I'm going to share with you my own thought processing and maybe it will help you, and maybe it won't. I may sound like an ICAN newsletter, but these are my own personal feelings that may have been adapted from ICAN.<br><br>
Surgery is surgery, no one should have surgery unless it is <b>needed</b>, period. C-sections are not an exception with me. C-sections are not a choice. Obviously, these are just my opinions.<br><br>
The risk of UR <i>is</i> scary. There is a small, but very real chance of uterine rupture yet not all uterine ruptures lead to death. <i>UR does not always equal death</i>, though sometimes it does happen and it is very real and tragic when it does. So, there <i>is</i> a small risk of UR, the risk of a catastrophic outcome of UR is even smaller. UR is not isolated to women with a scar on their uterus, any woman can experience UR at any time during pregnancy. Did you ever think about UR with your first pregnancy? Chances are, you didn't. Having a scar on your uterus slightly increases that risk, yet still it remains very low of less than 1% with a non-induced, non-autmented labor. <i>UR is not only isolated to women who desire VBAC after a previous c/s.</i> I believe the number is like 50% of UR occur before labor has begun. You can still experience UR when planning an elective repeat cesarean. So, in reality, having the primary c/s puts you at risk, it does not matter what kind of birth you're planning.<br><br>
The risks of elective repeat c-sections on my body and future pregnancies plus the risk of complications are even more scary to me. The more c/s you have, the more you increase your risk of UR. The more c/s you have, the more of a risk your future babies have. If you're planning on having more than one additional child, the risks seem too much to me to plan ERCS for all of them.<br><br>
I'm not a religious person, so I won't say anything like "our bodies are made for birthing" etc. I do, however, know how a woman's body functions. Birth, to me, is just another bodily function (the ultimate bodily function). I don't question if my body knows how to digest food or if my body won't know when it is tired and needs sleep, so why should I question it's ability to birth? A scar on the uterus has not changed the way your body births in the same was that a scar on your hand doesn't change how your hand works (well, in most cases). I understand that most people won't see it the way that I do and I respect that. I just have a very simplistic way of thinking and perhaps I'm naive and not putting enough emphasis on this. I know I have the ability to birth (even with a failed induction and 0 dilation), I know you have the ability to birth. Do you?<br><br>
I also read somewhere that just planning a hospital birth makes you 50% more likely to have a c-section. I personally feel that the safest place for a VBAC mom to birth is outside of the hospital. The interventions, even if you plan on refusing them-the chances are you will still have some sort of intervention if you have a hospital birth, are what increase a mother's risk and a baby's risk in normal birth. If you plan a homebirth, or out of hospital birth, you can do so in a way that you feel comfortable and have access to emergency medical treatment. In many cases of UR, with symptoms and mother's intuition there is adequate time to save the baby and the mother. Have a plan. You can always plan a homebirth and transfer to the hospital if you don't feel comfortable or if you feel something is not right, but chances are that if you plan only a hospital birth and want to go home-it is not likely to happen that way. It's not homebirth at all costs, or even VBAC at all costs. C-sections are there to save lives when they are needed.<br><br>
You know what went "wrong" in your previous birth and it may give you piece of mind to look into malposition in-depth and, as you suggested, finding a care provider who is experienced with malposition will help you acheive vaginal birth.<br><br>
Birth is only as safe as life itself. Life is very fragile in itself. There are risks in life, there are risks in birth even w/out a scar on your uterus. Becoming pregnant accepts these risks.<br><br>
In the end, you need to birth where you will feel most comfortable and where you feel works best for your family and your situation. I'm sorry to hear of all the losses that you have faced as a mother and I understand that you want to do what you feel is best for your babies.
Tasha, I am so sorry for your losses. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"> I also have a 17 mo old who was posterior and delivered by c-sec after 36 hours of labor at home with a midwife. I am finding myself in the same place you are...not pg yet, but wanting to research and be at peace with a decision before TTC#2.<br><br>
Some of your choices might be dictated by the area you live in, but IMHO if HBAC is an option in your area, you should go for it. I think as you research more about VBACs and what the actual risks are, you will be more comfortable and not see it as scary...certainly not as scary as major abdominal surgery.
Well as usual I have written a novel, lol...<br><br>
I understand some of your fears, although have not walked the same path as you with your previous experiences. I was so scared (and uninformed of my true choices) that for my second child's birth I chose a repeat c/s out of fear alone. I narrowly avoided having a preemie w/ a NICU stay because of that choice. I didn't know at the time the risks, especially how they compare to the risks of a VBAC.<br><br>
I started reading all the resources listed in the sticky here at the top of the VBAC forum. They are all helpful, especially the Plus-size-pregnancy site and the ICAN site.<br><br>
I read books about what normal labor is, and understood how my labor was derailed last time & what interventions to avoid next time. Henci Goer is one author whose material really helped me get clear on this.<br><br>
There is so much focus on the possibility of UR. Yes, it is a real risk and like all the risks of pregnancy and birth, no fun to think about. But is the reaction appropriate to the level of risk? Once you know you are informed, you need to address that for yourself; every woman's answer might be different. In my research, I've found there is an equal or greater risk of cord prolapse, for all women, than there is for UR in a VBAC mom. I have never considered fear of cord prolapse as a determining factor in my choice about how my future children will be born, so why should I let something even less likely to happen dictate my decision?<br><br>
As I read the research that says we now know that vaginal delivery has better outcomes for both mom and baby than elective repeat cesarean, I have to consider what situation will give me the best chance for a vaginal birth. I know for sure that at a hospital I would face interventions that increase my risk of c/s. So I would prefer to stay home as long as it is possible, including delivering at home if that is how it works out.<br><br>
I'm not at this point trying to label or define the birth I hope for. I've simply arrived at a point where I now say, I want and will accept no more medical attention than is necessary. Just like I wouldn't subject my already-born kids to unnecessary, potentially harmful medical procedures, neither will I subject myself or my unborn baby to them.<br><br>
I spoke to a midwife about the possibility of VBA2C, and she said she would not see me any differently than a woman who was delivering her first child. That really gave me a new perspective, to have a woman who has attended hundreds of births including vbacs, assure me that there is nothing so significantly flawed about my body that I should be considered differently than any other woman.
Tasha - I'm so touched by your story, all you've struggled through, and awed by your courage in looking forward so positively.<br><br>
My 3yo son was born by c/s, and I'm now expecting our second, due in October. It's been so hard not to second-guess every decision that lead to the c/s, but now that I feel so much more educated I can at least look at the chain of events and see where I might have made different decisions. And the very first one I wish I had made differently was to have chosen a midwife in place of an OB. I thought I had found a holistic practitioner, but when it came right down to it, she was also a trained surgeon who had to follow certain procedures or risk losing her license, and after little sleep for 36 hours I was easily lead to trust the judgment of others.<br><br>
When I first realized I was pregnant again, I felt such a rush of... power, really. I just KNEW that I was a strong, beautiful bearer of children and that everything would be fine and no-one would get in the way of having a beautiful birth. Since then, I've been pretty fatigued, nauseated and emotional which can all lead to self-doubt, but I'm really focusing on keeping that vision of woman as birth-goddess in my heart and mind, and remembering to trust that every single woman in my ancestry gave birth successfully - Every single one!!! And at least the last few generations had no c/s, so I'm guessing I'm the first in my line to have a c/s. Amazing thought!!!<br><br>
In waying risks, I know that if I set foot in a hospital to deliver, my risk of major surgery (with all its associated risks) is like 75-100%. But if I VBAC, my risk of UR is .5%. And you can't even factor in the power of your mind, heart and spirit. Lots of medical studies have shown the power of the "positive thinking" on good outcomes (for instance, severe burn victims heal many times better/faster when everyone around them keeps saying "they're going to be fine" even when they're unconscious, and people with terminal diseases have become disease-free through deep meditation and visualizing healthy cells). I think surrounding yourself with powerful, positive female energy throughout pregnancy and visualizing a strong and healthy birth can really make a difference in the birth. And I think men too need a supportive group around them during pregnancy - they can feel not-so-needed as women support each other, and can be feeling scared about the outcome after a previous c/s - after all, they watched their partner undergo major surgery, and usually without any warning.