C-Sec or vaginal delivery ?

[ktmelody]

WE just found out recently that my baby has IUGR. I will most likely be delivering around 32 weeks.
My question is about whether to have a c-section or vaginal delivery.
Of course if the baby is in distress at any of my BPP/NST appt. I just want her to be safe and would do the section.
My OB said that the peri's are very section happy and would rather do it that way, but he is the one that is "catching baby" and said that if there were no signs of stress on the baby that we could induce and go vaginally if the baby tolerates it.
How many of you mama's had your early babies vaginally?
I am of cousre worried about any damage being done to her, but I assume they are the same if not more risks to a section.
I have never had a section and this is my 5th baby. So I dont know what to expect and would prefer vaginal delivery.
Thanks!

[CallMeMommy]

I had my 31-weeker vaginally. I had PROM but no other problems, and he showed no signs of distress at all. He just wanted OUT!

[intorainbowz]

*

[ktmelody]

Well i posted before here about it.

I am having 2x a week BPP/NST
I go for another doppler and measurment scan in 2 weeks.
Baby has asymetrical IUGR. She was measuring 1 week behind on head and legs and 3 weeks behind on tummy. If she shows signs of slow or no growth then I will go to the hospital and get the steroids and deliver.
I am 29 weeks today.

I would love to try a vaginal, but i just dont want to cause her any harm....

[lindberg99]

It sounds like your OB is willing to try a vaginal birth so I think I would go with that.

I had a c-section with my 30 weeker but I was having a lot of bleeding and he was breech. The doctor ended up doing a vertical incision so then I had to have another c-section with my next baby, who was full term.

I don't know that many people who have had preemies but of the ones I know, the only ones who had c-sections were either having bleeding from an abruption or had had previous c-sections so just repeated. Although I know one woman who had a VBAC with her 26 weeker (her older two children were both c-section). So I don't think preemie always equals c-section.

[homewithtwinsmama]

vaginal

My 31 week babies were born vaginally. It is hard to recover from surgery and be present for your babies in the NICU so I would avoid cesarean just for the faster recovery time if baby can handle it. Plus cesereans do have added risks for mama at the time of surgery and for future pregnancies potentially.

Lorrie

[Jane]

This is your fifth baby, so I suspect that your OB assumes that your labor will be short and you will not push for very long to birth your baby. A shorter labor and quick pushing stage increases the chances that your baby will tolerate labor well - she doesn't have to do it for a long time.

If she tolerates labor, the process of labor could be helpful to her body in prepping her to breathe, and helpful to yours, too. Getting your milk in sooner, even by a few hours, could be beneficial to her.

Of course, if she doesn't like it, a quick c-section is going to be the best thing for her.

Is there something else going on with you/her? I've seen someone with similar "dissimilar" growth at 26-28-30 weeks, and similar perinatologist monitoring, and she was told that she was likely to go to "almost" term (36).

[ktmelody]

There is nothing else going on right now....
I guess IUGR is not an exact science and it has to be monitored very closely.
My ob/peri will not allow me to go past 37 weeks.
But they think she isnt growing at all, so I may make it to only 31-32 weeks.
It is just wait and see right now.
I hope to have her vaginally, but I worry about lack of oxygen in an already depleted baby and worry about brain damage. But they are probably just worries!
I cant imagine recovering from a section and having a tiny baby. Must be very difficult.....
Thanks for the input ladies, keep em coming.

[Jane]

Cool. Sounds like you have a good team, although I would like them better if they "strongly suggested that you not go past 37 weeks" rather than "not let you go past". My bias, though...The mom I was referring to made it to 36 weeks and a 5 pound baby, if I recall correctly. Not term, but close enough to be pretty sure that the baby would be going home right away.

Most babies do just fine in labor. The body is well adjusted to make sure that the blood flow is uninteruppted no matter what the contraction pattern is.
If you knew what the reason for the growth retardation was, like you had poor flow through the uterine arteries, or you had extremely high, uncontrolled blood pressure, or an autoimmune disease, that might shed light on the likelyhood of interuption of that crutial uterus to placenta to baby bloodflow.

[ktmelody]

Thye think that possiby a heart condition that I have is contributing to the poor growth. Also that i have had 3 pregnancies in 3 years doesnt help.

I was told that the risk of mortalitly is much higher for IUGR babies past 37 weeks and why they would induce if I make it to 37 weeks.
I dont have a problem with induction, as long as the baby is healthy.

I hope I get to go vaginally.....but it all depends on how baby feels....KWIM?

[tbavrbab]

Originally Posted by lindberg99

I don't know that many people who have had preemies but of the ones I know, the only ones who had c-sections were either having bleeding from an abruption or had had previous c-sections so just repeated. Although I know one woman who had a VBAC with her 26 weeker (her older two children were both c-section). So I don't think preemie always equals c-section.

No, preemie doesn't ALWAYS equal section, but in some cases it is important or necessary.

I had a vaginal birth with my ds (quite fast all things considered), but dd was c/s. When her head came down (I insisted on trying induction) her heart rate slowed and didn't recover well. Her stress level from labor went sky high...and I was given a choice for a section which everyone felt was best for Adara...because of my HELLP it was NOT the best option for me. If I hadn't had the epidural catheter in (unmedicated), they would have had to do a general because my levels were THAT bad, and I had a much greater risk of bleeding...

I made a choice for a c/s, but what I really chose was my baby over me and what I wanted.

So, I have to say that it is not GENERALLY true that "the only ones who had c-sections were either having bleeding from an abruption or had had previous c-sections so just repeated"

Though it may be true for those moms you know.

[sehbub]

DD3, 30wkr, was born vaginally. 33 hour labor, 2 pushes. We were monitored very very closely, but my little adrenaline junkie spiked her heart rate during each contraction instead of dropping it.

Good luck, mama!

[mandolin]

I had my preemie ds vaginally. I had PROM and otherwise she was healthy, but it was a quick and healthy delivery (until the placenta got stuck, but that's another story). If your OB is comfortable with a vaginal delivery, I think this is way better for both you and the baby. Birth kickstarts so many biological feedback loops that can help a preemie get a better start. Good luck!

[sweetpeasmom]

I had my 25 wker vaginally. There was no health issues with either of us and she was head down, so they allowed a vaginally birth. If they are good with it and all looks well for the both of you, i'd choose vaginal.
Hope everything is well with your baby

[pyzia]

My mom gave birth to my brother at 27 weeks vaginally. Mind you this was back in 1983. I don't know if this helps but I thought I would mention it.

[irangel]

As long as the baby is positioned correctly and tolerating labor there is no reason to do a c/s simply because of prematurity. Both of my preemies 29 and 25wkrs were supposed to be vaginal but the 29wkr turned breech after 60hrs of labor and the 25wkr who was due to be a VBAC had a cord prolapse and I ended up having an emergency c/s with her.

[susienjay]

I had a VBAC with my 29 weeker. She was head down and never had any heart rate drops so there really wasn't a need for a c-section. I delivered her in 3 pushes.

I had an emergency c-section for my 32 week twins- one of them was breech.

[forthebest]

I birthed my 28 week baby vaginally, unnassisted, 2 hour labour, slight bfding difficulties at first but got sorted soon after, no health problems,also she was born with a partial caul. All the very best with your forthcoming birth, and your wishes are respected.

[aris99]

I can't answer the question about c/s or vaginal but I have had 3 IUGR babies. My first was 4 weeks behind on stomach but 3 weeks head-wise. She was born at 38 weeks and weighed 4.5lbs. Today she is an extremely bright, active, overly curious 5 yo. My second child (3yo) probably could have gone fullterm but the U/S they did indicated that he weighed about 3.5lbs at 38 weeks and I was induced. He came out weighing 5lbs 11 oz...he would have been small but not THAT small. He's of average size and also extremely bright and annoying My 3rd, long story short, I prommed early on and delivered her at 26 weeks weighing 1lb 10 oz...she has issues but she seems to be working out of them. I guess my question to you is...do you think they need to deliver your baby that early? How reliable are the measurements they are taking? Could they let you go a little further to say 34 weeks? Just a couple of weeks extra makes such a world of difference developmentally! I'm not an expert but if you nst's and biophysicals are ok I'd think they'd want to give your baby a couple extra weeks.

[Jane]

I think it would be really hard for me to live with the uncertainly of knowing the decision just wouldn't be able to be made until the moment of birth. I mean, most mamas know they need a c-section well before the birth, or they find out just a few days/hours/minutes before (like the mama with PROM).
Doctors are adept at making these decisions - that's their job, and they are usually pretty good at it. If I trusted them, that would be my only certainty - but that would be tough.

Have you been able to pack a bag for the hospital yet? You might want to check out the c-section "what to pack" thread for information.