My biggest "con" right now to the VBAC is that I keep reading that VBAC's are lower risk than repeat SCHEDULED c-sections, but that scheduled c-sections are lower risk for complications than failed VBAC's with emergency c-sections.
Is this swaying anyone else towards just doing a scheduled RCS? I can't get a straight answer as to why my first one failed. My OB claims it was due to DS's size (he was 11lbs 7oz at birth, and no, I didn't have GD). My water broke, but I never progressed past 2cm, and my contractions never kicked in. They waited 9 hours, still nothing, and put me on pitocin. Even with the max pitocin, I never progressed past 2cm.
However, I also keep reading comments and get forwarded articles about how "big babies" are a myth, that I shouldn't accept that as the real reason that I never progressed. I trust my OB, and since I'm only 5'1, it does seem plausible to me that this baby was just TOO big to allow me to progress in labor.
So how can I know if it was BS, and if my failure to progress was due to something else (and might happen again with this baby, if it wasn't due to size)? If it WASN'T size related, doesn't that make it more risky for me to have a VBAC?
Re: wind up with rcs anyway?
My DS was 10 lbs 2 oz and the reason for my c/s was not his size, it was his positioning. In fact, they made sure to make it clear to me that I should not let any doctor try to tell me that the c/s was due to his size to try to deter me from a VBAC. I also did not have GD.
My VBAC baby was 8 lbs 5 oz. so size of first baby does not dictate size of second. Also, plenty of people here have VBACed large babies.
It's true that an ERCS has higher risks than a RCS, but an ECS carries more risks than a CS. Either way, VBACs carry less risk than both, so that is why I went that route. If an ERCS had to be performed, I was already in the hospital, and those risks at that point are on me, not the baby. So, for me, it was an easy decision.
I had a similar situation that you did, although my water didn't break on it's own. I was induced, had prostaglandins and a *** ton of pitocin. I never progressed past 1cm. My baby was 7lbs, 6 oz. So there it had nothing to do with size.
I VBACed an 8lb, 7oz baby.
For me, the risks were so small either way that it didn't really influence me. I'm low-risk in general, so I honestly just didn't really pay attention. Recovery time was a bigger issue for me in choosing a VBAC over a RCS.
How can I be sure it was size or position, or neither that caused my failure to progress, to find out my chances of a failed VBAC? The OB that delivered DS seems sure that it was his size, so I plan on asking what his position was (since I don't have it written down anywhere). But if they didn't document it, wouldn't I now have to weigh trusting the OB, or weighing my decision on an unknown factor?
In the advice and perspectives I've gotten, it seems like if it's size or position, my chances of success are higher than if it's something else that caused my lack of progression, and means I'm not as an ideal candidate for a VBAC, and it could result in an emergency c-section (and then a crappier recovery time as a result). If I'm thinking about recovery, obviously the VBAC would have the best recovery time, but if my chances of success are at something like 53%, I almost feel more safe scheduling the c-section, since most moms who've been through it will tell you that the recovery time from a scheduled RCS is a breeze compared to the first emergency c-section.
So, I guess my next step is to try and confirm why I failed to progress, and base my decision on where that puts me, in terms of good vs. not ideal VBAC candidate?
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The thing is when women are sectioned for failure to progress, most don't really know why it happened. Even if the doctors have an idea why it may have happened there's little way of knowing for sure. Things that would really make it impossible/unlikely for a baby to be born vaginally, like a malformation of the pelvis, would have to be investigated in other ways than just a doctor guessing at that being the reason.
For example, I had a C/S for FTP after stalling out at 8cm. That was very likely caused by baby's posterior position rather than anything physical, so I'm considered a good VBAC candidate, but there's really no way of knowing if it really was his positioning or if it's something physical with me. Now, if I had labored under the best of conditions (things like, being able to move around during labor, they didn't artifically rupture my membranes so early on giving DS time to get into a better position, etc.) and I still stalled out at 8cm it would be much more suspect that his position wasn't the reason for FTP, KWIM?
The other thing about your story, in addition to your LO actually being on the rather large side, is that he never descended into your pelvis. To me, that would indicate that either a) he really was too big for you (which is unlikely to happen, but CAN and doesn't necessarily mean it will be the same situation a second time), or b) your body just wasn't ready for labor. Considering your labor began with your water breaking you were essentially induced, which obviously could lead to your body not being ready to actually cooperate with the process.
I personally wouldn't choose a RCS over fear that there's a small chance that you physically won't be able to birth a baby vaginally. It's definitely unlikely statistically. You have a much better chance of having a successful VBAC. Besides that, you'll never know how it can go without a trial of labor to test things out. Especially being a VBAC you are going to be very closely monitored. They're going to look for specific things and they'll definitely keep your prior situation in mind. Even if you do end up with a C/S because your trial of labor doesn't work out, it doesn't mean it will be a true emergency C/S. You and your care provider might just decide things aren't progressing they way they should and move to a C/S and that shouldn't carry the same risks as a true emergent C/S.
GL!
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You're looking for clear hindsight and a crystal ball. Unfortunately, we have neither. Like PPers have said with FTP or CPD there really is no way to know why one baby will come out and another will not. There are tiny women who birth large babies and larger women who struggle with smaller babies. Birth is not an exact science.
I personally was comfortable going through the labor process again, regardless of the outcome. I needed to see if I could birth vaginally...and I did. But, I needed to try. The absolute WORST outcome for me would have been if I went late again and was not favorable for an induction. It would have meant a planned RCS against my wishes. But, if your absolute worst outcome is an unplanned or emergency c-section, then maybe the RCS is your answer.
All of this. Also, his position was written in my report. When my midwife read it over, she said that he was clearly in an unfavorable position as was clearly written.
That said, there's no saying that my second wasn't going to be breech or also turned strangely or any other millions of complications that could have gone on. For me, it was important to aim for the best outcome (VBAC) and I achieved that. I was ok with the idea of a RCS after labor if it came to that. It sounds like you are NOT ok with that, so you need to weigh your options accordingly.
What everyone else said. You really can't know if it's going to work or not, but have to decide what works for you. Are you with the same OB who did your c/s? Would you consider getting a second opinion from someone else, and see what they say?
I was also pretty worried about the risks of ending up with a RCS after attempting a VBAC, but for me, it was worth at least trying for a VBAC.
DS2 - Oct 2010 (my VBAC baby!)
as another lady pointed out here..without a crystal ball..theres no way to really know what situation u will end up in if u attempt a VBAC, so you just have to decideif the risk of an unplanned or emergency csection is worth it to you. There are risks with any birth..no matter the route you choose..
that said..i just attempted a vbac myself 5 months ago after my first baby being born via csection for failure to progress (my water broke, waited about 9 or 10 hours to start labour on my own, then we went to pitocin when i didnt start..23 hrs later i only dilated to 5?and baby hadnt dropped..so off we went for the section).
this time, labour started on its own, and after an eternity (really;) labouring without drugs, baby just wasnt coming out my ob assured me..so off we went for another unplanned section..while i am so disappointed that thats the ending, i am so glad i tried and i will say that my recovery was much better this time than the first time (i did wear a support belt this time and didn't the first time..so that may have added to my better recovery). i think the first one was just such a shock..this time not quitew as much...
hope you are able to come to a decision you are comfortable with..good luck to you!
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