worried about TOL ending in CS

[phaedra13]

Hi, all. Long-time lurker, first-time poster. I'm 23 weeks with baby #2. Planning for a VBAC. My fear is having TOL and then ending up with a c-section, safety wise. I'm looking for some stats on neonatal and maternal death when c-sections are emergency/unplanned/after a TOL verses when they are planned repeat cesarean. So I'm just wondering how much LESS safe it will be if my TOL ends in a repeat c-section than if I had just had a planned one. I have this idea in my head that a successful VBAC is the safest, followed by a planned c-section, followed by an unplanned one. Is this even right? For what it's worth, I'm not planning on having more children after this one, so multiple CS and then having another baby isn't really a concern for us. Thanks.

[WaitingForKiddos]

You are correct. A planned cesarean is 'safer' than one after a TOL when babe and mama might be facing additional issues. However, a vaginal birth, VBAC or otherwise, is safer than any cesarean. How much less safe is a cesarean after a TOL than one that's planned? I'm not sure there's a concrete answer to that. A planned cesarean involves pulling out a baby before there have been the hormonal benifits of labor and the general idea that babe is ready to be born. That planned 38 week birth might have been a 41 week birth if it was allowed to continue, KWIM? Then again, a planned cesarean removes the risks of labor, no mater how few. But then cesareans have their own set of dangers.

For me, I'll never have a cesarean without being in labor first unless there's a dire issue going on. I happened to go into labor the night before my planned cesarean (breech) and without a doubt, I think that those 7 hours of laboring made me and DS ready for birth.

I'm VBAC'ing as well this tiime around and I think there's a lot wrapped up in failing at it for one reason or another. For me, it really helps to focus on this pregnancy being different than my others and allowing this baby to be different. I don't HAVE to have another breech baby. You dont HAVE to have another _____ (whatever it was that ended up in a cesarean). I can let this baby just be born as it wants to be and I'm trying hard to listen to those needs.

 

[roadfamily6now]

What she said. :)

[phaedra13]

Oh, I would definitely never have a planned repeat CS before 40 weeks. I'd probably only consider doing one if I waited for early labor to begin and then had the CS after labor had started.

I think what's hardest for me, when thinking about my birth, is that there wasn't a clear "this happened, so I had a c-section" thing. So there's not any ONE thing I need to avoid. And that's nice, because I'm not living in fear of that one thing, but it's also hard because I had a birth where a series of several things led to a labor that didn't work and it really opened my eyes to just how unpredictable/out of control birth can be. I fear that happening again - not necessarily with the same factors (meconium, posterior presentation, cord around neck) - but just in general. I feel like there are so many factors outside of anyone's control. I didn't feel that way going into my first birth.

[WaitingForKiddos]

Ya, birth kinda' does that sometimes. I too had this picture in my mind what birth was. I couldn't have been more wrong. I wrote a post a few weeks ago asking how in the hell women 'trust birth'. The general answer : You don't. You just go with it becuase that's all you can do.