repeat c-section vs vbac

Thinking about baby number 2.  I REALLY really really want a vbac.  Of course it's not without risks.  But repeat c-sections also come with risks.  Which would/did you choose.  I am still sad about Sage's c-section because the more I think about it, the more I realize it was probably 100% preventable.

Thanks for the input!

My sister saw a midwife that specialized in VBAC. I hear it is very possible, and doctors are always ready to put someone under a knife. Hopefully you can find someone that would be willing to do your wishes in your area.

I am totally having another C-section. I know some women feel like they need to have a vaginal birth but I have no issues with the fact that I had a c-section. Some might not like this statement, but I am actually happy that I get to have a set date for when the baby will be do, since my family lives in another state.

Good luck with your decision! :)

Some moms do feel this way. I was in the UK  and 42 weeks and labored for 24hours and started at 2cm dialated and ended up at 4cm.  - I was exhausted and there was meconium in my waters so it was emergency c-section for me.  - so, mine was totally random and unpreventable.
My c-section in fact left me infertile (long story) - so yes - definite risks for both.

That said, I  have already discussed a c-section with my ob/gyn already - he does feel that if I want I can be induced, try to labor and assess my uterine wall/ scar as I do so. However, if I don't progress and dilate after a set number of hours, we will proceed to C-section. - At the moment, I think I will just opt for the c-section, but am glad my Dr. is willing to offer other avenues.

There are a lot of factors.  I am hoping to VBAC this baby, who is due in early December, but of course I believe the most important things are safety of mom and baby.  Second is a mother's choice.  I have friends who happily had repeat cesareans and said they were very easy compared to a primary c-section.  Others had VBACs and said they felt normalish in one to two weeks, which sounds very appealing to me considering how rotten abdominal surgery recovery can be.

If you get pregnant right now, your babies would only be 15ish months apart and some OBs/MWs think you need at least 18 months between a c-sec and a VBAC, so you might want to delay TTC for just a few more months. 

Ask yourself the following questions (and any more that are bothering you!):

*Are you hoping to have a lot of children?  If you only want two or maybe three, a repeat c-sec might not be a huge deal.  But if you want four, five, or you just don't want to have to decide the next time you are pregnant, you might want to go for the VBAC.  Of course, some moms have a ton of cesareans and never have a complication.  But others suffer from placenta accreta, bowel obstruction, excessive adhesions - a c-section's a big surgery. 

*Will the fear of a uterine rupture ruin your pregnancy or hinder your birth process?  I had to get over the idea, although I know the small risk does exist.  Other complications (cord prolapse, placental abruption, etc) can happen to any mother, VBAC or not, and I don't sit around worrying about them, so what I did is I chose the place I felt was safest to birth naturally or in an emergency.  It's a level 1 trauma center, but I'll be in the midwife wing.  They have anesthesiologists and OBs and even trauma surgeons in the building at all times. 

*Did you have any major pregnancy complications that might make a repeat c-section necessary at the eleventh hour?  I had chronic hypertension with my daughter and a big spike (not pre-eclampsia, though) at the end of pregnancy, which resulted in my OBs inducing my labor before my body was really ready.  This time around, my blood pressure has been great (yay for WLS!) but they have been watching me.  If my pressures had trended high for a significant time, I would have thought more seriously about a repeat c-section.  Since they're behaving, the VBAC is still a go.

*Have you researched providers, hospitals, etc?  Really look into your options.  Some states have very few VBAC friendly hospitals and providers, so you might have to do your homework.  Just because an OB or MW says at your first visit that you might be a good VBAC candidate doesn't mean you'll be supported throughout pregnancy.  Look at cold hard stats as well as try to get a feel for the providers.  I knew I'd found my place when I found a practice of hospital MWs with an 85% VBAC rate.  This makes me feel like even if I end up with another cesarean, my team and I will have given it our best shot. 

*Do you feel you had adequate support in your first birth?  I realized my DH and I were too scared to always ask the right questions or be firm in decisions the first time around.  Obviously, we would have deferred to my OBs in a true emergency, but we ended up OKing a c-section when my labor was just stalled.  I had no sign of complication or infection, and I always wonder if time would have helped me have a normal birth.  At any rate, that ship has long since sailed, and I am OK with how things happened, but it made me realize I needed another advocate besides my awesome, clueless-about-birth DH.  I hired a very experienced, cool doula this time around and she is such a help already.  I believe she'll be a good support during L&D too.

OK, sorry I talked so much about myself, but I wanted to give my perspective as someone who had a c-section 5 years ago and is a VBAC hopeful.  I wish you the best in trying to conceive your next baby.  Sage is cute as a button!  I'll let you know how my birth turns out - my biggest wish is that it's relatively peaceful and we both end up safe!

I am planning on waiting until Sage is 1 until we start really trying.  Right now we are not using protection but avoiding ovulation time.

While I recovered super fast from my c-section there is a part of me that feel inadequate for not being able to have a vaginal birth.  No one in my family has ever had a c-section.  The reason I say i feel it was preventable is because I was progressing just fine, until I let them administer pitocin.  That's when I asked for the epidural making it that much more easy for them to do a c-section.  The pitocin made me have one unending contraction, which caused the baby's heart rate to drop because she was in distress (which I am not totally convinced her heart rate was dropping because the external monitor wasn't working so the internal one in, but it wasn't in all the way it kept falling out, and when she came out there were no spots on her head where the monitor should have been).

Anyway I was at a 5 when they told me her cord was wrapped.  After the c-section they said it was never wrapped they "don't know why" her heart rate was dropping.  I am convinced it was from the pitocin, I was doing fine on my own before that.

I am wanting to have 2-3 kids, but with each c-section I know it gets harder.

Towards the end, like the last second my BP was spiking but I know it was because everyone was scaring the **** out of me talking about a c-section.  That was my absolute worst fear.

The hardest part will be finding someone willing to do a vbac.  My hospital has a no vbac policy and NJ as a general rule is c-section happy as it is.  I've been researching birthing centers but a lot of them wont take c-section patients.

I still have time to think about it, thanks for the response.

I will gladly choose another c-section.  Recovery for me was a breeze...I was back to normal in a few days.  I drove myself to my follow up appt on Monday after I got out of the hospital on Thursday.  I was totally off pain meds by Friday.  My BF had a natural birth and she tore so bad that she couldn't even walk well for 3 or 4 weeks.  And she said sex was sooo painful that it took her 6 months to feel close to normal.  I know this isn't the norm but I will definitely be choosing another c-section next time.  And I don't feel cheated or sad about my c-section birth at all.

C-Section was chosen for my 2nd , but VBAC was an option I refused. My first was a unplanned c-section as I was induced but never got past 3cm after laboring for 12 hours and I was high risk due to large baby (9lbs 6oz) and gestational diabetes. I healed pretty fast last time and it wasn't so bad at all. I'm choosing C-section this time as for me the benefits certainly out weigh the risks.

Some women tend to be made to feel less than by other women/mothers because they didn't have their baby the so called  "traditional" way. There are no traditional ways these days and I'm not going to be pressured into VBAC "because it's so called "natural".. Both have risks, so roll the dice and go for it. I like the idea of knowing when I'll have my baby, as my c-setion is scheduled for 02/25/11 (Unless the baby shows out and try and come earlier) :)

~~Gina

I totally agree with Gina....this will be my third baby and I am having a c-section and don't mind at all, but you will make the right choice for you and that's what matters. 

If I had been able to I would have had a VBAC, it was just too risky b/c my first was a classical. I think if you want it, go for it! Find someone who is willing to help you though the process and fight for it! It's your body, your birth experience and you should have it the way you want it.