Vbac or c section with second baby?

slugger1320 · July 2014

I'm trying to decide if I should try labor with my second baby after a rough first labor resulting in a C section. Doctors in my practice have different opinions... what did you do? Advice?

JSS1002 · July 2014

I'm having a repeat cs after my first resulted in an emergency cs after 12 hours of labor and 3 hours of pushing. My doctor was very straight forward, which is why I love her, and said "it's up to you but I don't recommend that you try for a VBAC given how narrow your pelvic bones are (which was ultimately the problem last time).

Pretty excited to have it scheduled and know when I can expect things to happen!

ss265 · July 2014

This is a very personal decision that only you can make. I am expecting my second child and am in a similar position and honestly, am pretty torn about whether to do a VBAC or RCS. I had a great recovery from my 1st C-section - didn't need to take pain meds after 3-4 days, feeling almost 100% after 2 weeks, no numbness in my incision etc. I am also fortunate in that I will have help for the first 2-4 weeks after my C-section with #2.

I am more than halfway though my pregnancy and still haven't made a decision - I am hoping that the baby makes the decision for me, if he is breech or in a bad position for a VBAC.

yeah. · July 2014

I tried to VBAC #2. DD1 was a section after a long ass labor and 4 hours of pushing, but I still wanted to try and because I dilated, my OB said I was a decent candidate. I went into labor with DD2, pushed for an hour, but her heartrate was deceling so I had another section.

I was disappointed but I'm glad I tried.

JustGoWithIt · July 2014

I'm scheduled for a RCS on Tuesday. DS#1 was breach so I didn't have much of an option. I could do vbac this time, but I know me, my body, etc & elected for the RCS. It's totally a personal choice.

rae_dylanzmom · July 2014

I'm going through similar decision, although I will have to switch practices and travel to try for VTOL/VBAC.

Reading on my own, 'not a good candidate' is looking at a ~60% success rate, so chances to me seem pretty good even if you don't fit the criteria for a good candidate.

What I am frustrated with is that the docs advice I've gotten (3 OBs at 3 different practices/hospitals) seems to have little to do with me as a patient and everything to do with practice/hospital policies and (my fav) their own issues with not wanting to sit around through my VTOL and then make the same $$ as if they just caught the baby.

Mostly, I just don't like being forced into anything for reasons that have nothing to do with me,... but that's just me.

Russiandea12 · July 2014

I am having a RCS this time. With DS I was in labor for 13 hours, and had an emergency c-section due to his hb going from 80-180 and fears cord was wrapped around his neck. I wasn't having good contractions and didn't respond well to pitocin - having to be on/off oxygen. We later found he wasn't even in the birth canal yet. My OB recommend I do a RCS rather than VBAC, and after some back & forth decided on RCS. This will be my last pregnancy, so I'm a little sad I wont have a v birth experience but I feel confident this is what is best for me & baby. Again, it is a difficult & personal decision, Good Luck with whatever you choose.

LucilleAustero · July 2014

I am trying for a vbac. I had a c/s with DD due to her size. My new ob follows the ACOG guidelines that state that size is not a reason for a c/s. However, I am in an area with a high rate of c/s due to malpractice rates, so a lot of the area hospitals have their own guidelines. I will be *okay* wth having another c/s, but my first was not pleasant and I am hopeful that I will not have to have another.

It is a personal decision. I think that as long as you would not be going AMA, it warrants a conversation with your doctor. S/he should be able to give you some good advice and weigh the pros and cons. While VBACs are advised by the ACOG for most women, there are some legitimate medical concerns that should be talked beforehand. Good luck with whatever you choose and remember that there are no wrong decisions, as long as you are not AMA.

ss265 · July 2014

@LucilleAustero, by AMA, do you mean advanced maternal age? I'm curious on why you are so against AMA women having VBACs.

Mally2011 · July 2014

I absolutely will be attempting to VBAC, but my c-section the first time was because of the baby's issues, not mine. I had no issues with my labor.

I would say to discuss with your OB whether you are a good candidate, and also keep in mind the pros and cons of each type of delivery. A repeat c-section is still a major abdominal surgery with risks to both mom and baby.

mysticl · July 2014

ss265 said:

@LucilleAustero, by AMA, do you mean advanced maternal age? I'm curious on why you are so against AMA women having VBACs.

I think she might mean Against Medical Advice. However, there is nothing wrong with going against medical advice either. Sometimes the advice is wrong. Doctors aren't infallible. Also, she mentioned there is a high level of c-sections in her area because of malpractice suites. I'm guessing that while the doctor may advise those c-sections there may not be a true medical reason for all of them. Plus, some hospitals forbid VBACs so of course the doctor is going to advise a c-section because they have to support the hospital's policies to retain their privileges. And plenty of doctors don't follow ACOG guidelines which means they are making recommendations that are against the medical advice of other doctors.

mysticl · July 2014

I'm planning a VBAC. Do some research on your own. See if there is an ICAN chapter in your area, they may have a Facebook group too. They are a great source of information and the one I participate in is supportive of VBAC or RCS as long as it is your choice and not something you are bullied into. But ultimately only you can make that decision.

glreding · July 2014

Yes, this has to be your own decision. Along with my OB, I decided on a repeat c-section. I did a lot of reading and research to come up with my decision. I know the likelihood of severe complications is very, very miniscule. The outcome of those complications, however, are just way too scary.

marathonmommy82 · July 2014

Trying for a VBAC . First pregnancy I went into labor on my own, progressed to 10cm -- then baby was in distress (dropped HR). Emergency C to get him out (he was fine, cord around his neck). MW s are supportive and encouraging !

seells · July 2014

Trying for a Vbac. First csection was FTP after an induction at 37 weeks due to pre-e. If baby comes on her own great, or if I hit 40 weeks and have a favorable bishop score I will try an induction. Otherwise I will go with a RCS. (I won't be going over 40 weeks due to hypertension currently and with my history of pre-e we would rather ere on the side of caution.)

LucilleAustero · July 2014

ss265 said:

@LucilleAustero, by AMA, do you mean advanced maternal age? I'm curious on why you are so against AMA women having VBACs.

AMA is against medical advice, not advanced maternal age.

LucilleAustero · July 2014

mysticl said:

ss265 said:

@LucilleAustero, by AMA, do you mean advanced maternal age? I'm curious on why you are so against AMA women having VBACs.

I think she might mean Against Medical Advice. However, there is nothing wrong with going against medical advice either. Sometimes the advice is wrong. Doctors aren't infallible. Also, she mentioned there is a high level of c-sections in her area because of malpractice suites. I'm guessing that while the doctor may advise those c-sections there may not be a true medical reason for all of them. Plus, some hospitals forbid VBACs so of course the doctor is going to advise a c-section because they have to support the hospital's policies to retain their privileges. And plenty of doctors don't follow ACOG guidelines which means they are making recommendations that are against the medical advice of other doctors.

Sometimes the advice is wrong, I agree. But, my medical knowledge is limited and no amount of internet research can make up for my lack of a medical education. I think the whole system needs a reboot, but for now we can only see what is safest for our babies within the confines of what is currently out there. I contacted iCan and they were kind of nasty about the fact that I would be okay with an rcs. I explained that I want a vbac and that I chose a doctor that is supportive of them, but I live where I live. The woman told me that if I was serious about a vbac I would do a home birth. Kind of turned me off to them. But, I do know that there are women that have had great experiences with them, so it is likely just my local group. In any event, I can't really blame doctors that want to be able to retain priveldges and to protect themselves from gratuitous lawsuits. It is a messed up thing, the business of obstetrics.

greeneyed_bride · July 2014

mysticl said:

ss265 said:

@LucilleAustero, by AMA, do you mean advanced maternal age? I'm curious on why you are so against AMA women having VBACs.

I think she might mean Against Medical Advice. However, there is nothing wrong with going against medical advice either. Sometimes the advice is wrong. Doctors aren't infallible. Also, she mentioned there is a high level of c-sections in her area because of malpractice suites. I'm guessing that while the doctor may advise those c-sections there may not be a true medical reason for all of them. Plus, some hospitals forbid VBACs so of course the doctor is going to advise a c-section because they have to support the hospital's policies to retain their privileges. And plenty of doctors don't follow ACOG guidelines which means they are making recommendations that are against the medical advice of other doctors.

I think this is why it's so important to have/find an OB who you can really trust and have a good relationship with. We chose my OB-GYN when my husband was in his medical residency because she was the OB that most of the nurses and residents recommended. She is amazing, tends toward doing things as intervention free as possible, and she has a stellar reputation among the other doctors and nurses at the hospital (except that some of the nurses and residents are slightly scared of her because she's gotten the reputation of being "mean" if she doesn't feel that her patients are receiving the best care.) When she told us 26 hours after my water broke (and when I was only dilated to 4cm and my son's heart rate was dropping) that it was her opinion that a c-section was the best course of action, we knew we could trust that she was doing what was in our best interest, not in her best interest. We feel the same way about her advising us to go with a RCS this time around, even though on paper, I'm a good VBAC candidate.

I think it's also important to realize that ACOG guidelines (and guidelines from every other professional organization for physicians) are based on statistics, whereas a good physician who knows you and your medical history is going to make a decision based in large part on you, not just on what the numbers say. If I have a physician I trust, I'm absolutely comfortable taking his/her advice over the guidelines made by a group of physicians I've never met.

megs2011 · July 2014

I'm trying for a vbac. I had an emergency section at 34+4 due to hellp syndrome, pre E and iugr in my twins. I never even went into labour so I'd like to give it a try. If I end up with another section then so be it. I had a horrible recovery the first time so I'd like to avoid it if I can this time especially since I have 2 toddlers to take care of after plus the newborn. Talk to your OB/MW and get their opinions. Mine told me I was a good candidate so I'll give it a try.

mysticl · July 2014

LucilleAustero said:

ss265 said:

@LucilleAustero, by AMA, do you mean advanced maternal age? I'm curious on why you are so against AMA women having VBACs.

AMA is against medical advice, not advanced maternal age.

It means both. You have to read it in context.

tusshie2004 · July 2014

I considered a VBAC with my second but decided on a C-section. For this LO I will be having another C-section. Talk to your doctor. Ask statistics. With a VBAC there are risks. My doctor scared the hell out of me. After talking to him I went with a c-section. It's your decision.

butterlfy2007 · July 2014

This is a very personal decision that only you can make. I had a c section with my first child and opted to try for a vbac with the second. I had no problems and have had a total of 3 children after the 1^st one and haven’t had another c section. I feel like the recovery from a c section is horrible even though I had help. It also depends on the reasons why you had one the first time. Talk with your doctor and see what their professional opinion is. Good Luck!<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

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