Terrified & Confused - Please Help

[RyleysMummy]

Hi everyone

I saw my doctor last week and again broached the subject of my VBAC with him.

He is in no way against me having one and if thats what I choose then we will go for a Trial of labour and see how we go. but there was a big BUT he went on to inform me that in his opinion the best and safest option for me and bub is a repeat CS as even though the chances of uterine rupture is very small, in that percentage the outcome is dire for both mum and bub. He explained the details of what actually happens when a uterus ruptures (which i was quiet unaware of)

I've been reading heaps, and aparently my chances are better because DS#1 was CS due to breech presentation etc. but i am really scared!

I know that i may go on to have a successful VBAC and never look back but what if i make the wrong decision and for selfish reasons jepodise the life of my beautiful baby and myself. i have a son and husband to think of also.

DH wants me to CS again, but what if i always regret not having a natural birthing experience?

Any advise would be wonderful, thanks ladies!

[Lila]

hard question to answer.
here on bubhub are sooo many girls who had wonderful VBACs and they all said it was the best choice they have ever made.

i tried to, but failed and ended in an em c/s due to uterus rupture with my 2.baby.
both of us were fine, which is not always the case....
i had to be knocked out, as it was really, really urgent.

i do not have any advice i can offer you, apart from: have an open mind about every option, write a birth plan INCLUDING a cs you WANT!!
(eg. skin to skin in theatre, feeding in theatre, not having to give bubby away after birth for weighing or stuff......)

GOOD LUCK

[becca74]

Hi RyleysMummy,

just a quick post I'm sorry, I'm inundated at the mo, so I wish I could respond more fully....

Your Ob isnt giving you evidence based information. VBAC is safer than repeat c/sec, all the stats prove it, when in your subsequent pregnancy, if you have no placenta issues, or develop other issues like pre-eclampsia etc. Ask your Ob to produce studies to back up his claims, and if he cant, hit him with these studies:

from: http://www.childbirth.org/section/VBACFAQ.html
btw, ACOG = American College of Obstetrics and Gyno.


ACOG recently updated their opinion on VBAC and stated "VBAC is safer than repeat cesarean and VBAC with more than one previous cesarean does not pose any increased risk". The Guidelines can be obtained from: ACOG, 409 12th St SW, Washington DC 20024.


This link here provides reputable research articles and explains things in laymans terms, (it is a must read!):

http://www.childbirthconnection.org/article.asp?ck=10210

eta - just thought I'd add the references to research used at the above link - you can google the studies individually, print them and take them to an appointment.


<H2>References


Guise J-M, Berlin M, McDonagh M, Osterweil P, Chan B, Helfand M. Safety of vaginal birth after cesarean: a systematic review. Obstet Gynecol 2004;103:420-9.

Guise J-M, McDonagh MS, Osterweil P, Nygren P, Chan BKS, Helfand M. Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section. BMJ 2004;329:159-65.

Hashima JN, Eden KB, Osterweil P, Nygren P, Guise J-M. Predicting vaginal birth after cesarean delivery: a review of prognostic factors and screening tools. Am J Obstet Gynecol 2004;190:547-55.

Lieberman E. Risk factors for uterine rupture during a trial of labor after cesarean. Clin Obstet Gynecol 2001;44:609-21. [Alone among references, this article is not a systematic review; it is included, however, as a well done review that addresses important questions for women facing the VBAC/repeat c-section decision.]

Childbirth Connection. Comparing risks of cesarean and vaginal birth to mothers, babies, and future reproductive capacity: a systematic review. New York: Childbirth Connection, April 2004. [The following study documents are available as PDF files from the Childbirth Connection website: description of methods and sources (http://www.childbirthconnection.org/pdf.asp?PDFDownload=methods_sources) (including full bibiliography), list of main questions and outcomes (http://www.childbirthconnection.org/pdf.asp?PDFDownload=ToCtablesA-F) (a table of contents for evidence tables), first file of evidence tables (http://www.childbirthconnection.org/pdf.asp?PDFDownload=tablesA-C), and second file of evidence tables (http://www.childbirthconnection.org/pdf.asp?PDFDownload=tablesD-F).]
</H2>
Good luck, let us know how it pans out for you!

[theycallmemum]

It's a really hard decision to make. I was also given the choice to VBAC but my OB made it clear that he thought it would be safer to have another c/s. I opted to have a c/s again and it was so good that I did as my uterus had adhered to my bladder and abdominal wall because of scarring from the previous c/s and I would have probably haemoraged internally because it would have torn away during a vaginal birth. The adhesions were only discovered during my c/s.

[becca74]

Just to let you know, I had adhesions after both c/secs (the tearing of them internally was painful enough to be feared to be pain from an ectopic pregnancy with both my babys post the c/secs), and had my 2 vbacs just fine (DS2 & DS4). I havent heard of any documented cases of adhesions being the cause of haemmorage, but if anyone has any links to studies, then that would be great!

Noone I know through Birthrites has had haemorage from adhesions tearing before.....I imagine it is so rare that it isnt even on the radar of Obs normal concerns. That is the first I have ever heard of that possibility, theycallmemum. Would your Ob be able to share some studies of this? Birthrites would be very interested in such information :thumbsup:

[greengables]

I heard a midwife say: 'Anything with your eyes open is a natural birth'

I loved that saying!

I would go with your gut feeling...I don't know what I would do if it was me. But I wouldn't let 'supermums' and other such people put their expectations on me!

[greengables]

hard question to answer.
here on bubhub are sooo many girls who had wonderful VBACs and they all said it was the best choice they have ever made.

i tried to, but failed and ended in an em c/s due to uterus rupture with my 2.baby.
both of us were fine, which is not always the case....
i had to be knocked out, as it was really, really urgent.

i do not have any advice i can offer you, apart from: have an open mind about every option, write a birth plan INCLUDING a cs you WANT!!
(eg. skin to skin in theatre, feeding in theatre, not having to give bubby away after birth for weighing or stuff......)

GOOD LUCK

I would like to modify the previous quote: 'Anything involving a baby coming out of a mum (eyes open or shut) is a natural birth'

[cmd'smum]

Do you know thats exactly what I thought?

But I did alot of reading and the FRANZCOG actually states that the risks of having a safe delivery for a first time mum and mum having a VBAC are vitrually the same? and In fact about 75% of the reported cases of uterine rupture occur in women who have not had previous uterine surgery.

Of the women who do have a scarred uterus and suffer a uterine rupture up to one third do not rupture along the scar line!

You know the way I see it, there are risks in EVERYTHING in life, especially major abdominal surgery! Don't let anyone make you feel guilty for wanting this! Research upon research and evidence states that VBAC is more safe than repeat C/section! I've got an Ob and are going to a private hospital and I am determined to have a VBAC. My Ob is supporting me and if he is away (he is on leave just before I'm due) the ob who will be covering for him is very keen on VBACs.

Belive me I'm nervous, but I have absolute faith in my body to be able to do this! You can do it too!:yes: :yes:

[HouseOfBlues]

I say go for the VBAC:thumbsup:

DS#1 was an emergency c/s becuase he was posterior and stuck.

I had a couple of obs tell me that I wouldnt be able to give birth vaginally unless I was to have a 6Ib baby. They said my chances of a VBAC were about 25%.

I soon ditched that ob and found one who had more faith in me and my body.

I went on to have a wonderful VBAC experience .
My baby wasn't 6Ib either, he was a healthy 9Ib 7oz!

As Becca said, research shows that it's safer to have a VBAC than having a repeat c/s.

[mum24]

Trial of labour and see how we go this quote is allowing the fear of "what if" to creep in, it's not a full 100% VBAC supportive statement.

Uterine rupture can happen whether a woman has had a caesarean or not. It is not solely linked to a "trial of VBAC".

RyleysMummy, you need to decide which birthing option you are going to go for and do just that... go for it! Birth is one of those events that you will remember even when you are an elderly lady, so make it the best experience you possibly can whether it be a VBAC or a caesarean. Do not let someone else make the decisions for you it's not their body that is giving birth.

Your doctor is not being very supportive if even now at this late stage in your pregnancy you are still being reminded of the negatives. Tell someone something negative everyday and watch their spirit die down, tell someone a postive everyday and watch their spirit soar. Well it's exactly the same for your birthing experience. Tell yourself everyday that something can go wrong, and you'll more than likely experience just that... tell yourself everyday of the positive birthing experience you want and you'll more than likely experience that. But you still have to decide which way you are going to go and just focus completely 100% on the positives of that decision. You've already been inundated with the negatives you don't need anymore. You've gained the knowledge of the small percentage (which is exactly the same for every woman giving birth, first, second, third etc) of what could go wrong, now focus on what could go right!

All the best RyleysMummy, and Let Your Birthing Goddess Roar.

[flib]

I've had 2 VBACs that were completely safe and wonderful. It was an amazing experience and much safer than having surgery. If I'd chosen elective c-sections, I would have been putting myself and my daughters at a much higher risk. So it wasn't just about my desire to birth naturally.

I think it's worth giving it a go especially after a c-section for a breech baby. My VBACs were so straightforward. I didn't even need a stitch or tear. I found out just how good birth can be!

My Ob was very supportive and I think it would have been more difficult if I had had to fight the medical profession at all.

Good luck and best wishes!

[Lila]

I would like to modify the previous quote: 'Anything involving a baby coming out of a mum (eyes open or shut) is a natural birth'
thank you!!! :hugs: my eyes were closed with my first 2- both em c/s- both REALLY urgent...
but i did give birth to them
and i finally was able to greet one myself- c/s but at least only epi

[theycallmemum]

Just to let you know, I had adhesions after both c/secs (the tearing of them internally was painful enough to be feared to be pain from an ectopic pregnancy with both my babys post the c/secs), and had my 2 vbacs just fine (DS2 & DS4). I havent heard of any documented cases of adhesions being the cause of haemmorage, but if anyone has any links to studies, then that would be great!

Noone I know through Birthrites has had haemorage from adhesions tearing before.....I imagine it is so rare that it isnt even on the radar of Obs normal concerns. That is the first I have ever heard of that possibility, theycallmemum. Would your Ob be able to share some studies of this? Birthrites would be very interested in such information :thumbsup:

I'm so sorry, I'm not a doctor so I can't give you any studies. It was definitely on the radar for my OB though. Although I am finding your post a tad abrupt I am heartened to hear you had more children after your c/s because I was warned heavily not to have anymore, I have just gone through a pregnancy scare and I was terrified I was pregnant and would have to go to the hospital and have another c/s, it is what is stopping me from having anymore children. My fear of hospital is very real, if I had found myself pregnant I'm not sure I wouldn't have risked giving birth at home 'by accident'.