Why do LTTTCers seem to prefer a c/s?

[Bathsheba]

Sush: I'm just lurking... kinda on behalf of my SIL who i think has thoughts like you describe (IVF with preference for c/s purely for the "safety" notion). I just want to congratulate you on expressing your thoughts so tactfully given the high degree of sensitivity of this subject and hope you don't mind me continuing to lurk!

The only thing I could suggest is that IVF women at least watch The Business of Being Born. I learnt soooo much about exactly why VB is technically the safer option for both mum and baby. I just needed to add that i think that most women (IVF or not) briefly entertain the idea that having a c/s might be the best way of getting baby out! I guess it just seems the smoothest option. You only have to look at diagrams of a VB to kinda "freak" and wonder how on earth THAT is meant to happen... it's a lot to wrap your brain around... it just looks so damn scary! Whereas the same set of diagrams illustrating a C/S seem so much more straightforward. BUT so much is left out of those schematic portrayals! They don't describe how beneficial it is, for example, how the contractions naturally squeeze out all the fluid from baby's lungs... how actually being pushed through the birth canal stimulates optimal breathing.... and being alert enough to BF when they are arrive into their mother's arms. I won't go on about it... but I think if these things were more known to pregnant women then they might be in a better position to make the best decision for themselves and their babies.

Anyhow.... sorry for interjecting... I do hope that my SIL somehow manages to labour and birth naturally and smoothly... but if she doesn't I won't be judging her... I just hope she is committing to being fully informed.

[nic]

Ok, I typed something up beforehand, and one handed too lol, then it got eaten!
But I managed to save it first.

I think there are a lot of women who believe a c/s is safer than a VB, that is until a lot of them end up here on BB reading.

And, it may very well be that LTTTCers have lost faith in their bodies, and so, place their faith in the medical profession that helped them conceive?

Maybe what BW said about control is right? (Right is the wrong word, but lack of sleep ATM, prevents me from thinking of the right word to use) Being able to 'choose' the birth day and how it will happen may be what some people need after having no choice or control over drug amounts, follicles numbers and growth, fertilisations -etc.. YKWIM.

Shannon also makes a great point about our DH's. After my DD was born (public system) I was told it would be a c/s from now on. It was always a great way to have an arguement with my husband, talking about a VBAC. He thought I had died after our DD was born, so it was quite emotional for him to even entertain the idea of a VBAC.
When pregnant with DS, my choices were to travel to the next town over (45minutes away with no family) to the public hospital who is extremely pro c/s, or 2 hours to my family, back to the same public hospital where DD was born. We chose a private OB after being LTTTCers, I wanted continuity of care more than anything, and we only had 2 OB's to choose from. One who I kind of knew was pro c/s, and the other who we went with, who is pro VBAC and breech birth. For us, the choices where we live played a big part in it too I suppose.
My OB, said no to vbac, but when I fronted up for my c/s and was already 8cms, he said he thought I would be able to birth DS, or I should at least try. I was terrified of ending up in the same situation as with DD, even though he explained why he thought I wouldn't, I didn't trust my body or have that belief in myself to do it.

BG, makes a great point about psychologicl issues too. I chose a GA with DS, simply because it was doing my head in thinking about that needle going in my back for a spinal c/s. I was forever crying at the thought of it, and after chatting to our OB, he said he was fine with the GA, because if I was already emotional , once I got into theatre, I could quite possibly become even worse when they started tugging and pulling.

Wouldn't it be great if there was so sort of inbetween services to AC/ LTTTCers to show them there are a huge variety of choices in their ante natal care and birthing experience.

[sushee]

Wouldn't it be great if there was so sort of inbetween services to AC/ LTTTCers to show them there are a huge variety of choices in their ante natal care and birthing experience.

That too is a great point (all the contributions to this thread have been fantastic! So many ideas and thoughts!). I have come to believe that the greatest disservice to IVFers is how they're left to flounder once they fall pregnant.

There are threads about how IVFers feel guilt about complaining about the more uncomfortable aspects of pregnancy.

There are threads about IVFers not 'connecting' with their unborn baby for fear that if they start to believe that something good has finally happened to them, something will go wrong.

There are threads about IVF mums putting incredible amounts of pressure on themselves to be 'perfect' mums that they drive themselves into the ground trying to live to a standard that is impossible to achieve.

So, as IVFers, we have to ask ourselves, why is that that once you fall pregnant, support and understanding seems to 'fall away' and suddenly you're expected to cope with this new and scary phase without anyone but the medical profession - and its 'medicalised' view of things - to help you with your decisions? Or feeling like you not only have to cope with all the anxiety that pregnancy brings, but also have to cope with your DH's anxieties as well? And cope without help or support?

I mean, you have gone through a traumatic and life changing event - dealing with you or your husband's infertility/subfertility, yet once you're pg, you're expected to just 'accept' that you're just another pregnant woman, when you feel so much more fragile, so much more anxious than anyone could possibly believe. Why isn't there anyone for you at that point in your life focussed on assisting you through your difficulties, to help you cope with the new phase of this never-ending journey.

What do we need to ensure that IVFers have as much support during pregnancy, birth, BFing, and parenting as they need, so that they can learn to trust in themselves, their bodies and their instincts again?

[Devon]

I also feel that I would prefer to have a GA if I had to have a caesar, the thought of being conscious while I feel myself being cut open and people moving my innards around is much, much more scary than the idea of labour for me (although I have experienced neither of these situations).

I do feel that my experience of medicalised conception (and pregnancy loss) has caused me to be more anxious about all aspects of pregnancy and birth. The whole thing perhaps seems more risky than if I had fallen pg easily and not lost a baby. I think that's why I never even questioned whether I would have ob care in my pregnancy. It's only since I started to feel 'safer' with this pregnancy that I gave labour and birth a second thought. I'm really grateful to BB for providing the information that started me thinking about the kind of labour that I would prefer, and I have discovered that I really do want to give birth with as little intervention as possible. That's just my decision, I don't think it should necessarily be anyone else's. I guess there are so many factors that influence the choice of how you would prefer to give birth, lots of them aren't related to LTTTC, some of them are, and all LTTTCers will arrive at their decision via lots of different ways.

ETA - really good points, Sushee. I found that the only way I could stay relatively sane during the early stages of my pregnancy was to keep seeing my fertility counsellor regularly to work through all the issues that I still had, even though I was now pregnant. Those issues certainly don't just disappear when you get pg. Infertility has such a massive impact across so many areas of one's life, DH and I are still dealing with the consequences, and I really feel that my experiences over the last two years have changed me for ever, and lots of those changes are quite negative.

[nic]

So, as IVFers, we have to ask ourselves, why is that that once you fall pregnant, support and understanding seems to 'fall away' and suddenly you're expected to cope with this new and scary phase without anyone but the medical profession

So very true. When we had our over the phone clinic interview, we were told that we could access counselling over the phone since we lived quite a distance from the clinic, we could also access their library, plus the usual nurse you have. She told us any books we wanted to borrow or questions we had, we just had to ring her.
Such personalised 'service'. Then you find out you're pregnant, and all of a sudden you are alright to go and find the mythical person you've heard about but never seen, called an OB lol.

You go from having all this support available, to nothing

[Ellie]

So glad you've continued this discussion Sushee...

I've posted in the other thread but in brief...for me even thinking about CS has little to do with the actual 'birthing' process and more to do with 'post traumatic stress'. I had an ectopic that ruptured and I was literally moments from death...people running around everywhere ...DH saying 'goodbye' as they couldn't get the plasma into me fast enough...thank God I was in the right place at the right time and knew my blood type so it all went done in minutes...I will always be so thankful that I was sitting in my Fert Clinic when it happened and my FS just happened to be across the hall...he never left my side...and with all that falling into place getting me to theatre still took time...it made me realise how fragile life is and how quickly it can be taken away...that probably doesn't make alot of sense but I guess it is about 'my body letting me down' and nearly killing me...so maybe I don't trust that it will do 'the right thing'...I need to think some more...

[scooby]

Great thread

I will try to keep this as brief as pos, i have DS concieved 1st go and very traumatic VB with him (in another thread somewhere!) This time over 3 years to concieve with OI, IUI an ectopic pregnancy and finally IVF, i have been told CS is the best option for me as i had a very bad 3rd degree tear with imense problems for the year after (and some ungoing issues) as well as having a very short perinum. I have researched and done this topic to death as i really wanted a natural birth, but have pretty much decided that the risk of ending up with fecal incontinence, will sway my decision.

All that said i would love, after all the medical intervention to feel like i "CAN" give something of myself to this baby! if that makes sense, and have a VB. I definately will be breast feeding.
I may be way out of line and making a gross generalisation but i know a few women who have "elected" to have CS these women have generally been "older" I think working, corporate women may prefer CS for convenience and the "too posh to push" reasoning. Again another generalisation but these tend to be the women who have babies later and need assisstance in the form of IVF etc. I realise some women may want to fry me for these comments, but i am only speaking from my own personal experience and maybe a partial reason for sushee's dilema.

It interesting too the "left to flounder" points made, i was just talking about that the other day as i dont believe ACers are any different to first time mums, we go to antenatal classes and you basically get taught about the different medical interventions. The whole system needs a shake up we need to learn the "real" way to give birth and lets be honest unless you hunt the information down it is not readily available and usually at a pretty high cost.
The thing is during AC you do become so dependant on the medical system, we basically hand our bodies over and its almost heartbreaking when you hear "we dont need to see you anymore" i know after 2 years i felt totally lost.

[lilmisshavachat]

Awsome thread Sushee...

I have been TTC 22mths now and am starting AC next cycle and my biggest fear right now is falling PG with twins (not that I wouldn't love that) as the suggestion towards c/s is so much stronger.. I have spent the 20mths reading and researching as much as I can about birth and really can't wait to experience a VB for myself.. If I had my way it'd be a homebirth for me but I have too many others around me who believe an OB will do a better job birthing my baby than I will.. I hadn't noticed necessarily that it was higher in the LTTTC that thought a c/s was safer, I feel it's pg women in general. My feeling is that as a society we aren't spending any time looking into our birth choices and putting too much trust in our doctors. Maybe it appears more prevalent in LTTTC as we spend more time (years v's months) on this site discussing our views due to the amount of trouble we have conceiving where a member that has only just joined and fallen pg quickly will more likely move on and not require this site as much. (if that makes any sense). Yes we have more time to think about this and worry about the outcome but I think LTTTC as well as all women need to be given more information on why a VB is safer that a c/s.. I think it's a fact we are losing sight of.. I also agree with Bathsheba.. "The business of being born" is a must see. My opinion only and I'm loving reading everyone elses...

[onthefly]

Wow, this is a really interesting thread. Thanks Sushee and everyone else for your contributions.
I guess, perhaps, that there's a general belief that surgery brings certainty and control, though I would agree with you Sushee that the evidence does not necessarily support this.
Personally, the thought of yet more medical intervention during labour/birth, as well as the prospect of recovery after major abdominal surgery completely put me off c/s. And that was before I read about the risks to my baby.
Having come through the other side now, and still not getting the natural birth that I so wanted, I only feel more strongly that that is what I want. I had a forceps delivery and episiotomy - not nice! But I still want a vaginal birth next time (fingers crossed, knock on wood) and hope for a home birth.
I think also during my pg that I forgot (or maybe just didn't realise) the continuity between conception, pregnancy, birth and parenting. What I mean is, I compartmentalised each, rather than seeing how they linked together and influenced each other. But, how we conceive affects our pregnancy, which in turn affects our birth, which in turn affects our parenting. How we labour and birth can also have a big influence on whether or not we successfully breastfeed, which is often overlooked, i think. Many ACers need help to make the jump from conception to 'mainstream' pregnancy and beyond, i believe...
Oh, not sure if this makes sense...

[Willow]

This is an interesting thread. I must say I'd never actually noticed the tendancy for LTTTCers/IVFers to opt for a c/s.

There really was absolutely no doubt in my mind that our baby would be born via VB and to be honest, my ob never mentioned any other option. But one of the reasons I chose him was because I knew he had a low intervention policy, which proved to be gold once we passed our EDD. One of my biggest fears at the end of my prg (there were many during, prg following a loss is HARD, let alone an IVF prg) was that we'd make it all the way and then something would go 'wrong' during labour and we'd end up with a c/s. I was terrified of the idea of a c/s.

BUT - like Sushee our IVF prg was a result of secondary infertility. I had birthed a baby vaginally before. Although I must admit that after losing our second baby, having to conceive via IVF and a few surgeries in between I had (and have) lost all faith in my body to do what it should do.

The other benefit I had was that I'd had pretty major surgery to remove a large cyst from my ovary. The recovery was long and extremely painful. There was no way I could grasp the concept of being in that much pain AND trying to care for a newborn baby. There is no way I'd sign up for that.

[Nixon]

Hey girls,

I haven't read all the comments, but I've read most.

We went thru ICSI due to male infertility factors. We were successful and I am now almost 12 weeks. I want to attempt a natural drug free birth, but I am not stupid nor am I uneducated. I will plan with contingencies - the levels of pain relief and when I will want them administered, vac V's forceps - C-section will be my last resort unless something is discovered pre-labour that changes the birth plan completely.

I will not put my baby's life at risk because I want to prove something. I trust my doctors and I will listen to what they are telling me. I also believe that having a plan for all eventualities will help me deal with things better post-baby in terms of the psychological effects. If I say now "No I will not have a C/s" and then for what ever reason end up having one - then I would feel like I had lost all control. If I plan for it in an emergency situation then I have control.

I don't think it's a matter of forcing women to see that VB is safer - I think it is a matter of SUPPORTING women in their choice and not making them feel like they are doing something wrong that could possibly hurt their baby by choosing to have a C/s.

Same goes for the BF-ing. I'm going to try , but I'm not going to kill myself over it. A lot of women do feel like failure because they can't do it. Sod that - I will do my best for my baby every day of my life and me beating myself up over whether I have a c/s or can't BF is NOT going to give my baby a healthy view of the world

[paradise lost]

I'm a lurker too, as i'm not a LTTTCer or an ACer, but man can i TALK!

I think a lot of the GENERAL (i.e. not just IVFers) trend towards cs as "the safest thing" is to do with familiarity. Watching any of the many "baby" shows - here to maternity, birth day, etc. the frequently show c-sections in graphic details. They FEATURE vaginal births, but they never SHOW them. As Bath says, you're left looking at pictures and thinking "Um, WHAT? How is THAT coming out of THERE!?" I was very lucky to have seen several animal births, and one human birth, before i became pregnant with DD and i had SEEN with my own eyes how beautifully the vagina can and does stretch, so i didn't suffer from that, but in a society where just to see another non-birthing, completely normal vagina one has to look at pornography, how is a woman really supposed to become familiar enough with the process that she will believe her body can and will perfectly well push her baby out into the world?

In other societies girls see birth as normal because it IS normal - there is no dash to hospital, no exclusion of sterility in a special room, no mysterious machines. There is only the woman, the labour, the baby. I have read several studies on groups of women in Africa and rural India and women who HAD needed treatment during labour, when asked "How did you know you needed to get to the hospital?" tended to reply something along the lines of "The labour lasted long enough for me to get there" - usually hospital was 80-100km away and the women walked or were carried by others who walked. For all the babies born within a day or two of the onset of labour there will have been maybe a dozen young related or close village girls and women who SAW the labour and the baby. I know among the !Kung San peoples of North Africa in the 70's (when the research i read at uni was done) the average girl having her first baby was something like 16.8 years old and had seen SEVEN babies born already - where is the mystery for those girls? Likewise, every single one of those babies was successfully breastfed or had died. There was no other option, and although babies who did not thrive weren't unknown, mothers who consistently failed to BF well enough to raise babies to childhood were incredibly rare. As a group though they often nursed one anothers' babies and pubescent but childless girls often offered a breast to comfort children they were caring for, so while it was "dry" nursing, most had nursed before they gave birth too.

It comes down to perception of life too - i recently read something about how Indonesian women seem to regard "normal" life starting when you have your first baby, in our society we talk about how life gets "turned upside-down" when we have our children. We seek a mythical reality which was irrelevant when we were in it, and will be impossible to regain once we're parents. Concepts of control speak of this to me. Whether one considers cs or vb to be the "in control" way of doing it, it seems to wipe out the gritty fact - with pregnancy, babies, children, parenting there IS no control for us to "get" or "keep". Birth, whether cs or vb, unfolds as it does. No-one, not the baby or the mum or the surgeon if there is one, has much control. Even the surgeon, who is "out of the loop" of labour and able to think clearly - he cannot know how the body of either mum or baby will react to the drugs, the procedure, the aftermath. But those Indonesian women regard that control as laughable - they know it doesn't exist except as a temporary illusion, they don't seek it, and when they have it they enjoy it but don't rely upon it. To them having a baby is how you get to normal, rather than being an interruption in your normal.

If you super-impose that model on top of the experience of the LTTTC IVF-assisted mother, well, it's not hard to see why such a woman might choose cs. Conception is a sexual function and birth is a psychosexual event. For such a woman the sexual function has been removed from the equation. Sex does not make her pregnant. In addition LTTTC and IVF are BOTH associated with sexual problems, so perhaps even her once-happy sex-life has been damaged too. Why would she NOT fear she was as incapable of the task of birth as she was with conception? Perhaps if the sexual element/nature of birth was more commonly discussed, women would feel less like just because conception didn't work out, birth won't either. Ability to orgasm would be a FAR better indication of ability to birth than ability to concieve is.

In addition i do wonder about the effect Obs have on this decision. I had a "pro-VB" ob. This meant he talked about the benefits of VB and didn't offer elective cs without medical reason. How then, did his cs rate get to be 53%?! INTERVENTION! He believed in a VB. But he believed it should be within very rigid parameters, with strict limitations on what he considered "safe". Most medical staff, when they encounter death or serious injury, will act to avoid that outcome in the future. Imagine you have 100 women who will naturally labour for longer than 24 hours (this is a rising trend due to higher numbers of obese mama's in our society - high BMI and bodyfat have been shown to interfere with calcium levels in muscle cells which in turn make contractions less organised and less strong, and thus labours can be far longer - has ANYONE had their Ob tell them their BMI is high and they should take calcium in high doses at the end of pregnancy and throughout labour? I will bet not!). Of those 100 women one will lose her baby during the labour/birth. The Ob who sees that woman, who catches that baby, will NEVER forget it. And for that reason he will push to section any woman who has been labouring for 23 hours regardless of the condition of her or the baby, to avoid the situation again. Which is good for the 1 woman who might avoid losing her baby with this limitation, but for the other 99 it's likely to mean unnecessary augmentation, foetal distress and a cs. In trusting our medical professionals we must also look at the how and why of their parameters. If my Ob had seen 30% of babies in mama's who were 11 days overdue die, i'd be more sympathetic in listening to his reasons to induce me than if he'd seen one baby EVER die, and never forgotten it.

Perhaps that's another element? In LTTTC/IVF hope can be in such low supply, and for hope we ignore statistics and look for anecdotes, stories, HUMAN experience that we can relate too. When facing low beta results, a behind-dates embryo, or a lack of a heartbeat when one should be there how much comfort is a table of stats? I know when i was losing my babies i didn't WANT to know "One in 3 women experience spotting or bleeding in early pregnancy, around half of these pregnancies end in miscarriage" i wanted a WOMAN to tell me it was going to be ok, or that it wasn't but that i would survive. So when an Ob tells a woman "i've seen babies die that way" we LISTEN! In REALITY the stats speak the more important truth, but a chart, graph, study doesn't really speak to you like a friend, midwife, ob can. I think the value of films like BOBB is that they present the stats, but in a far more accessible, human way.

Like it or not, LTTTC/IVF mums are exposed to the medical system more than those who conceive naturally, and the current model of care is often very fear-based rather than evidence based (because doctors are humans too!). How many of you have been told something by an FS, only for it to be countered by another FS or doctor? Drug regimes, diet regimes, AC regimes, all of those are dependant on not only the individual couple, but the individual FS too. After months or sometimes YEARS of putting your faith in your care-provider's knowledge, experience, and instinct, how are you supposed to suddenly hop to trusting yourself and your body once you've got a sticky baby growing in there? It reminds me of nic's birth up above - a whole PREGNANCY of "You'd better cs, it's safer, your body won't do it, you should really book it now" etc. etc. and then suddenly on the day "oh, it turns out you're labouring fine, want to VB?". How could ANYONE make that transition, from being the patient who needs special treatment to get a normal thing, to being a bog-standard nobody who can just hop through the hoops like everyone else? It's as you've said before Sushee - having a baby doesn't "cure" you of infertility. The trauma of infertility, treatment, loss, treatment, disappointment, treatment... doesn't go away when the 2 lines appear.

Perhaps there should actually be a dedicated service for LTTTC women who are newly PG to help them make the informed decisions they need to, but to be honest i see that as a hole in the WHOLE system - EVERY MOTHER should be given that support and help, and let's face it, they're not. Women come to places like BB to find out the reality and, heartbreakingly, it's often with one traumatic or horrific birth experience already under their belt. To me only the normalising of birth AS A WHOLE can hope to allow ALL women to make fully informed decisions which aren't being coloured by the medical climate surrounding pregnancy and birth. Perhaps in addition there should be a transitionary period of care for ACers, or maybe even a process within the ttc process, or familiarisation with services and models of care available. It's hard - how to say "think about birth" to a couple who are having to endure invasive, painful treatment to get PG?

Ina May Gaskin says there is only ONE hereditary and contagious factor that can affect a woman's ability to birth and that is fear.

Bx

[Hollybolly]

I can most definately see the trend, but can only speak from my point of view as to how I feel - but I can imagine there are a few women in my position also.

I'm sure everyone knows my dramas by now - but we've been doing IVF & have been LTTTC now for over 70 months - due to secondary infertility.

After having huge issues with my reproductive system since I first got AF at 9yrs (lovely), I was told that my chances of conceiving naturally, if at all, were slim.

After numerous surgeries, I was lucky to fall pg with Luke when I was 20 - had him when I was 21yrs old.

Although I'd spent my teenage years believing I wouldn't have children without a massive struggle, when I did fall pg I don't think I considered myself to be a LTTTC (well, I wasn't really, I was 21!) and so the VB/CS thoughts were not due to this.

I have to admit I KNEW I would need the C/S (All of the women on both sides of my family have smaller than average cervixes, they all have had c/s births... Luke was a big baby, and at that point in my life, I was a tiny person) - the midwives at the hospital I gave birth told me I talked myself into it - mainly because when we did the classes, they were only showing videos/strategies to get through a vaginal birth.
I asked constantly about strategies if faced with having to have a c/s - they told me not to worry, I wouldn't need one, it was rare, etc (maybe it was then, that was 11yrs ago now?) - and were really hesitant to lend me the video of a c/s birth. I had to sign and take the video home - also had to sign that I was aware that the footage could cause me fear & distress due to its graphic nature (WTF???!!!) - and they WOULDN"T play it at the classes (despite playing numerous videos of different VB).

I took the video home, watched it and felt I was better in control if I were to be faced with a c/s delivery.
NONE of the other girls in my class would take the video home - out of 13 of us, 8 of us ended up having c/s... all emergency c/s

My birth was horrendous - I was in labour from 9am Monday morning until 2.38pm Wednesday afternoon (56 and a half hrs) - when they took me to theatre, I was still only 2.5cm dilated & Luke was stuck sideways across my body - his head had been engaged, but when he couldn't make it through, had tried to move & gotten stuck.

Once he was born, and they measured the size of his head circumference, with my small cervix, the doctor said he WOULD NEVER have fit through, and my scan 4 weeks before showing his head measurements would have shown this.

ANYWAY!

Due to an infection I contracted during the c/s, we now have to have IVF to conceive, as my tubes have been damaged and cannot be fixed to conceive naturally.
The infection went unnoticed for years, as I left Lukes dad soon after he was born, and was not sexually active for a while in between ExDH and DH now.

Although the c/s should have freaked me out, it didn't (even with the infection and the fate its caused me) - i went through 3 days of hell in really painful labour (my labour started when my water broke, so it was pain from the beginning) - and honestly, I was so delerious by the time they wheeled me up to theatre that I honestly believed I was going to die.

I have never known fear like that in my life - I can't describe how bad it was, and the c/s for me was like an angel saving my life.
Sounds extreme, but I was beyond scared. And I was 21 years old.

This time around, I will do whatever is advised by my OB - knowing that I have a small cervix and knowing that I just didn't dilate last time, I'll just trust with whatever they suggest.
I also have other issues in the fact that when I was sewn up after my c/s, it was done wrongly and poorly, so my current doctor has concerns that my body may need an elective c/s next time round at about 36 weeks so he has the opportunity to fix the current scar for if /when there is a third pregnancy.

I'm not sure that my choices to leave it in their hands have much to do with the LTTTC part, but rather the fear from last time.

My c/s most definately saved Lukes life (and the doctor said mine as well) - thats a scary thing, and I'm scared as hell to be anywhere near that position again.
Add the fact that currently this next baby is still trying to be conceived after 6 and a half years... if the miracle of it DOES come, there is no way in hell I will do anything to risk it not becoming a live baby for me to hold in my arms.

Reading back that last statement, maybe the LTTTC does have a little to do with how I feel - but its only because it follows my experience of last time, if that makes sense?

If I got to the time, and my OB said it was safe, everything looked positive for a VBAC, I would choose that hands down - but if he said no way, then I wouldn't even second guess him.

I HAVE to put my safety (and my babys safety) in his hands.. and I have no issues doing that - I think that somes from the IVF and having no other choice but to put things in his hands.


In regards to breasfeeding, though, I can't say it has any effect at all.
I'm very pro breast feeding - I fed Luke until he weaned himself at almost 12months, and will do so (if I can ) for any further babies.

Because of his high risk birth, he had trouble feeding for the first few days, and for the first 2 days I breastfed via a tube.
I persisted, though - I was so determined that my body could do this after the birth.. and it was something I was sure I wanted to do from before I even fell pregnant.

I have lost a LOT of faith in my body since Lukes birth (and especially now after the too many years of TTC #2) - but I know my body did the breastfeeding last time, so I know I can do it again.

Maybe when the labour part comes around again, it might be different, but I have to go into it with my mind and my eyes open.

I DO look at the c/s as MY safer option - but thats ONLY because of my experience with my body & my circumstances.

(Good on you if you got this far!!!)

ETA - Bec, my whole post just makes the last statement of your post 100% correct!!!

[onthefly]

Hoobly - you make a really great point about control. In labour, I found I coped best and things progressed well when I let go and surrendered to it.
If I'm honest, I have to say that I do remember thinking during pg, when facing the uncertainty of labour and birth and worrying about what might go wrong, that perhaps a c/s would be better, for that sense (though perhaps illusionary) of control and certainty about what would happen. On reflection I decided the cons definitely outweighed the pros for me.

[happymel]

This is a great thread!! Its very interesting to hear everyone's thoughts. Initially, during the pregnancy, i was very pro VB. It was something that i wanted to go through, feel and have that special connection i thought that would come with a vaginal birth. But after long discussions with my OB, both my husband and I realised that by having a VB, we were putting our second baby at risk.
I know some people may not agree with this, but there is a greater risk to the second twin, and we wanted to eliminate that all together. My OB gave us statistics and research and gave us the decision, which didnt take long for us to make. It had taken us so long to get to this stage, we didnt want anything to go wrong. Our OB also told us that a number of second twins had died in the past year due to complications during a VB.
We would have had a c/s anyway in the end, with the babies being born early. If (big if right now!!), we have another baby, id love to deliver naturally. I dont even know if that will be a possibility for me, but i would love to have that experience. Not that our birth experience wasnt special, but it just wasnt the "natural" way. I dont mean to contradict myself in saying that, but we had a choice, and it was the right one, but if i had of been pg with just one baby, i would have wanted a VB.
As for BF, i was always determined to succeed no matter what. And i did, and have. It took 6 days before my milk really started to come in, and then the babies were in special care for 2 and a half weeks, but i got there!
I sometimes feel like IVF took something away from us. I wish that i could have the excitement of doing things "naturally", and finding out with a big surprise, wow im pg!! But it didnt happen, but BF was one thing that i could give my babies.
Sorry if i have gone off track! GL to everyone who is pg now, i hope that everything goes great for you all!!

[scooby]

Nixon I TOTALLY agree with you i think to much issue is put on either stradegy, we need to support one another not ridicule, this is were the mental issues of birth experiences step in and at the end of the day we are not going to comprise the health of ourselves or our babies for a "cause" only to feel guilty for the choices we make.

[sushee]

Firstly I'm not big on ridiculing someone's choices. I don't think anyone in this thread has done that. I suggest that everyone read the entire thread and everyone contributions before commenting.

Because I think using emotive words like 'forcing women' or 'making women feel like they're wrong' or 'ridiculing' actually starts to derail legitimate discussions like these. We are talking about why it is LTTTCers believe a c/s is safer, when stats and evidence show that a VB is safer. This is NOT a c/s vs VB debate, and while I don't like modding threads that I am contributing personal opinions to, I will make this point very clear - I don't believe questioning if the system, or the difficulties of the LTTTC journey, has let us as women down or failed us in some way constitutes persecuting people's choices, because no one has done that.

In fact I consider myself an IVF advocate, in that I believe women with fertility issues should be informed (and not kept in the dark by their clinics), they should feel empowered (at a time when they feel so powerless) and they should be given the support to heal themselves.

This is an extension of that - which is why I'm so interested in knowing what it is that changes in a woman's psyche when she endures the pain of LTTTC that she then makes decisions that may in fact put her and her child are more risk (like choosing a c/s without medical reason). It's not pro-VB to say a c/s carries more risk, it's a simple fact.

It doesn't make sense - LTTTCer are some of the most cautious pregnant women I've known. An IVF veteran tends to be the one who reads up so much that they know almost as much about IVF and the related technologies as a scientist. They make important, complex decisions about their treatment, yet once pregnant, this need to educate themselves seem to desert them. I just want to know why.

I'm typing fast because I had dinner on the fire, but hope I have gotten my point across. Before you comment, please read the whole thread and focus on the issue, and please don't make this a c/s vs VB debate.

[paradise lost]

LOL, sushee on my first readin i thought you said your dinner was ON FIRE! LOL. Yummo, charcoal, my fave

I'd be interested to see if the trend is stronger in those women who had to endure more treatment. Like the choices of women who fell PG on first cycle of AC as opposed to those who have had 3+ Stims and 5+ Fresh/frozen ET's?

The reason i wonder that is because it's SO SO clear to me how our own personal experience colours our views of what we can do and what is possible. I will hold up my hands, i concieved accidentally, i had a perfect nearly-natural Homebirth without trouble or complication. I didn't need stitches. I pushed only once and DD shot out. It is SO FAR from the "average" experience, yet my opinions are OF COURSE coloured by that view. Reading what Hollybolly went through i can see that if i'd had her experience i would not have my views. And i DO know people who tried for a homebirth and ended up with sections. I even know a couple who lost their baby during their homebirth. Would it put me off? No. But i'll tell you what, before that baby died i was really geared up for wanting a completely natural birth. With DD i used gas and air for an hour and i had the synto injection for the 3rd stage because about 10mins after birth the midwives were getting a bit twitchy, DD had been a bit blue, and i wanted everyone to feel happy and chilled like i did (DD had recovered by then!). But i was really keen to have a fully natural birth. I knew not only the couple, but the midwife at the birth where the baby died. It was a surprise breech, she got stuck, he head was completely unflexed and it took them 20minutes from the birth of the arms to get the head out. She was resussitated but died 5 weeks later from severe brain damage caused by the oxygen deprivation. I would still have a homebirth, because the fact that her head was unflexed, the cord was already white when her belly was born (though she was still moving at that point, so perhaps whatever went wrong had *just* gone wrong at that point) and the placenta came down fully detatched with the head indicated there was something wrong before birth. SHe turned breech during labour. It's incredibly rare. THat doesn't put me off homebirth at all (though it did for a time). BUT that midwife still isn't back to work. SHe was DEVASTATED by the experience. And now i feel that if my midwife is scared and wants to give me synto i will take it. Not because i think i'll need it, but because the cost to me of taking it, while relieving the fear my midwife might have that i will bleed out and die on her, when she is responsible for my life and that of my newborn, is nothing. So clearly that (long-winded, sorry) is an example of how my belief has been altered by experience.

So we look at the LTTTC woman who has been through many attempts with AC, IUI, IVF, maybe even ICSI to try for better quality embies, who has endured treatment after treatment, loss after loss. For such a woman it's not a case of her body needing a little extra push, or even a BIG extra push. For a couple who have their reproductive cells removed, mechanically united (as with ICSI) and then put back and perhaps had to take drugs in early pregnancy to maintain the pregnancy, their exprience of theor body and it's capabilities in the direction of reproduction is already going to be SO altered by all that. I do know that Ina May (i know i bang on about her, but she's the world expert in normal birth and the authority in figuring out who is high-risk before labour begins!) says that the more horrendous births a woman has had the more cautious she is about recommending birth-centre/home birthing, because it is in our NATURE to learn from our experiences and however chilled a woman can seem in pregnancy, the first contractions can often bring on paralysing fear at the memories of last time. She recommends therapy from midwife-counsellors who can talk to the mother about her previous experiences and fears so everyone can get a feel for how ready she is to try for a natural experience. We don't all react the same way. I saw a horrendous (to me, pretty standard to the midwives apparently) induction, and it made me want to avoid hospital at ALL COSTS. But i know a doctor who has seen horrible births in hospital and she is going to have a section at 38 weeks to avoid it all. She thinks birthing is so hard and said to me "Even with all the interventions we can offer it can go so wrong" - i think the intervention MAKES it go wrong! Similar experiences, totally different reaction.

Perhaps that's at the crux of it Sush? Perhaps when it comes to birthing LTTTC women are more likely to opt for cs because their own experience has shown them repeatedly and over a long period of time that their body will NOT do what it should? That's not really an intellectual exercise, and it's something that's difficult to override. If we as a species could override our poor experiences we'd have died out.

Happymel i had to smile when reading your post and seeing the ticker Twins are common in my family and DP's and i'm TERRIFIED of getting them because of the risk of cs birth. I have already exhausted myself with research and worked out my plan! LOL. If both twins are head down i'll hire a private midwife and have a homebirth. If twin 2 is breech/transverse i will go into hospital and allow them to site and test (but not put drugs into) the spinal/epidural so that i can be taken for a section immediately if need be. If both twins are breech/transverse i will show up for a cs in labour.

Bx