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VBAC
Talked to our Pro VBAC OB more in depth about my chances...
and he gave me an honest 50/50 chance. I only dilated to 4/5 with DD and stalled (and if I was better educated, I could have told my midwife that I wanted more time, but I was terrified something would happen to DD in that time so I went in for a C Section). It was a hard recovery after laboring HARD for 12 hours or so, but DD was a perfectly 7.5 lbs. So my OB thinks (with her average size and the contractions I was having during my induction with pitocin) that I have a 50/50 chance since DD didn't have a change to totally descend and put more pressure on my cervix. I think he thinks (along with DH and I) that the midwife shouldn't have let me be induced, my body and DD weren't really ready. He wants to avoid another C section after labor for me, but said he is more than willing to try, but he wants me to have a good recovery experience.
After this long thing. what I want to know is your thoughts? Are these good enough odds for me to try, or schedule a repeat section and have a better recovery with a 2 year old at home? DH and I are at a loss at what to choose. OB said that we can hold off on making a set in stone decision for awhile until he does a repeat U/S around 34 to 36 weeks to check this peanuts size and then we can go from there, but I don't want to have to make a decision at that point. We want a plan in place. The OB said that if the baby looks like she is measuring on track for a full term 6 to 6.5 lb baby then my odds will go up, but other than that its 50/50. Any advice is appreciated! (Sorry so long)
This discussion has been closed.
Re: Talked to our Pro VBAC OB more in depth about my chances...
Not sure why baby has to only be 6.5 lbs for it to be better odds? And those stupid U/S to check size are so subjective it drives me nuts that doctors waste their time with them.
That said, if I had a 50/50, I'd still try it. But that is just me. I successfully VBACed an 8lb, 5 oz baby after going to 41 weeks and being induced with pit. Since your reasoning for the C/S was an unsuccessful induction that was done too early, I can't figure out why your chances are only 50%? You sound like an excellent candidate for a VBAC. Is there another factor I am missing?
Considering you were induced, and your body didn't really have a chance to be 'ready' and labor on it's own, I'd think that if you were able to start labor on your own you'd have a pretty good chance. 7.5 lbs doesn't seem like a large baby at all to me (says the VBACer whose first was 8lbs 12 oz) and the entire size thing is questionable, in my opinion, if GD or a confirmed pelvis deformity isn't involved.
I guess honestly, to me, a 50% chance seems rather arbitrary, and kind of like saying, well, you may, you may not... the entire odds game of the VBAC seems bizarre to me, so I'm kind of at a loss on what to say. Every labor is different, even for the same women, so whose really to say what your real chances are?
I'm not at all a medical professional, and I'm not saying that you will get a VBAC or a VBAC is perfect for you, but I guess I just haven't seen that enough conclusive studies have been done to really take into account all the factors of what happened in previous labors and all the unknowns about your next labor to come up with any sort of 'odds' for your success or not.
I don't understand why he's giving you only 50/50 odds either. He said himself it sounds like your c-section was the result of an induction that shouldn't have been done in the first place, and inductions on first time mothers are known for doubling the c-section rate. And he said that your baby wasn't given a chance to descend, meaning if she had been, it's absolutely possible you would have dilated all the way and pushed her out.
To me that sounds like there is no reason to think you wouldn't deliver vaginally if your body was ready and you went into labor on your own.
I also wouldn't make plans based on an ultrasound weight measurement, personally. Those can be off by a pound or more in either direction during the third trimester. And it's not like your first c-section was due to having a 10 or 11 pound baby. It sounds like it was unrelated to your baby's size. I feel like doing ultrasound weight estimates in VBAC moms just gives doctors a chance to push a RCS, even though studies don't support using weight estimates alone as reason to do a c/s.
Personally for me 50/50 odds would be good enough to try, but you need to decide that for yourself. I will tell you that I attempted a VBAC almost 4 months ago. After 20 hours of labor and being stuck at 7 cm for 8 hours, I had an unplanned c/s because of heart decels (turned out the cord was wrapped around DS which was preventing him from descending and causing the decels). I am 100% happy with my decision to attempt a VBAC even though it wasn't successful. I never labored with my first son as he was breech. Both my c/s recoveries were pretty easy, but my second recovery was far easier than my 1st. DS2 was born on Thursday and by Monday I felt about 90 to 95%.
I will note that I personally have no faith in growth ultrasounds. Two days before my c/s with DS1, an u/s estimated him to be 7lbs 8oz. He was 5lbs 12oz. With DS2 I had a growth u/s at 36 weeks. He was estimated to be 6lbs 3oz at that point and they said he would be 8lbs at birth. He was born on his due date and he was 6lbs 5oz.
Your first experience sounds somewhat like mine. I was induced at 41 weeks, never made it past 5cm, labored for a good 12 hours and my dd was 7lb 6oz. She was facing the wrong direction but I don't think my body was ready for her to be born yet.
Fast forward to this weekend and I just had a 8lb 12oz VBAC. I pushed to go past 41 weeks this time and had more progress before I went into labor than I had with DD1. I would say try for it and see what your body does.
All of this. I had a very similar experience Sarah (only dilated to 6 during an induction that never should have happened as I was misdiagnosed, then she started having decels). I am not seeing the group of doctors that delivered her because the hospital where they have privileges now has a de facto VBAC ban in place, but even when I spoke to my regular gyno in that group he was very supportive of me VBACing in the future for the reasons bolded above. The CNM I'm seeing now has said the same thing.
" I feel like doing ultrasound weight estimates in VBAC moms just gives doctors a chance to push a RCS, even though studies don't support using weight estimates alone as reason to do a c/s."
I also agree with this. Fetal macrosomia is correlated to failed VBACs, but only slightly to uterine rupture (in mothers without a previous vaginal birth, oddly enough), and the criteria for macrosomia is over 4000 to 4500 grams. Nothing in the ACOG's VBAC guidelines has anything about fetal weight beyond that, so your doctor's comment about 6 lbs. and change giving you better odds sounds like a total ass-pull.
To be honest I dont' think he's as pro-VBAC as he claims to be.
Sarah - 12/23/2008
Alex - 9/30/2011
"I say embrace the total geek in yourself and just enjoy it. Life is too short to be cool." - Shirley Manson, Garbage