I just had my 12 week appointment with my doctor and now I really don't know what to do. I was leaning towards a RCS (I go back and forth all the time), but she said that with my history I probably have a good chance at a VBAC. Why is this such a difficult decision to make??
Because it’s easy to fear the unknown and easier to accept a path you’ve taken before. Learning about normal, uncomplicated births can really help to ease those uncertainties.
So, I'm in Canada and in a rural town. OBs are not all over the place. Your family physician basically finds you one and you get assigned. Slim picking. I was told at my first appointment that finding an OB that will do a VBA2C will be nearly impossible. Kind of heartbroken. I'm still going to try but it's not looking good for me.
I wish my doc would let me. I had two csections and she said it’s just too risky. She’s a great ob so I’m not going to change but I have to say I am a little disappointed.
@sasstass and @shrub So sorry to hear that the decision has been in some ways taken away from you, but prayers for a safe and happy delivery (however these babies come)!
@peacebubblebaby and others - i HIGHLY recommend you check out the evidence based VBAC group on Facebook. The chart you posted is misleading - risk of uterine rupture for VBA2C is 1:55 not 1:200 whatever, and it gets worse not better for #3. ICAN and other websites are known for sugar coating things in favor of pushing for VBACs.
Not trying to discourage anyone from trying for VBAC, but please make sure you are using legit information to make your decisions (especially if you are considering an at home VBAC!).
Me: 30 DH: 31 Married: 2012 BFP #1 Sept 2014, MMC Dec 2014 | BFP #2 May 2015, DD Jan 2016 | BFP #3 May 2017, MC July 2017 | BFP #4 Jan 2018, MC Feb 2018 | BFP #5 July 2018, fingers crossed
I’m not going to argue about it, but that group was recreated by trolls who took over a community by having someone get involved enough to be added as admin and she immediately kicked off all the former admins and added her collaborating friends...I was a part of it when it all went down. I don’t trust any of the stuff they spew. I trust ICAN, VBAC Facts, and Evidence Based Birth as reliable sources, as they have been for many years. They look at all the information, and provide the best that is out there instead of cherry picking the small studies and isolated stories that meet their agenda.
I don’t want to argue either, I certainly don’t know the histories of the various groups but I think we can agree that gathering a wide net of info is a good practice in general. The idea of UR is very scary IMO and it just doesn’t pass the sniff test that it becomes less likely with more scars/more pregnancies.
Me: 30 DH: 31 Married: 2012 BFP #1 Sept 2014, MMC Dec 2014 | BFP #2 May 2015, DD Jan 2016 | BFP #3 May 2017, MC July 2017 | BFP #4 Jan 2018, MC Feb 2018 | BFP #5 July 2018, fingers crossed
I think you might be looking at the chart wrong. A 3rd vbac is not the same as vba3c.... 3rd vbac would mean that you have had 3 vbacs after a 1 c-s. Vba3c is a vbac after 3 c/s. There is not as much information on the risks of vbac after multiple csections because it’s uncommon to have a provider allow it, let alone get a group large enough to have a reliable study on it.
I hope that that helps you understand the graphic better.
Had my first appointment monday and my OB was really encouraging about me being a good candidate for VBAC, or at least TOLAC.
I was worried because I was already overweight with the last pregnancy and have not lost all the baby weight, one online calculator put me at obese which I knew lowered my chances but she wasn't too concerned since I didn't gain much with the first pregnancy and there weren't any weight-related complications.
Last time we had a macrosomic baby and labor was not progressing so I'm really hoping this one stays under 9lbs and I go into labor naturally on or before my due date since we can't induce (which I'd prefer not to anyway). It's a lot of ifs, but fingers crossed!
I feel like the pressure is on because if I can't get a VBAC this time I probably won't get another chance, and just makes a 3rd pregnancy and birth more complicated.
@CaptainPhasma I too am hoping for a smaller kiddo this time around. My first was 10.5 pounds.
My midwife asked a lot of questions about why she was so huge, but I had a healthy pregnancy so the only answer I have is genetics.
My midwife was very supportive of my desire to VBAC and I chose the hospital/practice based on their high success rate, but she still said we had to keep an eye on the size towards the end.
I hope we both get blessed with smaller babies and the successful VBACs we are dreaming of!
@peacebubblebaby whoops, you are right I misread it! I do understand the difference between 2 vbacs/ vba2c etc but thanks for keeping me straight.
Me: 30 DH: 31 Married: 2012 BFP #1 Sept 2014, MMC Dec 2014 | BFP #2 May 2015, DD Jan 2016 | BFP #3 May 2017, MC July 2017 | BFP #4 Jan 2018, MC Feb 2018 | BFP #5 July 2018, fingers crossed
12 week appointment today and this new OB was so much more supportive when I brought up possibility of VBAC! Definitely echo the recommendation to switch (if you can) if your provider isn’t on the same page as you. I was so anxious about switching but today totally calmed those nerves.
Now that I'm further along, I'm really trying to narrow down RCS vs VBAC. Yesterday, I had a long conversation with my OB, and she really seems to think I should try for VBAC even though it means changing hospitals.
I don't know when I've ever had this hard of a time making a decision! I'm normally super decisive. I have a couple of questions to those who made this decision already
1) Was there any tipping point or particular reason that made you choose VBAC or RCS? 2) Do you think that opting for a VBAC means that you should also opt for a med-free birth? For some reason, I feel like I have to go all-in with the natural birth if I choose VBAC because the epidural during my first baby seemed to lead to the c-section (cascade of interventions, etc etc)
Thanks if anyone has feedback on one or both questions! Your birth stories have helped a lot, too.
@lindseyb918 That’s fantastic that she is so encouraging about a VBAC! I would check with her on whether having an epidural is optional or not, some things I’ve read suggest they prefer to have that in place for VBAC in case something goes wrong, that way they don’t have to completely knock you out to do the c section.
I am 90/10 leaning RCS over VBAC for some complicating health factors, but if I am being honest with myself, I’m also a little afraid of another unsuccessful labor. Plus my husband is not very supportive of a VBAC because of how scary the last labor/stat c section ended up (my attempts to educate him on how different it would be are working but he’s definitely in the “just schedule it” camp).
My advice would be to survey your life and determine if there are any non pregnancy related factors that could sway you (like having last minute childcare arrangements in place, partner’s feelings, or even leave time from work) and see how they stack up to your desires for how you want to meet baby.
Me: 30 DH: 31 Married: 2012 BFP #1 Sept 2014, MMC Dec 2014 | BFP #2 May 2015, DD Jan 2016 | BFP #3 May 2017, MC July 2017 | BFP #4 Jan 2018, MC Feb 2018 | BFP #5 July 2018, fingers crossed
@lindseyb918 For me the decision is a total no-brainer. I really wanted a natural birth the first time, and I still really want that experience. Also some complications after the surgery meant that I missed skin-to-skin time when by daughter was first born, and I don’t remember the first day of her life. The recovery was awful as well. So as long as there is not a medical reason for a c section I am going VBAC all the way!
Thank you guys! I told her I was leaning RCS because I got an extra two weeks off work, and she says "that's not a very good reason"
I also need to get MH onboard if we're gonna attempt a VBAC. He feels like RCS leaves a lot less room for something to go wrong, but the more I read, the risks are different with each option but overall fairly equal.
Not sure if anyone's still following this thread, but I'm circling back because I need to vent. My regular OB doesn't do VBACs because of the level of hospital we have in town here, but she thought I was a good candidate.
Today I met with an OB who delivers at a hospital that allows VBACs, and now I feel totally deflated. My prior CS report mentions a small pelvis (cephalopelvic disproportion) so she says I'm a very poor candidate for VBAC, that my chance of uterine rupture could be as high as 10% and my chance of successful VBAC is more like 30%. She said "some people just aren't meant to birth babies." WTF?
I'm frustrated and heartbroken after being so hopeful for a VBAC this past week and doing tons of research. I think CPD is kind of a bullshit diagnosis and that my CS was due to a multitude of factors that included but were not totally dependent on the size of my baby (8lb 7oz) and my body. I want to find a more supportive provider, but she says at this point I'd basically be looking for someone who is just going to tell me what I want to hear and not the true risks.
@lindseyb918 I decided to have a RCS even though I’m a good candidate for VBAC. My doctor said that a RCS is safer for the baby, VBAC safer for me (just due to normal complications of a csection that everyone has) and the worst possible outcome for both baby and I is trying for a VBAC and ending up with emergency c section. I was selfishly scared for a VBAC so I chose RCS solely because she said it wa safer for baby. I have no advice on if you choose VBAC if it should be unmedicated, I think that’s more of a personal choice for you maybe? I personally want all the medicine but that’s just me. I have heard that being induced and getting epidurals slows down labor and dialating for a little while so I’d definitely ask your doctor her opinion on that too.
@lindseyb918 I am really sorry. I understand wanting that VBAC so badly, and I can’t imagine how frustrated and disappointed you must feel. I also can’t believe that this doc told you that some people weren’t “meant” to birth. That is a ridiculous statement.
If it’s really important to you, I would get a second opinion. I don’t know how real a diagnosis of “small pelvis” is, but if it were me I would feel better hearing it from a second medical professional.
At the end of the day the most important thing is a safe delivery for you and your baby. It may not look like what you had planned, but it can be a beautiful entry into this world no matter what course you choose.
I really understand your disappointment though. I cried every night for two weeks after my c-section because I felt like I had failed at the very first step of motherhood. Take some time to grieve for the birth that you wanted, and be kind to yourself. Looking up “belly birth” and gentle c-sections may help you feel more empowered and develop a birth plan that you feel comfortable with.
CPD is a real thing, but it is definitely overused. This American Pregnancy Association article notes that CPD is frequently "diagnosed" in cases of labor failing to progress, but many of those likely aren't truly the condition, which is interesting based on what you're saying about your prior pregnancy.
Personally, I'd get a second opinion, especially considering true cases of CPD are pretty rare. That article also notes 65% of women who have CPD go on to later deliver vaginally.
@mamakeeg I agree, it seems like the risks for RCS and VBAC are higher for me for one, and higher for baby with other! I think that's a big reason MH would feel more comfortable with a CS. I'm glad you and your doctor found the option that you can both feel comfortable with!
@maggiemadeit thank you for the sweet words! I think a lot of my bad feelings are residuals from my first CS as well. I'll definitely look into those options, they sound like the way to go if I have RCS!
@lovesclimbing sorry, that was a poor choice of words! I definitely agree CPD is a valid diagnosis but probably overused. Thank you for the article, it really touched on everything going through my head right now. I don't know how she estimated a 30% success rate for me, when everything I read says 60-80% overall success rate for VBAC, closer to 60% with a previous CS for CPD.
Also, I feel like I need to call it something other than "success rate." I don't want to feel like a failure again if I have an RCS after giving it my best shot!
So I did something a little crazy yesterday and I officially switched providers at 23/24 weeks. I didn’t have a bad experience with my provider, but the whole thing was starting to feel really overmedicalized. At first they sounded really supportive of the VBAC, and their group does have good statistics, but we got a size estimate from a recent ultrasound I could already start to feel the language and mood change. I grow big babies, but in my mind that’s not a good reason to schedule a RCS.
So I switched to the midwife group at a local hospital that is known for their low intervention rates and VBAC success. They are also the only place around me that does water birth. I just want to give myself and this baby every fighting chance at the birth that I want. You can’t predict how things will turn out, but at least I will know that I did everything I could.
I had an emergency c/s with my daughter at 30 weeks. I was told I would be a good candidate to have a vbac but they would not induce/would have to be natural. This is pretty standard, right? Since my body never went into labor w/DD are my chances of going into labor naturally pretty slim?
@lindseyb918 I can't remember what they said. I want to say they won't let me go past 39. I had preeclampsia/high blood pressure last time so they will have to keep an eye on that. Plus, something about me being 35 I think? My bp has been better this time but I still think they aren't going to let me go full. I guess it's going to be wait and see but I'm guessing even if its 39 weeks I probably won't go naturally .
@lisee923 I think it all comes down to provider policy and your medical history. It seems they all have different policies.
For example I am 35 and never went into labor with my first (induced at 41W). The practice I was at has very few policies set in stone. They will let me go to 42 weeks, and induction for the VBAC is an option.
I hope that you can go into labor on your own and have a chance at labor and delivery if that’s what you want.
Re: VBAC
Not trying to discourage anyone from trying for VBAC, but please make sure you are using legit information to make your decisions (especially if you are considering an at home VBAC!).
Married: 2012
BFP #1 Sept 2014, MMC Dec 2014 | BFP #2 May 2015, DD Jan 2016
Married: 2012
BFP #1 Sept 2014, MMC Dec 2014 | BFP #2 May 2015, DD Jan 2016
I hope that that helps you understand the graphic better.
I was worried because I was already overweight with the last pregnancy and have not lost all the baby weight, one online calculator put me at obese which I knew lowered my chances but she wasn't too concerned since I didn't gain much with the first pregnancy and there weren't any weight-related complications.
Last time we had a macrosomic baby and labor was not progressing so I'm really hoping this one stays under 9lbs and I go into labor naturally on or before my due date since we can't induce (which I'd prefer not to anyway). It's a lot of ifs, but fingers crossed!
I feel like the pressure is on because if I can't get a VBAC this time I probably won't get another chance, and just makes a 3rd pregnancy and birth more complicated.
My midwife asked a lot of questions about why she was so huge, but I had a healthy pregnancy so the only answer I have is genetics.
My midwife was very supportive of my desire to VBAC and I chose the hospital/practice based on their high success rate, but she still said we had to keep an eye on the size towards the end.
I hope we both get blessed with smaller babies and the successful VBACs we are dreaming of!
Married: 2012
BFP #1 Sept 2014, MMC Dec 2014 | BFP #2 May 2015, DD Jan 2016
Now that I'm further along, I'm really trying to narrow down RCS vs VBAC. Yesterday, I had a long conversation with my OB, and she really seems to think I should try for VBAC even though it means changing hospitals.
I don't know when I've ever had this hard of a time making a decision! I'm normally super decisive. I have a couple of questions to those who made this decision already
1) Was there any tipping point or particular reason that made you choose VBAC or RCS?
2) Do you think that opting for a VBAC means that you should also opt for a med-free birth? For some reason, I feel like I have to go all-in with the natural birth if I choose VBAC because the epidural during my first baby seemed to lead to the c-section (cascade of interventions, etc etc)
Thanks if anyone has feedback on one or both questions! Your birth stories have helped a lot, too.
I am 90/10 leaning RCS over VBAC for some complicating health factors, but if I am being honest with myself, I’m also a little afraid of another unsuccessful labor. Plus my husband is not very supportive of a VBAC because of how scary the last labor/stat c section ended up (my attempts to educate him on how different it would be are working but he’s definitely in the “just schedule it” camp).
My advice would be to survey your life and determine if there are any non pregnancy related factors that could sway you (like having last minute childcare arrangements in place, partner’s feelings, or even leave time from work) and see how they stack up to your desires for how you want to meet baby.
Married: 2012
BFP #1 Sept 2014, MMC Dec 2014 | BFP #2 May 2015, DD Jan 2016
I also need to get MH onboard if we're gonna attempt a VBAC. He feels like RCS leaves a lot less room for something to go wrong, but the more I read, the risks are different with each option but overall fairly equal.
Today I met with an OB who delivers at a hospital that allows VBACs, and now I feel totally deflated. My prior CS report mentions a small pelvis (cephalopelvic disproportion) so she says I'm a very poor candidate for VBAC, that my chance of uterine rupture could be as high as 10% and my chance of successful VBAC is more like 30%. She said "some people just aren't meant to birth babies." WTF?
I'm frustrated and heartbroken after being so hopeful for a VBAC this past week and doing tons of research. I think CPD is kind of a bullshit diagnosis and that my CS was due to a multitude of factors that included but were not totally dependent on the size of my baby (8lb 7oz) and my body. I want to find a more supportive provider, but she says at this point I'd basically be looking for someone who is just going to tell me what I want to hear and not the true risks.
If it’s really important to you, I would get a second opinion. I don’t know how real a diagnosis of “small pelvis” is, but if it were me I would feel better hearing it from a second medical professional.
At the end of the day the most important thing is a safe delivery for you and your baby. It may not look like what you had planned, but it can be a beautiful entry into this world no matter what course you choose.
I really understand your disappointment though. I cried every night for two weeks after my c-section because I felt like I had failed at the very first step of motherhood. Take some time to grieve for the birth that you wanted, and be kind to yourself. Looking up “belly birth” and gentle c-sections may help you feel more empowered and develop a birth plan that you feel comfortable with.
Hugs to you.
CPD is a real thing, but it is definitely overused. This American Pregnancy Association article notes that CPD is frequently "diagnosed" in cases of labor failing to progress, but many of those likely aren't truly the condition, which is interesting based on what you're saying about your prior pregnancy.
https://americanpregnancy.org/labor-and-birth/cephalopelvic-disproportion/
Personally, I'd get a second opinion, especially considering true cases of CPD are pretty rare. That article also notes 65% of women who have CPD go on to later deliver vaginally.
@maggiemadeit thank you for the sweet words! I think a lot of my bad feelings are residuals from my first CS as well. I'll definitely look into those options, they sound like the way to go if I have RCS!
@lovesclimbing sorry, that was a poor choice of words! I definitely agree CPD is a valid diagnosis but probably overused. Thank you for the article, it really touched on everything going through my head right now. I don't know how she estimated a 30% success rate for me, when everything I read says 60-80% overall success rate for VBAC, closer to 60% with a previous CS for CPD.
Also, I feel like I need to call it something other than "success rate." I don't want to feel like a failure again if I have an RCS after giving it my best shot!
So I switched to the midwife group at a local hospital that is known for their low intervention rates and VBAC success. They are also the only place around me that does water birth. I just want to give myself and this baby every fighting chance at the birth that I want. You can’t predict how things will turn out, but at least I will know that I did everything I could.
@lisee923 you'll definitely go into labor naturally, if they wait long enough! Did they say how far along they would let you go?
For example I am 35 and never went into labor with my first (induced at 41W). The practice I was at has very few policies set in stone. They will let me go to 42 weeks, and induction for the VBAC is an option.
I hope that you can go into labor on your own and have a chance at labor and delivery if that’s what you want.