Am considering a scheduled c-section

[ladylee]

This is a support only thread, please. I'm not interested in debating whether I should try for a VBAC or not, and don't feel I need to be "saved" from possibly going with a c-section. I'm interested in discussing the means of making this an empowered choice with others who have done same or are considering same.

As I've been contemplating another child, I've been exploring all birth options. Among them is planning to have a c-section outright. I feel no burning desire to prove myself by having a VBAC--and am contemplating a planned C because in a way it would be a more proactive choice than attempting VBAC and taking the chance of having to go w/surgery at the last minute.

This is what I'm contemplating today--not necessarily what will end up happening. For myself, I find it to be most productive to be prepared for any and all outcomes--this is part of my process I suppose. Does anyone have similar thoughts or experiences?

[sarahmae1]

Hi. I'm pretty new here, and I'm considering a scheduled c-section - but I'm also considering VBAC. I'm not even pg yet, just starting ttc... but I've just begun researching my options.
I really have decided anything at all yet, still pretty confused on what is the right option for me.
I had a emergency c-section w/ my ds and was put under, so I think that if I do decide to do the repeat c-section this time it will be at least better in that I will get to be awake for the surgery.
Anyways, just wanted to say that yes, I'm considering sechduling a repeat c-section, so I can relate.

[PumpkinSeeds]

Well, the good news is that you get to decide. No one else. I think in the end you have to do what works for you.

[LiamnEmma]

Lee, I initially intended to VBAC dd, but in the end, things occurred that made us schedule a c-section the day before her birth. She turned breech suddenly--I mean, in the middle of the night, heaved herself on up and threw herself sideways, making me sit up out of a deep sleep and cry out in pain--and DH and I decided to take that as a sign. We knew we could have attempted a version, but we really felt it was a sign we needed to heed...that she knew something we didn't. And as it turned out, her umbilical cord was exceedingly short, less than 12 inches long, and her placenta was attached to the top of my uterus, making everybody in the surgical room believe that a vaginal birth might have proved catastrophic (here I go defending my c-section birth again : almost impossible to avoid, isn't it?).

Anyhoo, what I wanted to comment on to you was the complete difference in dd's birth vs. ds's birth. ds's birth was under general anesthesia, with all the issues attending that. It was scary, there were bonding issues, you name it. dd's birth happened first thing in the morning--this was important because it meant dh could go home that night and be with ds because we felt he'd fare better ultimately--and there was an air of celebration in the air...this was a BIRTH day afterall...not a sense of urgency and fear. That was very nice. Of course, I still had time in the recovery room, away from dd, but for me, just being awake was a huge improvement! lol Plus, I knew dh was with her and guarding against pacifiers and formula. I missed her, but it wasn't long before she was nestled in with me, nursing away, and she never left my hospital bed again for those few days.

I know what you mean about wanting to think this part through, and I was initially very sad about it happening when I realized she'd turned breech and sought advice from friends who'd had multiple sections. OTOH, the very difficult thing afterward was not having the ability to pick up ds for a couple of weeks. Because he was only 21 months old at the time, it was difficult to explain this to him, and of course, adding a sibling into the mix was even more difficult but we all lived through it and he seems to like her and me so I guess he's unscathed.

Good luck with your ultimate decision. I'll support you.

[dlb]

Hey Ladylee-- I just posted in the c-section only mama's thread, in case you would like to hear my story.

I had two emergency sections, and two planned. I felt so empowered by the planned ones, because they were absolutely my choice, and I was able to state my preferences ahead of time. I was absolutely at peace with the course I was on, and able to choose the doctor, hospital, and to have the screen lowered to watch the birth, and hold my babes immeadiately. No pain, just expectation, not too tired--able to cary on with mothering.


The planned c-sections were truely less painful--must be scar tissue perhaps, or the fact that I was not regretting the loss of a vaginal birth, or already exhausted from a fruitless labor. My third baby did, however, have some initial breathing difficulty, but he was three weeks early in a high-risk pregnancy, and I had been on bed rest and anti-labor drugs throughout. I was maxed out on those, his amnio said the lungs were mature, he weighed 8 14 at 37 weeks. maybe it was still to early, but he was having trouble in the pregnancy, and his problems resolved after a few hours.

With the second planned c-sec, I went to almost the full fourty weeks, and had had some contractions prior to the delivery. He had no breathing trouble at all, so perhaps planning for a later delivery, if possible, would make a difference in the baby's outcome. Just one issue to look out for.

In any case, I called my planned c-sections my birth parties. I truely enjoyed them. Listen to your own heart, your own body, do your own research, and be empowered.


dlb

[kama'aina mama]

I am curious. Must a planned C-Birth always be a scheduled one? I can certainly see the convenience of it but I worry about how early they do them sometimes. I mean, yeah, 38 weeks is almost full term (and may technically be by medical definition) but I just think it is better, if at all possible, to let the baby tell you when s/he is ready to be born. Is this the kind of request that just makes doctors roll their eyes? Am I naive to think it would be worth the struggle?

[LiamnEmma]

I know what you mean kama'aina mama. I was at 41 weeks for my dd's planned birth, and I could feel that morning that I was beginning labor, and in fact several nurses asked me if I was feeling all the contractions I was having before the surgery. I was thinking after I posted Lee, that it might be something you want to consider too. I know some people are able to convince their doctors to wait until they begin labor for the c-section. Makes them feel more like the baby chose the day of birth, rather than the parents. I don't know if that's important to you or not. Again, good luck with your decision!

[ladylee]

Thank you so much to everyone who shared here--I've been reading but haven't had time to respond, and only have a second now. But thank you--all of the things everyone has said are very, very helpful, and I'll be back tomorrow--thanks again...

[zombiemommie]

I guess I wanted to say that even tho I *am* heartily planning on a VBAC, I do have my "backup" plan and altho it isn't a scheduled c/s per se, I do have a crystal clear realization that I could well wind up with a c/s, and what am I going to do about it, and also what things about labor/pregnancy would it be "okay" for me to go for a scheduled c/s.

For example, I have a history of genital herpes. Totally not active for years and years, but it *could* happen. And then I would have to have a section. So that is always there. And I am okay with that.

Then, there is the pre-eclampsia. I had pre-eclampsia last time, which led to my induction, and to my c/section. I do not want that experience again. I think if I did develop pre-eclampsia again and it could not be controlled or managed conservatively in order for me to go into labor on my own, I *would* be okay with a c/s, and would most likely be the one suggesting it, over an induction because #1 I am not comfortable with VBAC induction, and #2, the meds I had to take for the pre-eclampsia made me so sick I'd rather have a c/s than take those meds.

Then there is the breech thing. Last time, my ds was in the vertex position from like 24 weeks and never moved and stayed there and liked it very much. This baby, at 30 weeks, is transverse half the day, and then vertex the other half, and then who knows where in between. I have a flipper. I am fully prepared that if I had a breech presentation, I will not have a version, because I am of the mindset that maybe there is a reason why (short cord, placenta problem, whatever) and I have to take it as a sign. I would try Wbester technique and other stuff, but not physically force baby to vertex. I would go to 40 weeks, I'd want to wait until labor started so I know baby is ready, but I would have the c/s.

I will not be induced. At all. Maybe augmented a little bit with Pit, dependign on the situation. But if it comes to induction vs. c/s, I go c/s.

As far as trial of labor goes or whatever, I never had a labor, I never had a chance. I have an "untried pelvis" and personally, I'd like to give it a try KWIM because I believe I can do it. But I'm not out to "prove" that I can, I just don't want a c/section again because it is alot of work with a toddler at home, no support and a nursing baby. I don't want to be cut open again, and I don't want to lose the opportunity to ever have a vaginal birth again, because if I have another c/s, likely any other birth will be by c/s. So altho I am not itching per-se to birth vaginally, I still mourn the idea that I may never get the chance, does that make sense ? I want to do whatever is best for my body and for me, and for me, right now, that is to VBAC with my "contingency plans".

I hope something I have said is helpful, I am not an "all or nothing" VBAC person, I have taken 7 months to come to this place where I feel I am comfortable, I know what I will/wont do, where I need to be for my MIND too. I hope that you can find that place. It is so hard to deal with all of this, and then be pregnant and hormonal at the same time. I think ANY choice you make will be an "empowered" one, because you are the one doing the deciding and you are the one taking your birth into your own hands. Of course, if you choose to schedule it is the best for you, and nobody knows better than you what is the best, KWIM ? No author, no friend/advisor/whoever. Just you. It is your body, and you know your body/mind/spirit better than anyone. You have to trust yourself to make the best decision for you, and by exploring every option, you are allowing your mind/self/spirit to touch every option, you are giving yourself the power to make your decision . Does that make sense or sound too "hokey". LOL.

((((Hugs)))) my heart is with you on this journey. I have been more affected spiritually and emotionally on this pregnancy by this whole VBAC dilemma journey and I think most of it is dealing with my "self" and learning to take control, but at the same time, give up some control, and it is very very hard.

Whatever happened to the stork !!?!? Things would certainly be easier ROFLMAO

[ladylee]

Julie, it would be a lot easier, wouldn't it? :LOL Best of luck to you!

Okay, back again after much reflection on everyone's thoughts. I appreciate everyone making it safe to talk about this. LiamNEmma and dlb your stories were very uplifting, thank you. And yes, kama--an excellent point. That is what I meant by saying "scheduled" I guess--just intending to have one from the beginning. I *would* want to wait until labor for the whole day of birth issue. These are all things I need to look into, obviously.

I spent a lot of time over the weekend reflecting on this and some feelings that came up for me were how if I were to try for a VBAC I would almost feel that the birth would be too much about that than the birth of the child itself. Of course I'm in control of how much I decide to make it *be* about that--but still, there is a lot of pressure and extra baggage that goes along with it--particularly if it turns into a battle with a resistant medical community or certain options are not available. Sigh. Such an incredible leap of faith, this. Anyway, I'm processing along here and really, really appreciate everyone taking the time to respond.

[zombiemommie]

I just wanted to add something about what you said in your last post that if you try for the VBAC being worried that the birth would be more about that then the birth of the child itself.

I wanted to say that I was pretty much obsessed with VBAC for the 2 years after my c-section, and then worried sick about it the first few months of my pregnancy. Actually, I am almost done with the Bradley classes and due in early February, a little less than 10 weeks to go, and last week in class we talked about c-sections, and I realized how long it had been since my focus was actually on the *VBAC*, it has lately been more on having a natural non-medicated birth, and I made the comment to my doula that for a few weeks at least, I had FORGOTTEN all about the VBAC ! (It was like, oh YEAH, I totally forgot about the VBAC part of this whole thing LOL) What a GREAT FEELING ! I've been reading "Spiritual Midwifery" lately and really revelling in the capacity of the human body, and how cool birth itself can be, and how awesome little babies are and reflecting on things like nursing and teeny fingers and toes. And, I've been more focused on keeping my body healthy and on my relaxation techniques and my little flippin' wanna-be breech babe (who is today, thankfully, head down again LOL) than even thinking about the VBAC. I think that alot has to do with the caregivers and the environment I have found myself luckily to be in, either that or somethign/someone has intervened and helped me "let go" from above

But I wanted to share that, because in the beginning, that was ALL it was about for me (you remember my thread on letting go and trusting your caregivers? back a few months ago ... how much battle would be necessary with the hospital, with my CNM's, with everybody/everything, would the hospital even be DOING VBAC by the time it came time for me, etc). Now that I have gotten the answers to my questions, and worked through many issues, this pregnancy/upcoming birth is more about me, and the process, and the baby. And like I said in my prior post, I understand and ACCEPT that the process and birth may not be a VBAC, and that has helped enormously too.

Have you thought of actually making a "date" for the c/s, like scheduling it anyway, whether you do a VBAC or not, so that it is done, over and out in the open, and then working backwards (I mean, you can always change your mind but maybe actually DOING it would make it less of a weight on your shoulders...) just a thought.

[ladylee]

julie, it is so wonderful to hear how far you've come in your process .

[Sherricp]

I wonder if you would find it helpful to start writing out a birth plan for both the c-section itself and what comes afterwards. I'm still piecing things together, but I'm finding it helpful to talk about what I want and learning about how to get it. If you have a choice of hospitals or aren't yet firm in your care provider, it can also be helpful in making decisions.

There are a lot of choices about anaesthesia before and meds after, whether the baby. if all is well, gets brought right to you after a very minimal observation, goes to a nursery, or spends time in an incubator and is brought to you after stiches are done (all are possible). Can you do complete rooming in after a c-section? Does someone have to stay with you? How long do you want to stay in the hospital? What can you eat? If you did or did not have problems with nausea last time, this gives you important information, too. You may want nausea meds with the others before surgery. Or you may want to have exactly what you had last time.

Planning beforehand, even for people who are going the VBAC route, can help you get a lot more of what you want. For example, I want to go home early. I have great care at home and went home 24 hours after my c-section. I've talked to a lot of local women who said 48 hours was the earliest and the hospital gave them much grief for it. My midwife, however, said that it is unusual but that since I do make a good case for going home early, I might be able to get that pre-approved.

Good luck with your plans and decisions!

[ladylee]

Great advice, thank you, Sherri!

[bec]

Hi! I just wanted to make a quick reply to the suggestion of waiting for labor to start. Waiting for the baby to tell you he/she is ready. The onset of labor releases a last minute dose of hormones that help the lungs get ready to breath air. That's one of the reasons c/s babies often have breathing problems.

I don't know if a doctor would be amenable to planning a c/s this way, but it is worth asking the question.

I think the most important thing for you to do, though, is to be informed about your decision, and your possibilities. Read as much as you can about the drugs, scheduling, etc. Know your options. Then you can feel like you are making an informed decision that is best for you and your baby.


Bec

[applejuice]

Even tho I had my 4 at home, I always had a plan of action if there was a c-sec in my future.

There are no guarantees in life.

Semper Paratus

[MelissaEvans]

When I had my li'l guy c/s, we went through 30 hours of labor first, 3 of hard pushing, but the kid just didn't budge. His poor head was so coned! When I was thinking out loud to one of the nurses in the nursery about VBAC, she mentioned that she had all of hers c/s. She said she'd rather have the pain than the baby. It kinda made sense. I haven't figured out what I want yet for #2, but that's a ways away. Good luck with yours!

~Melissa

[phoebekate]

with regards to "scheduling" a c/s for whenever you go into labour - plain and simple they cannot make you turn up to be cut before you are ready! There are some situations where I would agree it is medically dangerous to wait to go into labour and it really is better to be sure you will get that baby safely born before labour starts. But I think that those cases are pretty rare and we were very clear with our carers when discussing our birth plan that if something should occur before my due date that made us agree a planned c/s was necessary that we would still be waiting for labour. If your Dr really needs to set a date then set it for 41.5 - 42 weeks, if you go into labour before then they just have to move it up :-), if not then it is probably appropriate to just go ahead with it by then anyway.

One of my girlfriends had a nice agreement with her OB for her second - that if she went into labour by her due date then it would be a VBAC and after that they would schedule a c/s. She ended up with a c/s at about 41 weeks with no sign of labour. This isn't what I would do but it worked really well for her and she had a number of issues I don't - historically DC1 was c/s at 2 weeks over due, 11lbs, and clearly over cooked with no sign of labour. DC2 was also clearly very large and had a pre-diagnosed kidney defect so there were concerns about a long/difficult labour when she might need surgery in her first days/weeks.

my point is that there are a number of ways to approach definitely or probably having a c/s that don't require booking in at 38 weeks, and if your carer seems determined to book you in early for spurious reasons I would simply make it clear that you won't be turning up then unless you are in labour.

[kaje62]

I am also thinking of scheduling a c-section this time. I am also looking at VBAC. I am heavy, 40 and my first was breech. I am so afraid of losing the baby that VBAC scares me.

[tarablesue]

I have had 2 C/s and no vaginal births

The first was after 32 hours of labor,and ended with my dd haveing difficulty breathing,I didn't get to hold her,or nurse her for over a day. Heck, I didn't get to nurse for 2 weeks actually,...but my second c-section was scheduled and I still feel guilty about it. It was much better than the first, baby came out great, I got to room-in right away, nurse the whole bit.
But I feel like I was selfish the second time. I had ultrasounds to measure babys weight, ( I will never do this again!) and found out my baby was 10lbs. 10oz. at 40 weeks. I got scared! I cried because I didn't know what to do. I wanted a vaginal birth so much, but I was afraid of failure. So I scheduled the c/s, out of that fear,because baby was "so big". AND indeed she was! (11lbs. 6 oz.)
But I think all the time, could I have birthed her vaginally? (yes, I know I could have,this is my thought not intended to push toward VBAC)) I was very huge,and miserable,and in the end had pre-eclampsia again! So I think my miserable state,empowered me...and that is why I chosse the section.
I plan on having more children, not too soon, but I want to HAVE A VBAC! Or at least try:
Just know that you won't have any regrets before you make your decision. I do, and I can't go back on it now. I can only say "What if?"

I typed this very fast, now reading it it might not make much sense but it is honestly how I feel.
I hope you make the right decision....