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Old 08-26-2011, 05:02 PM   #11
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Re: Why did you choose a c-section over VBAC?

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I was going to try for a Vbac up until today... then I got some news that changed my decision so I am scheduled to do a repeat c-section on Monday.

My last DD was only 6lbs 11oz at 42 weeks and I never dilated past 5 and that was very much like your story.. .water broke...no contractions, pitiocin, 26 hours later, no baby and only 5cm. So we did the emergency section.

Today I had a U/S to check on DD2 and she's TINY. They say about 6lbs. So that can go 1lb either way. Because DD1 was also small and did NOT tolerate labor very well (her heart rate went down waay to much) the doctor today suggested that I either get NST's all next week or schedule a c-section.

The baby is doing fine now but they are just scared the same scenario will play out again if I TOL with her. So to save myself grief, 26 potential hours of pain and panic, to just go ahead and do another section.

Makes it easy to schedule things with my family anyways. I'm at peace with it.
I respect your decision, but there is just no research that says that a baby who is small for gestational age is better off being born by c-section than a normal-sized baby. Babies often are distressed by pitocin contractions; it's a known side effect. It's much rarer for a baby to have serious decelerations with physiological uterine contractions, regardless of size. Babies undergoing vaginal birth are better prepared by the hormones that are going on. Planned c-sections are basically babies being pulled (rather violently, I might add- have you ever watched a c-section?) out of the abdomen without the benefit of any of those hormones.

My sister and I were born at 31 weeks vaginally with no ill side effects from the method of our birth. We were around 3 pounds. Size of the baby might be a reason in your mind to plan a c-section this time around, but there is simply no research to suggest that small babies will not be able to tolerate vaginal birth as well as a surgical birth.

Are you sure of your conception date? Birth Sense just had a good couple of posts about "when the due date is wrong" that outline how off the calculations can be for EDD, and what the complications or results of that can be.

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Old 08-26-2011, 08:08 PM   #12
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Re: Why did you choose a c-section over VBAC?

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I respect your decision, but there is just no research that says that a baby who is small for gestational age is better off being born by c-section than a normal-sized baby. Babies often are distressed by pitocin contractions; it's a known side effect. It's much rarer for a baby to have serious decelerations with physiological uterine contractions, regardless of size. Babies undergoing vaginal birth are better prepared by the hormones that are going on. Planned c-sections are basically babies being pulled (rather violently, I might add- have you ever watched a c-section?) out of the abdomen without the benefit of any of those hormones.

My sister and I were born at 31 weeks vaginally with no ill side effects from the method of our birth. We were around 3 pounds. Size of the baby might be a reason in your mind to plan a c-section this time around, but there is simply no research to suggest that small babies will not be able to tolerate vaginal birth as well as a surgical birth.

Are you sure of your conception date? Birth Sense just had a good couple of posts about "when the due date is wrong" that outline how off the calculations can be for EDD, and what the complications or results of that can be.
I respect your thoughts but I trust my doctors more than someone on a internet forum.

IF I had given birth vaginally to my first DD without any complications they may have been less likely to suggest a c-section in my case however with all the information combined it was decided to do it this way.

Yes I'm positive on conception dates because DH and I were TTC.

Again thank you for your thoughts and concerns.
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Old 08-27-2011, 10:29 AM   #13
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Re: Why did you choose a c-section over VBAC?

Thanks for your post Sara. I like hearing the positive side of waiting and would rather my baby to come on his own than being taken by c-section before labor begins. I know my conception date is right too, and based on that my dd is 9/4. U/S and measuring have always put me around 8/31. My next appt is on 8/31.

Anyone have ideas on how to make my cervix "favorable"? I've been at 50% effaced with no dilation for almost 3 weeks now.
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Old 08-27-2011, 11:31 AM   #14
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Re: Why did you choose a c-section over VBAC?

I know that some women insert EPO vaginally in an attempt to soften the cervix, however I don't know if research supports doing that. I didn't do anything to try to get labor to start, but then again, I only got to 40 weeks. I might have been more tempted if I had started to be threatened with induction. Generally, I'm of the mind that labor will start when the baby's ready, and rushing the process is not beneficial for mom and baby. I know that's not what you probably want to hear....but from all of the experiences that I've read, that's the impression that I get.

I hope that you go into labor on your own before you get too worried about it. Even if you do opt for a repeat c-section, letting labor start first will help prep the baby for breathing and coping in the outside world. I mentioned that a woman that I was going to be a doula for, but reluctantly opted for a repeat c-section when she felt her circumstances warranted it, ended up with a surprise VBAC after all. I will add that her first birth sounds a lot like your first birth- she labored for a long time spontaneously, in lots of different positions, but her baby was large and stuck. Her second labor happened 2 weeks sooner, so she had a smaller baby, and a much quicker labor. Her baby was born about 30 minutes after arriving at the hospital! So you never know what will happen- this labor could be totally different than the last, because after all, it's a different baby!
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Old 08-27-2011, 04:10 PM   #15
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Re: Why did you choose a c-section over VBAC?

What a hard decision, and I've been there!

There are risks with a RCS and there are risks with a VBAC/TOLC, you know this, so I won't bother rehashing it and boring you to death!

I personally decided to VBAC. I had blood pressure issues and had to decide between an induction with pitocin or a RCS. I decided to pursue an induction. It went very, very, very well and I'm thankful I went down that path!

If you are concerned that your 1st induction didn't go well and resulted in a cesarean, always remember every experience is individual! My first induction was horrible and ended in a c-section. My second induction was a polar opposite and went wonderfully! So don't let that fear deter you!

That being said, I know women who decided that a RCS suited them better and they all said their planned cesarean was a polar opposite from their emergency section or from their failed induction turned cesarean. Something else to keep in mind!

I'd use caution in inducing or sectioning for a suspected big baby - as you know - u/s estimates can be off. My daughter was estimated 9lbs 3oz and was 6lbs 13oz. Then again, they can also be spot on! My son was estimated 7lbs 6oz and was 7lbs 3oz! Something else you just have to weigh. 8lbs is a "good" weight for a full term baby, which your first was. I'm definitely not telling you to discount what the doctor says re: weight though - because 2nd babies tend to be larger (not always, but it is the typical trend) and a vaginal birth is of course more successful - or has more chance of being successful - with a "normal" sized baby!


If you decide to take the route of induction to avoid a large baby, or because you go postdates, there are several things you can do to help increase your chance of success! If you'd like more information, let me know and I'll be happy to post.


Good luck with your choice and if you have any other questions, let me know and I'll try to help as best I can. Just remember - whether this baby is born vaginally or VIA the sunroof, he/she will be perfect nonetheless and you will soon be snuggling that sweet baby!
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Old 08-27-2011, 06:23 PM   #16
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Re: Why did you choose a c-section over VBAC?

DS was an emergency C-section. His heartrate plummeted during labor and they whisked me away. He was born less than ten minutes later. I met him three hours later after I recovered from general anesthesia. I was very out of it from the anesthesia and the meds, exhausted from the labor (pitocin-enhanced btw) and the rigors of surgery.

After DS, I researched VBAC. I was and still am a huge proponent of VBAC. I found a midwife and a new hospital to labor at. Our closest hospital allows VBACs, but isn't very supportive and is ruled by 4 very large OB practices - no midwives allowed. My switch to the midwife was followed by two miscarriages. Went to a specialist to determine if there was a reason to be found. There wasn't, but I was diagnosed with Type 2 Diabetes, and had just officially risked out of my midwife's services. Six weeks later I found out I was pregnant and it was back to our old hospital and monster OB groups.

During the first months of this pregnancy, I debated VBAC v. C-section. At the end, I determined that a VBAC would be an uphill battle that I probably wouldn't be able to win considering my circumstances, and would ultimately add greatly to my stress levels. Our hospital is a baby factory. WIth each OB group weighing in at about 10 Docs a piece, none of them know their patients. They allow VBACs, but it quickly became apparent in the first few months that they don't encourage them. And once you enter that hospital in labor, their support can mean all the difference between a successful VBAC and another unscheduled C-section, or god forbid another emergent one. The topper on the cake though was the Diabetes. I didn't necessarily expect to produce a large baby (my son was only 7lbs6oz after all), but I felt for sure that the doctors would be quick to talk to c-section if there was any hint that kid would weigh in at 8+ lbs. So, ultimately, for sake of ease I scheduled the repeat C-section.

My decision was probably influenced by my fears most of all - the fear of the fight, of labor, of another emergency, of failing a second time around (and a repeat C-section seems really convenient compared to the countless unknowns of labor and delivery). It was cowardly of me to choose a c-section without trying for the VBAC. I had up to a couple weeks ago vaguely daydreamed about throwing caution to the wind, upsetting everyone's plans, and going for the VBAC (especially considering that this kid isn't going to be anywhere near large, and will likely be a low range 7-pounder). But at this point the whole thing is moot - I'm almost 36 weeks and the kid is still in Breech. I doubt he will be moving anytime soon.
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Old 08-27-2011, 07:42 PM   #17
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The decision was made for me. No doctor will allow me a VBAC due to lack of documentation to the direction of the cut to my uterus from ODS. My German doctor refused to document it so I'm stuck. Not my ideal but at least the due date isn't a surprise. (Positive spin, I would love a VBAC but I value my life etc.)
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Old 08-27-2011, 08:27 PM   #18
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Re: Why did you choose a c-section over VBAC?

I chose a c-section for my second because I didn't want to go through an induction again. With my first I went to 42 weeks with zero dilation, they induced me and then 12 hours later his heartrate started dropping. They got it back up but it continued to go down with each contraction and I was still at zero dilation so I ended up with a c-section. The second time around I went to 40 weeks with once again zero dilation. I can't imagine this time around will be any different in regards to my cervix so already planning on another c-section.
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Old 08-27-2011, 09:25 PM   #19
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Re: Why did you choose a c-section over VBAC?

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I chose a c-section for my second because I didn't want to go through an induction again. With my first I went to 42 weeks with zero dilation, they induced me and then 12 hours later his heartrate started dropping. They got it back up but it continued to go down with each contraction and I was still at zero dilation so I ended up with a c-section. The second time around I went to 40 weeks with once again zero dilation. I can't imagine this time around will be any different in regards to my cervix so already planning on another c-section.
I can understand that for sure... Keep in mind though - all inductions are different!! My first one was horrible and ended in a section, my second was amazing and I VBACd.


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The decision was made for me. No doctor will allow me a VBAC due to lack of documentation to the direction of the cut to my uterus from ODS. My German doctor refused to document it so I'm stuck. Not my ideal but at least the due date isn't a surprise. (Positive spin, I would love a VBAC but I value my life etc.)
Did you take a copy of the ACOG VBAC recommendations (revised one - most recent) - because it specifically mentions a TOLAC even when the scar type is unknown if I'm not mistaken!


That's if you even desire a VBAC attempt - if not, ignore me
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Old 08-27-2011, 09:32 PM   #20
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Re: Why did you choose a c-section over VBAC?

With my first pregnancy, I decided for an induction at 39 weeks with no medical reason. The story in brief, my OB did not tell me she would be on vacation for the next two weeks, which would fall on my due date. Her back-up OB and I had just had an issue when I had to go into L&D with what I thought was my water leaking. Anyway, I labored for 24 hours, made it to nine. I would not progress further, and she felt my sons head was not coming down. I dunno... I was starting to run a fever, wore out, so on. I decided to go for the c-section. My son was born at 7 pounds 13 ounces.

I found out I was pregnant with my daughter when my son was 7.5 months. Knowing my OB felt my pelvis was too small, I knew she would not be favorable for a VBAC. I decided to switch to a midwife. I ended up with a successful VBAC with my daughter. She was born at 41 weeks 3 days at 8 pounds 15 ounces. Just a note, the day I went into labor, I was only 1 cm dilated, 50 - 75% effaced. My daughter's head was still very high as was my cervix. My midwife had explained to me that at that point, it was not favorable that I would go into labor. She also could not take care of me past 42 weeks, so we needed to make a decision. I went into labor that night and was in labor for 21 hours.

Now, onto my most recent pregnancy... I was given the diagnosis of macrosomia. I had been measuring 6 - 8 weeks ahead for half of my pregnancy. My midwife had already ordered an ultrasound on me around 35 weeks, which showed my daughter to be already 8 pounds. I went in for another ultrasound at her request when I was 39 weeks. It showed my daughter to be 9 pounds 11 ounces. My midwife told me she would not VBAC me with a 10 pound baby, and explained again how she felt I was not favorable to go into labor. The baby was high. However, I had been contracting for weeks and was already 2 - 3 cm dilated. I was about 75% effaced. I struggled with what to do at this visit as I knew that none of that mattered. I could still go into labor. I proved that with my last pregnancy. But, what was I to do only a week from my due date, and knowing no one in town would VBAC me. She was the only person who was likely to do it. She had her back-up OB come in and explain to me the risk of a VBAC with a baby that large. It scared me and my husband, so what did we do...schedule a c-section. My daughter was born three days later at 10 pounds 14 ounces.

Now, do I think I could have VBAC'ed her? I don't know. I have read many women who have with even larger babies, with no shoulder dystocia or anything. I have even read many woman saying babies this size and larger were the easiest out of all to deliver.

I know this post is all jumbled, but I am still struggling today with this decision. I tried so hard for my VBAC with my second, and got it. It was the best experience! I am now left with the decision of continuing with c-sections, or switching to a home birth midwife.

My thoughts on your situation are to go for that VBAC! If you have to, find someone else who is willing to help you do that. I know you said your OB does not want you to go past your due date, but I wouldn't even be concerned with that. Nor would I be concerned if your cervix is not favorable. That literally could change in an hour! I also have read that after your first baby, the baby doesn't drop down until labor starts and your cervix doesn't show much action either. I am sure you have done your research, but keep reading. That always helped me to stay positive and focused on what I wanted for my birth.
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