VBAC

Struggling with postpone or not to postpone c-section.... VBAC

So, for two weeks I have been contracting pretty consistently for all, but a couple of days. I am at 2 1/2-close 3cm and 70% effaced. I have had three doctors tell me that VBAC is an option, but my main Dr. is not a fan. He has pushed a repeat section pretty hard... He told me that I have to do the c-section Monday, because of uterine rupture risks. The other doctors agree it's a risk, but not like he is pushing. I also know that he is going out of town and I feel that is why he is pushing the section. I really want the full chance to go into labor and VBAC. What should I do?
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Re: Struggling with postpone or not to postpone c-section.... VBAC

  • If you really want a VBAC, then you should say no.  I know that is hard, but you can do it.  You don't have to do the c/s on Monday--it's your body and your doctor cannot tell you that you have to do something without your consent.  

    The risk of rupture is small if you've had one c/s and you had a low, horizontal incision.  Your chance of having a rupture is around 0.7%.  And the chance of losing your baby to a rupture is only around 1 in 2000.  Compare that to the risk of an amniocentesis, which doctors do often, where you have a risk of 1 in 200-1 in 400 of losing the baby.

    Is there another doctor in the practice who is more supportive of your desire to VBAC? 

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  • I would almost be happy that your doctor is going out of town. There seem to be other doctors I'm assuming in the same practice that are way more supportive. I would want anyone of them by my side. It sounds like your body is getting ready to go into labor anyway. If you want a VBAC say no.
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  • it sounds like you know what to do, just need some encouragement.  has your doctor given you a reason to think that you are at any more risk of uterine rupture than any other vbac patient? 
  • Without a really good reason from your doctor for why you should have an early c/s, I would continue to push for the VBAC until you're at least 41 weeks (assuming you, your baby, and the placenta are all doing well).  I agree with you that it sounds like your doctor wants to do a c/s before he leaves on his trip and I also agree with the PP that I'd hope to go into labor while he's gone, in the hope that one of the other doctors at your practice will be more supportive of you having a VBAC.

    Whatever you do, whatever happens, good luck!  Trust your instincts! 

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  • It sounds like you are VERY close to a regular labor and delivery.  You are not even going to be 40 weeks on Monday.  If the rest of the doctors are supportive of your VBAC, let your main doctor go on vacation and deliver with the supportive doctor (or switch your main care to one of the other doctors).  If he is pushing a c/s just because of risk of rupture and you aren't at any increased risk than any other VBACer, then is is pushing it to deliver you before he leaves.

    If you want to try to VBAC, cancel that c/s and give yourself another week or so.

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  • Thank you ladies... I do know in my heart that I want to at least give LO another week or so. I haven't been given a reason for any extra risk... I am disappointed in my primary dr... I do feel he is just pushing me, because he wants to get it done before he leaves. He was so wonderful with my first son, but I just don't feel this section is right for me... at least not yet. And I have had three of the other doctors show wupport for the VBAC even one who doesn't normally go with them. I am going to get check tomorrow and see where I am. I had my membranes stripped yesterday. I was a very close 3cm and 70 plus% effaced. I am hoping that the powerful contractions I have been having the last several hours are going to continue me where I need to be. 
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  • Your doc works for you so they should be doing what you want. I was told that as long as I was 2+ and more than 50% I was favorable for vbac induction. My OB tried to "fit me in earlier" for my RCS without my knowledge. I had to explain that I wanted more time to open and would like to wait until 41 weeks (I am 1cm and 50%). They were fine and rescheduled it for the later date. GL stick to your guns. 
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  • There is just as much risk to doing a VBAC as there is to having a C-section. If you feel that you would like to try and go into labor on your own and have a successful vaginal birth, then that is what you should do.

    I actually find it a little disheartening that your doctor is trying to discourage you from that, rather than support and encourage the choice, but there's not much you can do about that at this point.

    And for what it's worth, no doctor or anyone for that matter, can make you do anything. You don't have to have a C-section if you don't want to. You can go to 42 weeks to give yourself a chance to go into labor on your own before anyone will have to medically intervene.  

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