VBAC vs. C-Section?

LaSraOrtega · February 2013

Hi Ladies,

Yesterday during my 9 week appt, my doctor said that since I already had a c-section (back in 2011), I have the option of either a VBAC or another C-Section. With DS I was in labor for 17 hours and even with the pitocin I barely got to 5 cm. We opted for the c-section to avoid the risks of infection or trauma to the baby. I'm tiny, 4' 11", with a small frame, so that may have been why I didn't progress enough...

She mentioned that if I choose VBAC, the chances of complications due to a rupture are less than 1%. She also mentioned that due to the 1st c-section they can't induce me or use too much pitocin as they would with a normal birth.

If I choose to have another C-Section, we would schedule it 1 week before my due date. If I opt for a 2nd c-section, she said if we chose to have a 3rd child there is no option for VBAC since my uterus would be too weak at the incision.

I'm unsure of scheduling a c-section 1 week early because I've always thought you want to keep the baby as close to your due date as possible to give the baby all the time to develop and he/she will come when they're ready. Also, I hated how groggy I was afterwards and the recovery from major surgery.

I'm thinking of going with a VBAC but if I have the same experience with labor of me not progressing, especially since I'll be on less pitocin to help, is it worth even trying if I'll probably end up with another c-section?

Does anyone have any experience with one or the other? I was checking out the VBAC board but it seems so anti c-section there, I decided against posting. I also looked into the ICAN websites, but they seem way to biased for what I'm looking for.

Any help would be greatly appreciated! Thanks!!

JNoelleE · February 2013

Were you induced with your first?

You can always choose to have your Csection on your due date. They cant make you do it at 39 weeks.

I would choose vbac, if I were you. I would not worry that because you're tiny you are unable to give birth vaginally. You can! And I don't think your being short necessarily has anything to do with your labor not progressing. My labor with my first was a total of 62 hours. 18 hrs of pitocin. I am almost 6ft tall. The reason I wasn't progressing was because I was being induced before I was ready at 38 weeks for pree. I ended up still avoiding a csection and had my boy vaginally. I was at a natural birth friendly hospital and was on monitors so they were making sure it was safe to continue laboring.

Usually second labors are shorter, and you could have, and probably will, a completely different experience than your first.

jennychrm · February 2013

I have not had a c section, but I agree with the previous poster... why not wait to go into labor and try and if the VBAC doesn't work, have the csection at that point. Maybe it is not "just that easy" though?

Also as pp suggested, consult with a doula, or at least a midwife as they tend to be more receptive to VBACs from what I know.

Did your water break with your first? I had a 24 hour labor and was not given Pitocen at all. 12 hours in I was only 4 cm, my water didn't break until I hit 9cm. I think a midwife has more of a tendency to let things happen naturally, if that is what you want, and it may help you be more successful in avoiding a c section!

SweetPeaK26 · February 2013

I have no personal experience, only know that every single vbac attempt that I've heard of :friends and bumpies: have failed to progress, resulting in a repeat.

kdv77 · February 2013

Your second birth might be much easier than your first, you just don't know at this point and I would think it better to at least try for a vbac first before throwing in the towel. At the very least, I'd wait until you went into labor naturally. I've had many friends with successful vbac's when they went into labor on their own. Good luck with your decision.

jacks198122 · February 2013

I also had a csection the first time due to failure to progress and am considering a vbac. I recently met with a midwife who was very informative and positive about vbac and it being a great option for me. She said at their practice of only midwives, they have an 80 success rate for vbac but she also said many doctors do not support it as fully and therefore have a much lower success rate. They believe that birth is a natural thing, not something that can be scheduled and controlled perfectly by modern medicine.
If you're interested in a different perspective on this topic you might want to meet with a midwife just to feel more comfortable and aware of your options.

mmdd20 · February 2013

I am hoping for a VBAC. My doctor has the same policy, won't induce for a VBAC. I dilated fully, but DS never fully dropped into my pelvis, possibly because he was posterior. I pushed for three hours, tried the vacuum, ended up with a c-section.

I will have a c-section scheduled for my due date (or a couple days after), but am hoping to go into labor before.

Since I haven't gone through with either yet, I don't have much more experience beyond that. But for me, I would rather give it another shot then not try at all, especially with a supportive doctor and medical staff (the hospital is pro-VBAC as well). I don't know if I will push for another three hours, or if they will even let me, but I am hoping my body gives me the opportunity to at least try.

1026pumpkin · February 2013

I spent a lot of time researching both options and decided that for me, a repeat c-section is the best option. With DS, one of the factors that led to my c was his head getting stuck. His head has always been off the growth charts and his pediatrician was considering ordering an MRI before finding out the size of DH's and DH's dad's heads....they having congenital megaencephalopathy, so there is a good chance we would have the same issue with LO2. I have also had a LEEP since then and it's likely the scar tissue will delay dilation, and they don't let you labor as long with a vbac.

With so many factors making it likely I'd wind up with a repeat anyway, I feel like it's better to just schedule the c. My intention had been a med free vaginal delivery with DS1 and that didn't happen due to an emergency induction for low fluid levels, but I'm not disappointed at all. I had a really good experience with my first c, and don't feel like I'm missing out on anything by having another.

Another factor that contributed to my decision is that we're very likely done after this LO, with a very remote possibility of a 3rd. Due to age, more than that probably wouldn't be possible for us anyway. I know that depending on how your uterus heals, you're not recommended to have too many sections, so if you're planning a large family, you might want to consider the vbac more strongly.

Looking4rainbows · February 2013

I chose a second section while my dr thought I was a good candidate for vbac...young, healthy. The second was scheduled for the Tuesday before my due date...surgery day. Baby was bigger and just as healthy as my first. Decision was made to avoid disappointment. 2 healthy babies
...never regretted decision! Ur dr would not schedule section before baby was ready!

nikki_rob_weddingplans · February 2013

I have one friend who did a VBAC and said it was the worst decision and she so wished she had done a RCS. Then I have another friend who did a VBAC and said it was the best decision she ever made and so glad she didn't do a RCS.

Everyone is different so you just have to weigh all the pros and cons and go with your gut. Me personally, definitely the RCS, not even considering a VBAC. The extra two weeks I get for maternity leave and extra cuddle time with the baby are well worth the longer recovery time, but again everyone is different. GL with whatever you decide!

Pattern · February 2013

I have a tiny frame too...same height. I was induced and never progressed past 2....I had contractions,no pain, and was given max dosag of pitocin. I had a c section. My little guy was pretty large for me...he weighed 8.5 My dr. thinks my uterus was distended unable to push him out. I am planning on vbac...but who knows...guess I will wait see...just hope little one arrived safely.

Good luck!

nde99 · February 2013

I had a very similar birth expereince with my son. I was in labor for 19 hours and only dilated to a 1. After my water was broken for 19 hours, a fever, vomiting and no progress we decided it was best to have a c/s. I've thought about a vbac and if I go into labor naturally before 39 weeks I may attempt it, but if not I'm planning a RCS for 39 weeks. My OB did warn me that due to the failure to progress with my last delivery, my chances of having a successful vbac do go down. It's a personal choice, so do what you're comfortable with.

LaSraOrtega · February 2013

Thanks, everyone!

My water broke on it's own at 39 weeks and once we were at the hospital they found that my water hadn't broken completely so they finished the job. When my water broke at home, it sure felt like it was completely broken!

I think I'm going to go with a VBAC and see what happens, if I end up with a RCS anyway, at least I know I tried and gave the baby full time to develop.

magdalina.h · February 2013

I've never been in labor but my rcs was a breeze. My rcs are scheduled at 38 weeks because I have a classical cut on the inside so I have a greater risk of rupture if I go into labor.

thedash · February 2013

Definitely interview some doulas! I have decided to try for VBAC after my emergency c/s with DS. I will say that my OB is very supportive and really encouraged me to at least give VBAC a try. Talking it over with a doula was very helpful - she is big on "evidence based" decisions about childbirth and even encouraged me to request my medical records so we can go through them and really understand what happened last time to be more prepared.

I shared your exact same concerns with ICAN and other groups being 100% anti c/s no matter what. I think my first c/s saved DS's life and possibly my ability to have more kids. I just want to make an informed decision this time, KWIM?

missmuffin87 · February 2013

Since you are leaning towards VBAC, just go for it. Every labor is different so this one might progress totally differently from your last. Your water might not even break which would give you more time to dilate on your own without it being a race to get baby out. Also your physical size has nothing to do with your ability to deliver a baby, so don't let that get you down. Tiny women all over the world deliver babies every day.

Ask your OB what their VBAC and c/s rates are. You can compare that to other OBs and hospitals in your state. You also might want to consider switching to a CNM who will be much more likely to have success with a VBAC delivery. GL

LaSraOrtega · February 2013

laurelannie:
LaSraOrtega:

Thanks, everyone!

My water broke on it's own at 39 weeks and once we were at the hospital they found that my water hadn't broken completely so they finished the job. When my water broke at home, it sure felt like it was completely broken!

I think I'm going to go with a VBAC and see what happens, if I end up with a RCS anyway, at least I know I tried and gave the baby full time to develop.

Let me know if you need help finding a doula. I swear they make a difference, it's been proven that a doula assisted birth has a lower chance of c-section, I'm not sure if those studies were done with VBACs, but I don't see why the same wouldn't be true for doula assisted VBACs. They'll provide you with so much physical and emotional support and encouragement, and I've also found they can be great at coaching dad in the best ways to support you and be involved productively in the birth of his baby.

I'll keep ya posted if I do! Thanks so much!! Smile

lovelyophelia · February 2013

I'm a mom who has had two c-sections. I would try for the VBAC if your doctor feels you are a good candidate for it. I will say that having another failed labor and then the c-section is more than likely to be just as unpleasant of an experience as your previous one. My rcs was a breeze. I had a lot of pain due to my son never being able to drop due to his huge head and a failed induction. But, overall, do what you feel is right for you.

jchytil · February 2013

Like people said do what your gut is telling you. I too was induced because of high blood pressure and even with two rounds of the strongest pictocin and over 24 hours I never progressed past 4cm. My poor little guy was stuck and in distress. So I had to have emergency c-section. I am opting to just do a repeat c-section because thats what I feel is best for me.

SkobysBride · February 2013

I had a successful VBAC with my 2nd and plan on another for this one. For me the difference between a c-section and the VBAC was night and day. I was miserable for about a week with my c, with the VBAC I practically sprung out of bed after delivery. Yea, I was a little sore down there for a while, but seriously it was nothing compared to the pain of the c-section and I couldn't imagine going through that with other children at home demanding my care. I say go for the VBAC, if it doesn't work out at least you'll know you gave it your best shot!

SkobysBride · February 2013

I'd also like to add that there are doctors/midwives that will do VBA2C (there's someone in so even if you did end with a c-section you might find someone to VBAC a third.

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