herpes and debating vbac or c-section?

[goodnight moon]

I am currently 35 weeks pregnant and planning a vbac. My first pregnancy 3 years ago ended in a scheduled c-section 2 days before my due date because I had an outbreak of genital herpes. I had started taking Valtrex at 36 weeks to suppress outbreaks and still got a very bad one that would not clear up. (I hate taking prescription meds and NEVER take them when I am not pregnant, so the fact that I took them and they didn't even work was pretty upsetting to me.)

This pregnancy I have been driving almost 2 hours to midwife appts in order to get my vbac (in my area all doctors would do an automatic repeat c-section). I really do not want another c-section but.... Now that I am 5 weeks away from my due date, I am starting to get SO worried about the possibility of passing herpes to my baby from shedding the virus. Almost every single week I feel the beginning symptoms of an outbreak coming on, and the symptoms last between 1-3 days and then go away on their own. I would think at these times (and possibly a few days before and after) I am actively shedding virus.... I am absolutely terrified that I will pass this virus to my baby. I got it from my husband when he had no symptoms, so he must have been having asymptomatic shedding? I have no faith in taking the antivirals for suppression of shedding the virus as they did not work for me last time. When I try to talk to my midwives about this, they are pretty non-responsive (their solution is to start the Valtrex earlier this time which makes no sense to me.) On top of that, any stress seems to bring on symptoms for me, so I am also concerned that labor would bring on these symptoms...

I have read a lot about this online and I know that the risks are low of passing this to baby (with recurrent herpes), but I also know that they are there...

I am so scared about this that I am now contemplating whether a repeat C-section would not be the most peaceful choice for me. I really do not want another c-section, and especially one that is unnecessary!! However, I have so much fear about the baby coming through the birth canal, that I have been told (by my friend who is a doula) that my fear may cause my labor to stop and I might end up with a C section anyway.... I cannot seem to get past this fear. I have tried hypnobabies and it did not help.

I am 5 weeks away from my due date and need to make a decision one way or the other. I do not want to make a decision out of fear. I also do not want to subject myself to a birth experience where the entire time I am scared to death that I will infect my baby with this virus and therefore cannot enjoy it. At this point, I am probably leaning more towards a c-section, because I feel more calm and at peace with this choice. At the same time, I feel so sad about the thought of another surgery and the experience that I would be again missing out on (and all the negatives that come with a c-section). I am struggling so much with this that it is taking away from my enjoyment of this pregnancy. I hate feeling so indecisive and I just want to make a choice, make my peace with it, and move forward to try to enjoy the rest of the pregnancy...

Sorry this is so long! I would love to hear others' experiences with this and if anyone has any support or thoughts either way.

[MamaMereMere]

Have you reached out to a local ICAN group?

[cinderella08]

Here are some links you may find helpful

http://www.globalherbalsupplies.com/herpes/women.html#facts_about_herpes_and_pregnancy

http://herpes-virus.org/pregnancy.htmhttp://www.marchofdimes.com/complications_herpes.html

http://www.marchofdimes.com/complications_herpes.html

[SAMarshall]

Maybe you could wait to make the decision until you go into labor? I mean, labor will most likely last several hours, and if you find that you do have an outbreak at that time, then go for the c-section. I don't know the details of what constitutes greater risk for passing herpes, but with all the research you have been doing, you do know. If you go into labor and the risks are too high, then call up the hospital and tell them the situation. If you're in labor and you're outbreak-free, then why not try for a vaginal birth? From what I understand, it might not be a decision that you can make 5 weeks in advance, you know? 

[MamaMereMere]

I think SAMarshall's suggestion is really great! 

[goodnight moon]

Thank you all so much for your thoughts, support, and links. They were all very helpful.

Samarshall- Thank you for your response! My concern is that even if I have no signs or symptoms of the virus at the time of labor, that I could still be shedding the virus (asymptomatic shedding) and therefore pass it to my baby even in the absence of a visible outbreak.
From what I have read, there is a 3% chance of this (silent infection/asymptomatic shedding) happening in a mother who has had the virus for some time. I do realize that is a small number, but my concern is that since I have been getting frequent symptoms, that I am shedding virus often. And another statistic that I have come across is that 50-70% of babies that contract neonatal herpes get it from a mother who does not have symptoms at the time of birth.
So I am not sure that I feel comfortable with a vaginal delivery even if I am outbreak free.... That is my dilemma. Otherwise I would definitely just wait and see if I had an outbreak at the onset of labor... But I am feeling nervous to deliver even without an outbreak. Hopefully that makes sense....

[goodnight moon]

And MamaMereMere- I have not spoken to anyone in my local ICAN group, although I have been on their website quite a bit. Maybe that would be a good next step for me if I am still struggling with this decision in the next few days. Thanks!!

[cinderella08]

Originally Posted by goodnight moon 

Thank you all so much for your thoughts, support, and links. They were all very helpful.

Samarshall- Thank you for your response! My concern is that even if I have no signs or symptoms of the virus at the time of labor, that I could still be shedding the virus (asymptomatic shedding) and therefore pass it to my baby even in the absence of a visible outbreak.
From what I have read, there is a 3% chance of this (silent infection/asymptomatic shedding) happening in a mother who has had the virus for some time. I do realize that is a small number, but my concern is that since I have been getting frequent symptoms, that I am shedding virus often. And another statistic that I have come across is that 50-70% of babies that contract neonatal herpes get it from a mother who does not have symptoms at the time of birth.
So I am not sure that I feel comfortable with a vaginal delivery even if I am outbreak free.... That is my dilemma. Otherwise I would definitely just wait and see if I had an outbreak at the onset of labor... But I am feeling nervous to deliver even without an outbreak. Hopefully that makes sense....

Like anything in life, if you are not 100% comfortable with something - then don't do it.  Something such as this is, in my opinion, a legitimate reason for a cesarean delivery.  If you want to go that route, that is fine!!!  There are so many things you can do to make a necessary cesarean section more enjoyable, and a better bonding experience for all involved.  I'm sure it must be a hard choice for sure, but just know that whatever choice you make - you must be 100% comfortable with it.
 

[SAMarshall]

I'm sorry you are being faced with such a tough decision. I'm sorry, too, that I can't be more help to you. Like others have said, just make sure you are comfortable with the decision you make so you won't have regrets. There is nothing wrong with having a c-section to protect your child.

The only things that come to mind are: You might take into consideration how many more children you would like to have. With me, I've already had 2 c-sections, and we plan on having at least 4 children, possibly more. So the thought of 4+ c-sections makes me lean harder toward a VBAC. But again, that's something for you to think about in your personal situation.

Also, would you be comfortable waiting until you show signs of labor before going through the c-section? A due date can be pretty off, and it might be a good idea to let the child choose his/her birthday. 

If planning a c-section, I know there are a few threads on here that talk about making the surgery as comfortable and enjoyable for you as possible. Surgery is no fun, I know, but you can take steps to make it more family-friendly. Best wishes for everything!

[goodnight moon]

cinderella and samarshall- thank you both for your support. It is definitely a very hard decision.

We aren't sure if we want two or three kids. We are planning on deciding whether or not we will have a third child in a few years. I would definitely prefer not to end up having three c-sections, so it is something to consider.

Again, I really appreciate all the support from everyone on here!