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Better to C-sec or VBA2C? ~ EDITED with new question~

post #1 of 40
Thread Starter 
I'm currently 29 weeks pregnant with #3 (a boy!) I've had two prior c-secs:

1st one: went in for induction, no sooner had pitocin bag been hung up then a big contraction hit and they "lost" the baby's heartbeat. Jumped by 6 or so nurses, turned every which way, given shot to stop pitocin effect, cath'ed........finally found heartbeat again. Then doc wanted to start pitocin again. Originally scheduled for induction due to high blood pressure issues and fear of preeclampsia. We opted out of the start-stop-start game of pitocin and asked for a c-sec. Baby safely delivered at 39 weeks - DS 6lb 4 oz 19.5"

2nd one: never considered possibility of VBAC so just automatically assumed the c-sec. No blood pressure issues this time, smooth sailing through pregnancy, flawless c-sec. Delivered at 38 weeks - DD 6lb 4oz 19"

So, not really looking forward to the process of a c-sec again and the enormous recovery time, my mind has been toying with the possibility of a VBA2C. Other than the obvious concerns and risks involved, I can't help but worry about having to go through a very long labor and then ending up with a c-sec anyway.

I don't even know if my OB would support the idea anyway. I'm in a group practice and have only met two of the docs one time each. My other visits have been with the nurse practitioners. I'm not real happy there. Even if I do the c-sec I don't feel as if I even know the doc doing it. How much confidence would you have in someone cutting you open that you've only met once or twice for maybe 5-10 minutes each?????!!!!

I feel real confused right now and don't know what to do. I like the "planned" nature of a c-sec but I also don't feel like going through all that again. And I worry too about labor. I've never done it and I don't think I'm a "no drugs at all" kinda girl.

I'm very torn right now and would appreciate any advice, support, encouragement, or reality check.

Thanks!
post #2 of 40
is money an issue? Would your insurance pay for a midwife? Usually many women end up having a successful vbac at home with a midwife because of less interventions. I recommend you post in Finding your tribe for suggestions for experienced VBAC midwives. Good luck and welcome!
post #3 of 40
Thread Starter 
Hi! Thanks for the welcome! I'm not sure if our insurance covers midwives......never checked into it but I will now. And if they don't, I don't know that we could afford to pay out of pocket. So I might be on the hunt for a willing OB if that's the case. I might be on the hunt for a new OB regardless. I'm very displeased with my current group.
post #4 of 40
I would, without a doubt, go for a vba2c. I did, actually... and ended up with another section, but I can honestly only see the good in attempting a vaginal birth if that's what you really desire.

It might be hard to find a supportive OB and hospital, but they're out there. I would look for a homebirth midwife or a CNM to attend a hospital vba2c if that's what you're more comfortable with. you might be surprised at what your insurance covers or how a MW may work with you to set up a payment plan.

Best of luck!
post #5 of 40
Quote:
Originally Posted by whiteisle View Post
So, not really looking forward to the process of a c-sec again and the enormous recovery time, my mind has been toying with the possibility of a VBA2C. Other than the obvious concerns and risks involved, I can't help but worry about having to go through a very long labor and then ending up with a c-sec anyway.
I may be a little weird in this, but having done both, I'd much, much rather labour prior to the surgery than just schedule. It's also better for the baby. (I'm not labouring this time, but my story's a little complicated, and there are several factors behind my decision.)

Quote:
Even if I do the c-sec I don't feel as if I even know the doc doing it. How much confidence would you have in someone cutting you open that you've only met once or twice for maybe 5-10 minutes each?????!!!!
This was the thinking that led me to actually give a crap when my former OB threatened to drop me from care. If I could go back and rewrite the whole thing, I'd have let him drop me, and if a c-section had become necessary, I'd take the stranger. I've had two emergency c-sections, and they were both done by OBs I didn't know (in the first one, I never even saw him until the next morning, as I was already out when he entered OR - in the second, I'd talked to her a couple of times in L&D, but that was it). They were done every bit as well as the two by the manipulative, self-absorbed OB that I stuck with because he was "the best" (in terms of surgical skills). Oddly enough, that oh-so-wonderful surgeon was the one who left me with what appears to be permanent nerve damage (the baby is 3.5, and I still suffer widespread pelvic/abdominal numbness). Maybe I'd have been better off with the OB on call...

It's easy to get freaked out about this stuff, but as far as I can tell, most modern OBs can perform a decent c-section...they get lots of practice, for one thing.

Quote:
I feel real confused right now and don't know what to do. I like the "planned" nature of a c-sec but I also don't feel like going through all that again. And I worry too about labor. I've never done it and I don't think I'm a "no drugs at all" kinda girl.

I'm very torn right now and would appreciate any advice, support, encouragement, or reality check.

Thanks!
I'm afraid I have no advice for you. I can't relate at all to liking the planned nature of scheduled c-section (it creeps me out) and I hate the drugs. So, obviously, I'm coming at things from a different perspective. FWIW, I'd happily trade my 48+ hour labour for 15 minutes of c-section recovery...don't know if that helps on the worrying about labour front.

Good luck. These decisions are really hard.
post #6 of 40
Thread Starter 
Quote:
Originally Posted by Storm Bride View Post


I'm afraid I have no advice for you. I can't relate at all to liking the planned nature of scheduled c-section (it creeps me out) and I hate the drugs. So, obviously, I'm coming at things from a different perspective. FWIW, I'd happily trade my 48+ hour labour for 15 minutes of c-section recovery...don't know if that helps on the worrying about labour front.

Good luck. These decisions are really hard.
I WISH it were only a 15 minute recovery! LOL Took me about 1-1 1/2 hrs for the numbness to go away and then after the morph wore off I was on a constant round of Tylenol and Ibuproferin for 2-3 weeks and LOTS of pain and discomfort....oh! and the "you have to get up and walk" within X time (OUCH!). Did you know everything is connected to you abdomen?? Even your leg hairs?? lol And then it took me about 6 weeks or so to recover so that I could function half-way normal and independently.

That's part of my wanting to VBA2C........shorter, easier recovery.
post #7 of 40
Quote:
Originally Posted by whiteisle View Post
I WISH it were only a 15 minute recovery!
I know the feeling! I hear about how some women have "easy" c/s recoveries but NOT ME!!! I was in PAIN for months afterwards! Not to mention my back ached at the site where they placed the epi for almost a year after later.

You couldn't drag me to an elective c/s, unless I had 4 or more c/s.
post #8 of 40
I personally would totally go for it!!!!

I had an easy c/s recovery. So easy that we drove 14 hours when my DS was 12 days old and I was standing in a wedding when he was 16 days old. No biggy.

BUT, my VBAC, man, that was nice. I did have an episiotomy, so that part was the only reason I even felt like I had a baby. Otherwise, seriously, my body felt great! And even the episiotomy was no biggy very soon. It bothered me at about 1 week, only because I was having trouble going potty...so once i went to the bathroom, my episiotomy basically felt like it didn't exist either. So my VBAC recovery was a breeze, even compared to my easy c/s recovery.

But on top of that, having a toddler and not having to worry about a c/s, that was nice!

I was nervously excited about labor as well. Granted, I did have a labor with DS, but it was induced. So, I was nervously excited about when it would happen and if it would happen..it did and it was great. Very exciting to know that my body did it's thing! And I decided early on that even if I went through hours and hours of labor and hours of pushing (like I did with DS) and still ended up with a c/s, I knew I tried. That was my thing, I didn't want to sign up for the repeat c/s and always wonder what if...if I tried and still had a c/s, at least I wouldn't wonder because I tried.

So...I'd start looking around now for someone to support your VBA2C. I know it can be hard to find an OB to support a VBAC, I was very lucky as the one I was currently seeing actually asked ME if I was interested in doing a VBAC. I'm not sure what her take would have been about doing a VBA2C...but I know there are some OB's out there. But look into the midwife option too! It doesn't hurt to ask and look! Do what you feel is best and right...you deserve it mama!
post #9 of 40
Quote:
Originally Posted by whiteisle View Post
I WISH it were only a 15 minute recovery! LOL Took me about 1-1 1/2 hrs for the numbness to go away and then after the morph wore off I was on a constant round of Tylenol and Ibuproferin for 2-3 weeks and LOTS of pain and discomfort....oh! and the "you have to get up and walk" within X time (OUCH!). Did you know everything is connected to you abdomen?? Even your leg hairs?? lol And then it took me about 6 weeks or so to recover so that I could function half-way normal and independently.

That's part of my wanting to VBA2C........shorter, easier recovery.
I wasn't suggesting that it's only 15 minutes. I had 7-8 months of pain with dd (my only labour free one). I'm saying that I'd rather have 48 hours of labour than even 15 minutes of the c-section recovery. C-section recoveries are hell, and they don't get any better with more kids around.

I can't compare to the pushing part of childbirth, though. I've never done that part. I've had some women tell me that it was the most painful part, and other women tell me it was the easiest...
post #10 of 40
Thread Starter 
Quote:
Originally Posted by Storm Bride View Post
I wasn't suggesting that it's only 15 minutes. I had 7-8 months of pain with dd (my only labour free one). I'm saying that I'd rather have 48 hours of labour than even 15 minutes of the c-section recovery. C-section recoveries are hell, and they don't get any better with more kids around.

I can't compare to the pushing part of childbirth, though. I've never done that part. I've had some women tell me that it was the most painful part, and other women tell me it was the easiest...

Sorry Storm Bride......I must have misread your post and gotten the meaning backwards. But wouldn't that be something? A 15 min. recovery?? Wahoo! I'd sign up! LOL

I'll have a 5 year old and a 3 year old waiting for me at home after this birth (whichever way it goes) and the thought of being laid-up due to surgery makes me sick. Plus it puts an awful lot on DH to have to take care of them, me AND a new baby.

I've been reading more information about VBA2Cs and I'm feeling more positive about it. In fact, I found a group in my phone book that has two CNMs in their OB practice. I plan on calling them first thing Monday morning to see what their policies are and to see if they'll take me.

I don't have a clue about labor so I guess that's the next thing I'll need to read up on.
post #11 of 40
if i have another, i will go for a vba2c. my c/s recoveries have truly been a breeze (all of my friends' vaginal deliveries seem much harder to recover from than my cs were), so it's not the recovery. it's just that the risks to a mom keep going up and up with each c/s, sharply. i read through a LOT of studies on vbac when i was planning mine (didn't happen), and imo, vba2c is only slightly more dangerous to babe than a vba1c. it's just that because of the scar tissue, emergency surgery is harder, so it can take longer to get to babe, and you're more likely to be injured. so if the worst happens, yeah, it's going to be more dangerous.

i wouldn't vba2c at home, but i wouldn't vba1c at home either. continuous monitoring was key to my comfort.

i don't know how hard it would be to find a doc willing to do one though! i have talked to a L&D nurse friend in the town we're moving to, and she says the docs at her hospital share care with the docs that do vbacs at the nearest vbac hosptial (1.5 hours away). that means i can get my care in my town but still deliver 1.5 hours away. maybe you can find a similar situation, so that if someone who will vba2c is hours away, you only have to make the trip for delivery, not prenatals.

also, there's nothing wrong with getting an epidural for your vbac. if i didn't have one in place with DD1, i would have been under general for the birth, which is the #1 thing i didn't want. i still wasn't sure if i was going to get one with my vbac, just to eliminate the chance that i'd have to go under general in a worst case scenario. my plan was to just wait and see how i felt at the time.

good luck! one of my closest friends had a vba2c with her almost 9 lb, sunny-side up daughter. she said the recovery made it worth it.
post #12 of 40
Quote:
Originally Posted by majormajor View Post
also, there's nothing wrong with getting an epidural for your vbac. if i didn't have one in place with DD1, i would have been under general for the birth, which is the #1 thing i didn't want.
Seeing as how epi's increase the rate of c/s, I wouldn't suggest one. Personally, I'd much rather labor w/o an epi and have a higher chance of a successful VBAC than be concious for a c/s. They can knock me out if it's a true life/death emergency.
post #13 of 40
Quote:
Originally Posted by ShwarmaQueen View Post
Seeing as how epi's increase the rate of c/s, I wouldn't suggest one. Personally, I'd much rather labor w/o an epi and have a higher chance of a successful VBAC than be concious for a c/s. They can knock me out if it's a true life/death emergency.
i dunno, that's one of those areas that the research really doesn't seem to have nailed down yet. the research that suggested a link between epis and c/s is old, and technique has gotten better since then. however, if you want an epi, i think your best bet is to talk about it with your OB in advance. my understanding is that turning off the epi before pushing and allowing the baby to labor down without pushing in the meanwhile is the best bet.

but, to each their own. i'd still take a slightly increased risk of c/s over the possiblity of a c/s under general because that's an idea that scares the daylights out of me. personal preference, though. my aunt had to finagle to get a c/s under general because she didn't want to be awake for it. i don't get it, but i'm glad she got her wish.
post #14 of 40
Quote:
Originally Posted by whiteisle View Post
Sorry Storm Bride......I must have misread your post and gotten the meaning backwards. But wouldn't that be something? A 15 min. recovery?? Wahoo! I'd sign up! LOL
I don't know if I'd sign up, but it does sound sweet!

Quote:
I'll have a 5 year old and a 3 year old waiting for me at home after this birth (whichever way it goes) and the thought of being laid-up due to surgery makes me sick. Plus it puts an awful lot on DH to have to take care of them, me AND a new baby.
I know exactly what you mean. When I have mine in June, dd will be just-turned-six, and ds2 will be almost 4. I used to think being home with dd when she was two and I'd had surgery was rough, but ds2 is way harder to handle than she was. I'm honestly just trying not to think about it too much.

Quote:
Originally Posted by majormajor View Post
but, to each their own. i'd still take a slightly increased risk of c/s over the possiblity of a c/s under general because that's an idea that scares the daylights out of me. personal preference, though. my aunt had to finagle to get a c/s under general because she didn't want to be awake for it. i don't get it, but i'm glad she got her wish.
I talked to a former (?) member here whose husband was an anesthesiologist, and she explained that the risks to a pregnant woman from general are higher. Also, they won't let a husband in the OR if the woman is under general. I do appreciate being able to see my baby more quickly with a spinal (even though it felt longer with dd). So, I won't ask for general anesthesia. However, I totally understand your aunt's preference. The only part of any of my c-sections that's been even remotely tolerable for me was the fact that I was unconscious for two of them. Being awake while someone cuts into my mid-section, and knowing it's happening, even though I can't feel it, has been the most horrifying, ugly, brutal, terrifying experience of my life...NO CONTEST.
post #15 of 40
FWIW: I did an almost natural VBAC with my DD..I was pushing as hard as I could and I was approaching that 2 hour point where I gave in with DS and signed up for my c/s. This time I was getting frustrated with DD's pushing, since mentally, I thought going into labor on my own equaled quick pushing (hahaha!!!!!) (I was induced with DS).

Anyway, I pushed for a nice long while naturally...then, I finally gave in to an epi, mostly for an emotional and mental break. But pushing when I didn't have an epi, just felt right, my body NEEDED to push during a contraction.

At the point of the epi, even though I had been pushing prior without it, I didn't feel like I knew what I was doing! I felt like I had no control over my pushes and I felt like I wasn't doing anything to help.

Eventually my DD came out...but I didn't feel like it was me doing it! I personally liked pushing naturally better...I hope I can next time...I think it will be amazing!

BUT, I also am one to say that natural is best for some, so they can change positions and do what's best to get baby down and out...but I can also see why an epi is good for some...if mama cannot relax enough to let her body do her thing..well, she needs to let her body do her thing and an epi just may be the right thing for her! JMO!!!
post #16 of 40

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Edited by maotmsmi - 5/21/11 at 12:27pm
post #17 of 40
Thread Starter 
Quote:
Originally Posted by MommyKrista View Post
I've been through 2 long, induced labors (my first was also for suspected pre-e) that both ended in c-sections and I would absolutely take laboring over a scheduled c/s. I will be trying for a homebirth vba2c with my next pregnancy. My body has shown me twice that hospitals and intervention do not equal a vaginal birth for me so I've decided to listen! Look at the risks to your body, fertility, and future children, etc after you've had 3 c-sections (if you haven't already). That is what sealed the deal for me as I know I want more then 3 kids. The risks and complications increase dramatically after 3 c-sections so I have to at least try to avoid it.
So here's my new question:

Since DH and I are very convinced that this 3rd child will certainly be our last, what other concerns are there for having a 3rd c-section other than "future pregnancies" worries? And also other than the obvious "it's major surgery with long recovery"? I'm trying to figure out if having a 3rd c-section will have any other long-term impact on my health or well-being.

Thanks!
post #18 of 40
Quote:
Originally Posted by whiteisle View Post
So here's my new question:

Since DH and I are very convinced that this 3rd child will certainly be our last, what other concerns are there for having a 3rd c-section other than "future pregnancies" worries? And also other than the obvious "it's major surgery with long recovery"? I'm trying to figure out if having a 3rd c-section will have any other long-term impact on my health or well-being.

Thanks!
Well, it may have been a fluke, but it was my 3rd c-section that did the nerve damage. The results of that were:

1) I'm still unable to feel a large chunk of my abdomen and part of my pelvis (the "baby" will be 4 in July).
2) I have extreme difficulty doing kegels or "Tupler technique" abdominal work - they both take an intense amount of concentration...and I used to be the "do 100 kegels while you stand at the stove" type.
3) For about six months, I had no clitoral sensation...absolutely nothing. As you can imagine, this didn't have a wonderful impact on my sex life.
4) I've lost most of my bladder sensation. Actually, I don't know if I ever got any of it back, or if I've just learned to feel even very slight pressure on other organs in my pelvis. When I had my 4th section, the recovery was made significantly more painful by the fact that I didn't know I had to pee until my bladder was so full that it was putting pressure on my incision.


Honestly...it's a crap shoot, imo. I've had four, and they've all been different. There are risks for every section, and I think that many of them increase as the number of previous surgeries increases. It apparently takes longer for the surgeon to get in each time, due to the scar tissue, so the mom and baby are under anesthesia longer each time, which kind of freaks me out (I hate anesthesia, anyway). I don't know of any specific increased risk to a third section, but I do think they get riskier, in general, a you have more of them.
post #19 of 40
Thread Starter 
Quote:
Originally Posted by Storm Bride View Post
Well, it may have been a fluke, but it was my 3rd c-section that did the nerve damage. The results of that were:

1) I'm still unable to feel a large chunk of my abdomen and part of my pelvis (the "baby" will be 4 in July).
2) I have extreme difficulty doing kegels or "Tupler technique" abdominal work - they both take an intense amount of concentration...and I used to be the "do 100 kegels while you stand at the stove" type.
3) For about six months, I had no clitoral sensation...absolutely nothing. As you can imagine, this didn't have a wonderful impact on my sex life.
4) I've lost most of my bladder sensation. Actually, I don't know if I ever got any of it back, or if I've just learned to feel even very slight pressure on other organs in my pelvis. When I had my 4th section, the recovery was made significantly more painful by the fact that I didn't know I had to pee until my bladder was so full that it was putting pressure on my incision.


Honestly...it's a crap shoot, imo. I've had four, and they've all been different. There are risks for every section, and I think that many of them increase as the number of previous surgeries increases. It apparently takes longer for the surgeon to get in each time, due to the scar tissue, so the mom and baby are under anesthesia longer each time, which kind of freaks me out (I hate anesthesia, anyway). I don't know of any specific increased risk to a third section, but I do think they get riskier, in general, a you have more of them.
Thank you Storm Bride for the information.....I agree........it's a total crap shoot...either way really, I guess.

No other group will take me this late in the game so I have to wait til the 3rd of April to talk with my current OB. I have no idea what they will or won't do. We'll see.
post #20 of 40

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Edited by maotmsmi - 5/21/11 at 12:28pm
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