VBAC or RCS

mozartsmuse

i hope it is okay to start a new thread on this, I was curious if any STM+ had any insights on VBACs or RCSs. I had a CS w DD but had rapid onset pre-e so I didn’t really have a choice. Recovery was awful - I was in the hospital a week bc my kidneys wouldn’t work and my BP wouldn’t go down. I then bled, heavily, constantly for TEN WEEKS. Like calling the on-call people asking if I was dying bleeding. It was tough, and I’d like to try for a VBAC provided I don’t get pre-e again. Would love to hear insights and experiences of others here. I know there’s a topic board for vbacs, but posts are old and sparse and I’d rather hear from people here - others may be curious as well. 

ETA - please don’t be terrified of CS bc of my experience, thousands of women have CS and recover fine 

jennybeans46

So I’m on my 3rd baby. My first was a csection due to the baby’s heart rate de-celing and I stopped progressing. As far as a first delivery experience, it was awful. Recovery wasn’t too bad but I didn’t know any better. With my second, my ob gave me the option of a vbac
or a csection and I chose the csection. He told me he couldn’t be sure, but I had a greater risk of some of the things that cause my 1st (in my opinion traumatic) delivery to be a csection happening again. At least it was something I had experienced before. My water broke and we headed to the hospital and I was in recovery 2 hours later holding my baby. Csections aren’t fun, recover can be difficult, but I’m preparing for my 3rd (dr didn’t give me an option this time) and I’m ok with it.

fallbabyround3

Had 3 c sections already. The 1st was an emergency was fine but took the longest to recover completely from. My 2nd which was only 1e mknths later was much easier as it was a repeat i felt good after 4 days. My last one was even better felt really good after 3 days. Each one so far has been easier and easier. All 3 sections were between 2012 and 2016 so they were decently close together. My doctor. And i are already talking about my 4th and since i habe great physical recovery and minimal scar tissue my doctors are always very confident in my c section and recovery. So try to relax. You should really discuss with your doctor more about your options and success rate. I personally having so many as well as a tilt uterus and a history of not dilating have a extremely low rate of success. 

mozartsmuse

fallbabyround3 said:

Had 3 c sections already. The 1st was an emergency was fine but took the longest to recover completely from. My 2nd which was only 1e mknths later was much easier as it was a repeat i felt good after 4 days. My last one was even better felt really good after 3 days. Each one so far has been easier and easier. All 3 sections were between 2012 and 2016 so they were decently close together. My doctor. And i are already talking about my 4th and since i habe great physical recovery and minimal scar tissue my doctors are always very confident in my c section and recovery. So try to relax. You should really discuss with your doctor more about your options and success rate. I personally having so many as well as a tilt uterus and a history of not dilating have a extremely low rate of success. 

Yes I’ve been discussing with my docs and midwives. They’re okay with me trying for a VBAC as long as everything is okay and the pre-e is not back. I never went into labor with DD so I don’t have any historical data regarding the actual labor process...I never even had a contraction. So who knows how happy my birth canal is? 

princesslockness

@mozartsmuse I had a cs with L, then a med-free vbac with E.  
I recommend the epi. I didn't have a chance to get it with E and I will not go that route again, if possible. I didn't have any extra monitoring for trying a vbac, I did for my cervix issues. 

If you you have any specific questions now or later, I'll do my best to answer or help find answers for them. 

ssthomps

I am in a similar situation, except I had a Myomectomy and then a natural delivery. My new OB is suggesting that I have a C section. He doesn’t believe it is safe to have another vaginal delivery even though my first one had no complication. My issue is a Myomectomy is similar to a c section. Instead of delivering a baby you remove fibroids, but the incision is similar to a csection. I am getting a second opinion because I would prefer to have another vaginal delivery. We shall see. Though good luck with your decision. 

princesslockness

I was told that chances of a vbac greatly depend on what type of scar/incision you had. If it was vertical, running up to you navel, then the likely hood of tearing is greater than if it ran horizontal. 

suzystar829

Has anyone has a CS due to posterior (or any "wrong way" baby) and had a successful VBAC for a subsequent pregnancy?

I ended with a CS since my DS was posterior and afterward my OB told me I was a fine candidate for a VBAC since it was him and not me (I dilated all the way, my stats were fine, etc., he was just jammed in there). But at my last appointment she made it seem like I will end up with a CS again since history is more likely to repeat itself. I left feeling really nervous and unsettled by it -- I'm going to talk to her again about it at my next one since I am hoping its just a misunderstanding. I have since gotten my pre-approval letter from my insurance she she put in for a CS. I know its just to cover her bases, but I'm still really hoping to VBAC.

princesslockness

@suzystar829 I did. L was frank breech, so knees to his chest, butt first. E was not. She was in the correct position and dropped for weeks. Its 100% possible to not have a baby be out of position in a different pregnancy. 

mozartsmuse

princesslockness said:

I was told that chances of a vbac greatly depend on what type of scar/incision you had. If it was vertical, running up to you navel, then the likely hood of tearing is greater than if it ran horizontal. 

I have heard the exact same thing. Mine was horizontal.

lolog531

suzystar829 said:

Has anyone has a CS due to posterior (or any "wrong way" baby) and had a successful VBAC for a subsequent pregnancy?

I ended with a CS since my DS was posterior and afterward my OB told me I was a fine candidate for a VBAC since it was him and not me (I dilated all the way, my stats were fine, etc., he was just jammed in there). But at my last appointment she made it seem like I will end up with a CS again since history is more likely to repeat itself. I left feeling really nervous and unsettled by it -- I'm going to talk to her again about it at my next one since I am hoping its just a misunderstanding. I have since gotten my pre-approval letter from my insurance she she put in for a CS. I know its just to cover her bases, but I'm still really hoping to VBAC.

I had a very similar situation - I dialated to a 9, stats were good, went almost 30 hours from water breaking to delivery, everything was okay, but DS was wedged into my right hip and 'sunny side up'. My DH and I decided for the c/s at that point since the changes were slim to none of him coming vaginally. My OB at delivery time, and all the times we've talked since, said that it doesn't necessarily mean that it would happen again. I have an retroverted (I think I said that right!!) uterus, so she thinks that *might* have played a part, but there's no way to know for certain and it doesn't always. I'm not really much help since I haven't had a VBAC, just hear to say that I would definitely keep talking to your OB about it because mine has always seemed open to it if that's what I chose!

hardlyhannah

@mozartsmuse We are in similar situations. I had a csection because I was induced with rapid onset pre-e at 37 weeks, and essentially had a failed induction. I never progressed past 6cm dilated and after 36 hours made the decision to have the surgery. My recovery was average though for a csection.

The practice that I go to I see several doctors. The first one said that my pelvis was just too small and that I would have to have a repeat csection (this was at my postnatal appointment after DS). The second doctor I saw for my first OB with current baby said I should consider a vbac which got me excited but I was hesitant because of what the first doctor said. My last appointment was with one of the midwives because my doctor got called into surgery, and she was the first person to call DS's delivery a failed induction, and that basically solidified my decision to try for a vbac. They said they would not induce, I would only be able to go into labor naturally. If it was a situation where induction was necessary then it would be straight to csection which I understand.

There is some sort of success predictor tool that exists to give you your 'rating' on if you'll be able to have a successful vbac. I haven't gotten my score yet but I am going to ask them about it next week.

delujm0

I have no experience with CS, but DD1 was sunny side up (posterior) and I was able to push her out vaginally, though she got stuck in my pubic bone for a while and I pushed for 2.5 hours.  Her heart rate was fine so they let me keep pushing.  DD2 was face down, thankfully, and basically fell out.
 
The position of your baby can completely vary between pregnancies.  Your baby is more likely to present as sunny side up if you have anterior placenta (as i did with my first pregnancy).  Now I'm just praying this one isn't breech because I'd like to avoid a CS if possible.  My vag is already wrecked, may as well continue using it as an out hole ;-)

suzystar829

@princesslockness Thanks for your insight! That's what my OB said immediately after DS was born, that position of baby can vary greatly so VBAC was fine. So I've spent the last year+ assuming that, but then she made it seem like positioning tends to repeat itself... I am hoping I just heard her wrong since she is fabulous otherwise!

@lolog531 I hear that! After 27.5 hours of labor and 2.5 hours of pushing I could not get that kid out and I was just exhausted. My OB has previously said the same thing.. that it may not happen again so VBAC is on table.. until my last appointment and it seemed like she was swaying toward CS. Hoping it was just a misunderstanding on my part!

@delujm0 Kudos to you! I tried so hard to push DS out for 2.5 hours too, but he would not tuck his chin and kept arching his back and head and making it impossible to pass. I am hoping #2 will be in better position, DS was posterior at my last 36 week sonogram and never moved.

pghctwife

Since you only needed the C.S. due to pree without that I’d imagine you are a good candidate for vbac.

i haven’t had a C.S. (or therefore a vbac) but my sis did - her C.S. was a cascade of interventions starting with a pre-40 induction and she was a good candidate and had a smooth vbac. She said afterwards that she found it healing in a way she didn’t even know she needed. 

Personally i found recovery and and how I felt postpartum to be way better for my unmedicsted births than the 1 I had epi if that translates at all.

rhat said ive heard planned C.S. are much easier to recover etc than emergency

pghctwife

Position totally can vary!!!! My first was born with shoulder dystocia due to bad position (not anatomy) and other 2 no issue. There is stuff you can do late preg and in labor to encourage better position - spinning babies is a good resource. In labor moving and walking and different positions helps 

Piperella

After 2.5 days in labor with my first, I ended up with an emergency c-section. Luckily my hospitalist was amazing and I healed really well and quickly. This time, also because I'm having twins, they said I was not a candidate for VBAC.  I was fine with that as I had a great first experience with a c-section, so I imagine a planned one being even better.  I think if you have talked to your doctor and they've left it up to you, I'd go with your gut. Just know that things may have to change, but I think if you really want to go for a VBAC, you should definitely plan for it.

suzystar829

pghctwife said:

Position totally can vary!!!! My first was born with shoulder dystocia due to bad position (not anatomy) and other 2 no issue. There is stuff you can do late preg and in labor to encourage better position - spinning babies is a good resource. In labor moving and walking and different positions helps 

@pghctwife I tried some spinning babies things during my last 4 weeks and it was no such luck. My kid was stubborn, clearly! My OB and another from the practice tried turning him while I was on labor too, several times. Fate was not on my side!

mozartsmuse

I am a total type A control freak personality. If having DD taught me anything, it was humility in knowing that when the time comes, there are multiple factors that are completely out of my control!