Second time around: Should I go VBAC or C-section?

I had a c-section for my first baby (unplanned, but necessary after a long labor in which my cervix did not dilate. At all.) My second two deliveries were vaginal. Curiously, I had the opposite experience of most women--my recovery from the c-section was super quick and relatively problem-free. My second delivery--again a long, arduous labor--was followed by a terribly long and difficult recovery. Number three was an easier delivery, but still, the recovery was harder than with baby number one. I guess you just never know, so be careful what you wish for ;-)

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It seems to me, from what you said, that the epidural caused the problems with your first child. Maybe you're allergic to something in it, or had some other sort of abreaction. Either way, if you plan a VBAC, it would seem to me (from what you said, which is brief and not detailed, so what do I know?) that you would want to do it naturally (or at least sans epidural) to avoid risking the same complication with baby #2.

I had my (first) daughter naturally, without even a Tylenol, and it was the best experience of my life. I'd go back and do it over again for a decent night's sleep (and I've said that since the beginning, so it's not just the "oh she forgot what it really feels like" thing). I'm 33 weeks with #2 (hence the not sleeping and the abundant use of parentheses - I like the shape, they feel like me ( ) ), and I plan to do this one au naturel too.

The other advantage to going natural is that you'd be able to feel it if something goes wrong. I would worry, with a VBAC, where uterine rupture is a risk, that if you had an epidural, you might not feel it if something went badly. On the other hand, you might not recognize the sensation as "wrong" if something did go badly, anyway, having not been through it before.

Certainly talk to your OB. A lot of them won't even do them anymore because of liability. If you love your doctor, and want to use him/her again, but s/he doesn't do them, that could add another layer to your decision.

Anyway, here's what I found with labor - when you get to the point where you're saying "I CAN'T DO THIS ANYMORE" you're done. Pushing felt really good, and pain free, for me, except for the whole head crowning part, which sucked, but then I knew I really was almost done. Of course, I have fast labor (3.75 hours with #1, I'm worried that I've already had #2 and I just haven't noticed yet...) so what do I know about normal labor?

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I am in a similar boat as you. While I didn't have a reaction to the epidural I ended up not dilating after being on the highest dose of pit for 12 hours. We had fetal distress issues and an emergency c-section. My son has seizures after birth and was diagnosed with epilepsy at 2.

I am due shortly after you in September and totally going back and forth between section and VBAC. I can't help but feel like I was robbed. I want to have a regular delivery. I want to go through what millions of woman for years and years have come through. I want what I am entitled to. I just want to make sure it's the best decision.

My doc will do a VBAC and I think so far that is what we are planning. I may change my tune down the road, but I doubt it. This post just really hit home because I am in the exact same spot.

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I had a VBAC seven months ago. I have to say that the recover is just different. However, I felt better in the short term. I was able to leave the hospital in two days instead of seven. I would recommend to attempt a VBAC, it was an amazing experience.

My only recommendation is to find a VERY supportive OB. My local hospital would not let me VBAC so I traveled to a bigger city. The Dr. my local OB recommended tried to talk me out of it, so I interviewed other drs until I found one who was supportive. They did not pressure me at all and let me labor and push for quite a while. Support and lack of pressure to repeat c/s is very important.

If you are not successful do not feel badly. The final goal to a pregnancy is a healthy baby.

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I had a scheduled C-section with my first since she was breech. I am 20 weeks pregnant with #2 and planning a VBAC this time around. Having gone from thinking I would be having an unmedicated birth to having the ultimate intervention (and everything was fine--short recovery), I am a lot more relaxed now. However baby comes, I'll be happy enough. But I am seeing midwives with experience doing VBAC and delivering in our hospital's alternative birthing center, where I'll have access to water pools for labor (and birth, if desired).
http://marketingmommy.blogspot.com

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I've been blogging about the same issues. I'm due in 2 days and have been planning on a VBAC all along, but I'm not progressing and am down to decision making time. I had a lot of complications during my first labor and ended up with an emergency c/s for various reasons. I fear going through a long and complicated (and potentially dangerous) labor again just to satisfy my own urge to deliver vaginally, however, I also am aware that the complications may have been due to the induction and not likely to reoccur.

The decision is hard and it's a very personal one. My friends think I'm crazy for even attempting it after what happened last time but it's still something that I would like to try. I have a c/s planned for next week but I am desperately hoping he make an apperance on his own and I have the chance to labor.

I've become at peace with either route for now though, sice it's pretty much out of my hands if he decides to come on his own or not.

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My first child was born via C-section after I failed to dilate more than 2 centimeters. I was induced at 39 weeks due to gestational diabetes. The C-section went fine, but the recovery was long and hard. We were in the hospital for 5 days and I was exhausted after laboring for 24 hours and then going through the C-section. With my second child I opted for the repeat C-section. I also went back and forth for months before he was born, I was hoping to try for VBAC as well. My decision for the C-section was a hard one to make but I'm glad I did it. The planned C-section went smoothly and my recovery was quick and pretty pain free.

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Statistically, VBAC is safer than elective c-section after c-section.

Get thee to the ICAN website to begin researching.

You are in Toronto, right? I'd highly recommend meeting with a midwife instead of an OB. Docs in Ontario are starting to become OB shy.

Get yourself a doula! A good doula will feel like a miracle during labour. (Doula CARE is an Ontario doula association you can get referrals from.)

Good luck!

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Cripes, I really ought to re-read before hitting post!

OBs in Ontario are becoming VBAC shy, is what I meant to say!

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I had a scheduled c-section with my first because she was breech, even though I had wanted a natural birth. She was in a position that would have made it close to impossible to deliver vaginally.

I'm pregnant with #2 right now, and plan to have a VBAC. My doctor is very supportive of it, and the hospital is also supportive (they did a study on VBACs at that hospital and found them to be just as safe as repeat c-sections).

I hated my c-section recovery, and would like to go as natural as possible this time. Plus, after a c-section, you can't lift anything heavier than your newborn for 8 weeks. If I couldn't pick up my (needy) toddler for 8 weeks, I can guarantee it would be the worst 8 weeks of my life - and my toddler's, and my husband's!

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I'm in the same boat also. Emergency C-section for #1 and am now 15 weeks along with #2. I'm willing to try for a VBAC but I'm keeping my mind open about the possibility of another C-section. For me, recovery from the C-section was short and problem-free.

I know for sure that I will not allow my doc to induce me because the risk of rupture is 5-7% with induction, which is high enough for me to say no way.

If I go a couple weeks over my due date as I did the last time, am still not progressing, and there is fetal distress (that was the scenario the first time around), at that time I will agree to the C-section.

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My first labor ended in a c-section after more than 40 hours in labor.

You have a lot of wonderful suggestions and support for VBAC here, and I think the ICAN site is great.

But in the end I did have a scheduled c-section for my second.

First, I had a major issue with pitocin. I was on it for 12 hours and after my c-section I hemorrhaged badly. I later learned that the pitocin is a risk factor for that. I had three nurses leaning on my belly trying to get my uterus to shrink back as it was so floppy. I did not want to use pitocin to induce or accelerate labor again. As Tara mentioned, the risk of rupture is much higher with induction. So my rule was: I will attempt VBAC only if I can do it without intervention.

Second, my recovery from labor plus c-section plus bruising was very difficult. Therefore I did not want labor PLUS c-section again.

Third, my kids were only 19 months apart and this is right on the line for VBAC (they usually say at least 18 months).

So I waited until 40 weeks to schedule a c-section. People kept saying to me "you know you might go into labor then" and I said "yes, and that would be fine." In fact, I didn't go into labor, and went in for the scheduled c-section where again my uterus would not shrink and I hemorrhaged, but this time they took care of it during surgery and there wasn't the bruising. I went home after two days and had an easy recovery.

For the most part I'm happy with my choice, though I feel a little guilty when I read people's rants against c-sections. I sometimes think I should have waited until 41 weeks, though since my baby was 8 lbs 2 oz I think we would have had a size issue anyway.

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Talk to midwives, and you might even consider homebirth; hospitals are not so good at VBACs, they tend to get nervous about (falsely) perceived liability issues unless you show up pushing (and sometimes, even then).

C/secs are and should be emergency surgery; maternal and infant mortality risks are 3x those of vaginal in an otherwise uncomplicated birth.

There's a good midwife blog at http://observantmidwife.blogspot.com. She's done lots of VBACs (many homebirth), and could probably direct you to other places with good info.

here's one birth she attended:

http://observantmidwife.blogspot.com/2006/03/home-birth.html

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You have a lot to think about. More and more studies indicate a VBAC is healthier for mom and baby, but I have found that a c-section is A LOT easier then vaginal birth to recover from; I was walking funny for a month or so after 2nd degree tearing w/out episotomy, but the wound from the c-section seemed to just disappear so quickly. I do think you might want a doula if you go with a VBAC - it helps you and your partner to stay focused in what you want and while a doula will not speak for you she will remind you and encourage you to reach your goals. Indeed doulas seem to greatly increase the rate of success with VBACs.

Then there is the baby, all in all there seems to be less risks for vaginal birthed babies vs. c-section even with the minimal additional risks that a VBAC adds. Plus vaginally birthed babies are so much more alert and raring to go vs. babies born from c-section.

Lastly, you may not be thinking about it, but I did, c-sections can compromise your future reproductive health. If you are only having two or so, it's no problem, but additional scars in the uterus increase the risk of both miscarriage but also having too deep an implantation of the placenta (read: needed c-section and potential hysterectomy). Then there is build up of adhesions in your abdomen that might complicate any surgeries you might have in the future that aren't even related to your sexual reproductive organs.

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Do you know if your reaction to the epidural leaves you predisposed to have that same reaction again? If you want the epidural, and you are predisposed to this side effect, it might be worth a scheduled c-section.

I don't share your desire to have a vaginal birth. I had an elective c-section with twins (though one was breech, and I have a lung disease limiting my lung capacity) but I want to believe ultimately it was my decision and it was elective. I thought recovery was a breeze, but I had no complications.

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I had a vaginal birth with my son--long (36 hours) and hard (back labor)--but I consider it to be the single best experience of my life. Recovery was easy. My daughter was breech and I had a scheduled c-section, which, in terms of experience, was terrible. The recovery was much more difficult too. I say go for the vbac, but as you can see from the comments, it's different for everybody.

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This topic is close to so many hearts, including my own!

I just found out that I'm pregnant with #2, and I will more than likely opt for a scheduled c-section, instead of a VBAC.

With my daughter, we had been training for a Bradley birth but I ended up having a C-section for a variety of reasons: there was meconium in the amniotic fluid and I'd labored for over 16 hours (been contracting steadily for months) but the baby hadn't "dropped." We were all starting to become very concerned for her safety. As it turned out, she had a true knot in her cord, accounting for the meconium, and she weighed 9lbs6oz.

My recovery was very painful and very long. Once of the suture points in my wound became infected 3 days post-op, and I had to endure a month's worth of home health care followed by dressing changes on my own. It's something that I don't wish to go through again, especially since I now have a toddler at home. However, because of my history of scar infection and huge baby, and because I've read that statistically, women with failed trials of VBAC labor actually fare worse, in my case I think a repeat c-section is the best choice.

I think it's so important that each woman take her individual circumstances into consideration when making such a difficult decision. Best of luck to you!

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I attempted a VBAC with my third child. My first birth was natural, my second was a (questionably) necessary emergency section. I chose care with an amazing midwife and a wonderful doctor.
I went into the birth understanding that it was a trial of labor. I had knowledge of the risks I was running and support from the midwife and doctor, both. I had an amazing labor and dilated fully, was pushing when the unthinkable happened - I ruptured.
Because of the amazing medical team I had, my baby and I survived the rupture.
This could have been the worst experience of my life...IF I had not been prepared. IF I had not armed myself with knowledge and surrounded myself with my birth circle. It was not fun, it was definately a trauma I am still dealing with, but it happened - and it does happen, with results not as pretty as mine.
THat said, rupture is rare. I FULLY support a woman's right to VBAC - SAFELY, under the care and observation of a diligent OB (and a wonderful midwife if you are so inclined). Know the risks, weigh the risks, learn what to look for. Email me and I can get you in with a great group of women who are weighing the same decision you are.
No matter what you decide, I hope you embrace that decision - you can give birth just as beautifully either way.
Peace!

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You don't need to make a descion really til about 8 months. I would see how you feel and talk about in depth with your dr. Ask what could have happened with the last birth . What are the chances of it happening again.

I had a 2nd c section because I also didn't dialate at all.

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TALK TO YOUR DOCTOR>

I spoke with mine early on with my second pregnacy b/c I had a emer. c-section with my first. He said he wanted to wait and see what happens, the only thing he promised me was 1.) no large baby coming out and 2.) I would not go past my due date.

I ended up going a month early and the doctor on call said it was still my choice. I wanted a vbac badly, but scared b/c I didn't know what it would feel like and I knew what a c-section felt like and how I felt afterwards. (by the way, my first c-section was great!!) I ened up opting for another c-section b/c it was what I knew. And I am glad I did. I didn't have to induce labor and go thru all that. I went staight to c-section (with drugs) and had my baby. I was also a lot more alert afterwards b/c I wasn't as drugged with my second one as I was with my first.

I pregnant now with our third child and I think I woudl still opt for it even now, but it would honestly depend on my doctor.

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