VBAC vs RCS - Could use some advice

crystal8503 · July 2014

I have been stressing how this baby will be delivered almost since I found out I was pregnant. With my son, my waters spontaneously broke at 39w3d and I labored for 26+ hours with him before we was delivered via cesarean. I progressed to 9.5 only to regress to 6 and never made it beyond 8 again. My contractions were 10 minutes apart and lasted almost 5 minutes for the duration of my labor. I spiked a fever at one point and required antibiotics and his heart rate dropped once. My OB said I never would have delivered him vaginally because his head was very large. I'm not sure if that's because my cervix was swollen by that point or if it really was because of his head. I have approached this delivery with the mindset that I'll schedule my RCS by 40 weeks because I don't want to go late with my GD and will hopefully go into labor spontaneously again....until recently that is.

This baby is following so many of the same patterns my son showed. Now that it is getting to be large enough to feel almost constant moving, I'm feeling it curled up on my right side and head down, just as he was. Being that my baby is in the same exact position as my son I am getting a lot of anxiety over trying for a VBAC because my recovery was beyond HARD. It took me almost 6 weeks just to feel as if I could be left home alone with my son and I didn't go anywhere alone with him until he was over 8 weeks old because I didn't have the strength to lift his seat. He was born in the winter and I didn't feel comfortable wearing him into a store with the risk of slipping on ice.

So, all that said, what are you all doing? For those who are on 3+ kids, what did you choose to do and why? I feel like my body is telling me something and I just need to listen, but the thought of volunteering for surgery when I don't know if I could actually deliver vaginally is overwhelming and leaves me second guessing myself. My doctor fully supports whatever decision I make. ETA labor details I forgot to share.

ss265 · July 2014

I'm assuming that you had a C-section due to failure to progress? I just wanted to add that I wouldn't necessarily assume that you would need a C-section because this baby is in the same position in-utero as your son. I have also heard that recovery from a second C-section is easier, if that gives you some comfort but I would discuss that with your OB.

FWIW, I am in the same boat as you - C-section with my first and undecided between a VBAC and RCS with my second. Hoping that the next few weeks give me some clarity on what to do.

crystal8503 · July 2014

ss265 said:
I'm assuming that you had a C-section due to failure to progress? I just wanted to add that I wouldn't necessarily assume that you would need a C-section because this baby is in the same position in-utero as your son. I have also heard that recovery from a second C-section is easier, if that gives you some comfort but I would discuss that with your OB.
FWIW, I am in the same boat as you - C-section with my first and undecided between a VBAC and RCS with my second. Hoping that the next few weeks give me some clarity on what to do.

I actually did progress all the way to a 9.5 but regressed. I'll add those details to my OP.

ariel06 · July 2014

With DS1, I c/s because he was breech. My water broke before my scheduled c/s date, but I only labored for a short amount of time and the recovery was pretty easy.

With DS2, I VBACed. 24 hour of labor at the hospital (8 hours before that at home with regular contractions), pitocin, 6 hours of pushing, and the vacuum to get him out. I was not sold on a VBAC, but my doctor encouraged me to atleast consider it. We decided to let things play out as long as the situation looked liked I'd have a high chance of successful VBAC.

Have you shared your fears with your doctor? Maybe they can closer monitor baby's size to give you a better idea whether you would have a successful VBAC.

I thought it was easy to breast-feed and bond with my baby post VBAC than post C/S. Pain-wise the first two weeks, I thought c/s recovery was easier. At that point, I was pretty much pain-free from the VBAC, but had minor c/s pain for several more weeks.

Planned c/s recovery tends to be easier, I've heard 2nd c/s being much harder on your body.

SusieBW · July 2014

First, I feel like you still have a bunch of time to figure this out, so try not to put too much pressure on yourself about it yet. As the next 10-12 weeks pass, you may be able to get a better feeling both from your own body and from your doctor, about what the better decision might be.

Second, every pregnancy and every delivery is different, so just because you have some of the same feelings or you feel like this baby is in a similar position as your son was at this point doesn't necessarily that those things won't change a great deal before delivery time comes.

Finally, every recovery is different. The difficult recovery you had with your son doesn't mean that this one will be the same, whether it's recovering from a c/s or from a VBAC. Both options have their advantages and disadvantages, and either choice could turn out either way.

I would talk to your doctor about the anxiety that you're feeling and see what s/he thinks and whether there are ways to get you some more peace of mind - additional late ultrasounds to check on the baby's positioning and size, I know you said you have GD, so maybe there are ways to help allay your concerns about that, too.

trisharenee0316 · July 2014

You know what I'm doing because we've talked about it.

I was mostly convinced to try for VBAC because I thought that even after laboring before and ultimately having to have a c/s, my recovery was still pretty easy...and my labor didn't last for nearly as long as yours did! I also am kind of bummed about the thought of not picking up my sweet girl for 6 weeks. Beyond that, surgery is very scary to me with very real risks, and I wanted to limit those risks if possible. I also had trouble breastfeeding the first time and am hoping that a successful VBAC will help.

How were you laboring when you did--were you mostly on your back, or were you upright or walking or squatting and things like that? If a baby is even subtly malpositioned, it can be more difficult for the baby to be birthed vaginally so truly, vaginal birthing is kind of a miracle! I have really low pain tolerance but I had to labor last time mostly laying down because they gave me Pitocin (so I had to get an epi early), and that didn't help my DD drop down to get into position at all. As a trade off this time, I am going to have to avoid having an epi for as long as possible to help with positioning.

One very real consideration is to think about if you'll be done having kids at two, or if you think you might want three or more. There are increased risks to the mother if having multiple c-sections (and risks go up with each successive c-section).

ashie0610 · July 2014

I am planning to VBAC and I love that it's becoming a more common thing nowadays rather than going straight to a RCS. My daily mantra is that every pregnancy is different. You very well could have a much different experience than you did the first time around.

I'd definitely recommend that you have a frank conversation with your doctor around what your chances of success are and what their stance is on VBACs before you make a decision. You will get a sense for how supportive he or she is that could influence you to go in either direction.

That said, my prior delivery experience was much different than yours. My son was breech so my C/S was planned and my recovery was easier than I ever could have imagined it to be. I've said all along that had I been through labor and had an emergency surgery, or if my recovery had been tougher, I might have made a different decision.

Just based on the information you've provided and what you went through the first time, if I were in your position I probably would choose the RCS, unless your doctor is recommends the VBAC. It's such a tough decision though, because you also could have a VBAC that goes smoothly. It's one of those things that you'll just have to go with your gut on, but that's probably what I'd do.

crystal8503 · July 2014

Thanks ladies for sharing your experience and taking the time to give me advice.

I'm going to have a long talk with my doctor on August 4th and will hopefully have a better game plan by then. I have been told by two different providers at two different office that I am a good candidate in theory but they feel I'll probably end in a cesarean again. I trust their judgment, especially my current office because they are super VBAC supportive, but signing up for surgery scares me. That said, I'm petrified to labor that long again only to end in surgery because my recovery was so hard on me last time. I guess I will talk with my doctor and try to let myself make a decision I can be at peace with because I know this anxiety over the matter isn't healthy. I'm seriously consumed by it.

kindacrunchy · July 2014

This is such a personal decision, only you can decide what is right for you. It sounds like both options scare you. Something to keep in mind, you will have a lot more control in how long you labor this time. Having had a c section you could do a trial labor and if things are moving along stay with it and if they aren't opt for a c section. Good luck with making a decision!

P.s. I'm pretty involved in the birth community locally and have heard so many amazing vbac stories. If I were you I would read a ton of vbac birth stories to help me decide.

BabyBsOven · July 2014

Maybe you could compromise a bit and leave any expectations at the wayside. Would it be possible to plan for a VBAC if you go into labor spontaneously by a certain date and hope everything goes well but be okay if it turns in to a C-sec. Then schedule your C-sec after the time limit you set.

i.e. "I will try for a VBAC if I go into labor spontaneously by 38w2d and hope everything goes well but will not be disappointed if it ends in a C-sec. I will also schedule my C-sec for 39w1d and if I don't go into spontaneous labor by then, I will be okay with my C-sec decision."

Also, try not to plan too much as things always change. Maybe baby won't be head down, maybe baby will measure large on the ultrasound closer to your due date, maybe a C-sec would be recommended due to GD closer to your due date.

Anyway, good luck and I hope you and your doc come to a plan you are comfortable with!

crystal8503 · July 2014

@BabyBsoven, that's the plan I've had all along, it's just that I'm beginning to doubt my body's capabilities as this baby grows and behaves like my son. Thank you for your advice and I will definitely be talking with my doctor about it in August, which can't come soon enough since I'm a giant stress ball.

Justabean3 · July 2014

Which ever way you decide to go, I will say my planned csection was 500x easier recovery than my induced then emergency section.

My body wasn't bruised feeling all over, I didn't feel beat down and exhausted other than normal " I just had a baby"

I was up walking around 1st day and moving around easily at home with with the 2 kids.

I think long term it is obviously up to you which you decide but I think what makes emergency c's exceptionally hard is actual labor first

crystal8503 · July 2014

Justabean3 said:

Which ever way you decide to go, I will say my planned csection was 500x easier recovery than my induced then emergency section. My body wasn't bruised feeling all over, I didn't feel beat down and exhausted other than normal " I just had a baby" I was up walking around 1st day and moving around easily at home with with the 2 kids. I think long term it is obviously up to you which you decide but I think what makes emergency c's exceptionally hard is actual labor first

That's exactly my fear. My first recovery was terrible and I'm scared of a repeat.

AmandaJean12 · July 2014

This might sound corny but I think part of it is getting in the right mindset. If you go into a VBAC believing it's not going to work again, the odds of it working are probably a lot lower. If you go that way, read only the positive stories for a while or try different labor strategies. Just an idea.

badgererin · July 2014

I understand that fear of not trusting your body to do what it's meant to. With DS I started induction at 41w and he wasn't born until 41w3d. That's a lot of labor. Pushed for 3 hrs and ended up having a CS bc he wouldn't fit. Recovery was awful and I am close to tears just thinking about the same labor/recovery experience. Been a lot more active this go around and have been thinking a LOT about what to do. Totally tough decision. Sorry

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