Weighing up the pros and cons

[~Jo~]

Mmmmm....gosh there is so much to consider isnt there Deb. I had a forceps delivery first time around...emergency csection after bubs went into distress from too much intervention second time around...third time around ...i elected a c section...no suprises and my body wouldn't let me down so to speak. Being pregnant with Sammy though I felt like I didnt have as much say as I wanted. It was assumed that because of my history that the only way to go was for another csection...Ive long regretted choosing the csection path...but have been able to move on from it. Just wanted to add another persective. All the best with whatever you decide!

Jo

[Kristylin]

Hi Hon -
I too was induced with Jacksen that resulted in an emergency c/s at the end of it all

Uno what? I didn't find the caesar itself all that bad. Sure, it was bizarre but it was a far cry better than the agony that I'd been in for days!

and also felt this way, I was in fact smiling as I was wheeled into the lift and the tech guy said, oh this mustn't be your first cause I was smiling, but I just knew I was going to be holding my bub really soon. I didn't recover well from the c/s (ended up with temp) and was in agony when trying to get up for the first time, but over all it wasn't as bad as I feared. With Harry, due to my complications with Jacksen, I wasn't given great odds in being able to deliver 'naturally' but my ob was happy to go along with what ever I wanted as long as I was aware there was a huge chance it would result in another emergency c/s - I was satisified with the knowledge that had I really wanted to try VBAC, I was supported but thought the risks far outwayed the pros, so opted for the elective c/s. This c/s was such an incredible experience, I recovered so much quicker as I wasn't exhausted etc and was amazed how quickly I got up due to the pain relief that I had, that I couldn't with Jacksen due to the emergency c/s etc. So for me having a c/s second time round was a wonderful experience.
I am too debating what I will do this time round, having not had my ob appt yet, I am pretty certain having a vbac after 2 c/s wont be favourable but I will still ask questions, and if I end up having another elective c/s (which I am fairly certain will be the case) I will be ok with this. I feel that I am one of the lucky ones, I got to experience an induced labour, contractions and pushing (he just didn't come out), then I also got to experience the amazing world of c/s, both emergency and elective, So to me, I have experienced nearly every aspect of labour. The only thing I would have loved to experience is going into labour at home, being able to say to Chris 'Honey, I think its time' - lol, just like the movies. Now I know it doesn't happen like that, but I would've loved to experience it. (It was cool though, going into hospital the night before, knowing we were having our baby the next day, and noone else knowing ) And I didn't have a problem breastfeeding after it.
It was daunting coming home after a c/s to my 20 month old, cause he wasn't going to be able to understand that I couldn't just pick him up etc, but I found that I didn't have to wait the whole 6 weeks, and with the support of Chris, I managed fine.
Good luck with your decision hon, either way, as long as you are comfortable and happy, it will be the right choice.

[Debbie Lee]

Thanks for your input, Kris. It's great to hear success stories from both sides. I'll be seeing my Dr. on Monday and hopefully I'll get a chance to have a good talk to him about a few things. I'll have to make sure I write down a stack of questions. He'll have my previous records from my last GP but I still have to arrange for my hospital records from Geelong to be transferred (I guess I'll have to quiz the actual hospital about that? Another question for my Dr.!).

Thanks to everyone for your responses. It's great to have you all help me try and come to terms with a decision I don't feel like I'm goin' it alone.

I've mentioned it briefly to Neil but he's not really forthcoming with his feelings about it all. I don't think it interests him. I think he'd prefer I went with the caesar but who knows? I might do some more research and show him the more stand-out points and see what he thinks. Either way I know he'll support my decision. He did such a good job being there for me when I was in labour with Gab - I think he even surprised himself

[{sarah}]

Oh Deb, I just found this thread & wanted to say well done hun. Well done on having the guts to contemplate going there again, I know how hard that is for you. Well done on researching what's best for your new little bubba. I don't mean to sound condescending at all, but I am so proud that we have both been able to come to this point (I'm not sure I personally would have without BB )

This is my advice... RESEARCH! RESEARCH! RESEARCH! Read as much as you can about VBACs, go to Birthrites & get their info pack posted to you. Silent Knife is a fantastic book, very detailed but a great read. Personally I didn't like The Thinking Woman's Guide to Better Birth, it seemed less detailed than Silent Knife (which I read first) so it felt like a simpler version IMHO. Next on my list in New Active Birth and I have VBAC Companion on order with Amazon.

Talk to people that have been there - we have a great resource here on BB with people like Cailin, Christy Trish & Tiff. And I know all of those would be happy to chat with you, they have with me Talk to people who are planning a VBAC. Ask them why, find out why other people decided to go that way rather than a repeat c/s. See if what they are saying hits home for you. Like I said in my other thread, for me it's not about the natural birth it's about being in control.

But at the end of the day Deb, it's up to you. No-one will think any less of you if you choose have another c/s. I think the main point here is that you are willing to look into all possible options and not just blindly go in any direction. You should be applauded for that IMO And you know what, if you go for a VBAC & happen to end up with another c/s we'll still be applauding you for trying. That's all we can do, our very best with the circumstances thrown at us.


Kristy, BTW there's nothing to say you can't go for a VBAC after 2 previous c/s, it is possible.

[Debbie Lee]

Aww thanks, Sarah.
Actually... I really think that when I saw you were contemplating a VBAC, it made me really look at my decision. I know you had a very rough time of it with Zander so I thought if you could consider it, surely I can?

if you go for a VBAC & happen to end up with another c/s we'll still be applauding you for trying.

I think I'll feel better for it too. I was thinking the other day too. Considering I won't be induced this time, I think the labour before-hand won't have as much bearing on it in regards to how knackered I was. I mean, I was in pain for the good part of 5 days before having my caesar with Gab.... I won't be letting that happen again! So, yeah, if I do end up having the c/s, it will more than likely be a very different experience that may not take as much of a toll on my body.

[kmh]

Debbie just wanted to let you know that i had a c/s with my first as i failed to progress trough labour, i really thought about another c/s with Charlotte, but again i wanted to give birth naturally.
I was induced after i was overdue, was monerted (spel) the whole labour so i was bed ridden, and i mangaged an 7 hour labour and had a VBAC, it was the best thing ever, i b/f after an half an hour, and still am b/f, with Madison i didn't have any milk and i really think this beacause of my c/s.
You have to do what is right for you and your baby.
Good luck with your choises.

[{sarah}]

I was in pain for the good part of 5 days before having my caesar with Gab.... I won't be letting that happen again!

GO GIRL!!! See this is what it's all about, taking the power back. Not being bullied into an induction when the time's not right. You never failed Deb, the hospital failed you. But now you're in a new town, new hospital, new bub (hehe!) this one will be different if you choose to go down that path.

[Debbie Lee]

For sure, Sarah.
Induction is not an option for me.... not ever again.

Kelly - that's wonderful that you had such a positive experience second time round. Rather inspiring!

[Fi]

Deb - It was interesting at my osteo appt the other day. One of her patients, a younger first time mum (like 25-27??) overweight at about 100kg?, and due in 2 weeks. She has high blood pressure and Geelong hospital are suggesting an early induction.
I basically laid out a whole pile of alternatives for my osteo, and she is going to ring this patiend of hers and tell her to chat to them again. Having seen what you went through with a similar situation, I would try and help any mum prevent this themselves.
Apparently she isn't even close to going naturally, and they want to induce her. Bloody ridiculous - and this mum doesn't want a c/s, so hopefully they will listen to her, and a crap 5day induction can be avoided.

[pholmes]

Hi Deb,

best of luck with your decision, I know its not an easy one. I had a really horribloe experience with my emergency c/s and was terrified of having to go through that again so I never had too much trouble making the decision to try for a VBAC. I have had 2 vaginal births since then, one was a forceps delivery and the other was normal. Believe it or not the normal delivery was worse than the forceps delivery, every labour and birth is different. I wish you the best of luck with everything.

[Debbie Lee]

Good job, Fi. I'd hate for her to go through what I went through. I know that part of it was because I was happy to go along with whatever (value of hindsight, hey?) and also because the hospital was flat-out. However, I don't see the value in inducing when the baby isn't even presenting for birth! Why can't she have BP medication? Surely that'd be a safer option?? It totally baffles me.

[Debbie Lee]

Just another question for those of you that might know, when I'd had the epidural with Gab, she had a scalp clip attached to her head to help with monitoring.
I find the CTG is useless with me because of the amount of fat on my stomach. The midwives and doctors all said it shouldn't matter but the only way we could pick up her HB was if I pushed down firmly on the thing (any wonder my contractions were'nt being picked up).

Can you move around much with a scalp clip? It was certainly more reliable. I know I wouldn't be able to have a shower etc. but maybe it's an option for constant monitoring that still allows me to move around and stand up etc.?

Hmmm and I just read this on birthrites:

A woman with a prior Caesarean is at increased risk regardless of her mode of birth.

A failed VBAC (non-elective Caesarean section in labour) has a higher rate of maternal and neonatal morbidity than a successful VBAC or an elective repeat Caesarean.

So if my attempt at a VBAC is unsuccessful and I end up with another emergency caesar, I'm at even greater risk?? Hmm.. not very encouraging.

[christy]

Deb the increased risk bit is the one you need to question, "What is the increase?"

In my research it was around a 1% increase. Now no one wanted to be that 1 in a 100, but that is the increase I found, and yet the increase is exactly the same for someone being induced with a syntocin drip. Exactly the same for a VBAC.

The scalp clip should allow you to move more. You won't be able to trot up & down the halls, but its up to you.

The failed VBAC is because of having to be rushed into theatre I reckon... because of the reason for going into theatre more than being a failed VBAC, as a VBAC you are more likely to want to hold out longer before rushing into anything & sometimes thats not the best option either... having said that, they would have had to drug me big time to get me into a theatre during labour.

[BellyBelly]

Like Christy said, the risk is so, so small. The same risk of miscarriage as you would have with an amnio - but you could also have an adverse reaction to surgery too - its a tiny figure to debate over and a VBAC woman deserves the same treatment as a normal vaginally birthing woman. Takes confidence and knowledge to feel it.

[Debbie Lee]

Thanks guys.

Went to see my doctor today. My BP was normal so the meds are working which is great. Saw the baby (the blob! LOL) and the little heart beating.

I asked him about the course of action with labour and his answer was that we'd have to see as the pregnancy progressed. I said that I'd like to try for a VBAC but he was reluctant to give me any sort of definitive answer.
Everything moves along a bit slower here in the country. Apparently I don't get booked into the hospital until 20 weeks! Unheard of in the city!
Anyway, he mentioned something about there being a risk due to the scar tissue of the previous caesar and that a VBAC may not be possible... then he said the magic word... induction. I told him there was NO WAY IN HELL I'll be induced again after what I went through last time. He seemed a bit taken aback by that statement. I said that if I do decide to go for a VBAC that I will have to go into labour on my own. Again he was reluctant to say yay or nay. He said we'd speak to a gyno further down the track.
So hmmm... not sure how instrumental he's going to be in the birth (I'm still not clear on how the system works here). However, I think I might give the hospital a call after Chrissy to speak to them about it and ask if I can be referred to some kind of birth counsellor to sort things out.

I guess I was a little taken aback that the Dr. was so quick to jump on the risks involved with a VBAC but not on the inherent risks of another caesar - yet the information is there on the internet, easily found to support VBACs.

[BellyBelly]

Debbie, find out if he did a single layer closure or a double layer.

Your scar is strong, and according to studies I can give you of a VBAC trial, there was one death for the VBAC and one death for the caesar attributed to mode of birth.

There is HEAPS of info and study to support VBAC and as according to WHO recommendations a VBAC should be offered and supported to all women.

You need to find a carer supportive of your wishes or we all know what can happen... its the experience that makes or breaks a birth... if a caesar is needed its easier to accept and deal with if you trust your carer.

[Debbie Lee]

Thanks Kelly. I'll try to find that out.

I'm just realising how blindly I flew into Gabby's birth. I didn't research AT ALL.
I need to see the Dr. again in 4 weeks so hopefully I'll get some better dialogue happening to see if he's a 'caesar-happy' doctor or if he's going to be supportive of my choices.

[Trish]

Deb, sorry to hear that your Dr sounds apprehensive. What a shame that he can't see the good sides to you having a VBAC instead of anything negative. Put your foot down with him and don't take no for an answer. Either that or find a different Dr.

Remember, your body, your baby, YOUR decision.