I don't know what I want....

At my appointment the other day I had a ton of questions for my OB. (I have a feeling I will be totally rambling, so sorry in advance.)

Since I am new to town I know nothing about the hospitals. He told me I could deliver at either one I wanted and recommended I tour them both before I make a decision. So hopefully in the next couple weeks I can tour the hospitals. He set up an appointment with a pediatrician in town for me, so I can meet her and decide if I want her for my kids. So, that was all great.

Then we were talking about VBAC vs repeat c-section. I told him all along I have wanted a VBAC--even before we knew we were ever going to have more kids. He said ultimately it is up to me--as long as everything stays going well. He had to warn me of there being risks with having a VBAC-which I knew there are risks. No matter what there are going to be risks. As we got to talking I found myself thinking "maybe I will have a repeat c-section" but I can't just stick with one or the other. I know I have quite awhile to really decide but the earlier I start thinking about it the better for me. One thing he mentioned was with a c-section there is more control than with a VBAC. If my uterus was to rupture then I could lose the baby and/or my own life. I know there is only like a 1% chance of that happening but the thought of losing my baby scares me. I had such a horrible experience with the c-section before though. I was in so much pain for months afterwards, I hated not being able to cuddle with DS for a long time, I ended up with a spinal headache and had to have a blood patch done, I got a bad fever right after surgery.... It was just not a good experience and I really don't want to go through it again.
I just keep going back to the fact that I haven't been able to have a 'normal' delivery experience before and I want that chance...so I think VBAC. Then on the other hand--I haven't given birth to a healthy baby either. All of my babies have come out needing help and I want to give this one a chance to come out completely healthy...so I lean towards the c-section.

I asked DH what he would prefer and he tells me "I will support you in whatever decision you make." Well, that's just freakin' great. I love that he wants to support me--but seriously give me an opinion on the matter!! The plus side of scheduling a c-section is we know when to have DH use his vacation time so he can be there with no problems. But I really want a VBAC.

I am the worst person to give options to! I can never make up my mind and I wish someone would just tell me-"This is how it is, like it or not!" and decide for me.

ARGH!!! If you made it all the way through and actually made sense of what I said "CONGRATULATIONS!!" :laughing: I'm not sure I understand all of what I say.

Oh-and another thing we talked about was....He is the only doctor in his practice. I was worried that if I do decide to have a VBAC there would be a chance that I would end up with someone else delivering. He said that unless he gets hit by a bus or something like that he will be there no matter what. They don't take vacations and are there 24/7/365 for their patients and he guarantees (unless something horrible happens to him) that he will be delivering my baby. So, that made me feel good since I don't know any of the other doctors in town.

Okay...I think I am done rambling now.

 

Ok for what it's worth...here is my take on your situation.....VBAC vs. Csection....


either way you really can't plan it. The baby plans his/her own due date, even if you schedule it...they may decide to come early...they are not good at reading calendars! It is good in theory...but doesn't always work out that way!

VBAC....advantages....having a child vaginally is better in some ways....when they are born through the birth canal they are SQUEEZED! so it helps get excess fluid from their lungs and such.
diadvatge is the whole rupture thing...but that is rare, and if you have a good surgeon you usually have a very favorable outcome!

Repeat Csections....take longer....you have adhesions from where you have healed. longer recovery time than vaginal. However it is a more "controlled environment" than if you get pulled into an emergency situation.


I doubt anything I have put here helps you....but I just wanted to put it out there for you...this is what I see from the medical stand point!


Best of luck to you!

Missy

 

I totally understand where you are coming from (on most aspects). My c-section was a piece of cake though...no problems, etc. with it.

I still can't make up my mind either. I'm leaning more towards scheduled c-section, but nothing is 100% at this time. But, I figure I have some time also.

So, I don't have any advice for you, but just know you are not alone b/c I can't make up my mind either. I too wish my OB would just tell me what I HAVE to do...I hate that I need to make this decision and it's ALL about me...no one else can really help me out with it.

 

My c-section went great. My mom was so worried about me having twins and kept telling me not to be so disappointed that I couldn't give birth vaginally with the twins. It was also a scheduled c-section. All planned!
I want a VBAC. That is the plan at the moment. I feel that it is healthier for the baby if he comes out naturally. The whole squeeze & the stuff the baby picks up in the birth canal. A c-section is nice, but it is still major surgery. Besides, I hate the 2 week no drive rule! Oh, and I have twins to take care of afterwards! I really am hoping for a VBAC this time! I just hope I go into labor on my own!!! So, I will have a c-section IF it is necessary, but will hold out until the end.
In the end, it is your decision. Good luck! It's not an easy decision!

 

I talked to my OB about my planned VBAC and what would happen in case of a rupture and was told that they would almost certainly be able to get me to the surgery room for an emergency c-section that would save the baby. The chance of a rupture is so small and also related to whether you are induced that I really wasn't worried about it at all. I was more worried about having complications due to adhesions in future pregnancies if I had a c-section again.

My induction took 2 days and I pushed for 7 hours and my midwives were never worried about a rupture because Dax and I looked okay on the monitors. Like yours, my c-section with the twins was very difficult to heal from but recovery for my 2 day delivery with Dax was a piece of cake. I was perfectly fine 30 minutes after having him. I would definitely recommend a VBAC for anyone interested.

 

QUOTE(Ali M @ Dec 6 2007, 09:09 PM) [snapback]524210[/snapback]
I was more worried about having complications due to adhesions in future pregnancies if I had a c-section again.

That's one of the things I have thought about too. Although we aren't planning anymore-we weren't planning this one either, so I guess it could happen-it's something I have definitely thought about.

QUOTE
I would definitely recommend a VBAC for anyone interested.


I know I really want to try for a VBAC but all the what ifs are in the back of my mind. KWIM?

 

I just had my vbac...the recovery is way easier!

I encourage you to do you own research. The risk of rupture according to the ACOG is .5%-1.5% however this is not the risk of "catastrophic rupture"...this includes even cases where the scar simply separates or stretches in a measurable way. "catastrophic rupture" risk is even lower...around 1% of that .5-1.5%... and catastrophic rupture means the scar separates enough for the baby to come through it...but even among these cases not every baby or mother dies... the vast majority of catastrophic rupture cases go on to be just fine. Actually the odds of something else wrong happening are much higher than the risk of UR...for instance ANY woman who is having a baby via c/s or vag has a higher risk of a life threatening complication due to placental abruption or cord prolapse than a vbac woman has of uterine rupture. But doctor's don't spend time warning pg women that this could happen to them. Your doctor says that the c/s is more under control...well, that's his perspective...that's b/c he feels confident in his own skill and the predictability of a c/s.. He can't predict exactly what your body will do...so he feels more nervous about that. But in reality you actually have a higher chance of a hysterectomy with ANY c/s you have than you do with vbac. You have more of a chance of excessive loss of blood and need for a blood transfusion as well...and that's with any non-complicated c/s regardless of vbac attempt. But again the risks of both of those things are still so low that doctors don't focus on it.

In my view c/s has 2 major advantages...1. you get to pick the date and your schedule....2. In most cases you don't have to experience the pain of labor.

However, you pay a big price in recovery time and pain afterwards. For me the biggest factor in making the decision was knowing that I might not be done having kids. I didn't want to worry about a 3rd c/s. Another big factor is long term issues.. I already felt like my cycles were more painful after my first c/s. 60% of women who have 1 c/s will have scar tissue develop in a noticable way...95% of women who have 2c/s will have scar tissue develop. Ask any woman who has had 2 or more c/s how long it took for the doctor to cut through the scar tissue on the 2nd or 3rd c/s..most will answer it took a much longer time.

These are just my views. I did a lot of research on it. I still feel like it should be up to the woman to choose whichever birthing method she wants...it's your body regardless of what anyone says one way or the other. I encourage you to look up the actual medical journals on the issue...I can almost guarantee you that what you find will be extremely reassuring. For a woman who has no induction and no augmentation of labor at all, the risks are very, very low. Actually for a woman who has had a prior vaginal birth the risk of having any rupture no matter how minor goes down to .2% according to a recent study. That's really, really, really low.

One place I found a wealth of information from was baby center's vbac support thread. you can find it under their pregnancy-threads if you hunt for it. The moderator over there...Pam is her name, is an absolute wealth of information, she can hook you up with gobs and gobs of research and has stats on almost every concern related to vbac. Honestly, I started out my vbac research really uncertain, kind of scared. And by the time I was done with the research I had done I was not scared at all anymore. I felt really good about the decision I was making..and that's really important.

Once you've done your research and IF you decide to go for vbac it's really, really important that your doctor is truly supportive of them. A pro-vbac doctor will NOT require you to have the baby by 40 weeks. All the research out there indicates that any induction is not a good idea for vbac, unless you are already past 3-4 cm. All the research out there says that the risk for induction of vbac far outweighs the risk of a larger baby and vbac. Actually there is no noticable risk for vbac with a larger baby....vbac is more likely to be unsuccessful with babies over 10 pounds...but the risk of UR does not go up. So if your doctor starts talking about it being safer to vbac prior to 40 weeks then that's a big red flag. Basically what that tells you is that your doctor, who fully knows that only 50% of women will go into labor prior to 40 weeks, is probably banking on the fact that you won't go into labor by 40 weeks and so therefore he'll get to do a c/s which he is more comfortable with. And some docs like to induce b/c then they can plan when you will be at the hospital. Some hospitals require docs to be present in the L&D floor the entire time a vbac patient is there...from start to finish...so docs like to have a say on when that happens. Anyway, I think the biggest single indicator of a pro-vbac doctor is this question of whether or not they will allow a patient to go past 40 weeks when the baby and the mom look like they are doing fine. Most docs who say they are pro-vbac but really aren't will have the cut off at 40 weeks. Pro-vbac docs who really have done their research and listen to their own counsel (the ACOG) will allow you to go well into your 41st week if need be, so long as baby seems fine. B/c vbac success is much higher if you go into labor naturally. Okay...I have a ton of other things I could tell you ...but I'll stop... please go check out that thread over on baby center...you'll find a ton of information and vbac stories that will help you make a decision from facts and not just the mainstream fear that is prevalent.

One thing you should realize is that the general notion of fear over vbac is mostly caused by the issues they had in the 90s from them. During the 90s, induction via cytotec was very popular...it was a drug that wasn't even approved, and still isn't approved for induction by the fda. it's actually a stomach ulser drug meant to be taken orally. Anyway...it was causing UR rates of around 7% in vbac patients!! Many lawsuits happened b/c moms and babies were dying or being seriously injured. And in those UR cases a much higher percentage were catastrophic...the drug just made these women's uteri go into overdrive. Anyway, b/c of how badly that was managed lots of docs and hospitals started clamping down and not allowing any vbacs regardless of induction or not. Anyway, lots of fear abounded due to all these lawsuits...and the mainstream opinion in the media and for doctors became that vbacs were super, super dangerous. And it simply isn't true. A natural vbac carries very low risks. Yes, the risk of UR will always be higher for a woman with a scar....but there are many other risks for that same woman should she decide to have another c/s. And UR can happen in any woman...my sister's SIL actually had a catastrophic UR for her very first baby. It was due to being given too much pitocin. She wound up in ICU for 3 weeks after her UR..but ultimately she and her baby were fine. She went on to have one more child via early c/s. So it shows that no one is completely immune to a scary emergency.

okay...enough...hope you are able to do your research and then feel very strongly one way or the other about the issue. I think it's just most important to make your choice and know for sure that you feel good about what decision you are making. Honestly, even if you decide to go for c/s b/c of the convenient scheduling, that's completely your right...I don't think anyone should look down on a woman for choosing that...so long as she isn't insisting that it be prior to 38 weeks... b/c then that would compromise the health of the baby. But seriously, it's your body and if you choose to go with c/s you are the one who has to recover from it, no one else...so that should be your right..and no one else has the right to come down on you for it. Both c/s and vbac are reasonable choices in terms of the risks being very low. The only thing I will argue is that vbac, IMHO, does NOT carry significantly higher risks for either mother or baby...the research out there supports that 100%... so long as major interventions are not used... (meaning cervical ripening gels...or use of pitocin prior to 4cm dilation....)

can you tell that this is a passionate topic for me!! LOL...making myself stop now!!

 

It can be a tedious decision. I have always felt that the most important thing is healthy baby(ies) and healthy mom. That's the approach that I took through my whole twin pregnancy. I knew that there would be things that were out of my control, but that my goal was that my babies and I were healthy. I tried not to get my heart set on either way. It was a good thing because I would have preferred a vag. delivery, but Bella was breech and my doctor was not comfortable with that. I trusted her opinion completely and went with the c/s. The girls and I did great, so it was everything I wanted.

 

QUOTE
Anyway, I think the biggest single indicator of a pro-vbac doctor is this question of whether or not they will allow a patient to go past 40 weeks when the baby and the mom look like they are doing fine. Most docs who say they are pro-vbac but really aren't will have the cut off at 40 weeks.


This is actually one thing I asked him about the other day. He said as long as everything is going well then we want the baby to 'cook' as long as possible. He also said "by the end most mom's are asking for the baby to just be here!" I told him I have had 3 babies early and all had problems at birth--I will have NO problem with keeping a baby in as long as possible.

 

Rhonda, I totally feel your pain!

I had a c/s with my twins and it was horrible! Long, boring story that you don't need to hear!! I did however have a VBAC with my daughter Grace, and it was the most amazing experience of my life...I highly reccommend it...I agree with everyone else, that you should research the risks of both and talk to your OB and husband, and in the end, you will know in your heart what you are comfortable with, and lets face it... the bottom line is that baby gets here safe. But, the recovery for me was simple from the VBAC, and I was able to hold and pick up the twins, and I was home sooner. But mostly the experience for me of holding my baby the second she came out was life altering ( I know ... sounds cheesy... but it was truly amazing!)

I am 11 weeks now and hope to have another VBAC (I'm sure I'll be on here venting about that soon!..another long story!)

I wish you the best, and just know that you are not alone in agonizing your decision!

Good Luck!