Decisions to make for baby #3

[Clover Honey]

Hello,

This has been weighing heavily on my mind and I hope to get any advice anyone may have.  

My first was born via c-section after becoming lodged in the birth canal (24 hrs of labor, 3 hours pushing, they had to pull her out of my pelvis during the c-section), after which I suffered PTSD and PPD (incl. breastfeeding related trauma, most likely due to sensory problem with DD, and birth trauma).  I gathered myself and all of my strength and sought out formal therapy, attempted antidepressants and ultimately healed myself and proceeded to have baby #2, after much education and soul searching.

My second was born via unmedicated VBAC - an amazing experience but a difficult birth including 4th degree tear and lingering effects from that.  He is currently in OT and PT for developmental delay (gross and fine motor) and sensory processing problems.  He had feeding problems from the start, hypotonia, could not sit unsupported at 12 months etc etc.  He is doing well now, but still not walking at 19 months.  

My question is - and I can't believe that I"m even thinking about this because I am completely dedicated to my two children and I especially cannot imagine what the future holds for DS right now - but what in the world am I going to do if we have a third and final child?  It is clear that his sensory issues could have been triggered by the difficult birth; every therapist asks about it and the fact that he was completely healthy and seemingly typical at birth.  If my children are prone to sensory issues, and I have history of a 4h degree tear with continued complications after - should I choose another VBAC or repeat c-section?  My main concerns are the health of the baby and that I do not have a repeat tear.  I know that there are more complications associated with c-sections, and I also know that it is unlikely that I would have a repeat tear as severe - but both of my children have vestibular/sensory issues, and both of their noggins had too hard of a time passing through.  I have extreme guilt of course, but most of all want to do what's best.  Are there times when a surgical birth is best?

My heart is breaking over this, I guess I'm trying to figure out if I hurt my son even though I was trying to give him the gift of a gentle birth.  I'm not sure if I will have any more children, but I would be so sad to rule it out because of fear of another traumatic delivery or damage to either of us.  (although there are no guarantees, I feel like my decisions greatly influence the outcomes).

Thanks.

[lunarlady]

I am so sorry for your difficult births and the ongoing issues with both your children. The truth of the matter is that while birth trauma can certainly play a role in the development of mental and physical issues in children, it is usually impossible to know for sure. Yes, it could have been oxygen supply issues during labor, or other birth trauma, but it could be genetics, or toxin exposure, or hundreds of other things. Simply put, your children's issues are not your fault. You did your very best by them, and fought hard to give them the best birth possible.

That said, if I were you I would think carefully about a planned c-section if you decide to try for a third. Although it is major surgery, and not without serious risks, I think it would both set your mind at ease and allow you to avoid the "what ifs" that often plague us. It sounds like both of your births were fairly traumatic for you, although for different reasons, but maybe removing the element of chance from the equation would make you feel safer?

I hope time brings you peace and emotional healing.

[Clover Honey]

Thank you so much for your kind reply.  I suspect that you are right, and that I just need to let go of the anxiety.  I am such a believer in normal birth, and am in denial that I may need to take the road I try so hard to avoid.  I wonder what a more 'normal' postpartum period could be like - be that after a planned c-section or vaginal birthing.  So far, mine have been filled with hope but then dashed by years of sadness and full of guilt (and joy of course).  I think I've got to protect my integrity and that of my children, which probably includes swallowing my (guilty) pride and not even attempting the vbac.  After I let this go, and more time passes then I will be able to make the decision of whether to try for another baby with some kind of clarity.  Thanks again.

[Clover Honey]

Ah, oh dear.  I find myself still in the same position as my original post - and I am now happily pregnant with our 3rd baby.  I thought I could make this decision by now, but oscillating wildly back and forth.  I found an amazing birthing team who will fully support a vaginal birth, and move to a RCS if things are not progressing well or if the scar tissue is not looking good - but I feel like I need to tell them how uncomfortable I am about what happened with my son's birth and his neurological/sensory problems and the possibility that his issues may have been exasperated by that difficult birth.  I am also having fecal incontinence (minor, but as you can imagine still stressful and difficult to deal with), and so I feel that I have two reasons that are holding me back from another VBAC.  

But I could also have a wonderful birth this time - that I could walk away from comfortably!  This could be my big chance.  I"ll have to go over this until I feel better about it one way or the other.  If anyone would share what they might do, I would find that helpful.

As of now, the plan is to proceed with labor and see what happens, and the same birth team would move into a "gentle" RCS with no separation of baby and I and immediate skin to skin, etc.  My anxiety is through the roof.  Baby was already measuring large at a 13 week scan.  My son was over 9lbs, and I am 5' 3"... I could birth another baby his size, but if this baby is 10 lbs, that might be stressing my tissues too much.  

[Mom2M]

I typed out a reply yesterday and lost it. I think you should definitely talk to your care providers about your fears and what the risks/benefits are for you either way. Your birth can be wonderful whether it is a vaginal birth or c section. I'm a huge advocate for VBAC's but I can understand your fear, if I were looking at increased chances of fecal incontinence I would be freaking out. I know it is a terrible thing to live with and your quality of life after your baby is born is extremely important also.
I have had 2 c sections, 1 VBAC and 1 VBA2C. Since you asked for a wwyd answer...if I believed there would be a good chance of damaging my rectum, I would do a c section.

Good luck, I'll be thinking of you and the baby!