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VBAC
On the fence (long)
Maybe some of you with firsthand experience can weigh in on this. 2 years ago I had a C/S with my daughter. The labor itself progressed very quickly and I wasn't even able to receive a full epidural (they gave me a low dose which wore off after about an hour bc by the time I was ready to get it i was 9 cm). The nurses were all telling me I was doing great for a FTM.
Then, I ended up pushing for 3 hours straight with no progress. I was so exhausted and literally felt like I was going to split in half (pain in pelvis). They tried pitocin to help get a better contraction/push and it caused DD's hr to drop but this reversed as soon as it was turned off so she was not considered distressed. After 3.5 hours I told the doc I thought i only had 30 more minutes in me. I ended up with a C/S although I was not considered failure to progress. After the C/S the doc told me I made a good decision- baby was 8lbs 11 oz (he had guessed high 6's based on my size) and apparently my pelvic outlet is narrow. Plus her head was turned in such a way which made her present larger than she is. My initial recovery was great but I am very active and have had chronic pelvic issues which make running and other activities tough since (although I don't know if this was from the pushing or the C/S).
So now, I had decided to go with a RCS. Honestly the small community hospital where I had DD is not set up for VBAC. I liked it there and liked my OB and after talking with him and a few nurses I know it seemed like a good idea. But now I'm moving a couple hours away and (if a new practice will take me at 24+ weeks) have the option of VBAC at two different hospitals. I'm considering at least talking to a new OB about my chances of success. From what I've seen people who get hung up pushing (esp in my case where there was very minimal medical intervention used) dont have the best success rates, and I cant change my size or the baby's size....but I'd love to not have the long hospital stay and difficult recovery if I can help it.
Anyone have a similar experience to me and go on to have an easier second labor? Any advice? Although part of me wants to try it the other part is scared to just have the same thing happen a second time.
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Re: On the fence (long)
My first labor was really similar to yours. I dilated fairly quickly, and then pushed for 4+ hours before having a c/s. He was occiput posterior (which makes it harder for babies to come out!), and just under 8.5 lbs. I had a VBAC with my second son with no problems, and he was 10.5 lbs and a few inches longer than my first.
For me, it was all about positioning (and that I was worn out by the time I started pushing with DS1, too). It sounds like your DD's position could have had a lot to do with the c/s rather than a narrow pelvis. True CPD is really rare, whereas I think a baby's head position has a larger effect on a successful vaginal birth than people think. hth!
DS2 - Oct 2010 (my VBAC baby!)
Next to a having a supportive provider, it seems that positioning is the second most important aspect to VBAC success. (Just my own observations from all the successful VBACs). If her head was turned, that might have made all the difference.
There are many Moms on here who were unable to push out #1, but had no problems with #2. I didn't push for very long with DD#1, but I was super exhausted and just couldn't get her out. She was 9lbs 1oz. With DD#2, I only pushed for 45 minutes and I could feel myself making progress with each push. She was 8lbs 1oz. So, you might also have a smaller baby.
Really, its up to you. Talk with your new provider and see what they think. I also had pelvic pain after my c-section - for almost 18 months. That was one of my top reasons to try the VBAC. My recovery from the VBAC was a breeze. Good Luck!
You can't change your size or the baby's size, but you can definitely do things to help like exercises and chiropractic care to encourage optimal fetal positioning and you can push in a position which opens up your pelvis making room for baby to descend. Maybe you did these things last time though, but if you didn't it's definitely worth a try.
I will always prefer attempting a VBAC to a RCS, but you have to make the decision for yourself. I say do your research on your options, figure out what you can do to better your chances and go from there.
I think we're probably all scared that we'll have the same experience as last time if it was a difficult one, but every labor is different. Just because it didn't work out last time doesn't mean that it won't this time.
GL!
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I had a c/s after pushing for 2 hours and I went on to have a VBAC with my second. My first baby was in a weird position and my second baby wasn't, and that made a huge difference. Your baby was also malpositioned, so that may be the reason he wasn't descending. It's possible that your pelvis is small but honestly, that gets way overdiagnosed. I was also told me pelvis was too small to ever deliver vaginally--well, obviously that was wrong.
Even though VBAC success rates tend to be lower for moms in your situation, they are still pretty good--over 60% in some studies. When you consider that our country's high c/s rates means there is only a 75% vaginal delivery rate in FTMs and 68% overall, your odds are really not that different.
I'm living proof that your second birth can be the absolute complete opposite of your first. And we have many posters here who have had a similar experience. Of course, if you are most comfortable doing a RCS, that is an option too. I would find a doctor who is supportive of VBAC and that way you will have both options open to you. You can always change your plans.
GL!
FWIW, my VBAC son was 7lb 14oz and I'm 5 feet flat and a size 0. He probably would gone over 8 lbs like his sister but he came at 38w.
I too pushed for hours with a poorly positioned baby the first time around before the c/s. DS1 was 8 lbs 2 oz but git stuck because of an asynclitic head position. From everything I've read and researched, which is a lot, positioning is everything. And it's something that is not likely to recur.
Take your time to explore your options. It's definitely worth considering.
I had a completely natural labour with ds1 and pushed for three hours, followed by csection. He was OP. I had a vbac with ds2 with a short and uncomplicated labour. My entire labour with ds2 was just two hours... shorter than my unsuccessful pushing phase with ds1, which kind of blew my mind. Ds2 was OA and I pushed on my knees, not lying on my back, and a vertical pushing position can help too.
As said above, "small pelvis" is diagnosed way too often. A friend of mine had a csection with her first after failure to progress. They diagnosed her with CPD but she didnt believe the diagnosis. She went on to have a quick and uncomplicated vbac with a 10 pound baby. For her third baby, her second vbac, the OB again told her that she would be unable to deliver naturally because of her pelvis. The OB apparently didnt believe her when she said she had already vbac'd a large baby. She delivered the third baby, who was also large, in another very fast and uncomplicated labour.
Proper positioning makes a huge difference in getting baby out. I understand your hesitation, though. It is a difficult thing to think about.
Thanks for all of the responses, they are helpful. I think my main hesitation is that I know this is it for us, so really 2 c-sections are not the end of the world. If we planned on 3+ that would push me towards vbac for sure.
Im just nervous bc I know I handled it fine(the operation) and most of what I'm reading shows no great benefit to the baby either way. I know there is less fluid in the lungs with a vaginal birth but anything else I'm missing? I nursed DD right from day one so feeding was not an issue post c/s with her, but I'm aware it can be.
I have worked with disabled children and many of them have injuries due to birth complications/lack of oxygen, so it all makes me even more nervous.