Leaning Toward Having a Second C-Section

[hakunamatata]

I've been wrestling with whether or not to try for a VBAC, but I think I'll be choosing a second c-section. I was reading this link and found this information:

Overall estimated risk:

Spoiler

Overall estimated risk — The NICHD consensus conference panel determined the following risk estimates based on data obtained by systematic review [34,54].

In a hypothetical group of 100,000 women of any gestational age who undergo TOLAC, there will be 4 maternal deaths, 468 cases of uterine rupture, and 133 perinatal deaths [54].

In a hypothetical group of 100,000 women of any gestational age who undergo ERCD, there will be 13 maternal deaths, 26 uterine ruptures, and 50 perinatal deaths

Risk to baby is small for either a VBAC or an elective repeat c-section, but it is slightly safer for the baby to have a c-section, so that's why I'm thinking of a repeat c-section.

abbreviations:

TOLAC - trial of labor after c-section - if successful it results in a VBAC
VBAC - vaginal birth after c-section
ERCD - elective repeat cesarian delivery

 

[baileybubs]

I know I'm a bit early in considering this as my first is only 5 weeks old and I'm not pregnant again yet but I am also considering what's best for the future.

I think the risks are pretty similar either way really so I think it's maybe a case of what is best for each individual. For me, I'm leaning more towards c section because the reason for my first is because she got stuck and became distressed, and I wouldn't want to go through that again. Also I was induced due to high blood pressure so there's every chance that would happen again with me.

It's also been pointed out to me though that you need to consider the recovery which will be much longer with a c section and of course you will have a toddler to look after as well as a newborn this time, so it might depend what support you will have available and for how long.

But on the other hand I know how much I would hate to try for a vbac, go all through labour and end up having another emcs again!!

Sorry that probably wasn't much help! But maybe wait a bit longer before you make any decision as its possible it might end up being made for you, baby could end up being breech or something you never know.

 

[hakunamatata]

Congrats on your new baby!

My first was breech which is why I had the c-section. If baby #2 is pointing in the right direction, I could consider the vbac. The c-section was "elective", however the hospital refused to attempt to vaginally birth a breech baby, which is fine because obviously the baby's safety comes first.

Sorry to hear about your difficult labor and your emcs.

 

[solitaire89]

Could I suggest that you team your results with the stats for women who haven't had a previous CS? It may be that the stats are similar - therefore it's nothing to do with the previous method of delivery. I don't know, they may be the same, they may be wildly different, but there is something niggling somewhere that a CS uterine scar is the strongest part of the uterus, which makes me wonder about applying the findings of the study... Please don't quote me on that though, I've not researched it thoroughly.
I hope you come to a decision you are happy with (and I'd be quite interested to see what you find out if you look at it)

 

[mummyfin]

Aside from statistics, here's one experience of the situation. I had an emcs with DS that was fantastic, great op and recovery. 4 and a half years later I have just had an elective because I thought it would be better than a vbac, but my recovery has been horrendous. Two infections, wound opened up four weeks after and I have a keloid scar that's still not properly healed 10 weeks later.

So just a wee reminder of how serious, painful and life-restricting the recovery can be from a c-section too, even if you have a good first experience. I wish I'd had a vbac now.

 

[Momof2TTC]

I had an Emcs with my first because he was face up and got stuck. He went into distress. The recovery as rough! I elected to have a cs with my daughter 2 years later. The recovery was SO much easier. I needed no pain meds after the epi wore off. It was tough to move around sometimes with my 2 year old but honestly I don't regret it. I opted not to vbac because I did not want to go through that again and end up with an emcs. I didn't give the stats a second thought.

 

[vintage67]

I have been so traumatized by a recent case of a woman refusing a c-section or an induction and letting a baby go nearly 43 weeks and having it stillborn all because the importance of a VBAC was put before everything. The internet and The Business of Being Born has fueled this and tried to make every woman who had a c-section feel like a failure and her doctor a criminal. I understand someone feeling a bit traumaticed by an EMCS, but it doesn't help when on the internet you have those feelings being fueled by women who didn't birth "naturally" being insulted.

Sorry to get so worked up.