VBAC or repeat?

Misty - posted on 06/11/2009 ( 23 moms have responded )

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Have any of you done a vbac (vaginal birth after cesarean)? What are your thoughts? Would you do it again? Would you recommend it?

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Tamara - posted on 06/12/2009

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While I haven't had a VBAC, I am in the planning stages of one and I would do it in a heartbeat. I advise going over to http://www.ican-online.org to go over the many articles and going through the forums to speak to the many wonderful women there who have had VBACs and know the ins and outs of having a successful VBAC.

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Shakinyi - posted on 04/01/2013

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VBAC's have a higher rate/ risk of complications than repeat cesarians. Thats a proven scientific fact.

So i personally dont get the logic of people that are anti-c-section but promote VBACs given that fact. It seems selfish to risk your life and the life of your baby, a doctor's practice and reputation, and a hospitals's liability... all to prove a point to no-one but yourself. The rest of the world doesnt care. All they will ask is how is mum, and baby...not how did your baby get here? Cause at the end of the day, IT. REALLY. DOESNT. MATTER.

I have also learned not to argue such facts with people that have little or no knowledge of medicine and do not research because the conversation will digress into insanity levels that id rather not be privy too. Lots of conjecture and political opinion, very little fact.

But while we are talking about facts, it is not worth years in med school, 6 figure student loans, 7+ figure salary potential and retirement to help prove to a single woman that she did indeed deliver a baby even though she had some help. It just isnt.

If it makes you feel like less of a woman to deliver a baby one way over another....in spite of the millions of women that will never experience the joy either way, or the hundreds of millions before you that have died trying....then you have deeply seeded issues that an OBGYN wont fix. A Psychiatrist may be of better assistance.

Sarah - posted on 06/14/2009

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Quoting Jessica:



Quoting Erin:

Hi!! I had 2 c sections--the first was because the baby was breech, and over 8 pounds. Also, I was 37 years old--I considered VBAC, but went with a 2nd c section--just didn't feel comfy with the risks--neither did my doctor. And I delivered in a big city hospital (Buffalo, NY). By #2, I was 39 years old--it doesn't matter HOW the baby arrives--as long as you both are healthy!! Amen!






I've also had 2 c-sections.  I believe a mother should do what is right for them.  I had my 1st c-section because my physician recommended it.  She said that I could attempt vaginal delivery but she was almost certain it would result in an emergency c-section.  I chose to trust her and I've never regretted it.  The second c-section was because my physician does not do v-bacs and I chose to stay with a physician I trusted over attempting a risky procedure to experience a natural delivery.  Both of my children were over 10lbs.  I had an AMAZING experience with both and have never felt like I "missed out" on something.  I even over-heard a woman at the hospital when I had my first child saying that "You haven't experienced giving birth to your child unless you push him out of your body."  It didn't bother me at the time but I did wonder if I would feel like less of a woman after.  I never did feel that way, EVER.  I did what was best for my child and myself. 






 






My children were healthy and happy and as a result of doing what was right for myself and my body to get them here in that condition, I was too!  That, to me, meant I could focus on bonding and loving them.  A very good friend of mine at the time had a baby 2 months before me.  She planned through her entire pregnancy to have an all natural delivery at a home birthing center with midwives.  She was so determined to do things her way, no matter what.  I really applauded her for sticking to her guns and making sure everyone followed suit.  She was advised by her physician toward the end of her pregnancy to change plans, her baby was measuring to be at least 11lbs and was in stress.  She refused.  She waited & went into labor and went ahead to the birthing center.  The center had to call an ambulance after nearly 23 hours of extremely hard labor and she was rushed to the hospital.  I could go on with the horrific details but i'll just say her son almost died and she was all but dead.  The pain and trauma (just in the life saving stage, not counting the attempted labor) she experienced was so profound she refuses to even discuss it and will never have another child.  All she really has said since is that the hospital staff treated her like she was a complete moron (which is disgusting to me for ANY reason) and made her feel like the whole thing was her fault for being so stupid.  It was very sad.  She withdrew from everyone and had serious post partum depression.  She is ok now but has never been the same. 






 






Anyway my point is, trust your doctor.  If you don't, find one that you can and do what they recommend.  THEY are the doctor.  I'm not saying you shouldn't inform yourself, YOU SHOULD, but in the end, trust the people who are trained to take care of you and your baby!  And NEVER let any woman make you feel like less than her because you didn't push a child through your vagina!   THAT is not what makes you a mother. 






GOOD LUCK ON WHAT EVER YOU DECIDE!!!   






 






 





i think you make a good point there, i think some people are so determined to have the birth THEY want, that they don't always listen to the reasons not to.



i had a c-section with my 2nd as she was breach, they didn't find that out until after they'd induced me tho, so it was an emergency c-section. i think if i were to have another, i would consider a VBAC, but i would have to know what the doctors thought. if they were dubious about whether it would be successful or not, and they had good reasons for thinking that, i wouldn't hesitate to have another c-section. at the end of the day, it's not really about the type of birth i would prefer, it's about delivering the baby safely. :)

Rachel - posted on 06/14/2009

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This was a big question for me. With my first baby, I had an emergency c-section after 8 hours of labor, because of fetal distress (cord around her neck). When I was pregnant with my second, my doctor was open to the possibility of VBAC. I had ultrasounds to measure the baby and confirm that he was not too large, and also to evaluate the scar from the first time. All appeared to be ok, and I was in generally good health, so VBAC seemed like an option.

However after discussing all the risks and scenarios, I finally decided to have a c-section after all. I was very sad about this in a way - it sort of felt wrong and I wondered if I should have tried for the VBAC after all. But when I did have the surgery, the doctor found that actually my scar was paper-thin (although on the ultrasound it appeared normal) and he said there was no way it would have gotten through labor without a rupture. So in the end it all turned out ok. I did miss having a normal birth experience, but having my 2 wonderful healthy kids means far more to me!

Mary - posted on 06/14/2009

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I'm probably going to kick myself for responding to this, but here goes...



I should start out by saying that I am an L&D nurse with 15 years of experience, so what I have to say is shaped by that. I think the biggest factor in deciding whether or not to try for a VBAC is the REASON FOR THE 1ST C/S !!!! If it was for breech, fetal distress, an HSV outbreak or multiples, than, yes, I think it is reasonable to consider. If it was because of failure to progress (you didn't get past, say, 4cms) or you pushed but the head didn't descend, well...odds aren't good that it will work. If the 1st baby didn't fit, it's a pretty sure thing that a 2nd one won't either. Generally, each successive baby is a bit bigger than the one before (discounting things like gestational diabetes or IUGR). Truly, you never know until you try, but you can sometimes make an educated guess.



Uterine rupture is rare, but it is something we certainly monitor for closely in VBAC's. In all my years, the 2 ruptures I've seen have been on women who had never had a c/s. Truly, we used to do a lot of VBAC's in the 90's, but they have fallen out of favor b/c of the high litigation rates in obstetrics in general. Sadly, we live in a society where everyone expects a perfect child, and think that somebody else MUST be to blame if that child is less than perfect, regardless of the real reason for those imperfections. Sorry, I don't want to travel down THAT road here.



Bottom line, it is a choice that you & your doc need to make together. I know a lot of people believe that a c/s recovery is longer, or harder than a vaginal delivery, but I'm not sure that's always true. I've seen some really bad bottoms in my time, and I would rather have a c/s than a 3rd or 4th degree tear!! (my own 2nd degree was bad enough!). There is no absolute right or wrong here, and no guaranteed outcome. It basically comes down to what you are comfortable with, and how important a vaginal birth really is to you.



I wish you the best of luck, a happy birth experience, and - most importantly - a healthy mom & baby!!

Jessica - posted on 06/13/2009

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Quoting Erin:

Hi!! I had 2 c sections--the first was because the baby was breech, and over 8 pounds. Also, I was 37 years old--I considered VBAC, but went with a 2nd c section--just didn't feel comfy with the risks--neither did my doctor. And I delivered in a big city hospital (Buffalo, NY). By #2, I was 39 years old--it doesn't matter HOW the baby arrives--as long as you both are healthy!! Amen!



I've also had 2 c-sections.  I believe a mother should do what is right for them.  I had my 1st c-section because my physician recommended it.  She said that I could attempt vaginal delivery but she was almost certain it would result in an emergency c-section.  I chose to trust her and I've never regretted it.  The second c-section was because my physician does not do v-bacs and I chose to stay with a physician I trusted over attempting a risky procedure to experience a natural delivery.  Both of my children were over 10lbs.  I had an AMAZING experience with both and have never felt like I "missed out" on something.  I even over-heard a woman at the hospital when I had my first child saying that "You haven't experienced giving birth to your child unless you push him out of your body."  It didn't bother me at the time but I did wonder if I would feel like less of a woman after.  I never did feel that way, EVER.  I did what was best for my child and myself. 



 



My children were healthy and happy and as a result of doing what was right for myself and my body to get them here in that condition, I was too!  That, to me, meant I could focus on bonding and loving them.  A very good friend of mine at the time had a baby 2 months before me.  She planned through her entire pregnancy to have an all natural delivery at a home birthing center with midwives.  She was so determined to do things her way, no matter what.  I really applauded her for sticking to her guns and making sure everyone followed suit.  She was advised by her physician toward the end of her pregnancy to change plans, her baby was measuring to be at least 11lbs and was in stress.  She refused.  She waited & went into labor and went ahead to the birthing center.  The center had to call an ambulance after nearly 23 hours of extremely hard labor and she was rushed to the hospital.  I could go on with the horrific details but i'll just say her son almost died and she was all but dead.  The pain and trauma (just in the life saving stage, not counting the attempted labor) she experienced was so profound she refuses to even discuss it and will never have another child.  All she really has said since is that the hospital staff treated her like she was a complete moron (which is disgusting to me for ANY reason) and made her feel like the whole thing was her fault for being so stupid.  It was very sad.  She withdrew from everyone and had serious post partum depression.  She is ok now but has never been the same. 



 



Anyway my point is, trust your doctor.  If you don't, find one that you can and do what they recommend.  THEY are the doctor.  I'm not saying you shouldn't inform yourself, YOU SHOULD, but in the end, trust the people who are trained to take care of you and your baby!  And NEVER let any woman make you feel like less than her because you didn't push a child through your vagina!   THAT is not what makes you a mother. 



GOOD LUCK ON WHAT EVER YOU DECIDE!!!   



 



 

Erin - posted on 06/13/2009

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Hi!! I had 2 c sections--the first was because the baby was breech, and over 8 pounds. Also, I was 37 years old--I considered VBAC, but went with a 2nd c section--just didn't feel comfy with the risks--neither did my doctor. And I delivered in a big city hospital (Buffalo, NY). By #2, I was 39 years old--it doesn't matter HOW the baby arrives--as long as you both are healthy!! Amen!

Malinda - posted on 06/12/2009

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Quoting Beth:





 






They are scared that you or your baby will die....I think that is something to be worried about....why risk someone's life unnecessarily?









 






You mean like with unnecessary major surgeries?  You also said that doctors are worried that if a baby dies in labor you will sue them, but what if you (or your baby) dies in surgery?  That certainly happens, too - shouldn't that be a concern?  Or is it that we're such a surgery-happy culture that there are OB's who have actually delivered as many or more babies by c-section and view it as a "normal" and perfectly healthy alternative to actual birth?



Yes, I am all for c-sections in actual emergencies.  But the fact that OB's will not only suggest them in the absence of an actual emergency, but allow people to voluntarily go under the knife for a variety of unnecessary reasons does nothing to instill confidence in me that an OB has *my* best intrest at heart.  Especially if they're going to recommend a c-section to avoid a law suit and save their own butts.



Western medicine is a great thing when there are actual treatable illnesses, but IMO totally misses the boat on things the body is *supposed* to do.

Beth - posted on 06/12/2009

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Quoting Tamara:



Quoting Amber:

I had a c-section with my daughter, and now I am planning to have another baby. I personally do not feel comfortble with VBAC. As a matter of fact I am almost finished with nursing school and I just did a maternity rotation and class, we were taught that VBAC is fairly dangerous, in fact many OBGYNs will not do them b/c of the increased risk of uterine rupture. It's a personal choice, but since it is risky and many doctors won't do them, I don't feel comfortable with the risk. I would suggest that you research the benefits and the risk and decide whether or not you are personally comfortable with VBAC.





I didn't know that OB's were scared of a half of a percentage point risk of UR in uninduced VBACs.  Wow.  Wonder what other things they're scared of?



 



 



They are scared that you or your baby will die....I think that is something to be worried about....why risk someone's life unnecessarily?





 

Tamara - posted on 06/12/2009

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Quoting Amber:

I had a c-section with my daughter, and now I am planning to have another baby. I personally do not feel comfortble with VBAC. As a matter of fact I am almost finished with nursing school and I just did a maternity rotation and class, we were taught that VBAC is fairly dangerous, in fact many OBGYNs will not do them b/c of the increased risk of uterine rupture. It's a personal choice, but since it is risky and many doctors won't do them, I don't feel comfortable with the risk. I would suggest that you research the benefits and the risk and decide whether or not you are personally comfortable with VBAC.


I didn't know that OB's were scared of a half of a percentage point risk of UR in uninduced VBACs.  Wow.  Wonder what other things they're scared of?

Beth - posted on 06/12/2009

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I just want to say one other thing in defense of the doctors who do them...if they hold off on doing a c-section when the baby is in crisis, and the baby dies, you will probably sue them. So perhaps doctors do sometimes err on the side of caution, because experience has taught them to do so.....





so while a c-section IS major surgery, and does take longer to recover from, we should appreciate the fact that it IS available and many babies (and Moms) are alive today because it is an option.





If you trust your OB, then trust that they want to do what is best for you and your baby and if they DO err on the side of caution and do a c-section that some might deem "unnecessary", try and understand if from their side as well.

App+7mnejhu - posted on 06/12/2009

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Well said Malinda...I was thinking the same thing about all the mention of VBAC risks. Yes it is true there are risks however it is less then 1% risk of uterine rupture and actually like you said there are more risks with c-sections that are rarely even discussed. That is why it is so important to do your own research so you can become informed and know all the risks and benefits before making your decision. Again I wish you the best!

Malinda - posted on 06/12/2009

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If you like personal testimonies along side statistics and information, I highly recommend that you read The VBAC Companion (http://www.amazon.com/VBAC-Companion-Exp...)



I can't share my story with you yet, as I'm due in August, but I will afterwards (successful or not). And I will say that my first child likely did not need to be born by c-section. I truly believe that I had a c-section out of convienience for the doctor. It was late, everyone was tired, and I was given a story about "failure to progress" (at 8.5cm for less than 2 hours) that can not now be fully backed up by medical professionals. At the time, however, I felt as if c-section was my only option. The doctors used words like "let's do it now before it becomes an emergency" but there was no reason to believe that it would.... So I let them cut me open and regretted it ever since.



There is much mention in previous posts about the risks involved in VBAC (i.e. uterine rupture), but why none about the risks involved in c-section (and especially repeat c-section)? It is, after all *major abdominal surgery* and also includes risk of uterine rupture and infection, along with faulty scheduling techniques that increase the risk of premate birth. Definitely look at both sides and (as others have said) make sure that you have a very supportive staff of people involved in your birth.



Good Luck to you!! I hope that whatever the outcome you have a wonderful and rewarding birth experience this time around!

Misty - posted on 06/12/2009

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Thanks a lot for all your thoughtful and helpful responses. The reason my first child was an emergency c-section was because she was intolerant (or insolent;) to delivery, meaning that her heart rate began to drop every time I had a contraction. I've still got a lot of thinking and researching and praying before I make any decisions. Keep posting; personal testimonials mean a lot more to me than dry research.

Marne - posted on 06/12/2009

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Vbac is really something that has to be decided on a case by case basis. My first son was a c-section due to fetal distress and when I became pregnant the second time I told my ob I wanted a VBAC. He said he was willing to entertain the idea but would not commit to it until he saw how things developed during my pregnancy. As it turned out I was pregnant with twins and developed a mild heart condition so vbac was out of the question. If your prgnancy procedes normally and there is no problems with you or the baby, I would discuss the possibility with your OB. Any surgery carries it's own risks and at that point the risks are about equal. If there is ANY question of a problem with either of you then a c-section would be the better choice. I wish a natural childbirth had been possible for me but I certainly don't love my kids any less for not having one.

Beth - posted on 06/12/2009

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I think one of the things that bothers me is when I read "absolutes" - like "you should breastfeed because baby formula is poison" or "you should have a vaginal birth becauwse its more natural" - there aren't any absolutes and it concerns me that some women will read what others post on these Boards and feel that they 'have to" do certain things or others will judge them or criticize them.



There are no easy answers - to breastfeed or not, to have a c-section or not, etc.



Having a c-section is major surgery, and no ethical doctor wants to do it for kicks. I have had the same ob/gyn for 22 years and I believe that he has always had my health, and the health of my baby, as his highest priority. I also believe that he probably saved my life 19 years ago.....



so all the women who read these Boards should read the different thoughts and opinions but in the end make whatever decision works best for them and for their child - and never worry that they have to explain or defend that decision to anyone else.

Amber - posted on 06/12/2009

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Quoting Beth:

I think it all depends....thats great that you had your third child vaginally and that it worked out....but everyone is different....I almost died having my second child and was in the hopital for three weeks after she was born. I was unwilling to do that to my body again and went ahead and had a c-section with my third which was relatively easy and drama-free. For me, that worked out better but I think everyone has to do what works for them - there is no "right" or "wrong"



Exactly! Everyone is different, some women have problem free VBAC experiences, but other have complications that lead to longer hospital stays, sometimes hysterectomy when they cannot stop the bleeding, and occasionally even worse, death due to hemorrhage. There is no way to know which will happen beforehand. It's a big risk to take simply b/c when it goes wrong it's generally lifethreatening. Good doctors and medical staff can often get a woman suffering from these complications out of the woods, but those are some terrifying moments!



 



I understand that complications can occur with any birth, but something that carries so big a risk  that states and doctors are abandoning the procedure should not be taken lightly.

Amber - posted on 06/12/2009

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I had a c-section with my daughter, and now I am planning to have another baby. I personally do not feel comfortble with VBAC. As a matter of fact I am almost finished with nursing school and I just did a maternity rotation and class, we were taught that VBAC is fairly dangerous, in fact many OBGYNs will not do them b/c of the increased risk of uterine rupture. It's a personal choice, but since it is risky and many doctors won't do them, I don't feel comfortable with the risk. I would suggest that you research the benefits and the risk and decide whether or not you are personally comfortable with VBAC.

Beth - posted on 06/12/2009

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I think it all depends....thats great that you had your third child vaginally and that it worked out....but everyone is different....I almost died having my second child and was in the hopital for three weeks after she was born. I was unwilling to do that to my body again and went ahead and had a c-section with my third which was relatively easy and drama-free. For me, that worked out better but I think everyone has to do what works for them - there is no "right" or "wrong"

Monique - posted on 06/12/2009

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my first 2 children were cesarean and when i got pregnant with my third my doctor strongly encouraged VBAC - i didn't even think it was an option!! this was 1995 and I was 29 - and living in a city with an excellent teaching hospital. she persuaded me to give it a try - and she wasd with me all the way - not even an obstetrician! it was a wonderful experience and i would recommend it - so long as you are planning to go to a fully serviced hospital should anything go wrong - ie. anesthesiologist on all the time. i was home the very next day! and needless to say all the residents were very interested! any new mom to be who thinks cesarean is the easy way to go doesn't know what she's talking about - giving birth was the most amazing experience! check it out - get lots of info and good luck!

Whitney - posted on 06/11/2009

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The big concern with having a VBAC is that the uterus is more weak from the c-section and may rupture. You would need to check with your Dr to see if they even do them. Alot of states are now doing against the VBACs due to the increased risk.

Beth - posted on 06/11/2009

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I tried...it didn't work...I ended up having another c-section...



so I had one child vaginally and two by c-section....



personally, I thought my last c-section was the easiest birth of the three....

App+7mnejhu - posted on 06/11/2009

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Hi, yes I had a VBAC 7 months ago and it was the most amazing experience ever. To answer your questions, Yes I would do it again and yes I would recommend it. There are really only a few medical reasons that make having a repeat c-section necessary and about 80% of women will have successful VBACs. I suggest doing your own research and finding a dr./midwife who is 100% supportive, not just tolerant but encouraging and believing that you can succeed. Ask what their VBAC success rate is and that of the hospital if you deliver in a hospital. I delivered mine in a birth center not associated with the hospital with wonderful midwives. What was your reason for your first c-section? Here are some good websites to check out and I also have started a VBAC support blog if you want to check it out: www.thepathtovbac.blogspot.com

www.vbac.com

www.ican-online.org

www.childbirthconnection.org

If you have any other questions I would love to help!

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