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VBAC
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Breech first baby, vbac or rcs?
nc@hotmail.com
member
in VBAC
I am having a lot of difficulty in deciding which way to go when I deliver DS in Oct.
My first was a scheduled CS in 11/10 due to breech presentation. I tried an ECVthe week prior, but it was unsuccessful. Upon delivery, my DD had the cord wrapped around her head a few times. In retrospect, the ECV could have been really dangerous to DD.
I recently reviewed the pro/con fact sheet from my pro VBAC obgyn and frankly the risks of a VBAC scare me more than those of a RCS. My heart wants to try for the VBAC, but my brain tells me to just RCS. There are so many factors to consider and each carries a different weight of importance. If you have been in this situation, how did you come to your decision on how to deliver your second baby?
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Re: Breech first baby, vbac or rcs?
DD was breech and I hope to VBAC when we have #2.
What risks are you concerned about? I'm a little curious if your OB is slanting things toward a RCS and would be Leary of your OB since mine gave me a sheet and it was clear how much safer a VBAC is and showed the same facts I'd found about the risks of a RCS and VBAC.
For me the fact that I was 3 times more likely to die in a RCS than a VBAC was huge and outweighed the at most 1% risk of a UR.
As my husband said "it would hurt me if something happened to our baby but I would die if something happened to you."
So for us it was an easy decision since DH and DD need me and DH doesn't want to raise 2 kids on his own.
My doctor is encouraging me to VBAC. My husband and I are with you in that my safety comes first, but I'm looking at the stats on harm to baby (taking the handout given to me at face value, I'll start double checking the 'facts' to make sure they are accurate). Yes- these instances are all very rare, but still occur enough to scare me. Here's a recap of the little chart I'm looking at:
VBAC RCS
Rupture 5/1000. 2/1000
Hysterectomy. 2/1000. 3/1000
Blood transfusion. 17/1000. 10/1000
Maternal infection. 29/1000. 8/1000
Infant infection. 50/1000. 20/1000
Infant breathing problems 13/1000. 41/1000
Serious inf breath prob. 1/1000. 4/1000
Infant death. 4/1000. 1/1000
Rupture isn't really a concern to me as rupture can occur even before a RCS. I guess I was under the impression that VBAC was overall a safer option and now I feel differently. I am really scared of trying a VBAC and winding up with a CS anyway. Has anyone tried a VBAC unsuccesfully. Would you still take the unsuccessful VBAC over a scheduled RCS?
I read a book called Pushed. My decision was pretty easy only because a RCS is statistically more dangerous than a VBAC. Even ACOG recommends VBACs. I had a c-section for the same reason you did. And my chances of a successful VBAC are 85% according to my doc. I would recommend the org. called ICAN and also google info and good books to read on the subject.
I just had a VBAC 4 weeks ago and let me tell you how much easier the recovery process was! I also my first baby via c-section due to her being breech. This time, the bleeding stopped quicker and I was up and walking around the same day after delivery. I was able to breastfeed easier because I didn't have a giant gaping hole in my uterus while contracting. Also, it's much cheaper to have a vaginal delivery. My heart was set on having a VBAC because of the fact that I didn't feel "accomplished" after having a c-section. I am soo glad I tried for the VBAC and I truly feel it was one of the best decisions I ever made
Good luck with your decision and remember that it's whatever you feel is best for your situation.
This exactly! My VBAC was incredibly healing and empowering, I am so so glad we chose to make it happen. My C/S was terrifying and I would never want to do it again, my vaginal delivery was awesome - I would definitely relive it if I could. Please try to find an ICAN group near you, it is very helpful. GL!
Why is the maternal infection risk here so much higher with VBAC than RCS? Anyone? Bueller?
I agree. These numbers don't seem correct. Every scientific research article has shown that maternal infection is significantly higher with c/s. Which makes sense. Not sure which other numbers might be off. Either way, all of these numbers statistically are still extremely low.
Yes, the stats I got also left me thinking WHUCK? Common sense tells me infection should be higher with major abdominal surgery. I'm having a google fest for more info. My next OBGYN appt will be interesting
.
With my first pregnancy my plan and heart were set on a natural delivery assisted by a good friend who is a doula. I was terrified of the CS, but afterward I realized I had the best possible CS you could potentially have. For a long time I felt incomplete or like I was less of a woman because I didn't have my daughter in the way I desired, but I have finally come to a place where I'm okay with how my situation turned out and no matter how it happened I did give birth (i have family members who have pulled the 'well you didnt really give birth' card) and thankfully I now have a healthy, happy, beautiful toddler.
I guess I'm scared of the unknown. I most likely know what a RCS will be like, I have no idea how a VBAC will turn out for me. The stats I was reading made me rethink what I had planned. Thanks for sharing your VBAC outcomes. I think I need to re-read my Ina May to bolster my confidence back up!
My blog
Yeah, that was the one thing that left me scratching my head. I have no idea why infection would be higher with a VBAC. Perhaps these are stats for how the patient intended to give birth (rather than how they did?). Meaning that some of those who VBAC still end up with a RCS. I thought I recalled reading somewhere that unplanned RCS have a high incidence of infection.
C-Section due to breech is one of the better reasons to have a VBAC. ACOG says VBAC is much safer than RCS.
Having cord wrapped around your LO's neck isn't nearly as dangerous as it sounds 99% of the time. A good doctor won't be freaked out delivering a baby vaginally and calmly untangling the cord as they go. It isn't at all rare and isn't a big deal at all.
I would love to see where those facts are coming from. Risk of maternal infection in particular causes me to raise my eyebrows. Risks if infection with surgery are always going to be higher than not surgery.
Please go to ICAN's website and do some research there about the risks. Go to ACOG's website.
My DD was a c-section due to breech presentation. I didn't have any feelings of being incomplete or any frustration with the way she was delivered. I accepted it early on and was okay with it.
With this pregnancy, I decided the risks of a RCS were definitely higher than a VBAC. I know several woman who have had severe complications (placenta accreta and hysterectomy) as a result of the RCS.
If you plan to have 3 or 4 kids, you really should consider not having a RCS. It's really hard to find a OB that will let you VBA2C.
Additionally, as a NICU nurse, the benefits to a baby to go through the birth canal are not to be underestimated.
And finally, I am hoping for a much quicker recovery. I don't have family close to help out and don't want to be using the steps several times a day with a toddler and newborn. The thought makes my old incision burn. lol
GL!
BFP May 2017.
BFP November 2011 TWINS!!!. Lost a twin at 7 weeks. DS born VBAC.
BFP July 2009. DD born via c/section for breech presentation.
BFP Jan. 2009. Missed miscarriage at 9 weeks.D&C March 2010
December 2009 - Diagnosed with bicornuate uterus.
Do you think your OB might be steering you toward a RCS? My OB is very VBAC friendly IF you are a good candidate. My DS was a scheduled c/s b/c he was breech. I never labored. She told me that is considered to be an ideal situation in which to try a VBAC/TOL, I was basically like a first time mom from a labor perspective.
From what I understand, the VBAC is actually safer for mom. The RCS is slightly safer for baby. The recovery time is what I am most concerned about + the fact that I likely will have more children and if I can avoid it, would prefer not to have c/s's with each.
But, now...I am 11 days overdue with DD and it appears that I might be doing that RCS in 3 days anyway. My OB would let me go 2 wks past due with monitoring (which has been successful, thank goodness!) and we are nearly there.
If anything she is steering me to VBAC, the paperwork given to me is the standard info/waiver/disclaimer sheet you have to review and sign to do the VBAC/TOL. As you stated, I'm an ideal candidate as my reason for the first CS was breech presentation. She has also said that she will let me go to 42 weeks as long as fluid levels look good, ect. The first thing said to me at our 8 week appt was "So we are doing a VBAC this time, right?".
Has anyone regretted their VBAC or tried to VBAC, failed, had the RCS and then wished they had just scheduled the RCS? At this stage I am 85% wanting to VBAC, but then I'm on to deciding do I try a natural delivery or do I get an epi 'just in case' the attempt leads to RCS (I really don't want to have general anesthesia)?
Welcome to indecision 2012
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DD #1 was breech and I had a scheduled c/s. I unfortunately did not find out she was breech until my 39 week appointment and my husband and I did not want to try an external version. DS was just born on 6/29 and I was hoping so much for a vbac. My providers were on board, but once again he was breech. This time we found out earlier, but probably not early enough. At 35 and a half weeks we determined him to be breech too. I had my RCS scheduled for two days after my due date. I did everything I could think of to get him to turn. I did everything on spinningbabies.com, saw a chiropractor skilled in the Webster technique, swam every day that it wasn't raining, etc.
I went into labor early and had a much more difficult delivery. I was contracting every 4-5 minutes and there was nothing they could do to help the pain since they were waiting for my blood work and an OR. I probably would have been fine to cope with the pain if I knew I was working towards a vbac, but I felt so defeated that he was still breech and I needed the c/s anyway. With that being said, this recovery has been much easier. I'm still not satisfied about having to have this c/s but I'm coping the best I can. Emotionally I am okay, physically I just hurt and wish I could take better care of my first child.
If I had to do it all over again I just would have been more proactive about preventing another breech baby. I would have started Webster earlier, the breech inversion exercises earlier, everything earlier to try and prevent breech presentation. I'm so happy that I gave it my best effort to try to vbac. I would have regretted not trying. I know that I did everything I could to try and make my uterus and pelvis as favorable as possible to get this baby to turn. My dilemma will be if we have a third what to do as my current provider does not do v2bacs.
Good luck in your decision.
My first was breech and I had a c/s so when my second was coming a RCS seemed doable since I had been through it and knew what to expect. A VBAC was just scary and had a new set of scary things attatched. Ultimatily it was in the last minutes of my 41 week pregnancy when I went in for my RCS and my Ob simply asked "Do you want more kids?".
I had a wonderful, safe, fast delivery with my second baby.
DS - 7.2006 - C-Section b/c Breech
DS2 - 4.2008 - Successful Vbac
DD - 5.2012 - Successful Vbac