Vbac vs csection

cassmarkgraf

I am really struggling with deciding to go vbac or having another csection. My first child I was 19 and had an emergency csection due to breach, I am now 33 and have the choice.  Both scenarios seem to gabs positives and negatives,  how have other moms made this decision?  

jessafishy

I have not had a c-section but I do have some questions.

1. Were you unhappy with your first birth experience?
2. What would your reaction be if you tried for a VBAC and ended up with another ECS?

If I were in your shoes and I was unhappy with my first ECS and did not want to risk another I would choose a RCS. It would make me, personally, feel more in control of the experience.

jessafishy

Also, welcome and stick around. I've seen this question in a few other threads so I'm sure other ladies here are dealing with the same question.

carries2018

it is a hard decision to make, there are risks and benefits to both. i will say VBACs due to baby being breach do have a high success rate.

We had a similar discussion in the STM check in thread so i will just copy and paste "my story" and advice.

Csection with DD1 was bc she was wrapped in cord and not dropping. Her HR was dipping low and we went for csection upon opening me they discovered I have a narrow pelvis or something and they didn't think my 7lb baby would fit through. 

I literally didnt decide for RSC until 2 days before. I had one scheduled after my due date JIC but it wasn't with my doc. I had pressure with H's job. His boss was only allowing certain dates off. And it was cutting into my recovery time if I waited to see what would happen. Which with a toddler at home was overwhelming to me. The "narrow pelvis" whatever that means was looming over me that I might not even have a successful Vbac. DD2 was measuring bigger than DD1 (she was 8lbs). 2 days before my RCS they called me that an opening opened with my doc (5 days before due date) so I took it as a sign and took it. She was also wrapped but my doc said I wouldn't have had a successful vbac bc of pelvis. 

Even with having it confirmed I still question if I made the right decision. I was always on the fence about it but leaning towards Vbac so I think I never had time to feel confident in my choice. And I felt like too many outside factors were playing a role and I don't think it's fair. But it's life. My suggestion to ppl - whatever you chose is the right choice. But if you are on the fence I say try Vbac bc you don't want to live with what if. And if I had a terrible  csection as far as the surgery itself goes and I was traumatized by it I 100% would do a RCS so I know I could control as much as possible (doctors etc).

aprilsarahjune

I think it is a very interesting and personal issue.  First, check with your doctor and make sure that it is available to you.  When I was discussing this with my doctor regarding my second birth, the guideline was that you should be at least 2 years out from your last delivery at the time of the VBAC to allow for sufficient healing.  Also, not all doctors or hospitals can offer VBACs, especially if you do not live near a hospital with higher levels of care (i.e., the hospital has to ship out high risk patients).  

My DH had a strong preference that I go for a R-CS.  Our first labor and delivery was not stressful but had some complications.  I recovered very easily from my emergency cs.  For round two, I think the idea of us and the doctors having more control appealed to DH.  I had no strong preference and was not a momma who was invested in a particular birth experience.  DS's due date was 2 days before our DDs' 2nd birthday, so we were barely in the running for a VBAC anyway.  FWIW, the cs experience was familiar to DH - our children were born that way and his mother had only had cs experiences, so it was what he understood.  (Not that the last factor had much sway with me, but I do respect his opinion on it as he just wanted what was best for his family.)

We decided for a R-CS well in advance but my water broke at 37 weeks and we were again given the option of a VBAC before they called in the surgery team.  For us, it was kind of a luck of the draw that we stuck with the R-CS decision as my uterus was already torn at the prior incision sight before my ob even got to that during the R-CS.  We could not have known that beforehand and if I had gone through traditional labor, there would have been serious complications and risks for me and DS.  But mine was an exceptional case and there are risks to having a baby no matter what your prior or current circumstances and no matter which route you choose.

OliveOyl2014

I attempted a vbac with my second. It did not go as planned. I had gestational diabetes so I was induced a week early. I got to being fully dilated, started pushing, and nothing was happening. I ended up with another csection. I was so disappointed that I got so close and had to get another section. My midwife will not allow a vbac attempt this time. She said only one doctor in our area will do it, depending on your situation. If I end up with diabetes again, their practice won't accept me. 

I would definitely talk to your doctor. Having a breach baby is not something that usually prevents you from attempting a vbac. And it's been so long since your last csection I don't think there's a big worry of spacing. This will be my 3rd one since 2014. It is nice to know we will have some control over this birth, since I don't have much choice other than that. The risk factors for complications are what influenced my choice the most with my second.  Good luck with whatever you choose! 

carries2018

that is interesting @aprilsarahjune my H was pretty pro RCS, he wanted me to make the decision and would support me obviously. but he was always leaning towards RCS. i think probably it is really hard for them to see us go through that, and they feel like they have more control with the RCS.

my most favorite part of the RCS or csections in general i guess, which i probably weird to most. but i love how the baby gets one on one time with H before i get there. i think that is really special. Like their first hour of life, they have their father there to "protect" them. not that he can protect them from anything haha that is the doctors job but you know what i mean.

that is super scary though about your uterus! that was a big worry of mine too, even though i know the odds are slim. mine are 19 months apart and they told me they wanted at least 18 months. so i was cutting it close.

spark88

I am following because I have the option for a VBAC and am still deciding. I like reading others experiences. 

carries2018

@OliveOyl2014 you are really going to enjoy this birth experience. it is really surreal going for a planned CS. but it is so calm. something you are obviously not used to. like you wake up knowing you will be holding a baby in a few hours. everyone is so happy. you walk right up to the operation table. and there is just this joy that fills the room. and no fear of unknowns.

OliveOyl2014

@carries2018 thank you! It's hard accepting it that I will never be able to experience a vaginal birth  (I don't know why it's such a big deal for me) but it's nice to know it will be so much easier in terms of knowing when it will happen, having someone ready to watch the kids, etc.  And I hopefully won't be as exhausted after like I was with the other 2. 

carries2018

i know i feel the same way. it isnt like i mind necessarily having csections. like i dont feel like i am a failure or anything. but just not experiencing it is hard to accept. and i have a hard time with other people's comments. but it only feels fresh when birthing is on the horizon. you know as much as the next guy, how they got here doesnt matter...they are here. but i promise you will love this delivery so much.

curlyq423

carries2018 said:

@OliveOyl2014 you are really going to enjoy this birth experience. it is really surreal going for a planned CS. but it is so calm. something you are obviously not used to. like you wake up knowing you will be holding a baby in a few hours. everyone is so happy. you walk right up to the operation table. and there is just this joy that fills the room. and no fear of unknowns.

Hearing you say this makes me less nervous of a CS. I get anxious when things are beyond my control and not knowing how these babies will be delivered scares me. I would rather have a scheduled CS than try vaginal then everything being emergent. Thank you for this insight! 

Sorry to hijack the thread!

sdarling2010

The great thing about having had a CS is being able to choose what's best for you and your family! Here is what I posted on the STM thread yesterday about the same topic  

I had a csection after 30 hours of labor (water broke, progressed very little, pitocin to get things moving, got to 6 cm then epidural, got to 10 cm) pushed for 2 hours - DH did see DD's head, but she wasn't coming down far enough. Because it had been so long since my water broke, we had no choice but to do a csection. During the surgery, they discovered DD's giant head was stuck in the birth canal ... 14 inches giant ... so they had to pull her out the opposite direction before actually getting her out. 

This time around I'm hoping for a VBAC. My midwives are onboard with this so long as everything during the pregnancy goes well. I have to meet with an OB at 32 weeks to discuss risks and determine if it's the best option. The main issue is baby's head. DD was a normal 8lbs 6 oz baby with a head that didn't cone and was round as a bowling ball. This is standard in my family, unfortunately. As far as I know there isn't a good way to tell how big this baby's head will actually be.

For me, recovery from the csection was hell and I hope I don't have to do it again, but I'm prepared if that's what has to be done. Until someone tells me I have to go that route, I'll be aiming for VBAC. 

Do what is best for you and what makes you most comfortable! 

KSweet

I had five vaginal births, an emergency c-section because he was transverse, and then a VBAC. I will try for the VBAC this go round but will keep in mind that a c-section is a possibility. My OB and the hospital suggested the VBAC. I wanted it because recovery from the c-section was so much worse and because I hoped to have more kids and multiple c-sections seem to be riskier. But I have a "proven pelvis", as they keep telling me (which is a really weird expression to me). 

carries2018

side note - what do you guys classify as "emergency csection" because i keep seeing that used. i was taught in my birthing class that an emergency csection is where they knock you out (you are not awake) due to complications and they have the baby out within 2 minutes.

with my first one everything moved very quickly, but not that fast. i dont know if that is just how my hospital classifies it or what. but just curious.

sdarling2010

@carries2018 I understand it to be the same as you - being knocked out.

I don't classify mine as "emergency" it was just the next step to get baby out safely. She was fine and so was I. We waited about 45 minutes before actually going into surgery. 

carries2018

mine was urgent, she was out within 15 minutes. but i wasn't knocked out and there was some time for breathing/getting situated.

OliveOyl2014

I take an emergency csection to be one where baby needs to be out now. With both of mine, we waited at least a half hour for everyone to get prepared. 

jessafishy

I think unplanned c-section would cover it @carries2018. Unplanned would still suck as you are still laboring for quite some time first. 

I think emergency is probably more traumatic since you have to go under general anesthesia and miss the whole experience.

carries2018

yea i dont classify mine as emergency.

nbcarlson

My doctors used the term emergency C-section but I do feel like that makes it sound much worse than it was. Unplanned is a much better term.

aprilsarahjune

I guess under those definitions, both of my CSs were "urgent".  I had a regular epidural and was awake but neither was scheduled and my water broke on its own prior to the CSs.

grkgdss00

This is such a tough decision for me! I think about it daily and I really want the vaginal birth experience, but I also had a great "urgent" c-section experience and recovery. I have a few risks against me = pregnancies being only 1 year apart (DD is 15 months), and I also had GD last time (diet controlled so it was never a real issue). My OB is awesome and a very progressive, natural birth proponent. He said we can definitely go for it, but will obviously need to wait to see how things progress with this pregnancy.

Backstory with my urgent c-section: I was 8 days overdue and asked to be induced. They would have let me go to 42w. In the process, heart decels and chaos started very early on (I wasn't even dilated yet), maybe 2 hours in which led us to the semi-emergency c-section. I was awake, spinal block, joking happening in the OR, it was a stressful time that was made enjoyable by the team around us. Cord was wrapped around her neck and also prolapsed - so could have ended badly, but she was healthy and no issues! So thankful for my c-section! 

ETA: the one downside my doc did mention with a VBAC is i'd have to be constantly monitored/hooked up - so I wouldn't be free to move around and labor on my own which leaves me sad about it.

KSweet

@carrie2018 With mine, they turned the baby twice and he kept going transverse. Then they were worried his cord could slip into the canal before him....so they rushed me to the surgery room. I already had an epidural going so they didn't knock me out but he was out pretty quickly once they wheeled me in. I guess I have always pictured it as emergency/unplanned versus planned. 

ShreyaR

carries2018 said:

side note - what do you guys classify as "emergency csection" because i keep seeing that used. i was taught in my birthing class that an emergency csection is where they knock you out (you are not awake) due to complications and they have the baby out within 2 minutes.

with my first one everything moved very quickly, but not that fast. i dont know if that is just how my hospital classifies it or what. but just curious.

I was told mine was emergency c-section because it was not planned ahead, I mean they induced me at 38 weeks and since nothing happened, we had to do c-section, I thought it was planned c-section but my midwife said it was considered emergency c-section. 

I am glad this topic is up since I am confused what I should go for this time. I am in UK and here they encourage VBAC, I haven't had my appointment yet regarding VBAC, it is due at the end of this month, I will probably be more certain once I talk to someone about VBAC vs C-Sec. My recovery from c-sec was quite painful, no complication but it was too painful but I guess that is normal, it is major surgery after all. I am scared shit off VBAC though, I have nightmares of baby getting stuck and all that, fear of the unknown I guess. 

carries2018

Just food for thought I guess recovery with a planned csection is easier than one that went through labor. Something to do with the contractions I guess, your uterus isnt going Through all that work to be cut open. I'm not saying it's a walk in the park or anything but I felt pretty normal after a couple days. Where it was well over a week with the first. 

OliveOyl2014

carries2018 said:

Just food for thought I guess recovery with a planned csection is easier than one that went through labor. Something to do with the contractions I guess, your uterus isnt going Through all that work to be cut open. I'm not saying it's a walk in the park or anything but I felt pretty normal after a couple days. Where it was well over a week with the first. 

That's good to know! I felt like crap for weeks with my 2. 

beautyundefined

I am going to go for a Vbac, only because there are risks to both. I trust that if anything were to go wrong with my vbac, that my healthcare team will know immediately.  I am super afraid of another c section because you have a higher chance of a major complication with each c section that you have.  
At first I wasn't confident in my decision for a vbac, but I just found put that while I'm in labor I will have a midwife with me the whole time. 

Do what you feel comfortable doing, don't let anyone else decide for you!

hayes559

Ultimately the decision is yours to make. I had an emergency c-section with my first and have decided to go forward with another when the time comes. My husband is a doctor and there are many risks involved with vbac but also there is a convience factor with his schedule if we schedule a c section. Also the benefit of not having to deal with urinary incontinence or a bladder prolapse as I age, which are common among women who have vaginal deliveries, is a good enough reason to me. 

s_corrigall

I'm planning on fighting for another c-section this go around. My first was planned due to baby being breach, and me not being comfortable with going through a breach birth. Everyone is different, but because my c-sec was planned, my recovery was a breeze; I felt like I could do cartwheels three days later.

I get annoyed when people try to convince me to go VBAC because they "would hate for me to not experience giving birth", or I'm told that I'll feel such a sense of achievement if I deliver vaginally. Dude, I grew a baby for nine months, and have kept her alive for two years and counting. THAT'S an achievement!

At the end of the day, as long as baby and mommy are healthy, it doesn't matter how you get there.

carries2018

@s_corrigall don't let anyone talk you into otherwise! And let me at your doctors if they give you trouble :P

folamij

I am opting for a vbac. I honestly am still accepting how delivery went the first time around. It took a bit for me to recover from my csection (mostly because I was pumped full of fluids and had to take lasics to get rid of excess fluid). Either way; I'm preparing my mind that anything can happen.

s_corrigall

carries2018 said:

@s_corrigall don't let anyone talk you into otherwise! And let me at your doctors if they give you trouble :P

Thanks! I don't know if the team at the hospital will pressure me one way or other; I don't meet with them until next month. My family doctor mentioned that they might prefer me to deliver vaginally, but she told me to stick to my guns and I can get my way.

cassmarkgraf

Mine was true emergency nobody could be in the room I was out under within minutes.  It was traumatic but it was what was best for my daughter. This is honestly one of the decisions I think I have ever made

joforyoga

I had an unplanned csection with my first. It went very smoothly and I felt 100% comfortable with the medical team and I had a smooth recovery. As smooth as it goes when you've got major abdominal surgery I guess. My son will be 23 months when I have my second so I'm cleared to try a vaginal birth so far. I'm a fairly small person  and it's unlikely that I will have a giant baby according to my midwife,so if possible I will likely go ahead with a vaginal  birth. My midwife said that during labour if A vaginal birth continues to go smoothly than that is the safer option as opposed to the risks that come with major surgery. But of course there are pros and cons to both. My C-section experience was wonderful but I don't feel like I'm the type of person that wants to opt for surgery if it's not necessary.  As I said I recovered fine but at that point you're still recovering from surgery which I think takes longer than recovering from a vaginal birth Although I may be wrong because I have not experienced imaginal birth.And I'm only 14 weeks along now so we'll have to see how the rest of this pregnancy progresses I guess.  Whatever keeps me and my baby the safest is my end goal as I'm sure it is for all of us!