps happening but it does.
I really hoping my vbac works. I just had my anatomy scan and they say my placenta is low lying. If it doesn't move up, I wont even be given the chance to vbac. So now I'm just so hopeful that it will move but they say with a prior cs, the scar tissue can get in the way.
Sorry for the ten page letter, I'm just so into this topic pic right now. I hope whatever all you ladies are hoping for, you cone out with the best outcome possible and healthily little lo's.

 

[fuschia]

Sass hi! Thanks for posting- I too am really into this at the mo - I think about it all the time !

I think what helps me in mY mind is that I know there are measures in place this time to avoid a PrOlonged longer labour- which it sounds like you had that too!

I wonder why you Had the infection- I also had a nasty infection in my uterus lining but this was discovered 5 days post partum and was put down to mY waters being broke for so long then the section.

My consultant has written in my notes that I am to have preventative antibiotics with section or natural birth to be safe and just in case I am liable to get it. Is this worth discussing with your doctor?

Where abouts.are you? In the UK?

 

[SoupDragon]

definitely following this post..

we are ttc number two and I'm wondering the same thing...

I was induced with DD on the Thursday and had her by EMCS on the sunday lunch time after breaking my waters at 10:30 on Saturday night. I got to 9 cm but then went back down to 6cm when they finally called for the section. I was so tired, completely out of it (to the point that my OH was worried about my state) and was begging for them to help me.

Lo was 10lb 1oz and I was told on the operating table by the surgeon that I wouldn't have been able to give birth to her naturally because of her size and that my pelvis was too small (similar to above comments).

I've had the experience of labour as such with the contractions etc so am glad about that but am also wondering whether to try for vbac. My concerns are if I have another baby who is as big, or bigger, than my DD. I asked if I'd have growth scans in a future pregnancy and was told no due to their inaccuracies.

I think either way there's always that feeling of what if and, for me, guilt.

are you me?!

Ok, we're not ttc yet, but after going into labour on my own and contracting for 2 days, I got to 9cm and then my cervix swelled so I went back to 6-7cm. I had the whole lot - G&A, pethidine, waters broken for me, epidural, and eventually an emcs. The surgeon also told me I'd never have got DD out on my own - she was also over 10lb and was back-to-back so hadn't been able to descend.

If there is a next time, I'll be having growth scans throughout (I have a medical condition that requires me to have them anyway, though the ones I had with DD didn't pick up her size; they estimated she'd be 8lb) and if the baby is of a suitable size and in the right position, I'll be allowed to try for a vbac.

I found the emcs very traumatic and I took forever to recover from it. I was devastated for a while about not having her vaginally; I suppose I felt cheated of the experience I wanted, and while I've (mostly) come to terms with it and obviously understand that I had to have the cs in order to keep DD and myself healthy, I'd still like the chance to go for a vaginal delivery again.

They have said that they wouldn't induce me, so if I went overdue it would be an automatic repeat section.

 

[IsabellaJayne]

I had an EMCS under GA due to slow progression after induction and fetal distress. I will be pushing for VBAC definitely. I'm only early so obviously I haven't had any appts discussing it but it will be made clear to my consultant that I want a VBAC. Unless it gets to the point of induction, I'll have an elective

 

[Sass827]

Hey fuschia! I've wondered about the infection too. My doctors always mention pulling my notes at my appointments but, to my knowledge, haven't yet. I guessed that maybe it came from all the pitocin or maybe the meconium? Just guesses though.
I'm in the U.S. I will def ask about the antibiotics at my next appointment at the end of April. Did your notes give you an idea of why you had your infection? Thanks for the info!

 

[bitethebullet]

Hi hun i am in the uk! Thanks for that it was really helpful. Not spoken to midwife yet I found out I was pregnant yesterday so will be fue around 12th nov all being well... i know i am way ahead of myself worrying lol!!! I have become literally petrified of birth I can't even watch it on soaps :/ and this is someone that used to work in a hospital.. i don't know what has happened to me. It has been just over two years since I had DD and we were trying for this baby but I had a bit of sudden panic after the initial joy of the bfp yesterday... i must sound ridiculous. I am going to have a good read through all of your ladies previous replies now

When I spoke to my midwife I was so surprised by how supportive she was in my decision to potentially go for an elective given that there probably isn't any reason I shouldn't try a VBAC in my circumstance.

 

[fuschia]

Sass- my notes didn't indicate why I got infection but I was told it was just because the time between waters breaking and baby coming was quite great and also followed by the c section it was a even higher risk. My question to them is why on earth didn't someone have the clever idea of giving me antibiotics considering how high risk I was ! They didn't even tell me things to look out for. So I was back in hospital because some of the symptoms from infection I was putting down to recovering from the section!

I'm Happy to have preventative antibiotics this time though for sure !

 

[Sass827]

How much time passed?
They took my dd to the NICU for 48 hours because they thought she had the infection too. Luckily she did not and it was only me. Did they think something like that for you too?

 

[bitethebullet]

My first was breech- we found out at 42 weeks just as they were about to induce. I had a c section instead of trying to turn her. I'm also now trying to make up my mind whether to go for VBAC or elective c section. I'm so torn.

That's exactly what happened in my first pregnancy. I was 41w5d when I went in for the induction and I mentioned my feeling that he was breech to the nurse who was hooking up the fetal heart monitor and she thought it was worth checking further into. My cnm had poked around on my belly when I asked her about it, and she assured me he was head down. Well, the nurse grabbed a portable u/s and actually looked. Sure enough, he was frank breech, and face up. The OB was called in to look and he said also there was almost no fluid left (my water hadn't broke, it just sort of naturally starts to get low if you go overdue, but mine had gone like extra low) so he said we could try to turn him, but it probably wouldn't work. He said if he was a full breech instead of frank, we could still induce if I wanted to, but we talked it over and did the cesarean.

With my second, I had the option of vbac as long as baby was head down and I didn't go more than a week overdue. Baby was in perfect position, but my office won't induce on a vbac so at 41w1d, I had a RCS.

Personally, my recovery was much worse the second time around, but I know some of that was due to the fact that I just did not want to be having the surgery but was basically forced into it.

Now that I've had two cesareans, no matter how the pregnancy goes, I have no option but to have a cesarean every time now.

So remember to think about that too, when you're deciding whther or not to have a second cesarean. The second one doesn't carry much more risk than the first one does, but each one after that, the risk goes up signifigantly. The risk of really scary things like needing blood transfusions or maternal death is much higher for a third cesarean than it is for a vbac!

Obviously some people, like the ladies who have an abnormally small pelvis, for example, really don't have the option to decide, but some of you do. Another good thing about vbac is that your baby comes when it's ready instead of on the doctors timetable. That's also true in the cases of a cesarean after a trial of labor.

I was just so glad that they scan before induction at the hospital I went to! Everyone who felt my tummy though she was head down. It's a good point about the risk of future sections. We don't plan to have a 3rd chikd but I guess we could change our minds at some point.

 

[m nonie]

With DS my waters broke but I wasn't get strong contractions they could monitor and his heart beat was plummeting so it ended up being a emcs, he was prem and pretty small but as always a wee fighter. I was almost sent home as "I wasn't in labour" half a hour before I was rushed into the labour ward it wasn't until the consultant checked they found I was 6cms. Unfortunately I don't have any real memories of my first 3 days after having him, which is far and away the most difficult thing I've had to deal with. I so wish I could remember anything from those days.

Me and OH have sat and talked this over so much, we've decided to have another c-sec as I dont think I could cope with the missing memories again if it ended up being a emergency this way hopefully I can fell a bit more in control and know that baby is definitely with her dad (they last hospital didn't tell him DS had been born till well after as he wasn't married to me ). Tbh I feel real guilty but then I also know I've got to know I control anything. Hope that makes sense.

Ps thank you guys, I keep feeling judged about my choice so I'm glad I'm not alone in this decision.

 

[captainj1]

Just a quick update from me - I didn't get my vbac. Went 7 days overdue and baby still wasn't engaged and cervix was closed so I couldn't be induced without using gel, which my consultant is against when there has been a previous section because of the risk of it bringing on strong contractions quickly and hence risk of uterine rupture. So I had an elcs at 41+2. It was physically (the operation bit) more traumatic than the emcs which I wasn't prepared for - having been in labour before my emcs, my ds was head down and low down in the uterus so right where the incision was and was pulled out straightaway. Because I wasn't in labour this time, dd was up high in my uterus and two midwives had to push her down from under my ribs quite aggressively - making me very aware of the being pushed and pulled and feeling very sick. I also had a big drop in blood pressure so ended up with an oxygen mask on. I spoke to the consultant afterwards and she said that all that pushing around is quite normal for an elcs...wasn't very nice!

 

[Sass827]

I'm sorry you didn't get your vbac captainj. Congrats on your baby girl! Hope you're recovering well.