Okay...now I'm really confused about birthing choices!

[monnie]

At about 31 weeks, my Ob. at the time (I've since changed) announced that I would need to have a c/s due to past uterine surgery...at the time I was devastated as I was not expecting it...I sought out a 2nd opinion...but started to try and get my head around this possibility, given the risks that were explained to me (e.g. uterine rupture due to scarring which could lead to hysterectomy)

So...at 34 weeks I see another Ob. (who is lovely) and says that he will look into for me...meanwhile, my old Ob. announces that he is leaving the hospital I'm booked in at (effective immediately)...so I'm very fortunate to be accepted as a new patient by this 2nd Ob.

Anyway...the 2nd Ob. goes on holidays for 2 weeks (well deserved!!!) and I see his fill-in.

This 3rd Ob. basically says I would be crazy to consider anything but a c/s given the potential risks...but acknowledges that he is just a fill-in and I should wait for the 'official word' from my other Ob. (Ob. no.2)

So...we go and see Ob. no.2 last night...poor guy...appointment was at 6:45pm, we saw him at 8:40pm!!!

Anyway...he's totally lovely BUT forgot to look into the impact of my surgery on birthing choices...but says that he thinks I should go for a VD!!!

So...at nearly 37 weeks...I'm totally confused!

• 2 Obs. are saying that c/s is the only way
• 1 Ob. is saying that VD is definitely possible
• I know that 1 Ob. is honest enough to admit that he hasn't looked into the impact of my surgery (it was a rare procedure)...the others, I doubt have looked into it, but wouldn't really admit it!
• I've spent 5 weeks getting my head around the c/s...researching heaps...writing out my c/s birth plan and letting go of my dream for a VD
• Felt like I accepted the high possibility of a c/s...and was actually getting excited that I might meet this baby earlier than expected...and feeling empowered by a birth plan that was 'naturalising' c/s
• We cancelled our attendance at active birth workshops because of the high likelihood of a c/s (I just didn't want to sit through it!)
• I'm scared of the risk of uterine rupture...it took us 3 years to get pregnant!

So...we wait another week to visit my Ob. again...and see what he says then!

In the meantime, I guess I better start getting my head around a VD...

I just feel so out-of-control, I guess...I don't know what's happening...maybe that's just a feeling I need to get used to, given we are about to become parents!!!

Thanks for reading this...(if you got this far)...sometimes it just helps to write things out...

[Pandora]

Is OB number 2 still going to look in to it?
I guess you need to know the risk of UR vs the risk of C/S in your particular situation.
In the end it has to come down to what you feel comfortable with. As long as you are in control and making the decisions, then what you decide should be right for you.
I think the problems start when choices are taken out of you hands and made for you (i.e. OB 1 and 3), so its the out of control feeling I'm most concerned about. You can opt for a c/s, but if its your choice not something thats pushed on you, you are likely to be a whole lot more satisified with your birthing experience. Same goes for a VB.

Have you thought about having a private midwife if you go for a c/s - that way you'll have a much higher liklihood of having ziggy in recovery with you, early b/f (if thats what you're planning) etc

Good luck. I hope your OB does a bit of research for you before your next appt.

[Cricket]

You can always opt for a carefully monitored trial of labour. They will have everything ready to go should you need a c-section, and will be watching carefully for the first sign of trouble, so you and baby should be quite safe. Give it a try, I think, if your own OB is willing to let you! Hope all goes well, and you get some good answers before you need make a final decision.

[BellyBelly]

Monnie, email me your story behind the surgery etc and I will send it to a list of midwives I know and see what they say. You can compare their responses too, they will be honest. info@bellybelly.com.au.

c/s is uterine surgery and risk of rupture is 0.7% with a VBAC so I would imagine your surgery would be on the same level? Induction also has a risk of rupture so I would tend to lean towards the Ob with the VD - he wouldn't say so unless he had reason to think otherwise. Many Obs prefer to be ultra conservative these days with litigation, hence why many now section for breech despite it being very possible and even suggested in certain cases on the RANZCOG website.

[Cherie]

Monnie, at this stage, you essentially have 3 OB's making an uneducated opinion about your best option for birthing, so don't be swayed by the "2 out of 3" that think a c/s is the way to go - none of them have looked into your situation specifically yet. Your current OB is going to be the OB caring for you during your birth, whichever way you choose to go, so you need to feel confident in his opinion, and confident in your own knowledge and preferences. If you're scared of uterine rupture, ask your OB to find out as much as he can about the real risks of your uterus rupturing, and what that would mean for you, and also ask him to find out what are the risks associated with you having a c/s (there might be specific things related to your previous surgery). You need to know the risks of both before you can make an educated decision for yourself.

[becmc]

You would be far better off doing your own research than letting them tell you what to do. Yes there is a tiny chance of UR, but compared to the risks of an elective c/s I know what I am choosing! Personally Ithink the careful monitoring does more harm than good but that is just my opinion, and the reason I am having a homebirth after a previous c/s.
Did you know that there is also a chance of hysterectomy due to elective surgery too?? But obs fail to tell women that, and focus on what could go wrong in natural labour instead.

[monnie]

WOW!

You girls are incredibly wise...

Thankyou for such considered advice...so appreciated!

Feeling much better as a result...

[Alan]

Hi Monnie
VBAC is safe. There is a 0.7% chance of your scar rupturing during labour but there is a 1% chance of problems caused by a CS.
If you email me I will send you back some research articles on this.
alan@yourmidwife.com.au

[BellyBelly]

I've sent you a few different things now, hope it helps you make your decision... it must be unsettling so close to the birth, but just know that whatever decision you make, it was the right one, because you have spent so much time trying to make the right choice. If you didn't care, then you wouldn't have done it. So well done

[monnie]

Thanks so much guys...

Kellie...the info. you sent through was fantastic...

My Ob. contacted me today and has let me know that he is very happy for me to go for a VD!!!!

YAYAYAYAYAY!!!

He has contacted a professor who specialises in the area of embolisation and fibroids who said that there was no increased risk of uterine rupture...

There are two increased risks: one is for breech or transverse positioning (which thankfully I don't have...but the baby is currently posterior!) and secondly, the placenta can be a bit denser...which could cause difficulty when it needs to separate from the uterus...but the Ob. will put some extra precautions in place (e.g. have blood ready for a transfusion)...

He said that having a c-section or VD wouldn't influence the risk of difficult placental delivery...

Anyway...I'm so thrilled to have the opportunity to birth through VD...now it's time to really get my head around it!!!

Many thanks for your support guys...so appreciated!!!

[becmc]

Good for you Monnie! That's excellent.

[BellyBelly]

Great news monnie I knew it would all work out great!

[Willow]

Monnie that's fantastic news!! Congratulations.

I know it must have been very hard trying to decide which way to go.

Not long to go now!!

[BellyBelly]

Monnie - have you thought about how you want the third stage to go if all is well? Do you want a managed third stage or a physiological third stage?

[Julie Doula]

So happy for you Monnie. It pays to get some different opinions and do some of your own research - It's a great help we have people like Kelly and Alan to help with that. The knowledge is out there and I find when I have a sticky issue I talk to some of the midwives' groups as well as do a Google search to find out what I can before going back to talk to care providers.

I hope all goes wonderfully well. Monnie. There are things you can do to help the posterior position both before and during labour too, which I'm sure you're aware of.

Keep us posted, we're cheering for you.

[Adnil]

Yay Monnie! I'm so glad this has all worked out for you! So glad your OB is being so supportive of it!

[MantaRay]

Congrats Monnie. I am so glad this has now been resolved for you, and the way that you wanted.

It is disappointing (but probably not surprising) that two obs just took the easy way out and said you needed a cs rather than take the time to research and find out. Thank goodness you found one of the rare ones that was prepared to spend a little time to find a result that was best for the patient.

[monnie]

Yeah...I totally agree Melanie...

Unfortunately, the medical system seems to be set up and funded to find the quickest, easiest 'solution' without really taking into account what's best for the patient in the long run...and yet, they spout all this politically correct rhetoric about being 'consumer focussed' and having a service of 'quality'...

I'm so relieved that I found this guy...

Thanks for you encouragement!