October 2015 Moms

VBAC or repeat cesarian

Ok, I am 27 weeks pregnant with my 3rd child. I had a somewhat stressful vaginal birth with my first. His heart rate was dropping and not rising very fast during pushing. This caused my OB to give me a 3rd degree episiotomy and use the vacuum 3 times to get him out. My last pregnancy ended up an emergency cesarian because my baby had hydrops. That was about 15 months ago.

I thought I had made a decision to just go ahead and do a repeat cesarian, but after talking more with my OB and doing more research, I'm just not sure. Here are my biggest concerns:

1. The hospital does not have an anesthesiologist on staff 24/7. They are required to be there within 30 mins when called.

2. My OB will do the cesarian, but it's a 4:5 chance it will be another doctor that does the VBAC.

3. Cesarian poses a higher risk of lung problems due to amniotic fluid on the lungs without that squeeze through the birth canal.

4. Longer recovery with cesarian.

I am just so scared either way. I want to do what's best for the baby, I have this thought that if I get that far, I just want him out without the fear of the unknown with doing a trial of labor. I just feel like so much can go wrong in labor and a cesarian seems so straightforward.

Anyone else dealing with this decision? Are there other questions I should ask my OB before committing? She wants me to decide this week so we can schedule the cesarian with her if that's the way I want to go.

Thanks in advance:-)

ETA: Fast fingers posted too soon.
Baby Birthday Ticker Ticker

Re: VBAC or repeat cesarian

  • I can't tell you what to do, and it seems like you are well informed of the benefits and risks of both decisions. I have not had a previous cesarean, but am having to decide between a cesarean or trial of labor this time. Saying a prayer for you while you make that decision. I know it's hard. 
  • Loading the player...
  • Having a planned c-section is much better than an emergency or unplanned one. I'll be having my 3rd c-section. You're a good candidate for vbac because of your previous vaginal birth. Just go with your gut feeling of what you think will make you more comfortable.
  • Did they give you a reason for the decels last time? I will say no two of my vaginal births have been the same. If you decided to try for vbac i would see see about a doula. You seem well informed, the only point i will add is to consider if you will be finished having babies after this one. The risks to you are greater with each surgery, so it's something to think about. If you have a local ICAN chapter you might want to contact them and discuss it with somebody who has experienced vbac at the hospital or with the ob you use. Best of luck with your decision!
  • I'm kinda in the same boat...my first child I had a vaginal delivery, very routine. My second I had a c section 3 years ago because DS was breech. This time with my 3rd, I can choose which way to go as my dr thinks I'm a great candidate for a VBAC. I have similar concerns. I want to avoid an emergency c section at all costs. This is what I came to....at 30 weeks I was able to pick a date with the hospital to schedule my c section. So I did (oct 4th yay!) if I go into labor on my own before that date I will attempt the vbac if the baby is in good position. The dr said I can always cancel the c section scheduled date at any time. So that's my plan for now. I still have no idea what position baby is in at this point so that could effect things at the end anyway. He moves and flips so much. So it's just a waiting game now. Hope this helps.
  • I have had all c sections. I wish I would have had the option of a vbac but unfortunately because of the type of emergency c section with my first, I couldn't deliver vagianally ever. This is the info I know about multiple c sections.

    1. You are limited to how many kids you can have due to increased adhesions and added risk those cause.
    2. The adhesions can become very painful years after you are done having children.
    3. Each c section has been easier to recover from than the previous.
    4. Scheduled c sections are much easier on you and your baby than an emergency one.
    6. The more c sections you have the less pelvic support you have. The muscles that are cut never return to normal.

    Really get all the pros and cons as pertaining to you from your OB for both types of delivery. It seems like you have the general ones but ask for more specifics with your situation. Your OB may want to schedule you now but you can wait until you are sure or schedule with stipulations like PP said.

    Whatever choice you make is fine. Vagianal delivery and c sections are both a lot of hard work for mom and no one way makes you better or somehow lacking. The most important thing is a healthy baby and mama at the end of it all!
  • Thank you guys, it really helps to hear what others are going through. It definitely getting me to think of things I hadn't! :-)
    Baby Birthday Ticker Ticker
  • komorebi said:

    Did they give you a reason for the decels last time? I will say no two of my vaginal births have been the same. If you decided to try for vbac i would see see about a doula. You seem well informed, the only point i will add is to consider if you will be finished having babies after this one. The risks to you are greater with each surgery, so it's something to think about. If you have a local ICAN chapter you might want to contact them and discuss it with somebody who has experienced vbac at the hospital or with the ob you use. Best of luck with your decision!


    No, I'm not sure why he was deceling. They couldn't really say either. That's why it worries me.I will absolutely check into the ICAN chapter.

    Thank you so much.
    Baby Birthday Ticker Ticker
  • I like @mack1737's plan and will probably do that too. My ob had one emergency csec and then planned her next two that way. My sister had a vbac and regrets it, but her son was 10 lbs. I'm going to schedule a rcs but if I go into labor before 40 weeks and/or the baby seems smallish then I'll do a trial of labor. My emergency csec was easy to recover from, looking forward to an even easier recovery if I have to do a rcs!
  • I'm doing everything I can to have a vba2c. I changed docs, hospitals and hired the best vbac doula in our area. I'm seeing chiro and acupuncture if needed. We may want more children, this is #3 for us and the risks for mom go up exponentionally with each repeat c/s.
    Warning No formatter is installed for the format bbhtml
  • I'm also trying to decide between a RCS or VBAC…my first pregnancy (4 years ago) ended in an emergency CS after after 15 hours of (induced) labor and then, fetal distress. It was very scary and I hope to never go through that again!  I am not yet sure though if we'll have more than 2 children, so my Dr prefers patients (that are good candidates) to try for a VBAC if they anticipate having more children.

    The CS itself was without complications and I had a fairly easy recovery.  My Dr said I'm a good candidate for a VBAC so I am planning on scheduling the RCS as late as my Dr will allow me (I'm assuming right at or a few days after my EDD), and if I go into labor on my own, I'll try for a VBAC, but if I end up with a RCS, then that's what's meant to be.
    TTC Baby #2 Since May 2014
    BFP February 6th 2015!!!
    EDD October 15, 2015
  • I am still deciding for sure if I want to attempt a VBAC or schedule a RCS. I had an emergency c-section with my son due to pre-eclampsia (and my doctor not wanting to take the risk/time to induce because my BP was getting so high). Honestly the worst part of it was how scared I felt in the hours leading up to my son's birth. Recovery was by no means enjoyable or easy, but it wasn't bad. I was well enough to get up and go to church 2 weeks postpartum.

    My current doctor is very pro VBAC, but ultimately he's leaving the decision up to me. There are advantages and disadvantages to both options as I see them.

    A VBAC is safer, in general, since it's not major surgery. The chance of uterine rupture is very low (1%), so while it could happen, that's not something I really worry about. I could tear or need an episiotomy, but who's to say I will? My biggest fear is that I'll end up needing a c-section anyway.

    If I have a c-section, I know what to expect. I also have the option of getting my tubes tied while in surgery, which is appealing because DH and I are 100% sure we're done making babies. Also, the OB I see now is the same doctor who did my D&C back in November, so if I'm going to trust anyone to do surgery on my uterus, it would be him. With this option, I know what to expect and I feel like o can better plan for it. But then I'll never experience labor . . . The only other thing I'd worry about is that if I'm getting my tubes tied in the process, I have to go to a different hospital. The one next to my OB's office is a catholic hospital and has restrictions against that. I don't know if that means a different doctor would be delivering my baby, but if it's just a matter of which hospital I'm at, all the hospitals in my area are decent.

    OP, it sounds like you have through through this a lot, and you know neither choice would be wrong. I agree that a scheduled cesarean seems much more straightforward (as opposed to trial labor and then needing a c-section anyway). I wish I could help you decide one way or another, but I'm in the same boat as you - really torn between the options.

    a href="http://www.thebump.com/?utm_source=ticker&utm_medium=HTML&utm_campaign=tickers" title="Parenting Tips"><img src="http://global.thebump.com/tickers/tt1c2dc3.aspx" alt=" Pregnancy Ticker" border="0"  /></a>
  • I'm also trying to decide between a RCS or VBAC…my first pregnancy (4 years ago) ended in an emergency CS after after 15 hours of (induced) labor and then, fetal distress. It was very scary and I hope to never go through that again!  I am not yet sure though if we'll have more than 2 children, so my Dr prefers patients (that are good candidates) to try for a VBAC if they anticipate having more children.


    The CS itself was without complications and I had a fairly easy recovery.  My Dr said I'm a good candidate for a VBAC so I am planning on scheduling the RCS as late as my Dr will allow me (I'm assuming right at or a few days after my EDD), and if I go into labor on my own, I'll try for a VBAC, but if I end up with a RCS, then that's what's meant to be.

    My doc will let me go to 42 weeks and hasn't even mentioned scheduling a rcs.
    Warning No formatter is installed for the format bbhtml
  • Honestly, after a hard labor with my first, and the 15 mins in the OR with a CS, I would just go with the C. Did they give you the horrifying list of thing that could go wrong with VBAC? That was enough to scare me out of it. The worst part for me after the C was the drugs wearing off. I felt like absolute sh*t, but luckily it's just for the day. 
    Baby Birthday Ticker Ticker

  • komorebikomorebi member
    edited August 2015
    https://www.childbirthconnection.org/article.asp?ck=10210

    I guess it's perspective and personal experience but vbac has been shown to be a safe option. If your provider is not supportive that is the best indication for if you will have a vbac or if a tol will result in rc.

    And what @1stComesLove421 said. I know it's a very personal decision. I don't heal well from surgery so the very idea terrifies me.
  • I'm not one who has the right to really say anything since I can't relate.

    If it were me, I would tell the OB I'm going to plan for a vbac with the possibility of changing my mind.

    If you or a doctor feels iffy during labor you can always switch.

    Again I can't relate, but I do wish you the best of luck!
  • Hi there! Lurking from N15, this is my third baby and I'm hoping for another successful VBAC. I had a horrible recovery from my section, took me a very long time to heal. But I did VBAC with my second and it was amazing. I did labour for 25hrs but it was completely worth it! Definitely excited for another VBAC. Unless it's an emergency ofcourse. Best of luck! :)
    image BabyFruit Ticker VOTE on my Name List
  • Honestly, after a hard labor with my first, and the 15 mins in the OR with a CS, I would just go with the C. Did they give you the horrifying list of thing that could go wrong with VBAC? That was enough to scare me out of it. The worst part for me after the C was the drugs wearing off. I felt like absolute sh*t, but luckily it's just for the day. 

    Have you ever seen the horrifying list of things than can go wrong with a repeat c section? There's a reason why the ACOG recommends a TOL for most women post c section.
    Warning No formatter is installed for the format bbhtml
  • komorebi said:

    https://www.childbirthconnection.org/article.asp?ck=10210

    I guess it's perspective and personal experience but vbac has been shown to be a safe option. If your provider is not supportive that is the best indication for if you will have a vbac or if a tol will result in rc.

    And what @1stComesLove421 said. I know it's a very personal decision. I don't heal well from surgery so the very idea terrifies me.

    Thank you for that article, very informative.
    Baby Birthday Ticker Ticker
  • jegoffin said:

    Honestly, after a hard labor with my first, and the 15 mins in the OR with a CS, I would just go with the C. Did they give you the horrifying list of thing that could go wrong with VBAC? That was enough to scare me out of it. The worst part for me after the C was the drugs wearing off. I felt like absolute sh*t, but luckily it's just for the day. 

    Have you ever seen the horrifying list of things than can go wrong with a repeat c section? There's a reason why the ACOG recommends a TOL for most women post c section.
    There are horrifying things that can happen no matter your mode of delivery. A c-section is major surgery, so while it's safe, it's not something to take lightly. A VBAC is safe, often considered safer than a RCS, but isn't right for everyone. It's really a personal decision, and the end result of delivering a healthy baby is what truly matters.

    a href="http://www.thebump.com/?utm_source=ticker&utm_medium=HTML&utm_campaign=tickers" title="Parenting Tips"><img src="http://global.thebump.com/tickers/tt1c2dc3.aspx" alt=" Pregnancy Ticker" border="0"  /></a>
  • MamaOwl15 said:

    jegoffin said:

    Honestly, after a hard labor with my first, and the 15 mins in the OR with a CS, I would just go with the C. Did they give you the horrifying list of thing that could go wrong with VBAC? That was enough to scare me out of it. The worst part for me after the C was the drugs wearing off. I felt like absolute sh*t, but luckily it's just for the day. 

    Have you ever seen the horrifying list of things than can go wrong with a repeat c section? There's a reason why the ACOG recommends a TOL for most women post c section.
    There are horrifying things that can happen no matter your mode of delivery. A c-section is major surgery, so while it's safe, it's not something to take lightly. A VBAC is safe, often considered safer than a RCS, but isn't right for everyone. It's really a personal decision, and the end result of delivering a healthy baby is what truly matters.
    That's my point exactly. VBAC is the only thing that they will send you home a sheet for with all the possible issues. You don't get that for a regular vaginally delivery or a scheduled c section. VBAC is inconvenient for the doc and the hospital but it's a valid and reasonable option for most.
    Warning No formatter is installed for the format bbhtml
  • I was told that I am not a candidate for VBAC due to numerous risk factors I have, and I am completely at peace with a rcs. I know what to expect, I know that I hired a competent OB, I know that my family and friends will be there to support me if my rcs recovery doesn't go as well as my first and I know that my baby and I will be monitored closely as we approach my goal date (we are happy if I make it to 38 weeks without complications requiring earlier birth).

    Not that I meant to go AW in my response, so here's my point. Continue your research, talk with your doctor, trust your gut and, most importantly, don't allow yourself to second guess your decision. The overall desired end result is healthy mom and baby, so do whatever you have to do for that to happen. And know that we will be there to support you, whatever your choice.
  • jegoffin said:

    MamaOwl15 said:

    jegoffin said:

    Honestly, after a hard labor with my first, and the 15 mins in the OR with a CS, I would just go with the C. Did they give you the horrifying list of thing that could go wrong with VBAC? That was enough to scare me out of it. The worst part for me after the C was the drugs wearing off. I felt like absolute sh*t, but luckily it's just for the day. 

    Have you ever seen the horrifying list of things than can go wrong with a repeat c section? There's a reason why the ACOG recommends a TOL for most women post c section.
    There are horrifying things that can happen no matter your mode of delivery. A c-section is major surgery, so while it's safe, it's not something to take lightly. A VBAC is safe, often considered safer than a RCS, but isn't right for everyone. It's really a personal decision, and the end result of delivering a healthy baby is what truly matters.
    That's my point exactly. VBAC is the only thing that they will send you home a sheet for with all the possible issues. You don't get that for a regular vaginally delivery or a scheduled c section. VBAC is inconvenient for the doc and the hospital but it's a valid and reasonable option for most.
    This is a very good point. It occurs to me that my OB's office handed me a form very early on about VBACs that had a list of possible complications. Though it was like "there's only about a 1% chance of any of this happening," it was this horrifying list. The only time I had something similar handed to me regarding c-sections was when I signed the consent form to deliver my son! Up till that point, I assumed I'd have an uncomplicated vaginal delivery and never thought about things that could go wrong.

    a href="http://www.thebump.com/?utm_source=ticker&utm_medium=HTML&utm_campaign=tickers" title="Parenting Tips"><img src="http://global.thebump.com/tickers/tt1c2dc3.aspx" alt=" Pregnancy Ticker" border="0"  /></a>
Sign In or Register to comment.
Choose Another Board
Search Boards
"
"