Shocked...considering a C-Section instead of VBAC

[PiscesMama24]

I have always be anti-intervention, pro-natural childbirth, and attempted to have a home water birth with DD1, which resulted in an 82 hour labor, 4 hours of pushing and a C-Section. I am still coming to terms with this loss.

Which is why I am so shocked with myself for even considering a c-section the second time around. As I think about it, my main motivation for having a c-section is the fact that I have more control over the process than if I were to labor naturally, and possibly recieve the cascade of interventions all over again.

The control issue mainly stems from my struggle with potentially being away from DD1 (2.5) for a prolonged time period (we have never been apart for more than a few hours, let alone overnight). With new hospital policy she can't even come into the hospital due to the H1N1 hype.

I can't help but think, if waited to go into labor natually, and then called the hospital to tell them I was on my way and wanted a c-section, I could have my new baby in arms within the day, DH could be back home with DD1, and I wouldn't have to worry about leaving her alone.

There are just so many unknowns with my original VBAC plan, and for some reson I'm feeling this need to control things as much as I can.

I was in the hospital for 5 days with DD1, theres no way I could do that again this time around. But there's nothing to say that I would have an easy labor and birth this time either. Ideally, I would wait as long as I could, go to the hospital, give birth and be home within 24 hours, but that is HIGHLY unlikely.

And what if this baby gets "stuck" too, needs forceps, a vaccum, or another c-section. Then wouldn't it have been better to start the process early and be done with it so I could be home with my family?

I'm so torn, and honestly, a bit ashamed I'm even thinking this way, as I've always been against a C-Sections unless medically necessary.

Any thoughts/advice would be greatly appreciated! Thanks mamas!

[jeninejessica]

*hugs mama* This is a difficult decision, and don't feel bad about making the choice that's right for you. Don't forget also though that you can change your mind at any point. Have you thought of planning for a vaginal birth, and then giving yourself a limit? ie laboring over 12 hours, or if you feel like you need an epidural, or they want to augment with pitocin, etc, then make that your cut off for asking for the c-section-- that way you'll feel more in control knowing that it's not going on forever, and that you have control over when to vote for a c-section. Don't feel like just because you plan for a vaginal birth means you can't ever change your mind once you get there. You're still the one calling the shots here.

One thing to consider also though is that recovery from the c-section will affect what you're able to do with DD. So you may be home, but you still won't be able to do the 'normal' things and that may be just as hard as not being with her. A vaginal birth will almost certainly have a faster recovery.

Are there any birthing centres near you that would take a vbac so that DD could be with you, or you would be able to leave quicker?

[skolbut]

Oh, mama, I have SO been there! After my first C I told hubby 'next time we're just going to schedule'. Fast forward 20 months and I had a textbook vbac. Now that's not to guarantee that you will, but I'll be honest, the recovery, bonding, and total experience are so different for a vaginal birth, I would have gone home after 6 hours-ish if I had thought ahead long enough to clear it with my OB. Also, my dad was able to come and stay with my DS at our house, so it was someone familiar and already part of his life (ie not a random sitter). I say, go for the vbac!!! Then, line up help for after, and like a pp said, set yourself some limits, and if/when you decide for a C you'll know it was YOUR choice and YOU were in control of that decision!

[etsdtm99]

i agree with the others, think about the recovery .. you may spend less time pre-baby away from DD , but you may spend more time post-baby away from her due to C-section recovery or even possible complications during recovery.. sure, it would suck to do both - but there is nothing saying that is more likely to happen than not.. kwim?

i agree about the limits.. i did something similar with my last birth, which was an induction .. i swore i would not go through pit labor, with no progress for longer than 5-6 hours without getting an epidural .. i was going to let myself get an epidural after so long (and i did, because after 7 hours i was still at 3cm..) there is no reason you couldn't make the same rule about a c-section.. ..

[lach]

I think that there is nothing shameful about considering all your options carefully. That is the totally sane, rational thing to do in any situation. Especially one which last time left you with surgery and some trauma. I think that if you went into your next pregnancy without any thought to the last one, you just weren't being realistic. I don't think that anyone could possibly fault you for that, and if the do they're just not being realistic.

That said, I think that this is something that you should talk about with your midwife/OB, assuming they're not C-happy. Does your care provider have any reason to think that something similar will happen again? I have a friend who, after 60+ hours of labor had a C section and afterwards it turned out that there was something wrong with her pelvis and the baby just plain didn't fit. (I can't remember all the details, because this happened a few years ago, but it was something like that!) Or is your care provider fairly confident that last time was a one-off and you have no reason to think a VBAC won't be successful.

Whatever you choose, I'm sure that it will be what is best for you and your family. I had an emergency C with my first, because for some reason that no one ever figured out my heart rate was getting dangerously high and I was blacking out. I was adamantly anti-C, saw it as a sign of weakness. Which I am ashamed of now. I honestly didn't even really consider a VBAC for #2, because the situation the first time was so scary.

[MegBoz]

I agree with PPs - no need to feel shameful. I think you've gotten some great advice, especially from jeninejessica. If there is a local ICAN chapter in your area, I'm sure that would be a great venue for support.
Good luck!

[PiscesMama24]

Thanks for all your advice! DH and I did look into a birth center, but didn't get a good feeling about it and realized it was WAY out of our price range.

But I think maybe I will wait to go into labor, then depending on how things are progressing, see how I feel about interventions. It's so hard for me not to be in control lately, I guess I'll have to learn to let go and just accept whatever happens, knowing I have alternatives (epidural, c-section) if I need them.

It's just so weird because last time around I was ADAMANT about not having any interventions and I ended up with all of them. The fact that I'm considering many interventions this time around just feels so counterintuitive. I'm trying not to look at is as something to be ashamed of though. Thanks again mamas!

[leavemealone]

I can't say that I ever seriously considered a repeat, but I knew it was an option if I wanted it. I would advise going to a VBAC supportive provider so you do have a choice. I assume you already are b/c you are considering a VBAC and you are pregnant. I doubt that even the most VBAC supportive provider wouldn't "allow" you to have a repeat if that's what you chose. I would also advise talking to some doulas in your area. They can give you some information based on what they have seen in the past. There is some comfort in doing what you already know and, in that respect, I can see how a repeat would be appealing. However, no one (vaginal, VBAC, or c-section) knows how any birth will go.

My first VBAC was easy. I left the hospital 26 hours after he was born. I would have left earlier but the dr didn't come around until about 1pm and by the time the hearing test, etc was done, it was closer to 26 hours after birth. He was born on a Sunday and I was out at Costco on Wednesday. My second VBAC wasn't so easy, but it was still better than my c-section. I will be having my third VBAC in April.

[jeninejessica]

Originally Posted by PiscesMama24

The fact that I'm considering many interventions this time around just feels so counterintuitive. I'm trying not to look at is as something to be ashamed of though. Thanks again mamas!

There should never be shame in using options with informed consent. You seem very educated, you know the risks and the benefits, both physically and psychologically as well, which can't be ruled out, and you are making an educated decision that WILL be right for you and your family. No one can ever fault you for that.

[Fujiko]

Been there. I was shocked that I considered it too, and almost felt ashamed as though everything I've believed about birth was "wrong" if I was feeling this way (even though it's not). Don't have any advice on how I resolved my feelings, because they kind of resolved themselves in time. But you definitely aren't the only one to have these conflicting feelings.

PS: If your feelings don't resolve themselves either and you decide to have a c-section, nobody will come and picket in front of your house. It's your decision and I fully support it, especially since I assume you know the risks and benefits of both RCS and VBAC.

[lach]

Originally Posted by jeninejessica

There should never be shame in using options with informed consent. You seem very educated, you know the risks and the benefits, both physically and psychologically as well, which can't be ruled out, and you are making an educated decision that WILL be right for you and your family. No one can ever fault you for that.

This is so very well said.

[majormajor]

i ended up choosing a repeat c-section, and it was definitely the right choice for me. i found myself starting to get stressed about choosing VBAC and the risk/benefit calculation of that decision, so i changed my mindset about halfway through the pregnancy and focused on the birth that was right for my baby. i talked to her about having the birth that she wanted, and prayed about being at peace with the way my baby needed to be born. then, when i was 40w4d, a nurse doing a NST palipated my belly and told me that DD was in a terrible position--head all the way by my hip, not down against my cervix. she said she didn't think that a vaginal delivery would go well (probably a c-section she said, but of course not certainly). i talked about this with my OB (who was really pushing for a VBAC), and she agreed that it didn't look good. so, we did the c/s. it went perfectly (both of mine did) and i was home within 48 hours. poor DD had torticollis from her bad positioning (her head was tilted to the right for months there in utero, ear to shoulder, and we had to do physical therapy for almost a year).

anyway, i also didn't forsee myself opting for a repeat c at the beginning of the pregnancy or before it, but it truly felt like the right decision. but, since it's not a decision you can make until the end of the pregnancy, i wouldn't focus too much on "deciding" right now.

oh, and i saw someone else said something about bonding and experience being different (better? i thought that was the implication) after their VBAC, and i wanted to say that there's no reason that the method of delivery should affect bonding. i was worried that just walking into a c/s cold would be a "less than" kind of birth experience, but wow was i mistaken. it was like birth stripped of everything but the pure joy and miracle of life--there was no me and my achievement like i had envisioned for my VBAC, but what happened was something so much better. just pure joy, like heaven touched earth. so don't worry about that part!

[Storm Bride]

Originally Posted by majormajor

oh, and i saw someone else said something about bonding and experience being different (better? i thought that was the implication) after their VBAC, and i wanted to say that there's no reason that the method of delivery should affect bonding. i was worried that just walking into a c/s cold would be a "less than" kind of birth experience, but wow was i mistaken. it was like birth stripped of everything but the pure joy and miracle of life--there was no me and my achievement like i had envisioned for my VBAC, but what happened was something so much better. just pure joy, like heaven touched earth. so don't worry about that part!

It is something to think about, though. It's different for everybody. My scheduled sections, except the last, were pure hell on the bonding front. It sucked.

OP: You just have to do what's right for you. I honestly can't begin to wrap my brain around scheduling a section to feel more in control (I've never felt less in control in my life!) or to minimize my hospital stay (as I could have left the hospital more quickly every time if I hadn't had surgery). But, just because those particular reasons don't click for me doesn't mean they don't work for you.

Wishing you the best, no matter what you decide.

[moaningminny]

I have absolutely been there. I wanted a TOL right up until week 36, and after doing a lot of research, going to VBAC classes and really searching my soul I decided on the repeat c-section. My first emergency section (under a general anesthetic at 31 weeks) was so traumatizing for me that the thought of having to undergo another emergency c-section the same way terrified me. I spent a lot of sleepless nights crying about the decision, but in the end I'm happy with how it all turned out.

I really, really struggled with my decision. I mentally knew that a VBAC was a wonderful option for me, but I felt so out of control the last time that I felt that having a repeat scheduled would make me feel more in control, so I totally understand the control factor.

I'm very sad that I wasn't able to hold my babies on my bare chest right after their birth, and I'm very sad that I'll never experience labour but I've come to terms with the fact that for me, it wasn't meant to happen. Although it does make me sad, I don't regret the decision I made second time around.

My recovery was much better with my second, partly because I didn't have to have a general anesthetic. I was able to be there for my child's birth, and we were able to videotape it when she came out so I can actually see her entering the world.

It sounds like you're making a very educated decision, and whatever it ends up being you'll be fine. I wish you luck.

[lunaleau]

I too had planned a homebirth for my first, transferred and had a C. 39 hours of labor, every intervention in the book. With my second I knew I wanted to vbac but at 35 weeks I flipped out. I was so torn about how I feeling. I was scared! I scared of the birth, scared of a transfer ( I ended up planning a homebirth again long story not necessary here). I think it is really normal. Of course you can only do what is right for you but I will throw out my super vbac support because that is just me, take it or leave it! 1. Last time you got to pushing, there is no reason to think this time since your body has labored, dilated, etc that you cannot do that again and in all likelihood you will be more like those 2nd time moms. 2. Control, I hate to say it, but we never have it. In planned surgery, in birth. For me- and I say this not knowing you at all- I had to let go, because even if I walked in and asked for a c-section I had no control over how that would go. 3. For what it is worth, it is safer to vbac.

One of the things my husband said to me over and over during my big freakout was really important. I would cry "what if I can't!" "what if I get another C?" " what if I die?" and it would go on and on. he would always answer, " what if you didn't? What if you just had the baby?" And thats what happened. I have seen women vbac at home, at the hospital, with and without interventions, the weird thing is most of the time it just happens! I think that is what is so insidious about a primary c-section is that it plants this idea that deep within us something is wrong with us and our bodies. From the sounds of it, you just had a hitch, you labor, progress and push, you just need the baby to come out, you have done it all before there is no reason you can't do it again.

Ok, long pro vbac tirade over. If you do have a C. Make a plan, have it be as positive as possible, play soothing music during the surgery, have your baby skin to skin. Know that you can only do the best in the moment and find peace. I send you hugs and faith

[wombatclay]

Big hugs and hopes that you find the balance you need.

I've had two vbacs after a natural birth experience that tumbled through the eventual cascade into a c/s. I had PPD after that surgical birth and was scared silly of a rc/s. And even so, I found myself thinking more and more about scheduling... I just couldn't bear the thought of trying so hard again and "failing" again.

I had an OB team for my second pregnancy and they were 110% gung ho natural birth pro vbac. I talked with them about my fears, and they had a lot of wonderful suggestions. One of which was that a c/s could be done at any time and there was no need to schedule one. I could always wait till contractions began and then play it by ear from there. So they suggested making a detailed c/s birth plan and deciding for myself when I'd shift from vbac to rc/s (my first labor was looooooong and I stalled at 7cm for 19hrs, with huge tidal wave contractions so my personal list included things like "if I stall for more than 4 hours, despite contractions during active labor, I want a rc/s").

My first vbac was wonderful, but I had some serious physical trauma. Enough that I was told by several specialists that I should plan c/s for any future births. So when I got pregnant with ds my 'birth option stress" went through the roof. I was scared silly of causing more damage to my body. But like Storm Bride can tell you... a rc/s is no certainty that there wont be physical damage. So I found a midwife/OB team willing to attend a vbac despite my history of shoulder dystocia, 4th degree tear, pelvic organ prolapse. And I wrote an even more specific list of "when to call for rc/s" that I discussed with my care providers, my doula, and my dh. And I had another vbac, this time with no additional physical damage! I was thrilled, but also aware of how much luck is involved in birth.

Anyway, give yourself permission to "try on" all sorts of birth scenarios and see how you feel in each picture. Talk with your provider, with women at ICAN, with local doulas. Try on best case as well as worst case scenarios for all the options... from easy vaginal birth to complicated vaginal birth, from textbook c/s to surgical complications. Which ones make you feel the best, which ones can you accept? Try programs like hypnobabies, tapping, meditation, journaling to work through the emotions/hopes/fears.

And good luck! I hope you have an amazing birth. no matter what shape it takes.

[fwlady]

Your post really resounded with me. I could have written your post, and I have already had SIX VBACs. I have NEVER had doubts about VBAC, until THIS PG, even from my first one. But, there are so many different things that have gone on this pregnancy than ANY of the others. I have had 7 "uneventful" pregnancies. The first one was fine until 38 wks, when they discovered I had high BP, and possibly pre-e developing. That was when pre-e was on every OBs radar because it was new and unpredictable. I didn't have pre-e, but PIH, although it didn't matter at the time. It went from home bedrest, to hospital bedrest, induction, baby stress, to csection. To baby with sugar issues and a 5 day stay.

The 2nd-7th children were all VBACs. Some were unattended homebirths with and without transfers. The transfers after were always for me. There was one that was transfer before for PROM and meconium. That one was a hospital birth in the end, that went perfect. The babies were all very healthy. My labors ranged from 19 hrs down to 4 hrs start to finish. Some had prodromal labor. Not in that order.

This PG has been riddled with issues; another lost twin (the last PG had a lost twin confirmed after birth), PROM at 20 wks that resealed, and BP creeping up. Now, I am on FULL bedrest at home and was in the hospital for that. I have been 10-26 days overdue with most of my VBAC babies. That is normal for me. Probably the only reason they let me out to come home and wait for labor to hit.

There have been many moments that I have considered a repeat section for this one. I asked my DH about scheduling a RCS and tying my tubes while they are in there. He knew I was just being hormonal. I know the control factor is the biggie. My DH is a trucker and does overnights twice a week. What if he wasn't here (again). He missed my first VBAC, his first DD's birth. He has been at all the others, even if he was just sleeping or taking care of the other kids in the other room. I have had other friends here when I have birthed at times. Other times, the dr did the assisting, obviously. I don't want to go into labor, and it can go fast for me once I realize it isn't false labor afterall, and not have him available. I am not close to a hospital, and I have hemmoraged after some of my births for various reasons. The last one was a fiasco. The last one, I also lost a twin, and this one. So, there are just so many variables.

So, I really did consider a RCS. I can control the PPH thing. I could have my DH home. I considered an induction, but most don't induce VBACs, and I have never been before, so I think it would be risky for me. My scar hasn't proven itself under those circumstances.

The last baby has had health problems since 4 mos old, and I was so scared this one would too, so we did a 20 wk U/S to check her out. I don't normally do that. I have switched care providers when I was told RCS was my only option at 39 wks, and had to go to a stranger hospital when I realized that my BP was getting out of control. Now I am on complete bedrest. We have been given options, and the dr wasn't even the one that suggested an RCS. He wanted to induce, I would rather RCS instead. I got to go home to wait amazingly.

This has been a real roller coaster ride. And, even though I could usually expect an uneventful PG and birth, that didn't happen this time. I have resigned myself that this is just the way it is. What did end up happening, is that the bargain I made with the dr was that my DH would be here to take me in at a drop of the hat for certain things, that we were monitoring at the hospital. We have to monitor these things at home. I could have had that RCS on Thurs, and it was scheduled, per our plan. But, then we were doing so well, that it wasn't medically indicated. I was very open to it, because I had been considering it most of my PG. But, then when I read the paper on the Csection recovery, I decided that I better avoid that. And, I have even wanted an epi for this one, because I have to labor in bed. I have NEVER done that. And, although my active labor may be short, there are no guarantees, and I have had 2 very long painful labors. The shorter ones are still very painful, just shorter. One just doesn't forget the pain after #6!!

I felt like I was in control at the hospital. The drs were being very reasonable. The 2nd dr wasn't willing to induce, but I had already decided I wasn't either. The 3rd dr wanted me to stay, but my doc had already released me the day before (and I had to stay because my DH's job messed things up). She may have induced, I think. I am ok, IF I stay in bed, and the baby looks great. No reason to evict her yet. IF I need a csection, I am more open to it than I ever have been before. But, it is a journey.

Take your journey one day at a time if need be. Keep moving forward. Address your fears. Read "Silent Knife" by Nancy Cohen. The best book ever. Read it more than once. Take lots of baths. Don't worry about going overdue, because you probably will, and that is okay. Just relax. VBAC is safer and you will get back to your DD quicker. You may get to the hospital ready to push and be amazed after and wonder why you worried so much. Kymberli

[lotus.blossom]

Just wanted to weigh in on your dilemma.....
My first c/s was a birth center- failure to progress. Stuck at 6cm- transfer, had some interventions, and ended up with decels. So I felt that I still had a good chance for a vbac at home with a midwife and NO interventions. My hbac labor was awesome. Intense but short and manageable, BUT when I got to the pushing phase I was stuck there for 5 hours with no progress. Transfer and c/s. My babes come down posterior and get stuck at my pelvic arch. There was NO WAY he was coming out the way he was positioned. Considering I have had 2 posterior acynclitic babies even with the utmost care in positioning and regular chiropractic adjustments till the end, I am coming to terms with the fact that I'll probably never vbac.

I see your concerns considering the fact that you pushed for so long. Now that I have had the "trial of pushing" (<--my own term) my mind is changed about my potential for vbac. That being said, you still have only one c/s under your belt. It certainly can't hurt to try for a VBAC even if you end up with a c/s. Something might be different this time around. Who knows!?

There is still a little piece of my heart that would want to try again for a VBA2C if I got pregnant with a third. Its hard to quell that desire for a normal birth.

Oh and I agree with the PP's that said a c/s will be hard on your daughter for at least 6 weeks. I wasn't able to be the mother I wanted to be to my ds1. Fortunately I had a lot of help from my mother. She really filled in for me.

[lyterae]

We haven't begun TTC for baby #2 yet, my daughter was intended as a natural birth and our end result was a c-section (3+ hours of pushing with no progress, she was ROT). The first time around I had no doubts I could do it, now I worry.. Do I want to go through labor and pushing just to end up with another c-section?

I don't think there's anything wrong with making an informed decision based on your needs and your families.

[BetsyS]

I had parameters in my mind about going for a VBAC. I wanted to labor spontaneously (no induction), not past 42 weeks, and I wanted labor to be fairly straight-forward (the first time, I stayed at 9.5 cm for over 10 hours).

When I didn't go into labor by 42 weeks, I scheduled a ERCS. I'm happy with that choice. I felt that I had some control over it.