Should I consider a Vba2C

1001 Views 26 Replies 9 Participants Last post by Storm Bride, Jul 16, 2005

Jessica-Ann

Discussion Starter · Jun 21, 2005

My DH and I are TTC this month. My DD was a cs after 30hrs of labor, failure to dilate and her not tolerating labor well, I was young and scared and wasn't aware of all the things you can do to help labor, so conceded to a CS. With DS born 04, I wanted to do a VBAC but after going a week late and no change in my cervix and having GD, the OB who is an advocate for VBACs and people drive hours to see him, because most hosp. around here won't do VBACs said that he thought I should have a CS, that things were getting risky. So once again I agreed. Come to find out when they delivered him, he had the cord wrapped around his neck 2x and around is body as well. Also Dr said my incision line from previous cs was quite thin and might have ruptured, as well as DS might have had touble with the way the cord was. Also Dr. felt my pelvis was very small.

So my questions, should I attempt to have a VBA2c, is it safe?

Does anyone know how many CS you can have, we would like to have at least two more? Is it okay to have 4 CS?

Thanks
Jess

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2rubies

· #2 · Jun 21, 2005

I can't offer you much help, but I wanted to know that I am in the same situation. I just found out that I'm pregnant, and I'm already worried about what kind of birth to plan for. I had 2Cs before, and I was also told at the second that my incision line was quite thin and may have ruptured. I think that scared me enough to plan Cs for any future children, but I also thought we were done at the time! Now I'm not so sure. I was told that there really is no limit on the number of Cs you can have, but that they should be at least 18 mos apart. I'll be watching, hoping you get some more replies.

Kristin

Amylcd

· #3 · Jun 21, 2005

I have a family member who has had 6 csections with no complications, and I've heard of people having a vbac after 2 csections with out a problem.

Jessica-Ann

Discussion Starter · #4 · Jun 21, 2005

Thanks 2Rubies,

Does the 18mos apart mean from the time of the CS to the next CS? For instance my DS was born in January 04, and we want to start trying now, Does that mean I should wait until he is 18mos to get PG? Or does the 18mos apart mean the actual dates the CS was preformed?

Jessica-Ann

Discussion Starter · #5 · Jun 21, 2005

Thanks Amylcd, that takes my worries away

We have 2 DC now and want at least 2 more. I was worried that someone would tell me that because I have already had 2 CS that I shouldn't have anymore children or that I should only have one more at the most.

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2rubies

· #6 · Jun 21, 2005

The 18mos rule would mean that the actual surgeries are 18mos apart. Good luck!
Kristin

Storm Bride

· #7 · Jun 21, 2005

I'm trying for a VBA2C after two c/s for breech - one emergency, and one scheduled a couple days ahead of time. My babies tend to turn very late in pregnancy, for whatever reason. I've got my fingers crossed this time.

My OB will readily do 4 c-sections, but doesn't like to go over that. It really depends on the person doing the surgery, I think, as I've heard of more than that. I'm quite happy with my OB's limit, because four children is what I want. DH probably wants to stop at three, so it may be academic, anyway.

There are several studies floating around about VBAC vs. VBA2C...except that most of them compare VBAC after one previous cesarean with VBAC after two or more previous cesareans...which means the risk factors if you've had three or four are all jumbled together. My OB uses 3% as the rupture risk for VBA2C, but I've seen anything from 1.5-2.0% cited in various places...and most of the studies don't seem to adjust for induced labour. It's generally agreed that your risk jumps if you're induced.

I can't see why you shouldn't be able to VBA2C. The stuff about the thin incision line sounds a little iffy to me - I don't think anybody really knows why some women rupture and some women don't. The only thing I'm absolutely sure about is that I won't be induced.

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Jessica-Ann

Discussion Starter · #8 · Jun 23, 2005

Thanks, that gives me hope, my DH and I are discussing the option of VBA2C. I would like the option to try but still have to discuss it with the Dr. as well.

I think 4 is the limit for us as well

Wow! I just noticed that you are really close to your due date, keep me posted, I would love to hear how your VBA2C went

Jess

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Storm Bride

· #9 · Jun 23, 2005

I'll do that. My edd in my signature is actually wrong...my OB is using July 14th (according to the date of my last period), and my GP is using July 7th, based on my early ultrasound. I thought I'd just leave it and see when baby decides to arrive. I'm just hoping it holds off at least another week - I have a road test on the 29th, and my OB isn't back from vacation until the week after that. He's VBAC friendly, and not too upset about me wanting to VBA2C, but I don't know what kind of attitude I'd get from the hospital's OB on call.

I saw another study recently that showed a rupture rate as low as 1.0% for VBA2C, with a 75% success rate! I find the idea of rupture scary, but the odds are definitely against it.

altarflame

· #10 · Jun 24, 2005

I've always heard 3-4 c/s listed as the safe limit, but I've also heard of many mothers having more than that. The issue is just that you have more built up scar tissue to cut through and sew up, each time. You should also know that if you have c/s #3, your risk factor for uterine rupture in a future vbac will jump, statistically...I am planning a vba3c right now, and I so, so wish that I had done it after two, instead...According to my midwife the most recent studies suggest that 1-2 c/s have a rupture rate of only 1-2% - it's basically the same for both. But after 3 or more, it jumps to 4-5%. Granted, those numbers take hospital births that use pitocin into account, and that makes vbac less safe.

One thing that really solidified my own personal desire to birth naturally this time was learning that while the baby faces slightly increased risk, *I* am 10 times more likely to die in a c/s - and my very worst nightmare is leaving my 3 pre-existing kids with no mother...I don't even view death in terms of personal loss anymore, you know? I just can't imagine them without a mom...

I posted a big ol long thing way down this folder about my OB consultation, a childbirth class I went to, and one of my prenatal appts, that all really helped me feel good about this choice. If you have some free time, it might say something that helps you.

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Jessica-Ann

Discussion Starter · #11 · Jun 25, 2005

Thanks altarflame for the insight it is really helpful and I'll have to look down at that, I am really interested

I am so interested in trying for a VBA2C. My husband is unsure though, and not really sure if the Dr. here will do a VBAC2 in my case, so will be scouting around.

Storm Bride, thanks for keeping me posted

I really appreciate it

I am sending you happy good birthing wishes

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Storm Bride

· #12 · Jun 25, 2005

hmmm...I think I'm starting to get Braxton-Hicks, but I'm not entirely sure, as I don't recall ever having them (at least not noticeably) with my other pregnancies. My cervix was still completely closed on Wednesday, but I know that can change very quickly. Hopefully, I'll hold off at least another week...then I can pass the road test for my driver's license, and my OB will be back.

Jessica-Ann

Discussion Starter · #13 · Jun 26, 2005

I never really had any Braxton hicks with either of my children, don't know why but it never happened. My SIL had lots of Braxton Hicks, she also had contractions at night time when it got close to the due date but she will still over 6 days for each of her children.

I hope you do well on your driver's test, I am sure you will!!!

I noticed you were in Vancouver, BC, I grew up in Saint John, New Brunswick. I went to Sea Cadet Camp in Comox, BC. It was so beautiful, I hope someday to go back and visit

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Storm Bride

· #14 · Jun 26, 2005

I haven't been to Comox in years! We used to camp all over BC when I was growing up, but I haven't taken a proper vacation in a long time...and I never have made it to the East coast. DH and I may be moving to Tennessee next year. If we do, I may decide to vacation in eastern Canada sometime.

Thanks - about the road test. I failed it two weeks ago...I don't test well when someone's monitoring me (I'm fine when it's just write the test then hand it in, though), and blew some really basic stuff. Frustrating. I really want my license before this baby arrives! Doing things by bus is okay with dd, but I think it would be pretty hard with dd and a newborn.

Still not in labour...just another week or so, and that would be great...

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RosieTook

· #15 · Jun 26, 2005

I checked this thread out of a curiosity..dh and I are kinda ttc now that my dd is 9 months and it is 18 months or more between births..that is the safety line as far as I had seen, and my mw told me too. I have only had one c/s, but it never hurts to prepare.

What made me decide to post is all this talk about Comox, I live in Campbell River!!

Good Luck to al you ladies, I'll keep an eye out over here.

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Jessica-Ann

Discussion Starter · #16 · Jun 26, 2005

Wow that is cool, I remember I had a friend that lived in Campbell River, but I can't remember her name now as it was over 15 years ago, we never kept in contact.

I always said I was going to go back to BC but have yet to make it. We have some friends in Washington State so maybe I'll get back that way sometime soon, I would love to go back.

Lumpy

· #17 · Jun 30, 2005

I am lurking this thread...curious as to outcome.

I am due with baby #4 in September or Oct. (EDD Oct. 1st)

Long story short, after 2 sections (one emergency for twins) and another elective after baby showed a chin sunny side up presentation, I am having a heck of a time trying to find someone to support a VBAC this time.

4 doctors, 2 different hospitals and 2 consultations with 2 different midwives.

Everyone has agreed with my history that VBAC would be risky, and my *risk rate* would be higher than national average.

Anyone heard of this? When is your option for VBAC just not possible? Am I in denial???Any advice?

Watching this thread for outcome and more replies...

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Storm Bride

· #18 · Jun 30, 2005

Lumpy: Things seem to be swinging back against VBAC in the US...which means it will happen here in a couple years. That's the way it goes. I don't really have any advice. Some moms on here have explored options involving travelling to other midwives. That wouldn't be feasible for my family, but maybe it would work for you?

If it turns out that you have to have the c-section, and can't find anyone willing to support you in a VBAC, you should check out the c-section support thread in the Birth & Beyond forum. It's helped me get through a lot of my anger and frustration over my birth history. I'm never going to be happy about my sections, but I'm at least getting to where I can live with them without undue emotional turmoil.

Good luck with whatever your decision (if that's really the right word when you're stuck!) ends up being.

I really wish all the doctors who are so anti-VBAC would acknowledge that their own quickness to perform primary sections is what creates the situation in the first place!

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cathicog

· #19 · Jul 2, 2005

I have worked with ladies who have had 2 sections , then a home waterbirth...Ethel Kennedy had 11 sections! I would definitely work with a midwife who does homebirths, and if you have to transport, then so be it. I would also call your first section totally unnecessary, as you probably weren't even ready for birth yet, despite the timetable...most women go to "43" weeks and more, since for the first 2 weeks, you aren't even pregnant yet!! so when they say 40 weeks, you are really only 38...it is a big scam....

Jessica-Ann

Discussion Starter · #20 · Jul 4, 2005

Hi Cathi,

Not sure if you meant this post to me as there are others posting in here, but if so I totally agree with what you said, I just didn't know what to expect during labor and I didn't know what I could do to help it.

I wish I had done research and asked for help from a doula or midwife.

Thanks for your reply and your input it is really encouraging to hear that someone had a VBA2C and it was a HB.

The Dr.'s can sure put a lot of fear into you when you have had one previous cs. I want to the have the option to attempt a vba2c.

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