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vba2c or not vba2c -- don't know

2K views 20 replies 16 participants last post by  maternus.aeternum 
#1 ·
I'm nervous about posting here because I'm not sure what I want yet. But I guess I just wanted to talk it out a bit.

I had 2 c sections. The first was very necessary. The second was a failed vbac with a great midwife. I worked hard for the vbac and was excited about it, was laboring in the water and had a great doula. After 16 hours of hard labor, I got out of the tub for my midwife to check me (she had mostly left me alone) and I was at 4 and then my waters broke and so much meconium was in them. My doula said it was really a lot and had rarely seen so much in her (long) experience. My midwife gently told me that it was my choice, but that she felt I still had a ways to go and the possibility of aspiration was very real at this point. She recommended a c-section. Since my sister's lungs had collapsed at birth due to mec aspiration, I agreed.

So now I'm pregnant and went back to this same midwife (who has a high vbac success rate) and I was trepidatious and unconfident in my ability to birth. And I asked her, am I a candidate for a vba2c and at first she said, well, not really. No successful vaginal births, 2 sections, and she remembered my last labor and said her gut instinct was that I have long difficult labors and big babies that have big heads (true enough, over 100th percentile heads actually) and I'm a petite person. She suggested a repeat section. I asked if I could go into labor naturally, and she said definitely, no fear of rupture, no problem laboring for a while first. I was sad, but also relieved that she agreed to labor starting naturally for tons of reasons.

So today I went to see her again, and we talked some more, and she said, look if you go into labor on your own, and get to the hospital making good progress, we'll deliver the baby. We'll see what happens. But let's plan on a repeat section, and if you have a vaginal delivery, terrific.

I just don't know how to feel about all this. I read this board and see people gung ho, like I was with my second birth, and I know that vba2c is not significantly more risky. I see people fighting and advocating for vaginal birth. And I believe in that so much. Somehow, when it comes to me, I feel so little confidence in my ability to give birth vaginally and so much fear about an emergency section -- by "planning" for one I feel like I'll have more control over what I want (which drugs, a pillow, not strapped down, etc..) and my midwife guaranteed that, barring an emergency, like the baby not breathing or something, I could hold my baby during repair and try to breastfeed then if baby feels like it. Somehow it feels better to not plan a vba2c with the possibility of "failure" and "emergency" again, but to plan for a successful c-section with the possibility of a vaginal birth.

But obviously, since I'm writing all this, part of me is just not at peace. How can you plan for a c-section. I am healthy and don't believe my scars put me at any significant risk. My midwife's "wait and see what happens" approach is both comforting (birth is unpredictable and mysterious) and also hard for me to wrap my head around. I *might* have a vba2c but I'm not preparing for one. Weird.

If anyone read all this, thanks for listening.
 
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#2 ·
I am currently planning my VBAC and while I am 100% determined to have a natural birth this time around I can totally understand your dilemma. I think one of the biggest deciding factors for me in my VABC (besides the health benefits for me and baby) is the fact that I would rather try to have a natural birth and not be able to than have never had tried at all. It sounds like your MW is not totally opposed to trying to deliver naturally, and if you go into labor with no complications the chances of you being able to deliver naturally are not null.

As far as having control over a c/s I can relate to that too as I am worried that I will not have the c/s experience I want if it comes to that. Because of this, I am writing two birth plans, one for a natural delivery and one for a c/s and am having them both approved and agreed to by my MW's and their back up OB so that if I do have a c/s at least I can have my arms free, hold and nurse right away, etc. This way, No matter what happens I will still feel like I have some control of the situation and will have made the best decisions for me and baby. Hope I helped!
 
#3 ·
i wish i had more time and ill try to come back later but i think what you need to consider is the reasons for your first 2 c/s's. from what you have written, both c/s's seem to have been for medical reasons. and for those reasons, i am thankful that c/s's exist (ftr, i believe both mine were unnecessary).

however, look at the last 2 you had and ask yourself "what are your chances of those situations happening again"?

have you joined ICAN? i have only recently joined and they are a wealth of information (the list..the website is too but the list is invaluable).

i think the fact that your MW is willing to work with a laboring mom and do a "wait and see" approach gives you hope that a repeat c/s may not be necessary for you, dependent on so many factors at the time of your birth, yk.

i dont know how much you read w/ your attempted vbac before but i wouldsuggest reading all of that again...b/c my youngest is 2 and i have forgotten most of that stuff. building up your confidence is a big thing too for you and for your birthing experience.

good luck. ill try to return to this topic if i can.
 
#4 ·
I also had 2 c-sections (for different reasons), and when I became pg with my 3rd, I still wanted to try for a vbac. I went back to the same midwife practice, which is backed by o.b's, and my mw fought hard for my case and they said I could vbac as long as it wasn't a 10lb+ baby. I ended up going into labor spontaneously at 38w, labored at home, arrived at the hospital at 10cm and +3 station, and delivered via vba2c 35 minutes later. DS was 8 lbs 10 oz.

All I can say is every baby and pregnancy is completely different. When I was in labor this last time, I was in complete denial because I was comparing it to my previous labor. Who knew I would be 10 cm when I got to the hospital... I labored differently, pushed differently... everything was different. Even at almost 9 lbs, since the baby was in the right position, it just worked. My previous DS was 10lbs 3 oz, posterior, and asynclitic, and just wasn't coming, even after 8 hours of grueling pushing with mw's and a fab doula, and a vacuum to try and suck him out!

I recommend taking a private Bradley class, and reading as much as possible about dilating, baby positioning, opening up, laboring naturally, and labor positions for different times during the baby's descent to maximize the pelvis opening and to better your chances of feeling confident, relaxed, and having a vbac. Hire your bradley teacher as a doula if she's willing.

It sounds like your mw might be realistic, and at least she's letting you keep going rather than automatically schedule. At each appointment, talk about the baby's position, making sure it remains posterior, and talk about labor and pushing positions. Get in the groove and mind-set. And, if a c becomes necessary, than it's a good thing, as it can be a life-saver. It's still a birth - and its miraculous nonetheless.

I, too, had 2 birth preferences - one for natural birth, and another for a c. Be as prepared as you can in both respects, and you'll feel much better regardless of the 'mode of delivery'...

best wishes!!
susan

-- my vba2c birth story is posted in the vbac birth story sections - I don't know how to link to it... there are some inspiring stories over there...
 
#5 ·
I had two sections too.. and when I got pregnant with my third I was just so tired.. so tired of the stress, the need to fight for everything (I had an attempted vbac with my second), the need to justify everything to the Drs..I just didn't have it in me anymore.. I thought..
I went along with my OBs.. I was planning my third section.. when at 20 weeks.. something in me just snapped to.. and I just could not go through with it.. not unless it was needed...I wanted to try a vbac.. and I found a wonderful, supportive lay midwife and had an HBA2C a year ago.

I am glad that I finally listened to my inner voice.. it took a while for it to be heard by me.. Listen to your inner voice.. what does it say? If you make choices (when possible) listening to yourself.. you'll be much more at peace with the way you deliver your baby than if you feel that those choices have been taken away from you and made for you by someone else..

*hugs* and all the best to you.
 
#6 ·

It's hard to work through all those emotions. I had a c/s with my first, a vbac with my 2nd, and ended up with another c/s two weeks ago with my third (cord prolapse and then meconium aspiration).
I am dealing with some of the same emotions you are with regards to my birth plans for next time. It feels so silly to even think about it, since my youngest is only two weeks old, but it's really been on my mind. I guess it's because for the first time ever, I don't know what I want.
Anyway, just wanted to let you know that you're not alone
 
#7 ·
I had a VBA2C in 2006. My first CS was an emergency after a failed induction that lasted 53-1/2 hours. It was horrific. second time around, I just surrendered to the CS. W/ that one, I developed a BAD infection in my incision area and didn't heal for 8 weeks and wasn't able to get into bed. I slept in my recliner the whole time.

I knew I couldn't handle it a third time. I also knew that my dates were wrong, because I figured I ovulated late in my cycle. so when I was induced the first time around, I was only 38 weeks NOT 39, but still, my body wasn't ready.

W/ Natalie, I went into labor on my own. I was 41 weeks and 5 days when labor started. When my water did break, it was only a bit of meconium, but still meconium. I was really encouraged by my midwife and all the people that were to support me, and I think that is what made the difference. I labored for approx. 36 hours w/ an hour of pushing.

She needing to be suctioned after birth and it was a bit before she really breathed and cried. The cord was around her a bit, but she was okay.

I did not have a proven pelvis and was "diagnosed" w/ FTP w/ my first labor. But it doesn't mean a thing.

I think the MOST important thing is to have people who support you. Birthing is as much a physical thing as it is mental. DO some reading, talk w/ the women from ICAN. Be informed as you can possibly be and THEN make your decision.


Good luck!
 
#9 ·
Thanks for these responses, so much.

What is particularly resonating with me is the idea of being tired, emotionally after fighting for and preparing for my last vbac and it "failing" again. I think that's where I am, and I am also at 14 weeks starting to hear an inner "voice" fighting against that tiredness. It's all a little scary.

Another thing that is resonating is the reminders that every birth is different. That's amazing going to the hospital at 10! Wow. I've learned a lot about birth over the years. I went through Bradley with my first, and went through Birthworks (which I really loved) in preparation for my second. Had hypnosis to help me work through my first (very difficult) c-section. I'm a grad student and I've "over-researched" for years which is why my failure to have a vaginal birth two times in a row really threw me. The labors were great with both too, powerful, transformative--but slow. And who knows, that doesn't mean this labor will be slow.

I haven't joined ICAN cause I'm afraid or emotional about gearing up for another vbac this time. Joining ICAN would be a clear sign that that's what I want. I'm also afraid a little of pressure, I need to work through this a little slowly I think. But the birth stories are really beautiful and encouraging, and that part is a very good thing.

I don't think yet, that I'd need another midwife. It's hard to find anyone to do a vba2c and when I ask the local birth scene, she's the name that comes to mind because she *does* them. Even though she is letting me know she isn't sure I'm a good candidate for one, which is reinforcing my own lack of confidence, I also believe that if I push for one, she'll support me. She's already said as much, both by agreeing to a natural onset of labor and also by keeping a "wait and see" attitude about the method of birth.

Do you think I could find a doula who would come and support me, knowing that it could be a vba2c but might turn into a repeat c-section? Do doulas come to c-sections? Maybe finding a doula to support me through this would be the best first step. (I had one last time, but she was gung ho vbac as was I.)

I'm staying here on this board as I process this. I appreciate your responses so much and LOVE to listen in on what everyone is working through and especially the birthstories.
 
#10 ·
I share similar stories with many others - I had two c-sections - a failed VBAC with the 2nd birth. I was SO devastated. When I became pregnant a 3rd time I tried to convince myself to just sign up for the c-section - it would be emotionally easier if I choose it.
But I cried and cried, it just didn't feel right to sign up for something I didn't consider medically necessary.
After much letter writing, etc...I did find a doctor practice willing to take me, but that ultimately didn't feel right either, I switched to a homebirth, and had a beautiful VBA2C this past summer.
At the same time, I can understand how some women feel signing up for a c-section after a failed VBAC is the best choice for them. I would echo the "follow your heart."
Good Luck!
 
#11 ·
yes - so true to follow your heart. I went back and forth about weather to have an elective c vs. a vba2c, since having had 2 c/s already, it was familiar, and I knew what to expect. Though, chasing around a 15m old after another c would be a bit of a challenge for me.

I know how you feel about committing yourself to a vbac... I didn't want to read anything or believe that it might be a reality for the longest time during my pregnancy, since I was a 'wait and see' candidate also. My mw's told me the chief o.b. (who did my last c) said I could vba2c as long as it wasn't a 10 lb baby, so for most of the pregnancy, I was petrified that it would be another big baby or that I'd go late again or that something else would come up. We didn't know what was going to happen until literally my 38w appointment when I had an u/s, which said he was about 8 lbs 1 oz. But I'd say around 25 weeks or so, I did start gearing up with reading about the risks of repeat c's, and getting programmed on how to labor and especially push and deal with different scenarios (such as those that came up with my last labor... slow to progress... posterior positioning...). I started reading my books and got so motivated and trusting of the whole vbac scenario, and even though my birth pref's included a section on c's, I was pumped about giving it a go, and I welcomed the internal monitor - gave me confidence, freedom of movement, security...

As for doulas, with my last DS, our doula stayed with us the entire time - she came to my house when I was in real labor, came with us to the hospital, worked with me throughout my first stage getting to 10cm, coached me during stage 2 with pushing, and was an amazing resource to have on hand that was not affiliated with the hospital whenever I had questions or the hospital staff would suggest something. When the time came to decide if we should have a c, she was right there with us, and even came into the o.r. with us. She described what was going on, took pictures and video of DH and I with our new baby, stayed with me when DH went with the baby be checked out, (plus, I had a minor complication - my bladder had adhered to my uterus from my previous c/s healing, so they had to 'unattach' it and make sure there were no leaks - I peed windex-colored pee for the next day!) and she stayed with me the entire time during that procedure. Then she came with us to the recovery room, and we talked about everything. It was so nice having someone there who was my advocate, but not a hospital staff person... someone whom I trusted, and made me feel right about each decision along the way. She came back to the house a week later to see how I was doing. She was also our Bradley teacher, so we were on the same page as her regarding the ideal type of birth we had hoped for.... so even though it ended up as a c, she was 100% helpful, supportive, and made me feel empowered and thrilled with everything.

We didn't hire a doula this time, partly because I thought there was a really good chance I'd end up with a scheduled c, and doulas where we are are really expensive... I felt our last doula was still with us in our minds and hearts, since she was such an amazing woman and changed our lives forever.
 
#12 ·
Quote:

Originally Posted by Astoria View Post
resonating with me is the idea of being tired, emotionally after fighting for and preparing for my last vbac and it "failing" again.
HUGS for you!!!

Quote:

Originally Posted by Astoria View Post
I think that's where I am, and I am also at 14 weeks starting to hear an inner "voice" fighting against that tiredness. It's all a little scary.
It is a little scary.. I would swing from elation to terror and back again.

What really helped me, even in my darkest moments, was to "See" the birth I wanted. I would see it, from start to finish. It always helped center me.. bring me a sense of peace..

Quote:

Originally Posted by Astoria View Post
Do you think I could find a doula who would come and support me, knowing that it could be a vba2c but might turn into a repeat c-section? Do doulas come to c-sections? Maybe finding a doula to support me through this would be the best first step. (I had one last time, but she was gung ho vbac as was I.) .
Yes.. I had a doula the second time, and it ended as a c/s birth. She stayed through the whole thing and was a wonderful pillar of support through everything.
 
#13 ·
I've had two vbacs and I'm here to tell you IT'S WORTH IT!!! With both dd #2 and ds there were plenty of times during my pg when I would just have a complete and total nervous breakdown, sobbing onto dh's shoulder, begging him to let me schedule a section. I was terrified of a repeat section and just figured why bother fighting? Why not just schedule it like everyone else does and get it over with???? I live in Mississippi, which has one of the highest section rates in the country, so I have always felt a ton of pressure to just schedule a section. With both pgs, my dh encouraged me in his quiet way and never let me schedule a section. He always told me he'd support me no matter what, but that he knew ultimately what was best for me and the baby was a vbac. And dammit, he was right both times!


You absolutely must get a doula if you can afford one; and if not, please try to work something out. Even if you have a section, a doula is an invaluable personal resource. I called mine once a week to cry/complain/question/etc. and she was always there for me, always calm, and most importantly, objective. And objectivity is something that pg mamas, especially me, don't always have. Good luck in making your decision; but fortunately, every labor is different! My labor with ds was so stinkin' short it shouldn't even qualify as a labor. And he was my smallest baby! VBACs are totally worth all the emotional anxiety leading up to them; at least for me they both were. I fought hard for both my vbacs, both with the medical community and my own personal demons, of which there were plenty. Sorry to write an absolute novel, but I do think that your very desire to question a vbac's place in your life is a brave and admirable thing; sorry you have had such a difficult road to get here. Good luck and keep coming back here...mamas need to stick together.
 
#14 ·
I'm also praying for a VBA2C and my confidence is shaky. I believed in my ability to give birth *so* strongly last time, I did everything "right" and I STILL ended up with a c/s. And THAT was with an awesome homebirth midwife
So having an OB who expects me to fail this time isn't helpful.

I have an awesome doula (who was the midwife for dd2!) and that's a huge help. She believes in me and my body and I know I can count on her to tell me I can do it. So I definitely agree a doula is a wonderful thing! If I end up with a c/s she'll give me extra PP care.

Much love to you mama!
 
#15 ·
I think that its always good to work towards the most natural birth possible. If you still have a c-section then you and your baby still benefit from laboring.

I do believe that the hospital is not the best place for most women to labor though. If you do choose to have the birth in the hospital I think it would be best to stay home as long as you possibly can.

You stated she has a high success rate but even still she didn't sound over confident in the abilities of the female body to have a natural birth. I don't think I'd feel comfortable with a provider like that. I want my provider to have the utmost confidence in my ability but still be wary and able to step in but only if needed.
 
#16 ·
Hey there! I hope you read this! I am due 3 days before you! o8/08/08
I am having a homebirth after 2 cesctions. My csections are due to twins, and a double wrapped umbilical cord/fetal distress. I have a bicornuate uterus, and my births will be less then 2 years apart. Luckily here in Michigan, we have ALOT of options. I am not sure where you are from, but my FIRST thing would say to get a new midwife. I understand you may like this women, but you need someone who believes in your bodys ability to have a baby vaginally. Go to youtube.com and type in vbac or homebirth and you will find a whole host of women who video tape there births after multiple csections. You CAN do it. Meconium is not something that happens in all subsequent births. Also, my mom is 5'3 and had 4 natural vaginal 9 pound plus babys, including one 11 lb. It is about babies position, not your size! You can do it! TRY IT! I think you will feel better to try it. Homebirth midwifes would be much more apt to help you, hospital midwives are unfortunatly still medically oriented alot of the time. Good luck! I am routing for ya!
 
#17 ·
Quote:
Somehow it feels better to not plan a vba2c with the possibility of "failure" and "emergency" again, but to plan for a successful c-section with the possibility of a vaginal birth.
Well, there's your answer. You HAVE to factor in the possibility of another c-section when you're planning a VBAC. If you think you can't deal with an emergency or a true FTP c-section, then you need to schedule a c-section. When I was planning my VBA2C I was 100% at peace with the knowledge that things might not work out for me. You have to have confidence in your own body but you also have to be realistic (sounds like you are) because thing don't always go the way we plan them.

Now if you can come to terms with the fact that your VBA2C attempt could turn into another c-section, then go for the VBA2C. It's a very rewarding experience.
 
#18 ·
Reading this thread with great interest as I just found out I am
and have had two cesareans. (The second was a vbac turned cbac.) I know how so many of you feel.

I don't know what to do. I live in Alaska and homebirth vbacs are illegal, and there aren't any docs within 300 miles who will do a vba2c. They barely do vbacs here.

I've considered all sorts of things, but I just hate that if I want a natural birth it almost seems like I'd have to UC. Which in theory I'm OK with, but it just makes me nervous.
 
#19 ·
I had a VBA2C - it was a homebirth, I was lucky to find a midwife to take me.

Contact ICAN, find out about your rights. No hospital can "make" you have major surgery. If you show up in labor, you have the right to refuse a c-section, although you definitely should bring some very knowledgeable labor support people with you that are prepared to advocate for your rights, labor is no time to have to fight.

Doctors also legally are not supposed to drop you from care if you are within 30 days of your due date. You could get all of your prenatal care with an OB and when the time comes to schedule you for your section, just decide not to - collect all the data on the safety of VBACs, even multiple c-section VBACs, and all the dangers of repeat cesareans, put then with a cover letter stating why you are refusing the c-section, give it to the doctor, and bring it to the hospital in labor with your own refusal to consent to repeat c-section.

If you try something like this though, I really think your best chance is with some very strong doulas/birth advocates to back you up, support you during labor, and run interference.

The doctors and hospitals have so many liability issues, that's why they "ban" VBACs, especially after multiple c-sections - so they have policies against them - but by law, no hospital can turn away a laboring woman, and every woman has the right to refuse surgery.

Good luck, here are some useful links:

http://medicalcenter.osu.edu/patient...press/?ID=2835
http://www.greenjournal.org/cgi/cont...tract/108/1/21
http://vbacfacts.com/vbac/#FFR
 
#20 ·
TCA2008, that's great advice. Thank you. I am thinking I may do something like that, if I can get DH to support me on it. My aunt is a nurse and said that they have had women refuse a c-section when they come in active labor and then they have them sign a waiver form that says basically they understand the risks. They then let her labor away. There isn't anything they can do.

It sounds difficult to me to do that during labor but if one is determined enough, you can do it!!!
 
#21 ·
i could have written all of your posts.
gosh. this thread really hits home for me.

i have had two failed natural births - 1st hospital, face presentation, labored over 24 hours got to an 8 and then when they found out he was face pres. also with his hand by his face, they demanded i section by striking fear into my heart that my first darling baby would break his neck on the way out.

2nd, planned hbac, i got to 43 weeks and was dropped by my midwife after several non chemical induction techniques that didn't work.

i'm 13 weeks with #3 and waiver every single day on if i can do this or not. i'm with a great midwife, have a fantastic support system this time, and know i can do it, but am petrified of failing. i'm not petrified of the section. i've done that twice and i can handle it. i'm petrified of not being able to choose and having my birth stolen from me for a third time. i'm terrified of being transferred in an emergency situation and that scaring my older children (it scared my 1st awfully when i was transfered with my 2nd). i'm terrified of trying and failing, and knowing that i've once again failed. even if the other situations weren't my fault, i still take some blame.

it's so hard. there has not been one single day gone by in 7 years that i haven't thought about my experiences...

some days i say screw it, i'm scheduling a section. then i can plan find a supportive dr, and make it the best section ever.
the next day i am disgusted in myself for thinking those thoughts.

i'm still so undecided. i know i have a while, but i want a decision made now. i want to feel comfortable to enjoy this pregnancy and not be worrying and wondering 'what if' the whole time.

((hugs))
i'll journey with you.
 
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