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Old 05-25-2012, 12:04 PM   #1
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VBAC or 2nd C-Section...that is the question...GRRRR

My OB seems to be pro c-sect...he told me that uterine ruptures were too common to do VBAC...I am learning that is not really the case. I see him on next Thursday for my 16 week/AFP (thinking about refusing test) appt. so I intend to discuss ALL of my options with him...maybe HIS VBAC success rate is low...I'd really like to feel labor (I think!!!) and have the experience but I am concerned about the risks. Here is my situation and LMK what you think...

I was 20lbs overweight when I got preggo with DS in 2008, gained about 35, he was a 10lb baby, had terrible abdominal muscle separation (diastasis???)did not have surgery to fix it yet...after this one I will, and PPD (untreated), OB would not let me deliver vaginally due to size of baby (head was GIGANTIC!!!) and risks associated with him getting stuck. I was really disappointed b/c I wanted au natural birth...BUT after realizing that it was the 'safest way for baby to be born' I was on board, who cares about Momma right??? LOL
This time around (DUE NOV 13, 2012) I am STILL overweight, but 15 - 20lbs MORE now!!! I have been eating great, taking vitamins (forgetting sometimes...), not exercising enough...I get tired/winded very easily...but on my way to getting better. I have not gained a pound, but mah belly is HUGE and most ppl don't believe me when i say I'm 15 weeks...they look like they think I am ready to deliver, but I don't' think I look that big yet...LOL Could the muscle separation be causing him to recommend another csect???

Need more info? I am sure I left out something! I don't mind posting weight if that helps either...I'm not shy!!!

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Old 05-25-2012, 05:12 PM   #2
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Re: VBAC or 2nd C-Section...that is the question...GRRRR

Even mamas who have never had uterine surgery have a slight chance of rupturing. There has been a ton of time since your c-section, wish lowers your risk. I am interested to hear what your doctor says at your next appointment. Are you willing to look for another provider if you want to pursue a VBAC and he's not on board? Are you wanting to have more children after this? (That is a concern for some mamas, since each time you have a c-section, there are surgical risks.) You mentioned getting your abdominal muscles repaired after this baby and I didn't know if that would contraindicate a future pregnancy.
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Old 05-26-2012, 04:19 PM   #3
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Re: VBAC or 2nd C-Section...that is the question...GRRRR

ruptures were too common?! Ask him for his DATA! LOL

My first suggestion: Find a new OB. One who is VBAC friendly, you don't need this to be a fight, you've only had one cesarean, trying for VBAC is recommended by ACOG and much safer for you.
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Old 05-26-2012, 06:15 PM   #4
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Re: VBAC or 2nd C-Section...that is the question...GRRRR

I was planning on a repeat c-section but my labor progressed too quickly and I ended up having a non-medicated VBAC (didn't even have the IV in yet when DS came out). The hospital and doctors I delivered with really pushed VBACs. The risks are about the same in my opinion. I got a post op abscess with my c-section and ended up really sick and in the hospital for quite a while.

I'd go with which YOU want.
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Old 06-27-2012, 06:55 PM   #5
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Re: VBAC or 2nd C-Section...that is the question...GRRRR

Cord prolapse is 6 times more likely than uterine scar rupture... that should put it a bit in perspective. Also, you can tell him the ACOG recommends VBAC not RC. Honestly, it might make your entire pregnancy and labor better to find another doc. If he's not on board I doubt you'll convince him, and you don't want his agenda mucking up your choices. There are supportive OBs out there. Check with a local ICAN or look up ICAN on the web and try to find a good OB in your area.
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Old 06-27-2012, 07:07 PM   #6
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Re: VBAC or 2nd C-Section...that is the question...GRRRR

Quote:
Originally Posted by Nimyue View Post
Cord prolapse is 6 times more likely than uterine scar rupture... that should put it a bit in perspective. Also, you can tell him the ACOG recommends VBAC not RC. Honestly, it might make your entire pregnancy and labor better to find another doc. If he's not on board I doubt you'll convince him, and you don't want his agenda mucking up your choices. There are supportive OBs out there. Check with a local ICAN or look up ICAN on the web and try to find a good OB in your area.
Who is ACOG? Do you have a link? This is something I've been thinking about too after an emergency c-section with #1.
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Old 06-27-2012, 07:16 PM   #7
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Re: VBAC or 2nd C-Section...that is the question...GRRRR

ACOG and ICAN

I'd get a new doctor.
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Old 06-27-2012, 08:52 PM   #8
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Re: VBAC or 2nd C-Section...that is the question...GRRRR

Push for what YOU want. My daughter is going to have a 2nd cs {her first, in 2008, was an emergency cs caused by, in my opinion, docs not letting her go more than a week & a half overdue before inducing resulting in an e-cs} in sept. Our local hospital won't let you have a vbac {unless you walk through the doors in labor of course, but she isn't that brave} and the other hospital is an hour and a half away.
It sucks that she doesn't have a viable choice & they want a 3rd child. It scares me a bit that she will have 3 CS.
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Old 06-29-2012, 06:03 AM   #9
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Re: VBAC or 2nd C-Section...that is the question...GRRRR

Babies tend to take what they want from you... It's great to eat healthy and work out during pregnancy, but keep in mind you still may have a 12 or 6 pound baby... Some docs/midwives say it will help and others say it won't. I'm from the belief it won't help, but you'll feel better! And many believe that subsequent babies tend to be bigger than priors... it's not always true, but a typical pattern.

Personally, I gained the most with my first child and he was 9lbs.8oz. He was a severe shoulder dystocia, almost died, lifelong birth injury, just very traumatic. I tried to keep my second child smaller. I gained 6 pounds my WHOLE pregnancy, ate extremely low carb and very healthy, worked out 6 days a week... he was 10lbs.3oz!!! Did not work, but that was my best pregnancy. My third baby, I gained 12pounds during pregnancy and did the best I could with diet and exercise and he was 12lbs2oz!!! whew! Now, my fourth baby was a girl... I gained 12-15pounds during my pregnancy and she was a tiny 8lbs.8oz... She just didn't take as much from me. Oh and no gestational diabetes with any of my pregnancies.

I had many red flags during my labor with my first that indicated an impending shoulder dystocia (getting stuck) that were ignored. A lot of women have red flags and some do not. Would you be comfortable agreeing with your OB that if you show 2-3 red flags (or even 1) during your "trial of labor" that you would be more than happy to get wheeled in for a c-section? And also reading up on ways to reduce your risks of that, if you do try a "trial of labor"? There are any dangers of a baby getting stuck and it's truly one a great fear with OBs/midwives... once you've seen 1 or 2, you do get more leary and want to err on the side of caution, so your doctor's thoughts are normal. Some women can birth 10lbers without trauma and some can not. But 50% of s/d's happen to babies under 9lbs too.

With my 2nd baby, I was in deep prayer about what to do (c-section or a trial of labor)... I remember praying for God to open and shut doors according to what would be healthiest for my baby (seeing what my first son goes through is hard enough). I found a doc who was willing to let me try with the thought of "the passage way being cleared" and trying to keep the baby smaller (which, as you know, didn't work). Well, my 2nd baby turned breech 5 DAYS before my due date! The doc did an ECV 5x with nooo luck at all. That started labor and so I went in for a c-section and he was larger with my first. I hate c-sections and yet I had a strange peace about it all because of my prayer of shut doors. I felt that this was God's way of telling me "don't even try it lady!". Of course the rest have been c-sections as well.

So if you are a praying woman, go into prayer about it. Pray for direction and peace about what way will be healthiest for your baby. Shoulder dystocias are traumatic for both baby and mother too (I have physical issues from it as well). Yes, you want to avoid that, but the unknown of whether it would happen or not, no one can predict.

((big hugs)). I KNOW it's not an easy decision, c-section vs. trial of labor!
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Old 06-30-2012, 06:05 AM   #10
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Re: VBAC or 2nd C-Section...that is the question...GRRRR

Ruptures are NOT common in VBACS. They're more common than in first time moms with an intact uterus, but it's still far LESS risky than a RCS. I'd find another provider who can think with something other than his scalpel. This one doesn't appear to be able to support you and you're in for an uphill battle. Believe me, the difference between a good birth experience and a bad one is almost entirely in the support you surround yourself with.
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