Struggling with a birth decision...

ccip82 · December 2013

I am seriously having an internal battle with myself in regards to how I want DS delivered (via VBAC vs. RCS). I have thoroughly researched both procedures and I am not looking to start a VBAC vs. RCS debate. I was hoping to see if anyone else was facing a similar struggle and had any advice or venting of their own.

We found out at our appointment yesterday that DS is most likely in a head down position (but I still feel him switching positions frequently). Next week, we will have our final ultrasound to help determine estimated size and position. It is at this appointment I was going to make the call whether or not to have a VBAC or schedule a RCS. Lately, a big part of me really wants to simply schedule a RCS irregardless of size and position of DS. However, there is another part of me that feels I am selling myself short and giving up before even trying. My anxiety levels have been through the roof lately thinking about this. I just want DS to come out the safest way for both of us.

Anyone have any advice or facing a similar decision?

gina0485 · December 2013

No advice but whatever you decide for your baby is the "right" decision. I can totally see how you might be having anxiety over making up your mind.

SvedkaStoli · December 2013

I am sorry you are struggling. It is a tough decision. Statistically speaking, you will have an easier time with VBAC but my c-section was a breeze to heal from. If you do want to try VBAC, you should go for it! What does you OB think?

ccip82 · December 2013

Thank you so much ladies for all your input so far. It really means a lot

slmille4 · December 2013

Maybe make a list (I'm a huge list person). Like recovery time for both, what u would need after both, ask ur doc it u had a c section this time would it take vbac off the table next time. A huge decision may also be when the first time a rcs could be scheduled too. I know someone mentioned with the holidays coming up the only induction date option for them was Christmas Day. Good luck!!

worleygirl · December 2013

You could explain all this to your Dr and ask for their opinion. Maybe that would help you decide. Good luck with your decision.

candypantsls · December 2013

I feel confident that whichever you decide, you'll find peace with that decision and go forward confident and prepared. You got it!!!

Roses87 · December 2013

This may sound weird. How many kids do you want? The more kids you have/ more c sections the higher risk there are too you and future babies. If this is your last and your leaning towards RCS and it will be less anxiety to you, I say do it. If you plan on having more kiddos I say try to consider a vbac, its a better recovery and its better for future babies.

If you don't mind me asking, why did you have a c section with your daughter? That plays a role in if a vbac would be more or less likely to be successful.

monkeybutt61612 · December 2013

I chose rcs because I did not want to end up with one regardless after a possible unsuccessful vbac attempt. I'd rather go straight to the section then risk one after hours and hours of trying again.

Unknown · December 2013

This content has been removed.

cnwilbur1030 · December 2013

I chose RCS this time because DD literally got stuck in my "small pelvic opening". My OB said she'd be all for me trying a VBAC but that this LO would probably get stuck too due to size. So I decided to skip the whole labor thing and just go with the RCS. I know VBAC recovery would be easier, but I don't want to attempt a RCS recovery after hours of labor and pushing again.

My OB also said I would have a higher VbAC success if labor stopped progressing or DD was breech or I needed the first C due to medical condition. But just getting stuck would probably mean RCS.

bensmommy518 · December 2013

I completely agree with what @Jessiejam said. Try to imagine what your ideal birth would be like. What are the important aspects that make you feel safe and comfortable. There is no right or wrong way to birth a child so you need to do what makes the most sense for you. If there are concerns about VBAC that make you more anxious, you will be fighting that anxiety the whole time which will make the whole process less comfortable for you and less likely to work successfully. Whatever you decided will be the right choice and talk to you OB. You may still have time to think about it more before you have to decide for sure.

ccip82 · December 2013

Thanks again everyone!!

@Roses87

DH and I are on the fence about having another one after this. I had a scheduled C/S with DD because she was breech.

worleygirl said:

You could explain all this to your Dr and ask for their opinion. Maybe that would help you decide. Good luck with your decision.

@worleygirl

I would bring this up with my midwife, but she is pretty bias. I am overall very pleased with the care that I am receiving here, but in the UK I've found they are very pro VBAC. My midwife while very nice, has been pushing a VBAC.

litzo27 · December 2013

Good luck with your decision! I'm no help since I have no experience with C/S but I was talking a lot about this with my cousin previously. She had 2 vaginal and 3rd emergency C/S because they were in a car-accident at 37 weeks. She had a lot of doubts about what to do for her 4th. Ultimately she chose VBAC because she thought her recoveries with the first two were much easier and because the C/S was not due to any complications with labor/baby but the external factors. Her doctor was very neutral and didn't advocate one way or another although he honestly said that repeat C/S would be easier for him because there are less things to worry about in terms of prior scarring, etc. She ended up unexpectedly having a fifth several years later also via VBAC.

ccip82 · December 2013

Amylou333 said:

Thanks again everyone!!

@worleygirl

I would bring this up with my midwife, but she is pretty bias. I am overall very pleased with the care that I am receiving here, but in the UK I've found they are very pro VBAC. My midwife while very nice, has been pushing a VBAC.
@ccip82 that is definitely true for midwives. Have you tried discussing with your GP? I find they tend to me far more impartial. My midwife thinks vag birth, ebf and cd-ing are the ONLY suitable options in life. I see a specialist (MFM equivalent) and he is a lot more open minded.

@Amylou333

Thank you

I have an appointment next week with a doctor since I've had a C/S before. I am hoping to ask more questions there!

JaneW2 · December 2013

Like cnwilbur1030 said, a key consideration is why you had the first c-section and whether the problem is likely to reoccur. If the first one was due to baby not fitting, there's a good chance the baby won't fit this time, either. In that case, I'd personally schedule RCS, because successful VBAC is unlikely.

However, you say your first c-section happened because the baby was breech. If this one has a better sense of direction, your chances of successful VBAC are quite a bit higher.

Still, all that really matters is that the baby gets out of you safely. I don't think there's a wrong choice here.

LimeDrops · December 2013

Ugh it sucks to have to make this decision, I have been facing a similar one (I've never had a c/s before but have the option this time). I switched back and forth a lot, but as the time draws nearer I'm more and more confident that I want the safest, most stress-free option (which in my specific situation happens to be c/s but could be the opposite for you). I agree with others that your comfort level is key. Good luck decision making!

LindsB314 · December 2013

No real advice but also wanted to say whatever you choose will be right for you :-) good luck with whatever you choose!

moosebaby2011 · December 2013

I don't have any experience with this personally, but I can certainly understand why you are torn on the issue. Obviously safety is your first concern, and I think if I were in your position I'd most likely try the VBAC, if only because my 2 year old is pretty demanding and I'd worry about recovery. He loves for mommy to hold him and I'd hate to have restrictions on how much or how often I can pick him up.

Really, though, there isn't a wrong decision here.

KEfam5 · December 2013

I'm having the very same anxiety. I know what I want in my heart but it's a tough decision.

aessary03 · December 2013

I understand the anxiety. And I'm sorry you're experiencing that anxiety and struggling with this decision. While I was never a candidate for a VBAC, I can only imagine the flip flopping you must be doing trying to make the best decision for you and your family. I have no real advice for you. You know what the recovery time for a c/s is and you know what to expect from it. So you can kind of gauge how you'll feel after baby is born and how much you'll be able to do with your DD and this baby. Good luck on your decision.

MamaP19 · December 2013

I thought before I got pregnant with DS that I would be dead-set on a VBAC. For the most part I really have been. I waver here and there when I think about how much more convenient it would be if I had a date and time set for his delivery so I knew exactly when I would need help with DD. MIL has to drive 2 hours to get here to watch her and has been changing the plan a lot on how long she'll be able to stay and help if/when I go into labor. I'm for sure a planner and so much of having a baby is up in the air that it makes me a little nuts.

I desperately wanted a pain med-free vaginal birth with DD and obviously didn't get that. I still really would like to experience it. That probably sounds strange, but I really want to push out a baby and have him placed on my chest right away. I want to start nursing right away - not lay on a table being stitched up while H gets to go hold the baby. I also really worry about recovering from a c/s and having two under 2 to take care of with potentially no help. H won't be able to take much time off of work if any. We have no help that we can rely on besides MIL (and lately who knows how reliable that help is).

One of the biggest reasons I want to try for a VBAC also is that we want more children eventually. When I look at the risks and stats of VBACs vs. RCSs I get worried that having more surgery ultimately means less children and a lot of potential complications.

The way I see it, I can at least try for a VBAC so long as everything is okay with DS and I. If something goes wrong or just doesn't progress the way it needs to and ends in a c/s, that's okay too - but at least I gave it a shot. Sorry for the book but this is definitely something that has been on my mind a lot lately. I hope you find what works best for you because that's the only "right" decision. If you have any interest I'm in a facebook group called VBAC Facts Community that provides a lot of really helpful information and support to women considering VBACs as well as RCS moms.

CopperT0p · December 2013

DH and I were having this discussion last night. DS was born via emergency c-section because he was breech and went into distress when my water broke (I had planned to try a breech delivery).

At our Tuesday appt with our midwife she brought up the topic of uterine rupture in VBAC for discussion as I had to sign a consent form that I wanted to try for a VBAC at home. DH went white and got scared, I had given the information folder about VBAC and home birth to read prior to the appointment but he hadn't read it.

Last night he finally was ready to talk about it. He is definitely scared, to him the 1% risk of uterine rupture is enough to make him worry that it will happen to me. His mind goes to the worst case scenario that he could lose both the baby and me due to a complete uterine rupture. I reminded him of how with a hospital the size of ours, the amount of time to get into the OR would be the same from home or hospital (we live less than 5 min from the hospital). He still said it all makes him nervous. I can appreciate that, and I appreciate that he cares about a safe birth outcome, which is what I assured him our midwives want to. They wouldn't let us attempt this if they felt the risk was too high.

I personally would like to avoid a c/s because of recovery while taking care of a 3 year old and newborn at home. DH has to go away for work for about 6 weeks starting at the beginning of February, so I would be home alone other than having my parents come down on weekends. We don't have a main floor bathroom, so I would be having to do stairs every time anybody needed a bathroom break or nap. We lived in an apartment when DS was born so I didn't have to worry much about stairs.

I think as PP's have mentioned it is important to talk through all the options and outcomes to figure out what you are comfortable with. I know our household has a lot more discussion to go through. I don't want DH to be this nervous when our due date is approaching quickly.

JaneW2 · December 2013

MamaP19: That's another key point. If you are planning lots of kids, repeated c-sections get riskier. If you only want two, then that's not such a consideration.

CopperT0p: Check with that local hospital whether your midwife has an established relationship with them. If not, in an emergency, quite a few minutes could be lost while the hospital figures out just what exactly you're doing there and what the situation is.

MamaP19 · December 2013

Just wanted to add that I think some doctors skew the risks of a VBAC. While the risk for a UR is around 1%, the risk for a catastrophic rupture (where mom or baby don't make it) is much much lower. This is a really good site to look on for more info: https://vbacfacts.com/13-myths-about-vbac/

"The risk of uterine rupture after one low transverse (bikini) cut cesarean is about 0.5% – 1% depending on factors. First time moms are at risk for complications that are equally serious to uterine rupture and occur at a similar rate such as placental abruption, cord prolapse, and shoulder dystocia."

KimberlyTX · December 2013

@ccip82--I had a c-section with DD because she was breech, too. This time around, I have decided to try for a VBAC if LO cooperates. With DD, I had been planning on trying for a med-free birth, so the c-section was a bit of a shock when we found out at 36 weeks she was breech. I started talking with my OB about a VBAC then. I was even talking to her about it while she was closing me up in the OR!

Despite all that, I've definitely had moments of doubt. My c-section recover was easy, and I wonder if I'll regret a vaginal delivery if I end up with a big tear, hemmis, and all the other fun things I hear about. There are a few reasons I'm still going to try, though. One, I think a c-section recovery will be more difficult with DD around since I won't be able to pick her up for 2 weeks or move as easily. Two, I ultimately think that, all things being equal, a vaginal birth is better for mom and baby (obviously, there are situations where that isn't true--like me the first time, DD and I probably both would have died without a c-section because of the breech position she was in). And three--and this is the biggest one for me, honestly--I know in my heart that I will have regret if I am in a position to try for a VBAC and don't.

I HAVE decided, though, that if this LO decides to go breech on me, I'm not going to do anything to try to flip him. I will schedule the RCS and chalk it up to fate making the call for me. I stressed about that stuff too much with DD at the end, and I don't want to do it again. I will also not hesitate to consent to a RCS if my OB thinks that is the right call once labor starts.

Whatever you decide will be the right choice for you, and good luck!!

Deblondie1 · December 2013

No advice because I've never been there. That being said, I hope you can come to a decision that you are comfortable with. However it happens, you'll have a beautiful squish at the end. I hope your anxiety calms a bit soon ::hugs::

Arrgcr · December 2013

I have no advice but I was just wanting you to know that I am thinking of you and I know that regardless of the decision, you will make the right one!

Trust your instincts/guts girl!

MiaMyPuggle · December 2013

I was so upset that my hospital doesn't allow VBACs and my doc assured me it is fine and made me feel somewhat better by saying that the VBACs are easier on the mom (bc of healing/recovery time) and c sections are easier on the baby (bc they won't be in distress). Whether that is actually true or if it is her opinion, that made me feel better about never being able to have a VBAC if I stay with this practice.
That's the one thing getting me thru having another c section, which was pretty easy and so fast.

McGuireMommy · December 2013

Jessiejam said:

As someone is a huge advocate of unmedicated birth and having as little intervention as possible my advice would be to do whatever makes you feel safe and comfortable. The only thing that could impede an enjoyable birth is fear. Of course, you could have a vbac if baby is cooperative but will you feel comfortable and safe? If you decide to opt for RCS will you feel safe and comfortable? There's no wrong answer, just visualise your birth and see what you feel happiest with.

@ccip82, I am in the same situation you are. My thoughts and opinions seem to change daily, and at this point, neither side is winning! I have stopped doing research for the time being, just to give my brain a break, but it's not really working. I know exactly how you feel.

@jessiejam, That is excellent advice. Thank you for saying that!

cyndilouwho77 · December 2013

First off (((HUGS))) to you! I can say it was an easy decision with my second DD, just because it was the safest option for us, but to be honest I am on my 3rd c-section and I have not been sleeping cause this one (only this one) is head engaged and ready to go...I feel the same way about selling myself short of doing it the way we were intended too. All I can tell you is that there is no right or wrong way and that give yourself this next week to think things over in your head but dont make any hard decisions before you go in. You wont have a clue if one of those options wont even be on the table by then. Try to relax and know that either way your sweet LO will be here in no time at all in any fashion that they choose! Good Luck and Prayers to you!

CopperT0p · December 2013

JaneW2 said:

CopperT0p: Check with that local hospital whether your midwife has an established relationship with them. If not, in an emergency, quite a few minutes could be lost while the hospital figures out just what exactly you're doing there and what the situation is.

They do have a good relationship (privileges) at the hospital, but they are a small enough hospital that they don't have an anesthesiologist there 24-7 or OB's there 24-7. She said it can take up to half an hour to get all the doctors on-site and have the OR prep'd for surgery if everybody is in bed.

My midwife is very clear that she won't let my labour proceed at home if I start having risk factors flag, like a long labour (18+hours) that would tire my uterus, or very hard contractions. Essentially a home birth VBAC will only proceed at home if the labour is close to textbook. If it falls outside of textbook, she would be recommending we transfer in to the hospital and continue to labour there.

sugarland726 · December 2013

I've had a long time to know that I will have a RCS because of hospital policy. I do believe that I would be a good VBAC candidate at another hospital, but mine doesn't allow them because they are too small. At this point, if I was told policy changed and I could try a VBAC, I wouldn't. I am happy and comfortable with my birth plan and how it affects not only me, but the rest of my family, especially DD. There are pros and cons to both. Personally, I would not want to labor again and be afraid of still needing a c-section and now it is emergency. Best of luck to you. You will make a good decision no matter what.

nbbride06 · December 2013

I am right there with you. And it's a little bit complicated because this LO is measuring big - whether it's just genetics (my mom had 4 big babies vaginally) or my GD (which has been completely controlled through diet), nobody knows. However, my recovery from my C-section was not fun and I imagine it would only be worse with a 2 year old at home. So, my choice is to attempt a VBAC with the understanding that if it doesn't happen, I'm not going to freak out. Whatever your choice is, you are not selling yourself short and it will be the best choice for you. The end result is the same.

If it makes you feel any better, my OB continually reminds me that the risk of VBAC is no greater than the risk of major abdominal surgery.

ETA: LO has been head down at my past few ultrasounds, but she still definitely moves all over the place. Butt on left, butt on right, kicks on left, kicks on right, kicks up top, etc. My doula and OB said they don't worry about position (unless breach) because often, especially with 2nd+ pregnancies, baby will not move into position until labor or just before.

ccip82 · December 2013

Thank you once again everyone for all your support and advice!! Much appreciated!!!

@PregJenn

I think you might have mistakenly flagged my post for abuse. Could you please reclick the flag button and unflag me please? Thanks

rowanthefrog · December 2013

I went through this when I was pg with DS2. Part of me really wanted the VBAC, but the "easy" choice seemed to be RCS.

At the end I decided to try for a VBAC, and by try I mean I wanted to go into labor on my own and see what happened. If things progressed and it looked like a VBAC was likely then awesome. I also did what I could to make sure I was "ok" with having another C-section.

My ultimate goal was to just see what my body could do on it's own. Turns out I got the VBAC and my body could do it.

It was a tough decision and tough waiting process. Since I went past my due date they even scheduled the RCS for 41 weeks. I begged them to give me one more weekend to go into labor, all the while wondering why I didn't just have the C and get to meet my baby!!

Factoring into my decision was that we were possibly having another child after my second and I heard that if you wanted to have 3-4 kids then it was best to try for a VBAC.

FWIW, I'm trying to VBAC again this time. While labor was hard, my recovery was SO MUCH easier which was great when I already had an active 2.5 yr old to care for. Now I have 2 kids to take care of and I don't want to be laid up for 1-2 weeks recovering from surgery. I had a very minor tear but DH swears that everything feels "the same" down there.

At the end, its a personal choice. I hear RCS are much easier than C-sections for other reasons and most people I know who have had RCS have had positive experiences.

I just knew that I would regret not giving it a try, so that is what I did.

A

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