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Discussion Starter · #1 ·
He thought that laboring before a c-section was the worst recovery ever. If I really needed a c-section then do it early. I couldn't believe it. What about labor being good for the baby?<br><br>
My midwives and Obs say schedule early or at MOST on the due date-if I schedule-so I can choose the surgeon.<br><br>
My first baby was born with a C-section at 42 weeks after 25 hours of failed induction. This in turn caused MUCH distress and it was kind of an emergency. A cord, meconium, etc seemed to justify it.<br><br>
Now I'm faced with the decision to schedule or wait and hope for a good labor and if a c-section is necessary that a good surgeon is on duty.<br><br>
Any thoughts?
 

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my first reaction is to urge you to find a different care provider, one who is more supportive and confident in your body's ability to give birth.<br><br>
but, I think I read somewhere that, statistically speaking, planned cesareans are much easier to recover from than emergency ones. How I handled the issue was to plan exactly how I wanted my cesarean, IF I should need one, and include that in my birth plan.
 

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I would also sugest switching OB care. It is never too late! Locate your local ICAN chapter & see if they have anyone to sugest. Also, do your homework. Reading books & online has been the best encouragement for me. I am reading "Open season" right now & it is really good & directed toward natural VBAC. Just a note (I had never read this before) that it said that when you are eating nutritionaly during your pregnancy, it most likely will make you go past your due date.<br><br>
You just do not need the emotional stress of the time frame OB's put on us. None of us do! These are our bodies & they ARE NOT BROKEN!<br><br>
Rachel
 

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You can have an unscheduled c-section that is not an emergency c-section. I have had two. The first was preceded by eight hours of labor. The second, my water broke and the baby was another footling breech, so there was an immediate section without any labor.<br><br>
My older daughter (with whom I labored) came out hollering and perfect and everything one could have hoped for. APGARS of 9 & 9. My younger came out silent--which is scary as hell--and needed suctioning. Definitely a better outcome with the first. As for me, there was no difference in the recovery between the one I labored before and the one I didn't.<br><br>
Of course it stands to reason that recovery from a scheduled c-section will be easier than that from an emergency c-section. A scheduled surgery just doesn't involve the problems that lead to emergency surgeries.<br><br>
If you want a VBAC, definitely find another provider. If you decide against it, you can consider keeping the one you have if he's otherwise a good provider, but make it clear that you're going to go into labor on your own. Unless you're well-acquainted with all the surgeons at the hospital, what does it really matter that you pick one?
 

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Discussion Starter · #5 ·
I'm waiting. My husband would like to get on with it, but I want to see what natural labor is like. This time I'm trying very hard to make sure I'm clear of any psychological obstructions that might prevent labor. I want to test that and if I need a c-section, then the Lord will just have to be in charge of the labor.<br><br>
Thanks for your thoughts!!
 

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I just don't understand the folks who say, yeah, you can have a VBAC, but I want you to schedule a repeat for your EDD or a week or 2 before.<br><br>
I had a cesarean with no labor beforehand, and I found recovery to be pretty awful. With my VBAC, I had a very long labor and some back issues the 1st couple of weeks after, and even so, recovery was *so* much better than with the C.<br><br>
Supportive caregivers are an important part of having a successful VBAC, IMO.
 

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I've had three sections - one emergency, one scheduled without labour, and one scheduled with labour. They all sucked. But, the one that was scheduled, but I laboured first was by far the best of the three in terms of my recovery <i>and</i> my emotional state.<br><br>
I think the "emergency vs. planned (no labour)" argument is asinine. Those are the two extremes. My emergency was the worst recovery - I don't think it's coincidental that it's also the only one I was knocked out for...
 

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I'm a bit confused. Are you planning a VBAC? Or are you wanting to have a repeat section, just questioning whether or not to have it done on a certain date vs. waiting for natural labor to begin?<br><br>
Obviously if you are truly wanting a VBAC, scheduling a repeat makes little sense. I'd be concerned about a provider that wanted to schedule a section at 39-40 weeks with the plan to 'try' for a VBAC should you go into labor prior to that date.<br><br>
If you are still on the fence regarding VBAC vs. repeat, that'd be the first decision to make.<br><br>
If you DO decide to go with a repeat, statistically speaking, scheduled sections are both safer AND easier to recover from. Almost every complication that can arise from a section is MORE likely after an emergency section AND an unplanned section. If you think about it, this only makes sense.<br><br>
If you are SURE of your dates, research indicates that 39 weeks is the EARLIEST a planned section should occur barring a medical reason to do otherwise.
 

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<div>Originally Posted by <strong>wifeandmom</strong></div>
<div style="font-style:italic;">If you DO decide to go with a repeat, statistically speaking, scheduled sections are both safer AND easier to recover from. Almost every complication that can arise from a section is MORE likely after an emergency section AND an unplanned section. If you think about it, this only makes sense.</div>
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Do you really think so? I think a scheduled section with no labour sucks. My body was not ready to have a baby - period. The whole thing was a terrible experience - well, all my sections have been terrible experiences, but in many ways, the scheduled one was the worst. I found just walking into the hospital and going "okay - I'm having this baby today" felt totally unnatural, and I still don't think I'm over it emotionally. I don't feel as though dd's birthday is really her birthday...it should have been another day. For the first couple of days, I had <i>nothing</i> for her in terms of feeding...not even colostrum, as far as I could tell. And, she had a lot of difficulty breathing, which ds2 didn't. (I'm not sure about ds1, as I didn't see quite as much of him in the first few days. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">: )<br><br>
I'd like to know what the stats on recovery are like in cases like mine where I went into labour before the scheduled section, but still (stupidly!!) acquiesced to the cut. I don't see much about these cases (probably because most women wouldn't have had the section in those circumstances), and I'm curious.
 

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<div style="font-style:italic;">Do you really think so? I think a scheduled section with no labour sucks. My body was not ready to have a baby - period. The whole thing was a terrible experience - well, all my sections have been terrible experiences, but in many ways, the scheduled one was the worst. I found just walking into the hospital and going "okay - I'm having this baby today" felt totally unnatural, and I still don't think I'm over it emotionally. I don't feel as though dd's birthday is really her birthday...it should have been another day. For the first couple of days, I had <i>nothing</i> for her in terms of feeding...not even colostrum, as far as I could tell. And, she had a lot of difficulty breathing, which ds2 didn't. (I'm not sure about ds1, as I didn't see quite as much of him in the first few days. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">: )<br><br>
I'd like to know what the stats on recovery are like in cases like mine where I went into labour before the scheduled section, but still (stupidly!!) acquiesced to the cut. I don't see much about these cases (probably because most women wouldn't have had the section in those circumstances), and I'm curious.</div>
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When I say that scheduled sections are statistically easier to recover from and have less complications, I mean strictly from a MEDICAL perspective.<br><br>
For example, mom is less likely to die after a scheduled section vs. an emergency or unplanned one. Mom is MUCH less likely to have a post-operative infection if she did NOT labor prior to surgery. Mom is less likely to have her bladder, intestines, and major blood vessels nicked during a scheduled section vs. an emergency one.<br><br>
When you think about the circumstances surrounding the two, it makes sense. When mom and baby are doing fine, come in at the beginning of the day usually, everyone is fresh and ready to go, OR is ready, nobody is in a big rush, etc etc etc....the risk for medical complications is naturally going to be less than when you consider an emergency procedure with mom and/or baby in trouble.<br><br>
Let's say you're laboring and baby is in grave danger. Mom is rushed off to the OR, maybe doc has been on for 20 hours already. Maybe the OR is already in use, things have to be rushed, back up nurses/techs/peds have to be called in. If baby is in trouble, you can believe they are going to cut a whole lot faster (thus making mistakes more often).<br><br>
Also, after hours of contracting, the uterus is not as good at clamping back down after surgery compared to the non-laboring uterus. This means blood loss and other complications are going to be greater in laboring women.<br><br>
One example from real life experience is from the first hospital I delivered at. Their post-op infection rate for NON-laboring moms was 7-8%. This is considered very low at the time (4-5 years ago these numbers were compiled). The post-op infection rate for LABORING moms who ended up sectioned was 24-25%, roughly THREE TIMES as high. This was a major teaching hospital with an overall section rate of less than 10%, which is obviously WAY WAY WAY under the national average.<br><br>
In the end though, we're just talking averages and statistics. Just as a woman can have a fabulous, wonderful, uneventful vaginal delivery and recovery, it is also quite possible to have serious complications and problems with vaginal delivery and recovery.<br><br>
The same is true for c-sections. *In general*, according to the research, it is easier to recover from a planned section vs. an unplanned one. It doesn't mean that *everyone* will have an easy recovery though. Nor does it mean that the recovery is necissarily *easier* than what a vaginal delivery and recovery would have been.<br><br>
I also think you are right in that actual stats on women who are sectioned after going into labor would be hard to come by, as the push now is to section women PRIOR to the onset of labor, usually around 39 weeks.<br><br>
I have nothing to back up this thought, but it would make sense to me if those women (that go into labor and THEN have the section) would fall closer in line with the scheduled section risks, assuming of course that mom doesn't go through intensive labor for hours (thus tiring the uterus), and both mom and baby are not in any sort of trouble when the section is done. You still would probably see more surgical errors if the section occurred at night or on the weekend though.
 

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I was actually nervous with ds2, because my section was at 9:00 in the morning. I know how long it takes me to get a jumpstart in the morning sometimes. Having a surgeon operating on me that early didn't really appeal.<br><br>
I suppose a scheduled section is better than an emergency one from a medical viewpoint, and my emergency section was the hardest to recover from - due to exhaustion and the general anesthesia. When I had the scheduled one, but went into labour first, I did get an infection. But, I think that had more to do with the fact that they stuck me in a bed by the west window - in July - and I had the hot sun pouring down on me for three days. I sweated more after that one than my other two combined...hard to keep the incision area clean, you know?<br><br>
I keep hearing about scheduled vs. emergency, but I know for sure that if I don't end up having a homebirth with baby #4 (eg. an actual medical reason appears - that would be novel), there's no way I'm having a section without labour again. Everytime I think about dd's "birth", I want to puke. I can't believe some people prefer that to just going into labour and having a baby...
 

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I can't find it now, but I read an article a few months back that stated that a trial of labor, even one ending in a c-section, resulted in better outcomes for babies than scheduled c-sections. Sorry I can't find the reference, but I think it was on Yahoo back in June, but it's not there now and I can't find anything that still mentions it. I did have a scheduled c-section for breech, and I have no doubt it was easier to recover from than one that had been unplanned (at least I had something similar to a regular night's sleep the night before), but I think it's best that you do what feels best for YOU. Find another provider if you feel uncomfortable with their rules.
 

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Discussion Starter · #13 ·
Ok, I was at a lecture yesterday morning listening to an OB that is not mine. After it was over I asked him his opinion. His thinking was that c-section without labor was the best recovery. Never let a woman go past 41 weeks without inducing. I think he was "cut" happy.<br><br>
At my practice I've been to see one OB. He said "schedule so you can insure a good surgeon-we like to schedule at 39 weeks. At most we could get you scheduled at 40."<br><br>
The midwife I like to see whenever she's available says "always go for the VBAC-don't ask for major surgery"<br><br>
I want to go for the VBAC. I'm hiring a doula to help me. My husband accepts that. Meanwhile I'm trusting the Super G that if an emergency does arise that a great dr will be there to deliver.<br><br>
The only real dilema is that I'm with an HMO. There is absolutely no hope of having someone I like actually like to be on duty. It's a joke, really. With my first I went through five shift changes-five midwives, five drs, different nurses and LOTS of different opinions. It's a battle.<br><br>
I just want encouragement to go for the VBAC and that labor will get started on its own...
 

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<div>Originally Posted by <strong>maureenfh</strong></div>
<div style="font-style:italic;">I did have a scheduled c-section for breech, and I have no doubt it was easier to recover from than one that had been unplanned (at least I had something similar to a regular night's sleep the night before)...</div>
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Ahh...I've heard of that, too. I didn't sleep at all the night before any of my sections - the first one because I was in labour, the second one one because I was depressed and terrified, and the second one because I was in labour, <i>and</i> terrified...and far too angry/frustrated to sleep.
 

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TakeItEasyMama: I'd go for the VBAC. I would think about what I wanted done in the case of a cesarean, just in case that becomes necessary. But, it's not necessary, just because you've had one before!<br><br>
If your body likes to "bake" babies a little longer than the average, then I think scheduling at 39 weeks is nuts! My dd was scheduled at 39w, 2d - and I don't think she was ready to be here. She wasn't preemie, but she wasn't...don't know how to describe it. But, she had a lot more trouble than my other two did. I went into labour with ds2 very late in the day at 41w, 5d...I think dd would have done better if she'd been able to bake another week or two.<br><br>
The decision is yours, of course. But, I think I'd go for VBAC.
 

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Discussion Starter · #16 ·
I think that's exactly what I'm going to do. Let it have it's time. I'm continuing to pray that it comes on its own. So what if I do end up with a c-section, at least I will have tried to be natural.<br><br>
Thanks for your helpful insight.
 

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A scheduled, no-labor c-section is better for the mother, but an unscheduled (nonemergency) c-section with a "trial of labor" is better for the baby. Uterine contractions serve to squeeze mucous out of the baby's passages (no, it's not 100%) and basically prepare it to thrive outside the womb. Also, if you insist on going into labor, you avoid possible problems with an accidentally premature baby. There was an article in <i>USA Today</i> a couple of weeks ago about problems that "near term" babies are more often being recognized as having. These problems are very similar to those encountered by preemies--breathing problems and the like. Now, I'm willing to say that a baby can only need to bake for 36 weeks. But if a baby is still hanging around at 39 or 40 weeks, I reckon there's a reason for it. (And I am living proof that even your own gestational history isn't a 100% marker--I am the mama of a perfectly-healthy baby born at 35w4d & I'm sitting at 41w 1d right now.)<br><br>
If you want a VBAC, stand firm. Keep in mind that doctors are, pretty much by definition, pathologists. They are trained to plan for the worst case scenario, and a good number of them allow that to overtake their thinking completely. And don't even get me started on the outdated stuff that they are being taught in medical school, or the fact that there's no requirement for them to have continuing education! (Nurses have to continually educate themselves to keep their licenses. Doctors do not.)
 
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