Would you do a VBAC or RCS? (also on VBAC board)
I'm curious what others would do..and their reasoning for it.
DS #1 was 5 years ago. Went into labor 9 days past due date. Never really dilated/effaced in advance. 29 hours of labor followed by c-section. Labor repeatedly stalled, got pitocin and the whole bit. Pushed a few hours but it never happened. DS was 9 pounds with a head circumference somewhere around 97-99th percentile. Never got specific reason for failed vaginal birth, but the head size was the main suspect.
DS #2 is due in 5 weeks. Doctor is open to VBAC or RCS, my choice. Ultrasound at 32 weeks showed head circumference measuring 2 weeks ahead (rest of baby about 1 week ahead).
Me: I was strenuously against a c-section the first time but, once it happened I was OK with it and I do not feel "robbed" of the vaginal birth experience. Had a pretty easy recovery and not necessarily more scared of a RCS than a VBAC. Both seem a little frightening in their own way.
My thoughts: I obviously want what is best for the baby & for me. I would in hindsight somewhat prefer a VBAC if it went smoothly. However, I feel a little unconfident it will work out given my experience, and do not want another 29-hour-labor-followed-by-c-section -- but am also not sure when I would call it "quits" in a VBAC attempt this time. 8 hours? 12 hours? 20 hours? I feel like I'd go in with a defeatist attitude and therefore fail. I do not want another exhausting, hard labor followed by c-section. These thoughts are leading me to lean slightly toward scheduling a c-section on my due date. My Dr. is willing to schedule a RCS to get it on the books, then wait to see how I'm dilating/effacing/progressing in the days leading up to it, and doing a VBAC if I want, but she doesn't schedule RCS past the due date, and I don't feel all that confident I'll go into labor prior to that given that DS1 was so late, so I feel like scheduling a RCS on my due date is very likely to eliminate a VBAC. I suppose I could also just go for the VBAC and then if necessary call it quits and get the RCS after a couple hours, but my Dr. feels a scheduled, pre-labor c-section is slightly safer.
So which would you choose/what would you do? And why???
Re: Would you do a VBAC or RCS? (also on VBAC board)
LO#1 induced at 41 weeks with cervadil and pitocin. Baby never dropped my body never really even labored. Just painful contractions that were not doing anything. 9 hours of labor and I hadn't even gotten past 2.5cm. Baby's heartrate plummeted and emergencey csection was done. It went really well with a super easy recovery. I never once felt like my birth experience was bad b/c of that.
I thought I should feel I wanted a VBAC for the 2nd so I asked OB about it. He said he did not consider me a good candidate for VBAC and I was really actually relieved to hear that. I am scheduled for RCS.
I think it is definitley a decision you and your DH should make together since you have the option to make it. I am sure you already have done research so just outweigh the pros and cons for you.
Whatever you decide do not feel guilty for choosing one over the other.
My first labor experience was similar to yours. I was never given a solid reason as to why it didnt happen, but DD would not descend and her size and position were the assumed culprits. I also believe it was because the epi stalled my labor badly and the pit gave me horrible pain and I couldn't breathe properly...it was a vicious cycle.
I, personally, would choose VBAC. But that's because I DID feel robbed. I had a hard time dealing with my inability to deliver vaginally. I'll have to do more serious thinking when I'm pregnant again, but for now, I believe that trying again, even if it ends up in c/s again, will be better for me emotionally than choosing RCS.
Because of your past experience and the fact that you had no qualms about the c/s, I would think a RCS would be best for you. Either way, good luck!
With my first, my water broke, I progressed to 5-6 cm and then stalled for a few hours. I was on pitocin and labored for 25 hours before dr came and said we were done and he wanted to do a c-section. Before I was in the hospital, I was against a c-section however at the point, after 25 hours, a fever, an infection, and just a lot of discomfort I was ready to get the baby out! Turns out she would not have come out well as she was face up and head back. Plus, she was almost 10 pounds! I was told, afterwards, that next time I would be induced 2 weeks early.
This time around, my doctor told me (before I even had a chance to ask) that she recommended a RCS. She said some pelvises can't turn the baby the right way for delivery and mine could be that way. I was relieved because I had read so many horrible stories of inductions gone wrong, but part of me felt like I "needed" to experience a vaginal delivery. I was relieved that she made the decision for me.
I am comfortable with this decision as I know it's what is best for me and the baby.
I had an emergency c-section with my son after I was in labor all day with an attempted vaginal delivery. (I was induced because my amniotic fluid was rapidly disappearing without my water having broken.) His head descended sideways and the pressure actually swelled my cervix shut after getting to 7 centimeters (yeah, nobody told me you can go BACKWARDS! lol). It ended up that his cord was wrapped around his neck several times - plus his head was off the growth chart for the first year of his life.
I've done a lot of research and I will definitely be going with a RCS this time. The risk of uterine rupture is much higher for moms attempting a VBAC (as I'm sure you probably know). From everything I've read, a planned C-section is a safe (as safe as any birth experience can be, I should say) choice for mom and baby - especially for moms like us whose bodies didn't "cooperate" the first time.
I did struggle for a long time with the fact that I didn't deliver vaginally - I was really bummed out about it. But now that the decision is staring me in the face, I have total peace about my choice to do a RCS. Plus, let's face it - everything is intact down there and although emergency c-section was *never* my first choice for delivery, everything still works like it's supposed to and I'm super thankful about that.
My decision to RCS was pretty much made for me and based entirely upon my previous birth experience and high-risk status. Once we got closer to my delivery date, even if everything had gone perfectly with DS1, I wouldn't have been a candidate for VBAC. DS2 was far too large to VBAC (11lbs, 10oz). I would have torn from here to Texas, seriously.
That being said, I also am one of those women who never felt robbed of my birth experience. I tend to lean more in the RCS camp, but it's such a personal decision based on your own circumstances.
I loved my RCS, by the way. I knew where DS1 was at all times, had everything scheduled ahead of time, and the planner/control freak in me loved that. LOL. Good luck with whatever you decide, though!
My first was born under similar circumstances--10lb baby, head in 99+ percentile. With my 2nd the idea was VBAC if I went into labor naturally before my EDD. I didn't, and ended up with a RCS. DD was 7lbs 14oz with a head in the 50th percentile. When I saw how small she was I was devasted I didn't VBAC.
My emergency c-section was a breeze. My scheduled one sucked. It isn't always easier to schedule one. I would definitely see where you are in terms of dilation/progess when you're to term and take it from there if I were in your shoes.
GL!
I think this is such a highly personal decision that none of our input should matter much to you. But since you're asking, I chose the RCS. I was perfectly happy with my first c/s birth experience and didn't care at ALL about not having a baby come out of my vagina. I was never hung up on a birth experience of any sort, and felt like as long as the baby and I were healthy, I was successful.
So that made it easy for me. I also wanted to avoid an emergency c/s at all costs - that was really the only kind of birth I feared.
On a more frivolous level, I really liked the planned aspect of it all. We knew when to have my parents fly in to care for our first child (a few days prior to the c/s so he was used to them in the house), we had pet care lined up, etc. It was just a very smooth process and I liked that.
(read it. you know you want to.)
anderson . september 2008
vivian . february 2010
mabel . august 2012
The chance of UR with VBAC is still only about .4-.7%, though. Not an insane risk, and it's about the same as the chance of a cord prolapse happening, which isn't something most women stay up late worrying about. Also, if you have one successful VBAC, your risk of UR goes way down again.
That being said, RCS or VBAC are both reasonable options.My first son was OP, and I had a c/s after pushing 4+ hours with no progress. He was just over 8lbs, and just wasn't lined up very well. DS2 was a VBAC, and was 10 lb, 10 oz, and just under 24" long - huuuge. I had a second degree tear, but the recovery was still quicker and easier than my c/s recovery.
Do you want to have more kids? That was a big factor in my decision - the risks associated with c/s go up with the more you have, and I am personally not comfortable with having 3+ c/s.
The only other thing I can add is to remind yourself that this is a different pregnancy, and it will be a different labor. Have you thought about hiring a doula? Someone to talk to about your concerns and help you through labor (if you go the VBAC route) might be helpful. Good luck!
This is a good link about VBAC vs. RCS:
https://www.childbirthconnection.org/article.asp?ck=10211&ClickedLink=293&area=27DS2 - Oct 2010 (my VBAC baby!)
Personally, my c/s experience and recovery was great. I don't have the choice because my hospital's policy is once a c/s always a c/s, and I have mentally prepared myself for a RCS from the very beginning (2 weeks postpartum). But, with DD#1 I went into the hospital mentally and emotionally prepared to have a c/s because she was in an unfavorable position, so I didn't feel robbed of the birth experience. My thought was "at least my vagina is still intact". And to be honest, even if I was given the choice, being in labor was far worse than recovering from a c/s, and I'm more scared about having to push a baby out and recover from a vaginal birth.
I had a very similar c/s experience to yours. DS was over 10lbs, never dialated past 7cm and after 44 hours in labor went for the c/s. I talked to my Dr. about the VBAC and while she said it certainly was possible the odds of success were less for me than someone who's first was because of a breech baby or something. She felt like it definitely was an option but told me that I had a high chance of another c/s.
I'm getting my tubes tied after this baby so with what my Dr. said and that this is my last I'm just doing the RCS. I don't want to labor for that long again and end up with another c/s. My recovery was horrible and I think my exhaustion from laboring was a huge part of it.
Also, this baby is measuring ahead and they are thinking it's going to be another big baby so I feel more reassured opting for the RCS.
I could have written this myself. Long labor, water broke at 2cm and contractions were 60 seconds long, 2-3 min apart. At 9cm baby got tachycardic and I got a fever, so decision was made for c section.
I personally would have to try for a VBAC. But that is just ME. The what if woudl kill me.
DS born via unplanned C-section at 40w6d
With dd2 I was on the fence. I wanted a VBAC, but since I stopped taking my baby aspirin when I stopped p17 at 36 weeks to prepare or delivery, I was terrified of losing her to a blood clot if I waited too long.
We put a RSC on the calendar with the agreement if I went into labor before then, I'd try for a VBAC. I did go into labor a few days before but never progressed. Got to the hospital at 1.5 cm and left 8 hours later not dilated at all. I had my RSC at 39w3d without any regrets.
BFP#1 Kaitlyn 11-17-04
BFP #2 Matthew pPROM 23w5d 06-03-07, b/33 weeks 8-6-07, d/10-15-07 SIDS,
BFP #3 m/c 8 weeks 2/20/09, BFP #4 m/c no hb 6w4d, m/c 9w4d, D&C 11w2d, BFP #5 C/P 12/18/09 after BFP- 9dpo
BFP #6 Samantha- 11-9-10
BFP #7 4/20/12 21 DPO beta: 2382 29 DPO beta: 23000! HB 6w2d 116 bpm due Christmas day!
This Momma's Journey
~Today I am pregnant and I love my baby~
With DD, my water broke, but I never began contracting on my own. I was given Pitocin and had an abnormal labor in that I had one, long contraction once I hit 3 cm. It was super fun.
Got the epi, dilated to 10 in less than two hours and pushed her out in less than two hours. I loved my L&D.
With DS, my water was leaking and after they broke the bag of water around his head, I started contracting regularly on my own. Got the epi and dilated to 10 quickly again. Pushed for three hours to no avail. DS's head was turned to the side and he wouldn't turn so I could push him out. Had a c/s. Recovery has been tough in that my incision opened a little and I had to pack the wound myself, but it's nothing awful. I see the c/s delivery with DS with the same affection I see the vaginal delivery with DD. They were both amazing experiences.
That being said, I would do a VBAC if we opt to have another one, just because of the recovery. As easy as a c/s recovery can be, a vaginal delivery is much easier. Especially with a toddler running around, it would have been easier to have the vaginal delivery.
I do, however, see pluses and minuses to both and don't feel like anyone should feel cheated out of a birth experience regardless of how baby is delivered.
Afterwards I was "diagnosed" with cephalic disproportion so I have been told I have no choice for a RCS. I, however, intend to fight that because I think it b.s. I have to find an OB or midwife who is willing to help me. I am about 99% positive my current OB is not someone who will help considering she gave me the dx and she is pro-c/s.
The only thing that scares me a bit is that I was tearing with DS already and there was a high concern that if I did get him out I would end up with a 4th degree tear. That is really my only "yikes" about VBACing.