Does anyone have experience with a VBAC and medically fragile child?

babylimas · January 2014

My son has a major heart defect (Tetralogy of Fallot) and Trisomy 21. I am assured the heart defect will cause no issues prior to the cord being cut and won't affect delivery method. I finally met with my delivery doctors at the high risk center yesterday and went over the timeline for here on out.

I would really like a VBAC, but obviously it's not the priority. My doctor said I need to delivery in the 39th week and we will decide if it's VBAC or RCS at my 38 week appointment according to the state of my cervix (whether or not I am ready to begin mild induction).

As can be expected, I'm being told from all angles that wanting a VBAC at this point is silly. Yet I have been told by my past OBs that a VBAC might actually be better since I can get to the NICU more quickly to be with him. Plus I am a very good candidate.

I'm just curious if there are others in a similar situation. I believe I am being very open-minded and flexible about everything, but it's hard not to feel some guilt for having a preference. If he were healthy I would be pushing very hard for an unmedicated VBAC with a doula present.

singingirl96 · January 2014

Hello. First of all, I'm sorry your baby has been diagnosed with both TOF / T21. This is a hard thing to go through, but the prognosis is good, so try not to worry too much. (easier said than done, I know).

I would suggest you post your question here. https://community.babycenter.com/groups/a5055/babies_and_children_with_heart_problems There are many other moms here that can help with your questions. In general, as a heart mom, it is a nice place to go to for some support.

As far as delivery. I don't see a reason why they would deliver you early. I think you should push for letting the baby comes when it is ready to come. For one, it'll give you the best chance for a VBAC, and two, the baby will be bigger and stronger to start dealing with his/her heart issues on its own. Right now, and until the umbilical cord is cut, you're doing all the hard work, and you're baby's heart hasn't taken over yet. That's why it is absolutely not silly to try for a VBAC.

When I had my son, (AVSD), I ended up having an emergency c-section. He was whisked away to the NICU right away and I didn't get to see my baby for about 3 hours. If you have a VBAC, you'll be able to see him/her a lot sooner.

Normally babies with TOF don't require early delivery or induction. I would seek a second opinion here. I just don't think that is necessary and I would refuse being induced if it were me.

Let me know how it goes!

babylimas · January 2014

Thank you for the information! I actually joined that board when I first discovered the defect. I did not think to ask them about experiences with VBAC.

As for the earlier delivery, my doctor said that the risk of still birth increases dramatically because of the chromosomal disorder at 40 weeks. I have not looked into this at all, so I don't know how true that is. The cardiologists insist he should be in there as long as possible for lung development, but 39 weeks seems to appease them.

Honestly, I had a great deal of depression and guilt after my first c-section. It took me a very long time to come to terms with it. I am making a concerted effort to not let myself get caught up in the planning and over-researching like I did with my first. I am trying to relax and trust in my doctors, while still expressing my preferences. If this were a normal pregnancy, I would let myself push harder and be more demanding (my prior OBs were very open to a VBAC), but I know I will be hit with enough grief and anxiety at delivery with this pregnancy that I can't let myself get lost in the emotions of the delivery method like I did last time.

I also have the complication that my husband is hesitant about the VBAC now that we have the diagnoses. He was an incredibly advocate for me with my first, but he has told me he does not want to argue with the doctors on this one because he is worried. So I am just trying my best to go with the flow.

I actually went into labor at 39 wks 4 days with my first, so hopefully the same will happen this time and induction can be avoided!

Thank you for the information. I will definitely update the board with how it goes if successful. It's nice to see another heart mom around with such a healthy little boy.

singingirl96 · January 2014

Well, since you went into labor before 40 weeks, with your second you'll most likely go around the same time or sooner. I hear that happens most of the time. The first babies are the ones that like to stay in longer

I would certainly try for a VBAC. Maybe you could compromise and be induced on your due date rather than a week early. I hear that the VBAC success rates dramatically decrease if induced though.
Well, I hope your baby comes out as healthy as possible and you get the delivery you want. Whichever way, congratulations! Heart babies are the best! They'll teach you more about yourself than most people ever get to know. You never know how strong you are until you have no choice but to be. Babies bounce back very quickly from surgery, so try to not to drive yourself crazy ok?

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