Trouble justifying a VBAC ...
First off, thank you for any insight in advance. I am having a very hard time deciding whether or not to try a VBAC, but I am already at 36 weeks, and I need to pretty much decide which doctor to finish my care with ASAP.
With DD1, I was induced with Cervadil (sp?) at 41 weeks, and then quickly went into labor with that alone. I was actually unprepared for the fact that my increasing contractions were going to be the real thing, because I was assured that I probably would not go into labor with that drug alone, and would be given pitocin in the AM. Long story short, sent my husband home, called him back, and then begged for the epidural at 8 cm. I continued to dilate to 10cm, water broke, but when it came time to push, I pushed for two hours without her descending. I made the decision to go to c/s instead of opting for a forceps assisted delivery.
I did not have a horrible recovery from my c/s. I have had other surgeries in the past, and I have to say the c/s recovery was the easiest of all. However, I did not like being stuck in the house, and dependent on others. I do not think that part helped me with my PPD/PPA. I also did not have 30# toddler that gets carried around constantly, and sleeps within a crib. So my main reason for considering a VBAC is to make my life easier when DD2 comes along.
I would almost prefer having the RCS in some ways. I am doctor (of veterinary medicine), and surgery is not scary to me. I think it is probably the easiest way to guarantee a safe outcome for me and the baby, if planned properly. I have horrible horrible vulvar varicosities, and if there is any chance of keeping those from being permanent or requireing surgery, that would be great. The timing of the the RCS coincides with my husbands vacation, and he will not be able to take any other time off before or after.
The only reason that I want to the VBAC is to keep me sane, and keep me able to maintain normalcy in DD1's life as much as possible. I met with an awesome OB today who was amenable to VBAC, but gave me some good statistics that do not make it a hands down choice.
Any thoughts? If you were/are on the fence, how do you justify the real (although quite low) risks to the baby if there is a uterine rupture?
Thanks again.
Re: Trouble justifying a VBAC ...
I have been so frustrated over the past month or so. Many people close to me (including coworkers) know I had an emergency csection with LO #1. Many of my coworkers are older and just assume I'm having a RCS. I try not to talk about it in general because everyone has their own opinions.
I even get a little overwhelmed checking the various vbac blogs, websites, etc. So many comments about how it's rare that you can't attempt or have a successful a vbac, etc. After doing a lot of reading and too much thinking and being hard on myself in many ways, I've realized that I really wished I wouldn't have agreed to my induction (d/t borderline pre-e and raise bp) at 40 weeks. I just wish things would have gone differently and then maybe I would not be dealing with this right now...
Hi there!
Actually, all of the research out there suggests that the safest outcome for you and baby is in a VBAC. Surgery (even very planned out) is much more dangerous for you.
I had an easy c/s recovery but my VBAC recovery was easier and came without the restrictions (which is sounds like is something you are thinking about- it's hard to tell a toddler you can't carry them around).
That said, you should just sit down with all of the research, read it, then sit with your DH and think about your personal circumstances and make the call that is best for you. There are certainly pros and cons with both so the decision has to be your own.
I knew that the flip side (RCS) put my life in more danger which mean potentially leaving my dh a widower with 2 kids to raise.
I also knew that a c-section does not guarantee me a healthy baby, especially since I've seen babies go into distress following c-sections.
I don't think you need to justify a VBAC. Women who've had prior vaginal births don't need to justify doing it again, KWIM?
And wanting a VBAC to keep you sane is a totally decent reason, too.
I'm curious - what stats did the OB give you? RCS vs. VBAC are both reasonable options (though 3+ CS are riskier than 3+ vaginal births).
DS2 - Oct 2010 (my VBAC baby!)
This. Who are you justifying it to?
There are no guarantees in life. You have to do what works for you and hope for the best. The risks either way are so small. It is really troublesome to me how overblown VBAC risks are. No one goes to a FTM and says that she might have a uterine rupture, but it happens then too.
You should not feel guilty about whatever decision you make. You should not feel like you should have to justify it.
Thanks for all of the replies. I need help justifying it to myself actually. I perform surgery in my career, and it's really not a scary situation to me. It's very controlled, and I understand how rare the complications are on a more tangible level than I can understand those in a VBAC or even natural birth. If that makes any sense to anyone.
We are in the position of going forward with the RCS. We would have had to change to another doctor within a few days of the appointment/discussion, since I was so far along. DH and I could never come to an agreement so we kept our appointment for the RCS this Friday.
If something happens naturally, however, we may seriously consider trying to VBAC at that point, but I understand how that may turn out, given that we've done absolutely no preparation.
Whether or not to have a VBAC is completely your decision and what you feel most comfortable with.
I have to ask, just in a general sense and in your occupation, have you never had complications arise in a patient you've operated on? Because you make it sound like that can't happen with a planned surgery.