Second C-Section... VBAC too risky?

  1. You have chosen to ignore posts from jcoastiegirl. Show jcoastiegirl's posts

    Second C-Section... VBAC too risky?

    I am a couple weeks away from a scheduled c-section for my second child and starting to have regrets for not trying VBAC...

    With my first child I tried labor for a long time but my son was in distress and we ended up with a c-section. I was pretty emotional and bummed about having the csec (still am!) but then come to find out they actually did a Vertical incision on my uterus... I still don't fully understand (2 yrs later) why it couldn't be the normal horizontal cut. However since I have the much more rare Vertical incision a VBAC is even riskier...

    I'm seeing a different doctor/going to a different hospital for this baby (not because of what happened with first... but more so because of location/convenience). My doctor now really does not reccomend trying VBAC because of the high risk. I obviously want what is best/safest for me and my baby... and I know I could try VBAC and still end up with a csec... but I feel like I am 'giving up' in a way and just 'having surgery' not giving birth....

    Any other moms, moms to be, nurses, docs... have opinions/advice on this? I'm going to stick to the csec but need help I guess 'being ok' with that and knowing I've done all I can do!

    Also a little disappointing to know that I can perhaps only have 1 or 2 at the most more pregnancies now (not that I can really afford more than 2 or 3 kids anyway!)

    So many hormones and emotions toward the end, lol! Thanks all for listening and helping!! :)

     
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  3. You have chosen to ignore posts from poppy609. Show poppy609's posts

    Re: Second C-Section... VBAC too risky?

    jcoast - I understand your internal conflicts about this issue because I also had an unplanned c-section and would have to have another c-section if I had another baby.

    Here are my 2 thoughts:
    1: there is nothing wrong with having a c-section.  It doesn't mean you have failed or that you are "giving up" and not legitimately "giving birth".  C-sections are the modern-day answer to v-births that would have resulted in injury or worse to mom and/or baby.  I, for one, am very happy that they were able to get my daughter out with no great harm to me or her, which might not have been the case if the only option was a v-birth.

    2: Each ob/gyn has their own opinions about VBACs.  There are some doctors who would NEVER "recommend" a VBAC even if there was no "high risk".  Other doctors are more comfortable exploring that option.  If you want, get a second and third opinion from different doctors (not easy to do in a few weeks' time, but you could try).  I don't know what the extra risk is if you have a vertical incision... do you?  Maybe you could ask your doctor for specifics to try to fully understand the issue.  In my case, I would not risk a VBAC because the two major arteries in the uterus ruptured during my c-section, therefore trying for a VBAC would put me at great risk for massive hemorrhaging.  Because I have that specific knowledge, I can make my decision more easily than if I only had vague details about my surgery.

    Good luck with your decision.
     
  4. You have chosen to ignore posts from hughkona. Show hughkona's posts

    Re: Second C-Section... VBAC too risky?

    I am generally pro VBAC, but as a NICU nurse who works closely with Labor/Delivery nurses, its always important to go directly to the souce for information.  In this case, the ACOG is the best bet for medical direction in certain situations. 

    Although the ACOG recommends VBAC for most women, it does NOT recommend it for women who've had a previous vertical incision: http://www.acog.org/publications/faq/faq070.pdf (see the bottom of page1).

    What I would do if I was you is try to research why you had the vertical incision in the first place.  Not that you can change the past, but just so you know, and if you find there was not a reason for it, I personally would contact the hospital and speak with the medical director there, citing the name of the OB that performed the c/s.  You can obtain your medical records by calling the hospital you delivered at and filling out a form.

    In the meantime, you can rest easy knowing that your doctors and the ACOG both agree that c/s is the best method for you to meet your little babe!
     
  5. You have chosen to ignore posts from calico79. Show calico79's posts

    Re: Second C-Section... VBAC too risky?

    I am in a similar situation as well and can't decide.  I have told myself over and over again the past 16 months to not be disappointed in myself for having a c-section and that having one is ok, but it's still difficult to digest.  You're not alone, and it is perfectly fine.  No matter what happens you have your story of what happened/happens and you own it.  And in the end you have the most beautiful gift anyone can get! 

    I don't have advice but just encouragement!  Wink  Good luck!!

     
  6. You have chosen to ignore posts from Lostgrouse. Show Lostgrouse's posts

    Re: Second C-Section... VBAC too risky?

    My SIL had 4 kids and they all started out with a vertical incision.  With each subsequent pregnancy they had to take the baby out earlier and earlier to ensure that the risk of rupture was low enough and acceptable to everyone.  So baby #4 was born at 34.5 weeks, but she's still a very heathly baby!  Just relax and know that you have trained people helping you make these decisions and who knows, maybe you'll end up with 4 like my SIL (I have no idea how she does it!!!)
     
  7. You have chosen to ignore posts from rsw978. Show rsw978's posts

    Re: Second C-Section... VBAC too risky?

    I ran from MGH (as the doctor was frighteninly aggressive about scheduling a cesearean) at 30 weeks to the midwife practice at Newton-Wellsley hospital.  Please ignore what some guy wrote above.  That is completely inappropriate.   I'm so glad I had a drug-free delivery.  At the time I had a 2 year old boy at home and could not deal with the consequences of major, painful surgery, taking care of a house and toddler.   I now have the most zen, happy smart almost 3 year old girl.  I would also look into the doctors and midwives at Mt. Auburn.  I would be happy to talk to you more about this topic.  Please feel free to email me. 
     
  8. You have chosen to ignore posts from MM379. Show MM379's posts

    Re: Second C-Section... VBAC too risky?

    Typically the vertical incision is used when the baby needs to come out particularly quickly due to urgency.  My understanding is the prevailing recommendation is to not try VBAC with a vertical incision.  I had an emergency c-sectin with my first.  I was supposed to have a scheduled with my second, but went into labor.  I still opted for the c-section as I had been advised during my first one that the positioning of my pelvis was not ideal for a v delivery and there was high probability of future babies getting stuck the same way DS did.  I will say, the second c-section, non-emergency was WAY better than the first.  I could hold DD right away, she was with me just as much as after a v birth, and I was up, walking, and showering pretty quickly.  The recovery was MUCH easier.  I hope this is helpful.  Good luck!

     
  9. You have chosen to ignore posts from luvRIboy. Show luvRIboy's posts

    Re: Second C-Section... VBAC too risky?

    I can totally understand some of your feelings about the c-section. I had to have a planned c-section with my DD because she was in breech presentation, and was not persuaded by any of my appeals for her to flip! I know that a planned c-section is a very different situation from one after laboring; I had two weeks to get used to the idea, whereas you probably had about 10 minutes, and that time was really important for me to prepare for the loss of the experience I had imagined.

    That said, I have since done a TON of VBAC research, because I, too, would like to go back the next time and do it the way I'd always imagined in my head. In that research, I can say that with a vertical incision the risks to you are so much higher than they are with a low horizontal incision, because of the nature of the incision.

    There is a lot of PTSD associated with unplanned C-sections; if this one is planned, there are ways to make it seem a little less clinical...ask for the lights to be lowered, ask that the anesthesiologist constantly update you on what's going on so that you feel involved, same for the OB. Ask if they're okay with some music playing to distract you.  A planned c-section will still be surgery, but it can be a little more on your terms.  Ask about skin-to-skin contact ASAP for you and baby.  Ask about all of the things you would have imagined for a VBAC birth and see what they come up with. 

     
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  11. You have chosen to ignore posts from hughkona. Show hughkona's posts

    Re: Second C-Section... VBAC too risky?

    someguy~ unfortunately, as a nurse who works on "the other side" I can say I have seen a TON of really crappy births that the mother doesn't even realize how mis-managed her labor was.  I think it is wise to always question medical decisions.  Always ask for another option AND what the medical data is that suggests that.  In this case though, there is strong medical data (from ACOG) that states that with a vertical incision it is NOT recommended.

    For everyone who is continuing to recommend she fight for a VBAC, please keep in mind that this is not your average VBAC- with a vertical incision it is NOT indicated!!

    I work at a hospital (in NH) that is amazing with c/s.  We put the baby on the moms chest IN THE OR and do not leave the baby just sitting alone on the warmer so we can do all the things WE need to do- its all about mom and baby (and dad and baby too, but mom is the priority).  Moms always have the baby skin to skin when leaving the OR with baby in their arms.  The baby is NOT sent to a nursery while mom is in recovery for 2 hours.  The baby goes with the mother and BFing is initiated while she is laying down recovering.  There is little reason other hospitals need to separate mom and baby for any reason but it is usually done routinely.  That is something to ask about- find out if its something they are willing to do, and let them know other hospitals do not insist on taking the baby away from you.  Do baby's really need a bath within an hour of birth? No, they need to be held and loved and near parents.  My opinions on birth have changed since I see how it could be and should be!  Just some food for thought :) :)
     
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  13. You have chosen to ignore posts from Micromom. Show Micromom's posts

    Re: Second C-Section... VBAC too risky?

    jcoastiegirl, I totally get it.  I had an unplanned emergency c-section when my son was born 4 months early.  On top of all the worry that went along with the baby's health, I really beat myself up over what, at the time, felt like a "failed" pregnancy and delivery.

    Eventually, I realized I was mourning the loss of the "conventional" birth story, with the sitcom style mad dash to the delivery room, and imagined natural delivery.  I had an idealized image of what it "should" look like, which probably wasn't even realistic.  Still, it took a while to let it go.  In defense of SomeGuy, my husband's ability to process these decisions rationally and clinically really helped me make peace with it.

    It took some time (and hormone stabilization) for me to realize that the every birth story is unique and special, and extraordinary, just like the children they create.  Be proud of yourself, and your story, no matter how it ends.

    By the way, I also had a vertical c-section and recently delivered my second child, via planned c-section.  For what it's worth, it was kind of awesome.  Very calm, no hysteria, the recovery was a breeze, and I got to stay in the hospital with my baby and husband for 4 days.  We had TV, room service, and quality quiet time with the newest member of our family.  After chasing a toddler for two years straight, it felt like a little vacation.

    I'm not advocating either way, everyone has to make their own choices, and the universe is full of surprises.  I just think we should spend a little more time celebrating ourselves, and encouraging each other.  Anything we can do to make happy, healthy children is a good thing.

    Good luck!
     
  14. You have chosen to ignore posts from MichelleandtheBoys. Show MichelleandtheBoys's posts

    Re: Second C-Section... VBAC too risky?

    I think what some-guy said was absolutely appropriate! Of course you don't want to blindly listen to doctors pushing c-sections, but with a vertical incision the opinion is pretty unanimous.  

    It's slightly disappointing, but I don't get the people who think they failed when they have a c-section.  I never expected to have one in a million years, didn't even pay attention to that part of the birthing class because it didn't apply to me.  After 24 hours of labor I unexpectedly ended up with both a c-section and a baby over 11 lbs! I was thankful it didn't go on any longer. We both could have been badly injured.

    The second time, I wanted to try for a VBAC but my doctor said no.  I switched to another doctor who also would not let me try, as she figured it was too risky if I had another big baby.  I was a little disappointed, but it was no big deal, and so much easier than the first. ALSO, at birth we discovered there was a loose, but complete knot in the cord, which could have been disastrous had it not been a c-section.  

    A healthy baby (and mom) is the only thing that matters - not how it got here!
     
  15. You have chosen to ignore posts from itsallnew. Show itsallnew's posts

    Re: Second C-Section... VBAC too risky?

    Just to chime and reiterate what many people have already said- I don't think Some Guy was inappropriate with his comments, I really like how MicroMom put it- each birth story is unique the way each child is unique.

    Personally, I don't like the label of "natural" versus "un-natural" delivery.  Whatever the circumstance that leads to the birth of your baby is the natural progression of your own pregnancy. 

    As HughKona suggested, it may help you to become more informed about the vertical incision, which is less common and for which VBACs are not recommended.  We don't know your circumstances or the particular risks for you, but maybe having that info would help you feel better about your circumstance.  A healthy mom = healthy baby.
     
  16. You have chosen to ignore posts from IPWBride. Show IPWBride's posts

    Re: Second C-Section... VBAC too risky?

    A third or forth person chiming in ... I also don't like when people think a c-section is a failure.  I also had a planned c-section because I was 9 days late and he was measuring at 10lbs on the ultrasound, and I could not have been less dialted or effaced.  I opted for a calm, scheduled surgery vs. what the doctor's thought would very likely be a failed induction attempt and then an emergency c-section.  The planned c-ser was very smooth, recovery was really great and I was able to spend a ton of close time with DS, including BFing him within my 2 hour recovery window.  If some folks insist on calling it a failure or unnatural, so be it.  But its the farthest from my experience.  And I will most definitely do it again for round two if we get the opportunity.
     
  17. You have chosen to ignore posts from dz76. Show dz76's posts

    Re: Second C-Section... VBAC too risky?

    With DD1, my water broke and after more than 24 hours w/o progress I practically jumped at the offer c-section.  Recover however was not fun.

    With DS and DD2 (twins), my OB must have asked me at every visit after 20 weeks if I wanted to try labor (vs. scheduling a c-section).  I really couldn't think of anything I'd like to do less (I kept picturing one v-birth and then having something go wrong and having to have a c-section anyway).  So, I scheduled the c-section.  I did go a few weeks early, so I had to wait for the OR to open up at the hospital but recovery this time was a breeze (although a bit of that might have been getting rid of the 17 lbs of baby I had been carrying around).

    I was very happy to be in the hospital for a few days without the toddler and with extra help.  There is some small piece of me that wishes I'd experienced a "natural" birth but I don't regret not opting for a c-section the second time.  I do regret that they didn't give me any pain meds while I waited for the c-section. ;-)
     
  18. You have chosen to ignore posts from June08bride. Show June08bride's posts

    Re: Second C-Section... VBAC too risky?

    I had 2 babies via c section and not one ounce of me feels like a failure.  At the end of the day, I have two healthy, beautiful children and how they were delivered into this world makes no difference to me.  Im sorry you arent going to be able to have the type of delivery you wanted.
     
  19. You have chosen to ignore posts from jcoastiegirl. Show jcoastiegirl's posts

    Re: Second C-Section... VBAC too risky?

    Wow, thanks everyone! I haven't been able to get online since my original post and just now caught up on all your responses! I truly appreciate all the sentiments and support :)


    I'm 1 wk and 1 day away from my scheduled c-section and doing much better. I think having this time to really accept it and know what is going to happen is helping! I've even talked to my doctor about some things I can control (having my husband cut the cord, taking a video, asking the doctors to tell me play by play what is happening, etc) and that is making me feel more involved and in control of my birth!

    I don't think there is anything 'wrong' with c sections. Sometimes it is a choice for ppl and sometimes it isn't. I think in my case I just never dealt with all the emotions and feelings from the first time and was delaying dealing with them this time! Also, since mine was not your typical c-section (a vertical incision) it was a little harder to accept because it is so finite... VBAC not truly being an option. Part of me, a small part, will always wonder what the V birth experience is like... but I know it wasn't meant to be for my body or my babies... thats all! (And many of my friends that have had VB say I'm not missing much ;) haha... ) Pros and cons to everything... such is life!

    No matter what having a baby is an amazing journey - physically and emotionally. I'm going to do what is best for baby and me and that is all that matters!

    Everyone has their 'ideal' birth plan and there is nothing wrong with that... nobody else can tell you it is right or wrong. So when things change (which they most likely will!) it is up to the individual how they handle it. So all your posts and comments, whether you are agreeing or disagreeing with each other, are okay!! :)

    Thanks again for listening to my original post/vent...and this one! :) Best of luck to all the moms/dads and mom/dads to be!  Hard to believe next week I will finally get to meet my lil guy/girl (we dont know the gender!)


     
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  21. You have chosen to ignore posts from jcoastiegirl. Show jcoastiegirl's posts

    Re: Second C-Section... VBAC too risky?

    some-guy: Not that I should have to justify or explain the options I am choosing for my csection... but to clarify for you...

    1. With a c-section the doctors actually cut the cord from the placenta and baby when they take him/her out, but just leave it longer than usual on the baby... so that my husband can go over to the baby on the side table and cut the cord closer (we actually did this with my first son). So he will not be along my body during the surgery (they dont allow that and we wouldn't want that anyways). My husband WANTS to do this. He asked, not me. It is his way of being involved in the birth and I am happy and proud he wants to take part! :)

    2. Regarding video, again NOT the surgery... just the baby part. We have the first few seconds/minutes of my son's life on video and we want the same for this baby. So once the baby is removed from me and brought over we can hit record, get those first cries and pics on record over to the side where the baby is cleaned up, etc... This is a video for us (and if anyone else wants to see it... we dont MAKE ppl watch it... but again it is just the baby...nothing of me!)

    3. And play by play... yes I do want that. I dont think they will be as specific as 'moving kidney left...' but I want to know when they are cutting in and when they are removing baby, etc... the basics. Last time around I had no clue what was happening or even what gender my baby was for a long time. I didn't like just laying there hearing beeping and doctors whispering... Again, my preference. Not everyones.

    I am not on a quest for control... I am not even a controlling person (far from it... I probably go with the flow too much and let ppl take advantage of me actually! but i guess that would be another discussion/post!)  

    I dont need anyone to justify for me what I am working out with my doctor. I just wanted everyone that responded to my initial post to know that I appreciate their thoughts, opinions, and support and am doing much better with what I have ahead of me! :)
     

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