Advice on Vag Birth /C Section Possibilities Help!

[eastkygal]

My dd was born in August via unplanned (pushed on me) c section. I'm from a small town and had recently moved to a big city. I know no one, and I found no "natural" birthing centers. I ended up going to a practice with all female doctors. I practiced for a Bradley birth, and my doctors supported me, though said I needed to be at the hospital. My mother had to deliver all of us via c section because she didn't dialte past seven.
Now, the doctors worried that my dd was too large to deliver because I was 9 lbs. and my dh was 10 lbs. They did 6 ultrasounds and said she was upwards of 10 lbs. I went in for my 9 months checkup and they said I would have to be induced if I had any hope of a natural delivery. My step-sister did hers natural and I so wished I could too. She felt great afterward. I said okay. I was knew to the thinking of "natural" family/parenting. No one I knew subscribed to it much either.
When I got to the hospital, they would not induce me and the on call dr. from my practice said I needed a c section if I wanted to insure my baby's health. She said I ran the risk of cp, her getting stuck, etc... I was frightened and so wanted a healthy baby. My family of course all listen to the OB and made me feel like it was okay to progress with that method.
I did have a healthy baby, but she was only 8.13 lbs. I kind of felt like me and my dd were gyped.
I had a rough healing period, but my dd helped me through. I refused pain medicine because I was breastfeeding. I made sure my dd roomed in, so I took care of her. My incision tore open upon returning home, and I was 3 months before I felt close to myself again.
Don't get me wrong. I'm so pleased my baby girl is healthy and I have her to hold. Sometimes I feel guilty about my choice for the c section. People have told me though that you are there to have a baby not a birth. I try to think that way. I just wanted what was best for my babe.

Now, the question. I plan on getting pregnant again in January of 2007. How possible is it for me to hope for a natural birth this time? Who should I look for for support? I know it is probably too dangerous now to try for a home birth because of possiblity of uterine rupture. Can someone offer me positive advice?:innocent

[Guest*]

I'm sorry you had to go through that.

Check out ICAN (http://www.ican-online.com/) or the VBAC board.

If you want a natural birth or a homebirth, you can have one! It's actually best if you have a natural birth and the best place to have a natural birth is at home. It is not too dangerous. If you have a natural labor, your chance of uterine rupture is only .5-1% higher than if you had not had a previous c-section (I think, someone please correct me if I'm wrong). That risk goes way up as soon as drugs and interventions are thrown into the mix.

Start reading, reading, reading and talking to other women who've done it before you.

[AnditheBee]

jlpolzin is right--without induction/augmentation of labor, the uterine rupture rate for VBACs is .7%. That's, frankly, one of the lowest risk numbers of any birth complication!

Now, there are some issues to consider:
-Did you have a low transverse (horizontal/bikini) incision?
-Is the placenta clear of the scar? (this should be checked in the third trimester)
-Is the placenta healthy and clear of the cervix? (no accreta, previa, etc.)

If the answer to all of these is "yes," then you are a good VBAC candidate and shouldn't have any trouble having a natural birth next time. I would definitely recommend looking around the web and in books for more VBAC info, which should reassure you that all will be well.

Frankly, the biggest problem with having a VBAC these days is finding a care provider who will support it! The physical issues really aren't that much of a concern for the vast majority of women. You even have that much-vaunted "proven pelvis" so you're way ahead of the game! :thumb

Best of luck to you!

[velcromom]

Join the ICAN list, definitely. You will learn what you need to know to give yourself and your next baby the best chance for a VBAC.

Don't discount the possibility of HBAC. It can be and has been done!

I recommend reading Silent Knife and then Open Season by Nancy Cohen, and also The Thinking Woman's Guide to a Better Birth by Henci Goer.

[AnditheBee]

Eastkygal, I forgot to say: I'm originally from East Ky. too! :) I grew up in Prestonsburg. Still have family in Johnson County.

Also: Check out the stickies at the top of the VBAC forum, for the "Great VBAC Books" and "VBAC Websites" threads. Lots of good info there!

[eleven]

You are an excellent candidate for VBAC!! I agree with AndiB - the hardest part is finding a truly supportive care provider.

I am so sorry that you were treated so poorly and bullied into surgery. You are definitely on the right track in educating yourself so you are prepared for your next birth.

[eastkygal]

Just wanted to say thanks for the advice. I'm definitely going to look in to things. Should I look for a midwife or is there another healthcare professional I should look for to help me along? I so appreciate your time and help. I wish I had known about this site sooner.

Also, fellow eastkygal, I graduated from Prestonsburg High School!!!:thumb

[Attached Mama]

.

If you want a natural birth or a homebirth, you can have one! It's actually best if you have a natural birth and the best place to have a natural birth is at home. It is not too dangerous. If you have a natural labor, your chance of uterine rupture is only .5-1% higher than if you had not had a previous c-section (I think, someone please correct me if I'm wrong). That risk goes way up as soon as drugs and interventions are thrown into the mix.

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I am so so so so sorry for you! I had a very necessary emergency c-section and it sucked!! Your situation makes me so angry with doctors. Too bad you couldn't sue them for doing an unnecessary cesarean... Make them think twice about all the people they do them to just in case. Stupid idiot doctors! Ok, done with my rant...

I am planning a homebirth for my next one (whenever that is). Best wishes and prayers...

[AnditheBee]

Also, fellow eastkygal, I graduated from Prestonsburg High School!!!:thumb
Me too! Small world. :) I've PM'd you...

[aprilushka]

Just a note on the stats... (based on the last two NEJM studies)

I don't have them in front of me, but I'm pretty sure that risk of uterine rupture is

with uninduced/unaugmented trial of labors after 1 c/s --0.4%

with pitocin only -- somewhere between 1 and 1.5%

with pitocin plus cervical ripeners-- over 1.5%, maybe as high as 2-3%

The 0.7% is from the 2000 study and lumps in all trials of labors, so 0.7% is actually higher than what is likely to be the uninduced/unaugumented risk

In Flamm's birth center study (much smaller study and not as weighted in terms of evidence, but still there) the uterine rupture rate was 0.2%

From the 2003 (or was it 2004?) study, the largest and best to date, the risk of death/severe brain damage to baby due to uterine rupture in trial of labor after 1 c/s was 1 in 2000. In the hospital of course.