Looking for advice on whether to choose a RCS or not

Robeano

I have read many of the posts on this board and have learned a lot of interesting things from you ladies. I do want to ask you for advice and your opinion cuz I don't have anybody IRL who is going through something similar to this.

So I had an emergency c-section with my DD, I was induced at 39 weeks with scary high blood pressure.  I stopped dilating at 8 cm and was stuck there for like 5 hours. So we agreed to an emergency c-section. The OB was wonderful, I healed from it fantastically. I had no issues with recovery or with feeling bad about the whole situation, lots of peace about the whole thing.

So I am 36 weeks pregnant now and I was REALLY hoping for a VBAC this time around. I've got a two year old at home, I don't have as much postpartum help this time around as I did with my first. So I was with the midwives, I figure they are the best chance for a VBAC. But I did consult with an OB to get the more medical side of things. I was given a 50/50 success rate. Also, the OB said if I was her patient she would not let me go past 40 weeks, then she would induce me. And she would not let the baby be measuring more than 8.8lbs on the ultrasound. Those were her conditions for a VBAC.

Fast forward to yesterday and my blood pressure is getting high, and the baby is measuring big already in ultrasounds. So my care got transferred from the midwives to the OB. Which is fine, I like this OB and I don't want to end up with whomever is on call if some emergency were to happen. But here is the dilemma.

The baby is 6.8lbs measuring on the ultrasound at 36 weeks. I feel like it's probably safe to say that I don't think I'll make it to 40 weeks with a baby weighing less than 8.8lbs. (I have no GD, just have big kids, DD was 9.3lbs a week early) So my options are to basically get induced early, and inductions really suck, but then I have my chance at a VBAC. OR I can plan a RCS for around 40ish weeks. Both have pros and cons. Everybody is like "it's your choice", which is great. But I want to know what is the best choice. And I know nobody can tell me that. But I'm curious what your thoughts are.

Oh I don't know if this is a factor, but I am overweight, which does affect the VBAC likelihood.

Thanks for any advice or thoughts!

edan3579

Yeah. I think I'd get more info on how they plan to induce. Pitocin increases the likelihood of rupture. My water broke with my attempted vbac before I started having contractions and they gave me the minimal amount of pitocin to get things started. I ended up rupturing. Not sure if it was due to the pit or not but I wish I would have refused it!

JAP09-02

I have read that some doctors will induce with a Foley bulb.  Not entirely sure what this entails or how effective it is, but as I understand it is safer than pitocin for VBACs.  

I also considered VBACing with my 2nd but decided not to based on the following factors:

1. I'd seen my friend who had a scheduled section.  She was bopping around the next day, where as I could hardly get out of bed because I labored before. I didn't want to labor just to end up with another section.

2. My first was only 5 lbs 15 oz and wouldn't come out.

3. I think I was only considering VBAC because I felt like I SHOULD, not because I necessarily wanted to.

4. My husband was in residency, and we have no family in town.  It was easier to plan ahead (not that baby couldn't come early). 

5. I'm not the type to mourn over not having a "natural" birth. 

Also, I'm not sure I'd put a lot of stock in the ultrasound that estimates the weight of baby.  They also told me a couple weeks before my due date that I should expect an 8+ pounder.  Granted you've had a larger baby, so likely it is true, but those estimates can be off by quite a bit. 

I'm sure if you went to the VBAC board they could give just as many reasons as to why you should at least try. Wouldn't it just be so much easier if there were a cut and dry answer?

Good luck in whatever you decide.

P.S. - My recovery from the RCS was way, way, way easier than my unplanned one. 

jnnfrrose6

I wanted to try for a vbac, but my office will not induce for vbacs because of the risks. (And ended up RCS because of low fluids). Are you sure yours will? How close to the 40 week mark will they let you get before you *have* to schedule the surgery?

Robeano

This office will induce with pitocin to a certain level, but I know it is highly monitored. And they will use a Foley bulb ahead of time. She suggested starting doing stretch and sweeps at around 37 weeks. But I won't have my appointment until next week so I don't have any more information.

@JAP09-02 yes I agree, if I only had a cut and dry answer. Or if I could know what choice was gonna be the right one

surpriseaddition

I've had a vaginal, and then 2 CS.  IMO the recovery from vaginal was the same as the 2 planned CS I had.  The post-partum discomfort is different, but equally uncomfortable in my opinion.  My first vaginal birth required 2 1/2 hours of pushing, DD was 8lbs 5oz and I needed an episiotomy, which you have to squirt with a water bottle each time you pee afterwards, etc.  Sorry if too graphic!  Yes, you have incision issues with a CS and the incision is bigger, but a lot of women end up with tears or episiotomies that are just as uncomfortable (you have to sit on that type of incision). GL with whatever decision you make. 

kellyfo14

I am a vote for RCS. The possibility of rupture scares the pants off me. Something to consider also is how many children you are planning on having. 3 is my limit and I would say RCS if you are only planning on 2 or 3. Many many people have no problem with RCS beyond 3 but the risks do increase.

jesselayne8

If you will regret not trying then I would attempt the VBAC. My induction with my VBAC was so much better than my first induction. My dr induced me at 40w3d by breaking my water. I was in full blown labor within an hour. I didn't need any pitocin but it was hanging and ready if I did.

nosoup4u

I had a VBAC with a 10.5 lb baby (we had no idea he'd be that big - my first was 8lbs). Go for the induction if you would regret not attempting a VBAC, tho I would also delay it as much as you can. Your odds are better than 50%! The average VBAC success rate is 75% (induction is included in that number). Stay upright as much as you can if you choose that route, and good luck w whatever decision you make!!

heartlandmom

That's a tough choice and there isn't a right answer really. If it were me I would choose the repeat csection, but I've been through three so I might be biased. Mine were very easy to recover from, but I know that's not the case for everyone, good luck with your decision!

onetxjewel

I am choosing to have a RCS.  My mother in law was just so confused by this choice...her words "Why would you do that again?  Don't you want to try to have the baby normally?"....ohhhh mother in laws!  I never got past 1cm with my son after my water broke...and that was after 13 hours of labor.  So I had the c-section and it went well.  He was 10lbs 21 inches.  My dr told me she didn't think i'd be able to have a baby over 8lbs...my pelvis never separated.  For me now with a 2.5 almost 3 year old I wanted to do what would be best for me and that's not stressing.  I will have a RCS at 39 weeks which was around the time my water broke with my son.  I had a growth scan on Monday because I was measuring 4cm big...everything came back normal but baby is measuring in the 75th percentile...3.5lbs at 29 weeks.  I know the measurements can be off (they told me my son wouldn't be more than 8 pounds...pshhh).  so i'm going to do what I know...I know what comes with a c-section recovery and I feel comfortable with that option!  

It really is up to you and what you feel the most comfortable with.  A VBAC scares the bejezzus out of me so it was never an option.

Good Luck and Hugs!!

SSCmomma

I haven't had a RCS but I just had my first. I was in a similar situation however in the fact that they told me I either had to induce or just go straight to scheduling a c section. Well I chose the induction in hopes of being able to have a vaginal delivery but after a day and a half of induction I ended up having a c section anyway. Also, my MW told me after having a csection I could eventually have a VBAC if I chose but it couldnt be an induction. She said that they wouldnt be able to use pitocin for me after having had a c section. I guess every provider has different guidelines but just food for thought.