Would you ever not have a VBAC...as a plan?

[Lisa1970]

Let me start by saying, I have already had vbacs. I love vbacs and know they are lower risk than repeat csects. I have always had confidence going in to my vbacs. I have given up on vbacs in the past over stupid things, like change of policy....which was dumb I went along with it. But, regardless, I am planning my 4th vbac with this baby after multiple C's.

Anyway, things are different this time. I do not feel the confidence. I don't know what is wrong with me. I even have bad dreams about it. The confidence and all I used to feel, it is just not there. I am wondering if I should just have a csect and be done with it. I never wanted another csect, but I am so worried. I could understand being nervous about a vbac if one has never had one..but this would be my 4th. What is wrong with me?

[mtn.mama]

Have you meditated on it?  Our innersense knows what's best for us.  Do you have to make the decision right now?  Is it possible to just let things unfold and see how you feel later?

[~Amy~]

How far along are you in your pregnancy?  Have you had any testing/are you planning any testing?  My first inclination is to think that perhaps you will find out something along the way that will contraindicate a VBAC.  To answer your question, yes, I would plan to not have a VBAC if I had a strong feeling that a C would be safer, even if I had no hard evidence to prove that. It's important to respect our intuition as mothers, even if we don't know why we feel the way we do.

[Lisa1970]

I have done everything I have done before, from visualization on over. Even when I go to sleep to dream about it, I dream of disaster. Last night, before bed, I prayed even to have dreams of the birth. Instead, I dreamt of the birth and the baby dying. Then I woke up (as I do a lot) and went to the bathroom. Came back, went to bed and dreamt of a csect and a live baby. 

Things that are different this time...I am over 40. My age never bothered me before...but maybe that is an issue that I did not know about? The hospital I have to go to is awful. My first csect was there and they were nasty. That was almost 17 yrs ago. My AFI is high, but was normal at the last sonogram, so that has not been bothering me. But one more thing......I have had 1 girl and 6 boys so far. This is my LAST baby. And this is a girl. I know if anything happens wrong, I won't be getting pregnant again. Years ago, when I was younger, I felt invincible. Now, I don't. I don't know. Not like it has been a long long time. It is just...it feels so different this time. I am taking my herbs, visualizing, walking, eating right.....I am not with the chiropractor or massage therapist yet this pregnancy just because I have not had any issues. Usually, I have gone there by now too. The baby is head down already, dropped weeks ago. I practice relaxing every time I have a BH. 

Maybe it is just knowing this is the last baby? I don't know.

[mtn.mama]

When I look at the title of your post, I give an emphatic yes.  I would totally plan a Cesarean.  You know what's best.   Follow your intuition.  Don't try to force something that shouldn't be.

I'm the same age as you.  I don't have 7 kids and one on the way, but I'll be 41 at my EDD.  Starting a few days after conception I kept "seeing" cord problems, so I felt early on in this  pregnancy that a hospital birth might be necessary.  I'm completely resigned to doing what ever is safest for me and my babies.  Do I "want" a home birth?  Of course.  If I have  just one baby on board, and everything feels right in the moment, then that's what it will be.  If I have two babies gestating, I'm totally planning a hospital birth.  And if anything in my 36 week U/S looks scary for vaginal birth, I'm on board with a section.  Will I be disappointed if it ends in Cesarean?  Probably, but I'm going to plan a "backup" family based Cesarean anyway.  It will all be what it will be.  I want to stay open to the opportunities, yet go with the flow.  

You can do this.  Your heart will tell you what to choose.

[happyblessedmama]

I have a feeling "in my gut" that I should not pursue a VBAC. I only have one c-s but I'm leaning pretty heavily towards a repeat C (I'm expecting baby #7, c/s was baby #6). I also know someone who had multiple vbacs, and had a bad feeling during her next pregnancy. She ended up goign into labor, and had a rupture and an emergency c/s. She's very into "trust your gut" at this point. Anecdotal, and not to scare you - I'm going with my gut and hoping it's the right choice.

[LisaSedai]

I had my VBAC baby at 42 so I am pretty sure she's my last child and only girl . From what I read, VBACs are safer for the Mom, and RCS may be safer for the infant, so I looked at it like I don't want anything bad to happen to the baby but if something bad happens to me- what about the son I already have?

Are your bad vibes coming from having to deliver at a hostile hospital? What is your OB/MW telling you? Do they feel RCS is the way to go?

It's a tough choice, wish you peace and a happy delivery whichever way you go.

[jenninjapan]

I am sure you know all about the stats and safety of vbacs after multiple sections.  That said, there are worse things than a repeat section. I spent 2 years doing everything possible and spent a lot of energy fighting the system only to have a section anyway.  BUT the section was great.  I felt good and alert and was feeling physically wonderful only days after.  Schedule a section and back out if you change your mind, or go through with it....no one will think any less of you!  Follow YOUR heart and you wont have any regrets.

[Lisa1970]

Her story sounds like it could be mine. I had multiple vbacs and multiple csects. I never had a bad feeling about vbacs going in to any of those boths. The repeat csects were only because of the OB problems forcing csects on me. I never needed them.  I just keep worrying about a variety of problems. I just do not have the confidence this time I have had in the past.
 

Originally Posted by happyblessedmama 

I have a feeling "in my gut" that I should not pursue a VBAC. I only have one c-s but I'm leaning pretty heavily towards a repeat C (I'm expecting baby #7, c/s was baby #6). I also know someone who had multiple vbacs, and had a bad feeling during her next pregnancy. She ended up goign into labor, and had a rupture and an emergency c/s. She's very into "trust your gut" at this point. Anecdotal, and not to scare you - I'm going with my gut and hoping it's the right choice.

[dlm194]

One of the women from ICAN suggests trying on both (which it kind of sounds like you are doing).  Spent a week planning your RCS.  Then spent a week planning your VBAC.  See which one makes you more comfortable.  I agree in trusting your gut. I think it's important to be comfortable and secure in your birth decision (above planning a particular birth because you "should")

[linnea27]

I'm struggling with this as well. Before getting pregnant with this one, I had fully intended on my next babe being delivered via rcs. However, once becoming pregnant I began to feel that I should go for the vbac. The problem is, I'm not finding peace with any decision. I've "tried on" all three options- rcs, homebirth, and hospital vbac, but all I can see are the cons to each. Basically I think I'm hoping this baby will magically pop out of my belly when I'm sleeping and I won't have to birth it at all.

[Lisa1970]

I know how you feel. I wish the baby would come early enough that the decision is made for me. But..I am already at that point now. I am 38w2d. They would have done the RCS a couple days ago if I had wanted it. I don't know how I will handle it if I go past due.
 

Originally Posted by linnea27 

I'm struggling with this as well. Before getting pregnant with this one, I had fully intended on my next babe being delivered via rcs. However, once becoming pregnant I began to feel that I should go for the vbac. The problem is, I'm not finding peace with any decision. I've "tried on" all three options- rcs, homebirth, and hospital vbac, but all I can see are the cons to each. Basically I think I'm hoping this baby will magically pop out of my belly when I'm sleeping and I won't have to birth it at all.

[happyblessedmama]

they schedule elective RCS at 38 weeks? I was told 39 (I'm barely in my 2nd trimester anyway)... and I am thinking about pushing that off anyway til 40w0d or something

[AlexisT]

For a while, the thinking was "37 weeks is term, so we can schedule it anytime between 37 and 39."

Two studies then showed the risk to early term babies (37 to 39 weeks) is higher. So there is a campaign, led by the March of Dimes, to delay induction and section until 39 weeks unless there is a specific medical indication. Many hospitals are now requiring their OBs to justify all planned deliveries before 39 weeks.

There are some wrinkles to this recommendation, though. History is not completely ignored. If you have a condition which means you should not labor, they will still schedule for 37 (possibly even earlier). Previous stillbirth/IUFD is still an indication for 37 week delivery. Many MFMs will still deliver women with a poor history of hypertension at 37, though mine will not if your pressure, NST and bloodwork are good.

My pressures are creeping but are still within normal range (everything else is fine)--my RCS has been scheduled for 39 weeks on the dot. OB would not schedule a day sooner unless my pressure goes over 140/90 (in which case, a single reading, given my history, will send me to the OR).

[cameragirl]

I am hoping for a VBAC, and preparing myself for one. However, I do have a condition that causes muscle rigidity and spasms. I know that if I am in the middle of a bad flare-up, a c-section would likely be the best option. You have to do what feels right for you. Trust yourself.

[AlexisT]

Also - I wound up scheduling this time. I went through this pregnancy knowing that a 37 week repeat was always very possible, and so I spent a long time getting over that. (There was a trial called HYPITAT that said that expectant management of gestational hypertension or mild preeclampsia was more risky than delivery past 37 weeks. As a chronic hypertensive with a history of severe pre-e, I knew I had a very high chance of having my BP rise before term and needing that delivery.) I was very, very lucky and my blood pressure has remained stable. However, it is creeping slightly, I am showing NO signs of being ready for labor anytime soon, and I'm just not sure I want to push my luck past 39.

My OB was great; as long as my BP behaved, it was entirely up to me. She always asked questions in an open ended way, she didn't push me to RCS unless my BP was high, in which case, she did not want me to labor. Ultimately, I felt like it was my decision and that made it okay.

[Arete]

I certainly wouldn't want to advise anyone to go against her gut or intuition--I just wanted to say, regarding dreams, with DS, I had nine months of wonderful, mystical dreams of a beautiful waterbirth, and wound up with an extremely traumatic emergency c/s.  Next time, I think if I have bad dreams, I will take it as a GOOD sign, because I don't trust 'em anymore. 

[kltroy]

Ultimately you have to go with your gut I think.  But I think you'll know what the right answer is when it gets down to it. And remember that some of the challenges you face won't be changed by c/s vs. VBAC.  For example if you'll be at a crummy hospital, that's the case regardless of whether you VBAC or have a c/s, right?  In any case, you basically have until the last minute to make your choice - I can't imagine that anyone would say to you, if you walked into the hospital in early labor and asked for a RCS, that no, you should just vaginally birth this one.  Similarly, you could just pick a day (like, say, 40 or 41 weeks) and schedule the RCS, figuring that if you go into labor before then it was simply meant to be. 

A decision to VBAC vs. schedule a c-section is very personal, and there are a lot of intangible risks and benefits that go well beyond your and your baby's immediate health risks.  Best of luck - I wish you a peaceful birth.