+ Reply to Thread
Page 1 of 2 12 LastLast
Results 1 to 10 of 11
  1. #1
    Join Date
    Jan 2016
    Posts
    2,929
    Thanks
    4,505
    Thanked
    7,089
    Reviews
    0
    Achievements:Topaz Star - 500 postsAmber Star - 2,000 posts

    Default VBAC or 2nd C section

    Hi, im wanting some advice on my thinking regarding a VBAC or a second C section. Kinda writing this out for myself too, to help me clarify my thoughts.

    Had my 1st baby via planned c section as she was breech the whole time. My experience was pretty good, i was able to hold bubba, feed her straight away and apart from the pain and 6 week recovery, i was totally ok with the whole experience.

    This time round, it will only have been 18 months since my last caesar when bubba no.2 is due.

    Midwives tell me you only have to wait 12 months and the risks of vbac are the same as any vaginal delivery and that there are more risks with c section.

    Drs, gps and obs are telling me another c section is the lowest risk option.

    I have no strong preference either way, i just want what is safest for bubba no.2 but part of me wants to try vbac as i will have an 18 month old and the idea of recovering in a week as opposed to 6 weeks is appealong so i can pick her up and play with her as normal. I wont be able to just sit on the couch all day like last time.

    Im worried that if something goes wrong and my uterus ruptures that bubba no.2 will have serious health issues or even die.

    So in considering worst case scenarios, I think, even if the risk is tiny, if bubba dies during a VBAC attempt, i will feel responsible and wish for the rest of my life that id just had a planned caesar. As 6 weeks of pain and not being able to play with bubba 1 is only temporary and i feel if i take this option its mostly because im thinking of myself and my current daughter.

    Whereas if bubba died during a planned c section, i would be able to say to myself that it was not my fault and just something that happened.

    Im finding it hard because i have 2 groups of medical professionals telling me different things. Midwives say vbac. Obs say c section. Im wanting to take medical advice but i dont know who to listen to, so im just trying to think about taking the path of least regret if the worst were to happen.

    Oh and i live 1 hour away from the hospital which is equiped to do vbac or planned or emergency c-sections so im also worried about going into labour then having to travel an hour, if my uterus ruptures in the ambulance bubba and i will be in dire straights.

    Im happy to hear what thought processes other people went througg when trying ti make the decision, only 18 months after last c section and also would really like to hear what others think of my reasoning? Am i missing something? Things I havent considered? Anything?

    Thanks ladies
    @MLadyEm can i tag you in this please as i think you are a midwife and was wondering if you could think of anything that might help me? It would be great to have avbac and have it all go well, but i cant guarantee that and i dont really have any preference other than me and bubs both leaving the hospital alive.

  2. #2
    Join Date
    Apr 2010
    Posts
    7,087
    Thanks
    748
    Thanked
    3,886
    Reviews
    0
    Achievements:Topaz Star - 500 postsAmber Star - 2,000 postsAmethyst Star - 5,000 posts
    Hey hun.

    im 7 weeks out from my 3rd Csection....

    My 1st was an Emergency Csection. My waters broke, it took forever to start contractions, i wasnt really dialating. They gave me the drip to bring on contractions, an epidural because i was exhausted and so so tired. But after several hours bubba wasnt responding after contractions the way they'd have liked him to. I kind of stalled at 6cm, so they decided he'd be better out than in. Like you, i couldnt really fault the Csection. Bubba was with me, or within my sight the entire time. They were calming and explained everything. I recovered exceptionally well.. I was just super tired as i had excess blood loss.

    My second was an elective Csection, 4 years later. Like you, I lived 100kms away from the hospital. I did want to attempt a VBAC, and all throughout i told them Id be happy to book a Csect for 40 weeks but wanted to attempt a VBAC should i go spontaneously (This was a plan i was super happy and confident with), but towards the end of the pregnancy the Obs told me it just wasnt possible as i had too many factors that could hinder a VBAC being effective. I had a high BMI, Bub was expected to be big (off the charts big), and i had high blood pressure...given my labour stalled with my first, they felt it wasnt an ideal option to attempt a VBAC. I went ahead with the elective Csection, and although it wasnt a bad experience i did feel a LOT more emotional going into it because i had time to consider the risks of surgery and i spent most of the time waiting on the day at the hospital in tears. But it went well, Bubba was big (10lb 1oz!! or just over 4.5kgs), I recovered well again. I left hospital with no pain killers.

    This time however, Ive noticed midwives are very supportive of a VBAC. OBs are not. I have said to Midwives when they've asked about delivery...."id like a VBAC but i know with 2 prior Csect thats not possible" And they've all said "its your body, your baby. If you want a VBAC - Go for it!" But then i see the OBs and they're like "umm...no. 2 prior Csections. This baby should be another Csection" One OB also tried the scare tactic of uterine rupture as a reason against it. This time, ive got similar, or even more risk factors against me so im just going with whatever. High BMI, Bubba is big again (98th percentile at 28 wk growth scan...my 32 wk scan is on thursday), high BP, GD, and now TWO prior Csections. 4 years, and 8 years ago. To complicate matters further, The hospital i was hoping to go to 1 hour away are now saying my BMI is too high, and have reffered me along further (long story) ....to a hospital THREE hours away.

    Whilst they are very pro-VBAC... they have advised against it for me. And given the circumstances THIS time, i think its probably easier to have another Csection. The thought of THREE hours *solid* driving in the car without breaks to get to the hospital in labour is far from appealing - without considering the risks of a VBAC, and the factors i have against me. I have to organise care for my 4yo and 8yo. Accomodation for my partner, mum and kids while im in....its just too much unknown.

    Im worried about juggling 3 kids, school drop offs, running a house etc while recovering because my partner is only taking the bare minimum days off, and returning to work (leaves around 5am, returns around dinner each night, up to 6 days a week) so a VBAC with hopefully a faster recovery would be easier on me.....But mum has said she'll stay and help...and she only lives 10mins away at the most anyway....And im *hoping* that since i bounced back well previously, im lucky again this time and have another fast recovery so i can get back into things within a few weeks. A girl can dream right?

    Have you attempted to contact a local VBAC support group or something? Spoken in great depth with the MWs about it? Maybe sourced a Doula for info too?? If I were in your position, i would certainly enquire and gather as much information as i could about VBACs so i knew i was well informed. But at the end of the day, you've gotta be happy and sure if you want to attempt one. I think going in with a strong head and confidence makes a huge difference to success rates too. At the end of the day, its your decision and so long as you're happy with your choice, thats all that matters.

    Best of luck with your decision!

  3. The Following User Says Thank You to shadowangel0205 For This Useful Post:

    gorgeousgeorge (27-03-2019)

  4. #3
    Join Date
    Aug 2013
    Posts
    7,805
    Thanks
    4,219
    Thanked
    7,108
    Reviews
    0
    Achievements:Topaz Star - 500 postsAmber Star - 2,000 postsAmethyst Star - 5,000 posts
    Quote Originally Posted by gorgeousgeorge View Post
    Midwives tell me you only have to wait 12 months and the risks of vbac are the same as any vaginal delivery and that there are more risks with c section.

    Drs, gps and obs are telling me another c section is the lowest risk option.

    I have no strong preference either way, i just want what is safest for bubba no.2 but part of me wants to try vbac as i will have an 18 month old and the idea of recovering in a week as opposed to 6 weeks is appealong so i can pick her up and play with her as normal. I wont be able to just sit on the couch all day like last time.

    Im worried that if something goes wrong and my uterus ruptures that bubba no.2 will have serious health issues or even die.

    So in considering worst case scenarios, I think, even if the risk is tiny, if bubba dies during a VBAC attempt, i will feel responsible and wish for the rest of my life that id just had a planned caesar. As 6 weeks of pain and not being able to play with bubba 1 is only temporary and i feel if i take this option its mostly because im thinking of myself and my current daughter.

    Whereas if bubba died during a planned c section, i would be able to say to myself that it was not my fault and just something that happened.

    Im finding it hard because i have 2 groups of medical professionals telling me different things. Midwives say vbac. Obs say c section. Im wanting to take medical advice but i dont know who to listen to, so im just trying to think about taking the path of least regret if the worst were to happen.

    Oh and i live 1 hour away from the hospital which is equiped to do vbac or planned or emergency c-sections so im also worried about going into labour then having to travel an hour, if my uterus ruptures in the ambulance bubba and i will be in dire straights.
    Thanks ladies
    Ok. I’ve quoted the relevant bit so I can refer back to what you’ve written.

    My understanding is that VBAC is suitable after 15 months. That’s what I was told after my CS. Recommendation used to be 2yrs, then 18 months. At 18 months post CS you should be good to try for a VBAC if that’s what you want.

    The risk of uterine rupture is small. Very small, but obviously still a risk. In saying that we have thousands of births a year. Quite a few of them VBACs. Only 1 uterine rupture springs to mind and there were other factors that contributed to the rupture. That woman was something like 5yrs post her CS and really a prime candidate for a successful VBAC when looking at risk factor. So they do happen.

    I would be discussing with your/an obstetrician about a VBAC in better detail. ie what are their/the hospitals guidelines for having a VBAC. For example, some obstetricians won’t use syntocinon (the oxytocin hormone) on a VBAC, where as some will. Will you have to go into labour spontaneously or are they happy to induce you? If you have an induction, will they use syntocinon or just break your waters and see what happens? Do they have a preferred time frame for delivery? Obviously this will depend on your individual circumstances and pregnancy. For me, I definitely want a VBAC for my next baby. BUT I am also happy to book a CS date at 41 weeks if induction is not an option. That way I have time to go into labour (40+5 with DD) on my own. That way you can get a clearer picture of what may/may not happen which may help you make up your mind.

    If the hospital you are delivering at does VBACs then I would hope they have access to 24/7 theatres. If they do, the chance of your baby dying from a uterine rupture in hospital is so slim. As you live so far from the hospital you would be recommended to start heading in as soon as you start contractions. An hour is a very long time to be labouring in the car. Better to do the drive in the early stage than in the later stage! If required, call an ambulance. At least then you can lie down and they can give you pain relief if need be!

    Some of the research coming out is saying that vaginal birth is the safer option in a VBAC when looking at the major risks (uterine rupture) vs the risks of a caesarean. While a CS is usually pretty straightforward they can have some impacts on you down the track that people don’t always think about. For example, how many children do you want? Every pregnancy and subsequent CS puts strain on your scar, increasing the chance of rupture. Also a scar on your uterus increases risks of things like placenta praevia/accents/increta/percreta. There is always the chance of injury to your bladder (given it sits right in front of your uterus), bowel injury, hysterectomy etc. These are just general risks of a CS - nothing to do with whether you’ve had a previous CS.

    Could it be an option to have an ultrasound on your scar at 36-38 weeks to get them to assess thickness of your scar? It might give a bit of an indication as to whether they think the scar will hold up.

    Potentially look into a doula for support during labour if you choose a VBAC. Just make sure they’re what you want! Look into them well before making a decision. They are there to support you in labour not have an opinion or a vote towards your medical options. Some doulas are amazing and worth their weight in gold. Others... not so much.

    I hope I’ve answered some of your questions. I’m tired now so I’m not sure if I’ve covered everything. Feel free to ask if there’s anything else. I’ll re-read tomorrow when I’m more awake and se if I missed anything!

  5. The Following User Says Thank You to MLadyEm For This Useful Post:

    gorgeousgeorge (27-03-2019)

  6. #4
    Join Date
    Jun 2009
    Posts
    4,854
    Thanks
    1,793
    Thanked
    2,818
    Reviews
    0
    Achievements:Topaz Star - 500 postsAmber Star - 2,000 posts
    I did a lot of research before my VBAC attempt. I went to the study data rather then relying on opinions and articles. The risks for both are very small and I found it hard to extract out other correlating issues (eg. A lot of CS births happen due to other complications, such a pre-eclampsia) so it's hard to know if it was just the CS or a combination of issues. Ditto the variables with VBAC such as if any chemicals were used for induction.

    Even going to the source data it was still quite overwhelming so I found the biggest reassurance was how small the risk figures are for either option in terms of per 1000 births etc.

    My hospital could do an EMCS at short notice as they always have a local OB on call and theatre staff available.

    My OB was supportive but somewhat pessimistic. He said, based on his personal experience, women tend to have the same problem next time around. I only effaced, never dilated, with my first despite hours of strong natural contractions at 2.5 minutes apart. He'd said if I'd made it to 9cm but bub had turned awkwardly causing a problem he'd be much more hopeful for my chances. (He was right nagdammit!) So in your case this is an unknown and not something to consider.

    When I got my GDM diagnosis he got more doom and gloom as it added another 'risk factor' and may have meant needing to deliver at 38w, or at another hospital. Since starting labour through induction wasn't an option, if I didn't go into labour by then it would be an automatic CS. I was also 'old' (37) and my blood pressure spiked that day (d'uh, you tested it right after you told me I had GDM! It was back to nice an low from then on.)

    Once it was clear my GDM wasn't causing issues he changed his tune and said despite all my risk factors I was an ideal patient for BP, growth, fluid levels, and so on.

    I went into labour naturally at 39+2 but as stated above, despite being a much different labour (I was vomiting and running a fever with my first) bub went tachicardic again (I think my contractions just stress my babies!). As I was in good shape, I was offered pitocin to ramp up contractions or a repeat CS. We decided better the devil we knew and went the CS. I could have tried longer for my VBAC but I was, and am, 100% at peace with my decisions. I'm happy that bub came when he wanted to (eg. I got to have spontaneous labour again) and accepting of the long recovery to ensure my baby was safe earth side. I think being my 2nd baby (and not ill or poorly prepared - my 1st came at 37w) I was a lot more in control, felt listened to and that each decision was my own.

    It really is a personal decision and I flip-flopped between the 2 options about 1000 times in 9 months (plus I'd had 5 years between babies to think about it!!). Best of luck with deciding.

  7. The Following User Says Thank You to Stretched For This Useful Post:

    gorgeousgeorge (27-03-2019)

  8. #5
    Join Date
    Sep 2013
    Posts
    2,273
    Thanks
    2,287
    Thanked
    1,534
    Reviews
    0
    Achievements:Topaz Star - 500 postsAmber Star - 2,000 posts
    @gorgeousgeorge, I'll be 40 when this bub comes along in July. Because of this, my ob doesn't want me going past 39w. And they won't induce due to the previous CS. So unless I go before 39w, it'll have to be a CS for me. I'm not looking forward to the recovery with a 3yo in tow. To add to the fun, I have a low lying placenta, and if that doesn't move out of the way, it's definitely a CS. I've pretty much assumed the universe is trying to tell me something and the cs is almost inevitable

  9. The Following User Says Thank You to SJ565 For This Useful Post:

    gorgeousgeorge (27-03-2019)

  10. #6
    Join Date
    Mar 2009
    Posts
    1,841
    Thanks
    613
    Thanked
    476
    Reviews
    0
    Achievements:Topaz Star - 500 posts
    My first baby was an emergency c-section, I didn’t even go into labour with him. So when I came to second baby I was keen to try for VBAC, mainly because I wanted to see what labour was like. I was also worried about uterine rupture, and as we had come reasonably close to losing baby number 1, I was quite stressed about the whole thing.
    Anyway, my VBAC attempt ended in a c-section, looking back, I think I could have had a successful VBAC if my heart had really been in it, and I wasn’t so focused on the potential complications. My midwife had told me I could opt out at any time and have a c-section. So after 24 hours of contractions and still not being fully dilated, I opted out!
    The recovery after a planned c-section (has this with my 3rd baby) is much easier than the recovery after an unsuccessful VBAC attempt.

  11. The Following User Says Thank You to LittleBug'sMum For This Useful Post:

    gorgeousgeorge (27-03-2019)

  12. #7
    Join Date
    Jul 2015
    Posts
    12,709
    Thanks
    8,655
    Thanked
    8,642
    Reviews
    0
    Achievements:Topaz Star - 500 postsAmber Star - 2,000 postsAmethyst Star - 5,000 postsEmerald Star - 10,000 posts

    Default VBAC or 2nd C section

    my first was an an emergency cs, very similar to shadowangel0205’s experience. waters broke at home and labour started but there was meconium in the water so i was put on monitoring the whole time, unable to move around much which i hated. things progressed but very slowly. i was using shower as pain relief. then contractions stopped. i was put on the drip but it all became too painful so i requested epidural. laboured a bit longer but i dilated to about 6cm then they said ds was getting into distress and taking longer to come back from it. this was 28 hours after arriving at hospital. i was tired and fed up and couldn’t face the idea of still pushing. ds’ welfare was my primary concern so i decided then and there for a cs.
    this was in the public system.

    this time i’m doing private. ob was supportive of vbac but i’m now 34 weeks and bub is still not head down (transverse or something as of last week). so a vbac is most definitely not an option. bub is also big which is even less encouraging for a vbac.

    i made my peace pretty early on this pregnancy that i didn’t want a vbac. i was very disappointed and sad for a long time after ds’ birth, not getting the vaginal delivery i had hoped and prepared for. this time however i’m opting for what’s safest and best given our situation. we’ve little family help and so the certainty of a set date is useful in arranging care for ds. i really feel no attachment or desire now for a vaginal birth. i doubt it would happen anyway given how things played out last time, plus with bub’s position and size this time. it’s a relief to not feel in limbo and just have a set plan and go with it.

    i do think obs have a tendency to push for c sections as it helps them manage their workload. nobody wants to be disturbed at 3am.

    i’ve heard the risk of uterine rupture is the same for a woman who’s had a c section and a woman who’s never had one. not sure how true that is, but i would’ve thought a vaginal delivery would come with more unknown risks than a c section which is planned surgery. i think the overall risk of uterine rupture is pretty tiny.

    obviously i’m not looking forward to the physical aftermath of this cs either. ds is 3 and a handful and the idea of being immobile and unable to do much plus in pain worries me. hubby will be around to help me and do the heavy lifting re ds but yeah, i get that aspect is unattractive.

    ultimately it’s up to you, it’s your body, your baby and your birth experience. in the absence of any seriously mitigating factors, you could quite easily try for a vbac. i guess you just need to mentally prepare yourself for the fact that if it’s unsuccessful, and you end up with an emergency cs again, will you be ok with it? i found that disappointment tough to handle. have moved past it now but yeah, it tore me up for a while.
    Last edited by turquoisecoast; 27-03-2019 at 11:23.

  13. The Following User Says Thank You to turquoisecoast For This Useful Post:

    gorgeousgeorge (27-03-2019)

  14. #8
    Join Date
    Feb 2017
    Posts
    783
    Thanks
    664
    Thanked
    1,329
    Reviews
    0
    Achievements:Topaz Star - 500 posts
    My first daughter was breech and a planned c-section for her delivery was actually a really good experience. My recovery was great and pain was easily managed.

    When I had my 6 week check up my Ob said I was a prime candidate for a VBAC if I wanted to try next time around, as long as I waited 18 months.

    DD2 was all set for a VBAC, but she ended up with a cervical teratoma which made that plan impossible and I had to have an EXIT procedure to get her out.

    Because of the extensive scarring from my previous two deliveries, my pro-VBAC Obstetrician is recommending another c-section.

    I have some sadness about a vaginal delivery not being a part of my experience, but at the end of the day those feelings need to be set aside and the safety of my baby put first. Especially after DD2 passed away at birth (while I was under general anaesthesia) I know first hand that it really doesn't matter how babies are born. Whatever difficulties you have in recovery are temporary and don't matter in the long term, as long as your bub makes it out safely and alive.

    It's DD1's 5th birthday today and no one has asked me which way she came out

  15. The Following User Says Thank You to bubbletrouble For This Useful Post:

    gorgeousgeorge (27-03-2019)

  16. #9
    Join Date
    Jan 2016
    Posts
    2,929
    Thanks
    4,505
    Thanked
    7,089
    Reviews
    0
    Achievements:Topaz Star - 500 postsAmber Star - 2,000 posts
    Hi everyone, i have read all of your replies and wanted to say thank you very much for your responses. I havent had time to reply personally to everyone to thank them. I will try later tonight. xx

  17. #10
    Join Date
    Jan 2016
    Posts
    2,929
    Thanks
    4,505
    Thanked
    7,089
    Reviews
    0
    Achievements:Topaz Star - 500 postsAmber Star - 2,000 posts
    Me again, just sat down with time to reply properly. And my thoughts after reading all your thoughtful replies.
    Its been really helpful to consider getting a scan ti check the thickness if my scar and waiting to see what happens as im approaching due date.
    Also, yes kinda hoping circumstance takes the decsion out if my hands. So also not "worrying" until its time to actually make a decision and spending the time learning and thinking instead of worrying.
    If bubba comes early before I have decided, I will take the medical advice im given at the hospital at the time.
    I think I'll be ok with that as i really dont mind whether i do a vbac or a caesarian. Perhaps because ive ony ever had a c section, i don'thave anything to compare it to and i didnt have an unpleasant experience (even thoigh my anaesthetist didnt give me enough anaesthetic and i could move my legs about 10 mins after they pulled bubba out and the stitching back up was ouchy- kinda forgot about that ) So i didnt have any regrets or negative emotions about having a c section so i dont think i will have any this time either.
    I also have no real plans to have any more kids as Im 39, tried for 7 years to fall preggers with DD and finally did after usong donor embryos in Greece. Then this bubba, i fell pregant naturally, so i was totally expectong to only have 1 baby and this one is a total bonus so i guess any fertility related risks for another c section shouldnt be an issue.
    I guess, i kinda feel that if anyone should be at risk, it should be me rather than bubba.
    DH will be home for at least 6 weeks to help with everything so I should be able to cope physically.
    So, aa um doing shared care with midwives and gp atm i have to wait until im about 33 weeks to see public obstetrician at the nearest hospital. I will chat with him then.
    I guess it also felt weird trying to advocate to do a VBAC when i dont really mind about the method of delivery. I have no problems being my own advocate with regards to mesical stuff, its just in this case i dont feel strongly one way or another.
    Anyways, im waffling now but just really wanting to say thank you for taking the time and effort to help me. xx

  18. The Following User Says Thank You to gorgeousgeorge For This Useful Post:

    Yogis Mumma (27-03-2019)


 

Similar Threads

  1. VBAC after 2 c sections... in sydney?
    By indi2kiss in forum VBAC
    Replies: 5
    Last Post: 08-06-2009, 14:30
  2. Risks of VBAC vs Repeat C/Section
    By Tracie in forum VBAC
    Replies: 24
    Last Post: 05-05-2009, 15:29
  3. 2nd C section and feeling nervous
    By Debs78 in forum elective c-section and positive c-section experiences
    Replies: 16
    Last Post: 19-10-2007, 21:32
  4. Replies: 19
    Last Post: 06-05-2007, 14:50
  5. VBAC vs 2nd caesar?
    By Two Little Buggalugs in forum VBAC
    Replies: 25
    Last Post: 06-02-2007, 09:54

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

ADVERTISEMENT

ADVERTISEMENT

FEATURED SUPPORTER
Glowing ExpectationsA one stop shop, 40 week, online pregnancy fitness and wellbeing program - recommended by Doctors. Convenient, ...