V-bac after 2 csections

[KimmieHawkins]

Ok so long story short my first son was 40wks and 3 days and dr said I HAD to induce(I was 20 and had no idea so I went with it) the induction was terrible. I was in labor for 3 whole days and my son became stuck and I had an emergency CSection.

My second son they told me I HAD to get a CSection bc if my first got stuck he would too. After the scare of heart rate dip and such with my first I wasn't willing to risk it and went with the csection.


Here I am 3 years later pregnant with my 3rd and final baby. I whole heartedly want to experience a vbac. I'm totally concerned about the risk though bc I've had 2 csections in the last 5 years.

Any of you ladies had a vbac after 2 csections? Any advice is welcomed.

 

[JJay]

I'm no help but interested to see replies. I've had two sections also - very similar situations, although first was at 40+15 and second at 40+12. I really wanted to vbac last time but after going so over due, they didn't recommend induction and DS was high, back to back and estimated to be 10-11lb. I got nervous and agreed to an elective.

I'm pretty sure I'll go for an elective this time but there is a small part of me that would love to try for a natural birth. I got to 9cm with DD so I was nearly there!

 

[laila 44]

I'm having my third csection similar to you my daughter just failed to descend first time at 10cm and second was just a planned one. My OB isn't keen on vbacs in general mainly bc he lost a mother and baby years ago to uterine rupture so he doesn't encourage it. However he may let you try if you've only had one previous csection and depending on circumstances etc. I know after 2 csections he refuses and tells patients who want to attempt to plainly go elsewhere. Too many risks, too much scar tissue. Depending on who your provider is they may let you try. However I thought about it myself and did research and have decided the risks don't outweigh the benefits for ME so I'll be going with another planned section. Good luck in wtv you choose xx

 

[KimmieHawkins]

Thank you ladies!!

 

[Marumi]

I have only had one C Section but interesting question. I want to attempt a VBAC bc I am a very good candidate for it with over 4 years between pregnancies. I was also told that a knowledgeable midwife can see the warning signs if it won't work out before problems arise. The risk of uterine rupture is astronomically low after one C-Section to the point that a C Section bears a higher risk of complication but idk after 2 times.

 

[pinkpassion]

The risks are very low compared to the risks of a c-section and ANYONE willing to deny that is not educated. Any ob when asked, will tell you the main risk of vbac is uterine rupture which is quite small 0.7-2% risk, BUT of that 0.7-2% only a very very small percentage of them are catastrophic (loss of baby or mother). On the other hand the risk of c-section (and you sign a form stating you are aware of these at the time) are incredible, injury to organs, bowel perforation, uterine rupture, injury to baby, hemorrhage, hysterectomy, blood clot, embolism, stroke, death, sids risk is higher in c-section babies, the risks go on and on, especially if you are planning more children, risks of placenta accreta and other issues raise!.
Educate yourself with real statistics, not stories from people who "know of someone that..." or from fearful obs. Many obs arent willing to take the risks due to their steep insurance costs and risk of malpractice. Seek a midwife that has seen many vbacs, even if you want an ob with hospital birth (which I've chosen because that's where I feel more comfortable for my vbac ) but if nothing else a midwife can share some information with you.
Many drs will tell you because you had a "failure to descend" that you probably have cpd (cephalo-pelvic disproportion) where baby can't descend because the head is too big to fit in the birth canal or pelvis. True cpd is rare.

My point is, educate yourself on everything. What happened in your other labors, what you can do now to prepare, what the real statistics are and what the TRUE risks are. AND not only what is best for you but also baby. Even if you find a dr willing to allow you a TOLAC (trial of labor after c-section) the hormones released are good for the baby and help your baby prepare for the outside world.

I personally am choosing to vbac this time. I had a c-section with my daughter after the "cascade of interventions". I've been studying non stop and I've interviewed 12 obstetricians and 3 midwives in the greater Houston area. I've seen the literature, I've learned and begun to understand the human body and how labor works. I'm taking many steps this time to ensure I've done everything possible to get have a vbac. I'm eating healthy, exercising and staying very fit, stretching and yoga, regular chiropractic care, healthy pregnancy weight gain (25-35 lbs total, more like 20-25 lbs for me personally because I'm so small already 93 lbs prepregnancy so I don't need to gain as much as others). All these things can make a difference. Especially chiropractic care, making sure your spine and pelvis are in perfect alignment.

I hope some of this information is helpful. Ultimately it is up to you to find out the real facts and make the best decision for you and your baby! Good luck!!!!

 

[babybambi]

I'm the same as mauri, one emergency section and four years since. I have an appointment with a consultant after my 20 week scan to discuss a VBAC as I should be ok to have one according to my midwife. My section was due to my sons meconium aspiration and his heart dropping. It was a scary time and I want the birth to be as smooth as possible.

 

[6lilpigs]

Kimmie, slightly of topic but did you have any scans yet to have a quick peek as to who's in there

 

[laila 44]

I think attempting a vbac after one csection is do able it's when you've had two that it becomes a tad more complicated. Although I had thought of it, for me it really doesn't matter to live the experience of a "natural" birth. All I care about is a healthy baby. In the end how he/she gets here is of zero relevance for me. So I think it's a personal choice. Even though there is that small chance of uterine rupture there still is a chance and it does happen! I just don't want to be that statistic. Csections have their own risks as well but comparing the two is a bit extreme. My OB is one of the top and is very easy going not alarmist has been in tons of crazy birth scenarios but vbac is just not something he recommends after 2 csections... My previous OB with my first didn't entertain the idea at all no matter how many previous csections. It's very personal decision and what works for one may not for another.

 

[pinkpassion]

Laila but I do believe you HAVE to compare the two after all those are your two choices. There is no other way to get baby out so YES you must compare the two and their individual risks.
I agree it is an individual choice. And perhaps my post should have been more clear. that statistics I quoted are for vbac after 1 section and the higher end was for 2+, so you see the risks are not that increased. And as I stated OF THAT rate only a very few are catastrophic. Everyone is so scared of rupture but Rupture isn't always fatal. In fact it very rarely is, especially when monitored closely. So the fear that dr's DO instill in their patients comes from not wanting to see that very small percentage. WHO WOULD? Who, after spending 9 months caring for a mother and her unborn baby would ever want to see that. It DOES happen but those numbers are so small. That is why a woman has to decide which risks they would like to take, vbac vs c-section, and based on the current pregnancy and past labors, what is best for you!!
There really is no judgement from me. My only concern is for a healthy baby, healthy Mother. Period. How that happens in the end is irrelevant!!!

 

[laila 44]

Laila but I do believe you HAVE to compare the two after all those are your two choices. There is no other way to get baby out so YES you must compare the two and their individual risks.
I agree it is an individual choice. And perhaps my post should have been more clear. that statistics I quoted are for vbac after 1 section and the higher end was for 2+, so you see the risks are not that increased. And as I stated OF THAT rate only a very few are catastrophic. Everyone is so scared of rupture but Rupture isn't always fatal. In fact it very rarely is, especially when monitored closely. So the fear that dr's DO instill in their patients comes from not wanting to see that very small percentage. WHO WOULD? Who, after spending 9 months caring for a mother and her unborn baby would ever want to see that. It DOES happen but those numbers are so small. That is why a woman has to decide which risks they would like to take, vbac vs c-section, and based on the current pregnancy and past labors, what is best for you!!
There really is no judgement from me. My only concern is for a healthy baby, healthy Mother. Period. How that happens in the end is irrelevant!!!

Totally

 

[KimmieHawkins]

Kimmie, slightly of topic but did you have any scans yet to have a quick peek as to who's in there

Lol I go on the 6th!!!!! Lol

 

[Septie]

I just had my third section this past summer, and we are so lucky we did not have a vbac, according to my obgyn: First, I had a uterine window - so a very thin uterus that would likely have ruptured during labor (and probably due to my prior sections). Second, even without the risk of rupture, baby had a true knot in the cord, which the doc was quite surprised about - and which may have led to problems during labor as well. Generally, after much research, I think a planned (!!) section is safer for baby, but less safe for the mom... Most stats on complications from natural birth vs section lump the emergency sections with sections - which is simply not a fair comparison!

 

[KimmieHawkins]

Thanks ladies!!!! I'm totally going to explore my options!!! Hubby wants me just to do the csection but I'm not 100%. I just want a ob or midwife to actually sit down and discuss my specific case instead of just giving me an automatic no like I have no say in it. My local mommy friends gave me a few dr recommendations and at 13weeks I have a little bit of time to play with my options. Thanks so much for all the detailed information

 

[KimmieHawkins]

I just had my third section this past summer, and we are so lucky we did not have a vbac, according to my obgyn: First, I had a uterine window - so a very thin uterus that would likely have ruptured during labor (and probably due to my prior sections). Second, even without the risk of rupture, baby had a true knot in the cord, which the doc was quite surprised about - and which may have led to problems during labor as well. Generally, after much research, I think a planned (!!) section is safer for baby, but less safe for the mom... Most stats on complications from natural birth vs section lump the emergency sections with sections - which is simply not a fair comparison!

When did they discover the thin uterus? I'm scared I might have something going on down there bc I have a constant pain on my right side of my csection scar

 

[biscuits104]

Kimmie, slightly of topic but did you have any scans yet to have a quick peek as to who's in there

Lol I go on the 6th!!!!! Lol

I too can't wait to hear what you are having!

 

[KimmieHawkins]

Kimmie, slightly of topic but did you have any scans yet to have a quick peek as to who's in there

Lol I go on the 6th!!!!! Lol

I too can't wait to hear what you are having!

We're so close!!!! I'm terrified! lol I'm PRAYING. I see those magical 3 lines! Lol

 

[eva1978]

Curious to follow the conversation!
I've also had two sections (not by choice - various issues in late stages of pregnancy, in second case problems ONLY arose during natural labour).

With this pregnancy I've seen 1 midwife and she was very encouraging about VBAC ... which I used to think I wanted. I was pretty set on VBAC with baby #2, and I did a lot of the same things to prepare that pinkpassion is doing now. However, things didn't work out the way I was hoping in terms of labour and birth. In the end I think the C-section probably saved my baby's life and so I'm really nervous about trying to go natural this time. I'm now leaning toward an elective section (never thought I'd say that!), but need to explore my options a bit further first. The thing that's ringing true to me is the sheer anxiety I feel when I think about VBAC and things going wrong, like they did last time.

A C-section is indeed risky - and recovery can be a bitch - but there is less uncertainty involved. Especially when you've already had more than 1!

 

[Itsychik]

The "problem" with trying for a VBAC after 2 (or more) c-sections is that there's such a stigma around this in many hospitals (especially in the U.S.) and due to liability many doctors won't even consider it.

I had an EMCS with my first after 14 hours of labour (after induction) due to fetal distress (his heart rate dropped and his blood oxygen levels were very low) and when he was born the cord had been wrapped multiple times around his neck and chest, and he was blue and not breathing. I'd never progressed past 4cm. I was just glad that he was 'safe', but for my second baby I was desperate for a vbac, and also tried preparing myself in many ways other PP's have mentioned. I refused all interventions (and a planned c-section) and was convinced that a natural labour should help. Long story short, but after 16 hours of labour and (again) failing to progress past 4cm, my DD turned and got her forehead stuck in my cervix and her heart rate started dropping significantly with each contraction... so ended up with another EMCS.

So now I'm on #3. I desperately long to experience a vaginal birth. I want the experience of holding my baby immediately after the birth, skin-to-skin and breastfeeding, to be the first to hold him/her and not have to wait until my arms are un-numbed enough to move around, till the post-op shaking has stopped. I want to be able to go home after the birth and hug, cuddle, and pick up my other children without a terrible pain from the c-section (let alone walking my son to school in the weeks following the birth...). I could go on and on... there are so many experiences that I wish I could have that just aren't possible after having another c-section. From the moment I found out I was pregnant and had my first appointment with the midwife, I've been adamant that I want to try for a VBAC and I'm willing to switch hospitals several times if need be to find someone willing to evaluate my case FAIRLY and not just give a blanket "no" just because it's "not done" in many places.

There are risks to any procedure, and from what I've been reading/hearing the "increased" risk of uterine rupture is very small. The OBGYN I spoke to told me that there are other increased risks, such as with a 3rd emergency c-section that the risk of damage to other organs (I forget the medical term, but some of the organs sticking to each other?) can increase (from 0.5% to 1%)... but to be honest that wasn't a number I found particularly troubling. And in terms of an actual increased risk to the baby I couldn't find any details about and my OBGYN couldn't give me any concrete examples or risks either.

I've had some other complications this pregnancy that I didn't have with with the others (at the moment, a large blood clot/haematoma which is blocking the cervix) which might mean I end up needing a planned c-section anyway (if it doesn't move). Which I could accept, but I just wasn't willing to accept "no" for an answer purely on the basis of it being common practice to automatically perform a c-section if you've already had 2+.

If it's important to you, I suggest you discuss your options with your doctor. If they're really close-minded and not even willing to discuss, then consider looking for an alternative doctor who could give you some unbiased advice. But that's just my 2 cents...

 

[jenmcn1]

It can become a serious risk if you've had a vertical c-section (like in my case)...then a vbac is not aloud. If you're having a vbac after a normal csection than its only a 2% risk of uterine rupture.
I would personally see a midwife if I were in your shoes....and also watch 'the business of being born'...really interesting look at birthing and vbacs etc.
It's the documentary that Ricky Lake did.