VBAC or C-section

[jenmatt1]

So I am already thinking about birthing process even though I am only 9 weeks along. I am wondering how many chose or were able to choose a VBAC. I had an emergency C-section under gas because of complications with me and my daughter, but I am wondering what I want to try this time.

My gut tells me that I should have a C-section because of all the issues and complications, but I also actually looked forward to the whole labor thing. I never even had 1 contraction because it was so early.

Where any of you able to do a VBAC or did you plan one and end up having C-section anyway? I am just hopeful I get to choose myself this time, rather than having a c-section as my only option.

[jmom08]

My not-a-medical-professional understanding is that emergency c-sections frequently involve a different type of incision that creates additional risk of uterine rupture during an attempted VBAC (beyond the risk already created by having had a scheduled c-section).

I asked both my old and new OBs about VBACs. My old OB gave me the stats on risk of uterine rupture with my type of incision (she was able to use the safer type), and they still scared me. She basically said that if my uterus did rupture, they had X number of minutes to get the baby out -- she didn't sound excited about trying it. My new & current OB had a similar reaction, and my impression of his view (he didn't say it in so many words) is that VBACs aren't worth the risk, and that the recent surge in VBACs has been because of insurance companies pushing them to save money (not having to pay for c-sections). My impression is that his office has seen some bad VBAC outcomes, and they don't seem in favor of it.

I personally can't handle the risk, especially after the stress of my last pregnancy, so I decided to go with a repeat c-section. Good luck -- I hope that you and your doctor make a decision you are happy with. :)

[sezza]

Hey

I would go for a vbac every time. I think that ob's try and scare you with the risks of a vbac but from what i have researched the increased risk of uterine rupture when you have a csection scar is .2%. the majority of uterine ruptures happen in people who have not had a previous csection (75%-25%) which puts a different spin on it I think.

If you go in for a vbac then they will put you on a constant monitor which means that you will not be able to walk around which means that you will prob end up with a csection BUT I think ( and this is only my opinion) that it is better for the baby at least to go into labour. At least you know that their lungs are ready to face the world. There is new research that going though the birthing canal can promote better health for the baby for the rest of their lives. For example....
http://www.theage.com.au/lifestyle/wellbeing/natural-births-better-for-babies-20100529-wmfv.html

Only you can make the decision so I would research it independently and make the decision from there. There is a lot of information out there about the risks of both.

I am going to have a vbac if I get to term. I feel that the risks of a csection are greater than a vbac and I think that they come out that way for a reason.

I hope that you don't think that I am stalking you... I have been following your blog and always seem to reply on your posts. I think that we are just going through the same thing at the same time.

[anonpreemiemom]

Here is another good article citing some of the recent statistics from two large studies that VBACs are safe:
http://latimesblogs.latimes.com/booster_shots/2010/05/vbac-cesarean-mortality-pregnancy.html

I think the point from the research I have done is that VBACS are VERY safe for the right candidates:

- You cannot/should not have a VBAC if you have had a classical c-section. This is a vertical cut on the uterus which makes risk of uterine rupture higher (still very low overall). Yes this is often done for c-sections at early gestations but I had an emergency c-section at 28 weeks and was able to have a low transverse (horizontal cut) so not all early emergencies result in classical sections
- VBAC has a low risk IF you go into labor naturally and this is where my hospital stands. They are super pro VBAC as long as conditions are right. So they would prefer not to induce me then do VBAC. They would prefer my body naturally go into labor and then do VBAC.

It makes sense really. If you induce you are forcing your cervix and uterus before they are ready - putting alot of pressure on - and going against nature. And all the pitocin and other interventions are just making your body do something it isnt ready to. Whereas say your water breaks at 39 weeks and you are already dilated your body is moving in that direction and is all primed for birth. Much safer according to both my docs (and what I've read)

So that is our hope. Do VBAC under right conditions but if it doesnt work out, then we'll be looking at a C-section by July 1st!

I completely trust my docs since they are not set one way or the other but rather believe in seeing how conditions are at a particular time and understand that each situation is unique!

Good luck!

[jenmatt1]

even though I had an emergency C section, mine was also a low traverse small horizontal cut and my doctor said she is comfortable with my decision either way. I am already leaning towards another c-section but just wanted to make sure I explored all the possibilities before I make any definite decisions.

[blythe]

The decision is definitely up to you and your doctor and dependent on your health. I found this full text report recently that might help guide your decision-making
http://www.femalepatient.com/html/arc/sig/obsR/articles/035_05_037.asp

and here's an old discussion about VBACs after PE/ HELLP with links to more articles
http://www.preeclampsia.org/forum/viewtopic.php?t=36686&SearchTerms=,vbac

Good luck!!!