Scared to have another HBAC (not PG yet)

[JFTB1177]

So my HBAC baby just turned 1 last week. I don't know if anyone remembers me from last year, but I had my successful HBAC at 42 weeks and 5 days PG, 36+ hours of labor, pushed for 6 hours- yes 6! It was an extremely painful labor and difficult delivery... DS just wouldn't come out. My MW had to use all the tricks in her book to get him out, seems I have a "bump" on my pelvic bone as she had to push him under and out. In the end DS and I were totally healthy, and I had only 2 small tears. So was it successful? Yes! Was I happy I did it? Yes!

But I am scared to go through all of that again... seems I will always have difficult deliveries. The labor was so painful and I just remember screaming and screaming... DH is so traumatized by the experienced (although he did like catching DS and being the first to hold him) he doesn't want me to have another home birth. He is supportive of another VBAC, but in a hospital or birth center.

I am torn as I know with my difficult births the chances of another successful VBAC is greatest at home. But I too am scared to go through all that pain again. And I definitely do not want a RCS. <sigh>

And I am not even PG yet! Not even ttc! I would like to ttc #3 towards the end of the year.

Have any of you gone through something similiar?? Did you have a 2nd HBAC or VBAC?

[kathan12904]

I'm sorry to hear about your difficult birth. The one consolation I can give you is that no two births are alike and knowing how your body worked through the last one may help you with the next one. I am currently about a week overdue with my second hbac baby and am so tired of being pregnant that all of my anxieties about birth have evaporated in favor of almost constant frustration that I haven't done it already. I had a very nice hbac with my first and that still hasn't kept me from many moments of fear and angst over what hardships labor and birth might hold in store for me this time. After my son's birth I was so exhilirated by the experience that I couldn't wait to do it again, it was raising another baby that made me nervouse. All of that confidence has disappeared between then and now and I just don't want to deal with hard work and possible pain, even though I wouldn't have classified my last birth as painful. I think these fears and misgivings are a normal part of pregnancy, especially in our birth fear oriented culture and that you just have to work through them at your own pace. Try not to let your memories of the first time turn into monsters and try to remember all the things that make natural homebirth safer and more enjoyable than the hospital.

[cathicog]

Sorry you had a hard time. Hope your next one won't be quite so traumatic, however, if you were in a hospital, they would have NEVER waited to cut you open again. I think the reason you had a successful hb, is because you had a midwife who knew you could do it, even if it hurt. I am sure she would have transferred you if it were needed, but it wasn't. Birth sometimes DOES hurt. But how badly do you want to avoid future surgery, cuz your chances of a VBAC in a hospital these days is pretty low...they just don't want to wait for the baby to move down and around on his own. And the next birth might not be so painful...

[MNHall]

HUGS! I'm so sorry to hear that your HBAC was so difficult. But, you did it!!!!! I totally agree with the others, one, that no two births are alike. Granted, it seems like the pushing phase is more difficult for you, but now that you've had one baby pass through vaginally, "they say" it's easier the next time. At least that's what I'm hoping for, as the pushing phase is the difficult part for me too.

And like the other previous person said, in a hospital setting, you are often on a clock...of 2 hours! My c/s baby, I pushed for 2 hours and got a nice little speach from my OB. I "thought" I had no other option...that I had to have a c/s because I had been pushing for so long. With my VBAC baby, I had a different OB and when I got to the 90 minutes mark, intervention was mentioned and pushed. I gave in because I did not want to be cut...so, I totaled pushing for 2 1/2 hours...but this was after getting the epidural so the OB could turn my DD, getting an episiotomy, and using forceps. Not what i had planned, but these OB's have you on a clock from the minute you start pushing.

So...like mentioned, I think in a hospital, you will have to battle the clock a lot more. I am only TTC right now, but I have yet again changed OB's, because I do want to be in a hospital, so I have found an amazing provider that I KNOW had VBAC'd and even pushed for 4 hours with patients....when I met with him he said, "some women just have to push longer". So, if you are able to find a provider with an additude that you KNOW, 110% is supportive of someone that has to push longer and will not put you on the clock, that may be an option!

Anyway, the great thing is, you're already looking into your options and you're not pregnant...so you don't feel the pressure of sticking with your current provider because you are "too far along", ya know!

[AustinMom]

I would imagine that your second birth (vaginally) will be much easier. You were basically a first time mom giving birth with your previous HBAC. And sometimes, as a first timer going through the pushing stage especially, is really getting your body to understand what it is doing. The second time around, i'd say your body will remember what to do, and it would be much easier.

I do agree with the previous posts that if you were in a hospital, you would have had a c/s almost definitely. It would have taken a lot of advocacy on your part, and the OB would most likely not know all that the MW did.

[JFTB1177]

THANK YOU so much guys for all the support!!!

MnHall- did you have a OB or MW that lets women push for 4 hours in the hospital? What state are you in??

Do birth centers allow VBACs? I know here in MD they don't (they used to) but wondering if having had one vag birth changes my "status"?

Maybe you're right and the second HBAC wouldn't be as bad... I just remember screaming for drugs, I mean for hours. I mean I'm grateful I had the HBAC but it was so hard.

[MNHall]

MnHall- did you have a OB or MW that lets women push for 4 hours in the hospital? What state are you in??

It is an OB. However, he's a rare gem in this area, Louisiana. He will be my 3rd OB...and I know this time, I've found the best of the best when it comes to VBAC'ing and natural birthing OB's in a hospital.

The first OB is the one that c/s'd me just because I was pushing for 2 hours. The second is the one that did a LOT of interventions starting at the 90 minute point to get me my VBAC after 2 1/2 hours....I KNOW for a fact though, I was pushing the clock, BIG time!!!!

Anyone that I've come in contact with through a natural birthing group locally recommends him if you want to deliver in this hospital. He's the most VBAC and natural friendly OB there and much more like a MW, but he is an OB. I feel so lucky to have found him....finally!

I hope you can find someone you really trust and feel comfortable with!

[*Erin*]

your birth your choice, mama! you don't have to do an hbac if you don't want to. sounds like you had a heck of a time with your last one. both my babies were posterior, and i had a very painful and traumatic birth with my second- i didnt really begin to process thru it emotionally and mentally until he was about 1. that experience and the pain, definitely affected my choices for my next births. it may make you feel better about everything if you can get your midwife to go thru the birth with you, like a debriefing. talk about your fears and what you felt.

good luck to you whatever you decide to do

[shells_n_cheese]

Wow. I could have written you post! I really don't have any words of wisdom for you, I just wanted to let you know that I know how you feel 100%.

My second child was also an HBAC. We had a shoulder dystocia at the end (sounds like what you were describing) and my daughter was stuck for a while. We went through all the maneuvers used for SD, and nothing seemed to be working. When my daughter was finally pulled out, she wasn't breathing and needed CPR. After about a minute, she started to breathe... the longest minute of my life! Her right arm was also, limp and blue -- it was a brachial plexus injury, but thankfully has since resolved. It was a very traumatic experience, to say the least. It was NOT at all what I had hoped. The whole time planning for the birth, I was thinking about uterine rupture, not SD!

We are not pregnant yet (DD is just about 11 months) but plan to start TTC #3 sometime next year. ...And I am PETRIFIED of the birth. What the heck would I do? Another homebirth? Hospital? I am scared to death of another SD.

You aren't alone!

[cairomama]

As others have said, the second vaginal birth may be easier, but even if you have the same issues, if you use the same midwife, she knows your anatomy and may be able to help better next time.

Also, with the Pink Kit, you spend a lot of time exploring your anatomy and various suggestions to try to help baby through it. I haven't used it, yet for a birth, but a friend did and found it amazingly helpful.

Anyway, it looks promising. http://www.thepinkkit.com

One thing to think about is would you rather have another long labor that ends in VBAC or another c-section? There's no right answer to that. Your next labor might not be as hard but if it is and you are with the same midwife, you will be more likely to get the baby our yourself than if you are in the hospital.

[shruley]

Birth centers around here (and granted they are just opening) are really no different than a home birth, other than you're in someone else's home and probably closer to a hospital. They won't have any other interventions to offer you probably, so DH is probably thinking more of a hospital setting.

I cannot imagine a doctor allowing you as a VBAC to push that long. There may be a couple, but they will be few. My OB, who was awesome and pretty hardcore about VBACs, told me should couldn't let me push more than 2 or 2:30 hours. She's moved but we're still friends, and I know that she literally couldn't let me....hospital policy, malpractice, lots of reasons that her hands were tied. The hospital had been wanting to stop doing all VBACs (and pretty much ban them now, after she's left) and she knew to continue to be "allowed" to do them, she had to play by some rules, and letting a woman push for 6 hours would've been a no-no.

People are right in that no 2 births are the same...they are all so different. Only you can make the decision that if it all goes badly again, and the pain is bad and it's long....would you be ok with it ending in a c-section knowing you avoided the trauma and pain, or do you want a natural birth, in spite of the pain? I have no idea, but knowing about your anatomy now, is there a way use that info to help baby manuver better/faster next time? The pink kit may also be good. I'd talk with a midwife whose really experienced and good with positioning and ask their thoughts. Good luck on whatever you decide!

[TCA2008]

After two c-sections, I had a great homebirth - but it was very, very painful and intense. When I became pregnant with my fourth, I was absolutely dreading labor. I planned another homebirth. Actually, the closer I got to delivery, the more scared I got. I began seriously comtemplating going to the hospital and begging to be induced just so I could have an epidural this time. I actually posted about ways to reduce pain. I secured a TENS unit to help. I researched all the possible pain relief I could do at home - herbs, etc...
Well, my second homebirth ended up being much less painful than my first. One thing that helped was with my first homebirth VBAC, my baby was posterior. With my second, my midwife talked to me about how to turn the baby around - and this helped a lot. I also used a TENS unit, which at a minimum distracted me. And also, I think just having gone through it before made my body open easier, etc....so it was less painful.
I also remember the pain of recovering from my c-sections. I kept reminding myself I had to go through pain either now or later.
Chances are, your second one will be quicker and less painful, but of course, there is no way of knowing for sure.
You have to do what is right for you. Re-read all those birth preparation books, research other pain relief alternatives. You could certainly interview local OBs to see if they truly would be supportive of a hospital VBAC, which would allow you access to more pain relief options. Now that you've had a VBAC your chances of success are much greater, and the pushing time shouldn't be as long. Or you could plan a homebirth with as many additional pain coping techniques as possible, and perhaps make a plan for transfer after a certain point.
I understand the fear, I had it too. For me, I am glad I toughed it out and stayed at home again, it really was not as bad the second time.