Having mixed emotions regarding scheduling repeat section.

shannm

I would like to have a VBAC this time, or at least try.  My OB is cool with this and but has suggested to schedule a repeat section for about 40-41 weeks just in case.

At first I was glad she would let me go till 41 weeks.  Now that I have to call and schedule, I am nervous.  Here is why:

With DS, I had manageable GD but did require glyburide and therefore twice weekly non stress tests.  At one of the routine NS tests, at 39 weeks, they noticed heart decelerations during my mild contractions.  They were long enough to freak the perinatal doc out and therefore, he and my OB recommended an induction.  Of course, the induction sucked and I barely responded.  When they up'ed the drugs and made the contractions stronger, his vitals just plummeted so they did a section.

What has always bothered me about this was that I never truly knew why he was having decels.  I know every pregnancy is different but what if something similar happens this time around and because I (hopefully) won't be getting NS tests, I won't know it?  Then what if something happens at 41 weeks that would have not at 40?  

Am I worrying for nothing?  Should I schedule for 41 weeks anyway and hope that any major issues will be detected in time?  I would hate for something to happen and then have to live with my decision (which partly feels selfish) to push for a later delivery in hopes for a VBAC.

cchill01

By ~36weeks, you will be at the doctor every week listening to the heartbeat and will probably have at least one NST between 40 and 41 weeks.  You'll also be monitoring baby's movements on your own.  So, it may not be the same frequency, but you will be monitored often.

And the problem with intervention, is that it leads to more intervention.  No one can tell you if your first LO was really in jeopardy.  But, doctors are sued for inaction, not for overreaction.  Those decels may have been going on all along or maybe it was something serious.  But the more interventions and tests, the more likely they are to recommend more interventions and tests.

Life is full of decisions, small and large, with all sorts of consequences.  An RCS is not a consequence free decision either.  What if you elect for 40 weeks and baby's lungs aren't quite ready?  If your doctor is willing to let you go to 41 weeks, then it must be a reasonable decision and not something you should feel guilty about.

MAprincess

I agree with pp.  None of us can see into the future (not even your doctor!) and so we need to make the best decisions we can with the information we have.  I have a friend who wanted to VBAC but her doctor convinced her into a RCS at 39 weeks because he felt the baby was "too big".  That baby ended up in the NICU for almost two weeks for breathing issues because her lungs were not quite ready (she is fine now).  But my friend wished she had declined the CS and let the baby come later.

Personally, I VBACed at 41 weeks, 1 day and did not have any NSTs my entire pregnancy.  I am sure you and your doctor can make sure they happen for you if they will make you feel better about waiting until 41 weeks if the baby doesn't come sooner.  Talk your fears out with your doctor.  My midwife had to listen to me talk through VBAC fears almost every appointment and she was so supportive and patient with me.

shannm

Thanks ladies.

I wish the OB interaction I had regarding this was "supportive."  Unfortunately, I have to cycle through all the docs at the practice at least once/pregnancy and this last visit was with the queen of "I have NO bedside manner and patience."  Seriously, she was awful.  My DH is a doc and was there to witness it and was in shock by how she spoke to me.  

So I will schedule for 41 weeks and speak up about my fears with the OBs that I like and hopefully they will be a bit more supportive. 

Kristine Schilling

We are attempting a natural VBAC. The Dr agress tat there should be no induction or interventions to reduce risks during the VBAc attempt. At my 36 wk appt. we set up the "Do not pass go" RCS date. for 41 weeks. I was a bit insecure about doing it, but afterwards I started to feel better.

It kind of took a bit of worry off my shoulders to know that if for some reason I dont pop on time, I will be holding my LO on Jan 12th.  Call it an all or nothing scenario.